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Background/aim: The recently published Node-Reporting and Data System (Node-RADS) can aid the characterization of lymph nodes in cross-sectional imaging. This study investigated the Node-RADS system in computed tomography (CT) to characterize lymph nodes in esophageal cancer., Patients and Methods: Overall, 126 patients (15 female, 11.9%) with a mean age of 62.1±10.4 years comprised the patient sample. All patients underwent resection with curative intent and the lymph nodes were histopathologically analyzed during clinical routine. For every patient, the locoregional lymph nodes were scored in accordance with the Node-RADS classification. For statistical analysis, receiver-operating characteristics (ROC) with area under the curve (AUC) were used to test for diagnostic accuracy; inter-reader variability was assessed with Cohen's kappa., Results: Overall, 54 patients were nodal positive (42.9%), 72 patients were nodal negative (57.1%). Inter-reader agreement was substantial for the overall Node-RADS scoring ([Formula: see text]=0.65, p<0.001). ROC curve analysis for lymph node discrimination (N0 versus N1-3) showed an AUC of 0.69 (95% confidence interval=0.59-0.79). A threshold score of more than 2 resulted in a sensitivity of 0.77 and a specificity of 0.55 for correctly predicting nodal positivity. Node-RADS 1 category had a malignancy rate of 30%, Node-RADS 2 of 14%, Node-RADS 3 of 81%, Node-RADS 4 of 90.1% and Node-RADS 5 of 86.5%., Conclusion: The Node-RADS score on staging CT is associated with the malignancy rate of lymph nodes in patients with EC with only moderate diagnostic accuracy. The inter-reader variability is moderate, which could pose difficulties for translation into clinical routine., (Copyright © 2025, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)

Objective: The purpose of the meta-analysis was to compare the prevalence of sarcopenia on staging computed tomography (CT) in patients with solid tumors in different world regions. Materials and Methods: MEDLINE, Embase, and SCOPUS literature databases were screened for prevalence of sarcopenia in oncologic patients up to December 2022. Two hundred eighty studies met the inclusion criteria. The methodological quality of the involved studies was checked according to the Quality Assessment of Diagnostic Studies instrument. Results: Two hundred eighty studies with 81,885 patients were included. The prevalence of sarcopenia among all patients was 35.5%. Prevalence of sarcopenia was higher in Europe (45.6%) and North America (41.2%) than in Asia (29.6%). Prevalence rates for the curative cohort were similar in all three regions, with 43.7% in Europe, 41.3% in North America, and 37.4% in Asia. In the palliative cohort, sarcopenia prevalence was higher in Europe (55.7%) and Asia (45.7%) than in North America (34.0%). In the European cohort, prostate cancer (73.9%), esophageal cancer (74.2%), pancreatic cancer (62.5%), and renal cell cancer (65.3%) showed high prevalence rates of sarcopenia. Applied cutoff values differed among regions. Conclusion: Our study shows that prevalence rates for sarcopenia of patients with solid tumors differ between regions and are different for curative and palliative settings. European studies demonstrate high prevalence rates for both settings. There is need for regional harmonization of sarcopenia definitions.

Purpose: This study evaluates the prognostic significance of pleural effusion (PE) in COVID-19 patients across thirteen centers in Germany, aiming to clarify its role in predicting clinical outcomes., Methods: In this retrospective analysis within the RACOON project (Radiological Cooperative Network of the COVID-19 pandemic), 1183 patients (29.3 % women, 70.7 % men) underwent chest CT to assess PE. We investigated PE's association with 30-day mortality, ICU admission, and the need for mechanical ventilation., Results: PE was detected in 31.5 % of patients, showing a significant correlation with 30-day mortality (47.5 % in non-survivors vs. 27.3 % in survivors, p < 0.001), with a hazard ratio of 2.22 (95 % CI 1.65-2.99, p < 0.001). No significant association was found between PE volume or density and mortality. ICU admissions were noted in 46.8 % of patients, while mechanical ventilation was required for 26.7 %., Conclusion: Pleural effusion is present in a significant portion of COVID-19 patients and independently predicts increased 30-day mortality, underscoring its value as a prognostic marker. Its identification, irrespective of volume or density, should be a priority in radiological reports to guide clinical decision-making., Competing Interests: Declaration of competing interest The authors have no competing interests to declare that are relevant to the content of this article., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: The complex interactions of the tumor micromilieu may be reflected by diffusion-weighted imaging (DWI) derived from the magnetic resonance imaging (MRI). The present study investigated the association between apparent diffusion coefficient (ADC) values and histopathologic features in uterine cervical cancer., Methods: In this retrospective study, prebiopsy MRI was used to analyze histogram ADC-parameters. The biopsy specimens were stained for Ki-67, E-cadherin, vimentin and tumor-infiltrating lymphocytes (TIL, all CD45 positive cells). Tumor-stroma ratio (TSR) was calculated on routine H&E specimens. Spearman's correlation analysis and receiver-operating characteristics curves were used as statistical analyses., Results: The patient sample comprised 70 female patients (age range 32-79 years; mean age 55.4 years) with squamous cell cervical carcinoma. The interreader agreement was high ranging from intraclass coefficient (ICC) = 0.71 for entropy to ICC = 0.96 for ADCmedian. Several ADC-histogram parameters correlated strongly with the TSR. The highest correlation coefficient achieved p10 (r = -0.81, p < 0.0001). ADCmean can predict tumors with high TSR, AUC: 0.91, sensitivity: 0.91 (95% CI 0.77;0.96), specificity: 0.91 (95% CI 0.78;0.97). Several ADC-histogram parameters correlated slightly with the proliferation index Ki-67. No associations were found with TIL, E-Cadherin and vimentin. In well and moderately differentiated cancers, ADC histogram values showed stronger correlations with Ki-67 and TSR than in poorly differentiated tumors., Conclusion: ADC values are strongly associated with tumor-stroma ratio. The ADC mean can be used to predict tumors with high TSR. Associations between histopathology and ADC values depend on tumor differentiation. ADC values show only weak associations with Ki-67 and none with TIL, vimentin and E-cadherin., Competing Interests: Declarations. Ethics approval and consent to participate: Institutional Review Board Statement: The study was conducted according to the guidelines of the Declaration of Helsinki, and approved by the Institutional Review Board of the University of Leipzig (protocol code N° Ethical code: 012/13–28012013). Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

Rationale and Objectives: The prognostic role of computed tomography (CT)-defined skeletal muscle features in COVID-19 is still under investigation. The aim of the present study was to evaluate the prognostic role of CT-defined skeletal muscle area and density in patients with COVID-19 in a multicenter setting., Materials and Methods: This retrospective study is a part of the German multicenter project RACOON (Radiological Cooperative Network of the COVID-19 pandemic). The acquired sample included 1379 patients, 389 (28.2%) women and 990 (71.8%) men. In each case, chest CT was analyzed and pectoralis muscle area and density were calculated. Data were analyzed by means of descriptive statistics. Group differences were calculated using the Mann-Whitney-U test and Fisher's exact test. Univariable and multivariable logistic regression analyses were performed., Results: The 30-day mortality was 17.9%. Using median values as thresholds, low pectoralis muscle density (LPMD) was a strong and independent predictor of 30-day mortality, HR=2.97, 95%-CI: 1.52-5.80, p=0.001. Also in male patients, LPMD predicted independently 30-day mortality, HR=2.96, 95%-CI: 1.42-6.18, p=0.004. In female patients, the analyzed pectoralis muscle parameters did not predict 30-day mortality. For patients under 60 years of age, LPMD was strongly associated with 30-day mortality, HR=2.72, 95%-CI: 1.17;6.30, p=0.019. For patients over 60 years of age, pectoralis muscle parameters could not predict 30-day mortality., Conclusion: In male patients with COVID-19, low pectoralis muscle density is strongly associated with 30-day mortality and can be used for risk stratification. In female patients with COVID-19, pectoralis muscle parameters cannot predict 30-day mortality., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.)

Purpose: Coronavirus disease 2019 (COVID-19) and non-COVID-19 community-acquired pneumonia (NC-CAP) often result in hospitalization with considerable risks of mortality, ICU treatment, and long-term morbidity. A comparative analysis of clinical outcomes in COVID-19 CAP (C-CAP) and NC-CAP may improve clinical management., Methods: Using prospectively collected CAPNETZ study data (January 2017 to June 2021, 35 study centers), we conducted a comprehensive analysis of clinical outcomes including in-hospital death, ICU treatment, length of hospital stay (LOHS), 180-day survival, and post-discharge re-hospitalization rate. Logistic regression models were used to examine group differences between C-CAP and NC-CAP patients and associations with patient demography, recruitment period, comorbidity, and treatment., Results: Among 1368 patients (C-CAP: n = 344; NC-CAP: n = 1024), C-CAP showed elevated adjusted probabilities for in-hospital death (aOR 4.48 [95% CI 2.38-8.53]) and ICU treatment (aOR 8.08 [95% CI 5.31-12.52]) compared to NC-CAP. C-CAP patients were at increased risk of LOHS over seven days (aOR 1.88 [95% CI 1.47-2.42]). Although ICU patients had similar in-hospital mortality risk, C-CAP was associated with length of ICU stay over seven days (aOR 3.59 [95% CI 1.65-8.38]). Recruitment period influenced outcomes in C-CAP but not in NC-CAP. During follow-up, C-CAP was linked to a reduced risk of re-hospitalization and mortality post-discharge (aOR 0.43 [95% CI 0.27-0.70])., Conclusion: Distinct clinical trajectories of C-CAP and NC-CAP underscore the need for adapted management to avoid acute and long-term morbidity and mortality amid the evolving landscape of CAP pathogens., Competing Interests: Declarations. Conflict of interest: H.-J. M. reports a personal fee from Astra Zeneca for a lecture. G. R. reports personal fees from Astra Zeneca, Atriva, Boehringer Ingelheim, GSK, Insmed, MSD, Sanofi, Novartis, and Pfizer for consultancy during advisory board meetings and personal fees from Astra Zeneca, Berlin Chemie, BMS, Boehringer Ingelheim, Chiesi, Essex Pharma, Grifols, GSK, Insmed, MSD, Roche, Sanofi, Solvay, Takeda, Novartis, Pfizer, and Vertex for lectures. M. W. received funding for research, lectures, or advisory from Alexion, Aptarion, Astra Zeneca, Bayer Health Care, Biotest, Boehringer Ingelheim, Chiesi, Glaxo Smith Kline, Insmed, Novartis, Pantherna, Pfizer, Teva, and Vaxxilon. T. Z. received funding for research from Bundesministerium für Bildung und Forschung, Else Kröner Fresenius Stiftung and Gesellschaft für Internationale Zusammenarbeit., (© 2024. The Author(s).)

Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht.

Background: Body composition parameters provide relevant prognostic significance in critical care cohorts and cancer populations. Published results regarding polytrauma patients are inconclusive to date. The goal of this study was to analyse the role of body composition parameters in severely injured trauma patients., Methods: All consecutive patients requiring emergency tracheal intubation and mechanical ventilation before initial computed tomography (CT) at a level-1 trauma centre over a 12-year period (2008-2019) were reanalysed. The analysis included CT-derived body composition parameters based upon whole-body trauma CT as prognostic variables for 30-day mortality, intensive care unit length of stay (ICU LOS) and mechanical ventilation duration., Results: Four hundred seventy-two patients (75% male) with a median age of 49 years, median injury severity score of 26 and 30-day mortality rate of 22% (104 patients) met the inclusion criteria and were analysed. Regarding body composition parameters, 231 patients (49%) had visceral obesity, 75 patients had sarcopenia (16%) and 35 patients had sarcopenic obesity (7.4%). After adjustment for statistically significant univariable predictors age, body mass index, sarcopenic obesity, visceral obesity, American Society of Anesthesiologists classification ≥3, injury severity score and Glasgow Coma Scale ≤ 8 points, the Cox proportional hazard model identified sarcopenia as significant prognostic factor of 30-day mortality (hazard ratio 2.84; 95% confidence interval 1.38-5.85; P = 0.004), which was confirmed in Kaplan-Meier survival analysis (log-rank P = 0.006). In a subanalysis of 363 survivors, linear multivariable regression analysis revealed no significant associations of body composition parameters with ICU LOS and duration of mechanical ventilation., Conclusions: In a multivariable analysis of mechanically ventilated trauma patients, CT-defined sarcopenia was significantly associated with 30-day mortality whereas no associations of body composition parameters with ICU LOS and duration of mechanical ventilation were observed., (© 2024 The Author(s). Journal of Cachexia, Sarcopenia and Muscle published by Wiley Periodicals LLC.)

Purpose: The prognostic role of pleural and pericardial effusion in patients with acute pulmonary embolism (PE) is still unclear with a trend for worse clinical outcome. The aim of the present study was to demonstrate the prognostic role of pleural and pericardial effusion in patients with acute PE in a large multicentre setting., Methods: The investigated patient sampled was retrospectively comprised of 1082 patients (494 female, 45.7%) with a mean age of 63.8 years ± 15.8. In every case, contrast enhanced computed tomography (CT) pulmonalis angiography was analyzed to diagnose and quantify the pleural and pericardial effusion. The 30-day mortality was the primary endpoint of this study., Results: A total of 127 patients (11.7%) died within the 30-day observation period. Pleural effusion was identified in 438 patients (40.5%) and pericardial effusion was identified in 196 patients (18.1%). The presence of pleural effusion was associated with 30-day mortality, HR = 2.78 (95%CI1.89-4.0), p < 0.001 (univariable analysis), and HR = 2.52 (95%CI1.69-3.76), p < 0.001 (multivariable analysis). The pleural effusion width and density were not associated with 30-day mortality. The presence of pericardial effusion was not associated with 30-day mortality in multivariable analysis, HR = 1.28 (95%CI 0.80-2.03), p = 0.29., Conclusions: Pleural effusion is a common finding in patients with acute pulmonary embolism, occurring in 40.5% of cases, and is a prognostic imaging finding associated with 30-day mortality. The presence of pleural effusion alone, regardless of volume or density, has been shown to be prognostic and should be included in CT reports. The prognostic role of pericardial effusion is limited., Competing Interests: Declarations. Competing interests: The authors declare that they have no competing interests., (© 2024. The Author(s).)

In this work, the (MnCl 2 (C 6 N 10 H 6 ) complex has been synthesized via solid-state reaction between manganese (II) chloride and melamine in the molar ratio of 1:2. A similar synthesis has been repeated with CoCl 2 , and FeCl 2 , resulting in two new metal-melam complexes (FeCl 2 (C 6 N 11 H 9 ) and CoCl 2 (C 6 N 11 H 9 )). MnCl 2 (C 6 N 10 H 6 ) crystallizes in the monoclinic crystal system with the space group I 2/ a . The crystalline powder of MnCl 2 (C 6 N 10 H 6 ) was studied by X-ray diffraction, infrared spectroscopy, and thermogravimetric analysis to examine its structure and properties. MnCl 2 (C 6 N 10 H 6 ) also shows good thermal stability up to 370 °C; however, the complete decomposition occurred at 900 °C, yielding Mn 7 C 3 . This paper presents an easy synthesis of the first luminescent transition metal-melem complex, providing new insights into the reactivity of melamine at elevated temperatures in the presence of transition metal chlorides.

Rationale and Objectives: Coronary artery calcification (CAC) can be quantified by computed tomography (CT). It is an important predictive and prognostic imaging marker for cardiovascular disease. The prognostic role for CAC in oncological patients is provided in preliminary studies, especially in lung cancer patients. The aim of the present study was to establish the effect of CAC score on overall survival (OS) in lung cancer patients based on the published literature MATERIALS AND METHODS: Literature databases were screened for papers analyzing the association between CAC and overall survival in lung cancer patients up to June 2024. The primary endpoint of the present systematic review was the OS. Overall, seven studies were suitable for the analysis and were included., Results: The included studies comprised 2292 patients undergoing curative treatment. The pooled hazard ratio for the association between CAC score and OS was HR= 1.42 (95% CI=(1.19; 1.69), p < 0.0001) in the univariable analysis and HR= 1.56 (95% CI=(1.25; 1.94), p < 0.0001) in the multivariable analysis. The pooled odds ratio for the association between CAC score and major cardiovascular events was OR= 1.97 (95% CI=(1.24; 3.13)], p = 0.004., Conclusion: CT-defined CAC has a meaningful impact on overall survival and prediction of major cardiovascular events in lung cancer patients undergoing curative treatment. The sole presence of CAC on staging CT should be reported as an important prognostic marker in these patients., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.)

Purpose: Skeletal muscle quality assessment can be performed by cross-sectional imaging. Skeletal muscle density (SMD) identified to be of prognostic relevance of several clinically outcomes in patients with hematological diseases. The purpose of the present study was to establish the effect of SMD on overall survival (OS) and progression-free survival (PFS) in patients with multiple myeloma (MM)., Methods: All patients with MM were retrospectively analyzed between 2009 and 2019. 127 patients were included into the analysis. Whole-body computed tomography (CT) was used to calculate skeletal muscle index (SMI), SMD, albumin-gauge score and intramuscular adipose tissue content (IMAC)., Results: Overall, 28 patients (22.0%) of the patient sample died. In the discrimination analysis muscle density was higher in non-survivors compared to survivors (mean 30.8 ± 12.5 versus 24.1 ± 15.8, p = 0.03) and IMAC was lower in non-survivors (- 0.66 ± 1.8 versus - 0.25 ± 0.21, p = 0.01). These differences, however, were not demonstrated in the logistic regression analysis, which could not show prognostic relevance for the investigated muscle density parameters on PFS or OS., Conclusion: CT-defined muscle density parameters have no prognostic relevance on survival in patients with MM undergoing autologous stem cell therapy, which was demonstrated in a comprehensive analysis. These results corroborate previous smaller studies that body composition might have a limited role in this tumor entity., Competing Interests: Declarations Conflicts of interest The authors declare no competing interests. Ethical approval This study was conducted and complied with all international and local laws, the principles of the Declaration of Helsinki, and the Good Clinical Practice Guidelines. The study protocol and all its amendments were approved by the relevant institutional review boards or independent ethics committees., (© 2024. The Author(s).)

Competing Interests: Disclosure The authors report no conflicts of interest in this work.

Background: The significance of computed tomography (CT)-based volume measurement of the inferior vena cava (IVC) in the treatment and prognosis of trauma patients is not yet fully understood. The conflicting results that have been reported may be attributable to differences in injury severity and the use of different measurement methods, including IVC index and volumetry. The purpose of this study was to determine the relationship between IVC volume and red blood cell (RBC) transfusion and mortality in intubated trauma patients who were stable enough for initial CT imaging., Methods: A retrospective analysis was conducted on all consecutive trauma patients who underwent emergency tracheal intubation and mechanical ventilation before initial whole-body CT imaging at a level-1 trauma center over a 12-year period (2008-2019). The IVC volume was determined on initial trauma CT and included in multivariable models with demographic and diagnostic data. Associations of overall RBC transfusion, massive transfusion, 24-h mortality, and 30-day mortality were assessed using logistic regression analyses and Cox proportional hazard models., Results: A total of 438 patients (75.3% male) with a median age of 50 years, and a median injury severity score (ISS) of 26 points were included in the analysis. Most of the patients (97.5%) had suffered from blunt trauma mechanisms. Median IVC volume was 36.25 cm 3 , and RBC transfusion and massive transfusion were performed in 197 and 90 patients, respectively. The 24-h and 30-day mortality rates were 7.3% and 23.3%, respectively. VCI volume was found to be independently associated with the necessity of RBC transfusion and 24-h mortality (OR 0.98, 95% CI 0.96-0.99, p = 0.01 and HR 0.96, 95% CI 0.93-0.99, p = 0.025, respectively), while associations with massive transfusion and 30-day mortality were not statistically significant in multivariable analyses., Conclusion: Initial IVC volume may serve as a predictor of patients at risk for overall RBC transfusion requirements and 24-h mortality, suggesting the possibility of its diagnostic efficacy in short-term outcomes. Further studies are needed to confirm these findings., (© 2024. The Author(s).)

The compound Ta 4 SBr 11 was prepared by a comproportionation reaction of tantalum bromide with tantalum and elemental sulfur. The crystal structure, as refined by single-crystal X-ray diffraction, is composed of clusters with Ta 4 S cores, arranged in corrugated van der Waals layers. Individual layers appear to be displaced relative to each other along one direction. Successful crystal growth in a melt of CsBr yielded black platelets of Ta 4 SBr 11 , which were used to investigate the electrical properties of the compound. The electronic structure was studied by diffuse reflectance infrared Fourier transform (DRIFT) spectroscopy and by density functional theory (DFT) band structure calculations, revealing this material to be a small-gap semiconductor. DFT results, in combination with magnetic susceptibility measurements, suggest that metallicity originating from the one unpaired Ta d electron per cluster is most likely suppressed by electronic correlations, forming a cluster Mott insulator.

Introduction: The relationships between histopathology and imaging remain elusive, and investigating the underlying reasons for tumor microstructure leading to an imaging phenotype is of clinical importance. In the present study, a cross-sectional guided biopsy specimen was used to correlate prebioptic magnetic resonance imaging (MRI) with immunohistochemical staining of the histopathologic specimen using precise spatial biopsy localization., Methods: Twenty-seven patients with mass-forming cholangiocarcinoma (CCA) were included in the present analysis. All patients were imaged with a 1.5 T clinical scanner at least 1 month prior to biopsy. The contrast-enhanced dynamic sequences were analyzed with quantified signal intensities. The bioptic specimens were obtained by cross-sectional guided biopsy and further analyzed for cell density, proliferation index (Ki67), tumor-infiltrating lymphocytes, tumor-stroma ratio (TSR), and collagen., Results: There were no statistically significant correlations between MRI signal intensities and cell count, TSR, Ki67 index, and CD45 count. Only a moderate correlation was observed between relative signal intensities of the venous phase and the collagen-stained area (r = 0.40, p = 0.04)., Conclusion: DCE-MRI is not associated with histopathological features in CCA. The complex interactions of tumor and tumor microenvironment are not reflected in the MRI phenotype., (© 2024 S. Karger AG, Basel.)