Deep learning for MRI lesion segmentation in rectal cancer.

Rectal cancer (RC) is a globally prevalent malignant tumor, presenting significant challenges in its management and treatment. Currently, magnetic resonance imaging (MRI) offers superior soft tissue contrast and radiation-free effects for RC patients, making it the most widely used and effective detection method. In early screening, radiologists rely on patients' medical radiology characteristics and their extensive clinical experience for diagnosis. However, diagnostic accuracy may be hindered by factors such as limited expertise, visual fatigue, and image clarity issues, resulting in misdiagnosis or missed diagnosis. Moreover, the distribution of surrounding organs in RC is extensive with some organs having similar shapes to the tumor but unclear boundaries; these complexities greatly impede doctors' ability to diagnose RC accurately. With recent advancements in artificial intelligence, machine learning techniques like deep learning (DL) have demonstrated immense potential and broad prospects in medical image analysis. The emergence of this approach has significantly enhanced research capabilities in medical image classification, detection, and segmentation fields with particular emphasis on medical image segmentation. This review aims to discuss the developmental process of DL segmentation algorithms along with their application progress in lesion segmentation from MRI images of RC to provide theoretical guidance and support for further advancements in this field.

Performance of hippocampal radiomics models based on T2-FLAIR images in mesial temporal lobe epilepsy with hippocampal sclerosis.

PURPOSE: Preoperative identification of hippocampal sclerosis (HS) is crucial to successful surgery for mesial temporal lobe epilepsy (MTLE). We aimed to investigate the diagnostic performance of hippocampal radiomics models based on T2 fluid-attenuated inversion recovery (FLAIR) images in MTLE with HS. METHODS: We analysed 210 cases, including 172 HS pathology-confirmed cases (100 magnetic resonance imaging [MRI]-positive cases [MRI + HS], 72 MRI-negative HS cases [MRI - HS]), and 38 healthy controls (HC). The hippocampus was delineated slice by slice on an oblique coronal plane by a T2-FLAIR sequence, perpendicular to the hippocampus's long axis, to obtain a three-dimensional region of interest. Radiomics were processed using Artificial Intelligence Kit software; logistic regression radiomics models were constructed. The model evaluation indexes included the area under the curve (AUC), accuracy, sensitivity, and specificity. RESULTS: The respective AUC, accuracy, sensitivity, and specificity were 0.863, 81.4%, 78.0%, and 84.6% between the MRI - HS and HC groups in the training set and 0.855, 75.0%, 68.2%, and 81.8% in the test set; 0.975, 95.0%, 92.9%, and 98.0% between the MRI + HS and HC groups in the training set and 0.954, 88.7%, 90.0%, and 87.0% in the test set; and 0.912, 84.3%, 83.3%, and 86.5% between the MTLE and HC groups in the training set and 0.854, 79.7%, 80.8%, and 77.3% in the test set. The AUC values of the comparative radiomics models were > 0.85, indicating good diagnostic efficiency. CONCLUSION: The hippocampal radiomics models based on T2-FLAIR images can help diagnose MTLE with HS. They can be used as biological markers for MTLE diagnosis.

Corrigendum: Low-frequency repetitive transcranial magnetic stimulation restores dynamic functional connectivity in subcortical stroke.

[This corrects the article DOI: 10.3389/fneur.2021.771034.].

Abnormal metabolic connectivity in default mode network of right temporal lobe epilepsy.

Aims: Temporal lobe epilepsy (TLE) is a common neurological disorder associated with the dysfunction of the default mode network (DMN). Metabolic connectivity measured by 18F-fluorodeoxyglucose Positron Emission Computed Tomography (18F-FDG PET) has been widely used to assess cumulative energy consumption and provide valuable insights into the pathophysiology of TLE. However, the metabolic connectivity mechanism of DMN in TLE is far from fully elucidated. The present study investigated the metabolic connectivity mechanism of DMN in TLE using 18F-FDG PET. Method: Participants included 40 TLE patients and 41 health controls (HC) who were age- and gender-matched. A weighted undirected metabolic network of each group was constructed based on 14 primary volumes of interest (VOIs) in the DMN, in which Pearson's correlation coefficients between each pair-wise of the VOIs were calculated in an inter-subject manner. Graph theoretic analysis was then performed to analyze both global (global efficiency and the characteristic path length) and regional (nodal efficiency and degree centrality) network properties. Results: Metabolic connectivity in DMN showed that regionally networks changed in the TLE group, including bilateral posterior cingulate gyrus, right inferior parietal gyrus, right angular gyrus, and left precuneus. Besides, significantly decreased (P < 0.05, FDR corrected) metabolic connections of DMN in the TLE group were revealed, containing bilateral hippocampus, bilateral posterior cingulate gyrus, bilateral angular gyrus, right medial of superior frontal gyrus, and left inferior parietal gyrus. Conclusion: Taken together, the present study demonstrated the abnormal metabolic connectivity in DMN of TLE, which might provide further insights into the understanding the dysfunction mechanism and promote the treatment for TLE patients.

Lesions causing post-stroke spasticity localize to a common brain network.

Objective: The efficacy of clinical interventions for post-stroke spasticity (PSS) has been consistently unsatisfactory, probably because lesions causing PSS may occur at different locations in the brain, leaving the neuroanatomical substrates of spasticity unclear. Here, we investigated whether heterogeneous lesions causing PSS were localized to a common brain network and then identified the key nodes in this network. Methods: We used 32 cases of PSS and the Human Connectome dataset (n = 1,000), using a lesion network mapping method to identify the brain regions that were associated with each lesion in patients with PSS. Functional connectivity maps of all lesions were overlaid to identify common connectivity. Furthermore, a split-half replication method was used to evaluate reproducibility. Then, the lesion network mapping results were compared with those of patients with post-stroke non-spastic motor dysfunction (n = 29) to assess the specificity. Next, both sensitive and specific regions associated with PSS were identified using conjunction analyses, and the correlation between these regions and PSS was further explored by correlation analysis. Results: The lesions in all patients with PSS were located in different cortical and subcortical locations. However, at least 93% of these lesions (29/32) had functional connectivity with the bilateral putamen and globus pallidus. These connections were highly repeatable and specific, as compared to those in non-spastic patients. In addition, the functional connectivity between lesions and bilateral putamen and globus pallidus in patients with PSS was positively correlated with the degree of spasticity. Conclusion: We identified that lesions causing PSS were localized to a common functional connectivity network defined by connectivity to the bilateral putamen and globus pallidus. This network may best cover the locations of lesions causing PSS. The putamen and globus pallidus may be potential key regions in PSS. Our findings complement previous neuroimaging studies on PSS, contributing to identifying patients with stroke at high risk for spasticity at an early stage, and may point to PSS-specific brain stimulation targets.

Study on the Correlation Between CT Features and Vascular Tumor Thrombus Together With Nerve Invasion in Surgically Resected Lung Adenocarcinoma.

Background: We aimed to analyze the relationship between pulmonary adenocarcinoma patients with vascular tumor thrombus and nerve invasion and different CT features. Methods: The preoperative CT scanning data of 86 patients with lung adenocarcinoma who underwent surgical resection in our hospital from January 2020 to January 2022 were analyzed in the form of retrospective analysis. The CT images of all patients were observed, and the relationship between them and vascular tumor thrombus and nerve invasion of lung adenocarcinoma was analyzed. At the same time, the sensitivity, specificity, and accuracy of enhanced CT and plain CT were compared to evaluate the diagnostic efficacy of both. Results: The results showed that the vascular tumor thrombus of lung adenocarcinoma was mainly related to the solid components and lobulated and calcified tumors in CT images, and the nerve invasion of lung adenocarcinoma was mainly related to the tumors with bronchial inflation sign in CT images (P < 0.05). The sensitivity, specificity, and accuracy of enhanced CT in the diagnosis of vascular tumor thrombus were 78.26%, 96.83%, and 91.86%, respectively, and the sensitivity, specificity, and accuracy in the diagnosis of nerve invasion were 75.00%, 98.72%, and 96.51%, respectively. The sensitivity, specificity, and accuracy of plain CT in the diagnosis of vascular tumor thrombus were 43.48%, 92.06%, and 79.07%, respectively, and the sensitivity, specificity, and accuracy in the diagnosis of nerve invasion were 25.00%, 94.87%, and 88.37%, respectively. The contrast showed that the sensitivity and accuracy of enhanced CT were higher than those of plain CT (P < 0.05), but the difference of specificity was not obvious (P > 0.05). Conclusions: Solid components and lobulated and calcified tumors in CT signs are closely related to vascular tumor thrombus of lung adenocarcinoma, while patients with bronchial inflation sign are related to nerve invasion.

Study on the activity of Huo-Xue-Hua-Yu decoction and its drug groups in improving fracture healing using surface-enhanced Raman scattering (SERS) spectroscopy based on gold nanoparticles.

The Huo-Xue-Hua-Yu decoction (HXHYD) prescription, which possesses good clinical properties for healing fractures, is made up of 12 types of traditional Chinese medicines (TCMs). According to the drug efficacy of TCM, HXHYD consists of four drug-group prescriptions. This study focused on the type of active mechanism in these drug groups and the type of interaction between them in HXHYD. Surface-enhanced Raman scattering (SERS) spectroscopy was employed to study the effect of the incorporation of calcium hydroxyapatite (CHA), protein and lipid groups on the repair of complete tibial fractures in rats treated with HXHYD and its drug-group prescriptions and without treatment to reveal the efficacy rule of the drug groups in the prescription. The rats were divided into seven groups, each of which was subdivided into three subgroups (evaluated on days 15, 21 and 30 after surgery). The six treatment groups were treated HXHYD, four drug-group prescriptions and Gu-Zhe-Cuo-Shang capsule therapy (treated control). SERS readings were taken at the fractured sites. The results showed that the medical ingredients in HXHYD were not the simple addition of four drug-group prescriptions and the efficacy of HXHYD was stronger than every other drug group prescription because it contained the highest content of CHA and highest carbonate-to-phosphate and phosphate-to-phenylalanine ratios among the treatment groups at all time points in comparison with the fractured control group (no treatment). Thus, the SERS technique has great potential to provide a novel method for effectively and accurately studying the efficacy rule of drug groups in one prescription with the aim to optimize prescriptions.

Low-Frequency Repetitive Transcranial Magnetic Stimulation Restores Dynamic Functional Connectivity in Subcortical Stroke.

Background and Purpose: Strokes consistently result in brain network dysfunction. Previous studies have focused on the resting-state characteristics over the study period, while dynamic recombination remains largely unknown. Thus, we explored differences in dynamics between brain networks in patients who experienced subcortical stroke and the effects of low-frequency repetitive transcranial magnetic stimulation (LF-rTMS) on dynamic functional connectivity (dFC). Methods: A total of 41 patients with subcortical stroke were randomly divided into the LF-rTMS (n = 23) and the sham stimulation groups (n = 18). Resting-state functional MRI data were collected before (1 month after stroke) and after (3 months after stroke) treatment; a total of 20 age- and sex-matched healthy controls were also included. An independent component analysis, sliding window approach, and k-means clustering were used to identify different functional networks, estimate dFC matrices, and analyze dFC states before treatment. We further assessed the effect of LF-rTMS on dFCs in patients with subcortical stroke. Results: Compared to healthy controls, patients with stroke spent significantly more time in state I [p = 0.043, effect size (ES) = 0.64] and exhibited shortened stay in state II (p = 0.015, ES = 0.78); the dwell time gradually returned to normal after LF-rTMS treatment (p = 0.015, ES = 0.55). Changes in dwell time before and after LF-rTMS treatment were positively correlated with changes in the Fugl-Meyer Assessment for Upper Extremity (pr = 0.48, p = 0.028). Moreover, patients with stroke had decreased dFCs between the sensorimotor and cognitive control domains, yet connectivity within the cognitive control network increased. These abnormalities were partially improved after LF-rTMS treatment. Conclusion: Abnormal changes were noted in temporal and spatial characteristics of sensorimotor domains and cognitive control domains of patients who experience subcortical stroke; LF-rTMS can promote the partial recovery of dFC. These findings offer new insight into the dynamic neural mechanisms underlying effect of functional recombination and rTMS in subcortical stroke. Registration: http://www.chictr.org.cn/index.aspx, Unique.identifier: ChiCTR1800019452.

Single cell detection using intracellularly-grown-Au-nanoparticle based surface-enhanced Raman scattering spectroscopy for nasopharyngeal cell line classification.

The aim of this study was to evaluate the feasibility of applying intracellularly-grown-Au-nanoparticle (IGAuNP)-based surface-enhanced Raman scattering (SERS) technology to classify two types of nasopharyngeal cancer (NPC) cell lines (CNE2 and CNE1). The IGAuNP technology provides excellent delivery efficiency of Au NPs to the cytoplasm and nucleus, thus leading to an extraordinary enhancement of the Raman signals of cells. Compared with normal Raman scattering (NRS) spectra of cells, IGAuNP-based SERS spectra not only have a high signal-to-noise ratio, but also can detect more characteristic Raman peaks, which can be used to explore more differences when comparing the biochemical components of different nasopharyngeal carcinoma cell lines. Based on the linear discriminant analysis (LDA) and support vector machine (SVM) analysis of SERS spectral data, an exciting result with a diagnostic sensitivity of 100%, specificity of 100%, and accuracy of 100%, could be achieved to differentiate CNE2 and CNE1 cells, which is better than the result obtained by NRS spectroscopy. This exploratory study indicated that the SERS technology based on IGAuNPs in conjunction with multivariate statistical analysis methods has great potential in the identification of nasopharyngeal carcinoma cell lines.

Circular RNA 0007255 regulates the progression of breast cancer through miR-335-5p/SIX2 axis.

BACKGROUND: Breast cancer (BC) is a common cancer in women worldwide. Emerging evidence has indicated that circular RNA hsa-circ_0007255 (circ_0007255) is a prognostic mediator in BC progression. However, the functional role of circ_0007255 needs to be determined. METHODS: The expression of circ_0007255, microRNA (miR)-335-5p, and SIX Homeobox 2 (SIX2) was evaluated using quantitative real-time polymerase chain reaction (qRT-PCR) or western blot assay. Actinomycin D and RNase R treatment was performed to analyze the stability of circ_0007255. Additionally, Seahorse extracellular flux, colony formation and transwell analyses were carried out to detect oxygen consumption ratio (OCR), colony formation and cell mobility, respectively. The interaction between miR-335-5p and circ_0007255 or SIX2 was confirmed via dual-luciferase reporter assay. A xenograft tumor model was established to explore the role of circ_0007255 in vivo. RESULTS: Circ_0007255 and SIX2 were overexpressed, but miR-335-5p was diminished in BC tissues and cells. Circ_0007255 absence inhibited oxygen consumption, colony formation, cell migration and invasion, and these effects were particularly abrogated via miR-335-5p upregulation in BC cells. Moreover, SIX2 deficiency eliminated the promotion effects of miR-335-5p inhibitor on oxygen consumption, colony formation, and cell mobility in BC cells. Importantly, circ_0007255 inhibited tumor growth in vivo. Mechanically, circ_0007255 was a sponge of miR-335-5p to regulate SIX2 expression in BC progression. CONCLUSION: Circ_0007255 functioned as a novel oncogene in the progression of BC by regulating miR-335-5p/SIX2 axis, and might be a promising biomarker for BC treatment. KEY POINTS: Significant findings of the study: Levels of circ_0007255 and SIX2 were upregulated, but miR-335-5p was diminished in BC tissues and cells. Circ_0007255 was an oncogene in BC development and exerted its function via miR-335-5p/SIX2 axis in BC. Tumor growth was reduced by circ_0007255 absence. WHAT THIS STUDY ADDS: Circ_0007255 functioned as a novel oncogene in the progression of BC by regulating miR-335-5p/SIX2 axis, and might be a promising biomarker for BC treatment.

Cognitive decline and white matter changes in mesial temporal lobe epilepsy.

Noninvasive imaging plays a pivotal role in assessing the brain structural and functional changes in presurgical mesial temporal lobe epilepsy (MTLE) patients. Our goal was to study the relationship between the changes of cerebral white matter (WM) and cognitive functions in MTLE patients.Voxel-based morphometry (VBM) and tract-based spatial statistics (TBSS) MRI were performed on 24 right-handed MTLE patients (12 with left MTLE and 12 with right MTLE) and 12 matching healthy controls. Gray matter (GM), WM, and whole brain (WB) volumes were measured with VBM while fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) were measured with TBSS. All patients and controls also underwent Montreal Cognitive Assessment (MoCA) before MRI.WM volume and the ratio of WM volume versus WB volume were significantly lower in MTLE patients compared with controls. WM volume in MTLE patients had a positive correlation with MoCA score (r = 0.71, P < .001) and a negative correlation with the duration of epilepsy (r = -0.693, P < .001). Volumetric differences were mainly located in the corpus callosum, uncinate fasciculus, inferior longitudinal fasciculus, and superior longitudinal fasciculus. FA of both left MTLE and right MTLE groups was significantly decreased, while MD, AD, and RD were significantly increased. Most left MTLE patients showed bilateral WM fiber tract changes versus ipsilateral changes for right MTLE patients.Changes in DTI parameters and WM volume were found in MTLE patients and more ipsilateral changes were seen with right-sided MTLE. Cognitive changes of MTLE patients were found to be correlated with the changes in WM structure. These findings not only provide useful information for lateralization of the seizure focus but can also be used to explain functional connectivity disorders which may be an important physiological basis for cognitive changes in patients with MTLE.

Clinical study on Kangquan Recipe (康泉方) for benign prostatic hyperplasia patients: a randomized controlled trial.

OBJECTIVE: To observe the effectiveness and safety of Kangquan Recipe (康泉方, KQR) for benign prostatic hyperplasia (BPH) patients. METHODS: One hundred and six BPH patients were randomly assigned to the treatment group (53 cases) and the control group (53 cases) according to a random number table. The treatment group was given KQR orally; the control group was given cernilton orally. After 24-week treatment, the clinical effect and safety were evaluated using the International Prostatic Symptom Score (I-PSS), quality of life (QOL), maximum flow rate (Qmax), average flow rate (Qave), residual urine volume (RUV), total prostatic volume (TPV), etc. RESULTS: After treatment, the score of I-PSS was decreased from 16.9±5.6 to 12.5±4.6 in the treatment group, significantly lower compared with the control group; the levels of Qmax and Qave were from 10.9±3.5 to 15.6±4.5 and 5.4±2.1 to 7.3±2.5 (mL/s) in the treatment group, significantly higher compared with the control group; the levels of RUV and TPV were from 70.8±28.2 to 35.2±21.8 and 37.2±16.9 to 30.1±10.8 (mL) in the treatment group, significantly lower compared with the control group (all P<0.05). The incidence rate of adverse reaction was similar between the two groups (P>0.05). CONCLUSION: KQR is effective and safe for the treatment of BPH.

Bronchial and non-bronchial systemic arteries: value of multidetector CT angiography in diagnosis and angiographic embolisation feasibility analysis.

INTRODUCTION: The aim of this study is to evaluate the diagnostic performance of multidetector CT angiography (CTA) in depicting bronchial and non-bronchial systemic arteries in patients with haemoptysis and to assess whether this modality helps determine the feasibility of angiographic embolisation. MATERIALS AND METHODS: Fifty-two patients with haemoptysis between January 2010 and July 2011 underwent both preoperative multidetector CTA and digital subtraction angiography (DSA) imaging. Diagnostic performance of CTA in depicting arteries causing haemoptysis was assessed on a per-patient and a per-artery basis. The feasibility of the endovascular treatment evaluated by CTA was analysed. Sensitivity, specificity, and positive and negative predictive values for those analyses were determined. RESULTS: Fifty patients were included in the artery-presence-number analysis. In the per-patient analysis, neither CTA (P = 0.25) nor DSA (P = 1.00) showed statistical difference in the detection of arteries causing haemoptysis. The sensitivity, specificity, and positive and negative predictive values were 94%, 100%, 100%, and 40%, respectively, for the presence of pathologic arteries evaluated by CTA, and 98%, 100%, 100%, and 67%, respectively, for DSA. On the per-artery basis, CTA correctly identified 97% (107/110). Fifty-two patients were included in the feasibility analysis. The performance of CTA in predicting the feasibility of angiographic embolisation was not statistically different from the treatment performed (P = 1.00). The sensitivity, specificity, and positive and negative predictive values were 96%, 80%, 98% and 67%, respectively, for CTA. CONCLUSIONS: Multidetector CTA is an accurate imaging method in depicting the presence and number of arteries causing haemoptysis. This modality is also useful for determining the feasibility of angiographic embolisation for haemoptysis.

Visual pathway lesion and its development during hyperbaric oxygen treatment: a bold- fMRI and DTI study.

PURPOSE: To characterize and evaluate functional and anatomic changes of visual pathway lesions during hyperbaric oxygen (HBO) treatment with blood-oxygenation-level-dependent functional MRI (BOLD-fMRI) and diffusion tensor imaging (DTI). MATERIALS AND METHODS: Sixteen patients with visual pathway lesions received HBO treatment. Both BOLD-fMRI and DTI were performed before and after the treatment, while 12 healthy subjects were also studied with 2 examinations as control. The t-tests were used for the comparison of number of activated voxels (AVs) and fractional anisotropy (FA) between the two groups, and within the patient group before and after HBO treatment. Visual acuity of the patient group before and after the treatment was compared using Wilcoxon signed-rank test. RESULTS: Before the treatment, both AVs (P < 0.01) and FA (P < 0.05) in the bilateral cortexes of occipital lobes were significantly less in the patient group than in the control group. After the treatment, both AVs (P < 0.05) and FA (P < 0.05) were significantly increased. Moreover, The FA of 6 patients with lesions in the optical nerve was greater than the FA of the other 10 patients with lesions in the optic radiation (P < 0.05). CONCLUSION: BOLD-fMRI combined with DTI was useful for the characterization and evaluation of anatomic and functional changes of visual pathway lesions and their development during HBO treatment.

Evaluating ischemic stroke with diffusion tensor imaging.

INTRODUCTION: In recent years, diffusion tensor imaging (DTI) has emerged as a promising tool to study ischemic stroke. The aim of this study is to evaluate the anisotropic changes of cerebral white matter tracks in patients with ischemic stroke using DTI, and investigate the correlation between corticospinal tract damage and muscle strength in such patients during acute ischemia. METHODS: Nine patients with acute ischemic stroke and nine healthy subjects were examined with T1 weighted magnetic resonance imaging (MRI), T2 weighted MRI and DTI. Fractional anisotropy (FA) was measured and the three-dimensional fibrous band images of bilateral corticospinal tracts were reconstructed. The muscle strength of the affected hand was assessed by Brunnstorm standard. RESULTS: In the control group, there was no significant difference in FA between the bilateral corticospinal tracts, but FA in different white matter structures of the same side was significantly different (t=3.12, p<0.05); while in the patient group, FA of the infarcted sites was significantly lower than the contralateral ones (t=5.570, p<0.01). The ipsilateral corticospinal tract demonstrated continuous interruption and the loss of consistent anatomic structure. The involved severity of corticospinal tract had significant correlation with that of muscle strength of the ipsilateral hand (r=1.30, p<0.01). CONCLUSION: This study shows that DTI can be used to investigate ischemic stroke and assess ischemic stroke-induced damage. The damaged severity of corticospinal tracts is correlated with that of muscle strength.

[Clinical application of 16-slice spiral CT coronary angiography].

OBJECTIVE: To assess the clinical value of multislice spiral CT coronary angiography (MSCTCA). METHODS: Totally 79 patients were examined with MSCTCA and the CT images were reconstructed by several methods to analyze the factors crucial for the image quality, the ability of MSCT displaying the coronary artery vessels, along with the nature and calcification degrees of the plaques. The presence as well as the degree of vascular stenosis, visualization of the bypass graft, implanted stents and patency of the vessels were evaluated. RESULTS: The left main coronary artery and the left anterior descending artery were all best visualized in 75% R-R phases while the right coronary artery and the left circumflex artery in 62.5% R-R phases. CT images obtained by volume rendering showed the best quality at 75% R-R phases. 16-slice spiral CT was able to display from the primary to the tertiary, and even the quaternary branches of the coronary artery, and clearly displayed the coronary plaques, stenosis, implanted stents and bypass grafts. CONCLUSION: MSCTCA has a good clinical value in the primary identification of coronary heart disease and reexamination after revascularization.