New objective simple evaluation methods of amyloid PET/CT using whole-brain histogram and Top20%-Map.

OBJECTIVE: This study aims to assess the utility of newly developed objective methods for the evaluation of intracranial abnormal amyloid deposition using PET/CT histogram without use of cortical ROI analyses. METHODS: Twenty-five healthy volunteers (HV) and 38 patients with diagnosed or suspected dementia who had undergone 18F-FPYBF-2 PET/CT were retrospectively included in this study. Out of them, 11C-PiB PET/CT had been also performed in 13 subjects. In addition to the conventional methods, namely visual judgment and quantitative analyses using composed standardized uptake value ratio (comSUVR), the PET images were also evaluated by the following new parameters: the skewness and the mode-to-mean ratio (MMR) obtained from the histogram of the brain parenchyma; Top20%-map highlights the areas with high tracer accumulation occupying 20% volume of the total brain parenchymal on the individual's CT images. We evaluated the utility of the new methods using histogram compared with the visual assessment and comSUVR. The results of these new methods between 18F-FPYBF-2 and 11C-PiB were also compared in 13 subjects. RESULTS: In visual analysis, 32, 9, and 22 subjects showed negative, border, and positive results, and composed SUVR in each group were 1.11 ± 0.06, 1.20 ± 0.13, and 1.48 ± 0.18 (p < 0.0001), respectively. Visually positive subjects showed significantly low skewness and high MMR (p < 0.0001), and the Top20%-Map showed the presence or absence of abnormal deposits clearly. In comparison between the two tracers, visual evaluation was all consistent, and the ComSUVR, the skewness, the MMR showed significant good correlation. The Top20%-Maps showed similar pattern. CONCLUSIONS: Our new methods using the histogram of the brain parenchymal accumulation are simple and suitable for clinical practice of amyloid PET, and Top20%-Map on the individual's brain CT can be of great help for the visual assessment.

Three-Dimensional Photography for Evaluating the Effectiveness of Botulinum Toxin Injection for Masseter Hypertrophy.

BACKGROUND: Masseter hypertrophy is a common condition that causes a undesirable square face, and often treated with botulinum toxin type A (BoNTA). Subjective assessments of BoNTA effectiveness vary from physician to patient, necessitating an objective approach for evaluation. This study introduces three-dimensional photography (3DP) for the first time in clinical assessment to evaluate BoNTA treatment for masseter hypertrophy. METHODS: Ten patients received 36U of BoNTA at three injection points on each side masseter muscle. 3DP scanner using Artec Eva® was taken at the first, third, and sixth postoperative months for objective evaluation. Patient's self-perceived prominence, patients self-rated satisfaction, and physicians provided 5-grade scores were the subjective indicators. RESULTS: A significant decrease in left masseter volume at the sixth month (P = 0.002, P = 0.004 at rest and clenching, respectively) was observed. Patient's self-perceived prominence decreased at the first (P = 0.021) and third (P = 0.039) months. Physicians' scores significantly decreased at all postoperative months. No significant changes were noted in the right masseter volume and patients self-rated satisfaction. Patient self-rated satisfaction did not consistently correlate with objective measures, except for left masseter with clenching at the sixth month. CONCLUSION: Three-dimensional photography accurately quantifies facial changes post-BoNTA treatment. Despite objective improvements, patient satisfaction may not align consistently. Reliable assessment tools are crucial in cosmetic surgery to manage expectations and prevent disputes. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

G2NPAN: GAN-guided nuance perceptual attention network for multimodal medical fusion image quality assessment.

Multimodal medical fusion images (MMFI) are formed by fusing medical images of two or more modalities with the aim of displaying as much valuable information as possible in a single image. However, due to the different strategies of various fusion algorithms, the quality of the generated fused images is uneven. Thus, an effective blind image quality assessment (BIQA) method is urgently required. The challenge of MMFI quality assessment is to enable the network to perceive the nuances between fused images of different qualities, and the key point for the success of BIQA is the availability of valid reference information. To this end, this work proposes a generative adversarial network (GAN) -guided nuance perceptual attention network (G2NPAN) to implement BIQA for MMFI. Specifically, we achieve the blind evaluation style via the design of a GAN and develop a Unique Feature Warehouse module to learn the effective features of fused images from the pixel level. The redesigned loss function guides the network to perceive the image quality. In the end, the class activation mapping supervised quality assessment network is employed to obtain the MMFI quality score. Extensive experiments and validation have been conducted in a database of medical fusion images, and the proposed method is superior to the state-of-the-art BIQA method.

A Method to Develop the Driver-Adaptive Lane-Keeping Assistance System Based on Real Driver Preferences.

To satisfy the preference of each driver, the development of a Lane-Keeping Assistance (LKA) system that can adapt to individual drivers has become a research hotspot in recent years. However, existing studies have mostly relied on the assumption that the LKA characteristic aligned with the driver's preference is consistent with this driver's naturalistic driving characteristic. Nevertheless, this assumption may not always hold true, causing limitations to the effectiveness of this method. This paper proposes a novel method for a Driver-Adaptive Lane-Keeping Assistance (DALKA) system based on drivers' real preferences. First, metrics are extracted from collected naturalistic driving data using action point theory to describe drivers' naturalistic driving characteristics. Then, the subjective and objective evaluation method is introduced to obtain the real preference of each test driver for the LKA system. Finally, machine learning methods are employed to train a model that relates naturalistic driving characteristics to the drivers' real preferences, and the model-predicted preferences are integrated into the DALKA system. The developed DALKA system is then subjectively evaluated by the drivers. The results show that our DALKA system, developed using this method, can enhance or maintain the subjective evaluations of the LKA system for most drivers.

[Preparation and effectiveness evaluation of placebo of Jiawei Ermiao Granules].

This study explored the preparation process of the placebo of Jiawei Ermiao Granules and evaluated the placebo effect, aiming to provide qualified placebo samples for clinical trials of Jiawei Ermiao Granules and a reference for the preparation and quality evaluation of placebos of traditional Chinese medicine granules. On the basis of the comprehensive analysis results of Jiawei Ermiao Granules, the orthogonal experiment was conducted to optimize the flavoring agents and colorants. After manual evaluation, the placebo formula was determined as dextrin 10 g, Codonopsis Radix extract 5.0 g, bitter melon extract 1.6 g, Mume Fructus extract 0.3 g, stevioside 0.1 g, sucrose octaacetate 0.004 g, indigo 0.004 g, lemon yellow 0.003 1 g, sunset yellow 0.001 8 g, bitter tea powder 0.001 8 g, caramel 0.001 3 g. Pilot trials were conducted on the placebo formula. The simulation effect of placebo was evaluated independently and comparatively, and the objectively evaluated by electronic nose and electronic tongue. The results showed that the independent manual evaluation of the placebo formula had higher error rate, and the placebo and Jiawei Ermiao Granules showed the similarity of 99.61% in the comparative manual evaluation. The smell similarity between the placebo and Jiawei Ermiao Granules was 99.19%, and the electronic tongue test showed little difference in the taste. In conclusion, the placebo prepared in this study shows a high similarity to Jiawei Ermiao Granules, which is not easy to break the blindness when being applied to clinical trials. This study provides a reference for the preparation and quality evaluation and promotes the large-scale production of placebos of traditional Chinese medicine granules, playing a role in improving the persuasiveness and acceptance of the efficacy of traditional Chinese medicines.

Detection of kinematic abnormalities in persons with knee osteoarthritis using markerless motion capture during functional movement screen and daily activities.

Background: The functional movement screen (FMS) has been used to identify deficiencies in neuromuscular capabilities and balance among athletes. However, its effectiveness in detecting movement anomalies within the population afflicted by knee osteoarthritis (KOA), particularly through the application of a family-oriented objective assessment technique, remains unexplored. The objective of this study is to investigate the sensitivity of the FMS and daily activities in identifying kinematic abnormalities in KOA people employing a markerless motion capture system. Methods: A total of 45 persons, presenting various Kellgren-Lawrence grades of KOA, along with 15 healthy controls, completed five tasks of the FMS (deep squat, hurdle step, and in-line lunge) and daily activities (walking and sit-to-stand), which were recorded using the markerless motion capture system. The kinematic waveforms and discrete parameters were subjected to comparative analysis. Results: Notably, the FMS exhibited greater sensitivity compared to daily activities, with knee flexion, trunk sagittal, and trunk frontal angles during in-line lunge emerging as the most responsive indicators. Conclusion: The knee flexion, trunk sagittal, and trunk frontal angles during in-line lunge assessed via the markerless motion capture technique hold promise as potential indicators for the objective assessment of KOA.

Objective Assessment of Sleep Disorders in Patients with Lumbar Spinal Stenosis Using Wearable Trackers.

Introduction: Low-back pain causes sleep disorders, which impairs the quality of life (QOL) of patients. Sleep disorders are associated with lumbar spinal stenosis (LSS); however, the postoperative effects of LSS surgery on sleep disorders are unknown. This study aimed to assess sleep disorders in patients with LSS using wearable activity trackers and determine whether surgery improves sleep quality. Methods: A total of 39 patients scheduled for LSS surgery (mean age 71.1±8.7 years; 22 men and 17 women) were studied. Sleep disorders in the participants were objectively evaluated using a wearable Motionlogger Micro system. Sleep efficiency (SEf), mean active count (MAC), and wake after sleep onset (WASO) were measured before and 6 months following surgery. Furthermore, the patient-based outcomes of pain and QOL-related scores were measured and compared with those of healthy participants. The group with improved SEf following surgery was designated as "nonpoor sleepers," whereas the group that did not exhibit improvements was designated as "poor sleepers." The two groups were compared based on patient factors, patient-based questionnaires, and sleep disorder measurements. Results: The SEf and WASO were significantly worse in patients with LSS compared with healthy participants (P<0.05). Furthermore, the SEf in patients with LSS was associated with the Oswestry Disability Index scores. No improvement was observed in the SEf, MAC, and WASO before and after surgery. Evaluation of each case revealed 21 and 12 cases of nonpoor and poor sleepers, respectively. Preoperative low-back pain was significantly associated with improvement in postoperative sleep quality. Conclusions: Sleep disorders in patients with LSS were evaluated, and improvement in sleep disorders following surgery was associated with the intensity of preoperative low-back pain. Sleep disorders are associated with QOL disorders, suggesting that focusing on the treatment of sleep disorders is important in the management of patients with LSS.

Objective evaluation of nonsurgical treatment of prominent ears: A systematic review.

Background: The prominent ear is a type of congenital ear deformity that can be corrected by a variety of nonsurgical treatments, such as splinting and the taping method. However, there is no objective evaluation method that is universally accepted. The aim of this review is to evaluate objective measurement methods that are used in the available literature to analyze nonsurgical treatment of prominent ears. Methods: A systematic review was performed in the MEDLINE and Embase databases in December 2022 and updated on April 2023 according to Preferred Reporting Items for Systematics and Meta-Analyses (PRISMA) guideline. Any study using objective measurements (continuous variables such as distance and angle) to evaluate the effect of nonsurgical treatment of prominent ears was included. The Joanna Briggs Institute (JBI) critical appraisal for case series was used for quality assessment. Results: A total of 286 studies were screened for eligibility, of which five articles were eligible for inclusion. All of the included studies were case series. The helix mastoid distance (HMD) is the most commonly used parameter to measure treatment outcome. Pinna and cartilage stiffness, length, and width were also used, but without clear statistical relevance. HMD was classified into grading groups (i.e. good, moderate, and poor) to evaluate the treatment's effect. Conclusion: Based on the included studies, objective measurements are rarely used, and when used, they are largely heterogeneous. Although HMD was the most frequent measurement used, all studies used different definitions for the measurement and grouped subsequent outcomes differently. Automated algorithms, based on three-dimensional imaging, could be used for object measurements in the nonsurgical treatment of prominent ears.

Objective quantitative methods to evaluate microtia reconstruction: A scoping review.

Background: Commonly used methods to evaluate auricles are subjective and are therefore not specific, comprehensive, and precise nor effective in the assessment of microtia reconstruction outcomes. This scoping review aimed to summarize the objective methods for the accurate evaluation of microtia reconstruction. Methods: We performed a scoping review of publications that used objective measurement methods to evaluate outcomes of microtia reconstruction according to the PRISMA-ScR guidelines. A systematic literature search was conducted in the Embase, PubMed, Cochrane, CNKI, and VIP databases, and literature references were screened for additional records. Studies that evaluated auricles after microtia reconstruction using quantitative anthropometric methods were included, and data on these methods were collected. Results: Twenty-five publications reported on quantitative objective outcome measurements. Thirteen studies evaluated auricular protrusion, three articles assessed the position or symmetry, and twelve studies reported on auricle size. The quantitative measurements of fine structures, such as the tragus and concha, were described in three studies. All described measurements used manual landmarking, where fifteen studies described well-defined landmarks, fifteen studies described poorly defined landmarks, and four studies used a combination of well and poorly defined landmarks. Conclusion: The objective evaluation of microtia reconstruction outcomes is hindered by significant heterogeneity of measurement methods. The measurement methods used for general auricular measurements (auricular protrusion, auriculocephalic angle, and size) used in microtia reconstruction were abundant, while measurements of auricular position and the fine structures of the auricle were limited. Three-dimensional imaging combined with computer analyses poses promising future alternatives.

[OBJECTIVE EVALUATION OF SUBLINGUAL IMMUNOTHERAPY FOR PEDIATRIC ALLERGIC RHINITIS RESPOND TO SQ HOUSE DUST MITE].

BACKGROUND: Sublingual immunotherapy (SLIT) has become applicable to insurance for children in Japan in 2018. However, as for the efficacy of SLIT for children, objective evaluation methods have not been sufficiently investigated. SUBJECTS AND METHODS: We investigated the efficacy of SLIT as both subjective and objective evaluation in 44 children with allergic rhinitis sensitized to house dust mite who started the treatment in the summer of 2018 in our hospital. The children and their patients wrote the allergy diary every day, and in winter/spring/summer vacations, they answered Japanese allergic rhinitis quality of life standard questionnaire and were evaluated with nasal provocation test, blood test, rhinomanometry for 3 years. RESULTS: 29 (66%) of the 44 children continued SLIT for 3 years. Symptom scores, QOL scores, symptom medication scores halved in a year and the effect lasted in the second and third year. Nasal provocation test and rhinomanometry showed significant improvement. Specific IgE increased transiently and then decreased. Specific IgG4 increased annually. CONCLUSION: The present study showed a decrease in scores not only for subjective assessments but also for objective evaluation methods, the house dust nasal provocation test and the nasal airway resistance.

Subjective Assessment of Objective Image Quality Metrics Range Guaranteeing Visually Lossless Compression.

The usage of media such as images and videos has been extensively increased in recent years. It has become impractical to store images and videos acquired by camera sensors in their raw form due to their huge storage size. Generally, image data is compressed with a compression algorithm and then stored or transmitted to another platform. Thus, image compression helps to reduce the storage size and transmission cost of the images and videos. However, image compression might cause visual artifacts, depending on the compression level. In this regard, performance evaluation of the compression algorithms is an essential task needed to reconstruct images with visually or near-visually lossless quality in case of lossy compression. The performance of the compression algorithms is assessed by both subjective and objective image quality assessment (IQA) methodologies. In this paper, subjective and objective IQA methods are integrated to evaluate the range of the image quality metrics (IQMs) values that guarantee the visually or near-visually lossless compression performed by the JPEG 1 standard (ISO/IEC 10918). A novel "Flicker Test Software" is developed for conducting the proposed subjective and objective evaluation study. In the flicker test, the selected test images are subjectively analyzed by subjects at different compression levels. The IQMs are calculated at the previous compression level, when the images were visually lossless for each subject. The results analysis shows that the objective IQMs with more closely packed values having the least standard deviation that guaranteed the visually lossless compression of the images with JPEG 1 are the feature similarity index measure (FSIM), the multiscale structural similarity index measure (MS-SSIM), and the information content weighted SSIM (IW-SSIM), with average values of 0.9997, 0.9970, and 0.9970 respectively.

Mineral residue accelerant-enhanced anaerobic digestion of cow manure: An evaluation system of comprehensive performance.

Anaerobic digestion (AD) is an efficient technology for treating biowaste and generating biogas. A reasonable evaluation of AD performance is crucial to its development. Herein, a comprehensive evaluation system covering five dimensions (energy output, process stability, degradation efficiency, digestate fertility, and digestate safety) was established to assess AD performance. Each dimension in the evaluation system was assigned a specific indicator defined by a threshold or range. Additionally, the proposed evaluation system was applied to assess a case study of batch-mode mesophilic AD that employed three industrial waste residues as mineral accelerants (nickel­iron slag, steel slag, and fly ash). The mineral accelerants enhanced the energy output (methane yield by 66.55 %-87.54 %) and the feedstock degradation (chemical oxygen demand removal ratio by 11.23 %-32.42 %). The digestates also retained promising safety (heavy metal contents of 190-1260 mg/kg) and fertility (total nutrient contents of 3.71 %-4.69 %). The evaluation system reasonably appraised the comprehensive performance of accelerant-enhanced AD systems with cow manure. This work provides a reliable methodology for evaluating and comparing the performance of different novel accelerants and can be applied to evaluate the comprehensive performance of large-scale biogas projects with cow manure.

No-gold-standard evaluation of quantitative imaging methods in the presence of correlated noise.

Objective evaluation of quantitative imaging (QI) methods with patient data is highly desirable, but is hindered by the lack or unreliability of an available gold standard. To address this issue, techniques that can evaluate QI methods without access to a gold standard are being actively developed. These techniques assume that the true and measured values are linearly related by a slope, bias, and Gaussian-distributed noise term, where the noise between measurements made by different methods is independent of each other. However, this noise arises in the process of measuring the same quantitative value, and thus can be correlated. To address this limitation, we propose a no-gold-standard evaluation (NGSE) technique that models this correlated noise by a multi-variate Gaussian distribution parameterized by a covariance matrix. We derive a maximum-likelihood-based approach to estimate the parameters that describe the relationship between the true and measured values, without any knowledge of the true values. We then use the estimated slopes and diagonal elements of the covariance matrix to compute the noise-to-slope ratio (NSR) to rank the QI methods on the basis of precision. The proposed NGSE technique was evaluated with multiple numerical experiments. Our results showed that the technique reliably estimated the NSR values and yielded accurate rankings of the considered methods for 83% of 160 trials. In particular, the technique correctly identified the most precise method for ∼ 97% of the trials. Overall, this study demonstrates the efficacy of the NGSE technique to accurately rank different QI methods when correlated noise is present, and without access to any knowledge of the ground truth. The results motivate further validation of this technique with realistic simulation studies and patient data.

[Current methods of acoustic analysis of voice: a review].

Acoustic analysis of the voice, as an objective, quantitative, non-invasive and reproducible method for the evaluation of voice quality, can be used to detect and analyze the acoustic characteristics of normal, artistic or pathological voice. With the development of medicine, physics, statistics, and artificial intelligence technology, there are new advances in the study of voice acoustic analysis, especially in terms of acoustic parameters. In addition, artificial neural networks can be used to perform complex multi-parameter analysis, which greatly improves the efficiency of acoustic analysis. This paper provides an overview of the methods of acoustic analysis and its latest development.

[Diagnosis of hypomimia in Parkinson's disease]. / Diagnostika gipomimii pri bolezni Parkinsona.

OBJECTIVE: A clinical approbation of a proprietary method for evaluation of the diagnostic value of computer video analysis of hypomimia in patients with Parkinson's disease (PD). MATERIAL AND METHODS: The study included 31 patients diagnosed with PD and 31 healthy people. The method consists in contactless recognition of 68 reference points on the face that are used to determine the movement of eyebrows, eyelids and the mouth during diagnostic tests: smiling, drawing of the letter "O", winking, eyebrow raising, frowning, and text reading. RESULTS: Comparison of the results obtained with characteristics of healthy subjects has revealed statistically significant difference in the amplitude and speed of eyebrow, eyelid and mouth movement in PD patients. CONCLUSION: The method offers prospects for screening of patients with suspected PD and evaluation of therapy efficacy.

El odontólogo, custodio de la función masticatoria / The dentist, guardian of masticatory function

La masticación tiene como objetivo la adecuada preparación de los alimentos para su deglución y digestión. Cualquier alteración en el sistema estomatognático puede deteriorar la masticación. El odontó- logo es el profesional responsable de mantener y/o restaurar la función masticatoria. La evaluación de la función masticatoria puede hacerse de forma subjetiva utilizando cuestionarios para medir la percepción del paciente sobre su capacidad masticatoria o de forma objetiva analizando la fuerza oclusal, la actividad electromiográfica de los músculos mas- ticadores, la trayectoria de la mandíbula al masticar o la capacidad de trituración de los alimentos. Estos métodos se utilizan en proyectos de investigación, pero en la clínica ¿evaluamos si existe alguna alteración al masticar y al finalizar el tratamiento si cumplimos con el objetivo de restaurar la función masticatoria? ¿Realmente nos preocupamos por mantener y/o restaurar la función masticatoria? Por lo general no, ni en los consultorios, ni en las clínicas universitarias. Es esencial que nos concienticemos de nuestra responsabilidad y para ello es necesario que se le dé mayor peso curricular a la función masticatoria y cómo evaluarla. Seamos realmente custodios de la función masticatoria de nuestros pacientes (AU)

The goal of chewing is to properly prepare food for swallowing and digestion. Any problem in the stomatognathic system can deteriorate chewing. The professional responsible of maintaining and/or restoring masticatory function is the dentist. Masticatory function can be evaluated subjectively through questionnaires to measure the patient's perception of his/her masticatory capacity or objectively analyzing occlusal force, the electromyographic activity of the masticatory muscles, the movements of the mandible during chewing or the individual's capacity to breakdown food. These methods are used in research projects but, do we examine if there is any problem during chewing and if we are achieving our goal of restoring masticatory function at the end of the treatment in our offices? Do we really focus on maintaining and/or restoring masticatory function? Not truly, not in our offices or university clinics. It is imperative that we acknowledge our responsibility but for that it is essential that masticatory function and how to evaluate it is given more weight in the curriculum. Let us be genuine guardians of the masticatory function of our patients (AU)

Corrective derotation osteotomies to treat congenital radioulnar synostosis in children: results of a systematic review and meta-analysis.

Background: The primary objective of this review is to estimate the rotational correction after corrective derotation osteotomies (CDO) for congenital radioulnar synostosis (CRUS). The secondary objective of this review is to identify the complications with CDO in CRUS. Methods: We included studies in the English literature from electronic bibliographic databases Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL, Directory of Open access journals (DOAJ), EMBASE, MEDLINE, ProQuest, PubMed, and Scopus up to December 2020 that determined the effects of CDO in CRUS for two or more cases with a mean follow-up of 1 year or more. We used the National Institutes of health quality assessment tool for case series (interventional) and Modified Coleman methodology Score for assessment of risk of bias in the included studies. Results: We pooled 383 forearms (318 participants) from 23 studies with mean age of 6.28 ± 1.75 years. The mean pronation deformity was 72.83 ± 15.64° from 22 studies. The CDO derotated forearm to 10.4 ± 5.90° of mean pronation in 12 studies and 13.47 ± 9.51° of mean supination in nine studies. One study corrected the forearms to a neutral position. The mean derotation from CDO was 73.13 ± 16.54° (35° supination to 130° pronation). The overall mean difference was - 68.26° [95% CI - 86.87, - 49.66] of correction favoring supination. There were eight transient nerve palsies and six compartment syndromes from synostosis site osteotomies (four studies). Discussion: We had poor-quality studies at a high risk of bias on the described tools of assessment. We could estimate the directional effect of CDO in CRUS favoring correction from pronation to supination; however, due to the heterogeneity among studies, we cannot comment on the most efficient and least harmful CDO techniques. The single bone osteotomies seem to be efficient, simple, and reportedly low on complications but need evaluation. We cannot define the indications for correction and expected improvement in functional outcomes from osteotomy techniques. Supplementary Information: The online version contains supplementary material available at 10.1007/s43465-021-00582-4.

Quantitative assessments of late radiation-induced skin and soft tissue toxicity and correlation with RTOG scales and biological equivalent dose in breast cancer

PurposeRadiation-induced toxicity (RIT) is usually assessed by inspection and palpation. Due to their subjective and unquantitative nature, objective methods are required. This study aimed to determine whether a quantitative tool is able to assess RIT and establish an underlying BED-response relationship in breast cancer.MethodsPatients following seven different breast radiation protocols were recruited to this study for RIT assessment with qualitative and quantitative examination. The biologically equivalent dose (BED) was used to directly compare different radiation regimens. RIT was subjectively evaluated by physicians using the Radiation Therapy Oncology Group (RTOG) late toxicity scores. Simultaneously an objective multiprobe device was also used to quantitatively assess late RIT in terms of erythema, hyperpigmentation, elasticity and skin hydration.ResultsIn 194 patients, in terms of the objective measurements, treated breasts showed higher erythema and hyperpigmentation and lower elasticity and hydration than untreated breasts (p < 0.001, p < 0.001, p < 0.001, p = 0.019, respectively). As the BED increased, Δerythema and Δpigmentation gradually increased as well (p = 0.006 and p = 0.002, respectively). Regarding the clinical assessment, the increase in BED resulted in a higher RTOG toxicity grade (p < 0.001). Quantitative assessments were consistent with RTOG scores. As the RTOG toxicity grade increased, the erythema and pigmentation values increased, and the elasticity index decreased (p < 0.001, p = 0.016, p = 0.005, respectively).ConclusionsThe multiprobe device can be a sensitive and simple tool for research purpose and quantitatively assessing RIT in patients undergoing radiotherapy for breast cancer. Physician-assessed toxicity scores and objective measurements revealed that the BED was positively associated with the severity of RIT.

Quantitative assessments of late radiation-induced skin and soft tissue toxicity and correlation with RTOG scales and biological equivalent dose in breast cancer.

PURPOSE: Radiation-induced toxicity (RIT) is usually assessed by inspection and palpation. Due to their subjective and unquantitative nature, objective methods are required. This study aimed to determine whether a quantitative tool is able to assess RIT and establish an underlying BED-response relationship in breast cancer. METHODS: Patients following seven different breast radiation protocols were recruited to this study for RIT assessment with qualitative and quantitative examination. The biologically equivalent dose (BED) was used to directly compare different radiation regimens. RIT was subjectively evaluated by physicians using the Radiation Therapy Oncology Group (RTOG) late toxicity scores. Simultaneously an objective multiprobe device was also used to quantitatively assess late RIT in terms of erythema, hyperpigmentation, elasticity and skin hydration. RESULTS: In 194 patients, in terms of the objective measurements, treated breasts showed higher erythema and hyperpigmentation and lower elasticity and hydration than untreated breasts (p < 0.001, p < 0.001, p < 0.001, p = 0.019, respectively). As the BED increased, Δerythema and Δpigmentation gradually increased as well (p = 0.006 and p = 0.002, respectively). Regarding the clinical assessment, the increase in BED resulted in a higher RTOG toxicity grade (p < 0.001). Quantitative assessments were consistent with RTOG scores. As the RTOG toxicity grade increased, the erythema and pigmentation values increased, and the elasticity index decreased (p < 0.001, p = 0.016, p = 0.005, respectively). CONCLUSIONS: The multiprobe device can be a sensitive and simple tool for research purpose and quantitatively assessing RIT in patients undergoing radiotherapy for breast cancer. Physician-assessed toxicity scores and objective measurements revealed that the BED was positively associated with the severity of RIT.

Dynamic monitoring of scar changes by B-mode ultrasound / 中华医学美学美容杂志

Objective:To study the application of B-mode ultrasound in objective evaluation and dynamic monitoring of scar.Methods:The subjects were patients with scar in the outpatient and inpatient department of plastic surgery in the First Affiliated Hospital of Zhengzhou University from March 2018 to June 2020. According to the type of scar, they were divided into 3 groups: 21 patients in the normal scar group, 23 patients in the hypertrophic scar group, and 15 patients in the keloid group. All 59 patients were regularly scanned by B-mode ultrasound for scar images and the scar thickness was measured.Results:B-mode ultrasonic images of scars were analyzed in each group: The echo intensity of dermis of normal scar was uneven, hypertrophic scar and keloid dermis showed obvious hypoecho, and some cases of keloid presented a small amount of blood flow. There was no significant change in the ultrasonic images of scar in each group within 1 year. Changes in scar thickness were observed in each group. The normal scar thickness did not change significantly within 1 year. The thickness of hypertrophic scar showed a trend of first increasing and then stabilized within 1 year.Conclusions:B-mode ultrasound can assist to identify different scar types according to ultrasonic performance. B-mode ultrasound can be used to measure scar thickness objectively and accurately and monitor the dynamic changes of scars.