AtPCa-Net: anatomical-aware prostate cancer detection network on multi-parametric MRI.

Multi-parametric MRI (mpMRI) is widely used for prostate cancer (PCa) diagnosis. Deep learning models show good performance in detecting PCa on mpMRI, but domain-specific PCa-related anatomical information is sometimes overlooked and not fully explored even by state-of-the-art deep learning models, causing potential suboptimal performances in PCa detection. Symmetric-related anatomical information is commonly used when distinguishing PCa lesions from other visually similar but benign prostate tissue. In addition, different combinations of mpMRI findings are used for evaluating the aggressiveness of PCa for abnormal findings allocated in different prostate zones. In this study, we investigate these domain-specific anatomical properties in PCa diagnosis and how we can adopt them into the deep learning framework to improve the model's detection performance. We propose an anatomical-aware PCa detection Network (AtPCa-Net) for PCa detection on mpMRI. Experiments show that the AtPCa-Net can better utilize the anatomical-related information, and the proposed anatomical-aware designs help improve the overall model performance on both PCa detection and patient-level classification.

Med-cDiff: Conditional Medical Image Generation with Diffusion Models.

Conditional image generation plays a vital role in medical image analysis as it is effective in tasks such as super-resolution, denoising, and inpainting, among others. Diffusion models have been shown to perform at a state-of-the-art level in natural image generation, but they have not been thoroughly studied in medical image generation with specific conditions. Moreover, current medical image generation models have their own problems, limiting their usage in various medical image generation tasks. In this paper, we introduce the use of conditional Denoising Diffusion Probabilistic Models (cDDPMs) for medical image generation, which achieve state-of-the-art performance on several medical image generation tasks.

Nano-chromium picolinate and heat stress enhance insulin sensitivity in cross-bred sheep.

This study evaluated the effects of heat stress (HS) and dietary nano chromium picolinate (nCrPic) on metabolic responses of sheep to an intravenous glucose tolerance test (IVGTT), an intravenous insulin tolerance test (ITT) and an intramuscular adrenocorticotropin hormone (ACTH) challenge in sheep. Thirty-six sheep housed in metabolic cages were randomly allocated within 3 dietary groups (0, 400 and 800 µg/kg supplemental nCrPic) to either thermoneutral (22 °C) or cyclic HS (22 to 40 °C) conditions for 3 wk. Basal plasma glucose tended to be increased during HS (P = 0.052) and decreased by dietary nCrPic (P = 0.013) while plasma non-esterified fatty acid concentrations were decreased (P = 0.010) by HS. Dietary nCrPic reduced the plasma glucose area under the curve (P = 0.012) while there were no significant effects of HS on plasma glucose area under the curve in response to the IVGTT. The plasma insulin response over the first 60 min after the IVGTT was decreased by HS (P = 0.013) and dietary nCrPic (P = 0.022) with the effects being additive. In response to the ITT plasma glucose reached a nadir sooner (P = 0.005) in sheep exposed to HS, although there was no effect on the depth of the nadir. Dietary nCrPic decreased (P = 0.007) the plasma glucose nadir after ITT. Over the duration of the ITT plasma insulin concentrations were lower in sheep exposed to HS (P = 0.013) whereas there was no significant effect of supplemental nCrPic. There was no effect of either HS or nCrPic on cortisol response to ACTH. Dietary nCrPic supplementation decreased (P = 0.013) mitogen-activated protein kinase-8 (JNK) and increased (P = 0.050) carnitine palmitoyltransferase 1B (CPT1B) mRNA expression in skeletal muscle. Results of this experiment demonstrated that animals under HS and supplemented with nCrPic had greater insulin sensitivity.

CAT-Net: A Cross-Slice Attention Transformer Model for Prostate Zonal Segmentation in MRI.

Prostate cancer is the second leading cause of cancer death among men in the United States. The diagnosis of prostate MRI often relies on accurate prostate zonal segmentation. However, state-of-the-art automatic segmentation methods often fail to produce well-contained volumetric segmentation of the prostate zones since certain slices of prostate MRI, such as base and apex slices, are harder to segment than other slices. This difficulty can be overcome by leveraging important multi-scale image-based information from adjacent slices, but current methods do not fully learn and exploit such cross-slice information. In this paper, we propose a novel cross-slice attention mechanism, which we use in a Transformer module to systematically learn cross-slice information at multiple scales. The module can be utilized in any existing deep-learning-based segmentation framework with skip connections. Experiments show that our cross-slice attention is able to capture cross-slice information significant for prostate zonal segmentation in order to improve the performance of current state-of-the-art methods. Cross-slice attention improves segmentation accuracy in the peripheral zones, such that segmentation results are consistent across all the prostate slices (apex, mid-gland, and base). The code for the proposed model is available at https://bit.ly/CAT-Net.

What Is Your Diagnosis?

In collaboration with the American College of Veterinary Radiology.

Weakly- and Semisupervised Probabilistic Segmentation and Quantification of Reverberation Artifacts.

Objective and Impact Statement. We propose a weakly- and semisupervised, probabilistic needle-and-reverberation-artifact segmentation algorithm to separate the desired tissue-based pixel values from the superimposed artifacts. Our method models the intensity decay of artifact intensities and is designed to minimize the human labeling error. Introduction. Ultrasound image quality has continually been improving. However, when needles or other metallic objects are operating inside the tissue, the resulting reverberation artifacts can severely corrupt the surrounding image quality. Such effects are challenging for existing computer vision algorithms for medical image analysis. Needle reverberation artifacts can be hard to identify at times and affect various pixel values to different degrees. The boundaries of such artifacts are ambiguous, leading to disagreement among human experts labeling the artifacts. Methods. Our learning-based framework consists of three parts. The first part is a probabilistic segmentation network to generate the soft labels based on the human labels. These soft labels are input into the second part which is the transform function, where the training labels for the third part are generated. The third part outputs the final masks which quantifies the reverberation artifacts. Results. We demonstrate the applicability of the approach and compare it against other segmentation algorithms. Our method is capable of both differentiating between the reverberations from artifact-free patches and modeling the intensity fall-off in the artifacts. Conclusion. Our method matches state-of-the-art artifact segmentation performance and sets a new standard in estimating the per-pixel contributions of artifact vs underlying anatomy, especially in the immediately adjacent regions between reverberation lines. Our algorithm is also able to improve the performance of downstream image analysis algorithms.

How to Report: Wrist MRI.

Knowledge of the imaging anatomy of the wrist is essential for reporting magnetic resonance imaging (MRI). This familiarity should include the carpal bones, tendons (extensor and flexor compartments), triangular fibrocartilage complex (TFCC), intrinsic and extrinsic ligaments, and nerves, especially the median and ulnar nerves. Limitations of MRI in visualizing these structures, particularly the intrinsic ligaments and the TFCC, need to be considered. This article outlines the main features to comment on when reporting common conditions of the wrist on MRI, with some examples of terminology that can be used to describe these abnormalities.

Good and bad boundaries in ultrasound compounding: preserving anatomic boundaries while suppressing artifacts.

PURPOSE: Ultrasound compounding is to combine sonographic information captured from different angles and produce a single image. It is important for multi-view reconstruction, but as of yet there is no consensus on best practices for compounding. Current popular methods inevitably suppress or altogether leave out bright or dark regions that are useful and potentially introduce new artifacts. In this work, we establish a new algorithm to compound the overlapping pixels from different viewpoints in ultrasound. METHODS: Inspired by image fusion algorithms and ultrasound confidence, we uniquely leverage Laplacian and Gaussian pyramids to preserve the maximum boundary contrast without overemphasizing noise, speckles, and other artifacts in the compounded image, while taking the direction of the ultrasound probe into account. Besides, we designed an algorithm that detects the useful boundaries in ultrasound images to further improve the boundary contrast. RESULTS: We evaluate our algorithm by comparing it with previous algorithms both qualitatively and quantitatively, and we show that our approach not only preserves both light and dark details, but also somewhat suppresses noise and artifacts, rather than amplifying them. We also show that our algorithm can improve the performance of downstream tasks like segmentation. CONCLUSION: Our proposed method that is based on confidence, contrast, and both Gaussian and Laplacian pyramids appears to be better at preserving contrast at anatomic boundaries while suppressing artifacts than any of the other approaches we tested. This algorithm may have future utility with downstream tasks such as 3D ultrasound volume reconstruction and segmentation.

Dietary nano chromium picolinate can ameliorate some of the impacts of heat stress in cross-bred sheep.

Two studies were conducted to evaluate the effect of nano chromium picolinate (nCrPic) during heat stress (HS) in sheep. In the initial study, 36 Merino × Poll cross-bred sheep were individually penned and allocated to 3 dietary treatments (0, 400 and 800 µg/kg nCrPic) for 8 wk. Body composition was determined at the beginning and end of the experiment using dual energy X-ray absorptiometry. The sheep remained in their dietary groups but were then placed in metabolic cages and randomly allocated within the dietary group to differing ambient temperature regimes, i.e., thermo-neutral (TN) (n = 18) and HS (n = 18), for 3 wk. Dietary nCrPic had no effect on growth performance and body composition during the initial study conducted under TN conditions. Heat stress decreased average daily feed intake (ADFI) (P = 0.002) whereas sheep under HS had reduced average daily gain (ADG) and indeed lost weight (P < 0.001). Dietary nCrPic increased both ADFI (P = 0.041) and ADG (P = 0.049) under both TH and HS conditions such that the performance of sheep receiving supplemental nCrPic and exposed to HS was similar to that of control sheep maintained under TN conditions. Heat stress increased rectal temperature (P < 0.001) and respiration rate (P < 0.001), particularly during the hottest parts of the day as indicated by interactions (P < 0.001) between time of day and thermal treatment. Rectal temperature was lower in sheep fed nCrPic (P = 0.050), particularly under peak HS conditions during the afternoon as indicated by the interactions between dietary nCrPic and time of day (P < 0.001) and dietary nCrPic, thermal treatment and time of day (P = 0.010). Similarly, respiration rate was lower in sheep fed nCrPic under peak HS conditions during the afternoon as indicated by the interactions between dietary nCrPic and thermal treatment (P < 0.001) and dietary nCrPic and time of day (P = 0.030). In conclusion, dietary nCrPic can partially ameliorate the negative effects of HS as indicated by the maintenance of ADFI and decreased physiological responses, such as elevations in rectal temperature and respiration rate.

Ischaemic colitis: practical challenges and evidence-based recommendations for management.

Ischaemic colitis (IC) is a common condition with rising incidence, and in severe cases a high mortality rate. Its presentation, severity and disease behaviour can vary widely, and there exists significant heterogeneity in treatment strategies and resultant outcomes. In this article we explore practical challenges in the management of IC, and where available make evidence-based recommendations for its management based on a comprehensive review of available literature. An optimal approach to initial management requires early recognition of the diagnosis followed by prompt and appropriate investigation. Ideally, this should involve the input of both gastroenterology and surgery. CT with intravenous contrast is the imaging modality of choice. It can support clinical diagnosis, define the severity and distribution of ischaemia, and has prognostic value. In all but fulminant cases, this should be followed (within 48 hours) by lower gastrointestinal endoscopy to reach the distal-most extent of the disease, providing endoscopic (and histological) confirmation. The mainstay of medical management is conservative/supportive treatment, with bowel rest, fluid resuscitation and antibiotics. Specific laboratory, radiological and endoscopic features are recognised to correlate with more severe disease, higher rates of surgical intervention and ultimately worse outcomes. These factors should be carefully considered when deciding on the need for and timing of surgical intervention.

Nano Chromium Picolinate Improves Gene Expression Associated with Insulin Signaling in Porcine Skeletal Muscle and Adipose Tissue.

The aim of this study was to investigate the interactive effects of dietary nano chromium picolinate (nCrPic) and dietary fat on genes involved in insulin signaling in skeletal muscle and subcutaneous adipose tissue of pigs. Forty-eight gilts were stratified on body weight into four blocks of four pens of three pigs and then within each block each pen was randomly allocated to four treatment groups in a 2 × 2 factorial design. The respective factors were dietary fat (22 or 57 g/kg) and dietary nCrPic (0 or 400 ppb nCrPic) fed for six weeks. Skeletal muscle samples were collected from the Longissimus thoracis and subcutaneous adipose tissue collected from above this muscle. Dietary nCrPic increased adiponectin, uncoupling protein 3 (UCP3) and serine/threonine protein kinase (AKT) mRNA expression, whereas dietary fat decreased adiponectin and increased leptin, tumor necrosis factor-α (TNF-α), peroxisome proliferator-activated receptors γ (PPARγ) and CCAAT/enhancer-binding protein α (C/EBPα) mRNA expression in adipose tissue. In skeletal muscle, dietary nCrPic increased phosphatidylinositol 3 kinase (PI3K), AKT, UCP3 and interleukin-15 (IL-15), as well as decreased suppressor of cytokine signaling 3 (SOCS3) mRNA expression. The improvement in insulin signaling and muscle mass and the reduction in carcass fatness by dietary nCrPic may be via decreased SOCS3 and increased UCP3 and IL-15 in skeletal muscle and increased adiponectin in subcutaneous adipose tissue.

Metabolic excretion associated with nutrient-growth dysregulation promotes the rapid evolution of an overt metabolic defect.

In eukaryotes, conserved mechanisms ensure that cell growth is coordinated with nutrient availability. Overactive growth during nutrient limitation ("nutrient-growth dysregulation") can lead to rapid cell death. Here, we demonstrate that cells can adapt to nutrient-growth dysregulation by evolving major metabolic defects. Specifically, when yeast lysine-auxotrophic mutant lys- encountered lysine limitation, an evolutionarily novel stress, cells suffered nutrient-growth dysregulation. A subpopulation repeatedly evolved to lose the ability to synthesize organosulfurs (lys-orgS-). Organosulfurs, mainly reduced glutathione (GSH) and GSH conjugates, were released by lys- cells during lysine limitation when growth was dysregulated, but not during glucose limitation when growth was regulated. Limiting organosulfurs conferred a frequency-dependent fitness advantage to lys-orgS- by eliciting a proper slow growth program, including autophagy. Thus, nutrient-growth dysregulation is associated with rapid organosulfur release, which enables the selection of organosulfur auxotrophy to better tune cell growth to the metabolic environment. We speculate that evolutionarily novel stresses can trigger atypical release of certain metabolites, setting the stage for the evolution of new ecological interactions.

Dietary lecithin improves feed efficiency without impacting meat quality in immunocastrated male pigs and gilts fed a summer ration containing added fat.

The aim of this study was to investigate the effects of sex and dietary lecithin on growth performance, meat quality, muscle collagen content and gene expression of key genes involved in collagen synthesis in finisher pigs. A total of 256 pigs (Large White × Landrace) were allotted to a 2 × 2 factorial arrangement involving sex (gilt or immunocastrated [IC] male) and dietary treatment (0 or 5 g/kg of dietary lecithin). All diets were formulated to contain 4.6% tallow with relatively high total fat of 6.3%. After 5 weeks of dietary treatment, pigs were slaughtered and Longissimus dorsi muscle was obtained for evaluation of meat quality and collagen content. Rectus abdominis muscle was analysed for gene expression of key genes involved in collagen synthesis namely, type I (α1) procollagen (COL1A1), type III (α1) procollagen (COL3A1), α-subunit of prolyl 4-hydroxylase (P4H), lysyl oxidase and metalloproteinase-1 (MMP-1). The results showed that lecithin improved feed efficiency of all pigs (P < 0.05) but it had no effect on feed intake, average daily gain and dressing percentage (P > 0.05). Lecithin also had no effect on meat compression, shear force, collagen content and gene expression (P > 0.05). Immunocastrated male had higher growth rate and increased COL1A1 expression than gilts. However, sex had no effect on fat depth at the P2 site (65 mm from the midline over the last rib), collagen content and expression of other genes (P > 0.05). In conclusion, lecithin improved feed efficiency in finishing pigs without impacting pork quality. Thus, inclusion of lecithin in diets containing high amount of tallow during the summer period could be beneficial.

Towards fully commercial, UV-compatible fiber patch cords.

We present and analyze two pathways to produce commercial optical-fiber patch cords with stable long-term transmission in the ultraviolet (UV) at powers up to ~ 200 mW, and typical bulk transmission between 66-75 %. Commercial fiber patch cords in the UV are of great interest across a wide variety of scientific applications ranging from biology to metrology, and the lack of availability has yet to be suitably addressed. We provide a guide to producing such solarization-resistant, hydrogen-passivated, polarization-maintaining, connectorized and jacketed optical fibers compatible with demanding scientific and industrial applications. Our presentation describes the fabrication and hydrogen loading procedure in detail and presents a high-pressure vessel design, calculations of required H2 loading times, and information on patch cord handling and the mitigation of bending sensitivities. Transmission at 313 nm is measured over many months for cumulative energy on the fiber output of > 10 kJ with no demonstrable degradation due to UV solarization, in contrast to standard uncured fibers. Polarization sensitivity and stability are characterized yielding polarization extinction ratios between 15 dB and 25 dB at 313 nm, where we find patch cords become linearly polarizing. We observe that particle deposition at the fiber facet induced by high-intensity UV exposure can (reversibly) deteriorate patch cord performance and describe a technique for nitrogen purging of fiber collimators which mitigates this phenomenon.

Dietary Lecithin Decreases Skeletal Muscle COL1A1 and COL3A1 Gene Expression in Finisher Gilts.

The purpose of this study was to investigate the effect of dietary lecithin on skeletal muscle gene expression of collagen precursors and enzymes involved in collagen synthesis and degradation. Finisher gilts with an average start weight of 55.9 ± 2.22 kg were fed diets containing either 0, 4, 20 or 80 g/kg soybean lecithin prior to harvest for six weeks and the rectus abdominis muscle gene expression profile was analyzed by quantitative real-time PCR. Lecithin treatment down-regulated Type I (α1) procollagen (COL1A1) and Type III (α1) procollagen (COL3A1) mRNA expression ( p < 0.05, respectively), indicating a decrease in the precursors for collagen synthesis. The α-subunit of prolyl 4-hydroxylase (P4H) mRNA expression also tended to be down-regulated ( p = 0.056), indicating a decrease in collagen synthesis. Decreased matrix metalloproteinase-1 (MMP-1) mRNA expression may reflect a positive regulatory response to the reduced collagen synthesis in muscle from the pigs fed lecithin ( p = 0.035). Lecithin had no effect on tissue inhibitor metalloproteinase-1 (TIMP-1), matrix metalloproteinase-13 (MMP-13) and lysyl oxidase mRNA expression. In conclusion, lecithin down-regulated COL1A1 and COL3A1 as well as tended to down-regulate α-subunit P4H expression. However, determination of muscle collagen content and solubility are required to support the gene functions.

High accuracy of ultrasound in diagnosing the presence and type of groin hernia.

BACKGROUND: To evaluate the accuracy of ultrasound (US) in diagnosing the the presence and type of groin hernia. METHODS: We retrospectively studied the results of 172 US examinations of the groin in 151 patients (101 men and 50 women; mean age, 59 years) who had undergone US examination for suspected groin hernia. In total, 119 of the groin hernias had been diagnosed on US, and 108 (91%) had required subsequent surgery. All patients who had had positive results for hernia on US and did not undergo surgery (n = 11) and most of the patients whose US results had been negative for hernia (n = 48) underwent limited MRI or CT scanning. We determined the sensitivity, specificity, and accuracy of US in diagnosing the presence and type of groin hernia. To identify any change in the accuracy of US over time at our institution, we compared the sensitivity, specificity, and accuracy of its use from January 2002 through December 2010 (n = 54 groins) with those from January 2011 through December 2012 (n = 118 groins). RESULTS: The overall rates of sensitivity and specificity of US for diagnosing the presence of groin hernia were 96% and 96%. These rates reflect improvements from 92% and 88% prior to 2011 to 98% and 100% beginning in 2011. In addition, the overall accuracy of US for diagnosing the type of groin hernia was 96%. This also improved over time at our center from 91% prior to 2011 to 98% beginning in 2011. CONCLUSIONS: US is highly accurate at diagnosing the presence and type of groin hernia.

Dietary nano-chromium tripicolinate increases feed intake and decreases plasma cortisol in finisher gilts during summer.

Chromium (Cr) is an essential mineral element and has been used in pig diets to improve growth performance, insulin sensitivity, immune response and carcase traits and to reduce heat or other stress responses. The aims of thiss study were to determine the impact of nano-sized chromium tripicolinate (nCrPic) on growth performance, feed efficiency and carcase characteristics of finisher gilts during the summer period. A total of 60 finisher Large White x Landrace gilts were stratified on initial weight and then within strata randomly allocated into two treatment groups in three replicates during mid-summer for 28 days. All pigs were housed in individual pens and had ad libitum access to feed and water. Pigs were fed either a control finisher diet (wheat-based diet containing 13.8 MJ digestible energy (DE) per kilogram and 0.56 g available lysine/MJ DE) or a control diet containing 400 ppb Cr as nCrPic. Dietary nCrPic supplementation increased feed intake by 6 % over the entire study (P = 0.05). In particular, dietary nCrPic increased average daily feed intake (ADFI) by 8 % (P = 0.02) during the final 2 weeks of the study. Moreover, dietary nCrPic tended to improve average daily feed (ADFI) over the entire study (P = 0.09). However, there were no significant effects of nCrPic on feed conversion ratio (FCR), final weight, hot standard carcase weight (HCWT), P2 depth or dressing percentage. Plasma cortisol was decreased by 25 % (P = 0.06) by dietary nCrPic supplementation. However, there were no effects of nCrPic on plasma glucose, insulin and nonesterified fatty acids (NEFA), might because of the higher feed intake. In conclusion, this study demonstrates that dietary nCrPic supplementation at 400 ppb can increase feed intake in finisher gilts during mid-summer, suggesting that nCrPic can ameliorate some of the negative effects of heat stress in pigs, possibly via decreased of circulating cortisol.

Direct measurement of the signal intensity of diffusion-weighted magnetic resonance imaging for preoperative grading and treatment guidance for brain gliomas.

BACKGROUND: Magnetic resonance diffusion-weighted imaging (DWI) has been widely used clinically in imaging diagnosis of intracranial disorders. The purpose of current study was to present a quantitative method of direct measuring the DWI signal intensity of brain gliomas on the monitors of hospital picture archiving and communicating system (PACS) for grading gliomas. METHODS: This study recruited 135 patients with treatment-naïve brain gliomas. Direct measurement of the signal intensity of selected tumoral regions of interest (ROIs) by DWI on the monitors of the hospital PACS was performed for all patients. From the measurements, we obtained three values, defined as DWI(T) (tumor), DWI(N) (the homologous normal-appearing area of the tumor ROI in the contralateral hemisphere), and DWI(WM) (normal-appearing white matter) in the contralateral frontal lobe. Two ratios, DWI(T/WM) and DWI(T/N), were obtained for each tumoral ROI. The same method was used for apparent diffusion coefficient (ADC) ratios of the tumoral ROI. Fractional polynomial regression and the Mann-Whitney U test were applied to determine the correlation between tumor grading, MIB-1 labeling index, and DWI and ADC ratios. Logistic regression models and receiver operating characteristic curve analysis were used to establish diagnostic models. Measurements of intraobserver and interobserver agreement were also made at 1-month interval. RESULTS: The DWI ratios correlated positively with tumor grade and MIB-1 value (p < 0.01). Cut-off ratios of 1.62 for DWI(T/WM) and 1.47 for DWI(T/N) generated the optimal combination of sensitivity (0.82, 0.80), specificity (0.79, 0.86), and sound discriminating power, with an area under the curve of 0.87 and 0.84, respectively, to differentiate low-grade from high-grade gliomas. ADC ratios showed relatively worse sensitivity, specificity, and discriminating power than DWI ratios. Almost all intraobserver and interobserver measurements were within 95% agreement. CONCLUSION: The proposed method - direct measuring of tumor signal intensity of DWI on PACS monitors - is feasible for grading gliomas in clinical neuro-oncology imaging services and has a high level of reliability and reproducibility.

Imaging of the anterior cruciate ligament.

The anterior cruciate ligament (ACL) is an important structure in maintaining the normal biomechanics of the knee and is the most commonly injured knee ligament. However, the oblique course of the ACL within the intercondylar fossa limits the visualization and assessment of the pathology of the ligament. This pictorial essay provides a comprehensive and illustrative review of the anatomy and biomechanics as well as updated information on different modalities of radiological investigation of ACL, particularly magnetic resonance imaging.