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Background Both diabetes and osteoporosis have developed into major global public health problems due to the increasing aging population. It is crucial to screen populations at higher risk of developing osteoporosis for disease prevention and management in postmenopausal women with type 2 diabetes (T2D). This study aims to quantitatively investigate the association between risk factors and bone mineral density (BMD) and develop a self-assessment tool for early osteoporosis screening in postmenopausal women with T2D. Methods We retrospectively enrolled 1,309 postmenopausal women with T2D. Linear regression methods were used to assess the association between risk factors and BMD. Additionally, a multivariate logistic regression analysis was performed to identify independent risk factors associated with osteoporosis. Utilizing the logistic regression machine learning algorithm, we developed an osteoporosis screening tool that categorizes the population into three risk regions based on age and body mass index (BMI), indicating low, moderate, and high prevalence of osteoporosis in the age-BMI plane. Results Older age and lower BMI were independently associated with decreased BMD. The BMD at the total hip, femur neck, and lumbar spine differed by 12.9, 10.9, and 15.5 mg/cm2 for each 1 unit increase in BMI, respectively. Both age and BMI were identified as independent predictors of osteoporosis. The osteoporosis screening tool was developed by using two straight lines with equations of BMI = 0.56 * age−4.12 and BMI = 0.56 * age−10.88; there were no significant differences in the prevalence of osteoporosis among the training, internal test, and external test datasets in the low-, moderate-, and high-risk regions. Conclusion We have successfully developed and validated a self-assessment tool for early osteoporosis screening in postmenopausal women with T2D for the first time. BMI was identified as a significant modifiable risk factor. Our study may improve awareness of osteoporosis and is valuable for disease prevention and management for postmenopausal women with T2D.

Abstract Background Stage I lung adenocarcinoma is a heterogeneous group. Previous studies have shown the prognostic evaluation value of PET/CT in this cohort; however, few studies focused on stage I invasive adenocarcinoma manifesting as solid nodules. This study aimed to evaluate the recurrence risk for patients with stage I invasive lung adenocarcinoma manifesting as solid nodules based on 18F-FDG PET/CT, CT imaging signs, and clinicopathological parameters. Methods We retrospectively enrolled 230 patients who underwent 18F-FDG PET/CT examination between January 2013 and July 2019. Metabolic parameters: maximum standard uptake value (SUVmax), mean standard uptake value, tumor metabolic volume (MTV), and total tumor glucose digestion were collected. Kaplan–Meier method was used to evaluate recurrence-free survival (RFS), and the multivariate Cox proportional hazards model was used to determine the independent risk factors associated with RFS. The time-dependent receiver operating characteristic curve (ROC) method was used to calculate the optimal cutoff value of metabolic parameters. Results The 5-year RFS rate for all patients was 71.7%. Multivariate Cox analysis revealed that the International Association for the Study of Lung Cancer Pathology Committee (IASLC) pathologic grade 3 [Hazard ratio (HR), 3.96; 95% Confidence interval (CI), 1.11–14.09], the presence of cavity sign (HR 5.38; 95% CI 2.23–12.96), SUVmax (HR 1.23; 95% CI 1.13–1.33), and MTV (HR 1.05; 95% CI 1.01–1.08) were potential independent prognostic factors for RFS. Patients with IASLC grade 3, the presence of cavity sign, SUVmax > 3.9, or MTV > 5.4 cm3 were classified as high risk, while others were classified as low risk. There was a significant difference in RFS between the high-risk and low-risk groups (HR 6.04; 95% CI 2.17–16.82, P

Objective: To explore the association of motor reserve (MR) and clinical progression in Parkinson’s disease. Methods: This longitudinal study using data from the Parkinson’s progression markers initiative. Patients with de novo PD who underwent dopamine transporter scans at baseline and finished at least five years clinical follow-up assessments (including motor, cognitive, and non-motor symptoms) were included. The individual MR of PD patients were estimated based on initial motor deficits and striatal dopamine depletion using a residual model. Linear mixed-effects models (LME) were performed to examine the associations of baseline MR and clinical progression. Results: A total of 303 de novo PD patients were included and the mean follow-up time was 8.95 years. Results of LME models revealed that the baseline MR was associated with motor, cognitive, and non-motor symptoms in PD patients. There was a significant interaction between MR and disease duration for longitudinal changes in motor (p

Objective: To evaluate the diagnostic performance of (18F)-PSMA-1007 PET/CT in prostate cancer patients with biochemical recurrence (BCR) after radical prostatectomy and the effect of (18F)-PSMA-1007 PET/CT on treatment strategy. Methods: A total of 114 patients with BCR after radical prostatectomy who performed (18F)-PSMA-1007 PET/CT were retrospectively analyzed. The Gleason scores (GS), maximum standardized uptake values (SUVmax) and the diagnostic performance were compared according to different prostate-specific antigen (PSA) groups. To evaluate the impact of (18F)-PSMA-1007 PET/CT on treatment management, we also collected subjects’ therapy before and after PET/CT. The PSA value was monitored to evaluate the biochemical response. Results: (18F)-PSMA-1007PET/CT was positive in 92/114 patients (80.7%). The detection rates were 20/34 (58.8%), 13/17 (76.5%), 15/17 (88.2%) and 44/46 (95.7%) for PSA levels of 0.2-

ObjectivesThe aim of this study was to develop a preoperative positron emission tomography (PET)-based radiomics model for predicting peritoneal metastasis (PM) of gastric cancer (GC).MethodsIn this study, a total of 355 patients (109PM+, 246PM-) who underwent preoperative fluorine-18-fludeoxyglucose (18F-FDG) PET images were retrospectively analyzed. According to a 7:3 ratio, patients were randomly divided into a training set and a validation set. Radiomics features and metabolic parameters data were extracted from PET images. The radiomics features were selected by logistic regression after using maximum relevance and minimum redundancy (mRMR) and the least shrinkage and selection operator (LASSO) method. The radiomics models were based on the rest of these features. The performance of the models was determined by their discrimination, calibration, and clinical usefulness in the training and validation sets.ResultsAfter dimensionality reduction, 12 radiomics feature parameters were obtained to construct radiomics signatures. According to the results of the multivariate logistic regression analysis, only carbohydrate antigen 125 (CA125), maximum standardized uptake value (SUVmax), and the radiomics signature showed statistically significant differences between patients (P

Objective: Attention deficit hyperactivity disorder (ADHD) is a commonly diagnosed neuropsychiatric disorder in children, which is characterized by inattention, hyperactivity and impulsivity. Using resting-state functional magnetic resonance imaging (R-fMRI), the alterations of static and dynamic characteristics of intrinsic brain activity have been identified in patients with ADHD. Yet, it remains unclear whether the concordance among indices of dynamic R-fMRI is altered in ADHD.Methods: R-fMRI scans obtained from 50 patients with ADHD and 28 healthy controls (HC) were used for the current study. We calculated the regional dynamic changes in brain activity indices using the sliding-window method and compared the differences in variability of these indices between ADHD patients and HCs. Further, the concordance among these dynamic indices was calculated and compared. Finally, the relationship between variability/concordance of these indices and ADHD-relevant clinical test scores was investigated.Results: Patients with ADHD showed decreased variability of dynamic amplitude of low-frequency fluctuation (dALFF) in the left middle frontal gyrus and increased one in right middle occipital gyrus, as compared with the HCs. Besides, ADHD patients showed decreased voxel-wise concordance in the left middle frontal gyrus. Further, lower voxel-wise concordance in ADHD’s left middle frontal gyrus was associated with more non-perseverative errors in Wisconsin Card Sorting Test, which reflects worse cognitive control.Conclusion: Our findings suggest that variability and concordance in dynamic brain activity may serve as biomarkers for the diagnosis of ADHD. Further, the decreased voxel-wise concordance is associated with deficit in cognitive control in ADHD patients.

BackgroundThis study was conducted with the intent to develop and validate a radiomic model capable of predicting intrahepatic cholangiocarcinoma (ICC) in patients with intrahepatic lithiasis (IHL) complicated by imagologically diagnosed mass (IM).MethodsA radiomic model was developed in a training cohort of 96 patients with IHL-IM from January 2005 to July 2019. Radiomic characteristics were obtained from arterial-phase computed tomography (CT) scans. The radiomic score (rad-score), based on radiomic features, was built by logistic regression after using the least absolute shrinkage and selection operator (LASSO) method. The rad-score and other independent predictors were incorporated into a novel comprehensive model. The performance of the Model was determined by its discrimination, calibration, and clinical usefulness. This model was externally validated in 35 consecutive patients.ResultsThe rad-score was able to discriminate ICC from IHL in both the training group (AUC 0.829, sensitivity 0.868, specificity 0.635, and accuracy 0.723) and the validation group (AUC 0.879, sensitivity 0.824, specificity 0.778, and accuracy 0.800). Furthermore, the comprehensive model that combined rad-score and clinical features was great in predicting IHL-ICC (AUC 0.902, sensitivity 0.771, specificity 0.923, and accuracy 0.862).ConclusionsThe radiomic-based model holds promise as a novel and accurate tool for predicting IHL-ICC, which can identify lesions in IHL timely for hepatectomy or avoid unnecessary surgical resection.

Purpose. To investigate the effect of low tube voltage (80 kV) on image quality, radiation dose, and low-contrast detectability (LCD) at abdominal computed tomography (CT). Materials and Methods. A phantom containing low-contrast objects was scanned with a CT scanner at 80 and 120 kV, with tube current-time product settings at 150-650mAs. The differences between image noise, contrast-to-noise ratio (CNR), and scores of LCD obtained with 80 kV at 150-650mAs and those obtained with 120 kV at 300mAs were compared respectively. Results. The image noise substantially increased with low tube voltage. However, with identical dose, use of 80 kV resulted in higher CNR compared with CNR at 120 kV. There were no statistically significant difference in CNR and scores of LCD between 120 kV at 300mAs and 80 kV at 550-650mAs (P > 0.05). The relative dose delivered at 80 kV ranged from 58% at 550mAs to 68% at 650mAs. Conclusion. With a reduction of the tube voltage from 120 kV to 80 kV at abdominal CT, the radiation dose can be reduced by 32% to 42% without degradation of CNR and LCD. [ABSTRACT FROM AUTHOR]

We describe CT features of our three cases with localized Castleman disease in the retroperitoneum and review literature. Besides those CT features, which have been reported before, we mainly present some newly discovered CT findings of the disease. These new CT findings include the sign of peripheral ‘rim-like’ enhancement at the early phase of an enhanced CT scan, a higher ratio of the left sided retroperitoneal location to the right side and the presence of local peritoneal thickening around the lesion. In addition, the feeding artery of the lesion is more visually pronounced than ever before by a 16-detector CT scanner. After reviewing the literature and comparing with their histological findings, we suggest these newly discovered findings are relatively characteristic CT features of the disease. Moreover, multi-detector helical CT can now show more details of the disease than ever before. [ABSTRACT FROM AUTHOR]

We report CT features of four cases of Eosinophilic enteritis. The disease involves the jejunum in one case, the ileum in two cases, and the colon in the remaining case. Two cases demonstrate a predominantly mucosal type of eosinophilic enteritis, while the other two cases demonstrate a predominantly subserosal type. CT findings include bowel wall thickening in four cases, bowel fold thickening in two cases, layering of the bowel wall in two cases, luminal narrowing without obstruction in three cases, an intra-luminal granuloma mimicking a huge polyp in one case, an extra-luminal irregular granuloma markedly enhancing and slightly necrosing in one case, mesenteric lymphadenopathy with peripheral rim-like enhancement and marked necrosis in one case and ascites in one case. CT findings are more characteristic of an inflammatory disease rather than of a tumor, and these findings are helpful for assessing the extent and location of the disease. Moreover, combined with its typical clinical manifestations, CT findings may lead to the correct diagnosis. [ABSTRACT FROM AUTHOR]

The aim of this study was to establish musculoskeletal finite element (FE) model of the second and the fifth foot ray accounting for metatarsal cavities and calcaneal sinus. The model was then used to predict the effects of metatarsal cavities and calcaneal sinus on internal stresses/strains of plantar longitudinal arches. The geometry of foot bones and soft tissues were constructed by CT and MRI images of Virtual Chinese Human “female No. 1”. Two types of nonlinear FE models of sagittal foot rays were developed with or without metatarsal cavities and calcaneal sinus using ANSYS © software package. The sagittal trabecular architecture of metatarsals and calcaneus were obtained by cutting, defatting and bleaching fresh foot specimen of a cadaver. The model proposed was able to describe the isostatic stress flows in sagittal planes of plantar longitudinal arches. The size of metatarsal cavity or calcaneal sinus could affect stress/strain distributions on metatarsals and calcaneus, but had almost no effects on stress/strain of other foot bones and plantar soft tissues. During balance standing, the maximum von Mises stresses were predicted at the shaft and the basis of metatarsals, while the maximum strains of bony regions were found around metatarsal cavities. Among plantar soft tissues, relative high tensions were burdened by plantar fascia, followed by long plantar ligament. The minimum tensions occurred in plantar intrinsic muscles. The study shows that the tension/compression stress flows are geometrically similar with the tension/compression trabecular architectures in sagittal sections of metatarsal and calcaneus. The FE predictions of stress/strain concentration on metatarsals and fascia are useful in enhancing biomechanical knowledge on metatarsal stress fractures and plantar fasciitis. [ABSTRACT FROM AUTHOR]

Background: It has not been reported that ingesting large amounts of strong acid resulted in total gastrointestinal tract necrosis. Here we describe a case of a man with total gastrointestinal tract necrosis after ingestion of a considerable amount of hydrochloric acid.Discussion: Computed tomography (CT) scan showed significant free air in the neck, lateral esophagus, and abdominal cavity, which indicated perforation of the esophagus and gastrointestinal tract. In addition, the abdominal CT image showed splenic subcapsular hematorna and swollen pancreatic head caused by strong acid causis. We found the entire gastrointestinal tract from stomach to rectum necrosis in the emergency exploratory laparotomy. Our case suggests that ingestion of a considerable amount (e.g., 500 mL) and concentration of strong acid could result in total gastrointestinal tract necrosis. Emergency laparotomy should be performed as early as possible to benefit this kind of patient. [ABSTRACT FROM AUTHOR]