Diagnostic Imaging

诊断成像
  • 文章类型: Journal Article
    甲皱毛细管镜检查是监测人体健康的重要手段。全景指甲折叠图像提高了检查的效率和准确性。然而,很少研究全景指甲折叠图像的获取,并且在对此类图像进行图像拼接时,存在匹配特征点很少的问题。因此,提出了一种基于血管轮廓增强的全景指甲图像拼接方法,首先通过对比度约束自适应直方图均衡化(CLAHE)对图像进行预处理,解决匹配特征点少的问题,双边滤波(BF),和锐化算法。然后使用快速鲁棒功能(SURF)成功拼接指甲褶皱血管的全景图像,快速近似最近邻库(FLANN)和随机样本协议(RANSAC)算法。实验结果表明,本文算法拼接的全景图像的视场宽度为7.43mm,提高了诊断的效率和准确性。
    Nail fold capillaroscopy is an important means of monitoring human health. Panoramic nail fold images improve the efficiency and accuracy of examinations. However, the acquisition of panoramic nail fold images is seldom studied and the problem manifests of few matching feature points when image stitching is used for such images. Therefore, this paper presents a method for panoramic nail fold image stitching based on vascular contour enhancement, which first solves the problem of few matching feature points by pre-processing the image with contrast-constrained adaptive histogram equalization (CLAHE), bilateral filtering (BF), and sharpening algorithms. The panoramic images of the nail fold blood vessels are then successfully stitched using the fast robust feature (SURF), fast library of approximate nearest neighbors (FLANN) and random sample agreement (RANSAC) algorithms. The experimental results show that the panoramic image stitched by this paper\'s algorithm has a field of view width of 7.43 mm, which improves the efficiency and accuracy of diagnosis.
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  • 文章类型: Journal Article
    视觉变形金刚(ViT)在医学图像分析领域取得了令人瞩目的成就。然而,基于ViT的方法在一些小规模医学图像分类数据集上的分类效果较差。同时,许多基于ViT的模型为了卓越的性能而牺牲了计算成本,这在实际临床应用中是一个巨大的挑战。在本文中,我们提出了一种基于CNN和变压器串联的交替混合的高效医学图像分类网络,这就是所谓的Eff-CTNet。具体来说,现有的基于ViT的方法仍然主要依赖于多头自注意(MHSA)。其中,MHSA的注意力图非常相似,这导致了计算冗余。因此,我们提出了一个组级联注意(GCA)模块来分割特征图,它们被提供给不同的注意力头,以进一步提高注意力的多样性并降低计算成本。此外,我们提出了一个高效的CNN(EC)模块来增强模型的能力和提取医学图像中的局部细节信息。最后,我们将它们连接起来,设计出一个高效的混合医学图像分类网络,即Eff-CTNet。广泛的实验结果表明,我们的Eff-CTNet在三个公共医学图像分类数据集上以更低的计算成本实现了高级分类性能。
    Visual Transformers(ViT) have made remarkable achievements in the field of medical image analysis. However, ViT-based methods have poor classification results on some small-scale medical image classification datasets. Meanwhile, many ViT-based models sacrifice computational cost for superior performance, which is a great challenge in practical clinical applications. In this paper, we propose an efficient medical image classification network based on an alternating mixture of CNN and Transformer tandem, which is called Eff-CTNet. Specifically, the existing ViT-based method still mainly relies on multi-head self-attention (MHSA). Among them, the attention maps of MHSA are highly similar, which leads to computational redundancy. Therefore, we propose a group cascade attention (GCA) module to split the feature maps, which are provided to different attention heads to further improves the diversity of attention and reduce the computational cost. In addition, we propose an efficient CNN (EC) module to enhance the ability of the model and extract the local detail information in medical images. Finally, we connect them and design an efficient hybrid medical image classification network, namely Eff-CTNet. Extensive experimental results show that our Eff-CTNet achieves advanced classification performance with less computational cost on three public medical image classification datasets.
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  • 文章类型: English Abstract
    调查中国二级和三级医院放射科医学影像技术人员(MIT)的现状和需求,为医学影像技术产业的发展和卫生行政部门的相关决策提供参考和支持。
    问卷由中国影像技术学会制定。参与调查的每个医院的放射科都推荐了一个MIT填写在线问卷。内容包括:(a)医院的基本信息;(b)医院MIT的概述;(c)日常工作;(d)职业发展和晋升;(e)研究现状和需求,等。使用Mann-WhitneyU检验和卡方检验比较不同地区之间或不同级别医院之间需要的MIT的选定数量的差异。
    在这次调查中,最终从全国31个省份的5403家医院获得有效问卷。样本中涵盖的医院的MIT总数为67481。每个医院的MIT数量为9(5,16)。男女比例为1.41:1。20至40岁的MIT占78%。完成博士学位的MIT比例,master\'s,本科,大专,中专及以下学历为0.6%,3.3%,60.7%,30.8%,和4.55%,分别。主要MIT的比例,MIT副局长,主管MIT,主要MIT,助理技术员和以下人员为1.0%,4.21%,22.1%,51.8%,和20.9%,分别。MIT的整体专业满意度良好。“缺乏学习和交流机会”被引述为MIT在提高与工作相关的能力方面遇到的主要问题。59.2%的受访者在过去五年没有发表学术论文,在过去的五年中,只有7.0%的受访者在科学引文索引(SCI)中的期刊上发表过文章。
    中国的MIT平均相对年轻,MIT的数量大大增加。在这个阶段,应更加重视MIT的人才培养和继续教育,进一步加强学科建设,为我国医学影像技术产业的发展提供有力支撑。
    UNASSIGNED: To investigate the status quo and the needs of medical imaging technicians (MITs) in the radiology department of secondary and tertiary hospitals in China, so as to provide references and support for the development of the medical imaging technology industry and the relevant policymaking by health administrative departments.
    UNASSIGNED: The questionnaire was developed by the Chinese Society of Imaging Technology. The radiology department of each hospital involved in the survey recommended one MIT to fill out the online questionnaire. The contents included: (a) the basic information of the hospital; (b) a general overview of the MITs in the hospital; (c) daily work; (d) career development and promotion; (e) research status and needs, etc. Differences in the number of MIT staff were compared using the Mann-Whitney U test and the chi-square test was used to compare the differences in the selected numbers of MITs in need between regions or between different levels of hospitals.
    UNASSIGNED: In this investigation, valid questionnaires were finally obtained from a total of 5403 hospitals in 31 provinces in China. The total number of MITs of the hospitals covered in the sample was 67481. The number of MITs in each hospital was 9 (5, 16). The male-to-female ratio was 1.41:1. MITs who were 20 to 40 years old accounted for 78%. The proportions of MITs who had completed doctorate, master\'s, undergraduate, junior college, and technical secondary school or lower level education were 0.6%, 3.3%, 60.7%, 30.8%, and 4.55%, respectively. The proportions of chief MITs, deputy chief MITs, supervisor MITs, primary MITs, assistant technician and those below were 1.0%, 4.21%, 22.1%, 51.8%, and 20.9%, respectively. The overall professional satisfaction of MITs was good. \"Lack of opportunities for learning and communication\" was quoted as the main problem MITs encountered in regard to improving their job-related competency. 59.2% of the respondents had not published any academic papers in the past five years, and only 7.0% of the respondents had published in journals included in the Science Citation Index (SCI) in the past five years.
    UNASSIGNED: MITs in China are on average relatively young and the number of MITs has greatly increased. At this stage, more attention should be given to the cultivation of talents and continuing education of MITs and the construction of the discipline should be further strengthened, so as to provide strong support for the development of the medical imaging technology industry in China.
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  • 文章类型: Journal Article
    目的:随着前列腺磁共振成像(MRI)的广泛应用,在前列腺MR中对病变检测和准确诊断的需求不断增加,这在很大程度上依赖于令人满意的图像质量。重点关注前列腺成像报告和数据系统(PI-RADS)中涉及的主要序列,这项研究评估了临床实践中常见的质量问题(如信噪比(SNR)、神器,边界,和增强)。该研究的目的是确定图像质量对临床意义的前列腺癌(csPCa)检测的影响,阳性预测值(PPV)和放射科医生在不同序列和前列腺区的诊断。
    方法:本回顾性研究包括2021年2月至2022年12月进行前列腺MRI检查并有明确病理报告的306例患者。所有组织病理学标本均根据国际泌尿外科病理学会(ISUP)的建议进行评估。ISUP等级组≥2被认为是csPCa。来自不同中心的三个放射科医生分别从以下十个方面对图像质量进行了二进制分类评估:(1)轴平面中的T2WI:SNR,前列腺边界条件,伪影的存在;(2)矢状面或冠状面中的T2WI:前列腺边界条件;(3)DWI:SNR,外围区和过渡区之间的轮廓,文物的存在,DWI和T2WI图像的匹配;(4)DCE:闭孔动脉增强的评价,动态对比度增强的评价。Fleiss\'Kappa用于确定读者之间的协议。使用Wilson的95%置信区间(95%CI)计算PPV。采用卡方检验计算统计学意义。P值<0.05被认为是统计学上显著的。
    结果:高质量的图像在轴向T2WI中具有更高的csPCa检出率(56.5%至64.3%),DWI,DCE,轴向T2WI的SNR有显著的统计学差异(p0.002),轴向T2WI中存在伪影(p0.044),DWI中存在伪影(p<0.001),DWI和T2WI图像的匹配(p<0.001)。高质量图像具有较高的PPV(72.5%至78.8%),并且在轴向T2WI中显示出显着的统计学意义,DWI,DCE。此外,我们发现PI-RADS3(24.0%至52.9%)比PI-RADS4-5(20.6%至39.3%)包含更多的低质量图像,在轴向T2WI(p0.048)和DWI中存在伪影(p0.001)的前列腺边界条件方面存在显着统计学差异。关于不同前列腺区的csPCa检测与图像质量之间的关系,这项研究发现,仅在外周区(PZ)的高图像(63.5%~75.7%)和低质量图像(30.0%~50.0%)之间观察到显著的统计学差异.
    结论:前列腺MRI质量可能对诊断性能有影响。较差的图像质量与较低的csPCa检测率和PPV相关,这可能导致放射科医生诊断模糊的增加(PI-RADS3),尤其是位于PZ的病变。
    OBJECTIVE: With the widespread clinical application of prostate magnetic resonance imaging (MRI), there has been an increasing demand for lesion detection and accurate diagnosis in prostate MR, which relies heavily on satisfactory image quality. Focusing on the primary sequences involved in Prostate Imaging Reporting and Data System (PI-RADS), this study have evaluated common quality issues in clinical practice (such as signal-to-noise ratio (SNR), artifacts, boundaries, and enhancement). The aim of the study was to determine the impact of image quality on clinically significant prostate cancer (csPCa) detection, positive predictive value (PPV) and radiologist\'s diagnosis in different sequences and prostate zones.
    METHODS: This retrospective study included 306 patients who underwent prostate MRI with definitive pathological reports from February 2021 to December 2022. All histopathological specimens were evaluated according to the recommendations of the International Society of Urological Pathology (ISUP). An ISUP Grade Group ≥ 2 was considered as csPCa. Three radiologists from different centers respectively performed a binary classification assessment of image quality in the following ten aspects: (1) T2WI in the axial plane: SNR, prostate boundary conditions, the presence of artifacts; (2) T2WI in the sagittal or coronal plane: prostate boundary conditions; (3) DWI: SNR, delineation between the peripheral and transition zone, the presence of artifacts, the matching of DWI and T2WI images; (4) DCE: the evaluation of obturator artery enhancement, the evaluation of dynamic contrast enhancement. Fleiss\' Kappa was used to determine the inter-reader agreement. Wilson\'s 95% confidence interval (95% CI) was used to calculate PPV. Chi-square test was used to calculate statistical significance. A p-value < 0.05 was considered statistically significant.
    RESULTS: High-quality images had a higher csPCa detection rate (56.5% to 64.3%) in axial T2WI, DWI, and DCE, with significant statistical differences in SNR in axial T2WI (p 0.002), the presence of artifacts in axial T2WI (p 0.044), the presence of artifacts in DWI (p < 0.001), and the matching of DWI and T2WI images (p < 0.001). High-quality images had a higher PPV (72.5% to 78.8%) and showed significant statistical significance in axial T2WI, DWI, and DCE. Additionally, we found that PI-RADS 3 (24.0% to 52.9%) contained more low-quality images compared to PI-RADS 4-5 (20.6% to 39.3%), with significant statistical differences in the prostate boundary conditions in axial T2WI (p 0.048) and the presence of artifacts in DWI (p 0.001). Regarding the relationship between csPCa detection and image quality in different prostate zones, this study found that significant statistical differences were only observed between high- (63.5% to 75.7%) and low-quality (30.0% to 50.0%) images in the peripheral zone (PZ).
    CONCLUSIONS: Prostate MRI quality may have an impact on the diagnostic performance. The poorer image quality is associated with lower csPCa detection rates and PPV, which can lead to an increase in radiologist\'s ambiguous diagnosis (PI-RADS 3), especially for the lesions located at PZ.
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  • 文章类型: English Abstract
    In response to the issues of single-scale information loss and large model parameter size during the sampling process in U-Net and its variants for medical image segmentation, this paper proposes a multi-scale medical image segmentation method based on pixel encoding and spatial attention. Firstly, by redesigning the input strategy of the Transformer structure, a pixel encoding module is introduced to enable the model to extract global semantic information from multi-scale image features, obtaining richer feature information. Additionally, deformable convolutions are incorporated into the Transformer module to accelerate convergence speed and improve module performance. Secondly, a spatial attention module with residual connections is introduced to allow the model to focus on the foreground information of the fused feature maps. Finally, through ablation experiments, the network is lightweighted to enhance segmentation accuracy and accelerate model convergence. The proposed algorithm achieves satisfactory results on the Synapse dataset, an official public dataset for multi-organ segmentation provided by the International Conference on Medical Image Computing and Computer Assisted Intervention (MICCAI), with Dice similarity coefficient (DSC) and 95% Hausdorff distance (HD95) scores of 77.65 and 18.34, respectively. The experimental results demonstrate that the proposed algorithm can enhance multi-organ segmentation performance, potentially filling the gap in multi-scale medical image segmentation algorithms, and providing assistance for professional physicians in diagnosis.
    针对医学图像分割中U型网络(U-Net)及其变体下采样过程中单尺度信息丢失、模型参数量较大的问题,本文提出了一种基于像素编码和空间注意力的多尺度医学图像分割方法。首先,通过重新设计变换器(Transformer)结构输入策略,提出了像素编码模块,使模型能够从多尺度图像特征中提取全局语义信息,获取更丰富的特征信息,同时在Transformer模块中引入可变形卷积,加快收敛速度的同时提升模块性能。其次,引入空间注意力模块并加入残差连接,使模型能够重点关注融合后特征图的前景信息。最后,通过消融实验实现网络轻量化并提升分割精度,加快模型收敛。本文所提算法在国际计算机医学图像辅助协会官方公开多器官分割公共数据集——突触(Synapse)数据库中得到令人满意的结果,戴斯相似性系数(DSC)和95%豪斯多夫距离系数(HD95)分别为77.65和18.34。实验结果表明,本文算法能够提高多器官分割结果,有望完善多尺度医学图像分割算法的空白,并为专业医师提供辅助诊断。.
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  • 文章类型: Journal Article
    坏死性小肠结肠炎(NEC)是一种严重的新生儿肠道疾病,常发生在早产儿服用高渗配方后。它是NICU新生儿死亡的主要原因之一,目前,手术干预没有明确的标准,这通常取决于外科医生和新生儿科医师的共同判断。近年来,深度学习已经广泛应用于图像分割等领域,骨折和肺炎分类,药物开发,和病理诊断。
    使用床边X射线研究深度学习应用,以帮助优化新生儿NEC的手术决策。
    通过对2015年1月至2023年4月诊断为NEC的263例婴儿的前后床旁胸部和腹部X射线的回顾性分析,包括手术组(94例)和非手术组(169例),以7:3的比例将婴儿分为训练集和验证集.基于Resnet18,Densenet121和SimpleViT建立模型,以预测NEC患者是否需要手术干预。最后,使用额外的40个案例测试了模型的性能,包括手术和非手术的NEC病例,作为一个测试组。为了增强模型的可解释性,该研究采用2D-Grad-CAM技术来描述模型,重点放在X射线图像中的重要区域。
    Resnet18在二进制诊断能力方面表现突出,达到0.919的准确性,其精确的病变成像和可解释性特别强调。它的精度,特异性,灵敏度,F1得分明显较高,证明了其在优化新生儿NEC手术决策方面的优势。
    Resnet18深度学习模型,使用床边胸部和腹部成像构建,有效地帮助临床医生确定NEC婴儿是否需要手术干预。
    UNASSIGNED: Necrotizing enterocolitis (NEC) is a severe neonatal intestinal disease, often occurring in preterm infants following the administration of hyperosmolar formula. It is one of the leading causes of neonatal mortality in the NICU, and currently, there are no clear standards for surgical intervention, which typically depends on the joint discretion of surgeons and neonatologists. In recent years, deep learning has been extensively applied in areas such as image segmentation, fracture and pneumonia classification, drug development, and pathological diagnosis.
    UNASSIGNED: Investigating deep learning applications using bedside x-rays to help optimizing surgical decision-making in neonatal NEC.
    UNASSIGNED: Through a retrospective analysis of anteroposterior bedside chest and abdominal x-rays from 263 infants diagnosed with NEC between January 2015 and April 2023, including a surgery group (94 cases) and a non-surgery group (169 cases), the infants were divided into a training set and a validation set in a 7:3 ratio. Models were built based on Resnet18, Densenet121, and SimpleViT to predict whether NEC patients required surgical intervention. Finally, the model\'s performance was tested using an additional 40 cases, including both surgical and non-surgical NEC cases, as a test group. To enhance the interpretability of the models, the study employed 2D-Grad-CAM technology to describe the models\' focus on significant areas within the x-ray images.
    UNASSIGNED: Resnet18 demonstrated outstanding performance in binary diagnostic capability, achieving an accuracy of 0.919 with its precise lesion imaging and interpretability particularly highlighted. Its precision, specificity, sensitivity, and F1 score were significantly high, proving its advantages in optimizing surgical decision-making for neonatal NEC.
    UNASSIGNED: The Resnet18 deep learning model, constructed using bedside chest and abdominal imaging, effectively assists clinical physicians in determining whether infants with NEC require surgical intervention.
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  • 文章类型: Journal Article
    医学图像质量对于医生确保准确的诊断和治疗策略至关重要。然而,由于噪声的干扰,医学图像中通常存在各种类型的噪声和伪影。这不仅损害了图像的视觉清晰度,同时也降低了信息提取的准确性。考虑到医学图像的边缘具有丰富的高频信息,为了提高医学图像的质量,双重注意力机制,提出了U-Net框架中的信道特定和空间剩余注意网络(CSRAN)。CSRAN将U-Net架构与通道和空间特征关注(CSAR)模块无缝集成,以及低频通道注意模块。结合两个模块,提高了医学图像处理提取高频特征的能力,从而显著改善重建图像的边缘效应和清晰度。该模型可以在医学图像去噪和超分辨率重建任务中捕获高频信息和空间结构方面表现出更好的性能。它不仅增强了提取高频特征的能力,增强了其非线性表示能力,同时也赋予了该模型强大的边缘检测能力。实验结果进一步证明了CSRAN在医学图像去噪和超分辨率重建任务中的优越性。
    Medical image quality is crucial for physicians to ensure accurate diagnosis and therapeutic strategies. However, due to the interference of noise, there are often various types of noise and artifacts in medical images. This not only damages the visual clarity of images, but also reduces the accuracy of information extraction. Considering that the edges of medical images are rich in high-frequency information, to enhance the quality of medical images, a dual attention mechanism, the channel-specific and spatial residual attention network (CSRAN) in the U-Net framework is proposed. The CSRAN seamlessly integrates the U-Net architecture with channel-wise and spatial feature attention (CSAR) modules, as well as low-frequency channel attention modules. Combined with the two modules, the ability of medical image processing to extract high-frequency features is improved, thereby significantly improving the edge effects and clarity of reconstructed images. This model can present better performance in capturing high-frequency information and spatial structures in medical image denoising and super-resolution reconstruction tasks. It cannot only enhance the ability to extract high-frequency features and strengthen its nonlinear representation capability, but also endow strong edge detection capabilities of the model. The experimental results further prove the superiority of CSRAN in medical image denoising and super-resolution reconstruction tasks.
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  • 文章类型: Letter
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  • 文章类型: Journal Article
    背景:胆道闭锁(BA),影响小管-胆管功能/解剖的进行性疾病,需要及时的手术干预以获得良好的结果。因此,我们对常用诊断方法进行了网络荟萃分析,以评估其性能,并为临床决策提供循证支持.
    方法:我们回顾了PubMed,EMBASE,和Cochrane用于BA诊断。搜索包括γ-谷氨酰转移酶(GGT),直接/联合胆红素,基质金属蛋白酶7(MMP-7),超声波三角线标志(TCS),肝闪烁显像(HS),和经皮胆管造影/经皮经肝胆囊胆管造影(PCC/PTCC)。QUADAS-2评估研究质量。使用I2和Spearman相关性评估异质性和阈值效应。我们结合了效应估计,构建的SROC模型,并基于方差分析模型进行了网络荟萃分析,连同荟萃回归和亚组分析,获得BA的精确诊断性能评估。
    结果:共有40项研究纳入我们的分析。GGT对BA具有较高的诊断准确性,敏感性为81.5%(95%CI0.792-0.836),特异性为72.1%(95%CI0.693-0.748)。直接胆红素/结合胆红素的敏感性为87.6%(95%CI0.833-0.911),但特异性较低,为59.4%(95%CI0.549-0.638)。MMP-7的总敏感性为91.5%(95%CI0.893-0.934),特异性为84.3%(95%CI0.820-0.863)。TCS的敏感性为58.1%(95%CI0.549-0.613),高特异性为92.9%(95%CI0.911-0.944)。HS的敏感性为98.4%(95%CI0.968-0.994),特异性为79.0%(95%CI0.762-0.816)。PCC/PTCC表现出优异的诊断性能,灵敏度为100%(95%CI0.900-1.000),特异性为87.0%(95%CI0.767-0.939)。基于方差分析模型,网络荟萃分析显示,MMP-7总体排名第二,PCC/PTCC排名第一,与其他技术相比,两者都表现出更高的诊断准确性。我们的分析表明,在大多数方法中没有明显的偏差,但是MMP-7和肝胆闪烁显像显示出偏差,p值分别为0.023和0.002。
    结论:MMP-7和超声引导下的PCC/PTCC在BA的早期诊断中显示出诊断潜力,但由于实际应用的局限性,其临床应用受到限制。目前,MMP-7的临界值不清楚,需要进一步的循证医学研究来牢固确立其诊断价值。在有更多证据之前,MMP-7不适合广泛的诊断用途。因此,考虑到成本和操作简单性,肝功能检查联合超声检查仍是临床上最有价值的非侵入性BA诊断方法.
    BACKGROUND: Biliary atresia (BA), a progressive condition affecting canalicular-bile duct function/anatomy, requires prompt surgical intervention for favorable outcomes. Therefore, we conducted a network meta-analysis of common diagnostic methods to assess their performance and provide evidence-based support for clinical decision-making.
    METHODS: We reviewed literature in PubMed, EMBASE, and Cochrane for BA diagnostics. The search included gamma-glutamyl transferase (GGT), direct/combined bilirubin, matrix metalloproteinase 7 (MMP-7), ultrasonic triangular cord sign (TCS), hepatic scintigraphy (HS), and percutaneous cholangiocholangiography/percutaneous transhepatic cholecysto-cholangiography (PCC/PTCC). QUADAS-2 assessed study quality. Heterogeneity and threshold effect were evaluated using I2 and Spearman\'s correlation. We combined effect estimates, constructed SROC models, and conducted a network meta-analysis based on the ANOVA model, along with meta-regression and subgroup analysis, to obtain precise diagnostic performance assessments for BA.
    RESULTS: A total of 40 studies were included in our analysis. GGT demonstrated high diagnostic accuracy for BA with a sensitivity of 81.5% (95% CI 0.792-0.836) and specificity of 72.1% (95% CI 0.693-0.748). Direct bilirubin/conjugated bilirubin showed a sensitivity of 87.6% (95% CI 0.833-0.911) but lower specificity of 59.4% (95% CI 0.549-0.638). MMP-7 exhibited a total sensitivity of 91.5% (95% CI 0.893-0.934) and a specificity of 84.3% (95% CI 0.820-0.863). TCS exhibited a sensitivity of 58.1% (95% CI 0.549-0.613) and high specificity of 92.9% (95% CI 0.911-0.944). HS had a high sensitivity of 98.4% (95% CI 0.968-0.994) and moderate specificity of 79.0% (95% CI 0.762-0.816). PCC/PTCC exhibited excellent diagnostic performance with a sensitivity of 100% (95% CI 0.900-1.000) and specificity of 87.0% (95% CI 0.767-0.939). Based on the ANOVA model, the network meta-analysis revealed that MMP-7 ranked second overall, with PCC/PTCC ranking first, both exhibiting superior diagnostic accuracy compared to other techniques. Our analysis showed no significant bias in most methodologies, but MMP-7 and hepatobiliary scintigraphy exhibited biases, with p values of 0.023 and 0.002, respectively.
    CONCLUSIONS: MMP-7 and ultrasound-guided PCC/PTCC show diagnostic potential in the early diagnosis of BA, but their clinical application is restricted due to practical limitations. Currently, the cutoff value of MMP-7 is unclear, and further evidence-based medical research is needed to firmly establish its diagnostic value. Until more evidence is available, MMP-7 is not suitable for widespread diagnostic use. Therefore, considering cost and operational simplicity, liver function tests combined with ultrasound remain the most clinically valuable non-invasive diagnostic methods for BA.
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  • 文章类型: Journal Article
    一些细菌,如大肠杆菌(E.大肠杆菌)和鼠伤寒沙门氏菌(S.鼠伤寒),具有固有的定位实体瘤的能力,使它们成为一个多功能的平台,可以与其他工具相结合,以改善肿瘤的诊断和治疗。在抗癌治疗中,细菌通过直接携带药物或表达外源治疗基因发挥功能。细菌显像在肿瘤诊断中的应用一个新颖而有前途的研究领域,确实可以在治疗前评估和治疗后检测中提供动态和实时监控。不同的成像技术,包括光学技术,声学成像,磁共振成像(MRI)和核医学成像,让我们观察和追踪肿瘤相关的细菌.光学成像,包括生物发光和荧光,提供高灵敏度和高分辨率成像。声成像是一种具有良好穿透深度和空间分辨率的实时无创成像技术。MRI提供高空间分辨率和无辐射成像。核医学成像,包括正电子发射断层扫描(PET)和单光子发射计算机断层扫描(SPECT)可以提供有关细菌种群分布和动态的信息。此外,合成生物学修饰和纳米材料工程修饰策略可以在保持细菌自主性和生命力的同时提高细菌的生存能力和定位能力,从而有助于肠道细菌的可视化。然而,有一些挑战,例如肿瘤内相对较低的细菌丰度和异质性分布,空间数据集的高维性和成像标记工具的局限性。总之,随着成像技术和纳米技术的不断发展,有望进一步深入研究肿瘤相关细菌,开发新的肿瘤诊断细菌成像方法。
    Some bacteria, such as Escherichia coli (E. coli) and Salmonella typhimurium (S. typhimurium), have an inherent ability to locate solid tumours, making them a versatile platform that can be combined with other tools to improve the tumour diagnosis and treatment. In anti-cancer therapy, bacteria function by carrying drugs directly or expressing exogenous therapeutic genes. The application of bacterial imaging in tumour diagnosis, a novel and promising research area, can indeed provide dynamic and real-time monitoring in both pre-treatment assessment and post-treatment detection. Different imaging techniques, including optical technology, acoustic imaging, magnetic resonance imaging (MRI) and nuclear medicine imaging, allow us to observe and track tumour-associated bacteria. Optical imaging, including bioluminescence and fluorescence, provides high-sensitivity and high-resolution imaging. Acoustic imaging is a real-time and non-invasive imaging technique with good penetration depth and spatial resolution. MRI provides high spatial resolution and radiation-free imaging. Nuclear medicine imaging, including positron emission tomography (PET) and single photon emission computed tomography (SPECT) can provide information on the distribution and dynamics of bacterial population. Moreover, strategies of synthetic biology modification and nanomaterial engineering modification can improve the viability and localization ability of bacteria while maintaining their autonomy and vitality, thus aiding the visualization of gut bacteria. However, there are some challenges, such as the relatively low bacterial abundance and heterogeneously distribution within the tumour, the high dimensionality of spatial datasets and the limitations of imaging labeling tools. In summary, with the continuous development of imaging technology and nanotechnology, it is expected to further make in-depth study on tumour-associated bacteria and develop new bacterial imaging methods for tumour diagnosis.
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