Malignant lesions

  • 文章类型: Journal Article
    背景:尽管最近取得了进展,医疗技术尚未达到顶峰。精准医疗发展迅速,这要归功于机器学习的突破,这得益于计算能力的提高。本文探讨了深度学习在皮肤科计算机辅助诊断中的应用。方法:使用基于EfficientNetB3和深度学习的自定义模型,我们提出了一种皮肤病变分类的方法,它提供了更好的结果,更便宜,与其他模型相比,推理时间更快。用于本研究的皮肤图像数据集包括从作者收藏和ISIC2019档案中选择的8222个文件,涵盖六种皮肤病。结果:该模型在四个类别黑色素瘤中实现了95.4%的验证准确性,基底细胞癌,良性角化病样病变,和黑素细胞痣-平均每个类别使用1600张图像。添加两个图像较少的类别(每个约700个)-鳞状细胞癌和光化性角化病-将验证准确性降低到88.8%。该模型保持了在与训练数据集相同的条件下拍摄的新临床测试图像的准确性。结论:定制模型在不同的皮肤病变数据集上表现出优异的性能,具有进一步增强的巨大潜力。
    Background: Despite recent advancements, medical technology has not yet reached its peak. Precision medicine is growing rapidly, thanks to machine learning breakthroughs powered by increased computational capabilities. This article explores a deep learning application for computer-aided diagnosis in dermatology. Methods: Using a custom model based on EfficientNetB3 and deep learning, we propose an approach for skin lesion classification that offers superior results with smaller, cheaper, and faster inference times compared to other models. The skin images dataset used for this research includes 8222 files selected from the authors\' collection and the ISIC 2019 archive, covering six dermatological conditions. Results: The model achieved 95.4% validation accuracy in four categories-melanoma, basal cell carcinoma, benign keratosis-like lesions, and melanocytic nevi-using an average of 1600 images per category. Adding two categories with fewer images (about 700 each)-squamous cell carcinoma and actinic keratoses-reduced the validation accuracy to 88.8%. The model maintained accuracy on new clinical test images taken under the same conditions as the training dataset. Conclusions: The custom model demonstrated excellent performance on the diverse skin lesions dataset, with significant potential for further enhancements.
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  • 文章类型: Journal Article
    目的:在本研究中,我们基于高分辨率计算机断层扫描(HRCT)图像创建了一个影像组学模型,用于非侵入性预测亚厘米纯磨玻璃结节(pGGN)是良性还是恶性.
    方法:对235例患者(251亚厘米pGGNs)进行了术前HRCT扫描并有术后病理结果的回顾性评估。结节以7:3的比例随机分配到训练组(n=175)和验证组(n=76)。在薄层肺窗中描绘了感兴趣的体积,从中提取了1316个影像组学特征。使用最小绝对收缩和选择算子(LASSO)来选择影像组学特征。使用单变量和多变量逻辑回归评估独立风险变量。通过获得临床受试者工作特征(ROC)曲线来评估性能,影像组学,和组合模型,然后决策曲线分析(DCA)评估每个模型的临床适用性。
    结果:性别,volume,形状,通过单因素分析选择强度均值建立临床模型。通过LASSO回归保留了两个影像组学特征以建立影像组学模型。在训练组中,影像组学(AUC=0.844)和联合模型(AUC=0.871)的曲线下面积(AUC)高于临床模型(AUC=0.773)。在评估亚厘米pGGN是否为良性时,DCA表明,与临床模型相比,影像组学和联合模型具有更大的总体净获益.
    结论:影像组学模型可用于预测手术前良性和恶性亚厘米pGGN。

    OBJECTIVE: In this study, a radiomics model was created based on High-Resolution Computed Tomography (HRCT) images to noninvasively predict whether the sub-centimeter pure Ground Glass Nodule (pGGN) is benign or malignant.
    METHODS: A total of 235 patients (251 sub-centimeter pGGNs) who underwent preoperative HRCT scans and had postoperative pathology results were retrospectively evaluated. The nodules were randomized in a 7:3 ratio to the training (n=175) and the validation cohort (n=76). The volume of interest was delineated in the thin-slice lung window, from which 1316 radiomics features were extracted. The Least Absolute Shrinkage and Selection Operator (LASSO) was used to select the radiomics features. Univariate and multivariable logistic regression were used to evaluate the independent risk variables. The performance was assessed by obtaining Receiver Operating Characteristic (ROC) curves for the clinical, radiomics, and combined models, and then the Decision Curve Analysis (DCA) assessed the clinical applicability of each model.
    RESULTS: Sex, volume, shape, and intensity mean were chosen by univariate analysis to establish the clinical model. Two radiomics features were retained by LASSO regression to build the radiomics model. In the training cohort, the Area Under the Curve (AUC) of the radiomics (AUC=0.844) and combined model (AUC=0.871) was higher than the clinical model (AUC=0.773). In evaluating whether or not the sub-centimeter pGGN is benign, the DCA demonstrated that the radiomics and combined model had a greater overall net benefit than the clinical model.
    CONCLUSIONS: The radiomics model may be useful in predicting the benign and malignant sub-centimeter pGGN before surgery.

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  • 文章类型: Journal Article
    烟草主要作为吸烟或无烟烟草消费[SLT]。“无烟烟草”(SLT)术语用于以咀嚼形式消费与其他成分混合的烟草,随地吐痰和蘸水。无烟烟草的消费者咀嚼产品并吐出在口腔中积聚的汁液,这导致口腔的各种恶性和恶性前病变。
    描述性观察研究是通过耳鼻喉科在焦特布尔市进行的,头颈部手术,SN医学院博士,焦特布尔.
    无烟烟草的男女比例几乎相同。年龄的增加与口腔病变的发生有关,在年龄>64岁的组中,有43%的患者发生了口腔病变。持续时间是另一个相关因素,66%的人在使用<10年内出现症状。口腔粘膜下纤维化是最常见的病变。0.3%为恶性病变。大约78%的病例发展了依赖性。糖尿病患者更容易出现口腔病变。
    无烟烟草在口腔中的病变发展取决于各种因素,例如每天的烟草使用量,放烟草的地方和持续时间。了解其致命影响并及时诊断和管理可以挽救许多生命。
    UNASSIGNED: Tobacco is consumed mainly as smoking or smokeless tobacco [SLT]. \"Smokeless tobacco\" (SLT) term is used for the consumption of tobacco mixed with other constituents in form of chewing, spitting and dipping. Consumers of smokeless tobacco chew the products and spit out the juice that builds up in oral cavity which leads to various malignant and pre malignant lesions of oral cavity.
    UNASSIGNED: Descriptive observational study was conducted in the city of Jodhpur through department of ENT, Head & Neck Surgery, Dr. SN medical college, Jodhpur.
    UNASSIGNED: Male to female ratio of smokeless tobacco usage was almost same. Increasing age was associated with occurrence of oral lesions and 43% patients developed oral lesions in the group > 64 yrs of age. Duration was another associating factor and 66% developed symptoms within < 10 years of usage. Oral submucous fibrosis is the most common lesion. Malignant lesions were seen in 0.3% cases. Around 78% cases developed dependency. Diabetic patients were seen more prone to development of oral lesions.
    UNASSIGNED: Development of lesions in the oral cavity by smokeless tobacco depends on various factors such as quantity of tobacco usage per day, place of putting tobacco and duration. Awareness regarding its fatal effects and timely diagnosis and management can save many lives.
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  • 文章类型: Journal Article
    这项研究提出了人工智能(AI)在区分皮肤镜检查图像方面的创新应用,这些图像描绘了患有良性和恶性皮肤病变的个体。利用谷歌平台的协作能力,所开发的模型在实现准确诊断方面表现出显著的效率。该模型只接受了1小时33分钟的训练,利用谷歌的服务器,使过程既无成本又碳中和。利用代表良性和恶性病例的数据集,人工智能模型展示了值得称赞的性能指标。值得注意的是,该模型实现了整体准确性,精度,召回(敏感度),特异性,F1得分为92%。这些指标强调了模型在区分良性和恶性皮肤病变方面的熟练程度。Google协作平台的使用不仅加快了培训过程,而且体现了一种具有成本效益和环境可持续性的方法。虽然这些发现突出了AI在皮肤病理学中的潜力,认识到固有的局限性至关重要,包括数据集代表性和真实世界临床场景中的变化。这项研究有助于AI在皮肤科诊断中的应用不断发展,展示了一个有前途的工具,用于准确的病变分类。建议进一步研究和验证研究,以增强模型的鲁棒性,并促进其融入临床实践。
    This study presents an innovative application of artificial intelligence (AI) in distinguishing dermoscopy images depicting individuals with benign and malignant skin lesions. Leveraging the collaborative capabilities of Google\'s platform, the developed model exhibits remarkable efficiency in achieving accurate diagnoses. The model underwent training for a mere one hour and 33 minutes, utilizing Google\'s servers to render the process both cost-free and carbon-neutral. Utilizing a dataset representative of both benign and malignant cases, the AI model demonstrated commendable performance metrics. Notably, the model achieved an overall accuracy, precision, recall (sensitivity), specificity, and F1 score of 92%. These metrics underscore the model\'s proficiency in distinguishing between benign and malignant skin lesions. The use of Google\'s Collaboration platform not only expedited the training process but also exemplified a cost-effective and environmentally sustainable approach. While these findings highlight the potential of AI in dermatopathology, it is crucial to recognize the inherent limitations, including dataset representativity and variations in real-world clinical scenarios. This study contributes to the evolving landscape of AI applications in dermatologic diagnostics, showcasing a promising tool for accurate lesion classification. Further research and validation studies are recommended to enhance the model\'s robustness and facilitate its integration into clinical practice.
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  • 文章类型: Journal Article
    值得注意的是,三分之一的口腔癌或口腔组织功能障碍病例来自印度,主要是由于古特卡的消费,几种印度人口中普遍存在的一种无烟烟草。Gutkha是烟草的混合物,槟榔,熟石灰,Catechu,香料,甜味剂和香精。口腔粘膜下纤维化(OSMF),这与槟榔产品和烟草的消费有关,是慢性的,粘膜下组织的癌前状态。OSMF转化为口腔鳞状细胞癌(OSCC)的比率为7-13%。Gutkha还含有各种微量元素,如铜(Cu),锌(Zn),硒(Se)和钼(Mo)。体内微量元素水平的改变与癌症进展有关。本研究旨在确定OSMF和OSCC患者的血清和唾液微量元素水平。共选取80例患者进行研究,分为四组,每组20例(A组,不含OSMF的牙本质摄入;B组,OSMF摄入五味子;C组,OSCC;和D组,控制)。发现铜的含量增加,锌的含量增加,与对照组相比,OSMF和OSCC患者的血清中Se和Mo降低。这些元素的唾液水平低于血清中的水平。年龄和性别对这些微量元素水平没有显著影响。本研究的结果确认了以下事实:随着疾病的发展,恶性前和恶性病变中的血清和唾液微量元素会发生变化。由于唾液的成分经常变化,监测血清微量元素水平作为诊断和预后标志物可能有助于疾病的早期发现和治疗效果的管理。
    Of note, one third of oral cancer or oral tissue dysfunction cases are from India, primarily resulting from the consumption of Gutkha, a type of smokeless tobacco prevalent among several Indian populations. Gutkha is a mixture of tobacco, areca nut, slaked lime, catechu, spices, sweeteners and essences. Oral submucous fibrosis (OSMF), which is linked to the consumption of areca nut products and tobacco, is a chronic, precancerous condition of the submucosal tissues. OSMF transforms into oral squamous cell carcinoma (OSCC) at a rate of 7-13%. Gutkha also contains various trace elements, such as copper (Cu), zinc (Zn), selenium (Se) and molybdenum (Mo). Alterations in trace element levels in the body are associated with cancer progression. The present study aimed to determine the levels of serum and salivary trace elements in patients with OSMF and OSCC. A total of 80 patients were selected for the study and were divided into four groups of 20 patients in each (Group A, gutkha intake without OSMF; group B, gutkha intake with OSMF; group C, OSCC; and group D, control). The level of Cu was found to be increased and the levels of Zn, Se and Mo were decreased in the serum of patients with OSMF and OSCC compared with the controls. The salivary levels of these elements were lower compared with those in the serum. Age and sex had no significant effect on the levels of these trace elements. The results of the present study affirm the fact that serum and salivary trace elements are altered in pre-malignant and malignant lesions as the disease progresses. As the composition of saliva often varies, monitoring serum trace element levels as diagnostic and prognostic markers may aid in the early detection of the disease and in the management of the treatment efficacy.
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  • 文章类型: Journal Article
    目的:本研究旨在评估在gadoxeticacid(GA)增强肝脏MRI中区分局灶性肝脏病变(FLL)的定量特征,并确定这些特征是否可以准确区分良性和恶性病变。
    方法:单中心回顾性研究纳入了107例先前检查中具有180个明确FLL的患者。所有患者均接受GA肝脏MRI检查。其中良性病变99例,恶性病变74例。良性病变组包括60例局灶性结节性增生(FNH),22血管瘤(HMG),6肝腺瘤(HA),和其他11个良性病变(1个血管平滑肌瘤,6个病变组织病理学诊断为良性,没有进一步说明,或者缺乏恶性肿瘤特征的,和4个放射学诊断为良性的病变,在后续研究中保持稳定)。该组恶性病变包括51例原发性肝细胞癌,12转移,和11个恶性黑色素瘤转移(MMmeta)。排除7例FLL(4例组织病理学诊断不确定,2胆管癌,和1个再生结节)。对于包括的病变,由两名观察者在T2-w中进行ROI(感兴趣区域)测量,ADC(表观扩散系数)和在T1-w序列中的肝胆相(HBP)。通过Wilcoxon检验评估了观察者之间的一致性。克鲁斯卡尔-沃利斯,采用Mann-WhitneyU和事后Dunn's检验来评估单个病变之间的ROI值是否存在显著差异。P值<0.05的变量被认为是统计学上显著的。
    结果:我们发现p<0.0001的病变之间的ROI值存在显着差异。对于HMG,在T2-w序列中发现显著高的ROI值。对于转移和MM转移,ADC值最低。在HBP中发现FNH的最高ROI值,和最低的转移。我们还发现,良性和恶性病变之间的ROI值存在统计学上的显着差异,与恶性病变相比,良性病变的ROI值在统计学上较高。
    结论:不同类型FLL的ROI值存在显著差异。T2-w序列中的主要定量特征是HMG的极高ROI值。良性病变在T2-W中呈现统计学上较高的ROI值,ADC,和HBP序列与恶性病变的比较。对于除HA以外的所有病变都是如此。
    OBJECTIVE: The study aims at assessing the quantitative features which distinguish focal liver lesions (FLLs) in gadoxetic acid (GA) enhanced liver MRI and at determining whether these features can accurately differentiate benign from malignant lesions.
    METHODS: 107 patients with 180 unequivocal FLLs in previous examinations were included in a single-center retrospective study. All patients underwent a MRI test of the liver with GA. 99 benign and 74 malignant lesions were included. The group of benign lesions consisted of 60 focal nodular hyperplasias (FNH), 22 hemangiomas (HMG), 6 hepatic adenomas (HA), and 11 other benign lesions (1 angiomyolipioma, 6 lesions histopathology diagnoses as benign without further specification, or ones lacking features of malignancy, and 4 lesions radiologically diagnosed as benign which remained stable in the follow-up studies). The group of malignant lesions consisted of primary 51 hepatocellular carcinomas, 12 metastases, and 11 metastases from melanoma malignum (MM meta). 7 FLLs were excluded (4 cases of uncertain histopathological diagnosis, 2 cholangiocarcinomas, and 1 regenerative nodule). For the included lesions ROI (region of interest) measurements were taken by two observers in the T2-w, ADC (apparent diffusion coefficient) and in the T1-w sequence in the hepatobiliary phase (HBP). The interobserver agreement was evaluated with the Wilcoxon test. The Kruskal - Wallis, Mann - Whitney U and post hoc Dunn\'s tests were applied to assess if there were any significant differences in the ROI values between individual lesions. The variables with the p values of < 0.05 were considered statistically significant.
    RESULTS: We found significant differences in the ROI values between lesions with p < 0.0001. Strikingly high ROI values in the T2-w sequence were found for HMG. The lowest ADC values were encountered for metastases and MM metastases. The highest ROI values in the HBP were found for FNH, and the lowest for metastases. We also found statistically significant differences in the ROI values between benign and malignant lesions with benign lesions presenting statistically higher ROI values compared to malignant lesions.
    CONCLUSIONS: There were significant differences in the ROI values among different types of FLLs. The predominant quantitative feature in the T2-w sequence was a strikingly high ROI value for HMG. Benign lesions presented statistically higher ROI values in the T2-w, ADC, and HBP sequences compared to malignant lesions. This was true for all lesions except for HA.
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  • 文章类型: Journal Article
    背景:治疗良性和早期恶性直肠病变的最常见技术是经肛门内镜显微手术(TEM)。局部切除是高危和老年患者可接受的技术,但是几乎没有关于年轻患者的数据。
    目的:描述50岁以下患者的TEM结果。
    方法:我们收集了人口统计,临床,以及2005年1月至2018年12月在HasharonRabin医学中心接受TEM手术的所有50岁以下患者的病理数据。
    结果:在研究期间,共有26例50岁以下的患者接受了TEM手术.他们的平均年龄为43.3岁。男性11人(42.0%)。平均手术时间为67分钟,平均肿瘤大小为2.39厘米,平均肛门边缘距离为8.50厘米。术中或术后无重大并发症。中位住院时间为2d。7个(26.9%)病变为腺瘤伴低度发育不良,四个(15.4%)是高度异型增生腺瘤,两个是T1癌(7.8%),3例为T2癌(11.5%)。2例(7.8%)内镜下息肉切除术后未发现残留病变,但4人(15.4%)有其他病理。所有病例的手术切缘均为阴性。在手术后33个月的一名患者中检测到局部复发。
    结论:在年轻的成年患者中,TEM对良性直肠病变有很好的疗效。在直肠癌的治疗中,它还可以在完全肿瘤切除的功效与术后生活质量之间取得平衡。在某些情况下,它可能被认为是根治性手术的替代方案。
    BACKGROUND: The most common technique for treating benign and early malignant rectal lesions is transanal endoscopic microsurgery (TEM). Local excision is an acceptable technique for high-risk and elderly patients, but there are hardly any data regarding young patients.
    OBJECTIVE: To describe TEM outcomes in patients under 50 years of age.
    METHODS: We collected demographic, clinical, and pathological data from all patients under the age of 50 years who underwent the TEM procedure at Hasharon Rabin Medical Center from January 2005 to December 2018.
    RESULTS: During the study period, a total of 26 patients under the age of 50 years underwent TEM procedures. Their mean age was 43.3 years. Eleven (42.0%) were male. The mean operative time was 67 min, and the mean tumor size was 2.39 cm, with a mean anal verge distance of 8.50 cm. No major intraoperative or postoperative complications were recorded. The median length of stay was 2 d. Seven (26.9%) lesions were adenomas with low-grade dysplasia, four (15.4%) were high-grade dysplasia adenomas, two were T1 carcinomas (7.8%), and three were T2 carcinomas (11.5%). No residual disease was found following endoscopic polypectomy in two patients (7.8%), but four (15.4%) had other pathologies. Surgical margins were negative in all cases. Local recurrence was detected in one patient 33 mo following surgery.
    CONCLUSIONS: Among young adult patients, TEM for benign rectal lesions has excellent outcomes. It may also offer a balance between the efficacy of complete oncologic resection and postoperative quality of life in the treatment of rectal cancer. In some cases, it may be considered an alternative to radical surgery.
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  • 文章类型: Journal Article
    主要目标是通过完善选择标准来优化符合Mammotome微创手术(MIS)的人群。这涉及最大限度地提高程序效益,将恶性肿瘤风险降至最低,并降低恶性结局的发生率。
    对2016年11月至2021年8月来我院进行MammotomeMIS的1158例女性患者进行回顾性分析。在进行χ2检验以筛选风险变量之后,采用二元logistic回归分析确定恶性病变的独立预测因子.此外,为了更好地了解这些变量之间的关系,我们对BI-RADS超声(US)4a类病变进行了年龄与病变直径的相关性研究.
    接受MammotomeMIS的BI-RADS美国3类,4a类和4b类患者的恶性率为0.6%(9/1562),分别为6.4%(37/578)和8.3%(2/24)。恶性病变多见于40岁以上的患者,有可见的血供,和BI-RADS4类乳房X线照相术。在BI-RADS美国4a类病变中,恶性肿瘤的直径与年龄高度相关,这种相关性在40岁以上和BI-RADS4类乳腺X线摄影患者中得到加强。
    这项研究的结果表明,临床数据和影像学结果,尤其是年龄,血液供应,和乳房X线照相术分类,提供有价值的见解,以优化患者的手术选择并降低恶性结局的发生率。
    UNASSIGNED: The primary objective is to optimize the population eligible for Mammotome Minimally Invasive Surgery (MIS) by refining selection criteria. This involves maximizing procedure benefits, minimizing malignancy risk, and reducing the rate of malignant outcomes.
    UNASSIGNED: A total of 1158 female patients who came to our hospital from November 2016 to August 2021 for the Mammotome MIS were analyzed retrospectively. Following χ2 tests to screen for risk variables, binary logistic regression analysis was used to determine the independent predictors of malignant lesions. In addition, the correlation between age and lesion diameter was investigated for BI-RADS ultrasound (US) category 4a lesions in order to better understand the relationship between these variables.
    UNASSIGNED: The malignancy rates of BI-RADS US category 3, category 4a and category 4b patients who underwent the Mammotome MIS were 0.6% (9/1562), 6.4% (37/578) and 8.3% (2/24) respectively. Malignant lesions were more common in patients over the age of 40, have visible blood supply, and BI-RADS category 4 of mammography. In BI-RADS US category 4a lesions, the diameter of malignant tumor was highly correlated with age, and this correlation was strengthened in patients over the age of 40 and with BI-RADS category 4 of mammography.
    UNASSIGNED: The results of this study demonstrate that the clinical data and imaging results, particularly age, blood supply, and mammography classification, offer valuable insights to optimize patients\' surgical options and decrease the incidence of malignant outcomes.
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  • 文章类型: Journal Article
    目的:探讨骨转移的分割方法,以鉴别良恶性骨病变和表征恶性骨病变。
    方法:文献检索在Scopus,PubMed,IEEE和MedLine,和WebofScience电子数据库遵循系统审查和荟萃分析(PRISMA)的首选报告项目指南。共77篇原创文章,24篇评论文章,本综述纳入了2010年1月至2022年3月发表的1篇对比论文.
    结果:结果表明,在77篇原始文章中,大多数研究使用了基于神经网络的方法(58.44%)和基于CT的成像(50.65%)。然而,该评论强调缺乏肿瘤边界的黄金标准,并且需要手动校正分割输出,这在很大程度上解释了临床翻译研究的缺失。此外,只有19项研究(24.67%)特别提到了其拟议方法用于临床实践的可行性.
    结论:结合解剖信息和代谢活动的肿瘤分割技术的发展令人鼓舞,尽管没有一种适用于所有应用的最佳肿瘤分割方法,或者可以弥补数据限制中的所有困难。
    OBJECTIVE: To investigate the segmentation approaches for bone metastases in differentiating benign from malignant bone lesions and characterizing malignant bone lesions.
    METHODS: The literature search was conducted in Scopus, PubMed, IEEE and MedLine, and Web of Science electronic databases following the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A total of 77 original articles, 24 review articles, and 1 comparison paper published between January 2010 and March 2022 were included in the review.
    RESULTS: The results showed that most studies used neural network-based approaches (58.44%) and CT-based imaging (50.65%) out of 77 original articles. However, the review highlights the lack of a gold standard for tumor boundaries and the need for manual correction of the segmentation output, which largely explains the absence of clinical translation studies. Moreover, only 19 studies (24.67%) specifically mentioned the feasibility of their proposed methods for use in clinical practice.
    CONCLUSIONS: Development of tumor segmentation techniques that combine anatomical information and metabolic activities is encouraging despite not having an optimal tumor segmentation method for all applications or can compensate for all the difficulties built into data limitations.
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  • 文章类型: Journal Article
    背景:前列腺癌的早期诊断可改善其预后,虽然升级筛选工具是必不可少的。本研究旨在探索一种新的功能磁共振成像(MRI)技术的价值,即酰胺质子转移(APT)加权MRI,结合血清前列腺特异性抗原(PSA)水平来区分恶性前列腺病变和良性前列腺病变。
    方法:对2019年7月至2022年3月在重庆大学肿瘤医院行前列腺检查的患者资料进行回顾性分析。所有患者均行T2加权成像(T2WI),APT,弥散加权成像(DWI),和动态对比增强(DCE)MRI。两名放射科医生独立分析了这些图像。通过使用受试者工作特征(ROC)曲线比较了单独或不同组合的定量参数在区分恶性前列腺病变与良性前列腺病变中的能力。根据德隆测试,组合参数与相应的单一参数差异有统计学意义(P<0.05)。
    结果:最终纳入了79例患者,其中恶性组52例,良性组27例。对指标的单独评估表明,APTmax,APTmean,平均表观扩散系数(ADCmean),ADCmax,ADCmin,tPAD,游离前列腺特异性抗原(FPSA),FPSA/总前列腺特异性抗原(tPSA),PSA密度(PSAD)在两组间差异有统计学意义(P<0.05),而APTmin在两组间差异无统计学意义(P>0.05)。APTmax和APTmean具有较高的ROC曲线下面积值(AUC),分别为0.780和0.710。APTmax有很高的灵敏度,APTmean有很高的特异性。APTmax的组合,APTmean,ADCmean,和PSAD的AUC值最高(AUC:0.880,敏感性:86.540,特异性:78.260)。
    结论:APTmax,APTmean,ADCmean,ADCmin,tPAD,FPSA,和PSAD在单独评估指标中显示出在区分恶性前列腺病变和良性前列腺病变方面具有很高的价值。APTmax的组合,APTmean,ADCmean,PSAD的诊断价值最高。
    BACKGROUND: Early diagnosis of prostate cancer improves its prognosis, while it is essential to upgrade screening tools. This study aimed to explore the value of a novel functional magnetic resonance imaging (MRI) technique, namely amide proton transfer (APT)-weighted MRI, combined with serum prostate-specific antigen (PSA) levels to differentiate malignant prostate lesions from benign prostate lesions.
    METHODS: Data of patients who underwent prostate examinations at Chongqing University Cancer Hospital between July 2019 and March 2022 were retrospectively analyzed. All patients underwent T2-weighted imaging (T2WI), APT, diffusion-weighted imaging (DWI), and dynamic contrast-enhanced (DCE) MRI. Two radiologists analyzed the images independently. The ability of the quantitative parameters alone or in different combinations in differentiating malignant prostate lesions from benign prostate lesions were compared by using receiver operating characteristic (ROC) curves. According to the DeLong test, the combined parameters were significantly different from the corresponding single parameter (P < 0.05).
    RESULTS: A total of 79 patients were finally enrolled, including 52 patients in the malignant group and 27 patients in the benign group. The separate assessment of indexes revealed that APTmax, APTmean, mean apparent diffusion coefficient (ADCmean), ADCmax, ADCmin, tPAD, free prostate-specific antigen (FPSA), FPSA/total prostate-specific antigen (tPSA), and PSA density (PSAD) were significantly different between the two groups (P < 0.05), while APTmin was not significantly different between the two groups (P > 0.05). APTmax and APTmean had the high values of area under the ROC curve (AUC), which were 0.780 and 0.710, respectively. APTmax had a high sensitivity, and APTmean had a high specificity. The combination of APTmax, APTmean, ADCmean, and PSAD had the highest AUC value (AUC: 0.880, sensitivity: 86.540, specificity: 78.260).
    CONCLUSIONS: APTmax, APTmean, ADCmean, ADCmin, tPAD, FPSA, and PSAD showed to have a high value in differentiating malignant prostate lesions from benign prostate lesions in the separate assessment of indexes. The combination of APTmax, APTmean, ADCmean, and PSAD had the highest diagnostic value.
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