Multimodality imaging

多模态成像
  • 文章类型: Case Reports
    LEOPARD综合征(LS)是一种罕见的遗传性疾病,从儿童时期就表现出各种临床表现,复杂的诊断。在这项研究中,我们旨在完善LS的影像学表现,并强调多模态成像在提高诊断准确性和预防严重心血管事件方面的重要性.
    一名41岁的妇女因经胸超声心动图(TTE)检测到疑似根尖肿瘤而入院,后来通过心脏磁共振成像(CMR)确定为心尖心肌肥大。她从2岁开始心电图异常,4岁左右出现雀斑。近年来,她一直在经历劳力性呼吸困难。补充冠状动脉计算机断层扫描血管造影(CCTA)显示弥漫性冠状动脉扩张。多模态成像和临床表现都导致了对LS的怀疑,随后的基因检测证实了这一点。患者拒绝进一步治疗。3个月的随访CMR显示病变无明显变化。
    本报告阐明了一名41岁女性LS患者从TTE最初怀疑根尖肿瘤到CMR明确诊断左心室根尖肥大的转变。它强调了多模态成像的价值(TTE,CCTA,CMR)揭示了罕见的遗传性疾病如LS的异常心脏表现。
    UNASSIGNED: LEOPARD syndrome (LS) is a rare genetic disorder presenting various clinical manifestations from childhood, complicating its diagnosis. In this study, we aim to refine the imaging presentation of LS and emphasize the importance of multimodality imaging in enhancing diagnostic accuracy and preventing serious cardiovascular events.
    UNASSIGNED: A 41-year-old woman was admitted to hospital with a suspected apical tumor detected by a transthoracic echocardiogram (TTE), which was later identified as apical myocardial hypertrophy through cardiac magnetic resonance imaging (CMR). She had abnormal electrocardiograms from the age of 2 years and freckles around the age of 4 years. In recent years, she has been experiencing exertional dyspnea. Supplemental coronary computer tomography angiography (CCTA) revealed diffuse coronary dilatation. Both multimodality imaging and clinical manifestations led to a suspicion of LS, which was confirmed by subsequent genetic testing. The patient declined further treatment. A 3-month follow-up CMR showed no significant change in the lesion.
    UNASSIGNED: This report elucidates the diagnostic transition from an initial suspicion of an apical tumor by TTE to a definitive diagnosis of left ventricular apical hypertrophy by CMR in a 41-year-old woman with LS. It underscores the value of multimodality imaging (TTE, CCTA, CMR) in unraveling unusual cardiac manifestations in rare genetic disorders such as LS.
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  • 文章类型: Journal Article
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  • 文章类型: Letter
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  • 文章类型: Journal Article
    本研究旨在开发一种使用多模态成像的深度学习影像组学模型,以区分良性和恶性乳腺肿瘤。
    多模态成像数据,包括超声检查(美国),乳房X线照相术(MG),磁共振成像(MRI),在2018年12月至2023年5月期间,回顾性收集了322例经组织病理学证实的乳腺肿瘤患者(112例乳腺良性肿瘤和210例乳腺恶性肿瘤).基于多模态成像,实验分为三个部分:传统的影像组学,深度学习影像组学,和特征融合。我们测试了七个分类器的性能,即,SVM,KNN,随机森林,额外的树木,XGBoost,LightGBM,和LR,在不同的特征模型上。通过使用集成和堆叠策略的特征融合,我们获得了良性和恶性乳腺肿瘤的最佳分类模型。
    就传统的影像组学而言,集成融合策略达到了最高的精度,AUC,和特异性,值为0.892、0.942[0.886-0.996],和0.956[0.873-1.000],分别。与美国的早期融合战略,MG,MRI达到最高灵敏度0.952[0.887-1.000]。就深度学习影像组学而言,堆叠融合策略达到了最高的精度,AUC,和灵敏度,值为0.937、0.947[0.887-1.000],和1.000[0.999-1.000],分别。US+MRI和US+MG的早期融合策略达到0.954[0.867-1.000]的最高特异性。在特征融合方面,后期融合策略的集合和堆叠方法达到了0.968的最高精度。此外,堆叠实现了最高的AUC和特异性,分别为0.997[0.990-1.000]和1.000[0.999-1.000],分别。在早期融合策略下,USMGMR的传统影像和深度特征达到了1.000[0.999-1.000]的最高灵敏度。
    这项研究证明了将深度学习和影像组学特征与多模态图像集成的潜力。作为一种单一的模态,基于影像组学特征的MRI比US或MG具有更高的准确性。与单模或放射学模型相比,US和MG模型通过迁移学习实现了更高的准确性。在早期融合策略下,US+MG+MR的传统影像和深度特征达到了最高的灵敏度,显示出更高的诊断性能,并为乳腺良恶性肿瘤的鉴别提供了更有价值的信息。
    UNASSIGNED: This study aimed to develop a deep learning radiomic model using multimodal imaging to differentiate benign and malignant breast tumours.
    UNASSIGNED: Multimodality imaging data, including ultrasonography (US), mammography (MG), and magnetic resonance imaging (MRI), from 322 patients (112 with benign breast tumours and 210 with malignant breast tumours) with histopathologically confirmed breast tumours were retrospectively collected between December 2018 and May 2023. Based on multimodal imaging, the experiment was divided into three parts: traditional radiomics, deep learning radiomics, and feature fusion. We tested the performance of seven classifiers, namely, SVM, KNN, random forest, extra trees, XGBoost, LightGBM, and LR, on different feature models. Through feature fusion using ensemble and stacking strategies, we obtained the optimal classification model for benign and malignant breast tumours.
    UNASSIGNED: In terms of traditional radiomics, the ensemble fusion strategy achieved the highest accuracy, AUC, and specificity, with values of 0.892, 0.942 [0.886-0.996], and 0.956 [0.873-1.000], respectively. The early fusion strategy with US, MG, and MRI achieved the highest sensitivity of 0.952 [0.887-1.000]. In terms of deep learning radiomics, the stacking fusion strategy achieved the highest accuracy, AUC, and sensitivity, with values of 0.937, 0.947 [0.887-1.000], and 1.000 [0.999-1.000], respectively. The early fusion strategies of US+MRI and US+MG achieved the highest specificity of 0.954 [0.867-1.000]. In terms of feature fusion, the ensemble and stacking approaches of the late fusion strategy achieved the highest accuracy of 0.968. In addition, stacking achieved the highest AUC and specificity, which were 0.997 [0.990-1.000] and 1.000 [0.999-1.000], respectively. The traditional radiomic and depth features of US+MG + MR achieved the highest sensitivity of 1.000 [0.999-1.000] under the early fusion strategy.
    UNASSIGNED: This study demonstrated the potential of integrating deep learning and radiomic features with multimodal images. As a single modality, MRI based on radiomic features achieved greater accuracy than US or MG. The US and MG models achieved higher accuracy with transfer learning than the single-mode or radiomic models. The traditional radiomic and depth features of US+MG + MR achieved the highest sensitivity under the early fusion strategy, showed higher diagnostic performance, and provided more valuable information for differentiation between benign and malignant breast tumours.
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  • 文章类型: Journal Article
    区分良性和恶性骶骨肿瘤对于确定适当的治疗方案至关重要。这项研究旨在开发两个基准融合模型和深度学习放射学列线图(DLRN),能够使用多种成像方式区分良性和恶性骶骨肿瘤。我们回顾了134例经病理证实为骶骨肿瘤的患者的轴向T2加权成像(T2WI)和非对比计算机断层扫描(NCCT)。两个基准融合模型是使用融合深度学习(DL)特征和融合经典机器学习(CML)特征从多个成像模态开发的,采用逻辑回归,K-最近邻分类,和极度随机的树。将表现出最稳健预测性能的两个基准模型与临床数据合并以制定DLRN。性能评估涉及计算接受者工作特征曲线(AUC)下的面积,灵敏度,特异性,准确度,负预测值(NPV),和阳性预测值(PPV)。与CML融合模型相比,DL基准融合模型表现出优越的性能。DLRN,被确定为最优模型,表现出最高的预测性能,在测试集中实现0.889的准确度和0.961的AUC。校准曲线用于评估模型的预测能力,并进行决策曲线分析(DCA)以评估DLR模型的临床净获益.DLRN可以作为一个实用的预测工具,能够区分良性和恶性骶骨肿瘤,为风险咨询提供有价值的信息,并协助临床治疗决策。
    Differentiating between benign and malignant sacral tumors is crucial for determining appropriate treatment options. This study aims to develop two benchmark fusion models and a deep learning radiomic nomogram (DLRN) capable of distinguishing between benign and malignant sacral tumors using multiple imaging modalities. We reviewed axial T2-weighted imaging (T2WI) and non-contrast computed tomography (NCCT) of 134 patients pathologically confirmed as sacral tumors. The two benchmark fusion models were developed using fusion deep learning (DL) features and fusion classical machine learning (CML) features from multiple imaging modalities, employing logistic regression, K-nearest neighbor classification, and extremely randomized trees. The two benchmark models exhibiting the most robust predictive performance were merged with clinical data to formulate the DLRN. Performance assessment involved computing the area under the receiver operating characteristic curve (AUC), sensitivity, specificity, accuracy, negative predictive value (NPV), and positive predictive value (PPV). The DL benchmark fusion model demonstrated superior performance compared to the CML fusion model. The DLRN, identified as the optimal model, exhibited the highest predictive performance, achieving an accuracy of 0.889 and an AUC of 0.961 in the test sets. Calibration curves were utilized to evaluate the predictive capability of the models, and decision curve analysis (DCA) was conducted to assess the clinical net benefit of the DLR model. The DLRN could serve as a practical predictive tool, capable of distinguishing between benign and malignant sacral tumors, offering valuable information for risk counseling, and aiding in clinical treatment decisions.
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  • 文章类型: Case Reports
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  • 文章类型: Case Reports
    左心室心尖发育不全是最近描述的一种罕见的先天性畸形,其特征是:(1)左心室截断,隔膜向右心室突出;(2)源自扁平的左心室心尖的异常乳头状肌;(3)狭窄的右心室,包围左心室的心尖周围区域;(4)左心室心尖的脂肪浸润。我们报告了1例LVAH,并回顾了患者的临床表现。并通过多模态成像揭示其形态学特征,包括超声心动图和心脏磁共振成像。此外,我们回顾了32例报告中的41例,总结了LVAH的发病机制,并分析了LVAH的影像学表现,旨在为LVAH患者的诊断和临床管理提供新思路。
    Left ventricular apical hypoplasia is a rare malformation recently described congenital abnormality characterized by: (1) truncation of the left ventricle, with the septum projecting toward the right ventricle; (2) abnormal papillary muscle originating from the flattened left ventricular apex; (3) a narrow right ventricle encompassing the periapical area of the left ventricle; (4) fatty infiltration of the apex of the left ventricle. We reported a case of LVAH and reviewed the patient\'s clinical presentation. And its morphologic characteristics were revealed by multimodality imaging, including echocardiography and cardiac magnetic resonance imaging. Additionally, we reviewed 41 cases from 32 reports to summarize the pathogenesis and analyzed the imaging manifestations of LVAH in this study, aiming to provide new ideas for the diagnosis and clinical management of LVAH patients.
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  • 文章类型: Journal Article
    右心室在各种疾病中的重要病理生理和预后作用已得到充分确立。尽管如此,在评估右心室(RV)形态和功能时,常规的心血管成像方式通常与内在局限性相关.人工智能(AI)在多模态成像中的集成为规避这些障碍提供了一个有希望的途径,为未来的全自动成像范式铺平道路。这篇综述旨在解决临床医生和研究人员在整合RV成像和AI技术方面面临的当前挑战。全面概述AI在RV成像中的当前应用,并提供对未来方向的见解,机遇,以及这个快速发展的领域的潜在挑战。
    The crucial pathophysiological and prognostic roles of the right ventricle in various diseases have been well-established. Nonetheless, conventional cardiovascular imaging modalities are frequently associated with intrinsic limitations when evaluating right ventricular (RV) morphology and function. The integration of artificial intelligence (AI) in multimodality imaging presents a promising avenue to circumvent these obstacles, paving the way for future fully automated imaging paradigms. This review aimed to address the current challenges faced by clinicians and researchers in integrating RV imaging and AI technology, to provide a comprehensive overview of the current applications of AI in RV imaging, and to offer insights into future directions, opportunities, and potential challenges in this rapidly advancing field.
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  • 文章类型: Journal Article
    肝细胞癌(HCC)是一种恶性肿瘤,严重危害人类健康。肝癌的5年相对生存率仅为18%左右。索拉非尼,一种小分子多靶向酪氨酸激酶抑制剂(MTKI),已被列为HCC的一线治疗方案,并显着延长了晚期HCC患者的中位生存时间。然而,索拉非尼耐药性的出现大大阻碍了其进一步的临床应用。在这里,设计了基于光疗和小分子靶向治疗(SMTT)的纳米平台,以克服索拉非尼耐药并减少不良反应.采用硬模板法制备了中空介孔二氧化锰(H-MnO2),并将制备的H-MnO2用于负载索拉非尼和氯e6(Ce6)。随后,用多巴胺修饰纳米颗粒(NPs)以优化生物相容性。最终制备的NP(MCSNP)具有约97.02nm的水合粒度的规则球形。MCSNPs不仅具有肿瘤微环境(TME)刺激响应的药物释放性能,而且可以通过减轻肿瘤缺氧来增强光动力疗法的疗效并逆转索拉非尼抵抗。在光疗(Ce6)联合分子靶向治疗(索拉非尼)的作用下,MCSNP对索拉非尼敏感或对索拉非尼耐药的HCC细胞表现出令人满意的抗肿瘤作用,并保留索拉非尼的抗血管生成特性。在用索拉非尼耐药细胞构建的裸鼠皮下肿瘤模型中,MCSNPs表现出优越的肿瘤成像才能和优越的生物相容性。未进行激光照射的MCSNPs组的抑瘤率为53.4%,而激光照射的MCSNP组高达100%。新型智能TME响应纳米平台显示出克服索拉非尼耐药性的巨大潜力,并实现HCC的多模态成像和治疗。
    Hepatocellular carcinoma (HCC) is a malignant tumor, which seriously jeopardizes human health. The 5-year relative survival rate of HCC is only about 18%. Sorafenib, a small molecule multi-targeted tyrosine kinase inhibitor (MTKI), has been classified as the first-line treatment scheme for HCC and has significantly extended the median survival time for patients with advanced HCC. Nevertheless, the emergence of sorafenib resistance has substantially hampered its further clinical application. Herein, the nano-platform based on phototherapy and small molecular targeted therapy (SMTT) was devised to overcome the sorafenib resistance and reduce the adverse effects. Hollow mesoporous manganese dioxide (H-MnO2) was prepared by hard template method, and the prepared H-MnO2 was used to load sorafenib and Chlorin e6 (Ce6). Subsequently, the nanoparticle (NPs) were modified with dopamine to optimize biocompatibility. The final prepared NPs (MCS NPs) exhibit regular spherical shape with a hydrated particle size of approximately 97.02 nm. MCS NPs can not only possess tumor microenvironment (TME) stimuli-responsive drug release performance but also can enhance the efficacy of photodynamic therapy and reverse sorafenib resistance by alleviating tumor hypoxia. Under the action of phototherapy (Ce6) combined with molecular targeted therapy (sorafenib), MCS NPs manifest a satisfactory antitumor effect for sorafenib-sensitive or sorafenib-resistant HCC cells, and retain the antiangiogenic properties of sorafenib. In the nude mouse subcutaneous tumor model constructed with sorafenib-resistant cells, MCS NPs demonstrated superior tumor imaging ability and excellent biocompatibility. The tumor inhibition rate of the MCS NPs group without laser irradiation was 53.4 %, while the MCS NPs group with laser irradiation was as high as 100 %. The novel smart TME-responsive nano-platform shows great potential for overcoming sorafenib resistance and realizes multimodality imaging and therapy of HCC.
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  • 文章类型: Case Reports
    脂肪性房间隔肥大(LASH)伴房间隔缺损(ASD)是一种罕见的先天性异常。尽管LASH是一种组织学上的良性心脏病变,其特征是房间隔中脂肪过多沉积,从而避免了卵圆窝,它与室上性心律失常或病态窦房结综合征有关。多模态成像的应用对于准确诊断至关重要,用ASD适当治疗LASH,和后续行动。
    一名68岁女性患者反复出现胸闷和心悸。多模态成像揭示了LASH和ASD的特征。二维经食道超声心动图显示,头部和尾部区域呈“哑铃”形受累,但没有单个继发性ASD。具有亮度特征的隔膜是一种罕见的疾病,其特征是未封装的脂肪细胞沉积在房间隔中。实时四维经食管超声心动图反映了房间隔的脂肪瘤肥大和椭圆形的ASD。心脏计算机断层扫描血管造影后来证实了这一发现。患者在心内超声心动图(ICE)引导下进行ASD经皮封堵,取得了良好的临床反应。
    此案例演示了与ASD结合的LASH。多模态成像可以提供准确的诊断,并可以指导精确闭塞的过程。
    UNASSIGNED: Lipomatous atrial septal hypertrophy (LASH) with atrial septal defect (ASD) is a rare congenital anomaly. Although LASH is a histologically benign cardiac lesion characterized by excessive fat deposition in the interatrial septum that spares the fossa ovale, it has been associated with supraventricular arrhythmias or sick sinus syndrome. Application of multimodal imaging is crucial for accurate diagnosis, appropriate treatment of LASH with ASD, and follow-up.
    UNASSIGNED: A 68-year-old female patient presented with recurrent chest tightness and palpitation. Multimodal imaging revealed the characterizations of LASH and ASD. Two-dimensional transesophageal echocardiography showed a \"dumbbell\"-shaped involvement of the cephalad and caudal regions with sparing of a single secundum ASD. The septum with a brightness feature is an uncommon condition characterized by the deposition of unencapsulated fat cells in the atrial septum. Real-time four-dimensional transesophageal echocardiography reflected the lipomatous hypertrophy of the atrial septum and an oval-shaped ASD. Cardiac computer tomography angiography later confirmed this finding. The patient achieved a good clinical response with an ASD percutaneous occlusion guided by intracardiac echocardiography (ICE).
    UNASSIGNED: This case demonstrates a LASH combined with ASD. Multimodality imaging can provide an accurate diagnosis and may guide the procedure for precise occlusion.
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