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The article presents abstracts on medical studies with topics including bone biopsies in postmenopausal women who discontinued denosumab, the treatment of osteoporotic spinal compression fractures and the association between vitamin D and the risk of colorectal cancer.

Objectives: Few studies have evaluated the handling methods used in the histological diagnosis of Helicobacter pylori. Filter paper has conventionally been used as a receptacle for the biopsy specimen before fixation. The aim of this study was to determine the presence of any effect caused by the use of filter paper. Methods: The study population consisted of 104 consecutive patients undergoing endoscopic examination. Two antral biopsy specimens from the same area were obtained from each patient. One specimen was put onto a piece of filter paper, and the other into a plastic case. The specimens were fixed overnight in buffered formalin, embedded in paraffin, sectioned, and stained with hematoxylin and eosin and Giemsa. A direct smear was also prepared from 77 patients by vigorously rubbing the filter paper on a glass slide and staining it with Giemsa. Results: The detection rate of H. pylori was 47.1% (49 of 104) for the filter paper method, 56.7% (59 of 104) for the plastic case method, and 57.7% (60 of 104) for either of the two methods. Of the 60 positive patients, 11 filter paper specimens were negative, whereas only one plastic case specimen was negative. Statistical analysis revealed a significant difference between the two groups (p < 0.01). On the amount of H. pylori, the filter paper method showed a significantly lower grade than the plastic case method (p < 0.05). In the Giemsa-stained smears. H. pylori was identified in 17 (22.1%) of the 77 patients studied. Conclusions: Use of filter paper may decrease the sensitivity for detection of H. pylori infection. We recommend not using filter paper in the histological diagnosis of H. pylori. [ABSTRACT FROM AUTHOR]

In 2001 the ACPSEM published a position paper on quality assurance in screen film mammography which was subsequently adopted as a basis for the quality assurance programs of both the Royal Australian and New Zealand College of Radiologists (RANZCR) and of BreastScreen Australia. Since then the clinical implementation of digital mammography has been realised and it has become evident that existing screen-film protocols were not appropriate to assure the required image quality needed for reliable diagnosis or to address the new dose implications resulting from digital technology. In addition, the advantages and responsibilities inherent in teleradiology are most critical in mammography and also need to be addressed. The current document is the result of a review of current overseas practice and local experience in these areas. At this time the technology of digital imaging is undergoing significant development and there is still a lack of full international consensus about some of the detailed quality control (QC) tests that should be included in quality assurance (QA) programs. This document describes the current status in digital mammography QA and recommends test procedures that may be suitable in the Australasian environment. For completeness, this document also includes a review of the QA programs required for the various types of digital biopsy units used in mammography. In the future, international harmonisation of digital quality assurance in mammography and changes in the technology may require a review of this document. Version 2.0 represented the first of these updates and key changes related to image quality evaluation, ghost image evaluation and interpretation of signal to noise ratio measurements. In Version 3.0 some significant changes, made in light of further experience gained in testing digital mammography equipment were introduced. In Version 4.0, further changes have been made, most notably digital breast tomosynthesis (DBT) testing and QC have been addressed. Some additional testing for conventional projection imaging has been added in order that sites may have the capability to undertake dose surveys to confirm compliance with diagnostic reference levels (DRLs) that may be established at the National or State level. A key recommendation is that dosimetry calculations are now to be undertaken using the methodology of Dance et al. Some minor changes to existing facility QC tests have been made to ensure the suggested procedures align with those most recently adopted by the Royal Australian and New Zealand College of Radiologists and BreastScreen Australia. Future updates of this document may be provided as deemed necessary in electronic format on the ACPSEM's website ( and see also ). [ABSTRACT FROM AUTHOR]

A review is presented of Management Guide for Incidental Findings on Computed Tomography and Magnetic resonance imaging App by RADIOLOGiQ.

The article presents abstracts of scientific research. They include "MR Spectroscopy and Genomics in Pediatric Brain Tumor Biopsies," "Cerebral Proton Magnetic Resonance Spectroscopy in Children with Diabetic Ketoacidosis" and "Neuroimaging Features of Diffuse Brainstem Gliomas (BSG): A Report of the Pediatric Brain Tumor Consortium (PBTC)."

Biopsy as a procedure is technically simple but conceptually a challenge. The principles of biopsy have remained more or less the same for 3 decades. With the advent of imaging, hospital facilities, and pathology modalities, we feel it is important that these principles are revisited. Uncertainties are spread across the literature regarding this very important first step in the care of an oncology patient. A surgeon planning the biopsy should be equipped with an MRI for planning. A biopsy has to be considered even for a benign-looking lesion. Even though literature is not clear on what kind of biopsy a surgeon should undertake, it is, without doubt, core biopsy has the edge that fine needle biopsies fail to reproduce. Image guidance for a biopsy is paramount for the accuracy of the sample. Pre-biopsy embolization has to be an option in the toolbox of a surgeon. Biopsy samples from an open biopsy or expensive or difficult interventional radiologist-assisted biopsy should undergo a rapid assessment to reduce the error of sample collection and thereby avoid subjecting the patient to a repeat procedure. Even though clean procedures do not require antibiotic prophylaxis, in view of major endoprosthetic implantations in the future, antibiotic use may be justified. An appropriate biopsy set and methodology as per institution experience are described in the paper. [ABSTRACT FROM AUTHOR]

Transperineal ultrasound-guided (TP) prostate biopsy has been shown to significantly decrease the risk of post-procedural sepsis when compared to transrectal ultrasound-guided (TRUS) prostate biopsy. With guidance from the European Urology Association favouring adoption of a TP biopsy route, it is clear that, despite being a more technically challenging procedure, TP biopsy in an outpatient setting will replace TRUS biopsy. This paper gives the reader a succinct summary of outpatient transperineal prostate biopsy under local anaesthetic utilising a free-hand ultrasound technique. Patient preparation and consent process is outlined. A comprehensive pictorial review of the procedure, pitfalls and common post-procedural outcomes is presented. This paper provides a framework and guide for those wishing to adopt the transperineal approach under local anaesthetic. [ABSTRACT FROM AUTHOR]

The role of surgery in the management of primary central nervous system lymphomas (PCNSL) is currently confined to diagnosis. However, over recent years, an increasing number of papers have suggested a possible positive prognostic impact of surgery in selected cases. The present work aims to perform a meta-analysis of the available literature evidence. A meta-analysis with meta-regression on the role of surgical resection compared to biopsy in the management of PCNSL was conducted according to the PRISMA statement, searching MEDLINE via PubMed and Embase. The random effect model was used. The quality of evidence was assessed using the GRADE framework. After screening 1395 records, we included 11 papers in our analysis. Patients who underwent surgical resection harbored superficial and single-lesion tumors. At 1-, 2-, and 5-year follow-up, progression-free survival did not differ between the two groups, while overall survival favored resection, even if in a non-significant fashion. Meta-regression analysis showed that the overall survival rate at 2 years, but not at 1 or 5 years, was significantly influenced by tumor location. There were no differences in terms of age, sex, Karnofsky performance status, adjuvant therapy, or procedure-related complications. Overall, the quality of evidence is low. The results of the present meta-analysis do not change the current standard of care for PCNSL. However, surgery could be non-inferior to biopsy with an acceptable risk profile in selected patients harboring single and superficial lesions. The low quality of evidence prompts future randomized studies. [ABSTRACT FROM AUTHOR]

Background: Cancer-derived material circulating in the bloodstream and other bodily fluids, referred to as liquid biopsies (LBs), has become an appealing adjunct or alternative to tissue biopsies, showing vital promise in several clinical applications. Purpose: A systematic literature review was conducted to (1) summarize the current health economic evidence for LB assays and (2) identify and analyze the studies addressed or reported on the challenges of health economic modeling in precision medicine. Methods: Relevant studies were identified in the EMBASE, MEDLINE, Cochrane Library, EconLit, and the University of Melbourne Full Text Journal databases from 1 January 2013 to 16 September 2022. Included papers were selected if they were economic evaluations and/or budget impact analyses. Results: A total of 24 studies were included and analyzed, with the majority being full economic evaluations (n = 19, 79.2%). Four studies (16.7%) were health and budget impact analyses, and one study (4.1%) incorporated both an economic evaluation and a budget impact analysis. Cohort-level modeling techniques were the most common approach (n = 16; 80%). LB technologies were cost-effective in 15 studies (75%) considering different biomarkers, cancer types and stages, and economic analyses. These studies evaluated LBs for screening and early detection (66.7%), treatment selection (26.7%), and monitoring treatment response (6.6%). Budget impact analysis results were varied among included studies, with the majority of studies (n = 4; 80%) reporting either cost savings, minimal, or modest budget impact, while one study (20%) reported LBs as an efficient strategy. The reviewed studies often inadequately reported or addressed modeling challenges, such as patient-level processes, the combination of tests and treatments, preferences, and uncertainty. Conclusion: LBs could provide a cost-effective approach for treatment selection in lung cancer and aid in the screening and early detection of other cancers, including colorectal, gastric, breast, and brain cancers. This is in comparison with various alternatives, such as the standard of care (SOC) and no screening scenario. However, it is important to mention that in some comparisons, LBs were used in combination with SOC instead of replacing it. Importantly, few studies have pointed toward LBs' cost-effectiveness for monitoring treatment response. Most health and budget impact analyses, especially those focused on lung cancer, suggest potential cost savings or a minimal-to-moderate budget impact. Nevertheless, additional research is needed to ascertain their effectiveness across various stages of lung and colorectal cancer, as well as to address potential modeling challenges. Systematic review registration: PROSPERO CRD42022307939. [ABSTRACT FROM AUTHOR]

Diagnosis of prostate cancer (PC) has posed a challenge worldwide due to the sophisticated and costly diagnostics tools, which include DRE, TRUS, GSU, PET/CT scan, MRI, and biopsy. These diagnostic techniques are very helpful in the detection of PCs; however, all the techniques have their serious limitations. Biosensors are easier to fabricate and do not require any cutting-edge technology as required for other imaging techniques. In this regard, point-of-care (POC) biosensors are important due to their portability, convenience, low cost, and fast procedure. This review explains the various existing diagnostic tools for the detection of PCs and the limitation of these methods. It also focuses on the recent studies on biosensors technologies as an alternative to the conventional diagnostic techniques for the detection of PCs. [ABSTRACT FROM AUTHOR]

Liquid biopsy of cancers, detecting tumor-related information from liquid samples, has attracted wide attentions as an emerging technology. Our previously reported large-area PERFECT (Precise-Efficient-Robust-Flexible-Easy-Controllable-Thin) filter has demonstrated competitive sensitivity in recovering rare tumor cells from clinical samples. However, it is time-consuming and easily biased to manually inspect rare target cells among numerous background cells distributed in a large area (Φ ≥ 13 mm). This puts forward an urgent demand for rapid and bias-free inspection. Hereby, this paper implemented deep learning-based object detection for the inspection of rare tumor cells from large-field images of PERFECT filters with hematoxylin-eosin (HE)-stained cells recovered from bronchoalveolar lavage fluid (BALF). CenterNet, EfficientDet, and YOLOv5 were trained and validated with 240 and 60 image blocks containing tumor and/or background cells, respectively. YOLOv5 was selected as the basic network given the highest mAP@0.5 of 92.1%, compared to those of CenterNet and EfficientDet at 85.2% and 91.6%, respectively. Then, tricks including CIoU loss, image flip, mosaic, HSV augmentation and TTA were applied to enhance the performance of the YOLOv5 network, improving mAP@0.5 to 96.2%. This enhanced YOLOv5 network-based object detection, named as BALFilter Reader, was tested and cross-validated on 24 clinical cases. The overall diagnosis performance (~2 min) with sensitivity@66.7% ± 16.7%, specificity@100.0% ± 0.0% and accuracy@75.0% ± 12.5% was superior to that from two experienced pathologists (10–30 min) with sensitivity@61.1%, specificity@16.7% and accuracy@50.0%, with the histopathological result as the gold standard. The AUC of the BALFilter Reader is 0.84 ± 0.08. Moreover, a customized Web was developed for a user-friendly interface and the promotion of wide applications. The current results revealed that the developed BALFilter Reader is a rapid, bias-free and easily accessible AI-enabled tool to promote the transplantation of the BALFilter technique. This work can easily expand to other cytopathological diagnoses and improve the application value of micro/nanotechnology-based liquid biopsy in the era of intelligent pathology. [ABSTRACT FROM AUTHOR]

Purpose: To assess the impact of implementing the recommendations included in the 2014 American Urological Association (AUA) white paper on complications of transrectal prostate needle biopsy (PNB). Methods: In the outpatient setting of a single tertiary-care institution, prophylactic antibiotic use and rate of infectious complications were compared before and after implementation by nursing of a standardized algorithm to select antibiotic prophylaxis (derived from the recommendations of the AUA white paper). The 584 patients in cohort A (January 2011–January 2012) received antimicrobial prophylaxis at the discretion of the treating physician; 654 patients in cohort B (January 2014–January 2015) received standardized risk-adapted antibiotic prophylaxis. Data on antibiotics administered and infectious complications were analyzed. Results: Fluoroquinolone was the most common prophylactic regimen in both cohorts. In cohort A, 73% of men received a single-drug regimen, although 19 different regimens were utilized with duration of 72 h. In cohort B, 97% received 1 of 4 standardized single-drug antibiotic regimens for duration of 24 h. Infectious complications occurred in 19 men (3.3%) in cohort A, and in 18 men (2.8%) in cohort B (difference − 0.5%; one-sided 95% CI 1.1%). No clinically relevant increase in infectious complication rates was found after implementing this quality improvement initiative. Conclusions: Use of a standardized risk-adapted approach to select antibiotic prophylaxis for PNB by nursing staff reduced the duration of antimicrobial prophylaxis and number of antibiotic regimens used, without increasing the rate of infectious complications. Our findings validate the current AUA recommendations for antibiotic prophylaxis. [ABSTRACT FROM AUTHOR]

IgA nephropathy (IgAN) is the most common glomerulonephritis worldwide. It is diagnosed based on clinical and histological features including predominant IgA deposits in kidney biopsy. The multi-hit theory, based on the production of GDIgA1 and anti-GDIgA1 antibodies, and complement activation via alternative and lectin pathways and also a genetic tendency are crucial in the pathogenesis of IgAN. The aim of the present review is to summarize the utility of routine diagnostic tests in IgA nephropathy, such as IgA and C3 in serum and kidney biopsy specimens, for predicting the disease progression. The paper also contains data on new markers used in the diagnosis and prognosis of IgA nephropathy. [ABSTRACT FROM AUTHOR]

Dermoscopy and reflectance confocal microscopy (RCM) are two noninvasive, optical imaging tools used to facilitate clinical diagnosis. A biopsy technique that produces exact correlation with optical imaging features is not previously reported. To evaluate the applications of a novel feature-focused 'precision biopsy' technique that correlates clinical–dermoscopy–RCM findings with histopathology. This was a prospective case-series performed during August 2017 and June 2019 at a tertiary care cancer. We included consecutive patients requiring a precise dermoscopy–RCM–histopathologic correlation. We performed prebiopsy dermoscopy and both wide probe and handheld RCM of suspicious lesions. Features of interest were isolated with the aid of paper rings and a 2 mm punch biopsy was performed in the dermoscopy- or RCM-highlighted area. Tissue was processed either en face or with vertical sections. One-to-one correlation with histopathology was obtained. Twenty-three patients with 24 lesions were included in the study. The mean age was 64.6 years (range 22–91 years); there were 16 (69.6%) males, 14 (58.3%) lesions biopsied were on head and neck region. We achieved tissue-conservation diagnosis in 100% (24/24), 13 (54.2%) were clinically equivocal lesions, six (25%) were selected for 'feature correlation' of structures on dermoscopy or RCM, and five (20.8%) for 'correlation of new/unknown' RCM features seen on follow-up. The precision biopsy technique described herein is a novel method that facilitates direct histopathological correlation of dermoscopy and RCM features. With the aids of optical imaging devices, accurate diagnosis may be achieved by minimally invasive tissue extraction. [ABSTRACT FROM AUTHOR]

Objective: This large, retrospective, multicenter study examines the Mayo Clinic experience with temporal artery biopsies over an 11-year period to help form guidelines that would lead to optimal performance of the technique. Methods: Pathology records were identified from all patients at all three Mayo Clinic sites (Rochester, MN; Jacksonville, FL; and Scottsdale, AZ) who underwent temporal artery surgery over an 11-year period, from January 1, 1994, to December 31, 2004. From each report, we extracted demographic information, the length of the temporal artery removed in the biopsy from each side, and the pathologic findings in each specimen. We used logistic regression to assess whether biopsy positivity may be associated with the following factors: biopsy length, age, sex, type (unilateral vs. bilateral), and year of study. Results: Our data set included 3817 temporal artery biopsies performed on 2539 patients at Mayo Clinic. Overall, 681 patients (27%) had a positive biopsy on at least one side. Biopsy length was uniformly noted to have no significant effect on biopsy positivity. Of the 603 patients with a bilateral biopsy, 43 (7%) had a negative initial biopsy followed by a positive result on the contralateral side. Conclusion: Our results support that one can recommend any length of biopsy, within the range our study, without affecting the rate of positivity. Furthermore, we conclude that if a unilateral biopsy is negative on frozen section, then we recommend a second biopsy on the contralateral side to avoid possible missed diagnoses. Key Points • Our paper is a large retrospective study over all 3 Mayo Clinic campuses investigating the association between temporal artery biopsy length and the positivity rate of biopsies. • We also determined the value of performing bilateral biopsies in which the first biopsy was negative on frozen section. • We believe the strength of our study is having one of the largest sample sizes of biopsies in the literature to date including 3817 biopsies. • The sum of our research supports that we found biopsy positivity is not a function of length and, second, bilateral biopsies diagnose up to 7% of disease not otherwise picked up by unilateral approaches. [ABSTRACT FROM AUTHOR]

The number of melanoma diagnoses has increased dramatically over the past three decades, outpacing almost all other cancers. Nearly 1 in 4 skin biopsies is of melanocytic lesions, highlighting the clinical and public health importance of correct diagnosis. Deep learning image analysis methods may improve and complement current diagnostic and prognostic capabilities. The histologic evaluation of melanocytic lesions, including melanoma and its precursors, involves determining whether the melanocytic population involves the epidermis, dermis, or both. Semantic segmentation of clinically important structures in skin biopsies is a crucial step towards an accurate diagnosis. While training a segmentation model requires ground-truth labels, annotation of large images is a labor-intensive task. This issue becomes especially pronounced in a medical image dataset in which expert annotation is the gold standard. In this paper, we propose a two-stage segmentation pipeline using coarse and sparse annotations on a small region of the whole slide image as the training set. Segmentation results on whole slide images show promising performance for the proposed pipeline. [ABSTRACT FROM AUTHOR]

Background: Multiparametric MRI (mpMRI) became recognised in investigating those with suspected prostate cancer between 2010 and 2012; in the USA, the preventative task force moratorium on PSA screening was a strong catalyst. In a few short years, it has been adopted into daily urological and oncological practice. The pace of clinical uptake, born along by countless papers proclaiming high accuracy in detecting clinically significant prostate cancer, has sparked much debate about the timing of mpMRI within the traditional biopsy-driven clinical pathways. There are strongly held opposing views on using mpMRI as a triage test regarding the need for biopsy and/or guiding the biopsy pattern.Objective: To review the evidence base and present a position paper on the role of mpMRI in the diagnosis and management of prostate cancer.Methods: A subgroup of experts from the ESUR Prostate MRI Working Group conducted literature review and face to face and electronic exchanges to draw up a position statement.Results: This paper considers diagnostic strategies for clinically significant prostate cancer; current national and international guidance; the impact of pre-biopsy mpMRI in detection of clinically significant and clinically insignificant neoplasms; the impact of pre-biopsy mpMRI on biopsy strategies and targeting; the notion of mpMRI within a wider risk evaluation on a patient by patient basis; the problems that beset mpMRI including inter-observer variability.Conclusions: The paper concludes with a set of suggestions for using mpMRI to influence who to biopsy and who not to biopsy at diagnosis.Key Points: • Adopt mpMRI as the first, and primary, investigation in the workup of men with suspected prostate cancer. • PI-RADS assessment categories 1 and 2 have a high negative predictive value in excluding significant disease, and systematic biopsy may be postponed, especially in men with low-risk of disease following additional risk stratification. • PI-RADS assessment category lesions 4 and 5 should be targeted; PI-RADS assessment category lesion 3 may be biopsied as a target, as part of systematic biopsies or may be observed depending on risk stratification. [ABSTRACT FROM AUTHOR]

Purpose: Non-occlusive mesenteric ischemia (NOMI) is a misdiagnosed and dangerous condition. To our knowledge, a comprehensive evaluation of CT parameters that can predict the outcome of patients suffering from NOMI is still missing. Materials and methods: Contrast-enhanced CT examination of 84 patients with a confirmed diagnosis of NOMI (37 with clinical and laboratory confirmation and 47 biopsy or surgery proven) was retrospectively reviewed by assessing vessels, mesentery, bowel, and peritoneal cavity CT quantitative and dichotomous parameters, and data were analyzed with Fisher's test. Diameter of superior mesenteric artery (SMA), celiac trunk (CT), inferior vena cava (IVC), superior mesenteric vein (SMV), and differences in CT HU (Delta HU) of the bowel wall before and after intravenous contrast media (ICM) administration were correlated to the patients' outcome using ANOVA test. Receiver operating characteristic (ROC) curves were elaborated after a binary logistic regression was performed. Results: Increased number and diameter of vessels, bowel wall thickening, and hypervascularity were more frequent in patients with good prognosis. Conversely, pale mesentery, paper thin, hypovascularity, and aeroportia were more frequent in patients with bad prognosis. A significant correlation between diameters of SMA, CT, IVC, IMA, and SMV and outcome was found at univariate analysis. Also Delta HU resulted to be correlated with the outcome. At multivariate analysis only IVC and Delta HU were significant (p = 0.038 and 0.01) and the combined AUC resulted in 0.806 (CI 0.708–0.903). Conclusion: Dichotomous signs of reperfusion and quantitative CT parameters can predict the outcome of patients with NOMI. In particular the combination of IVC diameter and Delta HU of bowel wall allows to predict the prognosis with the highest accuracy. [ABSTRACT FROM AUTHOR]

The second leading cause of death from cancer among women is breast cancer. In order to prevent avoidable deaths, early detection is extremely necessary. Malignancy evaluation of tissue biopsies, however, is complicated and based on observer subjectivity. In addition, histological images stained with hematoxylin and eosin (H&E) exhibit a highly variable appearance, also at the same degree of malignancy. In this paper, we propose a classification model based on KNN with the combination of deep and handcrafted features using histological images to diagnose breast cancer. Here, four malignancy levels are considered, namely normal, benign, in situ, and invasive. The classification of four malignancy levels is examined by three classifiers with three sets of deep features and three handcrafted features. The deep features are extracted from the fc6 layer of three pre-trained networks: alexnet, vgg16, and vgg19. The handcrafted features are GLCM, HOG, and LBP. After evaluation, the top-performed classifier, deep feature, and handcrafted features are considered to frame the classification model. The classification model based on fine- KNN with combining the feature of vgg16 and LBP achieved satisfactory diagnostic effectiveness (accuracy) of 84.2% and area under the curve (AUC) of 0.85. Further, the likelihood ratio for positive results (LR+) is greater than 10, i.e., 12.5, which implicates the proposed method has a significant contribution to the diagnosis and a good diagnostic test. [ABSTRACT FROM AUTHOR]

Present problem of every country nowadays is not to defeat other countries in a war and protect its citizens, rather to defeat the deadly diseases in their own country, which are paralyzing the strength of the countries by their adverse effects. One of the major threatening diseases among them is cancer. According to latest reports given by WHO, nearly 2.3 million women were diagnosed by breast cancer in year 2020 which resulted in 685,000 deaths worldwide and this graph was highly ascended till the end of 2020 which reported 7.8 million women (alive) tested positive with breast cancer in the past 5 years which made the Breast cancer as the most prevalent cancer among all other cancers. Cancer is the result of changes in genes known as mutations, which are responsible for the growth of cells. Breast cancer cells typically form a tumor that can be diagnosed by either of these i.e., mammography, ultrasound, MRI, biopsy or by all which are dreadful and expensive procedures. Many expert systems are designed to help the oncologists in diagnosing the disease so as to save their time and efficiency, which can be utilized in treating the patients after diagnosis and gifting them back the crown of their life from which they were almost deprived off. Still there are some problems due to which these expert systems are not fully utilized for which they are meant. First problem is that these expert systems are limited to cities because of which villagers are deprived of this facility. As we know, even after 75 years of independence, women of village area are not given importance and so is their health. Second and most prevalent problem seen is the complicated and dreadful diagnosis procedure, which threatens women the most. To solve first problem, we have taken the decision to implement this system in villages after increasing its accuracy more, which will be convenient and easy for villagers. For making diagnosis phase comfortable for women, this research has opted the way which will not frighten the women, that is just to have a blood analysis by giving blood sample which can be easily undertaken without any panic, adding up a feather of novelty to our research. This work is surely going to help the oncologist, as the work has been done under the guidance of oncologist and rules of fuzzy logic are designed as per the information shared by oncologist. This paper intends to talk about the expert system that diagnosis the breast cancer using the values of nine parameters taken from Coimbra breast cancer dataset of UCI machine learning repository such as age, BMI, glucose, insulin, Homa-IR, leptin, adiponectin, Mcp-1 and resistin and gives the output as benign or malignant. This expert system is based on fuzzy logic rules which use mamdani interface system having fuzzifier for fuzzyfying the data values of parameters received from simple blood analysis, memory is used to store rules which predict the output and defuzzifier gives the output as benign or malignant with promising accuracy, sensitivity and specificity as 90.3%, 87.3% and 95% respectively. To our knowledge till now no such expert system is designed with all these attributes giving such high accuracy. It is easy to go process of diagnosing the disease with promising accuracy which will attract the women with symptoms to get it diagnosed at early stages thus help in reducing the mortality rates to a large fag end. [ABSTRACT FROM AUTHOR]

The brain is a delicate organ in the human body that requires extreme care. Brain-related diseases are unavoidable. Perse, neurosurgery is a complicated procedure that demands high precision and accuracy. Developing a surgical robot is a complex task. To date, there are only a handful of neurosurgery robots in the market that distinctly undergo clinical procedures. These robots have exorbitant cost that hinders the utmost care progress in the area as they are unaffordable. This paper looked at the historical perspective and presented insight literature of the magnetic resonance conditional stereotactic neurosurgery robots that find their ways in clinics, abandoning research projects and promising research yet to undergo clinical use. In addition, the study also gives a thorough insight into the advantage of magnetic resonance imaging modalities and magnetic resonance conditional robots and the future challenges in automation use. Image compatibility test data and accuracy results are also examined because they guarantee that these systems work correctly in particular imaging settings. The primary differences between these systems include actuation and control technologies, construction materials, and the degree of freedom. Thus, one system has an advantage over the other. [ABSTRACT FROM AUTHOR]

The rate of early misdiagnosis in patients with nodular fasciitis of the ear is high. To provide a basis for clinical diagnosis and treatment, we aimed to summarise the clinical manifestations, imaging results, pathological findings, treatment strategies, and postoperative follow-up results for three cases of paediatric nodular fasciitis (two girls, one boy) treated in the Department of Otorhinolaryngology, Head and Neck Surgery, at Beijing Children's Hospital of Capital Medical University from 2018 to 2020. The average age at diagnosis was 24 months. Lesions occurred in the left ear in two cases and right ear in one case. All patients had a history of biopsy before surgery. Rapid growth was observed following biopsy in two patients, and anti-inflammatory treatment was ineffective in all three cases. Fluorescence in situ hybridisation analysis of ubiquitin-specific peptidase 6 (USP6) was performed in two of the three cases, with positive results. The lesions exhibited hypo-intensity or iso-intensity on T1-weighted magnetic resonance imaging (MRI) and heterogeneous hyper-intensity on T2-weighted MRI. "Fascial tail" signs were observed on imaging in all cases. Surgical resection was performed in all cases. Intact ear appearance was observed at follow-up, and there were no cases of recurrence. Conclusion: Combining clinical features with imaging findings may improve the accuracy of preoperative diagnosis in patients with nodular fasciitis. In addition to pathological findings, genetic testing for USP6 may aid in diagnosis. The final diagnosis should be based on comprehensive assessment. Complete surgical resection can prevent recurrence. What is Known: • Paediatric NF around the ear is rare and is easily misdiagnosed as other inflammatory masses that have a higher incidence in children. • Most previous reports of NF were case reports. What is New: • Combining clinical and imaging findings with genetic testing for USP6 rearrangement may improve the accuracy of preoperative diagnosis in patients with NF. Nonetheless, the final diagnosis should be based on comprehensive assessment. • The present paper is significant in that it represents the only report of three cases of ear NF in children with a complete medical history and prognosis. [ABSTRACT FROM AUTHOR]

The Deep Convolutional Neural Network (DCNN) is one of the most powerful and successful deep learning approaches. DCNNs have already provided superior performance in different modalities of medical imaging including breast cancer classification, segmentation, and detection. Breast cancer is one of the most common and dangerous cancers impacting women worldwide. In this paper, we have proposed a method for breast cancer classification with the Inception Recurrent Residual Convolutional Neural Network (IRRCNN) model. The IRRCNN is a powerful DCNN model that combines the strength of the Inception Network (Inception-v4), the Residual Network (ResNet), and the Recurrent Convolutional Neural Network (RCNN). The IRRCNN shows superior performance against equivalent Inception Networks, Residual Networks, and RCNNs for object recognition tasks. In this paper, the IRRCNN approach is applied for breast cancer classification on two publicly available datasets including BreakHis and Breast Cancer (BC) classification challenge 2015. The experimental results are compared against the existing machine learning and deep learning–based approaches with respect to image-based, patch-based, image-level, and patient-level classification. The IRRCNN model provides superior classification performance in terms of sensitivity, area under the curve (AUC), the ROC curve, and global accuracy compared to existing approaches for both datasets. [ABSTRACT FROM AUTHOR]

Recently, we read a paper "Dacomitinib overcomes afatinib-refractory carcinomatous meningitis in a lung cancer patient harbouring EGFR Ex.19 deletion and G724S mutation" published in Investigational New Drugs. Their patient had a very rare compound EGFR mutation. To share our experience, we present a case of 58-year-old man with a long-term response to afatinib in a patient with previously unreported compound EGFR mutation. In patients with rare compound EGFR mutations, afatinib might be one of the treatment option. [ABSTRACT FROM AUTHOR]

The number of the Asbestos Bodies (AB), i.e. asbestos that developed an iron-protein coating during its permanence in biological tissues, is one of the most accessible markers of asbestos exposure in individuals. The approaches developed to perform AB count in biological tissues are based on the manual examination of tissue digests or histological sections by means of light or electron microscopies. Although these approaches are well established and relatively accessible, manual examination is time-consuming and can be reader-dependent. Besides, approximations are applied because of the limitations of 2D readings and to speed up manual counts. In addition, sample preparation using tissue digests require an amount of tissue that can only be obtained by invasive surgery or post-mortem sampling. In this paper, we propose a new approach to AB counting based on non-destructive 3D imaging, which has the potential to overcome most of the limitations of conventional approaches. This method allows automating the AB count and determining their morphometry distribution in bulk tissue samples (ideally non-invasive needle biopsies), with minimal sample preparation and avoiding approximations. Although the results are promising, additional testing on a larger number of AB-containing biological samples would be required to fully validate the method. [ABSTRACT FROM AUTHOR]

Liquid biopsy is considered as the most attractive alternative to traditional tissue biopsies. The major advantages of this approach lie in the non-invasive procedure, the rapidness of sample collection and the potential for early cancer diagnosis and real-time monitoring of the disease and the treatment response. Nanotechnology has dynamically emerged in a wide range of applications in the field of liquid biopsy. The benefits of using nanomaterials for biosensing include high sensitivity and detectability, simplicity in many cases, rapid analysis, the low cost of the analysis and the potential for portability and personalized medicine. The present paper reports on the nanomaterial-based methods and biosensors that have been developed for liquid biopsy applications. Most of the nanomaterials used exhibit great analytical performance; moreover, extremely low limits of detection have been achieved for all studied targets. This review will provide scientists with a comprehensive overview of all the nanomaterials and techniques that have been developed for liquid biopsy applications. A comparison of the developed methods in terms of detectability, dynamic range, time-length of the analysis and multiplicity, is also provided. [ABSTRACT FROM AUTHOR]

Little attention has been given to the efficiency and validity of performing routine endoscopic biopsies in normal areas in children. This study aimed to investigate the need to perform routine biopsies in upper gastrointestinal endoscopy (UDE) and colonoscopy in normal areas by comparing macroscopy and histology. It was a 10-year retrospective analysis with the inclusion of 761 UDEs and 177 colonoscopies. Considering all segments, UDEs showed false-positive result rates of 73.11% and false-negative result rates of 14.34%. The histological results modified the initial management in 53.95% of patients. Considering all segments, colonoscopies showed false-positive result rates of 63.64% and false-negative result rates of 30.97%. The histological results modified the initial management in 34.45% of patients. Conclusion: If biopsies were obtained only in abnormal areas, the diagnosis would be lost in 53.95% of the patients in upper endoscopies and 85.7% of the colonoscopies, which justifies routine maintenance of biopsies in macroscopically normal areas in children. What is Known: • Little attention has been given to the efficiency and validity of endoscopic biopsies of normal areas during pediatric exams. • Only a few pediatric studies have correlated macroscopic and histological findings from endoscopic biopsies, and low sensitivity and specificity, as well as poor agreement, were reported. What is New: • Our study confirms the evidence that routine biopsies from macroscopically normal areas during upper and lower digestive endoscopies can lead to histopathological diagnoses and different medical management. • This is the first research on this topic in a Latin population, from a developing country, reassuring the results obtained in previous papers from other countries. [ABSTRACT FROM AUTHOR]

Recently, virtual reality (VR) technologies started gaining momentum in surgical simulation-based training by allowing clinicians to practice their skills before performing real procedures. The design of such simulators is usually focused on the primary operative tasks to be taught, but little attention is paid to secondary tasks that the user needs to perform, such as changing his/her point of view when manipulating the surgical instruments. More particularly, it is not clear how to design appropriate interaction techniques for those tasks, and how the fidelity of these interactions can impact the user's performance on such systems. In this paper, we compare two viewpoint changing techniques having two different levels of interaction fidelity during needle insertion in a semi-immersive VR (SIVR) biopsy trainer. These techniques were designed based on observing clinicians performing actual biopsy procedures. The first technique is based on tracking the user's head position (high interaction fidelity), while the second technique is touch-based with the user utilizing his/her non-dominant hand fingers to manipulate the point of view on a touch screen (moderate interaction fidelity). A user study was carried out to investigate the impact of the interaction fidelity of the viewpoint changing task (secondary task) on the user's performance during the needle insertion task (main task). Twenty-one novice participants were asked to perform several trials of a needle insertion task while using the navigation techniques (within-subject design). Objective and subjective measures were recorded to compare the task performance (time to accomplish the task, precision of the tumor sampling, and errors) and user experience for both techniques. The results show that the touch-based viewpoint changing technique improves the users' task completion performance during needle insertion while maintaining a similar level of needle manipulation accuracy as compared to the head-tracking technique. These results suggest that high interaction fidelity is not always necessary when designing surgical trainers. This also highlights the importance of designing appropriate interactions for secondary tasks because they can influence the user's primary task performance in VR simulators. [ABSTRACT FROM AUTHOR]

Pre-biopsy multiparametric MRI is now recommended by multiple guidelines, not only for men with persistent suspicion of prostate cancer after prior negative systematic biopsy, but also at initial screening before the first biopsy. The major benefit of pre-biopsy MRI in the diagnostic work-up is to promote individualized risk-adapted approaches for biopsy-decision management. Multiple MRI-directed diagnostic pathways can be conceived, with each approach having net-benefit trade-offs between benefits and harms, based on improved diagnostic yields of significant cancers and reduced biopsy testing and reduced detection of indolent prostate cancer. In this paper, we illustrate how clinical benefits can be maximized in men with MRI-negative and MRI-positive results, using the PI-RADS Multiparametric MRI and MRI-directed biopsy pathway. From a practice perspective, we emphasize five golden rules: (1) that multiparametric MRI approach including targeted biopsies be reserved for men likely to benefit from early detection and treatment of prostate cancer; (2) that there is a need to carefully assess risk of significant disease using PSA and clinical parameters before and after MRI; (3) do not offer immediate biopsy if the MRI is negative, unless other high-risk factors are present; (4) accept that not all significant cancers are found immediately and have robust 'safety nets' for men with negative MRI scans who avoid immediate biopsy and for positive MRI patients with negative or non-explanatory histology; and (5) use MRI-directed biopsy methods that minimize overdiagnosis and improve risk stratification. [ABSTRACT FROM AUTHOR]

Trophectoderm biopsy is increasingly performed for pre-implantation genetic testing of aneuploidies and considered a safe procedure on short-term clinical outcome, without strong assessment of long-term consequences. Poor biological information on human trophectoderm is available due to ethical restrictions. Therefore, most studies have been conducted in vitro (choriocarcinoma cell lines, embryonic and pluripotent stem cells) and on murine models that nevertheless poorly reflect the human counterpart. Polarization, compaction, and blastomere differentiation (e.g., the basis to ascertain trophectoderm origin) are poorly known in humans. In addition, the trophectoderm function is poorly known from a biological point of view, although a panoply of questionable and controversial microarray studies suggest that important genes overexpressed in trophectoderm are involved in pluripotency, metabolism, cell cycle, endocrine function, and implantation. The intercellular communication system between the trophectoderm cells and the inner cell mass, modulated by cell junctions and filopodia in the murine model, is obscure in humans. For the purpose of this paper, data mainly on primary cells from human and murine embryos has been reviewed. This review suggests that the trophectoderm origin and functions have been insufficiently ascertained in humans so far. Therefore, trophectoderm biopsy should be considered an experimental procedure to be undertaken only under approved rigorous experimental protocols in academic contexts. [ABSTRACT FROM AUTHOR]

Background: Mucormycosis is a serious and often fatal mycotic infection caused by members of class Mucormycetes in populations with immunologic or metabolic disorders. Though several clinical manifestations are associated with mucormycetes, gastrointestinal involvement is quite rare. Case description: We described a rare case of invasive fungal infection due to Syncephalastrum racemosum associated with gastric adenocarcinoma in a 48-year-old male patient with type II Diabetes mellitus. He presented with complaints of abdominal pain, nausea, vomiting, dyspepsia, dysphagia, loss of appetite, and weight. Histopathological examination showed broad and aseptate hyphae and culture of endoscopic biopsy tissue from pylorus and antrum yielded the fungal pathogen S. racemosum. The species was confirmed by molecular sequencing of D1/D2 region of the ribosomal DNA. The in vitro susceptibility of S. racemosum was tested by broth microdilution assay as per CLSI guidelines. The MICs suggest that the isolate was susceptible to Amphotericin B (0.25 µg/ml), Itraconazole (0.25 µg/ml) and Posaconazole (0.06 µg/ml) and showed resistance to Micafungin (>16 µg/ml). The patient was successfully treated with radical subtotal gastrectomy with lymphadenectomy and Amphotericin B antifungal therapy. There was a dilemma in concluding the pathogenicity of the isolate since; the symptoms noted were common for both gastric adenocarcinoma and mucormycosis. A review of previously reported cases on Syncephalastrum was presented in the paper with their clinical manifestations, treatment, and outcome. Conclusion: To the best of our knowledge, this is the first report from India on the gastrointestinal involvement of S. racemosum. Patients with immunocompromised status are more prone to mucormycotic infections, and any typical presentations should be carefully examined for their etiological agent, and appropriate species directed therapy would help in a better outcome. [ABSTRACT FROM AUTHOR]

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Global modelling has traditionally been the approach taken to estimate needle deflection in soft tissue. In this paper, we propose a new method based on local data-driven modelling of needle deflection. External measurement of needle-tissue interactions is collected from several insertions in ex vivo tissue to form a cloud of data. Inputs to the system are the needle insertion depth, axial rotations, and the forces and torques measured at the needle base by a force sensor. When a new insertion is performed, the just-in-time learning method estimates the model outputs given the current inputs to the needle-tissue system and the historical database. The query is compared to every observation in the database and is given weights according to some similarity criteria. Only a subset of historical data that is most relevant to the query is selected and a local linear model is fit to the selected points to estimate the query output. The model outputs the 3D deflection of the needle tip and the needle insertion force. The proposed approach is validated in ex vivo multilayered biological tissue in different needle insertion scenarios. Experimental results in five different case studies indicate an accuracy in predicting needle deflection of 0.81 and 1.24 mm in the horizontal and vertical lanes, respectively, and an accuracy of 0.5 N in predicting the needle insertion force over 216 needle insertions. [ABSTRACT FROM AUTHOR]

Purpose: The biopsy procedure is an important phase in breast cancer diagnosis. Accurate breast imaging and precise needle placement are crucial in lesion targeting. This paper presents an end-effector (EE) for robotic 3D ultrasound (US) breast acquisitions and US-guided breast biopsies. The EE mechanically guides the needle to a specified target within the US plane. The needle is controlled in all degrees of freedom (DOFs) except for the direction of insertion, which is controlled by the radiologist. It determines the correct needle depth and stops the needle accordingly. Method: In the envisioned procedure, a robotic arm performs localization of the breast, 3D US volume acquisition and reconstruction, target identification and needle guidance. Therefore, the EE is equipped with a stereo camera setup, a picobeamer, US probe holder, a three-DOF needle guide and a needle stop. The design was realized by prototyping techniques. Experiments were performed to determine needle placement accuracy in-air. The EE was placed on a seven-DOF robotic manipulator to determine the biopsy accuracy on a cuboid phantom. Results: Needle placement accuracy was 0.3 ± 1.5 mm in and 0.1 ± 0.36 mm out of the US plane. Needle depth was regulated with an accuracy of 100 µm (maximum error 0.89 mm). The maximum holding force of the stop was approximately 6 N. The system reached a Euclidean distance error of 3.21 mm between the needle tip and the target and a normal distance of 3.03 mm between the needle trajectory and the target. Conclusion: An all in one solution was presented which, attached to a robotic arm, assists the radiologist in breast cancer imaging and biopsy. It has a high needle placement accuracy, yet the radiologist is in control like in the conventional procedure. [ABSTRACT FROM AUTHOR]

Transrectal ultrasound (TRUS) guided needle biopsy is currently the clinical routine for diagnosis of prostate cancer. Due to the blurry TRUS imaging, magnetic resonance imaging (MRI) of prostate is usually taken prior to the biopsy procedure to assist needle target planning. In this paper, a novel geometric transformation method, which is based on the mechanics of materials, is proposed to facilitate the deformable registration of lesion sites from MRI to ultrasound imaging. In the method an enlarged shell, scaled from the geometry of prostate constructed from ultrasound imaging, is used to squeeze the prostate constructed from MRI imaging. The prostate can automatically rotate and position itself towards the target geometry, and deforms to match the target throughout the entire volumes. Transformations of 3D volumes as well as 2D sections of prostate are carried out to evaluate the transformation performance with respect to different material properties and segmentation errors. Some practical issues on applying the method to clinical biopsy operations are discussed. We show that this FEM based transformation method is promising in deformable registration and could be used in other organ image registrations. [ABSTRACT FROM AUTHOR]

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Objectives: The aim of this study was to assess the potential of machine learning based on B-mode, shear-wave elastography (SWE), and dynamic contrast-enhanced ultrasound (DCE-US) radiomics for the localization of prostate cancer (PCa) lesions using transrectal ultrasound.Methods: This study was approved by the institutional review board and comprised 50 men with biopsy-confirmed PCa that were referred for radical prostatectomy. Prior to surgery, patients received transrectal ultrasound (TRUS), SWE, and DCE-US for three imaging planes. The images were automatically segmented and registered. First, model-based features related to contrast perfusion and dispersion were extracted from the DCE-US videos. Subsequently, radiomics were retrieved from all modalities. Machine learning was applied through a random forest classification algorithm, using the co-registered histopathology from the radical prostatectomy specimens as a reference to draw benign and malignant regions of interest. To avoid overfitting, the performance of the multiparametric classifier was assessed through leave-one-patient-out cross-validation.Results: The multiparametric classifier reached a region-wise area under the receiver operating characteristics curve (ROC-AUC) of 0.75 and 0.90 for PCa and Gleason > 3 + 4 significant PCa, respectively, thereby outperforming the best-performing single parameter (i.e., contrast velocity) yielding ROC-AUCs of 0.69 and 0.76, respectively. Machine learning revealed that combinations between perfusion-, dispersion-, and elasticity-related features were favored.Conclusions: In this paper, technical feasibility of multiparametric machine learning to improve upon single US modalities for the localization of PCa has been demonstrated. Extended datasets for training and testing may establish the clinical value of automatic multiparametric US classification in the early diagnosis of PCa.Key Points: • Combination of B-mode ultrasound, shear-wave elastography, and contrast ultrasound radiomics through machine learning is technically feasible. • Multiparametric ultrasound demonstrated a higher prostate cancer localization ability than single ultrasound modalities. • Computer-aided multiparametric ultrasound could help clinicians in biopsy targeting. [ABSTRACT FROM AUTHOR]

Neuroendoscopy enables diagnostic biopsy of intraventricular and/or paraventricular tumors and the simultaneous treatment of associated hydrocephalus in selected cases. The objective of this paper was to analyze the effectiveness and safety of this procedure. This retrospective study included 80 patients between 2 months and 78 years old diagnosed with intraventricular and/or paraventricular expansive lesion who underwent neuroendoscopic biopsy from 2004 to 2016. Collected variables were gender, age at diagnosis, clinical presentation, tumor location, surgical technique, management of hydrocephalus, pathological findings, procedure-related complications, and follow-up time. Neuroendoscopic biopsy was performed in 80 patients. Mean age at diagnosis was 27 years, and 52.5% were men. According to the Depreitere Classification, 71 were level I (conclusive diagnosis), 1 level III (problematic categorization), and 8 level IV (non-interpretable diagnosis). The most frequent diagnosis was grade I astrocytoma (14%). Diagnostic success per patient was 88.7%. Sixty-nine patients had hydrocephalus at diagnosis, 37 of whom were treated with endoscopic third ventriculostomy (ETV), with septostomy (SPT) in 14, and only SPT in 4. Twenty-eight patients underwent ventricular peritoneal shunt (VPS), with SPT in 20. The ETV success rate was 70.9%. The complication rate per patient was 11%: five patients presented intraventricular hemorrhage, three of whom died; one patient presented cerebrospinal fluid fistula; three presented transient oculomotor impairment. Postoperative follow-up was from 1 month to 12.4 years (mean 45 months). Neuroendoscopy is an effective procedure for the pathological diagnosis of intraventricular and paraventricular tumors, allowing the treatment of associated hydrocephalus. Nevertheless, it is not exempt from serious complications and requires proper training. [ABSTRACT FROM AUTHOR]

Purpose: This paper examines the feasibility of automated alignment in sagittal direction in MR-TRUS fusion biopsy of the prostate by comparing the prostate contour in axial images between different modalities. In the treatment of prostate cancer, an important factor affecting the prognosis of patients is focal therapy of cancer within the prostate. Therefore, MR-TRUS fusion biopsy of the prostate is attracting attention as one of the most effective localization techniques. Because the accuracy of this biopsy is highly dependent on the doctor performing it, automation should reduce variability in diagnostic performance. Method: The MR image is scaled to the same scale as the TRUS image, and the contours of the prostate on the MR and TRUS images are compared in polar coordinates. In addition, this method makes it possible to perform a robust comparison against deformation by comparing specific angle ranges. It is also possible to improve the accuracy of error calculation by accumulating contour data. Result: The axial image selected by the proposed method using the prostate contour obtained from the doctor-labeled segmentation image has an error of about 4 mm in the sagittal direction on average compared to the axial image selected by the doctor did. Furthermore, using the inaccurate prostate contours obtained by performing segmentation with U-Net only slightly reduced the accuracy. In addition, it was found that alignment accuracy is improved by using the angler weight. Conclusion: It has been shown that sagittal alignment can be performed with some degree of accuracy using only axial images. Also, the angular weight values used indicate that when comparing axial images, it may be an important factor in determining the same axial cross section to compare the parts that deform due to probe pressure. [ABSTRACT FROM AUTHOR]

Numerous research groups in the past have designed and developed robotic needle guide systems that improve the targeting accuracy and precision by either providing a physical guidance for manual insertion or enabling a complete automated intervention. Here we review systems that have been reported in the last 11 years and limited to straight line needle interventions. Most systems fall under the category of image guided systems as they either use magnetic resonance image, computed tomography, ultrasound or a combination of these modalities for real time image feedback of the intervention path being followed. Actuation and control technology along with materials used for construction are the main aspects that differentiate these systems from each other and have been reviewed here. Image compatibility test details and results are also reviewed as they are used to ensure proper functioning of these systems under the respective imaging environments. We have also reviewed needle guide systems which either don't use any image feedback or have not reported any but provide physical guidance. Throughout this paper, we provide a comprehensive review of the technological aspects and trends in the field of robotic, straight line, needle guide intervention systems. [ABSTRACT FROM AUTHOR]

An amendment to this paper has been published and can be accessed via a link at the top of the paper. [ABSTRACT FROM AUTHOR]

B Correction to: Clinical Oral Investigations b https://doi.org/10.1007/s00784-022-04620-9 The original version of this paper contained a transposition of Figure 1, 2, 3, 4 and Figure 5. The original article can be found online at https://doi.org/10.1007/s00784-022-04620-9. Correction to: Retrospective evaluation of the oral brush biopsy in daily dental routine - an effective way of early cancer detection. [Extracted from the article]

Background: Magnetic resonance imaging (MRI) can be used to target tumour components in biopsy procedures, while the ability to precisely correlate histology and MRI signal is crucial for imaging biomarker validation. Robotic MRI/computed tomography (CT) fusion biopsy offers the potential for this without in-gantry biopsy, although requires development. Methods: Test–retest T1 and T2 relaxation times, attenuation (Hounsfield units, HU), and biopsy core quality were prospectively assessed (January–December 2021) in a range of gelatin, agar, and mixed gelatin/agar solutions of differing concentrations on days 1 and 8 after manufacture. Suitable materials were chosen, and four biopsy phantoms were constructed with twelve spherical 1–3-cm diameter targets visible on MRI, but not on CT. A technical pipeline was developed, and intraoperator and interoperator reliability was tested in four operators performing a total of 96 biopsies. Statistical analysis included T1, T2, and HU repeatability using Bland–Altman analysis, Dice similarity coefficient (DSC), and intraoperator and interoperator reliability. Results: T1, T2, and HU repeatability had 95% limits-of-agreement of 8.3%, 3.4%, and 17.9%, respectively. The phantom was highly reproducible, with DSC of 0.93 versus 0.92 for scanning the same or two different phantoms, respectively. Hit rate was 100% (96/96 targets), and all operators performed robotic biopsies using a single volumetric acquisition. The fastest procedure time was 32 min for all 12 targets. Conclusions: A reproducible biopsy phantom was developed, validated, and used to test robotic MRI/CT-fusion biopsy. The technique was highly accurate, reliable, and achievable in clinically acceptable timescales meaning it is suitable for clinical application. [ABSTRACT FROM AUTHOR]

Drug reaction with eosinophilia and systemic symptoms (DRESS) is a severe hypersensitivity reaction characterized by cutaneous rash, lymphadenopathy, fever, eosinophilia, leukocytosis, and life-threatening organ dysfunctions. We describe the case of a 26 year old patient admitted to the Emergency Department for DRESS syndrome after sulfasalazine treatment for rheumatoid arthritis in the right knee. Whole body computer tomography showed multiple neck, chest, and abdominal lymphadenopathy with splenomegaly, massive ascites and severe hepatic cytolysis. Serology results for Epstein-Barr Virus (EBV), influenza, measles, rubella, hepatitis A and B were negative. The histologic analysis of skin, lymph node and bone marrow biopsies could not indicate a classical Hodgkin's Disease or iatrogenic immunodeficiency/EBV-associated lymphoproliferative disorder (LPD), Hodgkin type. The relatively small caliber of the CD30 + immunoreactive blastoid cells in the lymph nodes suggested reactive immunoblasts rather than Hodgkin cells. The morphologic aspects of the lymph node biopsies with predominance of T-cells were compatible with the diagnosis of a sulfasalazine-induced DRESS syndrome as the patient had a high RegiSCAR score for DRESS. [DRESS Syndrome Foundation: Diagnosis and Treatment. (2023)] The patient's complex clinical course, marked by two hospital admissions, highlights the challenges in diagnosing and managing DRESS. This case underscores the need for individualized care, close patient monitoring, and further research to better understand DRESS's underlying mechanisms and optimal therapeutic strategies. [ABSTRACT FROM AUTHOR]

Background: Inflammatory diseases have been associated with an increased cardiovascular risk. However, data on incident major adverse cardiovascular events (MACE) from large population-based cohorts of patients with eosinophilic esophagitis (EoE) is lacking. Methods: This study included all Swedish adults with EoE without a record of previous cardiovascular disease (CVD) (1990–2017, N = 1546) with follow-up until 2019. Individuals with EoE were identified from prospectively recorded histopathology reports from all Swedish pathology departments (n = 28). EoE patients were matched at index date for age, sex, calendar year and county with up to five general population reference individuals (N = 7281) without EoE or CVD. Multivariable-adjusted hazard ratios (aHRs) for MACE (ischemic heart disease, congestive heart failure, stroke and cardiovascular mortality) were calculated using Cox proportional hazards models. Full sibling comparisons and adjustment for cardiovascular medication were performed. Results: During a median follow-up of 6.0 years, we observed 65 incident MACE in patients with EoE (6.4/1000 person-years (PY)) and 225 in reference individuals (4.7/1000 PY). EoE was not associated with a higher risk of MACE (aHR = 1.14, 95% CI = 0.86–1.51) or any of its components. No differences between age, sex and follow-up time were observed. The results remained stable in sensitivity analyses, including when adjusting for relevant cardiovascular medications and a full sibling comparison. Conclusions: In this large population-based cohort study, patients with EoE had no increased risk of MACE compared to reference individuals and full siblings. The results are reassuring for patients with EoE. [ABSTRACT FROM AUTHOR]

Purpose: Considerable debate exists as to whether increases in strength that occur with resistance exercise are the result of increases in muscle size. Most studies have attempted to answer this question using assessments of whole muscle size and voluntary muscle strength, but examining changes at the individual muscle fiber level may also provide some insight. The purpose of this meta-analysis was to compare adaptations at the whole muscle and individual fiber level.Methods: A meta-analysis was conducted in February, 2018 including all previously published papers and was analyzed using a random effects model.Results: There were no differences (p = 0.88) when comparing hypertrophy at the whole muscle (4.6%) and individual fiber level (7.0%), but significantly larger (p < 0.001) strength gains were observed at the whole muscle level (43.3%) relative to the individual fiber (19.5%). Additionally, there was an increase in the specific tension of type 1 muscle fibers (p = 0.013), but not type 2 muscle fibers (p = 0.23) which was driven by similar increases in strength (type 1: 17.5%, type 2A: 17.7%), despite differences in muscle size (type 1: 6.7%, type 2A: 12.1%).Conclusion: These results support the hypothesis that the neural adaptations play a large role in increasing isotonic whole muscle strength, but also demonstrate that an improvement in specific tension of type 1 muscle fibers is present. These results would suggest that some mechanism intrinsic to the muscle fiber, and independent of muscle growth, may also be contributing to strength increases in response to resistance exercise providing an avenue for future research. [ABSTRACT FROM AUTHOR]

Micro-computed tomographic imaging (micro-CT) provides unprecedented information on stone structure and mineral composition. High-resolution micro-CT even allows visualization of the lumens of tubule and/or vessels within Randall's plaque, on stones or in papillary biopsies, thus giving a non-destructive way to study these sites of stone adhesion. This paper also shows an example of a stone growing on a different anchoring mechanism: a mineral plug within the lumen of a Bellini duct (BD plug). Micro-CT shows striking structural differences between stones that have grown on Randall's plaque and those that have grown on BD plugs. Thus, Randall's plaque can be distinguished by micro-CT, and this non-destructive method shows great promise in helping to elucidate the different mechanisms by which small stones are retained in the kidney during the development of nephrolithiasis. [ABSTRACT FROM AUTHOR]

The aim of this paper is to introduce an image source-independent automated method for segmentation and classification of prostate glands. This research focuses on light microscopic images of the samples from different laboratories using the same staining method. Color information in the image is highly dependent on the source and the conditions under which the image has been taken. The proposed method can be used to analyze images with color variations. Color information is used for the segmentation of tissue structures and Delaunay triangulation is used for gland segmentation. The proposed method uses triangulation to find the basic structure of any shaped and sized gland and to prevent misclassification of gland components. The proposed approach classifies the nuclei circumscribing the glands to single and multilayered. Other features used in the classification are the amount of nuclei and the area of the gland. The number of layers can be used for determining the malignancy of the tissue sample. In most cases, a single-layered gland is malignant and multilayered is benign. This segmentation approach is different than what has been previously used in the literature. In this paper, the glands are classified to four different categories: single layered, multilayered, rejected or nonclassified. This approach distinguishes majority of single and multilayered glands from each other. [ABSTRACT FROM AUTHOR]

Abstract: Radiomics is a process of extraction and analysis of quantitative features from diagnostic images. Liquid biopsy is a test done on a sample of blood to look for cancer cells or for pieces of tumourigenic DNA circulating in the blood. Radiomics and liquid biopsy have great potential in oncology, since both are minimally invasive, easy to perform, and can be repeated in patient follow-up visits, enabling the extraction of valuable information regarding tumour type, aggressiveness, progression, and response to treatment. Both methods are in their infancy, with major evidence of application in lung and gastrointestinal cancer, while still undergoing evaluation in other cancer types. In this paper, the main oncologic applications of radiomics and liquid biopsy are reviewed, and a synergistic approach incorporating both tests for cancer diagnosis and follow-up is discussed within the context of systems medicine.Teaching Points: • Radiomics is a process of extraction and analysis of quantitative features from diagnostic images.• Most clinical applications of radiomics are in the field of oncologic imaging.• Radiomics applies to all imaging modalities.• A cluster of radiomic features is a "radiomic signature".• Machine learning may improve the efficacy of radiomics analysis. [ABSTRACT FROM AUTHOR]