Disrupted Resting-State Functional Connectivity and Effective Connectivity of the Nucleus Accumbens in Chronic Low Back Pain: A Cross-Sectional Study.

Purpose: Chronic low back pain (cLBP) is a recurring and intractable disease that is often accompanied by emotional and cognitive disorders such as depression and anxiety. The nucleus accumbens (NAc) plays an important role in mediating emotional and cognitive processes and analgesia. This study investigated the resting-state functional connectivity (rsFC) and effective connectivity (EC) of NAc and its subregions in cLBP. Methods: Thirty-four cLBP patients and 34 age- and sex-matched healthy controls (HC) underwent resting-state functional magnetic resonance imaging (rs-fMRI). Seed-based rsFC and Dynamic Causal Modelling (DCM) were used to examine the alteration of the rsFC and EC of the NAc. Results: Our results showed that the cLBP group had increased rsFC of the bilateral NAc-left superior frontal cortex (SFC), orbital frontal cortex (OFC), left angular gyrus, the left NAc-bilateral middle temporal gyrus, as well as decreased rsFC of left NAc-left supramarginal gyrus, right precentral gyrus, left cerebellum, brainstem (medulla oblongata), and right insula pathways compared with the HC; the results of the subregions were largely consistent with the whole NAc. In addition, the rsFC of the left NAc-left SFC was negatively correlated with Hamilton's Depression Scale (HAMD) scores (r = -0.402, p = 0.018), and the rsFC of left NAc-OFC was positively correlated with present pain intensity scores (r = 0.406, p = 0.017) in the cLBP group. DCM showed that the cLBP group showed significantly increased EC from the left cerebellum to the right NAc (p = 0.012) as compared with HC. Conclusion: Overall, our findings demonstrate aberrant rsFC and EC between NAc and regions that are associated with emotional regulation and cognitive processing in individuals with cLBP, underscoring the pivotal roles of emotion and cognition in cLBP.

A Novel DNA Aptamer Probe Recognizing Castration Resistant Prostate Cancer in vitro and in vivo Based on Cell-SELEX.

Background: Early recognition of castration-resistant state is of significance for timely adjustment of treatment regimens and improvement of prognosis. Purpose: This study aims to screen new aptamers CRda8 and CRda21 which recognize castration resistant prostate cancer (CRPC) cells with high affinity and specificity by SELEX technology. Methods: The enrichment of specific aptamer candidates was monitored by flow cytometric analysis. The affinity and specificity of aptamer candidates were evaluated by flow cytometry and immunofluorescence assay. MR imaging of CRda21-conjugated polyethylene glycol (PEG)-Fe3O4 nanoparticles to CRPC was further explored in vivo. Results: Both aptamers showed high specificity to target cells with dissociation constants in the nanomolar range, and did not recognize other tested cells. The staining of clinical tissue sections with fluorescent dye labeled aptamers showed that sections from CRPC exhibited stronger fluorescence while sections from benign prostatic hyperplasia and androgen dependent prostate cancer did not exhibit notable fluorescence. In vivo MRI demonstrated that CRda21-conjugated PEG-Fe3O4 had good affinity to CRPC and produced strong T2WI signal intensity reduction distinguished from peritumoral tissue. Conclusion: The high affinity and specificity of CRda8 and CRda21 make the aptamer hold potential for early recognition of castration-resistant state and diagnosis of CRPC at the cellular level.

Synthetic MRI and amide proton transfer-weighted MRI for differentiating between benign and malignant sinonasal lesions.

OBJECTIVES: To explore the value of the synthetic MRI (SyMRI), combined with amide proton transfer-weighted (APTw) MRI for quantitative and morphologic assessment of sinonasal lesions, which could provide relative scale for the quantitative assessment of tissue properties. METHODS: A total of 80 patients (31 malignant and 49 benign) with sinonasal lesions, who underwent the SyMRI and APTw examination, were retrospectively analyzed. Quantitative parameters (T1, T2, proton density (PD)) and APT % were obtained through outlining the region of interest (ROI) and comparing the two groups utilizing independent Student t test or a Wilcoxon test. Receiver operating characteristic curve (ROC), Delong test, and logistic regression analysis were performed to assess the diagnostic efficiency of one-parameter and multiparametric models. RESULTS: SyMRI-derived mean T1, T2, and PD were significantly higher and APT % was relatively lower in benign compared to malignant sinonasal lesions (p < 0.05). The ROC analysis showed that the AUCs of the SyMRI-derived quantitative (T1, T2, PD) values and APT % ranged from 0.677 to 0.781 for differential diagnosis between benign and malignant sinonasal lesions. The T2 values showed the best diagnostic performance among all single parameters for differentiating these two masses. The AUCs of combined SyMRI-derived multiple parameters with APT % (AUC = 0.866) were the highest than that of any single parameter, which was significantly improved (p < 0.05). CONCLUSION: The combination of SyMRI and APTw imaging has the potential to reflect intrinsic tissue characteristics useful for differentiating benign from malignant sinonasal lesions. CLINICAL RELEVANCE STATEMENT: Combining synthetic MRI with amide proton transfer-weighted imaging could function as a quantitative and contrast-free approach, significantly enhancing the differentiation of benign and malignant sinonasal lesions and overcoming the limitations associated with the superficial nature of endoscopic nasal sampling. KEY POINTS: • Synthetic MRI and amide proton transfer-weighted MRI could differentiate benign from malignant sinonasal lesions based on quantitative parameters. • The diagnostic efficiency could be significantly improved through synthetic MRI + amide proton transfer-weighted imaging. • The combination of synthetic MRI and amide proton transfer-weighted MRI is a noninvasive method to evaluate sinonasal lesions.

Quantitative Assessment of Breast Tumor: Comparison of Four Methods of Positioning Region of Interest for Synthetic Relaxometry and Diffusion Measurement.

RATIONALE AND OBJECTIVES: To compare the differences in apparent diffusion coefficient (ADC) and synthetic magnetic resonance (MR) measurements of four region of interest (ROI) placement methods for breast tumor and to investigate their diagnostic performance. METHODS: 110 (70 malignant, 40 benign) newly diagnosed breast tumors were evaluated. The patients underwent 3.0 T MR examinations including diffusion-weighted imaging and synthetic MR. Two radiologists independently measured ADCs, T1 relaxation time (T1), T2 relaxation time (T2), and proton density (PD) using four ROI methods: round, square, freehand, and whole-tumor volume (WTV). The interclass correlation coefficient (ICC) was used to assess their measurement reliability. Diagnostic performance was evaluated using multivariate logistic regression analysis and the receiver operating characteristic (ROC) curves. RESULTS: The mean values of all ROI methods showed good or excellent interobserver reproducibility (0.79-0.99) and showed the best diagnostic performance compared to the minimum and maximum values. The square ROI exhibited superior performance in differentiating between benign from malignant breast lesions, followed by the freehand ROI. T2, PD, and ADC values were significantly lower in malignant breast lesions compared to benign ones for all ROI methods (p < 0.05). Multiparameters of T2 + ADC demonstrated the highest AUC values (0.82-0.95), surpassing the diagnostic efficacy of ADC or T2 alone (p < 0.05). CONCLUSION: ROI placement significantly influences ADC and synthetic MR values measured in breast tumors. Square ROI and mean values showed superior performance in differentiating benign and malignant breast lesions. The multiparameters of T2 + ADC surpassed the diagnostic efficacy of a single parameter.

Ultrafast laser fabrication of efficient polarization-insensitive demultiplexer circuit in YAG crystal.

Wavelength division multiplexing is a widely used monolithic device with modulating light sources at different wavelengths based on a designed configuration. In this paper, we report an in-chip demultiplexer with a simple design operating at 532/1064 nm in pure YAG crystal. The device is fabricated by femtosecond laser direct writing inside the transparent substrate with just a width of 36 µm. The compact structure is designed based on the principle of self-imaging, and the propagation features have been simulated by utilizing the beam propagation method. The performance of this wavelength demultiplexer has been investigated through an end-face coupling system, which proves the device can separate 532 nm and 1064 nm light into two discrete waveguides polarization-insensitively with an extinction ratio as high as 13 dB. These superior performances manifest this exquisite device can emerge into kinds of photonic applications in the future. Also, this work further proves that femtosecond laser direct writing technology has irreplaceable advantages in processing micro-nano devices in transparent materials for in-chip integration.

Study on Enhancing the Thermoelectric Stability of the ß-Cu2Se Phase by Mn Doping.

Cu2Se is a promising thermoelectric (TE) material due to its low cost, Earth abundance, and high thermoelectric properties. However, the biggest problem of Cu2Se is its unstable chemical properties. In particular, under the action of an electric field or gradient temperature field, the chemical potential of copper ions inside the material increases. When the external field is strong enough, the chemical potential of copper ions at the negative end of the material reaches the chemical potential of elemental copper. Under these conditions, copper ions must precipitate out, causing Cu2Se to be unstable, and making it unsuitable for use in applications. In this study, we prepared Cu2-xMnxSe (x = 0, 0.02, 0.04 and 0.06) series bulk materials by vacuum melting-annealing and sintered by spark plasma sintering (SPS). We investigated the effects of Mn doping on the composition, microstructure, band structure, scattering mechanism, thermoelectric properties, and stability of Cu2Se. The results show that Mn doping can adjust the carrier concentration, promote the stabilization of the ß-phase structure and improve the electrical properties of Cu2Se. When x = 0.06, the highest power factor (PF) value of Cu1.94Mn0.06Se at 873 K was 1.62 mW m-1 K-2. The results of carrier scattering mechanism analysis based on the conductivity ratio method show that the sample doped with Mn and pure Cu2Se had the characteristics of ionization impurity scattering, and the scattering factor was 3/2. However, the deterioration in thermal conductivity was large, and a superior zT value needs to be obtained. The cyclic test results of high-temperature thermoelectric properties show that Mn doping can hinder Cu+ migration and improve its thermoelectric stability, which preliminarily verifies the feasibility of using the stable zirconia mechanism to improve the thermoelectric stability of Cu2Se.

High Pressure Drives Microstructure Modification and zT Enhancement in Bismuth Telluride-Based Alloys.

Manipulating and integrating the microstructures at different scales is crucial to tune the electrical and thermal properties of a given compound. High-pressure sintering can modify the multiscale microstructures and thus empower the cutting-edge thermoelectric performance. In this work, the high-pressure sintering technique followed by annealing is adopted to prepare Gd-doped p-type (Bi0.2Sb0.8)2(Te0.97Se0.03)3 alloys. First, the high energy of high-pressure sintering promotes the reduction of grain size, thus increasing the content of 2D grain boundaries. Next, high-pressure sintering induces strong interior strain, where 1D dense dislocations are generated near the strain field. More interestingly, the rare-earth element Gd with a high melting temperature is dissolved into the matrix via high-pressure sintering, thus promoting the formation of 0D extrinsic point defects. This concurrently improves the carrier concentration and density-of-state effective mass, resulting in an enhanced power factor. In addition, the integrated 0D point defects, 1D dislocations, and 2D grain boundaries by high-pressure sintering strengthen phonon scattering, thereby achieving a low lattice thermal conductivity of 0.5 Wm-1 K-1 at 348 K. Consequently, a maximum zT value of ∼1.1 at 348 K is achieved in the 0.4 at % Gd-doped (Bi0.2Sb0.8)2(Te0.97Se0.03)3 sample. This work demonstrates that high-pressure sintering enables microstructure modification to enhance the thermoelectric performance of Bi2Te3-based and other bulk materials.

A tailored 100%-efficient 532/1064-nm demultiplexer in y-cut LiNbO3 crystal.

In this Letter, we report a tailored 532/1064-nm demultiplexer based on a multimode interference (MMI) coupler with an efficiency of 100%. The device structure is designed according to the self-imaging principle, and the propagation and the wavelength division performance are simulated by the beam propagation method. The demultiplexer is fabricated in a y-cut LiNbO3 crystal by femtosecond laser direct writing (FLDW) combined with the ion implantation technique. The end-face coupling system is used to measure the near field intensity distribution, and the spectra collected from the output ports are obtained by spectrometers. The simulated and the experimental results indicate that the customized demultiplexer in the LiNbO3 crystal presents excellent wavelength division performance operating at 532 nm and 1064 nm. This work demonstrates the application potential of FLDW technology for developing miniaturized photonic components and provides a new strategy for fabricating high-efficiency integrated wavelength division devices on an optical monocrystalline platform.

Opportunistic screening for osteoporosis using hydroxyapatite measurements of the vertebral by thorax dual-energy spectral CT in postmenopausal females.

The purpose of this study was to evaluate the feasibility of opportunistic screening for osteoporosis in postmenopausal females using the dual-energy CT(DECT)-derived hydroxyapatite (HAP) concentration and CT value of L1-vertebra. 239 consecutive postmenopausal female patients were enrolled and underwent both chest DECT and Dual energy X-ray absorptiometry (DXA). According to the T-score of the 1st lumbar vertebra on DXA, patients were divided into the osteoporosis group (T [Formula: see text]- 2.5, n = 112) and non-osteoporosis group (T [Formula: see text] - 2.5, n = 127). The HAP values of the 1st lumbar vertebra were measured from the coronal-view HAP(Fat)-based material decomposition(MD) images, and CT values were measured on the 75 keV monochromatic image. The cutoff values of using HAP and CT value for diagnosing osteoporosis were obtained by drawing receiver operating characteristic (ROC) curves. Both HAP and CT value of the 1st lumbar vertebra had moderate-high correlation with bone-mineral-density measurement on DXA (HAP, r = 0.614; CT value, r = 0.625; all p < 0.01). The area-under-the-curve (AUC), sensitivity, specificity, PPV and NPV for diagnosing osteoporosis was 0.754, 0.714, 0.693, 0.68 and 0.752 using HAP (cutoff value: 142.05 mg/cm3) and 0.766, 0.741, 0.7, 0.685 and 0.754 using CT value (cutoff value: 132HU), respectively. HAP measurements on HAP(Fat)-based MD images in DECT could provide reasonably accurate BMD quantification for diagnosing osteoporosis in postmenopausal females. DECT prescribed for lung cancer screening could also provide opportunistic screening for osteoporosis, extending the clinical application of DECT without additional radiation to patients.

Femtosecond Laser Induced Lattice Deformation in KTN Crystal.

In recent years, many novel optical phenomena have been discovered based on perovskite materials, but the practical applications are limited because of the difficulties of device fabrication. Here, we propose a method to directly induce localized lattice modification inside the potassium tantalate niobate crystal by using the femtosecond laser. This selective modification at the processed regions and the surrounding areas is characterized by two-dimensional Raman spectrum mapping. The spectrum variations corresponding to specific lattice vibration modes demonstrate the lattice structure deformation. In this way, the lattice expansion at the femtosecond laser irradiated regions and the lattice compression at the surrounding areas are revealed. Furthermore, surface morphology measurement confirms this lattice expansion and suggests the extension of lattice structure along the space diagonal direction. Moreover, the existence of an amorphization core is revealed. These modifications on the sample lattice can induce localized changes in physicochemical properties; therefore, this method can realize the fabrication of both linear diffraction and nonlinear frequency conversion devices by utilizing the novel optical responses of perovskite materials.

Enabling High Quality Factor and Enhanced Thermoelectric Performance in BiBr3-Doped Sn0.93Mn0.1Te via Band Convergence and Band Sharpening.

Lead-free SnTe-based materials are expected to replace PbTe and have gained much attention from the thermoelectric community. In this work, a maximum ZT of ∼1.31 at 873 K is attained in SnTe via promoting a high quality factor resulting from Mn alloying and BiBr3 doping. The results show that Mn alloying in SnTe converges the L band and the ∑ band in valence bands to supply enhanced valley degeneracy and the density of states effective mass, giving rise to a high power factor of ∼21.67 µW cm-1 K-2 at 723 K in Sn0.93Mn0.1Te. In addition, the subsequent BiBr3 doping can sharpen the top of the valence band to coordinate the contradiction between the band effective mass and the carrier mobility, thus enhancing the carrier mobility while maintaining a relatively large density of states effective mass. Consequently, a maximum power factor of 23.85 µW cm-1 K-2 at 873 K is achieved in Sn0.93Mn0.1Te-0.8 atom % BiBr3. In addition to band sharpening, BiBr3 doping can also effectively suppress the bipolar effect at elevated temperatures and reduce the lattice thermal conductivity by strengthening the point defect phonon scattering. Benefitting from doping BiBr3 in Sn0.93Mn0.1Te optimizes the carrier mobility and suppresses the lattice thermal conductivity, resulting in a dramatically enhanced quality factor. Accordingly, an average ZT of ∼0.62 in the temperature range of 300-873 K is obtained in Sn0.93Mn0.1Te-0.8 atom % BiBr3, ∼250% increase compared with that in Sn1.03Te.

The influence of a deep learning image reconstruction algorithm on the image quality and auto-analysis of pulmonary nodules at ultra-low dose chest CT: a phantom study.

Background: To investigate the effect of a new deep learning image reconstruction (DLIR) algorithm on the detection, characterization and image quality of pulmonary nodules (PNs) in ultra-low dose chest computed tomography (CT) in comparison with the adaptive statistical iterative reconstruction (ASIR-V) algorithm. Methods: Nine artificial pulmonary nodules [six ground glass nodules (GGNs) and three solid nodules (SNs); density: -800 HU, -630 HU, 100 HU; diameter: 12 mm, 10 mm, 8 mm] were randomly placed in a thorax anthropomorphic phantom (Lungman, Kyoto Kagaku Inc.) and scanned on a 256-row CT (Revolution CT, GE Healthcare). Eight scans were performed at 70 kVp with different tube currents (20, 30, 50, 70, 90, 100, 120, 150 mA). Raw data were reconstructed using the filtered back projection (FBP), ASIR-V (30%, 50%, 80%) and DLIR (Low, Medium, High; TrueFidelity™) at 0.625 mm thickness. The effective radiation dose was recorded. All images were automatically analyzed using a commercially available artificial intelligence software (Intelligent 4D Imaging System for Chest CT 5.5, YITU Healthcare) and CT value, standard deviation (SD), long and short diameters of each nodule and SD of air (background) were measured. The detection rate, deformation degree (long diameter/short diameter), signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of pulmonary nodules were calculated. Results: Nodule CT values were the same in all mA settings for all three types of reconstruction algorithms (all P>0.05). DLIR groups had significantly lower SD and higher SNR and CNR values, with better overall image quality than ASIR-V and FBP groups at each mA, ranging from 65-85% reduction in SD, 67-83% increase in SNR with DLIR-H over 50%ASIR-V and 75-91% reduction in SD and 77-89% increase in SNR with DLIR-H over FBP (all P<0.05). At ultra-low dose conditions (30 mA), the DLIR-H images had the highest detection rate of PNs (100%). In addition, the DLIR-M had a minimal negative effect on the characterization of PNs. Conclusions: DLIR algorithm can be a potential reconstruction technique to optimize image quality and improve detection rate of PNs in ultra-low dose lung screening.

Synthetic MRI with quantitative mappings for identifying receptor status, proliferation rate, and molecular subtypes of breast cancer.

OBJECTIVE: To investigate whether quantitative parameters of synthetic magnetic resonance imaging (MRI) can be used to differentiate among receptor status, proliferation rate, and molecular subtypes in patients with breast cancer. MATERIALS AND METHODS: This retrospective study included patients with suspicious breast lesions who underwent breast MR examinations (including synthetic MRI) from May 2019 to Oct 2020. Quantitative parameters of synthetic MRI, including T1, T2, and proton density (PD) in the breast lesions before and after (T1-Gd, T2-Gd, and PD-Gd) contrast agent injection were obtained. The Wilcoxon rank sum was utilized to analyze the differences between the parameters and receptor status, proliferation rate, Luminal A/B, TN, and HER2-enriched. The Spearman's rank correlation test was used to analyze association between parameters among five molecular subtypes. RESULTS: 115 patients who met the inclusion criteria were included. Quantitative T1, T2, PD, and T2-Gd can be used as imaging biomarkers for the different receptor status and proliferation rate of breast cancer. Among them, T2 and T2-Gd were significantly different in the molecular subtypes (P = 0.000 and P = 0.006, respectively) and can further differentiate luminal A/B breast cancers from non-luminal subtypes (P = 0.005 and P = 0.015, respectively). T1 and T2 were significantly different between triple negative (TN) and non-TN breast cancers (P = 0.004 and P = 0.024, respectively). T2 and T2-Gd values were lower for luminal A/B tumors (79.5 ms and 68.00 ms, respectively) and higher for non-luminal tumors (84.00 ms and 75.00 ms, respectively). T1 and T2 values were higher for TN tumors (1.54 × 103ms and 84.00 ms, respectively) and lower for non-TN tumors (1.39 × 103 ms and 80.00 ms, respectively). CONCLUSION: Quantitative parameters derived from synthetic MRI mappings may provide a non-invasive biomarker for discriminating receptor status, proliferation rate, and molecular subtypes in patients with breast cancer.

Unique beam deflection based on dynamic polarized nano-domains in Cu-doped KTN.

In this report, we successfully implement a unique cross-field beam deflector by exploiting the modulation of a one-dimensional refractive index in a copper-doped potassium tantalite niobite crystal. A theoretical model is established based on an electrostrictive effect regulated by the dynamic polarized nano-domains to explicate the mechanism of the abnormal beam deflection which is perpendicular to the applied electric field. Experimental results agree well with our theoretical deduction while validating the interactions between the dynamic polarized nano-domains and the applied electric field. Our findings will break the limitation of conventional electro-optic deflectors, paving the way to develop promising optical functional devices with a large field-of-view scanning angle and ultra-low driving voltage.

Selection of DNA Aptamers Recognizing EpCAM-Positive Prostate Cancer by Cell-SELEX for in vitro and in vivo MR Imaging.

BACKGROUND: The sensitive and specific detection of pathogenic cells is important in tumor diagnosis at an early stage. Aptamers are short single-stranded oligonucleotides evolved from systematic evolution of ligands by exponential enrichment (SELEX). It has been proved that aptamers can interact with cognate target molecules with high affinity and specificity and have great potential in the development of medical imaging at molecular level. PURPOSE: To select epithelial cell adhesion molecule (EpCAM) specific aptamers targeting prostate cancer and further to conjugate aptamers with GoldMag nanoparticles (a typical iron oxide core/gold shell structure) to construct magnetic molecular probes for medical imaging. METHODS: EpCAM-specific aptamers were selected by Cell-SELEX. The enrichment of specific aptamer candidates was monitored by flow cytometric analysis. Aptamers were further conjugated with GoldMag nanoparticles to construct magnetic molecular probes. The affinity and specificity of aptamer candidates and aptamer-conjugated GoldMag nanoparticles were evaluated. The MR imaging of aptamer-conjugated GoldMag nanoparticles to prostate cancer was further explored in vitro and in vivo. RESULTS: After 12 rounds of selection, aptamer candidates Eppc6 and Eppc14 could specifically target three types of prostate cancer cells, revealing a high affinity of Eppc6 and Eppc14. Moreover, aptamer-conjugated GoldMag nanoparticles not only exhibited good affinity to different prostate cancer cells but also produced strong T2WI signal intensity reduction distinguished from peritumoral tissue in MRI, indicating that the molecular probes possess both the affinity properties of EpCAM-specific aptamer and the superparamagnetic features of iron oxide. CONCLUSION: Our study indicates that aptamer Eppc6 and Eppc14 can recognize prostate cancer cells and tissues. The aptamer-conjugated GoldMag nanoparticles constructed in the study can be used as a molecular imaging agent for detection of PCa in MRI.

Investigation of Synthetic Relaxometry and Diffusion Measures in the Differentiation of Benign and Malignant Breast Lesions as Compared to BI-RADS.

BACKGROUND: Breast cancer is the most common malignant tumor in women and a quantitative contrast-free method is highly desirable for its diagnosis. PURPOSE: To investigate the performance of quantitative MRI in differentiating malignant from benign breast lesions and to compare with the Breast Imaging Reporting and Data System (BI-RADS). STUDY TYPE: Retrospective. SUBJECTS: Eighty patients (56 with malignant lesions and 24 with benign lesions). FIELD STRENGTH/SEQUENCE: Diffusion-weighted imaging (DWI) with a single-shot echo planar sequence and synthetic MRI with magnetic resonance image compilation (MAGiC) were performed at 3T. ASSESSMENT: T1 relaxation time (T1 ), T2 relaxation time (T2 ), and proton density (PD) from synthetic MRI and apparent diffusion coefficient (ADC) from DWI were analyzed by two radiologists (Reader A, Reader B). Univariable and multivariable models were developed to optimize differentiation between malignant and benign lesions and their performances compared to BI-RADS. STATISTICAL TESTS: The diagnostic performance was evaluated using multivariate logistic regression analysis and area under the receiver operating characteristic (ROC) curves (AUC). RESULTS: T2 , PD, and ADC values for malignant lesions were significantly lower than those in benign breast lesions for both radiologists (all P < 0.05). The combined T2 , PD, and ADC model had the best performance for differentiating malignant and benign lesions with AUC, sensitivity, specificity, positive predictive value, and negative predictive values of 0.904, 94.6%, 87.5%, 94.6%, and 87.5%, respectively. The corresponding results for BI-RADS were no AUC, 94.6%, 75.0%, 89.8%, and 85.7%, respectively. DATA CONCLUSION: The approach that combined synthetic MRI and DWI outperformed BI-RADS in the differential diagnosis of malignant and benign breast lesions and was achieved without contrast agents. This approach may serve as an alternative and effective strategy for the improvement of breast lesion differentiation. LEVEL OF EVIDENCE: 3. TECHNICAL EFFICACY STAGE: 3.

Mode-controllable waveguide fabricated by laser-induced phase transition in KTN.

We report the fabrication of a hexagonal cladding waveguide by femtosecond laser direct writing (FLDW) in a potassium tantalate niobate (KTN) crystal with a large electric-optical effect. Confocal micro-Raman results show the laser-induced phase transition occurs in the filament areas during the waveguide fabrication. The small filaments can strongly confine the polar nanoregions especially in its ferroelectric state to enhance the waveguide birefringence, enabling excellent polarization maintaining features for both TE and TM-polarized light propagations. The temperature-dependent phase transition allows for an active control of waveguide polarization modes as well as a switchable polarization-maintaining feature.

[Kaiser score for diagnosis of breast lesions presenting as non-mass enhancement on MRI].

OBJECTIVE: To evaluate the diagnostic efficacy of Kaiser score for breast lesions presenting as non-mass enhancement. METHODS: We collected data from patients with breast lesions presenting as non-mass enhancement on preoperative DCE-MRI between January, 2014 and June, 2019. All the cases were confirmed by surgical pathology or puncture biopsy. With pathology results as the gold standard, we evaluated the diagnostic efficacy of Kaiser score and MRI BI-RADS classification and the consistency between the diagnostic results by the two methods and the pathological results. RESULTS: A total of 90 lesions were detected in 88 patients, including 28 benign lesions (31.1%) and 62 malignant lesions (68.9%). For diagnosis of the lesions, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of Kaiser Score were 100%, 75%, 89.9%, 100% and 92%, as compared with 93.5%, 46.4%, 79.5%, 76.5% and 78.9% of MRI BI-RADS, respectively. The diagnostic specificity of Kaiser score was significantly higher than that of BI-RADS classification (P=0.021). CONCLUSIONS: The Kaiser score system provides a diagnostic strategy for BI-RADS classification of breast lesions with non-mass enhancement and has a better diagnostic efficacy than BI-RADS classification alone. The use of Kaiser score can significantly improve the diagnostic specificity of such breast lesions for inexperienced radiologists.

[Chest CT findings and their dynamic changes in patients with COVID-19].

ObjectiveTo define chest CT findings and their dynamic changes in patients with coronavirus disease 2019 (COVID-19) from disease onset to the cure.MethodWe analyzed the clinical and chest CT data of 6 patients with RT-PCR-confirmed COVID-19. According to the time from the disease onset to the cure or from the onset to each CT scan, the total of 30 chest CT scans were divided into 4 stages, namely stage 1 (0-4 days), stage 2 (5-9 days), stage 3 (10-14 days), and stage 4 (over 14 days). A semi-quantitative scoring system was used to quantitatively assess the pulmonary involvement on the basis of the involved area. The differences in chest CT signs and the lung injury scores based on CT findings were compared among the 4 stages.ResultsIn stage 1, ground-glass opacities (GGO) was found frequently in the subpleura, and the CT score was the lowest at 4.00±0.40. Stage 2 was characterized by an increased and mixed density (crazy-paving pattern) with mild consolidation of the lungs, and the CT score reached its peak level of 7.38±3.34 (P < 0.05). In stage 3, an expanded range of consolidation and linear lesions were found in the lungs, and the total CT score averaged 6.86±2.91. In stage 4, a gradual resolution of the consolidation occurred with more linear lesions in the lungs, and the total CT score was 6.21±1.56. The CT scores of the lower lobes were significantly higher compared with those of the middle/upper lobes (P < 0.05) in stage 3 and stage 4.ConclusionChest CT scans allows dynamic monitoring of the changes in the distribution, density and extent of the pulmonary lesions in the 4 stages, which are closely correlated with the evolution of the disease course of COVID-19.

The utility of measuring the apparent diffusion coefficient for peritumoral zone in assessing infiltration depth of endometrial cancer.

BACKGROUND: The invasion depth of endometrial cancer is one of the most important prognosis factors. The aim of the current study was to investigate the diagnostic value of the apparent diffusion coefficient (ADC) of the peritumoral zone for assessing the infiltration depth of endometrial cancer. METHODS: An institutional review board approved this prospective study, and all study participants provided informed consent. A total of 58 patients (mean age 54 ± 8.3 years, range 34-69 years) with endometrial cancer were prospectively enrolled. Two radiologists assessed all preoperative magnetic resonance images with T1, T2, and diffusion-weighted imaging, and determined the location of the deepest invasion of the tumor. The peritumoral zone was defined as a 5-mm-thick zone surrounding and adjacent to the cancerous endometrium. The mean ADC (ADCm) values of the tumor and the peritumoral zone were measured. Sensitivity, specificity, positive and negative predictive values, and the area under the receiver operating characteristic curve (Az) were calculated for visual inspection, and an ADC cutoff value for the peri-endometrial zone was determined for predicting the myometrial invasion depth. RESULTS: The ADCm values of tumors and peritumoral zones were 0.83 × 10- 3 mm2/sec and 1.06 × 10- 3 mm2/sec, respectively. There was no significant difference between the ADCm values of the tumors in the superficial and deep myometrial invasion groups (P > 0.05). However, the ADCm value at the peritumoral zone in the deep myometrial invasion group (1.23 × 10- 3 mm2/sec) significantly differed from that in the superficial myometrial invasion group (0.99 × 10- 3 mm2/sec) (p = 0.005). In assessments of deep myometrial invasion, the sensitivity, specificity, negative predictive value, and positive predictive value were 0.58, 0.93, 0.84, and 0.77, respectively, for the ADCm cutoff value of the peritumoral zone, and 0.71, 0.80, 0.87, and 0.60. respectively, for visual inspection. The accuracy of myometrial invasion depth assessment using the ADCm cutoff value and visual inspection were 83 and 78%, respectively. The Az for both was 0.76. CONCLUSION: ADCm at the peritumoral zone can predict deep myometrial invasion of endometrial cancer. This value can therefore enhance confidence in preoperative endometrial cancer evaluation, and when tailoring surgical approaches.