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Purpose@#High-dose radiotherapy (RT) for localized prostate cancer requires careful consideration of target position changes and adjacent organs-at-risk (OARs), such as the rectum and bladder. Therefore, daily monitoring of target position and OAR changes is crucial in minimizing interfractional dosimetric uncertainties. For efficient monitoring of the internal condition of patients, we assessed the feasibility of an auto-segmentation of OARs on the daily acquired images, such as megavoltage computed tomography (MVCT), via a commercial artificial intelligence (AI)-based solution in this study. @*Materials and Methods@#We collected MVCT images weekly during the entire course of RT for 100 prostate cancer patients treated with the helical TomoTherapy system. Based on the manually contoured body outline, the bladder including prostate area, and rectal balloon regions for the 100 MVCT images, we trained the commercially available fully convolutional (FC)-DenseNet model and tested its auto-contouring performance. @*Results@#Based on the optimally determined hyperparameters, the FC-DenseNet model successfully auto-contoured all regions of interest showing high dice similarity coefficient (DSC) over 0.8 and a small mean surface distance (MSD) within 1.43 mm in reference to the manually contoured data. With this well-trained AI model, we have efficiently monitored the patient's internal condition through six MVCT scans, analyzing DSC, MSD, centroid, and volume differences. @*Conclusion@#We have verified the feasibility of utilizing a commercial AI-based model for auto-segmentation with low-quality daily MVCT images. In the future, we will establish a fast and accurate auto-segmentation and internal organ monitoring system for efficiently determining the time for adaptive replanning.
ABSTRACT
Objective@#This study evaluated whether the hepatic steatosis index (HSI) at antineutrophil cytoplasmic antibody-associated vasculitis (AAV) diagnosis could forecast poor outcomes during the disease course in AAV patients. @*Methods@#This study included 260 AAV patients. The equation for HSI is as follows: HSI=8×(alanine aminotransferase/aspartate aminotransferase)+body mass index+(2, diabetes mellitus)+(2, female). The cut-off of HSI was obtained using the receiver operating characteristic curve. @*Results@#The median age of the 260 patients was 59.5 years, and 65.0% were female. Among the continuous variables excluding the parameters composing the equation for HSI, HSI was significantly correlated with Birmingham vasculitis activity score, fivefactor score, haemoglobin, blood urea nitrogen, serum creatinine, and total cholesterol. Among poor outcomes, the area under the curve of HSI for end-stage renal disease (ESRD) was significant, and the cut-off of HSI for ESRD was set at ≤30.82. AAV patients with HSI ≤30.82 exhibited a significantly higher risk of ESRD (relative risk 3.489) and a significantly lower cumulative ESRD-free survival rate than those with HSI >30.82. @*Conclusion@#This study is the first to demonstrate that HSI at AAV diagnosis could forecast ESRD during the disease course in AAV patients.
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PURPOSE: To assess the performance of the dynamic contour tonometer (DCT) in eyes undergoing excimer laser photorefractive keratectomy (PRK). METHODS: Intraocular pressure (IOP) was measured in 30 eyes after first time excimer laser PRK pre and three months post operatively using Goldmann applanation tonometer (GAT), noncontact air tonometer (NCT), and the DCT. RESULTS: There was significant correlation between central corneal thickness (CCT) and IOP measurements by GAT and NCT (CCT vs GAT: r2=0.31, p<0.01, CCT vs NCT: r2=0.39, p<0.01). However, the correlation between CCT and IOP measurements by DCT was not significant (CCT vs DCT: r2=0.14, p=0.32). After PRK, the mean change in CCT and IOP measurements using GAT, NCT, DCT were 73.70+/-26.92 micrometer (mean+/-SD), 2.43+/-2.86 mmHg (p<0.01), 3.83+/-2.34 mmHg (p<0.01) and 0.44+/-1.51 mmHg (p=0.125), respectively. The preoperative and postoperative DCT measurements did not differ significantly. CONCLUSIONS: The reduction in CCT induced by PRK doesn't appear to influence DCT measurements; therefore, DCT may be better suited over GAT or NCT for monitoring IOP in eyes that underwent refractive surgery.
Subject(s)
Eye , Intraocular Pressure , Lasers, Excimer , Peptides , Photorefractive Keratectomy , Refractive Surgical ProceduresABSTRACT
PURPOSE: To investigate the role of nitric oxide (NO) on the migration of cultured human Tenon's capsule PURPOSE: Necrobiotic xanthogranuloma is a very rare disease characterized by the presence of yellow subcutaneous skin lesions and systemic paraproteinemia. We report a case of post traumatic necrobiotic xanthograuloma that presented with a preseptal mass. CASE SUMMARY: A 31-year-old man presented with ptosis and a mass on the left superior orbit that developed after trauma 3 weeks prior to admission. A computed tomography scan showed a contrast-enhancing preseptal mass, and surgical exploration was performed. CONCLUSIONS: Histopathological examination revealed a tumor that had all the major features of necrobiotic xanthogranuloma, including fat necrosis with granulomatous inflammation, giant multinucleated cells, foamy cells, and several lymphoid follicles with germinal centers. Hematologic evaluation revealed polyclonal gammopathy.