Advancements in Radiogenomics for Clear Cell Renal Cell Carcinoma: Understanding the Impact of BAP1 Mutation.

Recent advancements in understanding clear cell renal cell carcinoma (ccRCC) have underscored the critical role of the BAP1 gene in its pathogenesis and prognosis. While the von Hippel-Lindau (VHL) mutation has been extensively studied, emerging evidence suggests that mutations in BAP1 and other genes significantly impact patient outcomes. Radiogenomics with and without texture analysis based on CT imaging holds promise in predicting BAP1 mutation status and overall survival outcomes. However, prospective studies with larger cohorts and standardized imaging protocols are needed to validate these findings and translate them into clinical practice effectively, paving the way for personalized treatment strategies in ccRCC. This review aims to summarize the current knowledge on the role of BAP1 mutation in ccRCC pathogenesis and prognosis, as well as the potential of radiogenomics in predicting mutation status and clinical outcomes.

Radiogenomics and Texture Analysis to Detect von Hippel-Lindau (VHL) Mutation in Clear Cell Renal Cell Carcinoma.

Radiogenomics, a burgeoning field in biomedical research, explores the correlation between imaging features and genomic data, aiming to link macroscopic manifestations with molecular characteristics. In this review, we examine existing radiogenomics literature in clear cell renal cell carcinoma (ccRCC), the predominant renal cancer, and von Hippel-Lindau (VHL) gene mutation, the most frequent genetic mutation in ccRCC. A thorough examination of the literature was conducted through searches on the PubMed, Medline, Cochrane Library, Google Scholar, and Web of Science databases. Inclusion criteria encompassed articles published in English between 2014 and 2022, resulting in 10 articles meeting the criteria out of 39 initially retrieved articles. Most of these studies applied computed tomography (CT) images obtained from open source and institutional databases. This literature review investigates the role of radiogenomics, with and without texture analysis, in predicting VHL gene mutation in ccRCC patients. Radiogenomics leverages imaging modalities such as CT and magnetic resonance imaging (MRI), to analyze macroscopic features and establish connections with molecular elements, providing insights into tumor heterogeneity and biological behavior. The investigations explored diverse mutations, with a specific focus on VHL mutation, and applied CT imaging features for radiogenomic analysis. Moreover, radiomics and machine learning techniques were employed to predict VHL gene mutations based on CT features, demonstrating promising results. Additional studies delved into the relationship between VHL mutation and body composition, revealing significant associations with adipose tissue distribution. The review concludes by highlighting the potential role of radiogenomics in guiding targeted and selective therapies.

Fat Matters: Exploring Cancer Risk through the Lens of Computed Tomography and Visceral Adiposity.

Obesity is an established risk factor for cancer. However, conventional measures like body mass index lack precision in assessing specific tissue quantities, particularly of the two primary abdominal fat compartments, visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT). Computed tomography (CT) stands as the gold standard for precisely quantifying diverse tissue types. VAT, distinguished by heightened hormonal and metabolic activity, plays a pivotal role in obesity-related tumor development. Excessive VAT is linked to aberrant secretion of adipokines, proinflammatory cytokines, and growth factors, fostering the carcinogenesis of obesity-related tumors. Accurate quantification of abdominal fat compartments is crucial for understanding VAT as an oncological risk factor. The purpose of the present research is to elucidate the role of CT, performed for staging purposes, in assessing VAT (quantity and distribution) as a critical factor in the oncogenesis of obesity-related tumors. In the field of precision medicine, this work takes on considerable importance, as quantifying VAT in oncological patients becomes fundamental in understanding the influence of VAT on cancer development-the potential "phenotypic expression" of excessive VAT accumulation. Previous studies analyzed in this research showed that VAT is a risk factor for clear cell renal cell carcinoma, non-clear cell renal cell carcinoma, prostate cancer, and hepatocarcinoma recurrence. Further studies will need to quantify VAT in other oncological diseases with specific mutations or gene expressions, in order to investigate the relationship of VAT with tumor genomics.

Knee Osteoarthritis after Arthroscopic Partial Meniscectomy: Prevalence and Progression of Radiographic Changes after 5 to 12 Years Compared with Contralateral Knee.

The purpose of this study was to study the clinical and radiographic changes in the knee after arthroscopic partial meniscectomy (APM) at a long-term follow-up compared with the contralateral knee. We assessed 57 patients (38 males and 19 females) with pre- and postoperative weight-bearing radiography with a follow-up ranging from 5.1 to 12.1 years (mean: 8.1) to analyze prevalence and progression of knee osteoarthritis (OA) after APM. We stratified patients according to body mass index (BMI), type of lesion (degenerative vs. traumatic), and side of meniscectomy (medial, lateral, and medial plus lateral). Patients were evaluated both clinically with Knee Osteoarthritis Outcome Score (KOOS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score and radiographically with the Kellgren and Lawrence (K/L) score. Radiographic OA was defined as K/L grade 2 or worse. The prevalence of knee OA was 62.69% in the tibiofemoral compartment. The progression of knee OA was statistically significant, ranging from 17.2% preoperatively to 65.95% postoperatively (p = 0.001) in the medial compartment and from 17.64% preoperatively to 58.82% postoperatively (p = 0.0324) in the lateral compartment. The progression of knee OA in the patellofemoral compartment ranged from 5.26 to 42.10% (p = 0.001). The OA progression regarding BMI was higher into the obese group than the normal-weight group and greater in the degenerative group than the traumatic one. The mean KOOS was 72.01 and the mean WOMAC was 73.84. The Spearman's test showed a statistical significance between clinical and radiographic results. Patients in the obese, overweight, and degenerative tear group had a greater predisposition to OA in the tibiofemoral and patellofemoral compartments after meniscectomy. The level of evidence is III, retrospective study.

Quality assessment of Zeus faber (Peter's fish) ovaries regularly commercialized for human consumption.

In the last few years, the consumption of fish eggs has increased rapidly, finding widespread use also in mass catering. This increase has involved also those of the Peter's fish (Zeus faber). Females of this species, by their reproductive characteristics, have highly developed gonads in different periods of the year, making the raw material easy to find. The aim of the present study was to perform a quality assessment of Zeus faber ovaries regularly commercialized for human consumption. A total number of 34 samples, divided in fresh (11) and frozen (23), were processed for microbiological characterization, parasitological and histological evaluations. Fresh and frozen samples have significant (P<0.01) differences in total bacterial charge, with values of 4.75±0.5 Log CFU/g and 3.65±0.7 Log CFU/g respectively. The mean value of Enterobacteriaceae was 2.58±0.7 Log CFU/g in fresh products, while 52.17% (12) of frozen samples reported loads of <1 Log CFU/g. No Salmonella spp. and Listeria monocytogenes were found. Aeromonas spp. was detected in two frozen sample (with loads of 2.2 and <1 Log CFU/g) and in 5 fresh ovaries with value ranged from 1.70 to 3.48 Log CFU/g. Vibrio spp. was found in 4 (36.36%) and 3 (13.04%) of fresh and frozen samples respectively, with loads always <1 Log CFU/g. All 31 Vibrio strains isolated, were identified as Vibrio alginolyticus, and 61.29% (19) of them was positive for the ToxRS factor and 6.45% (2) for ToxR. The 47.06% (16) of total samples showed infestations by larvae of Anisakis Type 1 in the serous and inside the ovary. In this last case, histologically it was found to be free larvae. This study attested satisfactory hygiene conditions for Zeus faber ovaries currently marked for human consumption. The presence of potentially pathogenic strains of V. alginolyticus and Aeromonas spp., but above all the frequent infestation by Anisakis larvae, represent a potentially hazard for the consumer.

Patellar Resurfacing in Total Knee Arthroplasty: Systematic Review and Meta-Analysis.

BACKGROUND: Patellar resurfacing in total knee arthroplasty remains controversial. The aim of this study is to evaluate this technique through an analysis of comparative studies in the current literature. METHODS: We performed a comprehensive search of PubMed, MEDLINE, Cochrane, CINAHL, and EMBASE databases using various combinations of the keywords "Knee," "Replacement," "Prosthesis," "Patella," "Resurfacing," and "Arthroplasty." All articles relevant to the subject were retrieved, and their bibliographies were hand searched for further references relevant to primary patellar resurfacing in total knee arthroplasty. Only articles published in peer-reviewed journals were included in this systematic review. RESULTS: The percentage for a reoperation was 1% for the patellar resurfacing group (17/1636) and 6.9% for the non-resurfacing group (118/1699) (odds ratio [OR] 0.18, 95% confidence interval [CI] 0.11-0.29, P < .00001). The patellar resurfacing group showed a significantly higher postop Knee Society Score (KSS) pain (OR 1.52, 95% CI 0.68-2.35, P = .004) and postop Hospital for Special Surgery score (OR 4.35, 95% CI 3.21-5.49, P < .00001), over the non-resurfacing group. CONCLUSION: Based on the outcome scores of KSS (pain), KSS (function), and Hospital for Special Surgery postop, patellar resurfacing TKAs have performed better than non-resurfaced TKAs. The lower secondary operation and revision rates for patellar resurfaced TKAs also demonstrate that this technique is the more effective option. However, the full impact of patellar resurfacing still needs to be critically evaluated by larger randomized controlled trials with long-term follow-up.

Outcomes of Posterior-Stabilized Compared with Cruciate-Retaining Total Knee Arthroplasty.

The aim of this systematic review is to compare clinical outcome scores, rate of complications, and range of motion (ROM) of posterior-stabilized (PS) and cruciate-retaining (CR) total knee arthroplasties (TKAs) both pre- and postoperatively to establish which of the two kinds of implants have the best efficiency. A comprehensive search was performed of studies comparing CR and PS TKAs on PubMed, OVID/Medline, Cochrane, CINAHL, Google scholar, and Embase databases. Finally, 37 studies were selected with a total of 5,407 knees in 4,445 patients. For the PS knees, the Knee Society Functional Score (KSFS) improved from 44.6 to 77.6 (p = 0.04), extension decreased from 6.6 to 1.8 degrees (p-value), and flexion increased from 115.2 to 119.4 degrees (p < 0.00001), compared with the CR knees. No significant difference in the Knee Society objective score (KSOS) (p = 0.82) or complication rates (p = 0.29) was found. The overall complication rate was 3.9%, 213 in 5,407 knees. Surgeons must be careful in interpreting these results, as an improved ROM for the PS group may not correlate to better patient outcomes. This meta-analysis has demonstrated that PS TKA has a statistically significant greater postoperative improvement of KSFS (p = 0.04), flexion (p < 0.00001), and extension (p = 0.02), compared with the CR group. These findings seem to lead the surgeons to prefer the PS design for TKAs especially to achieve a higher postoperative ROM in patients with high functional demands. On the contrary, the CR and PS TKAs have similar results in terms of complications and most of clinical outcomes analyzed in the included studies. Therefore, the long-term follow-up of high-quality randomized controlled trials is needed to clarify which of the two types of prosthesis provide the better clinical outcome and the lower rate of complications for osteoarthritis patients in particular cohorts. This is a systematic review (level II).

All-polyethylene versus metal-backed tibial component in total knee arthroplasty.

PURPOSE: The aim of this systematic review was to evaluate the clinical outcomes, rate of revisions and complications of all-polyethylene tibial and metal-backed tibial components in patients treated with knee arthroplasty for primary or secondary osteoarthritis. METHODS: A systematic review of the literature according to the PRISMA guidelines was performed. A comprehensive search of PubMed, Medline, CINAHL, Cochrane, Embase, and Google Scholar databases using various combinations of the keywords such as "knee", "arthroplasty", "metal-backed", and "all-polyethylene", since inception of databases to 2016, was performed. RESULTS: Thirty-two articles, describing patients with all-polyethylene tibial or metal-backed tibial components in the setting of osteoarthritis, were included. A total of 68,202 knees in 58,942 patients were included, with an average age at surgery of 69.3 years, ranging from a mean age of 57.9-82 years. The mean KSS was 82.4 and 81.3 (n.s.), the mean KSS(F) was 73.6 and 74.9 (p = 0.04), the mean ROM was 104.5 and 104.6 (n.s.), and the mean HSS was 87 and 86, each, respectively, for the metal-backed tibial components group and all-polyethylene tibial components group. The overall rate of revisions was 1.90 %. The rate of revision in the metal-backed tibial components group was 1.85 %, whilst the rate of revision in the all-polyethylene tibial components group was 2.02 % (p < 0.00001). CONCLUSION: Metal-backed tibial and all-polyethylene tibial components did not show any significant difference in most of the included outcome scores, but statistical differences were found in terms of complications and revision rate. These items have a negative impact on the cost-effectiveness of all-polyethylene tibial components. Even if all-polyethylene tibial components show similar clinical outcome score, equivalent range of knee motion, and long-term survival compared to metal-backed tibial components, complications and revision rate seem to lead the surgeon to prefer the last ones. The clinical relevance of this study is that metal-backed tibial components should be preferred in TKA surgery because complications are higher using all-polyethylene tibial components. On the other hand, the quality of evidence, according to GRADE system, is low underling the necessity of more randomised study to clarify these items. LEVEL OF EVIDENCE: III.