ablation zone

消融区
  • 文章类型: Journal Article
    肝肿瘤的微波消融(MWA)面临着诸如消融不足和过度消融的挑战,可能导致肿瘤破坏不足和对健康组织的损害。这项研究旨在开发个性化的三维(3D)模型来模拟肝脏肿瘤的MWA,结合患者特有的特征。主要目标是验证预测的消融区与临床结果的比较,在治疗前提供对MWA的见解,以促进准确的治疗计划。来自三名患者的对比增强CT图像用于创建3D模型。模拟使用耦合电磁波传播和生物传热来估计温度分布,预测肿瘤破坏和消融边缘。研究结果表明,一旦达到足够的边缘,长时间的消融并不能显着改善肿瘤的破坏。虽然它增加了组织损伤。临床消融区和预测消融区之间存在大量重叠。对于患者1,Dice评分为0.73,表明准确性高,灵敏度为0.72,特异性为0.76。对于患者2,Dice评分为0.86,灵敏度为0.79,特异性为0.96。对于患者3,Dice评分为0.8,灵敏度为0.85,特异性为0.74。患者特定的3D模型显示出准确预测消融区域和优化MWA治疗策略的潜力。
    Microwave ablation (MWA) of liver tumors presents challenges like under- and over-ablation, potentially leading to inadequate tumor destruction and damage to healthy tissue. This study aims to develop personalized three-dimensional (3D) models to simulate MWA for liver tumors, incorporating patient-specific characteristics. The primary objective is to validate the predicted ablation zones compared to clinical outcomes, offering insights into MWA before therapy to facilitate accurate treatment planning. Contrast-enhanced CT images from three patients were used to create 3D models. The simulations used coupled electromagnetic wave propagation and bioheat transfer to estimate the temperature distribution, predicting tumor destruction and ablation margins. The findings indicate that prolonged ablation does not significantly improve tumor destruction once an adequate margin is achieved, although it increases tissue damage. There was a substantial overlap between the clinical ablation zones and the predicted ablation zones. For patient 1, the Dice score was 0.73, indicating high accuracy, with a sensitivity of 0.72 and a specificity of 0.76. For patient 2, the Dice score was 0.86, with a sensitivity of 0.79 and a specificity of 0.96. For patient 3, the Dice score was 0.8, with a sensitivity of 0.85 and a specificity of 0.74. Patient-specific 3D models demonstrate potential in accurately predicting ablation zones and optimizing MWA treatment strategies.
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  • 文章类型: Journal Article
    目的:评估内在和外在条件对微波消融(MWA)后消融区体积(AZV)的影响。
    方法:使用NeuWavePR探针对38例初治肝肿瘤进行回顾性分析。消融在“标准模式”(65W,10分钟)或“手术模式”(95瓦,1分钟,然后是65瓦,10分钟)。在消融后立即从对比增强计算机断层扫描获得AZV测量值。
    结果:“标准模式”下的AZV比制造商预测的要小(长度3.6±0.6厘米,4.7厘米以下23%;宽度2.7±0.6,3.5厘米以下23%)。在28/32消融中,经过尖端的消融区限制为6mm。“手术模式”和“标准模式”之间的AZV差异不显着(15.6±7.8mL与13.9±8.8mL,p=0.6)。与转移相比,肝细胞癌(HCC)(n=19)的AZV明显更大(n=19;17.8±9.9mLvs.10.1±5.1mL,p=0.01)和非血管周围肿瘤位置(n=14)与血管周围位置(n=24,18.7±10.4mLvs.11.7±6.1mL,p=0.012),在双向方差分析中,这两个因素都保持显著(HCC与转移:p=0.02;血管周围vs.非血管周围肿瘤位置:p=0.044)。
    结论:与转移和非血管周围位置相比,在肝癌病例中可以预期更大的AZV。使用“手术模式”不会显着增加AZV。
    OBJECTIVE: Evaluation of the influence of intrinsic and extrinsic conditions on ablation zone volumes (AZV) after microwave ablation (MWA).
    METHODS: Retrospective analysis of 38 MWAs of therapy-naïve liver tumours performed with the NeuWave PR probe. Ablations were performed either in the \'standard mode\' (65 W, 10 min) or in the \'surgical mode\' (95 W, 1 min, then 65 W, 10 min). AZV measurements were obtained from contrast-enhanced computed tomography immediately post-ablation.
    RESULTS: AZVs in the \'standard mode\' were smaller than predicted by the manufacturer (length 3.6 ± 0.6 cm, 23% below 4.7 cm; width 2.7 ± 0.6, 23% below 3.5 cm). Ablation zone past the tip was limited to 6 mm in 28/32 ablations. Differences in AZV between the \'surgical mode\' and \'standard mode\' were not significant (15.6 ± 7.8 mL vs. 13.9 ± 8.8 mL, p = 0.6). AZVs were significantly larger in case of hepatocellular carcinomas (HCCs) (n = 19) compared to metastasis (n = 19; 17.8 ± 9.9 mL vs. 10.1 ± 5.1 mL, p = 0.01) and in non-perivascular tumour location (n = 14) compared to perivascular location (n = 24, 18.7 ± 10.4 mL vs. 11.7 ± 6.1 mL, p = 0.012), with both factors remaining significant in two-way analysis of variance (HCC vs. metastasis: p = 0.02; perivascular vs. non-perivascular tumour location: p = 0.044).
    CONCLUSIONS: Larger AZVs can be expected in cases of HCCs compared with metastases and in non-perivascular locations. Using the \'surgical mode\' does not increase AZV significantly.
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  • 文章类型: Journal Article
    本研究提出了一种用于确定MWA中消融区大小的测量原理,最终可以替代更昂贵的监测方法,如CT。测量方法基于微波传输测量。在离体牛肝上进行MWA实验以确定消融区。该设置使用在2.45GHz的工作频率下执行MWA的定制槽施加器和测量从施加器发射的波的定制蝴蝶结天线。此外,使用自定义测量探针来确定介电特性。使用时移分析来确定消融区的径向范围。以50W的功率进行10分钟的多次测量以显示再现性。结果表明,该方法可以提供可重复的结果来确定消融区,最大误差为4.11%。
    This study presents a measurement principle for determining the size of the ablation zone in MWA, which could ultimately form an alternative to more expensive monitoring approaches like CT. The measurement method is based on a microwave transmission measurement. A MWA is performed experimentally on ex vivo bovine liver to determine the ablation zone. This setup uses a custom slot applicator performing the MWA at an operating frequency of 2.45 GHz and a custom bowtie antenna measuring the waves transmitted from the applicator. Furthermore, a custom measurement probe is used to determine the dielectric properties. A time-shift analysis is used to determine the radial extent of the ablation zone. Several measurements are carried out with a power of 50 W for 10 min to show the reproducibility. The results show that this method can provide reproducible outcomes to determine the ablation zone with a maximum error of 4.11%.
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  • 文章类型: Journal Article
    由于单晶硅的高脆性和低断裂韧性的特点,其高精度和高质量的切割有很大的挑战。针对晶圆切割高效率的迫切需要,本文研究了不同激光工艺对激光切割坡口尺寸和加工影响区的影响规律。实验结果表明,激光切割单晶硅时,除了产生凹槽,在坡口两侧也会有一个加工影响区,两者的大小将直接影响到切削质量。擦拭材料表面切割产生的热产物后,基本可以消除切缝中的加工影响区和重铸层,以产生更宽的切缝,擦拭后的表面与切割前的表面基本相同。增加激光切割次数将增加材料的加工影响区的宽度和切屑去除后的凹槽宽度。当切割次数小于80时,增加切割次数将同时增加凹槽宽度;但是,切割次数超过80次后,凹槽宽度突然减小,然后缓慢增加。此外,激光扫描速度越低,切屑去除后,材料加工影响区的宽度和凹槽的宽度越大。激光频率的增加会增加裂纹宽度和切屑去除后的裂纹宽度,但会降低加工影响区的宽度。激光脉冲宽度对切割质量有一定的影响,但没有表现出规律性。当脉冲宽度为0.3ns时,切割质量最好,而当脉冲宽度为0.15ns时,切割质量最差。
    Due to the characteristics of high brittleness and low fracture toughness of monocrystalline silicon, its high precision and high-quality cutting have great challenges. Aiming at the urgent need of wafer cutting with high efficiency, this paper investigates the influence law of different laser processes on the size of the groove and the machining affected zone of laser cutting. The experimental results show that when laser cutting monocrystalline silicon, in addition to generating a groove, there will also be a machining affected zone on both sides of the groove and the size of both will directly affect the cutting quality. After wiping the thermal products generated by cutting on the material surface, the machining affected zone and the recast layer in the cutting seam can basically be eliminated to generate a wider cutting seam and the surface after wiping is basically the same as that before cutting. Increasing the laser cutting times will increase the width of the material\'s machining affected zone and the groove width after chip removal. When the cutting times are less than 80, increasing the cutting times will increase the groove width at the same time; but, after the cutting times exceed 80, the groove width abruptly decreases and then slowly increases. In addition, the lower the laser scanning speed, the larger the width of the material\'s machining affected zone and the width of the groove after chip removal. The increase in laser frequency will increase the crack width and the crack width after chip removal but decrease the machining affected zone width. The laser pulse width has a certain effect on the cutting quality but it does not show regularity. When the pulse width is 0.3 ns the cutting quality is the best and when the pulse width is 0.15 ns the cutting quality is the worst.
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  • 文章类型: Journal Article
    构建预后列线图,以预测微波消融(MWA)后甲状腺乳头状微小癌(PTMC)患者的消融区消失。
    从2020年4月至2022年4月,回顾性收集接受MWA治疗的PTMC患者。在第1天进行超声(US)或对比增强超声(CEUS),MWA消融后1、3、6、12、18、24个月不雅察疗效。音量,计算每个时间点消融区的体积减少率(VRR)和完全消失率.单因素和多因素logistic回归分析用于确定MWA后消融区消失的预后因素,并建立和验证了列线图。
    72例接受MWA的PTMC患者被纳入本研究。在MWA之后,无肿瘤进展(残留,复发或淋巴结转移)和发生主要术后并发症。28例(38.89%)患者在随访期间经MWA后消融区未完全消失。三个变量,包括年龄(赔率比[OR]:1.216),钙化类型(OR:12.283),多变量分析发现初始最大直径(OR:2.051)是预测MWA后消融区状态的独立预后因素.上述变量和结果通过列线图(C指数=0.847)可视化。
    MWA是一种安全有效的PTMC治疗方法。具有大钙化和较大大小PTMC的老年患者更不可能获得消融区的完全消失。消融区不完全消失与复发无关。
    To construct a prognostic nomogram to predict the ablation zone disappearance for patients with papillary thyroid microcarcinoma (PTMC) after microwave ablation (MWA).
    From April 2020 to April 2022, patients with PTMC who underwent MWA treatment were collected retrospectively. Ultrasound (US) or contrast-enhanced ultrasound (CEUS) was performed at 1 day, 1, 3, 6, 12, 18 and 24 months after MWA to observe the curative effect after ablation. The volume, volume reduction rate (VRR) and complete disappearance rate of the ablation zone at each time point were calculated. Univariate and multivariate logistic regression analysis were used to determine the prognostic factors associated with the disappearance of the ablation zone after MWA, and the nomogram was established and validated.
    72 patients with PTMCs underwent MWA were enrolled into this study. After MWA, no tumor progression (residual, recurrence or lymph node metastasis) and major postoperative complications occurred. The ablation zone in 28 (38.89%) patients did not completely disappear after MWA in the follow-up period. Three variables, including age (odds ratio [OR]: 1.216), calcification type (OR: 12.283), initial maximum diameter (OR: 2.051) were found to be independent prognostic factors predicting ablation zone status after MWA by multivariate analysis. The above variables and outcomes were visualized by nomogram (C-index=0.847).
    MWA was a safe and effective treatment for PTMC. Older patients with macrocalcification and larger size PTMCs were more unlikely to obtain complete disappearance of ablation zones. Incomplete disappearance of ablation zone was not related to recurrence.
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  • 文章类型: Journal Article
    微波消融(MWA)是肝细胞癌(HCC)的标准经皮局部治疗。据报道,下一代MWA比射频消融(RFA)产生更球形的消融区。我们比较了两个2.45GHzMWA消融探头的消融区和纵横比;Emprint®(13G)和Mimapro®(17G)。我们比较了肝细胞癌(HCC)患者MWA后的消融区与施加的能量。此外,我们调查了局部复发。
    我们纳入了20例肝癌患者,平均肿瘤直径为33.2±12.2mm,他使用Emprint®接受了MWA,和9例使用Mimapro®接受MWA的患者,平均肿瘤直径为31.1±10.5mm。两组均使用相同的功率设置进行相同的消融方案。MWA后获得的图像显示了治疗消融区和纵横比,使用三维图像分析软件进行测量和比较。
    Emprint®和Mimapro®组的纵横比分别为0.786±0.105和0.808±0.122,无显著性差异(p=0.604)。Mimapro®组的消融时间明显短于Emprint®组。爆裂频率或消融体积没有显着差异。两组局部复发差异无统计学意义。
    消融直径的纵横比没有显着差异,在这两种情况下,消融区几乎是球形的。17G的Mimapro®比13G的Emprint®侵入性小。
    UNASSIGNED: Microwave ablation (MWA) is a standard percutaneous local therapy for hepatocellular carcinoma (HCC). Next-generation MWA is reported to create a more spherical ablation zone than radiofrequency ablation (RFA). We compared the ablation zone and aspect ratio of two 2.45 GHz MWA ablation probes; Emprint® (13G) and Mimapro® (17G). We compared the ablation zone to the applied energy after MWA in patients with hepatocellular carcinoma (HCC). Furthermore, we investigated local recurrence.
    UNASSIGNED: We included 20 patients with HCC, with an average tumour diameter of 33.2 ± 12.2 mm, who underwent MWA using Emprint®, and 9 patients who underwent MWA using Mimapro® with an average tumour diameter of 31.1 ± 10.5 mm. Both groups underwent the same ablation protocol using the same power settings. The images obtained after MWA showed the treatment ablation zone and aspect ratio, which were measured and compared using three-dimensional image analysis software.
    UNASSIGNED: The aspect ratios in the Emprint® and Mimapro® groups were 0.786 ± 0.105 and 0.808 ± 0.122, respectively, with no significant difference (p = 0.604). The ablation time was significantly shorter in the Mimapro® group than in the Emprint® group, and there was no significant difference in the frequency of popping or the ablation volume. There were no significant differences in local recurrence between the two groups.
    UNASSIGNED: There was no significant difference in the aspect ratios of the ablation diameter, and the ablation zone was almost spherical in both cases. Mimapro® at 17G was less invasive than Emprint® at 13G.
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  • 文章类型: Journal Article
    肝癌是最常见的癌症之一,基于能量的肿瘤消融是一种被广泛接受的治疗方法。肝肿瘤和消融区的自动和鲁棒分割将有助于治疗成功的评估。这项研究的目的是开发和评估一种基于自动深度学习的方法,用于(1)在动脉和门静脉阶段分割肝脏和肝脏肿瘤,用于治疗前CT,(2)在动脉和门静脉阶段分割肝脏和消融区,以进行消融治疗。
    252张CT图像纳入了在大型大学医院接受肝肿瘤消融术的63例患者;每位患者都有治疗前和治疗后的多期CT图像。肝脏的三维体素手动分割,肿瘤和消融区域由放射科医师提供参考标准。用于肝脏和病变分割的深度学习模型最初在公共肝脏肿瘤分割挑战(LiTS)数据集上训练以获得基础模型。然后,应用迁移学习来适应临床训练集上的基础模型,获取动脉和门静脉期图像的肿瘤和消融分割模型。对于建模,2D残余注意力Unet(RA-Unet)用于肝脏分割,基于多尺度贴片的3DRA-Unet用于肿瘤和消融分割。
    在独立测试装置上,所提出的方法在动脉和门静脉阶段的肝脏分割中实现了0.96和0.95的骰子相似系数(DSC),分别。对于肝脏肿瘤,动脉期模型检测灵敏度达71%,DSC为0.64,门静脉期灵敏度为82%,DSC为0.73。对于>0.5cm3的肝脏肿瘤,性能提高到79%的灵敏度,动脉期的DSC0.65,灵敏度86%,门静脉期DSC0.72。对于消融区,该模型对动脉期的检测灵敏度达到90%,DSC为0.83,对门静脉期敏感性为90%,0.89的DSC。
    所提出的深度学习方法可以在多相(动脉和门静脉)和多时间点(治疗前后)CT上提供肝肿瘤和消融区的自动分割,从而能够定量评估治疗成功。
    OBJECTIVE: Liver cancer is one of the most commonly diagnosed cancer, and energy-based tumor ablation is a widely accepted treatment. Automatic and robust segmentation of liver tumors and ablation zones would facilitate the evaluation of treatment success. The purpose of this study was to develop and evaluate an automatic deep learning based method for (1) segmentation of liver and liver tumors in both arterial and portal venous phase for pre-treatment CT, and (2) segmentation of liver and ablation zones in both arterial and portal venous phase for after ablation treatment.
    METHODS: 252 CT images from 63 patients undergoing liver tumor ablation at a large University Hospital were retrospectively included; each patient had pre-treatment and post-treatment multi-phase CT images. 3D voxel-wise manual segmentation of the liver, tumors and ablation region by the radiologist provided reference standard. Deep learning models for liver and lesion segmentation were initially trained on the public Liver Tumor Segmentation Challenge (LiTS) dataset to obtain base models. Then, transfer learning was applied to adapt the base models on the clinical training-set, to obtain tumor and ablation segmentation models both for arterial and portal venous phase images. For modeling, 2D residual-attention Unet (RA-Unet) was employed for liver segmentation and a multi-scale patch-based 3D RA-Unet for tumor and ablation segmentation.
    RESULTS: On the independent test-set, the proposed method achieved a dice similarity coefficient (DSC) of 0.96 and 0.95 for liver segmentation on arterial and portal venous phase, respectively. For liver tumors, the model on arterial phase achieved detection sensitivity of 71%, DSC of 0.64, and on portal venous phase sensitivity of 82%, DSC of 0.73. For liver tumors >0.5cm3 performance improved to sensitivity 79%, DSC 0.65 on arterial phase and, sensitivity 86%, DSC 0.72 on portal venous phase. For ablation zone, the model on arterial phase achieved detection sensitivity of 90%, DSC of 0.83, and on portal venous phase sensitivity of 90%, DSC of 0.89.
    CONCLUSIONS: The proposed deep learning approach can provide automated segmentation of liver tumors and ablation zones on multi-phase (arterial and portal venous) and multi-time-point (before and after treatment) CT enabling quantitative evaluation of treatment success.
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  • 文章类型: Journal Article
    To explore the differences in ablation zone between liver cirrhosis and normal liver background and investigate the effect of hepatic blood flow on ablation zone of RFA.
    Between 2017 and 2019, 203 patients who had liver malignancies and underwent percutaneous RFA with Celon bipolar electrodes enrolled into this study. There were 90 patients had liver cirrhosis and 113 patients had normal liver background. They were 63 females and 140 males with average age of 59.0 ± 10.9 years old. Contrast-enhanced CT/MRI was used to evaluate the ablation zone in one month after RFA. The hepatic flow measurements on CDFI and CEUS were performed before RFA. Correlations between ablation zone versus hepatic flow were assessed using multiple linear regression analysis.
    The average ablation zone in cirrhotic liver was significantly larger than those in normal liver background with 3 cm tip of RF electrodes (length 3.5 ± 0.5 vs 3.1 ± 0.4 cm, p = 0.001; width 2.6 ± 0.3 vs 2.2 ± 0.3 cm, p < 0.001; thickness 2.5 ± 0.3 vs 2.0 ± 0.2 cm, p < 0.001). The similar result was found with three 4 cm tip of RF electrodes (width 3.6 ± 0.5 vs 3.1 ± 0.5 cm, p = 0.019; thickness 3.3 ± 0.5 vs 2.7 ± 0.5 cm, p = 0.002). The multiple linear regression analysis showed arrive time of hepatic vein and portal vein was statistically associated with ablation zone with 3 cm electrodes (p < 0.001, p = 0.001), but explained part of the variance (Adjusted R2=0.294, adjusted R2=0.212).
    The ablation zones of RFA with multi-bipolar electrodes in liver cirrhosis were significantly larger than those in normal liver background, being up to 6 mm in thickness. The hepatic flow parameters partly contributed to the ablation zone.
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  • 文章类型: Journal Article
    Purpose: The aims of this study were to evaluate a semi-automatic segmentation software for assessment of ablation zone geometry in computed tomography (CT)-guided microwave ablation (MWA) of liver tumors and to compare two different MWA systems.Material and Methods: 27 patients with 40 hepatic tumors (primary liver tumor n = 20, metastases n = 20) referred for CT-guided MWA were included in this retrospective IRB-approved study. MWA was performed using two systems (system 1: 915 MHz; n = 20; system 2: 2.45 GHz; n = 20). Ablation zone segmentation and ellipticity index calculations were performed using SAFIR (Software Assistant for Interventional Radiology). To validate semi-automatic software calculations, results (2 perpendicular diameters, ellipticity index, volume) were compared with those of manual analysis (intraclass correlation, Pearson\'s correlation, Mann-Whitney U test; p < 0.05 deemed significant.Results: Manual measurements of mean maximum ablation zone diameters were 43 mm (system 1) and 34 mm (system 2), respectively. Correlations between manual and semi-automatic measurements were r = 0.72 and r = 0.66 (both p < 0.0001) for perpendicular diameters, and r = 0.98 (p < 0.001) for volume. Manual analysis demonstrated that ablation zones created with system 2 had a significantly lower ellipticity index compared to system 1 (mean 1.17 vs. 1.86, p < 0.0001). Results correlated significantly with semi-automatic software measurements (r = 0.71, p < 0.0001).Conclusion: Semi-automatic assessment of ablation zone geometry using SAFIR is feasible. Software-assisted evaluation of ablation zones may prove beneficial with complex ablation procedures, especially for less experienced operators. The 2.45 GHz MWA system generated a significantly more spherical ablation zone compared to the 915 MHz system. The choice of a specific MWA system significantly influences ablation zone geometry.
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  • 文章类型: Journal Article
    在这项研究中,提出了一种基于超声回波去相关成像的微波诱导消融区(热损伤)监测方法。共进行了15例离体猪肝微波消融(MWA)实验。使用具有7.5MHz线性阵列换能器的商用临床超声扫描仪采集MWA期间不同时间的超声射频(RF)信号。计算了两个相邻帧RF数据的瞬时和累积回波去相关图像。基于阈值累积回波去相关图像获得多项式近似图像。实验结果表明,瞬时回波去相关图像在监测微波引起的热损伤方面优于传统的B模式图像。使用大体病理学测量作为参考标准,使用多项式近似图像估计热病变的平均准确率为88.60%.我们得出结论,瞬时超声回波去相关成像能够监测MWA期间热病变的变化,累积超声回波去相关成像和多项式近似成像对于定量描述热病变是可行的。
    In this study, a microwave-induced ablation zone (thermal lesion) monitoring method based on ultrasound echo decorrelation imaging was proposed. A total of 15 cases of ex vivo porcine liver microwave ablation (MWA) experiments were carried out. Ultrasound radiofrequency (RF) signals at different times during MWA were acquired using a commercial clinical ultrasound scanner with a 7.5-MHz linear-array transducer. Instantaneous and cumulative echo decorrelation images of two adjacent frames of RF data were calculated. Polynomial approximation images were obtained on the basis of the thresholded cumulative echo decorrelation images. Experimental results showed that the instantaneous echo decorrelation images outperformed conventional B-mode images in monitoring microwave-induced thermal lesions. Using gross pathology measurements as the reference standard, the estimation of thermal lesions using the polynomial approximation images yielded an average accuracy of 88.60%. We concluded that instantaneous ultrasound echo decorrelation imaging is capable of monitoring the change of thermal lesions during MWA, and cumulative ultrasound echo decorrelation imaging and polynomial approximation imaging are feasible for quantitatively depicting thermal lesions.
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