Slicer Wiki - User contributions [en]

Main Page/SlicerCommunity

2023-09-20T13:30:25Z

Marianna:

<includeonly>----
Go to <big>[[Main_Page/SlicerCommunity/2022|2022]] :: [[Main_Page/SlicerCommunity/2021|2021]] :: [[Main_Page/SlicerCommunity/2020|2020]] :: [[Main_Page/SlicerCommunity/2019|2019]] :: [[Main_Page/SlicerCommunity/2018|2018]] :: [[Main_Page/SlicerCommunity/2017|2017]] :: [[Main_Page/SlicerCommunity/2016|2016]] :: [[Main_Page/SlicerCommunity/2015|2015]] :: [[Main_Page/SlicerCommunity/2011-2014|2014-2011]] :: [[Main_Page/SlicerCommunity/2005-2010|2010-2000]]</big>
----</includeonly>
<noinclude>
=3D Slicer Enabled Research=
[[Documentation/{{documentation/currentversion}}/Slicer|3D Slicer]] is a free open source software package distributed under a BSD style [[License|license]] for analysis, integration, and visualization of medical images. 3D Slicer allows even those with limited image processing experience to effectively explore and quantify their imaging data for hypothesis-driven research.
</noinclude>

The community that relies on 3D Slicer is large and active: (numbers below updated on September 20th, 2023)

*[https://download.slicer.org/download-stats/ 1,340,397+ downloads] in the last 11 years (206,541 in 2022)
*[https://scholar.google.com/scholar?hl=en&as_sdt=1%2C22&as_vis=1&q=%28%223D+Slicer%22+OR+%22slicer+software%22+OR+%22slicer+org%22+OR+Slicer3D%29+-Slic3r+&btnG= over 17.000+ literature search results on Google Scholar]
**[https://scholar.google.com/scholar?hl=en&as_sdt=1%2C22&as_vis=1&q=%28cancer+OR+tumor+OR+radiation%29+AND+%28%223D+Slicer%22+OR+%22slicer+org%22+OR+Slicer3D%29+-Slic3r+&btnG= 12,800+ '''cancer''']
**[https://scholar.google.com/scholar?hl=en&as_sdt=1%2C22&as_vis=1&q=%28brain%29+AND+%28cancer+OR+tumor+OR+radiation%29+AND+%28%223D+Slicer%22+OR+%22slicer+org%22+OR+Slicer3D%29+-Slic3r+&btnG= 6.960+ '''brain''']
**[https://scholar.google.com/scholar?hl=en&as_sdt=1%2C22&as_vis=1&q=%28lung%29+AND+%28cancer+OR+tumor+OR+radiation%29+AND+%28%223D+Slicer%22+OR+%22slicer+org%22+OR+Slicer3D%29+-Slic3r+&btnG= 6,020+ '''lung''']
**[https://scholar.google.com/scholar?hl=en&as_sdt=1%2C22&as_vis=1&q=%28breast%29+AND+%28cancer+OR+tumor+OR+radiation%29+AND+%28%223D+Slicer%22+OR+%22slicer+org%22+OR+Slicer3D%29+-Slic3r+&btnG= 3,680+ '''breast''']
**[https://scholar.google.com/scholar?hl=en&as_sdt=1%2C22&as_vis=1&q=%28prostate%29+AND+%28cancer+OR+tumor+OR+radiation%29+AND+%28%223D+Slicer%22+OR+%22slicer+org%22+OR+Slicer3D%29+-Slic3r+&btnG= 2,940+ '''prostate''']

*[https://pubmed.ncbi.nlm.nih.gov/?sort=pubdate&size=200&linkname=pubmed_pubmed_citedin&from_uid=22770690 2,068+ papers on PubMed citing the Slicer platform paper]
**Fedorov A., Beichel R., Kalpathy-Cramer J., Finet J., Fillion-Robin J-C., Pujol S., Bauer C., Jennings D., Fennessy F.M., Sonka M., Buatti J., Aylward S.R., Miller J.V., Pieper S., Kikinis R. 3D Slicer as an Image Computing Platform for the Quantitative Imaging Network. Magnetic Resonance Imaging. 2012 Nov;30(9):1323-41. PMID: 22770690. PMCID: PMC3466397.

*[https://na-mic.github.io/ProjectWeek/ 39 events in open source hackathon series] continuously running since 2005 with 3260 total participants
*[https://discourse.slicer.org/ Slicer Forum] with +6,597 subscribers has approximately 275 posts every week



The following is a sample of the research performed using 3D Slicer outside of the group that develops it. <includeonly> in {{#titleparts: {{PAGENAME}} | 2 | 3 }}</includeonly><noinclude>

[[Main_Page/SlicerCommunity/2023|2023]] :: [[Main_Page/SlicerCommunity/2022|2022]] :: [[Main_Page/SlicerCommunity/2021|2021]] :: [[Main_Page/SlicerCommunity/2020|2020]] :: [[Main_Page/SlicerCommunity/2019|2019]] :: [[Main_Page/SlicerCommunity/2018|2018]] ::
[[Main_Page/SlicerCommunity/2017|2017]] :: [[Main_Page/SlicerCommunity/2016|2016]] :: [[Main_Page/SlicerCommunity/2015|2015]] ::
[[Main_Page/SlicerCommunity/2011-2014|2011-2014]] :: [[Main_Page/SlicerCommunity/2005-2010|2000-2010]]

We invite you to provide information using our [https://discourse.slicer.org/ discussion forum] on how you are using 3D Slicer to produce peer-reviewed research. Information about the scientific impact of this tool is helpful in raising funding for the continued support.
</noinclude>

We monitor PubMed and related databases to update these lists, but if you know of other research related to the Slicer community that should be included here please email: marianna (at) bwh.harvard.edu.

Main Page/SlicerCommunity

2023-09-20T13:27:40Z

Marianna:

<includeonly>----
Go to <big>[[Main_Page/SlicerCommunity/2022|2022]] :: [[Main_Page/SlicerCommunity/2021|2021]] :: [[Main_Page/SlicerCommunity/2020|2020]] :: [[Main_Page/SlicerCommunity/2019|2019]] :: [[Main_Page/SlicerCommunity/2018|2018]] :: [[Main_Page/SlicerCommunity/2017|2017]] :: [[Main_Page/SlicerCommunity/2016|2016]] :: [[Main_Page/SlicerCommunity/2015|2015]] :: [[Main_Page/SlicerCommunity/2011-2014|2014-2011]] :: [[Main_Page/SlicerCommunity/2005-2010|2010-2000]]</big>
----</includeonly>
<noinclude>
=3D Slicer Enabled Research=
[[Documentation/{{documentation/currentversion}}/Slicer|3D Slicer]] is a free open source software package distributed under a BSD style [[License|license]] for analysis, integration, and visualization of medical images. 3D Slicer allows even those with limited image processing experience to effectively explore and quantify their imaging data for hypothesis-driven research.
</noinclude>

The community that relies on 3D Slicer is large and active: (numbers below updated on September 20th, 2023)

*[https://download.slicer.org/download-stats/ 1,340,397+ downloads] in the last 11 years (206,541 in 2022)
*[https://scholar.google.com/scholar?hl=en&as_sdt=1%2C22&as_vis=1&q=%28%223D+Slicer%22+OR+%22slicer+software%22+OR+%22slicer+org%22+OR+Slicer3D%29+-Slic3r+&btnG= over 17.000+ literature search results on Google Scholar]
**[https://scholar.google.com/scholar?hl=en&as_sdt=1%2C22&as_vis=1&q=%28cancer+OR+tumor+OR+radiation%29+AND+%28%223D+Slicer%22+OR+%22slicer+org%22+OR+Slicer3D%29+-Slic3r+&btnG= 12,200+ '''cancer''']
**[https://scholar.google.com/scholar?hl=en&as_sdt=1%2C22&as_vis=1&q=%28brain%29+AND+%28cancer+OR+tumor+OR+radiation%29+AND+%28%223D+Slicer%22+OR+%22slicer+org%22+OR+Slicer3D%29+-Slic3r+&btnG= 6.580+ '''brain''']
**[https://scholar.google.com/scholar?hl=en&as_sdt=1%2C22&as_vis=1&q=%28lung%29+AND+%28cancer+OR+tumor+OR+radiation%29+AND+%28%223D+Slicer%22+OR+%22slicer+org%22+OR+Slicer3D%29+-Slic3r+&btnG= 5,610+ '''lung''']
**[https://scholar.google.com/scholar?hl=en&as_sdt=1%2C22&as_vis=1&q=%28breast%29+AND+%28cancer+OR+tumor+OR+radiation%29+AND+%28%223D+Slicer%22+OR+%22slicer+org%22+OR+Slicer3D%29+-Slic3r+&btnG= 3,410+ '''breast''']
**[https://scholar.google.com/scholar?hl=en&as_sdt=1%2C22&as_vis=1&q=%28prostate%29+AND+%28cancer+OR+tumor+OR+radiation%29+AND+%28%223D+Slicer%22+OR+%22slicer+org%22+OR+Slicer3D%29+-Slic3r+&btnG= 2,780+ '''prostate''']

*[https://pubmed.ncbi.nlm.nih.gov/?sort=pubdate&size=200&linkname=pubmed_pubmed_citedin&from_uid=22770690 1,962+ papers on PubMed citing the Slicer platform paper]
**Fedorov A., Beichel R., Kalpathy-Cramer J., Finet J., Fillion-Robin J-C., Pujol S., Bauer C., Jennings D., Fennessy F.M., Sonka M., Buatti J., Aylward S.R., Miller J.V., Pieper S., Kikinis R. 3D Slicer as an Image Computing Platform for the Quantitative Imaging Network. Magnetic Resonance Imaging. 2012 Nov;30(9):1323-41. PMID: 22770690. PMCID: PMC3466397.

*[https://na-mic.github.io/ProjectWeek/ 39 events in open source hackathon series] continuously running since 2005 with 3260 total participants
*[https://discourse.slicer.org/ Slicer Forum] with +6,597 subscribers has approximately 275 posts every week



The following is a sample of the research performed using 3D Slicer outside of the group that develops it. <includeonly> in {{#titleparts: {{PAGENAME}} | 2 | 3 }}</includeonly><noinclude>

[[Main_Page/SlicerCommunity/2023|2023]] :: [[Main_Page/SlicerCommunity/2022|2022]] :: [[Main_Page/SlicerCommunity/2021|2021]] :: [[Main_Page/SlicerCommunity/2020|2020]] :: [[Main_Page/SlicerCommunity/2019|2019]] :: [[Main_Page/SlicerCommunity/2018|2018]] ::
[[Main_Page/SlicerCommunity/2017|2017]] :: [[Main_Page/SlicerCommunity/2016|2016]] :: [[Main_Page/SlicerCommunity/2015|2015]] ::
[[Main_Page/SlicerCommunity/2011-2014|2011-2014]] :: [[Main_Page/SlicerCommunity/2005-2010|2000-2010]]

We invite you to provide information using our [https://discourse.slicer.org/ discussion forum] on how you are using 3D Slicer to produce peer-reviewed research. Information about the scientific impact of this tool is helpful in raising funding for the continued support.
</noinclude>

We monitor PubMed and related databases to update these lists, but if you know of other research related to the Slicer community that should be included here please email: marianna (at) bwh.harvard.edu.

Main Page/SlicerCommunity/2023

2023-09-11T18:57:16Z

Marianna: /* Dosimetric Assessment of Gadolinium-159 for Hepatic Radioembolization: Tomographic Images and Monte Carlo Simulation */

{{:Main_Page/SlicerCommunity}}

__TOC__

=2023=
==Clinical Study of Puncture Technique in Single Division of the Trigeminal Ganglion Intumescentia==

{| width="100%"
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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37183316 Pain Pract. 2023 Sep;23(7):743-58. PMID: 37183316] | [https://onlinelibrary.wiley.com/doi/epdf/10.1111/papr.13239 PDF]

'''Authors:''' Zhang L, Guo Y, Xu J, He Y, Qi Z, Chen H, Zhang H.

'''Institution:''' Department of Neurosurgery, Jianhu Hospital Affiliated to Nantong University, Yancheng, China.

'''Abstract:'''
Objective: We explored the feasibility of single-division puncture in the ophthalmic division, maxillary division, and mandibular division of the trigeminal ganglion intumescentia (TGI) and the feasibility of radiofrequency treatment of trigeminal neuralgia.

Methods: According to the previous anatomical image studies, [http://www.slicer.org '''3D Slicer'''] software was used to analyze the CT images of the patients. The trigeminal ganglion fossa (TGF) was used as the imaging sign. TGI was identified in the sagittal plane along the fiber. The puncture path starts from the TGI center-foramen ovale line, extending outward to the epidermis as the needle insertion point, and extending inward to the division boundary. For lateral puncture, which is blocked by the mandible, the positions of closed mouth, open mouth, and over-open mouth were used. Multiple targets were generated using straight electrodes and curved electrodes to achieve full coverage of TGI. According to the preoperative design, general anesthesia surgery was performed. Xper CT was used for imaging, and the puncture was guided by Xper Guide. Radiofrequency treatment of TGI was conducted.

Results: In total, 45 patients with trigeminal neuralgia underwent 50 single-division TGI punctures. The procedure was smooth and the compliance with the design was good. Continuous radiofrequency (CRF) was performed, the VAS scores were 25 times at 70°C, 19 times at 65°C, two times at 60°C, and two times at 50°C (both in the ophthalmic division). Pulsed radiofrequency (PRF) was conducted two times. Within 24 h after the procedure, the VAS scores were all 0. From 1 to 7 days after the procedure, pain recurrence was found in three cases, of whom two cases received pulsed radiofrequency treatment. Patients were followed up for 1-24 months and there were no recurrence. After continuous radiofrequency at 65-70°C, the moderate tactile loss was observed, and nearly half of the patients had food residues on the surgical side after 6 months. After continuous radiofrequency at 60°C, there was mild tactile loss and no food residue. The tactile sensation was slightly decreased after continuous radiofrequency at 50°C, and the tactile sensation was normal the next day.

Conclusion: Trigeminal ganglion intumescentia single-division radiofrequency is effective and feasible for the treatment of trigeminal neuralgia.
|}

==Dosimetric Assessment of Gadolinium-159 for Hepatic Radioembolization: Tomographic Images and Monte Carlo Simulation==

{| width="100%"
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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37393764 Appl Radiat Isot. 2023 Sep;199:110916. PMID: 37393764]

'''Authors:''' Musa AS, Abdul Hadi MFR, Hashikin NAA, Ashour NI, Ying CK.

'''Institution:''' School of Physics, Universiti Sains Malaysia, Penang, Malaysia.

'''Abstract:'''
A common therapeutic radionuclide used in hepatic radioembolization is yttrium-90 (90Y). However, the absence of gamma emissions makes it difficult to verify the post-treatment distribution of 90Y microspheres. Gadolinium-159 (159Gd) has physical properties that are suitable for therapy and post-treatment imaging in hepatic radioembolization procedures. The current study is innovative for conducting a dosimetric investigation of the use of 159Gd in hepatic radioembolization by simulating tomographic images using the Geant4 application for tomographic emission (GATE) Monte Carlo (MC) simulation. For registration and segmentation, tomographic images of five patients with hepatocellular carcinoma (HCC) who had undergone transarterial radioembolization (TARE) therapy were processed using a [http://www.slicer.org '''3D Slicer''']. The tomographic images with 159Gd and 90Y separately were simulated using the GATE MC Package. The output of simulation (dose image) was uploaded to [http://www.slicer.org '''3D Slicer'''] to compute the absorbed dose for each organ of interests. 159Gd were able to provide a recommended dose of 120 Gy to the tumour, with normal liver and lungs absorbed doses close to that of 90Y and less than the respective maximum permitted doses of 70 Gy and 30 Gy, respectively. Compared to 90Y, 159Gd requires higher administered activity approximately 4.92 times to achieve a tumour dose of 120 Gy. Thus; this research gives new insights into the use of 159Gd as a theranostic radioisotope, with the potential to be used as a90Y alternative for liver radioembolization.
|}

==The Cranial Capacity of the Saudi Population Measured Using 3D Computed Tomography Scans==

{| width="100%"
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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37482378 Neurosciences (Riyadh). 2023 Jul;28(3):184-89. PMID: 37482378]

'''Authors:''' Alshamrani KA.

'''Institution:''' Department of Radiological sciences, Faculty of Applied Medical Science, and from Health Research Centre, Najran University, Najran, Kingdom of Saudi Arabia.

'''Abstract:'''
Objectives: To measure the cranial capacity of members of the Saudi adult population across ages and genders.

Methods: This was a retrospective cross-sectional study that used 488 Computed Tomography (CT) scans of heads (of which 275 males) to measure cranial volume. The CT slices 0.625 mm thick were uploaded using the freely available [http://www.slicer.org '''3D Slicer'''] software, which then reconstructed the images and built a 3D module.

Results: The mean (±SD) cranial capacity of the males was 1481.6 (±110) cm3 (range: 1241-1723 cm3), whereas the cranial capacity of the females was 1375.4 (±104) cm3 (range: 1203-1678 cm3). This study showed that the males had a mean cranial capacity that was 7% greater than that of the females in this study. The average cranial capacity of the males between the ages of 31 and 40 years was statistically significantly larger to that of the males aged 61-80 (p<0.05).

Conclusion: This study demonstrated that the average cranial capacity of the males was larger than that of the females. These study results can help to determine the normal cranial capacity of adults in Saudi Arabia. Further work should be carried out to aid in establishing reference data for the Saudi population.
|}

==The Tracheal System of the Common Wasp (Vespula Vulgaris) - a Micro-CT Study==

{| width="100%"
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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37451536 J Insect Physiol. 2023 Jul 13;149:104547. PMID: 37451536]

'''Authors:''' Bell GD, Corps N, Mortimer D, Gretton S, Bury N, Connett GJ.

'''Institution:''' School of (EAST) Engineering, Arts, Science and Technology, University of Suffolk, James Hehir Building, UK.

'''Abstract:'''
X-ray micro-CT has been used to study the tracheal system of Pre and Post hibernation Queen wasps (Vespula vulgaris) and their workers. We have compared our findings in wasps with Snodgrass's description of the tracheal system of the honeybee as characterised by anatomical dissection. Our images, whilst broadly similar, identify the tracheal system as being considerably more complex than previously suggested. One of the 30 wasps imaged had a markedly different, previously undescribed tracheal system. Since completing this study, a large micro-CT study from the American Museum of Natural History (AMNH) has been published. This used different software, [http://www.slicer.org '''3D Slicer'''] and analysed 16bit digital data. We have compared our methods with that described in the AMNH publication, adopted their suggested nomenclature and have made recommendations for future studies.
|}
==Augmented Reality Presentation of the Extracranial Facial Nerve: An Innovation in Parotid Surgery==

{| width="100%"
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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37328316 Br J Oral Maxillofac Surg. 2023 Jul;61(6):428-36. PMID: 37328316]

'''Authors:''' Saadya A, Chegini S, Morley S, McGurk M.

'''Institution:''' University College London Hospital, UK.

'''Abstract:'''
Surgeons used to be unaware of the facial nerve's position during parotid surgery. Now, with special magnetic resonance imaging (MRI) sequences, it can be located and converted into a 3D model displayed on an augmented reality (AR) device for surgeons to study and manipulate. This study explores the accuracy and usefulness of the technique for the treatment of benign and malignant parotid tumours. A total of 20 patients with parotid tumours had 3-Tesla MRI scans, and their anatomical structures were segmented using [http://www.slicer.org '''3D Slicer'''] software. The structures were imported into a Microsoft HoloLens 2® device, displayed in 3D, and shown to the patient for consent. Intraoperative video recording was used to record the position of the facial nerve in relation to the tumour. The predicted path of the nerve taken from the 3D model was combined with surgical observation and video recording in all cases. The imaging proved to have application in both benign and malignant disease. It also improved the process of informed patient consent. Three-dimensional MRI imaging of the facial nerve within the parotid gland and its display in a 3D model is an innovative technique for parotid surgery. Surgeons can now see the nerve's position and tailor their approach to each patient's tumour, providing personalised care. The technique eliminates the surgeon's blind spot and is a significant advantage in parotid surgery.
|}

==Magnetic Resonance Imaging in Naso-Oropharyngeal Carcinoma: Role of Texture Analysis in the Assessment of Response to Radiochemotherapy, a Preliminary Study==

{| width="100%"
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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37336860/ Radiol Med. 2023 Jul;128(7):839-52. PMID: 37336860] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10317900/pdf/11547_2023_Article_1653.pdf PDF]

'''Authors:''' Bicci E, Nardi C, Calamandrei L, Barcali E, Pietragalla M, Calistri L, Desideri I, Mungai F, Bonasera L, Miele V.

'''Institution:''' Department of Experimental and Clinical Biomedical Sciences, Radiodiagnostic Unit #2, University of Florence, Florence, Italy.

'''Abstract:'''
Objective: Identifying MRI texture parameters able to distinguish inflammation, fibrosis, and residual cancer in patients with naso-oropharynx carcinoma after radiochemotherapy (RT-CHT).

Material and methods: In this single-centre, observational, retrospective study, texture analysis was performed on ADC maps and post-gadolinium T1 images of patients with histological diagnosis of naso-oropharyngeal carcinoma treated with RT-CHT. An initial cohort of 99 patients was selected; 57 of them were later excluded. The final cohort of 42 patients was divided into 3 groups (inflammation, fibrosis, and residual cancer) according to MRI, 18F-FDG-PET/CT performed 3-4 months after RT-CHT, and biopsy. Pre-RT-CHT lesions and the corresponding anatomic area post-RT-CHT were segmented with [http://www.slicer.org '''3D Slicer'''] software from which 107 textural features were derived. T-Student and Wilcoxon signed-rank tests were performed, and features with p-value < 0.01 were considered statistically significant. Cut-off values-obtained by ROC curves-to discriminate post-RT-CHT non-tumoural changes from residual cancer were calculated for the parameters statistically associated to the diseased status at follow-up.

Results: Two features-Energy and Grey Level Non-Uniformity-were statistically significant on T1 images in the comparison between 'positive' (residual cancer) and 'negative' patients (inflammation and fibrosis). Energy was also found to be statistically significant in both patients with fibrosis and residual cancer. Grey Level Non-Uniformity was significant in the differentiation between residual cancer and inflammation. Five features were statistically significant on ADC maps in the differentiation between 'positive' and 'negative' patients. The reduction in values of such features between pre- and post-RT-CHT was correlated with a good response to therapy.

Conclusions: Texture analysis on post-gadolinium T1 images and ADC maps can differentiate residual cancer from fibrosis and inflammation in early follow-up of naso-oropharyngeal carcinoma treated with RT-CHT.
|}

==BabelBrain: An Open-Source Application for Prospective Modeling of Transcranial Focused Ultrasound for Neuromodulation Applications==

{| width="100%"
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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37155375/ IEEE Trans Ultrason Ferroelectr Freq Control. 2023 Jul;70(7):587-99. PMID: 37155375]

'''Authors:''' Pichardo S.

'''Institution:''' Department of Radiology, University of Calgary, Calgary, Canada.

'''Abstract:'''
BabelBrain is an open-source standalone graphic-user-interface application designed for studies of neuromodulation using transcranial-focused ultrasound (FUS). It calculates the transmitted acoustic field in the brain tissue, taking into account the distortion effects caused by the skull barrier. The simulation is prepared using scans from magnetic resonance imaging (MRI) and, if available, computed tomography (CT) and zero-echo time MRI scans. It also calculates the thermal effects based on a given ultrasound regime, such as the total duration of exposure, the duty cycle, and acoustic intensity. The tool is designed to work in tandem with neuronavigation and visualization software, such as [http://www.slicer.org '''3D Slicer''']. It uses image processing to prepare domains for ultrasound simulation and uses the BabelViscoFDTD library for transcranial modeling calculations. BabelBrain supports multiple GPU backends, including Metal, OpenCL, and CUDA, and works on all major operating systems including Linux, macOS, and Windows. This tool is particularly optimized for Apple ARM64 systems, which are common in brain imaging research. The article presents the modeling pipeline used in BabelBrain and a numerical study where different methods of acoustic properties mapping were tested to select the best method that can reproduce the transcranial pressure transmission efficiency reported in the literature.
|}

==Volumetric Analysis of the Sinus and Orbit in Silent Sinus Syndrome After Endoscopic Sinus Surgery==

{| width="100%"
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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/36939460/ Otolaryngol Head Neck Surg. 2023 Jul;169(1):151-156. PMID: 36939460]

'''Authors:'''
Amin D, Chitguppi C, Xu V, Haghshenas C, Gorniak R, Rabinowitz M, Toskala E, Rosen M, Nyquist G.

'''Institution:''' Department of Otolaryngology-Head & Neck Surgery, Thomas Jefferson University, Philadelphia, PA, USA.

'''Abstract:'''
Objective: The term "silent sinus syndrome" (SSS) describes spontaneous enophthalmos secondary to subclinical maxillary sinus atelectasis. Debate remains on whether treatment with endoscopic maxillary antrostomy alone is adequate in reversing atelectasis and globe displacement. This study aims to determine the degree of volume change of the diseased sinus and orbit as well as the change in orbital height in patients treated with endoscopic antrostomy without orbital floor augmentation.

Study design: Retrospective review with image analysis.

Setting: Single tertiary care institution.

Methods: Three-dimensional (3D) analysis of computed tomographic imaging data was performed using [http://www.slicer.org '''3D Slicer''']. 3D models of the maxillary sinus and orbit of the diseased and normal sides were created, and volume measurements were calculated using the segmentation program.

Results: Thirteen patients with SSS who underwent endoscopic sinus surgery (ESS) and had follow-up computed tomographic imaging were analyzed. After endoscopic antrostomy, the mean volume of the diseased maxillary sinus significantly increased by 9.82%, from 6.37 to 7.00 cm3 (p = .0302). There was no significant change in mean orbital volume; however, the mean orbital height decreased by 5.67%, from 38.09 to 35.93 mm from pretreatment to posttreatment samples (p = .0101). All patients had resolution of clinical or radiographic enophthalmos and orbital displacement with ESS alone.

Conclusion: Endoscopic maxillary antrostomy alone in the treatment of SSS significantly increased maxillary sinus volume and decreased diseased orbital height. These changes were associated with clinical and radiographic improvement in globe displacement. These findings support performing ESS alone, reserving orbital augmentation for patients who do not exhibit adequate clinical improvement.
|}

==Safety and Efficacy of Thoracic Endovascular Aortic Repair for Acute Stanford Type B Aortic Dissection With Retrograde Type a Intramural Hematoma==

{| width="100%"
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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/36921645/ J Vasc Surg. 2023 Jul;78(1):61-69.e4. PMID: 36921645] | [https://www.jvascsurg.org/action/showPdf?pii=S0741-5214%2823%2900438-X PDF]

'''Authors:''' Wang J, Li M, Li J, He H, Zhou Y, Li X, Li Q, Gu F, Ye Z, Dardik A, Shu C.

'''Institution:''' Department of Vascular Surgery, Second Xiangya Hospital, Central South University, Changsha, China; Institute of Vascular Diseases, Central South University, Changsha, China.

'''Abstract:'''
Objective: The aim of this study was to evaluate safety and efficacy of thoracic endovascular aortic repair (TEVAR) for acute Stanford type B aortic dissection (TBAD) with retrograde type A intramural hematoma (TAIMH).

Methods: Patients with acute TBAD with retrograde TAIMH treated with TEVAR between January 1, 2014, to March 31, 2022, were retrospectively reviewed. Aortic diameter and distance were measured using the [http://www.slicer.org '''3D Slicer'''] image computing platform. Patients' characteristics, procedural, in-hospital and follow-up data, and aortic remodeling were analyzed.

Results: Fifty-two patients (average age, 52.6 years; 42 males [80.8%]) were included. The median interval from symptom onset to TEVAR was 11 days (interquartile range, 7.0-16.8 days). The maximal diameter of the ascending aorta (AA) was <50 mm, and the hematoma thickness in the AA was ≤10 mm in all patients. Both the in-hospital and 30-day mortality rates were 0%. The 30-day complication rate was 11.5%. The overall cumulative survival rates were 100% at 1 year, 97.1% at 3 years, and 92.6% at 5 years. Four of 52 patients (7.7%) developed retrograde type A aortic dissection at 10 days to 4 months postoperatively, and one of 52 patients (1.9%) developed an isolated AA dissection 4 months postoperatively; these five patients were treated and alive at late follow-up in March 2022. The rates of cumulative freedom from thoracic aortic re-intervention were 93.7% at 1 year and 90.7% at 5 years. Positive AA remodeling was observed in 92.3% (48/52) of patients during follow-up. The maximal diameter of AA (mean ± standard error of mean) at admission was 42.7 ± 0.8 mm, which decreased to 39.5 ± 0.9 mm at last follow-up. The maximal AA hematoma thickness at admission was 7.6 ± 0.3 mm, which reduced to 2.2 ± 0.9 mm at last follow-up.

Conclusions: For selected patients of acute Stanford TBAD with retrograde TAIMH, endovascular repair may be a safe, effective, and durable alternative treatment, if the maximum diameter of the AA is <50 mm and the intramural hematoma thickness in the AA is ≤10 mm.
|}

==The Traction Force of the Pulled Limb in Hip Arthroscopic Surgery Is Determined by Stiffness Coefficient Which Is Significantly Related to Muscle Volume==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/36477348/ Knee Surg Sports Traumatol Arthrosc. 2023 Jul;31(7):2708-2715. PMID: 36477348]

'''Authors:''' Yin Y, Xue S, Zhang X, Yang G, Xu Y, Wang J, Huang H.

'''Institution:''' Department of Sports Medicine, Beijing Key Laboratory of Sports Injuries, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing, People's Republic of China.

'''Abstract:'''
Purpose: To verify the relationship between muscle volume, lateral centre-edge angle (LCEA), alpha angle (AA), body mass index (BMI) and Beighton score with stiffness coefficient (SC). To analyse the difference of traction force at different physical states of hip joint capsule.

Methods: Thirty-six patients who underwent hip arthroscopy operation were included. The volumes of some related muscles were measured in MRI images by [http://www.slicer.org '''3D Slicer''']. We recorded and tested differences in traction force of five joint capsule physical states, including before (State 1) and after joint capsule puncture (State 2), after the establishment of anterolateral and mid-anterior approaches (State 3) and after incision of the joint capsule through these two approaches (States 4, 5). The correlation between muscle volume, BMI, LCEA, AA and SC was verified by Spearman test. Poisson regression was used to explain confounding variables.

Results: The average force at State 1 was 531.8 N. There were significant differences in traction force between these five states (p < 0.001). There was a significant positive correlation between muscle volumes and SC (p < 0.001). BMI had no correlation with SC (n.s.). The preoperative LCEA of the affected side was correlated with SC (p = 0.043). AA and SC were not correlated (n.s.).

Conclusion: The physical states of the hip joint capsule affected traction force. Muscle volume rather than BMI is an ideal index to estimate preoperative traction force. LCEA affected traction force, whilst AA and Beighton score did not. Measuring the muscle volume can help estimate the most suitable traction force for the patient.
|}

==Three-Dimensional Assessment of Tongue Cancer Prognosis by Preoperative MRI==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/35426211/ Oral Dis. 2023 Jul;29(5):2006-2011. PMID: 35426211]

'''Authors:''' Li C, Zhu L, Guo Y, Ji T, Ren Z.

'''Institution:''' Department of Oral and Maxillofacial Head and Neck Oncology, The Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

'''Abstract:'''
Purpose: To obtain the relative volume by measuring the tongue volume and the lesion volume, and further explore its relationship with the prognosis of patients, hoping to supplement the TNM staging with a new index.

Methods: ITK-SANP software was used to outline the patients' MRI. After MRI reconstruction and measurement, [http://www.slicer.org '''3D Slicer'''] software was used to estimate tumor volume.

Results: A total of 64 patients with tongue cancer who met the inclusion criteria were included in the study. The estimated tumor volume after MRI reconstruction revealed a significant and robust correlation with tumor stage (p < 0.05, Rs = 0.6207) and a substantial and medium correlation with early lymph node metastasis (p < 0.05, Rs = 0.4873).

Conclusions: We classified tongue cancer into three grades based on tumor volume (Stage I, tumors smaller than 1500 mm³; Stage II, tumors 1500-9000 mm³; and Stage III, tumors larger than 9000 mm³), and such grading could be used as a reference for tumor staging, lymph node metastasis, and patient prognosis to a certain extent.
|}

==Multimodal Measurements of Levator Bowl Volume in Nulligravid Asymptomatic Women: Endovaginal Ultrasound Versus MRI==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36656345 Int Urogynecol J. 2023 Jul;34(7):1627-33. PMID: 36656345]

'''Authors:''' Chill HH, Martin LC, Abramowitch SD, Rostaminia G.

'''Institution:''' Female Pelvic Medicine and Reconstructive Surgery (FPMRS), Division of Urogynecology, University of Chicago, Northshore University HealthSystem, Skokie, IL, USA.

'''Abstract:''' Introduction and hypothesis: Measurements of levator bowl volume using advanced imaging, may be predictive of pelvic floor muscle function. The aim of this study was to compare the volume of the levator bowl using both magnetic resonance imaging (MRI) and endovaginal ultrasound (EVU) of healthy asymptomatic women.

'''Methods:''' All participants underwent a comprehensive interview including completion of the Pelvic Floor Distress Inventory Questionnaire-20 questionnaire, pelvic examination with a pelvic organ prolapse quantification evaluation, MRI, and EVU. The pelvic floor was segmented using [http://www.slicer.org '''3D Slicer'''] and the MRI segmentations were trimmed using two methods: soft-tissue landmarks and the field of view (FOV) of the ultrasound volume. The levator bowl volume of the 3D segmented shapes was measured using Blender's 3D printing toolkit. Normality was tested using the Shapiro-Wilks test and comparisons were made using self-paired t tests.

'''Results:''' The final analysis included 19 patients. Levator bowl volume measured via MRI was larger than that measured in EVU (46.1 ± 7.9 cm3 vs 27.4 ± 5.9 cm3, p<0.001). Reducing the FOV of the MRI to that of EVU caused the MRI volume to be much closer to the EVU volume (35.5 ± 3.3 cm3 vs 27.4 ± 5.9 cm3, p<0.001); however, it remained significantly larger.

'''Conclusion:''' Levator bowl volume measured using MRI was larger than that measured using EVU no matter the method of delineation of the levator muscles. Although EVU is safe, cheap, and easy to perform, it captures a smaller volume of levator bowel than MRI.
|}

==Pectoralis Muscle Area Measured at T4 Level Is Closely Associated With Adverse COVID-19 Outcomes in Hospitalized Patients==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37259659 J Musculoskelet Neuronal Interact. 2023 Jun 1;23(2):196-204. PMID: 37259659] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10233225/pdf/JMNI-23-196.pdf PDF]

'''Authors:''' Tekin ZN, Dogruoz Karatekin B, Dogan MB, Bilgi Z.

'''Institution:''' Istanbul Medeniyet University, Goztepe Prof Dr Suleyman Yalcin City Hospital, Radiology, Istanbul, Turkey.

'''Abstract:'''
Objectives: Skeletal muscle area (SMA) at T4 level on chest computed tomography (CT) is a newly available method that can be used as a surrogate sarcopenia marker. The objective of this study is to evaluate association of SMA with adverse COVID-19 outcomes in hospitalized patients.

Methods: Hospitalized COVID-19 patients were prospectively recorded in a database containing age, gender, date of admission, date of outcome (discharge, mortality, presence of intensive care unit (ICU) stay, additional coding information (comorbidities, superimposed conditions). Admission CT-scans were retrospectively evaluated for segmentation (bilateral pectoralis major/minor, erector spinae, levator scapulae, rhomboideus minor and major and transversospinalis muscles) and SMA calculation using [http://www.slicer.org '''3D Slicer'''] software.

Results: 167 cases were evaluated (68 male, 72 female, 140 survived, 27 dead). Muscle area was lower in patients with ICU stay (p=0.023, p=0.018, p=0.008) and mortality outcome (p=0.004, p=0.007, p=0.002) for pectoralis, back and SMA. In multivariate Cox-regression analysis, hazard ratio (HR) value for the pectoralis muscle area value below 2800 mm2 was found to be 3.138(95% CI: 1.171-8.413) for mortality and 2.361(95% CI: 1.012-5.505) for ICU.

Conclusions: Pectoralis muscle area measured at T4 level with 3-D slicer was closely associated with adverse outcomes (mortality, ICU stay) in hospitalized COVID-19 patients. Since early treatment methods for COVID-19 are being evaluated, this method may be a useful adjunct to clinical decision making in regard to prioritization.
|}

==Precise Location of the Ventricular Catheter Tip in Ventriculoperitoneal Shunt Placement Guided by 3D Printed Individualized Guide==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37086587/ Clin Neurol Neurosurg. 2023 Jun;229:107730. PMID: 37086587]

'''Authors:''' Tian Q, Yi J, Wu Y, Wang S, Qu Y, Cai Q.

'''Institution:''' Department of Neurosurgery, Tangdu hospital, Air Force Medical University, Shaanxi, China.

'''Abstract:'''
Objective: Improper placement of the ventricular catheter tip is the most common cause of shunting disorders after ventriculoperitoneal shunt (VPS) placement surgery. Here, through two illustrative cases, we described a novel method of precise ventricular catheter tip location.

Methods: [http://www.slicer.org '''3D Slicer'''] software was used to define the ventricle puncture path and determine the ventricle catheter tip location preoperatively, and the 3D individualized guide model was printed.

Results: The ventricular puncture was performed under the guidance of the 3D guide to achieve precise ventricle catheter tip location intraoperatively.

Conclusions: This technique is safe, simple, efficient and cost-effective, which facilitates its clinical implementation and promotion.
|}

==PIRET-A Platform for Treatment Planning in Electroporation-Based Therapies==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37015676/ IEEE Trans Biomed Eng. 2023 Jun;70(6):1902-10. PMID: 37015676]

'''Authors:''' Perera-Bel E, Aycock KN, Salameh ZS, Gomez-Barea M, Davalos RV, Ivorra A, Ballester MAG.

'''Institution:''' BCN MedTech, Department of Information and Communication Technologies, Universitat Pompeu Fabra, Barcelona, Spain.

'''Abstract:'''
Tissue electroporation is the basis of several therapies. Electroporation is performed by briefly exposing tissues to high electric fields. It is generally accepted that electroporation is effective where an electric field magnitude threshold is overreached. However, it is difficult to preoperatively estimate the field distribution because it is highly dependent on anatomy and treatment parameters.

Objective: We developed PIRET, a platform to predict the treatment volume in electroporation-based therapies.

Methods: The platform seamlessly integrates tools to build patient-specific models where the electric field is simulated to predict the treatment volume. Patient anatomy is segmented from medical images and 3D reconstruction aids in placing the electrodes and setting up treatment parameters.

Results: Four canine patients that had been treated with high-frequency irreversible electroporation were retrospectively planned with PIRET and with a workflow commonly used in previous studies, which uses different general-purpose segmentation, [http://www.slicer.org '''3D Slicer'''] and modeling software (3Matic and COMSOL Multiphysics). PIRET outperformed the other workflow by 65 minutes (× 1.7 faster), thanks to the improved user experience during treatment setup and model building. Both approaches computed similarly accurate electric field distributions, with average Dice scores higher than 0.93.

Conclusion: A platform which integrates all the required tools for electroporation treatment planning is presented. Treatment plan can be performed rapidly with minimal user interaction in a stand-alone platform.

Significance: This platform is, to the best of our knowledge, the most complete software for treatment planning of irreversible electroporation. It can potentially be used for other electroporation applications.
|}

==Surgically Assisted Maxillary Expansion With or Without Pterygoid Disjunction Alters Maxillomandibular Positioning==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/35426586/ Oral Maxillofac Surg. 2023 Jun;27(2):269-281. PMID: 35426586]

'''Authors:''' Carvalho FSR, Soares ECS, de Medeiros JR, Júnior JMM, Hyppolito JOP, de Barros Silva PG, Ribeiro TR, Costa FWG.

'''Institution:''' Department of Oral and Maxillofacial Surgery, Federal University of Ceará Campus Sobral, Brazil.

'''Abstract:'''
Purpose: This study aimed to analyze alterations in mandibular positioning after surgically assisted maxillary expansion (SARME) with and without pterygoid disjunction (PD).

Methods: Cone-beam computed tomography scans of 24 healthy individuals (18-45 years old) with transverse deficiency, superior to 5 mm, underwent SARME with or without PD. The aspects prospectively assessed were (1) alignment and position of the head (ITK-Snap and [http://www.slicer.org '''3D Slicer'''] software); (2) McNamara's and Steiner-Tweed-Wits' cephalometric analysis (Dolphin Imaging®); and (3) colorimetric evaluation based on 3D correspondence analysis ([http://www.slicer.org '''3D Slicer'''] software).

Results: A decrease in 1-NA and 1-SN angles as well as an increased occlusal plane in both groups was observed. Superior-inferior and anteroposterior spatial displacements of the chin were statistically significant in the PD group. Altered colorimetric patterns were also observed in the PD group.

Conclusions: This study found more evident tooth inclination in the group without PD; mandibular alterations were more evident in the PD group. Further studies with 3D analysis are strongly recommended for more comprehensive results.
|}

==ERCP 2.0: Biliary 3D-Reconstruction in Patients With Malignant Hilar Stricture==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37379653 Clin Res Hepatol Gastroenterol. 2023 Jun 26;47(7):102172. PMID: 37379653]

'''Authors:''' Becq A, Szewczyk J, Salin G, Chartier M, Chaput U, Leenhardt R, Dray X, Arrive L, Camus M.

'''Institution:''' Department of Gastroenterology, Henri-Mondor University Hospital, AP-HP, EA 7375, Université Paris Est Créteil, France.

'''Abstract:'''
Background: Endoscopic retrograde cholangiopancreatography (ERCP) for malignant hilar strictures is challenging. The correlation between Magnetic resonance cholangiopancreatography (MRCP) and per ERCP 2D fluoroscopic images is not obvious. The aim of this study was to evaluate the feasibility and potential usefulness of MRCP-based handmade biliary 3D reconstruction in this setting.

Methods: Methods Patients who underwent MRCP followed by ERCP for biliary drainage of a malignant hilar stricture at our institution between 2018 and 2020 were reviewed. A handmade 3D segmentation using [http://www.slicer.org '''3D Slicer'''] (Kitware, France) was fashioned and reviewed with an expert radiologist. The primary outcome was the feasibility of biliary segmentation.

Results: A total of 16 patients were included. The mean age was 70.1 (+/- 8.6) years-old and 68.8% had hilar cholangiocarcinoma. Handmade segmentation was successful in all cases. The agreement between the MRCP interpretation and the 3D reconstruction was 37.5%, as per the Bismuth classification. 3D reconstruction available prior to ERCP could have helped guide for better stent placement in 11 cases (68.8%).

Conclusions: MRCP-based biliary 3D segmentation-reconstruction, in patients with malignant hilar stricture is feasible and seems to provide a better anatomical understanding compared to MRCP and could help improve endoscopic management.
|}

==3D Printing Personalized Guide Plate in the Management of Recurrent Intramuscular Venous Malformations: A Single Center Experience==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/36967547/ Phlebology. 2023 Jun;38(5):307-314. PMID: 36967547]

'''Authors:''' Han T, Jiang S, Xiong J, Cui J, Shen W.

'''Institution:''' Department of Burns and Plastic Surgery, Children's Hospital of Nanjing Medical University, Nanjing, China.

'''Abstract:'''
Objective: This study aimed to investigate the feasibility and effectiveness of 3D printing personalized guide plate in the management of recurrent intramuscular venous malformations (IVM).

Methods: Fifteen patients with recurrent IVM were retrospectively assessed. [http://www.slicer.org '''3D Slicer'''] software was used to extract and reconstruct the imaging data from CT and/or MRI to highlight the morphology, size, and puncture depth of the lesion. With the guidance of personalized plate, complete excision of the IVM was adopted along the pre-marked (methylene blue, MB) margin.

Results: Personalized guide plate matched involved extremity well, and MB-puncture approach was consistent with preoperative design. All IVMs were removed radically in one single session. Complete pain relief was obtained in all cases postoperatively.

Conclusion: The application of 3D printing guide plate can be safe, effective, and reliable to confirming the precise margin of IVM, renders a promising technique with a high practical value in resection of recurrent lesion.
|}

==White Matter Hyperintensities: A Possible Link Between Sarcopenia and Cognitive Impairment in Patients With Mild to Moderate Alzheimer's Disease==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37330930 Eur Geriatr Med. 2023 Jun 18. PMID: 37330930]

'''Authors:''' Weng X, Liu S, Li M, Zhang Y, Zhu J, Liu C, Hu H.

'''Institution:''' Department of Neurology, The Second Affiliated Hospital of Soochow University, Jiangsu, China.

'''Abstract:'''
Purpose: Alzheimer's disease (AD) has been reported to be associated with sarcopenia. White matter hyperintensities (WMH) are common in AD patients. However, the effect of WMH on sarcopenia in AD remains unclear. We hence aimed to investigate the possible association between regional WMH volumes and sarcopenic parameters in AD.

Methods: 57 mild to moderate AD patients and 22 normal controls (NC) were enrolled. Sarcopenic parameters were assessed, including appendicular skeletal mass index (ASMI), grip strength, 5-times sit-to-stand (5-STS) time, and gait speed. The volumes of periventricular hyperintensities (PVH) and deep white matter hyperintensities (DWMH) were quantified using [http://www.slicer.org '''3D Slicer'''] software.

Results: AD subjects exhibited a lower ASMI, a slower gait speed, an increased 5-STS time, and larger volumes of PVH and DWMH than those in the NC group. In AD subjects, total WMH and PVH volumes were related to cognitive impairment, particularly executive function decline. Moreover, total WMH volume and PVH volume were negatively correlated with gait speed across various clinical stages of AD. Multiple linear regression analysis showed that PVH volume was independently associated with 5-STS time and gait speed, whereas DWMH volume was only independently associated with gait speed.

Conclusion: WMH volume was associated with cognitive decline and various sarcopenic parameters. It thereby suggested that WMH may serve as the connection between sarcopenia and cognitive dysfunction in AD. Further studies are needed to confirm these findings and to determine whether sarcopenia interventions reduce WMH volume and improve cognitive function in AD.
|}

==CT Angiography Radiomics Combining Traditional Risk Factors to Predict Brain Arteriovenous Malformation Rupture: a Machine Learning, Multicenter Study==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37311939 Transl Stroke Res. 2023 Jun 13. PMID: 37311939]

'''Authors:''' Zhang S, Wang J, Sun S, Zhang Q, Zhai Y, Wang X, Ge P, Shi Z, Zhang D.

'''Institution:''' Department of Neurosurgery, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.

'''Abstract:'''
This study aimed to develop a machine learning model for predicting brain arteriovenous malformation (bAVM) rupture using a combination of traditional risk factors and radiomics features. This multicenter retrospective study enrolled 586 patients with unruptured bAVMs from 2010 to 2020. All patients were grouped into the hemorrhage (n = 368) and non-hemorrhage (n = 218) groups. The bAVM nidus were segmented on CT angiography images using [http://www.slicer.org '''3D Slicer'''] software, and radiomic features were extracted using Pyradiomics. The dataset included a training set and an independent testing set. The machine learning model was developed on the training set and validated on the testing set by merging numerous base estimators and a final estimator based on the stacking method. The area under the receiver operating characteristic (ROC) curve, precision, and the f1 score were evaluated to determine the performance of the model. A total of 1790 radiomics features and 8 traditional risk factors were contained in the original dataset, and 241 features remained for model training after L1 regularization filtering. The base estimator of the ensemble model was Logistic Regression, whereas the final estimator was Random Forest. In the training set, the area under the ROC curve of the model was 0.982 (0.967-0.996) and 0.893 (0.826-0.960) in the testing set. This study indicated that radiomics features are a valuable addition to traditional risk factors for predicting bAVM rupture. In the meantime, ensemble learning can effectively improve the performance of a prediction model.
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==Real-Time Integration Between Microsoft HoloLens 2 and 3D Slicer With Demonstration in Pedicle Screw Placement Planning==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37310561 Int J Comput Assist Radiol Surg. 2023 Jun 13. PMID: 37310561]

'''Authors:''' Pose-Díez-de-la-Lastra A, Ungi T, Morton D, Fichtinger G, Pascau J.

'''Institution:''' Departamento de Bioingeniería, Universidad Carlos III de Madrid, Spain.

'''Abstract:'''
Purpose: Up to date, there has been a lack of software infrastructure to connect [http://www.slicer.org '''3D Slicer'''] to any augmented reality (AR) device. This work describes a novel connection approach using Microsoft HoloLens 2 and OpenIGTLink, with a demonstration in pedicle screw placement planning.

Methods: We developed an AR application in Unity that is wirelessly rendered onto Microsoft HoloLens 2 using Holographic Remoting. Simultaneously, Unity connects to [http://www.slicer.org '''3D Slicer'''] using the OpenIGTLink communication protocol. Geometrical transform and image messages are transferred between both platforms in real time. Through the AR glasses, a user visualizes a patient's computed tomography overlaid onto virtual 3D models showing anatomical structures. We technically evaluated the system by measuring message transference latency between the platforms. Its functionality was assessed in pedicle screw placement planning. Six volunteers planned pedicle screws' position and orientation with the AR system and on a 2D desktop planner. We compared the placement accuracy of each screw with both methods. Finally, we administered a questionnaire to all participants to assess their experience with the AR system.

Results: The latency in message exchange is sufficiently low to enable real-time communication between the platforms. The AR method was non-inferior to the 2D desktop planner, with a mean error of 2.1 ± 1.4 mm. Moreover, 98% of the screw placements performed with the AR system were successful, according to the Gertzbein-Robbins scale. The average questionnaire outcomes were 4.5/5.

Conclusions: Real-time communication between Microsoft HoloLens 2 and 3D Slicer is feasible and supports accurate planning for pedicle screw placement.
|}

==Delirium After Traumatic Brain Injury: Prediction by Location and Size of Brain Lesion==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37317796 Ann Rehabil Med. 2023 Jun;47(3):214-21. PMID: 37317796] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10326395/pdf/arm-23008.pdf PDF]

'''Authors:''' Han SJ, Suh JH, Lee JY, Kim SJ.

'''Institution:''' Department of Rehabilitation Medicine, College of Medicine, Ewha Womans University, Seoul, Korea.

'''Abstract:'''
Objective: To examine (1) the location of brain lesion that would predict post-traumatic delirium and (2) the association between volume of brain lesion and occurrence of delirium in patients with traumatic brain injury (TBI).

Methods: A retrospective study was conducted by reviewing medical records of 68 TBI patients, categorized into two groups: the delirious group (n=38) and non-delirious group (n=30). The location and volume of TBI were investigated with the [http://www.slicer.org '''3D Slicer'''] software.

Results: The TBI region in the delirious group mainly involved the frontal or temporal lobe (p=0.038). All 36 delirious patients had brain injury on the right side (p=0.046). The volume of hemorrhage in the delirious group was larger by about 95 mL compared to the non-delirious group, but this difference was not statistically significant (p=0.382).

Conclusion: Patients with delirium after TBI had significantly different injury site and side, but not lesion size compared to patients without delirium.
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==Mitral Paravalvular Leak 3D Printing from 3D-Transesophageal Echocardiography==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37288866 Anatol J Cardiol. 2023 Jun 7. PMID: 37288866] | [https://doi.org/10.14744/AnatolJCardiol.2023.3008 PDF]

'''Authors:''' Jedrzejek M, Kozlowski M, Peszek-Przybyla E, Jadczyk T, Pysz P, Wojakowski W, Smolka G.

'''Institution:''' Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland.

'''Abstract:'''
Background: Paravalvular leaks can be detected in almost 15% of patients after mitral valve prosthesis implantation. This complication can result in congestive heart failure and hemolysis. Despite advancements in non-invasive imaging, percutaneous closure of paravalvular leaks is not always successful. Therefore, efforts are made to improve treatment outcomes by using 3D-printed models of defects as pre-procedural support for interventional cardiologists.

Methods: Retrospectively, 3D-transesophageal echocardiography recordings of 8 patients with clinically significant mitral paravalvular leaks were analyzed. Qlab Software was used to export DICOM images of each paravalvular leak channel, including surrounding tissue. Image segmentation was performed in [http://www.slicer.org '''3D Slicer'''], a free, open-source software package used for imaging research. Models were printed to actual size with the poly jet Stratasys Objet 30 printer with a transparent, rigid material.

Results: Duration of model preparation and printing, as well as the total cost, was calculated. Mean total time of model preparation was 430.5 ± 196 minutes.

Conclusion: 3D-printing from 3D-transesophageal echocardiography is technically feasible. Both shape and location of paravalvular leaks are preserved during model preparation and printing. It remains to be tested if 3D-printing would improve outcomes of percutaneous paravalvular leaks closure.
|}

==Prediction of Ki-67 Expression in Gastrointestinal Stromal Tumors Using Radiomics of Plain and Multiphase Contrast-Enhanced CT==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37266658 Eur Radiol. 2023 Jun 2. PMID: 37266658]

'''Authors:''' Liu Y, He C, Fang W, Peng L, Shi F 4, Xia Y, Zhou Q, Zhang R 5, Li C.

'''Institution:''' Medical Imaging Department, Chongqing University Central Hospital, Chongqing Emergency Medical Center, Chongqing, China.

'''Abstract:'''
Objective: To study the value of radiomics models based on plain and multiphase contrast-enhanced CT to predict Ki-67 expression in gastrointestinal stromal tumors (GISTs).

Methods: A total of 215 patients with GISTs were retrospectively analyzed, including 150 patients in one hospital as the training set and 65 patients in another hospital as the external verification set. The tumor at the largest level of CT images was delineated as the region of interest (ROI). The maximum diameter of the ROI was defined as the tumor size. A total of 851 radiomics features were extracted from each ROI by [http://www.slicer.org '''3D Slicer'''] Radiomics. After dimensionality reduction, three machine learning classification algorithms including logistic regression (LR), random forest (RF), and support vector machine (SVM) were used for Ki-67 expression prediction. Using a multivariable logistic model, a nomogram was established to predict the expression of Ki-67 individually.

Results: Delong tests showed that the SVM models had the highest accuracy in the arterial phase (Z value 0.217-1.139) and venous phase (Z value 0.022-1.396). For the plain phase, LR and SVM models had the highest accuracy (Z value 0.874-1.824, 1.139-1.763). For the delayed phase, LR models had the highest accuracy (Z value 0.056-1.824). For the combined phase, RF models had the highest accuracy (Z value 0.232-1.978). There was no significant difference among the above models for KI-67 expression prediction (Z value 0.022-1.978). A nomogram was developed with a C-index of 0.913 (95% CI, 0.878 to 0.956).

Conclusions: Radiomics of both plain and enhanced CT images could accurately predict the expression of Ki-67 in GIST. For patients who were not suitable to use contrast agents, plain scan could be used as an alternative.
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==Accuracy of Imaging Software for 3d Rendering of Tooth Structures, Usable in Clinical Settings==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37272346 Int J Comput Dent. 2023 Jun 5;0(0):0. PMID: 37272346]

'''Authors:''' Ronsivalle V, Venezia P, Migliorati M, Grippaudo C, Barbato E, Nucci L, Isola G, Leonardi RM, Lo Giudice A.

'''Institution:''' Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Policlinico Universitario "Vittorio Emanuele-G. Rodolico", Catania, Italy.

'''Abstract:'''
Aim: The aim of this study was to evaluate the segmentation accuracy of dentition testing four free-source semi-automatic software.

Materials and methods: A total of 20 cone-beam computed tomography (CBCT) were selected to perform semi-automatic segmentation of maxillary and mandibular dentition. The software tested were Invesalius, ITK-Snap, [http://www.slicer.org '''3D Slicer'''] and Seg3D. Each tooth model was also manually segmented (Mimics software) and set as the gold standard (GS) reference of the investigation. A specific 3D imaging technology was used to perform the superimposition between the teeth models obtained with semi-automatic software and the GS model, and to perform the surface-to-surface matching analysis. The accuracy of semi-automatic segmentation was evaluated calculating the volumetric mean differences (mean bias and limits of agreement) and the percentage of matching of the tooth models compared to the manual segmentation (GS). Qualitative assessments were performed using color-coded maps. All data were statistically analysed to perform software comparisons.

Result: Statistically significant differences were found in the volumetric and matching percentage data (p < 0,05). Invesalius was the most accurate software for 3D rendering of the dentition with a volumetric bias (Mimics) ranging from 4,59 mm3 to 85,79 mm3; instead, ITK-SNAP showed the higher volumetric bias, ranging from 30,22 mm3 to 319,83 mm3. The dis-matched area was mainly located at the radicular region of the teeth. Volumetric data showed excellent inter-software reliability with coefficient values ranging from 0,951 to 0,997.

Conclusion: Different semi-automatic software algorithms could generate different patterns of inaccuracy error in the segmentation of teeth.
|}

==A Retrospective Three-Dimensional Study of the Mandibular Growth During Preoperative Orthodontics in Late Adolescent Patients With Skeletal Class III Malocclusion==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37271262 J Stomatol Oral Maxillofac Surg. 2023 Jun 2;124(5):101526. PMID: 37271262]

'''Authors:''' Yuan M, Zheng Z, Li H, Wang P, Liu Y, Bi R.

'''Institution:''' State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthognathic and TMJ Surgery, West China Hospital of Stomatology, Sichuan University, China.

'''Abstract:'''
Introduction: The mandible's ongoing development presents a contraindication for combined orthodontic-orthognathic treatment. The aim of this study was to evaluate the mandibular stability before and after preoperative orthodontic treatment in late adolescent patients with skeletal Class III malocclusion and to investigate the most appropriate time to start preoperative orthodontic treatment.

Material and methods: The study population consisted of 58 adolescents, aged between 15 and 21 years, with skeletal Class III malocclusion; the adolescents underwent CT scans at the beginning (T1) and the end (T2) of preoperative orthodontic treatment. The CT data were analyzed using ITK-SNAP and [http://www.slicer.org '''3D Slicer'''] software, and the effects of age and gender on mandibular development were investigated.

Results: In these 58 patients, there were no significant local bone alterations in the condyle and anterior chin point between T1 and T2 and no significant changes in the mandibular branch height, mandibular body length, condylar distance, and mandibular angle distance (p>0.05). The mandibular growth at the angel of mandible was statistically significant (p<0.05), but it was not clinically significant because the mean value of the growth was small (right: 0.416±0.986 mm, left: 0.328±0.886 mm). No effect of age and gender on mandibular development was observed.

Conclusion: The mandibular morphology was stable during preoperative orthodontic treatment in patients at the late adolescent stage. This study provides evidence for the possibility of early implementation of preoperative orthodontics.
|}

==Assessment of Variabilities in Lung-Contouring Methods on CBCT Preclinical Radiomics Outputs==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37345013 Cancers (Basel). 2023 May 9;15(10):2677. PMID: 37345013] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10216427/pdf/cancers-15-02677.pdf PDF]

'''Authors:''' Brown KH, Illyuk J, Ghita M, Walls GM, McGarry CK, Butterworth KT.

'''Institution:''' Patrick G. Johnston Centre for Cancer Research, Queen's University Belfast, UK.

'''Abstract:'''
Radiomics image analysis has the potential to uncover disease characteristics for the development of predictive signatures and personalised radiotherapy treatment. Inter-observer and inter-software delineation variabilities are known to have downstream effects on radiomics features, reducing the reliability of the analysis. The purpose of this study was to investigate the impact of these variabilities on radiomics outputs from preclinical cone-beam computed tomography (CBCT) scans. Inter-observer variabilities were assessed using manual and semi-automated contours of mouse lungs (n = 16). Inter-software variabilities were determined between two tools ([http://www.slicer.org '''3D Slicer'''] and ITK-SNAP). The contours were compared using Dice similarity coefficient (DSC) scores and the 95th percentile of the Hausdorff distance (HD95p) metrics. The good reliability of the radiomics outputs was defined using intraclass correlation coefficients (ICC) and their 95% confidence intervals. The median DSC scores were high (0.82-0.94), and the HD95p metrics were within the submillimetre range for all comparisons. the shape and NGTDM features were impacted the most. Manual contours had the most reliable features (73%), followed by semi-automated (66%) and inter-software (51%) variabilities. From a total of 842 features, 314 robust features overlapped across all contouring methodologies. In addition, our results have a 70% overlap with features identified from clinical inter-observer studies.
|}

==A Training Tool for Clinicians in Segmenting Medical Images to Make 3D Models==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37342255 Ann Surg Open. 2023 May 23;4(2):e275. PMID: 37342255] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7614675/pdf/EMS170894.pdf PDF]

'''Authors:''' Chegini S, Tahim A, Liu M, Chooi Y, Edwards E, Clarkson M, Schilling C.

'''Institution:''' Department of Head and Neck Surgery, University College London Hospital, London, UK.

'''Abstract:'''
Introduction: 3D models produced from medical imaging can be used to plan treatment, design prosthesis, teach and for communication. Despite the clinical benefit, few clinicians have experience of how 3D models are produced.This is the first study evaluating a training tool to teach clinicians to produce 3D models and reporting the perceived impact on their clinical practice.

Method: Following ethical approval, 10 clinicians completed a bespoke training tool, comprising written and video material alongside online support. Each clinician and 2 technicians (included as control) were sent 3 CT scans and asked to produce 6 fibula 3D models using an open-source software, [http://www.slicer.org '''3D Slicer''']. The produced models were compared to those produced by the technicians using Hausdorff distance calculation. Thematic analysis was used to study the post-intervention questionnaire.

Results: The mean Hausdorff distance between the final model produced by the clinicians and technicians was 0.65mm SD0.54mm. The first model made by clinicians took a mean time of 1hr 25mins and the final model took 16:04mins (5:00-46:00mins). 100% of learners reported finding the training tool useful and will employ it in future practice.

Discussion: The training tool described in this paper is able to successfully train clinicians to produce fibula models from CT scans. Learners were able to produce comparable models to technicians within an acceptable timeframe. This does not replace technicians. However, the learners perceived this training will allow them to use this technology in more cases, with appropriate case selection and they appreciate the limits of this technology.
|}

==3D Slicer Combined With Neuroendoscope in Treatment of a Distal Segment Aneurysm of the Anterior Choroidal Artery Complicated Intraventricular Hemorrhage: A Case Report and Literature Review==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37251467 Heliyon. 2023 May 18;9(6):e16193. PMID: 37251467] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10220353/pdf/main.pdf PDF]

'''Authors:''' Zhou L, Ren Y, Li Z, Zhang H, Wei H, Song P, Cheng L, Wang W, Gao L, Lei P, Hua Q, Chen Q, Zhou J, Li G, Cai Q.

'''Institution:''' Department of Neurosurgery, Renmin Hospital of Wuhan University, Wuhan, China.

'''Abstract:'''
Introduction: Pure ventricular hemorrhage is often secondary to Moyamoya disease, rarely caused by rupture of ventricular aneurysm. The surgical treatment of the latter is very challenging. [http://www.slicer.org '''3D Slicer'''] reconstruction technology can accurately locate small intracranial lesions and combined with minimally invasive surgery with transcranial neuroendoscope is a new attempt to treat the above diseases.

Case presentation: We report a case of pure intraventricular hemorrhage secondary to rupture of a distal segment aneurysm of the anterior choroidal artery. Brain computed tomography (CT) before admission showed pure ventricular hemorrhage, and brain CT angiography (CTA) before operation showed a distal segment aneurysm of the anterior choroidal artery. We used [http://www.slicer.org '''3D Slicer'''] reconstruction and precise location of the focus before the operation and used the minimally invasive surgery technique with transcranial neuroendoscope to completely remove the hematoma in the ventricle, and found the responsible aneurysm located in the ventricle.

Conclusion: Pure intraventricular hemorrhage requires vigilance against the distal segment aneurysm of the anterior choroidal artery. At present, conventional microscopic craniotomy and intravascular interventional therapy have limitations, and [http://www.slicer.org '''3D Slicer'''] reconstruction and precise positioning technology combined with transcranial neuroendoscope minimally invasive surgery may be a good choice.
|}

==Application of Preoperative Multimodal Image Fusion Technique in Microvascular Decompression Surgery via Suboccipital Retrosigmoid Approach==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36716853 World Neurosurg. 2023 May;173:e37-e47. PMID: 36716853] | [https://pdf.sciencedirectassets.com/280061/AIP/1-s2.0-S1878875023001031/main.pdf PDF]

'''Authors:''' Liao CC, Wu KH, Chen G.

'''Institution:''' Department of Neurosurgery, Zhuhai People's Hospital (Zhuhai Hospital Affiliated with Jinan University,China), Zhuhai, China.

'''Abstract:'''
'''Objective:''' To explore the application value of preoperative multimodal image fusion technique in microvascular decompression (MVD) surgery via the suboccipital retrosigmoid approach.

'''Methods:''' Comprehensive data of 13 patients with primary trigeminal neuralgia (TN) and 13 patients with hemifacial spasm (HFS) treated by MVD surgery via the suboccipital retrosigmoid approach at the Department of Neurosurgery in Zhuhai People's Hospital from January 2021 to December 2021 were retrospectively analyzed. Preoperatively, all patients underwent cranial thin-section computed tomography and magnetic resonance examinations. Three-dimensional (3D) digital images of the skull, brainstem, nerves, and blood vessels were constructed by the [http://www.slicer.org '''3D Slicer'''] software or RadiAnt DICOM Viewer, which were then applied to design the surgical approach and surgical plan. The multimodal image fusion results, clinical characteristics, intraoperative data, surgical outcomes, and complications of all patients were summarized.

'''Results:''' The 3D digital images after fusion reconstruction can vividly show the anatomical relationship between the skull, brainstem, nerves, and blood vessels and was helpful to tailor the surgical strategy. All 26 patients underwent a smooth surgery. During the surgery, the key points were accurately located, the corners of the transverse sinus and sigmoid sinus were completely exposed, and no venous sinus injury occurred in all 26 patients. The key point was approximately located at the top point of the digastric groove, 12.3 ± 0.46 mm vertically above and 6.3 ± 0.6 mm laterally to the Frankfurt horizontal plane. The average cranial opening time was 30.4 (±3.6) min, and the mean operating time was 104.7 (±12.1) min. The diameter of the bone window was about 2.0 cm-3.0 cm, and the bone flap was restored. Among the 13 patients with primary TN, 12 (92.3%) exhibited complete relief of pain and 1 had significant relief. Complications of surgery included facial sensory numbness in 1 case, vertigo in 2 cases, and herpes at the corners of the mouth in 1 case. Of the 13 patients with HFS, 12 (92.3%) had complete relief of facial twitching symptoms and 1 had significant relief, and the complications included mild facial palsy in 2 (15.4%) cases and facial sensory numbness in another 2 (15.4%) cases. The mean follow-up time after surgery ranged from 6-16 months, and 1 of 26 patients experienced recurrence of HFS during the follow-up period.

'''Conclusions:''' Preoperative multimodal image fusion technology can provide adequate preoperative assessment for patients and assistance in designing surgical approaches, which is an important guideline for MVD surgery via the suboccipital retrosigmoid approach for primary TN and facial muscle spasm.
|}

==An Interactive App with Multi-parametric MRI - Whole-Mount Histology Correlation for Enhanced Prostate MRI Training of Radiology Residents==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37137744 Acad Radiol. 2023 May 1:S1076-6332(23)00183-6. PMID: 37137744]

'''Authors:''' Chatterjee A, Szasz T, Munakami M, Karademir I, Yusufishaq MS, Martens S, Wheeler C, Antic T, Thomas S, Karczmar GS, Oto A.

'''Institution:''' Department of Radiology, University of Chicago, Chicago, IL, USA.

'''Abstract:'''
Rationale and objectives: To validate the educational value of a newly created learning application in enhancing prostate MRI training of radiologists for detecting prostate cancer using an observer study.

Materials and methods: An interactive learning app, LearnRadiology, was developed using a web-based framework to display multi-parametric prostate MRI images with whole-mount histology for 20 cases curated for unique pathology and teaching points. Twenty new prostate MRI cases, different from the ones used in the web app, were uploaded on [http://www.slicer.org '''3D Slicer''']. Three radiologists (R1: radiologist; R2, R3: residents) blinded to pathology results were asked to mark areas suspected of cancer and provide a confidence score (1-5, with 5 being high confidence level). Then after a minimum memory washout period of 1 month, the same radiologists used the learning app and then repeated the same observer study. The diagnostic performance for detecting cancers before and after accessing the learning app was measured by correlating MRI with whole-mount pathology by an independent reviewer.

Results: The 20 subjects included in the observer study had 39 cancer lesions (13 Gleason 3 + 3, 17 Gleason 3 + 4, 7 Gleason 4 + 3, and 2 Gleason 4 + 5 lesions). The sensitivity (R1: 54% → 64%, P = 0.08; R2: 44% → 59%, P = 0.03; R3: 62% → 72%, P = 0.04) and positive predictive value (R1: 68% → 76%, P = 0.23; R2: 52% → 79%, P = 0.01; R3: 48% → 65%, P = 0.04) for all 3 radiologists improved after using the teaching app. The confidence score for true positive cancer lesion also improved significantly (R1: 4.0 ± 1.0 → 4.3 ± 0.8; R2: 3.1 ± 0.8 → 4.0 ± 1.1; R3: 2.8 ± 1.2 → 4.1 ± 1.1; P < 0.05).

Conclusion: The web-based and interactive LearnRadiology app learning resource can support medical student and postgraduate education by improving diagnostic performance of trainees for detecting prostate cancer.
|}

==3D Printed Guide Tube System for Acute Neuropixels Probe Recordings in Non-Human Primates==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37105161 J Neural Eng. 2023 May 11;20(3):036009. PMID: 37105161] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10172811/pdf/jne_20_3_036009.pdf PDF]

'''Authors:''' Bauer DL, Pobiel B, Hilber K, Verma AK, Wang J, Vitek J, Johnson M, Johnson L.

'''Institution:''' Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, USA.

'''Abstract:'''
Objective.
Neuropixels (NP) probes are a significant advance in electrophysiological recording technology that enable monitoring of hundreds of neurons in the brain simultaneously at different depths. Application of this technology has been predominately in rodents, however widespread use in non-human primates (NHPs) such as rhesus macaques has been limited. In this study we sought to overcome two overarching challenges that impede acute NP implantation in NHPs: (1) traditional microdrive systems that mount to cephalic chambers are commonly used to access cortical areas for microelectrode recordings but are not designed to accommodate NP probes, and (2) NHPs have thick dura mater and tissue growth within the cephalic chambers which poses a challenge for insertion of the extremely fragile NP probe.
Approach.
In this study we present a novel NP guide tube system that can be adapted to commercial microdrive systems and demonstrate an implant method using the NP guide tube system. This system was developed using a combination of CAD design, 3D printing, and small part machining. Software programs, [http://www.slicer.org '''3D Slicer'''] and SolidWorks were used to target cortical areas, approximate recording depths and locations, and for in-silico implant testing.
Main results.
We performedin vivotesting to validate our methodology, successfully implanting, explanting, and reimplanting NP probes. We collected stable neurophysiological recordings in the premotor cortex of a rhesus macaque at rest and during performance of a reaching task.Significance.In this study we demonstrate a robust Neuropixels implant system that allows multiple penetrations with the same NP probe and share design files that will facilitate the adoption of this powerful recording technology for NHP studies.
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==Diagnostic Value of 18F-FDG PET/CT-Based Radiomics Nomogram in Bone Marrow Involvement of Pediatric Neuroblastoma==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/36117128 Acad Radiol. 2023 May;30(5):940-51. PMID: 36117128]

'''Authors:''' Feng L, Yang X, Lu X, Kan Y, Wang C, Zhang H, Wang W, Yang J.

'''Institution:''' Department of Nuclear Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing, China.

'''Abstract:'''
Objectives: To develop and validate an 18F-FDG PET/CT-based radiomics nomogram and evaluate the value of the 18F-FDG PET/CT-based radiomics nomogram for the diagnosis of bone marrow involvement (BMI) in pediatric neuroblastoma.

Materials and methods: A total of 144 patients with neuroblastoma (100 in the training cohort and 44 in the validation cohort) were retrospectively included. The PET/CT images of patients were visually assessed. The results of bone marrow aspirates or biopsies were used as the gold standard for BMI. Radiomics features and conventional PET parameters were extracted using [http://www.slicer.org '''3D Slicer''']. Features were selected by the least absolute shrinkage and selection operator regression, and radiomics signature was constructed. Univariate and multivariate logistic regression analyses were applied to identify the independent clinical risk factors and construct the clinical model. Other different models, including the conventional PET model, combined PET-clinical model and combined radiomics model, were built using logistic regression. The combined radiomics model was based on clinical factors, conventional PET parameters and radiomics signature, which was presented as a radiomics nomogram. The diagnostic performance of the different models was evaluated by receiver operating characteristic (ROC) curves and decision curve analysis (DCA).

Results: By visual assessment, BMI was observed in 80 patients. Four conventional PET parameters (SUVmax, SUVmean, metabolic tumor volume, and total lesion glycolysis) were extracted. And 15 radiomics features were selected to build the radiomics signature. The 11q aberration, neuron-specific enolase and vanillylmandelic acid were identified as the independent clinical risk factors to establish the clinical model. The radiomics nomogram incorporating the radiomics signature, the independent clinical risk factors and SUVmean demonstrated the best diagnostic value for identifying BMI, with an area under the curve (AUC) of 0.963 and 0.931 in the training and validation cohorts, respectively. And the DCA demonstrated that the radiomics nomogram was clinically useful.

Conclusion: The 18F-FDG PET/CT-based radiomics nomogram which incorporates radiomics signature, independent clinical risk factors and conventional PET parameters could improve the diagnostic performance for BMI of pediatric neuroblastoma without additional medical costs and radiation exposure.
|}

==Opportunistic Screening for Osteoporosis Using CT Scans of the Knee: A Pilot Study==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37203533 Stud Health Technol Inform. 2023 May 18;302:909-910. PMID: 37203533]

'''Authors:''' Elmahdy M, Sebro R.

'''Institution:''' Department of Radiology, Mayo Clinic, Jacksonville, FL, USA.

'''Abstract:'''
Knee CT scans are used for planning for total knee arthroplasties in patients who are often simultaneously at risk for frailty fractures due to low bone mineral density. We retrospectively identified 200 patients (85.5% female) with concurrent CT scans of the knee and Dual energy x-ray absorptiometry (DXA). The mean CT attenuation of the distal femur, proximal tibia and fibula, and patella, were calculated using volumetric 3-dimensional segmentation using [http://www.slicer.org '''3D Slicer''']. Data were split randomly into training 80% and test 20% datasets. The optimal CT attenuation threshold for the proximal fibula was obtained in the training dataset and evaluated in the test dataset. A support vector machine (SVM) with radial basis function (RBF) using C-classification was trained and tuned using 5-fold cross-validation in the training dataset and then evaluated in the test dataset. The SVM had a higher area-under-the curve (AUC) of 0.937 and better performance to detect osteoporosis/osteopenia than the CT attenuation of the fibula (AUC of 0.717) (P=0.015). Opportunistic screening for osteoporosis/osteopenia could be accomplished using CT scans of the knee.
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==Sustainable 3D Printing of Oral Films With Tunable Characteristics Using CMC-Based Inks From Durian Rind Wastes==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/36933810 Eur J Pharm Biopharm. 2023 May;186:30-42. PMID: 36933810]

'''Authors:''' Panraksa P, Rachtanapun P, Thipchai P, Lesniewska E, Brachais CH, Debeaufort F, Chambin O, Jantrawut P.

'''Institution:''' Department of Pharmaceutical Sciences, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, Thailand.

'''Abstract:'''
With the growing interest in environmentally friendly and personalized medicines, new concept for combining three-dimensional printing (3DP) with natural-based biomaterials derived from agro-food wastes has emerged. This approach provides sustainable solutions for agricultural waste management and potential for developing of novel pharmaceutical products with tunable characteristics. This work demonstrated the feasibility of fabricating personalized theophylline films with four different structures (Full, Grid, Star, and Hilbert) using syringe extrusion 3DP and carboxymethyl cellulose (CMC) derived from durian rind wastes. Our findings suggested that all the CMC-based inks with shear thinning properties capable of being extruded smoothly through a small nozzle could potentially be used to fabricate the films with various complex printing patterns and high structural fidelity. The results also demonstrated that the film characteristics and release profiles could be easily modified by simply changing the slicing parameters (e.g., infill density and printing pattern). Amongst all formulations, Grid film, which was 3D-printed with 40 % infill and a grid pattern, demonstrated a highly porous structure with high total pore volume. The voids between printing layers in Grid film increased theophylline release (up to 90 % in 45 min) through improved wetting and water penetration. All findings in this study provide significant insight into how to modify film characteristics simply by digitally changing the printing pattern in [http://www.slicer.org '''3D Slicer'''] software without creating a new CAD model. This approach could help to simplify the 3DP process so that non-specialist users can easily implement it in community pharmacies or hospital on demand.
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==An Automated Landmark Method to Describe Geometric Changes in the Human Mandible During Growth==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/36893681 Arch Oral Biol. 2023 May;149:105663. PMID: 36893681]

'''Authors:''' Fournier G, Maret D, Telmon N, Savall F.

'''Institution:''' Faculté de Chirurgie Dentaire, Université Paul Sabatier, Centre Hospitalier Universitaire, Toulouse, France.

'''Abstract:'''
Objective: The principal aim of this study was to assess an automatic landmarking approach to human mandibles based on the atlas method. The secondary aim was to identify the areas of greatest variation in the mandibles of middle-aged to older adults.

Design: Our sample consisted of 160 mandibles from computed tomography scans of 80 men and 80 women aged between 40 and 79 years. Eleven anatomical landmarks were placed manually on mandibles. The automated landmarking through point cloud alignment and correspondence (ALPACA) method implemented in [http://www.slicer.org '''3D Slicer'''] was used to automatically place landmarks to all meshes. Euclidean distances, normalized centroid size, and Procrustes ANOVA were calculated for both methods. A pseudo-landmarks approach was followed using ALPACA to identify areas of changes among our sample.

Results: The ALPACA method showed significant differences in Euclidean distances for all landmarks compared to the manual method. A mean Euclidean distance of 1.7 mm was found for the ALPACA method and 0.99 mm for the manual method. Both methods found that sex, age, and size had a significant effect on mandibular shape. The greatest variations were observed in the condyle, ramus, and symphysis regions.

Conclusion: The results obtained using the ALPACA method are acceptable and promising. This approach can automatically place landmarks with an average accuracy of less than 2 mm, which may be sufficient in most anthropometric analyses. In the light of our results, however, odontological application such as occlusal analysis is not recommended.
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==Three-Dimensional Volume Rendering of Pelvic Floor Anatomy with Focus on Fibroids in Relation to the Lower Urogenital Tract Based on Cross-Sectional MRI Images==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37171621 J Med Syst. 2023 May 12;47(1):62. PMID: 37171621] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10181971/pdf/10916_2023_Article_1947.pdf PDF]

'''Authors:''' Fan KS, Durnea C, Nygaard CC, Khalil M, Doumouchtsis SK.

'''Institution:''' Institute for Medical and Biomedical Education, St. George's University of London, London, UK.

'''Abstract:'''
We aimed to assess the feasibility of developing three-dimensional (3D) models of pelvic organs using cross-sectional MRI images of patients with uterine fibroids and urinary symptoms and of obtaining anatomical information unavailable in 2D imaging modalities. We also aimed to compare two image processing applications. We performed a feasibility study analysing MRI scans from three women, aged 30 to 58 years old, with fibroids and urinary symptoms. Cross-sectional images were used to render 3D models of pelvic anatomy, including bladder, uterus and fibroids, using [http://www.slicer.org '''3D Slicer'''] and OsiriX. Dimensions, volumes and anatomical relationships of the pelvic organs were evaluated. Comparisons between anatomical landmarks and measurements obtained from the two image processing applications were undertaken. Rendered 3D pelvic models yielded detailed anatomical information and data on spatial relationships that were unobtainable from cross-sectional images. Models were rendered in sufficient resolution to aid understanding of spatial relationships between urinary bladder, uterus and fibroid(s). Measurements of fibroid volumes ranged from 5,336 to 418,012 mm3 and distances between the fibroid and urinary bladder ranged from 0.10 to 83.60 mm. Statistical analysis of measurements showed no significant differences in measurements between the two image processing applications. To date, limited data exist on the use of 3D volume reconstructions of routine MRI scans, to investigate pelvic pathologies such as fibroids in women with urinary symptoms. This study suggests that post-MRI image processing can provide additional information over standard MRI. Further studies are required to assess the role of these data in clinical practice, surgical planning and training. Three-dimensional reconstruction of routine two-dimensional magnetic resonance imaging provides additional anatomical information and may improve our understanding of anatomical relationships, their role in clinical presentations and possibly guide clinical and surgical management.
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==The First Endovascular Rat Glioma Model for Pre-Clinical Evaluation of Intra-Arterial Therapeutics==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37157800 Interv Neuroradiol. 2023 May 8:15910199231169597. PMID: 37157800]

'''Authors:''' Lim J, Baig AA, Donnelly BM, Chaves LD, Pol SU, Koenigsknecht C, Pionessa D, Levy BR, Gutierrez L, Tutino VM, Levy EI, Siddiqui AH.

'''Institution:''' Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA.

'''Abstract:'''
Background: Several translational animal models have been described assessing intra-arterial (IA) treatments for malignant gliomas. We describe the first endovascular animal model that allows testing of IA drug delivery as a first-line treatment, which is difficult to do in actual patients. We report a unique protocol for vascular access and IA delivery in the rat model that, unlike prior reports, does not require direct puncture and opening of proximal cerebrovasculature which carries risk of ischemia in the animal brain post-delivery.

Methods: Wistar rats underwent left femoral artery catherization with a Balt Magic 1.2F catheter or Marathon Flow directed 1.5F Microcatheter with an Asahi Chikai 0.008 micro-guidewire which was navigated to the left internal carotid artery under x-ray. 25% mannitol was administered to test blood brain barrier breakdown (BBBB). Additional rats were implanted with C6 glioma cells in the left frontal lobe. C6 Glioma-Implanted Rats (C6GRs) were monitored for overall survival and tumor growth. Tumor volumes from MRI images were calculated utilizing [http://www.slicer.org '''3D Slicer''']. Additional rats underwent femoral artery catheterization with Bevacizumab, carboplatin, or irinotecan injected into the left internal carotid artery to test feasibility and safety.

Results: A successful endovascular access and BBBB protocol was established. BBBB was confirmed with positive Evans blue staining. 10 rats were successfully implanted with C6 gliomas with confirmed growths on MRI. Overall survival was 19.75 ± 2.21 days. 5 rats were utilized for the development of our femoral catheterization protocol and BBBB testing. With regards to IA chemotherapy dosage testing, control rats tolerated targeted 10 mg/kg of bevascizumab, 2.4 mg/kg of carboplatin, and 15 mg/kg of irinotecan IA ICA injections without any complications.

Conclusions: We present the first endovascular IA rat glioma model that allows selective catheterization of the intracranial vasculature and assessment of IA therapies for gliomas without need for access and sacrifice of proximal cerebrovasculature.
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==Muscle Magnetic Resonance Characterization of STIM1 Tubular Aggregate Myopathy Using Unsupervised Learning==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37155641 PLoS One. 2023 May 8;18(5):e0285422. PMID: 37155641] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10166478/pdf/pone.0285422.pd PDF]

'''Authors:''' Lupi A, Spolaor S, Favero A, Bello L, Stramare R, Pegoraro E, Nobile MS.

'''Institution:''' Institute of Radiology, Department of Medicine-DIMED, University of Padua, Padua, Italy.

'''Abstract:'''
Purpose: Congenital myopathies are a heterogeneous group of diseases affecting the skeletal muscles and characterized by high clinical, genetic, and histological variability. Magnetic Resonance (MR) is a valuable tool for the assessment of involved muscles (i.e., fatty replacement and oedema) and disease progression. Machine Learning is becoming increasingly applied for diagnostic purposes, but to our knowledge, Self-Organizing Maps (SOMs) have never been used for the identification of the patterns in these diseases. The aim of this study is to evaluate if SOMs may discriminate between muscles with fatty replacement (S), oedema (E) or neither (N).

Methods: MR studies of a family affected by tubular aggregates myopathy (TAM) with the histologically proven autosomal dominant mutation of the STIM1 gene, were examined: for each patient, in two MR assessments (i.e., t0 and t1, the latter after 5 years), fifty-three muscles were evaluated for muscular fatty replacement on the T1w images, and for oedema on the STIR images, for reference. Sixty radiomic features were collected from each muscle at t0 and t1 MR assessment using [http://www.slicer.org '''3D Slicer'''] software, in order to obtain data from images. A SOM was created to analyze all datasets using three clusters (i.e., 0, 1 and 2) and results were compared with radiological evaluation.

Results: Six patients with TAM STIM1-mutation were included. At t0 MR assessments, all patients showed widespread fatty replacement that intensifies at t1, while oedema mainly affected the muscles of the legs and appears stable at follow-up. All muscles with oedema showed fatty replacement, too. At t0 SOM grid clustering shows almost all N muscles in Cluster 0 and most of the E muscles in Cluster 1; at t1 almost all E muscles appear in Cluster 1.

Conclusion: Our unsupervised learning model appears to be able to recognize muscles altered by the presence of edema and fatty replacement.
|}

==Quantifying the Effect of an Endo-Vaginal Probe on Position of the Pelvic Floor Viscera and Muscles==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37145123 Int Urogynecol J. 2023 May 5. PMID: 37145123]

'''Authors:''' Chill HH, Martin LC, Abramowitch SD, Rostaminia G.

'''Institution:''' Female Pelvic Medicine and Reconstructive Surgery (FPMRS) Division, University of Chicago Pritzker School of Medicine, Northshore University HealthSystem, Skokie, IL, USA.

'''Abstract:'''
Introduction and hypothesis: Endovaginal ultrasound has long been hypothesized to have a significant effect on locations of what it visualizes. However, little work has directly quantified its effect. This study aimed to quantify it.

Methods: This cross-sectional study consisted of 20 healthy asymptomatic volunteers who underwent both endovaginal ultrasound and MRI. The urethra, vagina, rectum, pelvic floor, and pubic bone were segmented in both ultrasound and MRI using [http://www.slicer.org '''3D Slicer''']. Then, using [http://www.slicer.org '''3D Slicer''']'s transform tool the volumes were rigidly aligned based on the posterior curvature of the pubic bone. The organs were then split into thirds along their long axis to compare their distal, middle, and proximal sections. Using Houdini, we compared the location of the centroid of each of the urethra, vagina, and rectum and the surface-to-surface difference of the urethra and rectum. The anterior curvature of the pelvic floor was also compared. Normality of all variables was assessed by Shapiro-Wilk test.

Results: The largest amount of surface-to-surface distance was observed in the proximal region for the urethra and rectum. Across all three organs, the majority of the deviation was in the anterior direction for geometries obtained from ultrasound versus those from MRI. For each subject, the trace defining the midline of the levator plate was more anterior for ultrasound compared to MRI.

Conclusions: While it has often been assumed that placing a probe in the vagina probably distorts the anatomy, this study quantified the distortion and displacement of the pelvic viscera. This allows for better interpretation of clinical and research findings based on this modality.
|}

==Laser Interstitial Thermal Therapy in the Treatment of Brain Metastases: The Relationship Between Changes in Postoperative Magnetic Resonance Imaging Characteristics and Tumor Recurrence==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36823478 Acta Neurochir (Wien). 2023 May;165(5):1379-1387. PMID: 36823478]

'''Authors:''' Xue Z, Guan X, Yuan L, Kang P, Zhang C, Li D, Jia G, Jia W.

'''Institution:''' Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, China.

'''Abstract:'''
'''Background:''' Laser interstitial thermal therapy (LITT) has been used to treat brain metastases (BMs) in several countries, and its safety and effectiveness have been confirmed. In most cases, magnetic resonance imaging (MRI) reveals an increase in tumor volume with an enhanced margin after LITT. However, little is known about the relationship between this MRI change and tumor recurrence.

'''Objective:''' We report the first case series of BMs treated by LITT in China to evaluate the clinical characteristics and predictive factors of tumor recurrence.

'''Material and Methods:''' Patients with less than four brain metastatic lesions and a Karnofsky performance status (KPS) > 70 were eligible for study inclusion. Standard LITT procedures were performed, and a follow-up MRI was performed to analyze the radiographic changes, especially the volume ratio of the enhanced margin and the whole lesion on MRI at 30 days postoperatively. All the volume-related data were delineated and calculated using [http://www.slicer.org '''3D Slicer'''] software. Related predictors were also collected to evaluate the correlation with local tumor control.

'''Results:''' Eighteen patients with nineteen lesions were enrolled for treatment and follow-up. Primary tumor histology included pulmonary carcinoma (n = 11) and breast cancer (n = 4). On average, the tumor size measured 3.01 cm3 (range, 0.40-7.40 cm3), the total ablation time was 13.58 min (range, 2.88-37.15 min), and the complete ablation rate was 92.4% (range, 29.2-100%). Comparing 3s0-day follow-up MRI results with preoperative MRI findings, 18 lesions showed a 2.28-fold (range, 1.21-4.88) volume increase; all the lesions displayed an enhanced component with a volume ratio of 42.35% (range, 10.14-100%). Five patients experienced tumor recurrence, and the local tumor control rates at 90 days and 180 days of follow-up were 68.4% and 66.7%, respectively. Univariate analysis indicated that the primary tumor, ablation rate, and enhanced volume ratio (EVR) > 40% in the 30-day MRI were associated with tumor recurrence, whereas multivariate analysis showed that only EVR > 40% was a predictive factor of local control.

'''Conclusion:''' LITT is a minimally invasive method used to ablate brain metastases which can be used as the first-line treatment for BM patients under certain indications. After LITT, most tumors showed volume enlargement on the 30-day MRI scan, and EVR > 40% on the 30-day MRI may indicate late tumor recurrence.
|}

==Image Data and Computational Grids for Computing Brain Shift and Solving the Electrocorticography Forward Problem==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37128587/ Data Brief. 2023 Apr 7;48:109122. PMID: 37128587] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10147975/pdf/main.pdf PDF]

'''Authors:''' Zwick BF, Safdar S, Bourantas GC, Joldes GR, Hyde DE, Warfield SK, Wittek A, Miller K.

'''Institution:''' Intelligent Systems for Medicine Laboratory, The University of Western Australia, 35 Stirling Highway, Perth, WA, Australia.

'''Abstract:'''
This article describes the dataset applied in the research reported in NeuroImage article "Patient-specific solution of the electrocorticography forward problem in deforming brain" [1] that is available for download from the Zenodo data repository (https://zenodo.org/record/7687631) [2]. Preoperative structural and diffusion-weighted magnetic resonance (MR) and postoperative computed tomography (CT) images of a 12-year-old female epilepsy patient under evaluation for surgical intervention were obtained retrospectively from Boston Children's Hospital. We used these images to conduct the analysis at The University of Western Australia's Intelligent Systems for Medicine Laboratory using SlicerCBM [3], our open-source software extension for the [http://www.slicer.org '''3D Slicer'''] medical imaging platform. As part of the analysis, we processed the images to extract the patient-specific brain geometry; created computational grids, including a tetrahedral grid for the meshless solution of the biomechanical model and a regular hexahedral grid for the finite element solution of the electrocorticography forward problem; predicted the postoperative MRI and DTI that correspond to the brain configuration deformed by the placement of subdural electrodes using biomechanics-based image warping; and solved the patient-specific electrocorticography forward problem to compute the electric potential distribution within the patient's head using the original preoperative and predicted postoperative image data. The well-established and open-source file formats used in this dataset, including Nearly Raw Raster Data (NRRD) files for images, STL files for surface geometry, and Visualization Toolkit (VTK) files for computational grids, allow other research groups to easily reuse the data presented herein to solve the electrocorticography forward problem accounting for the brain shift caused by implantation of subdural grid electrodes.
|}

==ImFinite Element Analysis of a Healthy Knee Joint at Deep Squatting for the Study of Tibiofemoral and Patellofemoral Contact==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37143926 J Orthop. 2023 Apr 21;40:7-16. PMID: 37143926]

'''Authors:''' Kothurkar R, Lekurwale R, Gad M, Rathod CM.

'''Institution:''' Department of Mechanical Engineering, K. J. Somaiya College of Engineering, Mumbai, India.

'''Abstract:'''
Background: In non-western countries, deep squatting is a daily activity, and prolonged deep squatting is common among occupational squatters. Household tasks, taking a bath, socializing, using toilets, and performing religious acts are among the activities frequently carried out while squatting by the Asian population. High knee loading is responsible for a knee injury and osteoarthritis. Finite element analysis is an effective tool to determine stresses on the knee joint.

Methods: Magnetic Resonance Imaging (MRI) and Computed Tomographic (CT) images were acquired of one adult without knee injuries. The CT images were acquired at the fully extended knee and one more set of images was acquired with the knee at a deeply flexed knee position. The MRI was acquired with the fully extended knee. 3 Dimensional models of bones were created using CT and soft tissue using MRI with the help of [http://www.slicer.org '''3D Slicer'''] software. Kinematics and finite element analysis of the knee was performed for standing and deep squatting posture using Ansys Workbench 2022.

Results: High peak stresses were observed at deep squatting compared to standing along with the reduction in the contact area. Peak von Mises stresses on femoral cartilage, tibial cartilage, patellar cartilage, and meniscus were increased from 3.3 MPa to 19.9 MPa, 2.9 MPa to 12.4 MPa, 1.5 MPa to 16.7 MPa and 15.8 MPa to 32.8 MPa respectively during deep squatting. Posterior translation of 7.01 mm, and 12.58 mm was observed for medial and lateral femoral condyle respectively from full extension to 153° knee flexion.

Conclusions: Increased stresses in the knee joint at deep squat posture may cause cartilage damage. A sustained deep squat posture should be avoided for healthy knee joints. More posterior translations of the medial femoral condyle at higher knee flexion angle warrant further investigation.
|}

==A Comparison of Machine Learning Models for Survival Prediction of Patients with Glioma Using Radiomic Features from MRI Scans==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37362372/ Indian J Radiol Imaging. 2023 Apr 28;33(3):338-343. PMID: 37362372] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10289839/pdf/10-1055-s-0043-1767786.pdf PDF]

'''Authors:''' Manjunath M, Saravanakumar S, Kiran S, Chatterjee J.

'''Institution:''' Department of Biotechnology, People's Education Society University, Bangalore, Karnataka, India.

'''Abstract:'''
Background Glioma is a primary, malignant, highly aggressive brain tumor, with patients having an average life expectancy of 14 to 16 months after diagnosis. Magnetic resonance imaging (MRI) scans of these patients can be used to extract and analyze quantifiable features with potential clinical significance. We hypothesize that there is a correlation between radiomic features extracted from MRI scans and survival. Along with clinical data, the radiomic features could be used in survival prediction of patients, providing beneficial information for clinicians to design personalized treatment plans. Methods In our study, we have utilized [http://www.slicer.org '''3D Slicer'''] for tumor segmentation and feature extraction and performed survival prediction of patients with glioma using four different machine learning models. Results and Conclusion Among the models compared, we have achieved a maximum prediction accuracy of 64.4% using the k-nearest neighbors model, which was trained and tested on a combination of clinical data and radiomic features extracted from MRI images provided in the BraTS 2020 dataset.
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==Circular RNA hsa_circ_0000690 as a Potential Biomarker for Diagnosis and Prognosis of Intracranial Aneurysm: Closely Relating to the Volume of Hemorrhage==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36879365 Brain Behav. Apr;13(4):e2929. PMID: 36879365] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10097068/pdf/BRB3-13-e2929.pdf PDF]

'''Authors:'''Huang Y, Cao H, Qi X, Guan C, Que S.

'''Institution:''' Department of Neurosurgery, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, Fujian, China.

'''Abstract:'''

'''Purpose:''' This study aimed to explore circular RNA (circRNA) hsa_circ_0000690 as a potential biomarker for diagnosis and prognosis of intracranial aneurysm (IA) and its relationship with clinical factors and complications of IA.

'''Material/Methods:''' 216 IA patients admitted to the neurosurgery department of our hospital from January 2019 to December 2020 were selected as the experimental group, and 186 healthy volunteers were selected as the control group. The expression of hsa_circ_0000690 in peripheral blood was detected by quantitative real-time PCR, and its diagnostic value was assessed by receiver operating characteristic curve. Relationship between hsa_circ_0000690 and clinical factors of IA was assessed by chi-square test. Nonparametric test was used in univariate analysis, and regression analysis was used in multivariate analysis. Multivariate Cox proportional hazards regression analysis was used to analyze the survival time.

'''Results:''' CircRNA hsa_circ_0000690 of IA patients was relatively lower than that in the control group (p < .001). The AUC of hsa_circ_0000690 was 0.752, the specificity was 0.780, and sensitivity was 0.620, with diagnostic threshold of 0.0449. In addition, hsa_circ_0000690 expression was correlated with Glasgow Coma Scale, the volume of subarachnoid hemorrhage, modified Fisher scale, Hunt-Hess levels and surgical type. For hydrocephalus and delayed cerebral ischemia, hsa_circ_0000690 was significant in univariate analysis, but nonsignificant in multivariate analysis. For prognosis, hsa_circ_0000690 was significantly associated with modified Rankin Scales after surgery for 3 months, but not associated with survival time.

'''Conclusions:''' The expression of hsa_circ_0000690 can act as a diagnostic marker for IA and predict the prognosis of 3 months after operation and is closely related to the volume of hemorrhage.

'''Keywords:''' [http://www.slicer.org '''3D Slicer''']; biomarker; circRNA; diagnosis; intracranial aneurysm; prognosis; subarachnoid hemorrhage
|}

==Can Quantitative Peritumoral CT Radiomics Features Predict the Prognosis of Patients With Non-Small Cell Lung Cancer? A Systematic Review==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36307554 Eur Radiol. 2023 Mar;33(3):2105-17. PMID: 36307554] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9935659/pdf/330_2022_Article_9174.pdf PDF]

'''Authors:''' Wu L, Lou X, Kong N, Xu M, Gao C.

'''Institution:''' Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China.

'''Abstract:''' Objectives: To provide an overarching evaluation of the value of peritumoral CT radiomics features for predicting the prognosis of non-small cell lung cancer and to assess the quality of the available studies.

'''Methods:''' The PubMed, Embase, Web of Science, and Cochrane Library databases were searched for studies predicting the prognosis in patients with non-small cell lung cancer (NSCLC) using CT-based peritumoral radiomics features. Information about the patient, CT-scanner, and radiomics analyses were all extracted for the included studies. Study quality was assessed using the Radiomics Quality Score (RQS) and the Prediction Model Risk of Bias Assessment Tool (PROBAST).

'''Results:''' Thirteen studies were included with 2942 patients from 2017 to 2022. Only one study was prospective, and the others were all retrospectively designed. Manual segmentation and multicenter studies were performed by 69% and 46% of the included studies, respectively. [http://www.slicer.org '''3D Slicer'''] and MATLAB software were most commonly used for the segmentation of lesions and extraction of features. The peritumoral region was most frequently defined as dilated from the tumor boundary of 15 mm, 20 mm, or 30 mm. The median RQS of the studies was 13 (range 4-19), while all of included studies were assessed as having a high risk of bias (ROB) overall.

'''Conclusions:''' Peritumoral radiomics features based on CT images showed promise in predicting the prognosis of NSCLC, although well-designed studies and further biological validation are still needed.

'''Key points:''' Peritumoral radiomics features based on CT images are promising and encouraging for predicting the prognosis of non-small cell lung cancer. The peritumoral region was often dilated from the tumor boundary of 15 mm or 20 mm because these were considered safe margins. The median Radiomics Quality Score of the included studies was 13 (range 4-19), and all of studies were considered to have a high risk of bias overall.
|}

==Three Dimensional Assessment of Radiographic Changes after Indirect Pulp Capping using Silver Diamine Fluoride with or without Potassium Iodide in Young Permanent Teeth (12-month RCT)==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36878216 Caries Res. 2023;57(2):177-188. PMID: 36878216]

'''Authors:''' Baraka MMAL, Cevidanes L, Tekeya M, Bakry N, Ruellas A, Botero T, Benavides E, Fontana M.

'''Institution:''' Department of Experimental Oncology, European Institute of Oncology, IRCCS, 20139 Milan, Italy.

'''Abstract:''' The aim was to have a three-dimensional evaluation of radiographic changes after indirect pulp capping (IPC) with silver diamine fluoride (SDF) with or without potassium iodide (KI) and resin modified glass ionomer cement (RMGIC) in deep carious young permanent molars using cone beam computed tomography (CBCT). 108 first permanent molars with deep occlusal cavitated caries lesions, in forty-nine 6-9-year-old children, were randomly allocated to one of 3 groups (n=36) and treated with SDF+KI, SDF and RMGIC as IPC materials. CBCT scans were taken at 0 and at 12-months to assess tertiary dentin formation (volume and grey level intensity), increase in root length, and pathological changes as secondary caries, periapical radiolucency, internal resorption and obliteration of the pulp. The three-dimensional image analysis procedures were performed using ITK-SNAP and [http://www.slicer.org '''3D Slicer'''] CMF. Comparisons were made using analysis of variance with a fixed effect for treatment and random effects for patient, and patient-by-treatment to account for within-patient correlations. A two-sided 5% significance level was used. There were no significant differences among the three groups regarding tertiary dentin volume (p=0.712) and grey level intensity (p=0.660), increase in root length (p=0.365), prevention of secondary caries (p=0.63) and periapical radiolucency (p=0.80) in the analysed 69 CBCT scans. The study did not find differences among the groups regarding quality and quantity of tertiary dentin formed, increase in root length, absence of secondary caries and other signs of failure as shown by CBCT.

'''Clinical Significance:''' The results show no significant differences in radiographic outcomes (quality and quantity of tertiary dentin formed, increase in root length, absence of secondary caries and other signs of failure) when using SDF+KI, SDF and RMGIC in IPC. The results of this study can help guide treatment decision making regarding use of SDF and SDF+KI as IPC materials in deep cavitated lesions.
|}

==Cross-Sectional Reliability and Concurrent Validity of a Quantitative 2-Dimensional Ultrasound Image Analysis of Effusion and Synovial Hypertrophy in Knee Osteoarthritis==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37008822/ Osteoarthr Cartil Open. 2023 Mar 16;5(2):100356. PMID: 37008822] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10060736/pdf/main.pdf PDF]

'''Authors:''' Dima R, Birmingham TB, Philpott HT, Bryant D, Fenster A, Appleton CT.

'''Institution:''' Faculty of Health Sciences, University of Western Ontario, London, ON, Canada.

'''Abstract:'''
Objective: Effusion-synovitis is related to pain and progression in knee osteoarthritis (OA), but current gold standard ultrasound (US) measures are limited to semi-quantitative grading of joint distension or 1-dimensional thickness measures. A novel quantitative 2-dimensional image analysis methodology is applied to US images of effusion-synovitis; reliability and concurrent validity was assessed in patients with knee OA.

Methods: Cross sectional analysis of US images collected from 51 patients with symptomatic knee OA were processed in ImageJ and segmented in [http://www.slicer.org '''3D Slicer'''] to produce a binary mask of the supra-patellar synovitis region of interest (ROI). Area measures (mm2) of total synovitis, effusion and hypertrophy components were exported. Intra-rater reliability and test-retest reliability (1-14 days washout) were estimated with intra-class correlation coefficients (ICCs). Concurrent validity was measured by Spearman correlations between quantitative measures and gold standard OMERACT and caliper measurements of synovitis.

Results: Intra-rater reliability for hypertrophy area was estimated at 0.98, 0.99 for effusion area, and 0.99 for total synovitis area. The test-retest reliability for total synovitis area was 0.63 (SEM 87.8 mm2), 0.59 for hypertrophy area (SEM 21.0 mm2), and 0.64 for effusion area (SEM 73.8 mm2). Correlation between total synovitis area and OMERACT grade was 0.84, 0.81 between total synovitis area and effusion-synovitis calipers, and 0.81 between total effusion area and effusion calipers.

Conclusion: This new research tool for image analysis demonstrated excellent intra-rater reliability, good concurrent validity, and moderate test-retest reliability. Quantitative 2D US measures of effusion-synovitis and its individual components may enhance the study and management of knee OA.
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==Patient-Specific Needle Guidance Templates Drilled Intraprocedurally for Image Guided Intervention: Feasibility Study in Swine==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36173542 Int J Comput Assist Radiol Surg. 2023 Mar;18(3):537-44. PMID: 36173542]

'''Authors:''' Glossop N, Bale R, Xu S, Pritchard WF, Karanian JW, Wood BJ.

'''Institution:''' Queen's University, Kingston, ON, Canada.

'''Abstract:'''
'''purpose:''' Thermal ablation of large tumors may benefit from simultaneous placement of multiple needles, but accurate placement becomes challenging as the number of needles increases. The aim of this work was to evaluate use of personalized needle guidance grid templates based on intraprocedural CT and fabricated at the point of care to implement ablation treatment plans with multiple needles in vivo.

'''Methods:''' A plastic frame was designed to hold two parallel plastic guide plates in a rigid relationship, fixed over the abdomen by a mounting arm. Steel ball targets (1.5 mm) were implanted under ultrasound in the livers of two domestic swine under general anesthesia. Following breath-hold CT of the subject and frame, the targets and frame were identified using customized [http://www.slicer.org '''3D Slicer''']-based planning software. Multiple needle trajectories targeting the balls were planned, including complex off-plane trajectories. A machining program for drilling the hole pattern corresponding to the planned needle trajectories was generated. The pattern was drilled in the two plates with a numerical-controlled milling machine in the suite. The plates were attached to the frame and needles passed through the paired holes to the calculated depth. Placement accuracy was defined as needle tip-to-target distance on post-placement CT.

'''Results:''' The planning process and manufacturing required approximately 6 and 15 min, respectively. Needles were rapidly inserted (n = 11) to the target points without complications or traversing nontarget anatomy. The mean needle tip-to-target distance error was 3.4 ± 2.2, range 0-7 mm.

'''Conclusion:''' Rapid and accurate needle placement was feasible using a subject-specific, custom-drilled, needle guidance grid template fabricated intraprocedurally. Targeting accuracy and performance were similar to more complex and expensive tracking systems which may enable accurate intraprocedural implementation of treatment plans in the liver or other organs. This may be of value in complex ablation cases or in areas where more advanced guidance systems are not available.
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==Automatic Landmark Identification in Cone-Beam Computed Tomography==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36811276 Orthod Craniofac Res. 2023 Feb 21. PMID: 36811276]

'''Authors:''' Gillot M, Miranda F, Baquero B, Ruellas A, Gurgel M, Al Turkestani N, Anchling L, Hutin N, Biggs E, Yatabe M, Paniagua B, Fillion-Robin JC, Allemang D, Bianchi J, Cevidanes L, Prieto JC.

'''Institution:''' Department of Orthodontics and Pediatric Dentistry, School of Dental Medicine, University of Michigan, Ann Arbor, MI, USA.

'''Abstract:'''
'''Objective:''' To present and validate an open-source fully automated landmark placement (ALICBCT) tool for cone-beam computed tomography scans.

'''Material and Methods:''' One hundred and forty-three large and medium field of view cone-beam computed tomography (CBCT) were used to train and test a novel approach, called ALICBCT that reformulates landmark detection as a classification problem through a virtual agent placed inside volumetric images. The landmark agents were trained to navigate in a multi-scale volumetric space to reach the estimated landmark position. The agent movements decision relies on a combination of DenseNet feature network and fully connected layers. For each CBCT, 32 ground truth landmark positions were identified by 2 clinician experts. After validation of the 32 landmarks, new models were trained to identify a total of 119 landmarks that are commonly used in clinical studies for the quantification of changes in bone morphology and tooth position.

'''Results:''' Our method achieved a high accuracy with an average of 1.54±0.87 mm error for the 32 landmark positions with rare failures, taking an average of 4.2s computation time to identify each landmark in one large 3D-CBCT scan using a conventional GPU.

'''Conclusion:''' The ALICBCT algorithm is a robust automatic identification tool that has been deployed for clinical and research use as an extension in the 3D Slicer platform allowing continuous updates for increased precision.
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==Development and In-Silico and Ex-Vivo Validation of a Software for a Semi-Automated Segmentation of the Round Window Niche to Design a Patient Specific Implant to Treat Inner Ear Disorders==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36826970 J Imaging. 2023 Feb 20;9(2):51. PMID: 36826970] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9965310/pdf/jimaging-09-00051.pdf PDF]

'''Authors:''' Matin-Mann F, Gao Z, Wei C, Repp F, Artukarslan EN, John S, Alcacer Labrador D, Lenarz T, Scheper V.

'''Institution:''' Lower Saxony Center for Biomedical Engineering, Implant Research and Development (NIFE), Department of Otorhinolaryngology, Head and Neck Surgery, Hannover Medical School, Hannover, Germany.

'''Abstract:''' The aim of this study was to develop and validate a semi-automated segmentation approach that identifies the round window niche (RWN) and round window membrane (RWM) for use in the development of patient individualized round window niche implants (RNI) to treat inner ear disorders. Twenty cone beam computed tomography (CBCT) datasets of unilateral temporal bones of patients were included in the study. Defined anatomical landmarks such as the RWM were used to develop a customized [http://www.slicer.org '''3D Slicer'''] plugin for semi-automated segmentation of the RWN. Two otolaryngologists (User 1 and User 2) segmented the datasets manually and semi-automatically using the developed software. Both methods were compared in-silico regarding the resulting RWM area and RWN volume. Finally, the developed software was validated ex-vivo in N = 3 body donor implantation tests with additively manufactured RNI. The independently segmented temporal bones of the different Users showed a strong consistency in the volume of the RWN and the area of the RWM. The volume of the semi-automated RWN segmentations were 48 ± 11% smaller on average than the manual segmentations and the area of the RWM of the semi-automated segmentations was 21 ± 17% smaller on average than the manual segmentation. All additively manufactured implants, based on the semi-automated segmentation method could be implanted successfully in a pressure-tight fit into the RWN. The implants based on the manual segmentations failed to fit into the RWN and this suggests that the larger manual segmentations were over-segmentations. This study presents a semi-automated approach for segmenting the RWN and RWM in temporal bone CBCT scans that is efficient, fast, accurate, and not dependent on trained users. In addition, the manual segmentation, often positioned as the gold-standard, actually failed to pass the implantation validation.
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==Design and Analysis of HSC-BPPV Diagnostic Maneuver Based on Virtual Simulation==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36873445 Front Neurol. 2023 Feb 17;14:1132343. PMID: 36873445] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9981954/pdf/fneur-14-1132343.pdf PDF]

'''Authors:''' Li Y, Yang X.

'''Institution:''' Department of Research Center, Third Affiliated Hospital of Shanghai University, Wenzhou Third Clinical Institute Affiliated to Wenzhou Medical University, Wenzhou People's Hospital, Wenzhou, China.

'''Abstract:'''
'''Background:''' The preferred supine roll test for the diagnosis of horizontal semicircular canal BPPV has several disadvantages, including difficulty in locating the affected ear, inconsistent nystagmus performance on repeated testing, and lack of a typical latency period, resulting in insensitive diagnosis.

Objectives: To investigate novel diagnostic techniques with more scientific design, more accessible application, and better diagnostic sensitivity and specificity.

'''Materials and Methods:''' Based on clinical microscopic CT data, we created a virtual simulation model of BPPV using Unity software. The physical simulation of the traditional supine roll test was performed to observe and analyse the movement of the otoliths, whose initial position was the typical stable position. In addition, the normal vectors of the plane and crista ampullaris of the horizontal semicircular canal were measured using [http://www.slicer.org '''3D Slicer'''] software. Based on this, we analyzed the critical steps for designing diagnostic maneuvers for BPPV in the horizontal semicircular canal. For a more accurate diagnosis of horizontal semicircular canal BPPV, it is critical to rotate the horizontal semicircular canal to be parallel to gravity. It is also necessary to move the otolith by swinging the head. As a result, we developed two diagnostic maneuvers: the 60° roll test and the prone roll test. We also performed simulations to observe otolith movement and predict nystagmus performance.

'''Conclusions:''' The 60° roll test and the prone roll test can complement the supine roll test. Compared to the supine roll test, they not only effectively differentiate canalolithiasis from cupulolithiasis, but also make it easier to determine the position of the otoliths, and the characteristics of the nystagmus are more pronounced. Significant diagnostic features have significant potential benefits for home and telemedicine.
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==The Simplified Tailor-Made Workflows for a [http://www.slicer.org '''3D Slicer''']-Based Craniofacial Implant Design==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36801943 Sci Rep. 2023 Feb 17;13(1):2850. PMID: 36801943] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9938178/pdf/41598_2023_Article_30117.pdf PDF]

'''Authors:''' Tantisatirapong S, Khunakornpattanakarn S, Suesatsakul T, Boonpratatong A, Benjamin I, Tongmeesee S, Kangkorn T, Chanwimalueang

'''Institution:''' Department of Biomedical Engineering, Faculty of Engineering, Srinakharinwirot University, Nakhon Nayok, Thailand.

'''Abstract:''' A specific design of craniofacial implant model is vital and urgent for patients with traumatic head injury. The mirror technique is commonly used for modeling these implants, but it requires the presence of a healthy skull region opposite to the defect. To address this limitation, we propose three processing workflows for modeling craniofacial implants: the mirror method, the baffle planner, and the baffle-based mirror guideline. These workflows are based on extension modules on the [http://www.slicer.org '''3D Slicer'''] platform and were developed to simplify the modeling process for a variety of craniofacial scenarios. To evaluate the effectiveness of these proposed workflows, we investigated craniofacial CT datasets collected from four accidental cases. The designed implant models were created using the three proposed workflows and compared to reference models created by an experienced neurosurgeon. The spatial properties of the models were evaluated using performance metrics. Our results show that the mirror method is suitable for cases where a healthy skull region can be completely reflected to the defect region. The baffle planner module offers a flexible prototype model that can be fit independently to any defect location, but it requires customized refinement of contour and thickness to fill the missing region seamlessly and relies on the user's experience and expertise. The proposed baffle-based mirror guideline method strengthens the baffle planner method by tracing the mirrored surface. Overall, our study suggests that the three proposed workflows for craniofacial implant modeling simplify the process and can be practically applied to a variety of craniofacial scenarios. These findings have the potential to improve the care of patients with traumatic head injuries and could be used by neurosurgeons and other medical professionals.
|}

==Predicting Transient Ischemic Attack Risk in Patients With Mild Carotid Stenosis Using Machine Learning and CT Radiomics==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36846119 Front Neurol. 2023 Feb 8;14:1105616. PMID: 36846119] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9944715/pdf/fneur-14-1105616.pdf PDF]

'''Authors:''' Xia H, Yuan L, Zhao W, Zhang C, Zhao L, Hou J, Luan Y, Bi Y, Feng Y.

'''Institution:''' Department of Vascular Surgery, The First Affiliated Hospital of Kunming Medical University, Kunming, China.

'''Abstract:'''
'''Objective:''' This study aims to establish a radiomics-based machine learning model that predicts the risk of transient ischemic attack in patients with mild carotid stenosis (30-50% North American Symptomatic Carotid Endarterectomy Trial) using extracted computed tomography radiomics features and clinical information.

'''Methods:''' A total of 179 patients underwent carotid computed tomography angiography (CTA), and 219 carotid arteries with a plaque at the carotid bifurcation or proximal to the internal carotid artery were selected. The patients were divided into two groups; patients with symptoms of transient ischemic attack after CTA and patients without symptoms of transient ischemic attack after CTA. Then we performed random sampling methods stratified by the predictive outcome to obtain the training set (N = 165) and testing set (N = 66). [http://www.slicer.org '''3D Slicer'''] was employed to select the site of plaque on the computed tomography image as the volume of interest. An open-source package PyRadiomics in Python was used to extract radiomics features from the volume of interests. The random forest and logistic regression models were used to screen feature variables, and five classification algorithms were used, including random forest, eXtreme Gradient Boosting, logistic regression, support vector machine, and k-nearest neighbors. Data on radiomic feature information, clinical information, and the combination of these pieces of information were used to generate the model that predicts the risk of transient ischemic attack in patients with mild carotid artery stenosis (30-50% North American Symptomatic Carotid Endarterectomy Trial).

'''Results:''' The random forest model that was built based on the radiomics and clinical feature information had the highest accuracy (area under curve = 0.879; 95% confidence interval, 0.787-0.979). The combined model outperformed the clinical model, whereas the combined model showed no significant difference from the radiomics model.

'''Conclusion:''' The random forest model constructed with both radiomics and clinical information can accurately predict and improve discriminative power of computed tomography angiography in identifying ischemic symptoms in patients with carotid atherosclerosis. This model can aid in guiding the follow-up treatment of patients at high risk.
|}

==Deep Learning Enabled Multi-Organ Segmentation of Mouse Embryos==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36802342 Biol Open. 2023 Feb 15;12(2):bio059698. PMID: 36802342] | [https://cob.silverchair-cdn.com/cob/content_public/journal/bio/12/2/10.1242_bio.059698/2/bio059698.pdf PDF]

'''Authors:''' Rolfe SM, Whikehart SM, Maga AM.

'''Institution:''' Center for Developmental Biology and Regenerative Medicine, Seattle Children's Research Institute, Seattle, WA, USA.

'''Abstract:''' The International Mouse Phenotyping Consortium (IMPC) has generated a large repository of three-dimensional (3D) imaging data from mouse embryos, providing a rich resource for investigating phenotype/genotype interactions. While the data is freely available, the computing resources and human effort required to segment these images for analysis of individual structures can create a significant hurdle for research. In this paper, we present an open source, deep learning-enabled tool, Mouse Embryo Multi-Organ Segmentation (MEMOS), that estimates a segmentation of 50 anatomical structures with a support for manually reviewing, editing, and analyzing the estimated segmentation in a single application. MEMOS is implemented as an extension on the [http://www.slicer.org '''3D Slicer'''] platform and is designed to be accessible to researchers without coding experience. We validate the performance of MEMOS-generated segmentations through comparison to state-of-the-art atlas-based segmentation and quantification of previously reported anatomical abnormalities in a Cbx4 knockout strain. This article has an associated First Person interview with the first author of the paper.
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==Development and Validation of an 18FFDG-PET/CT Radiomic Model for Predicting Progression-Free Survival for Patients With Stage II - III Thoracic Esophageal Squamous Cell Carcinoma Who Are Treated With Definitive Chemoradiotherapy==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36794365 Acta Oncol. 2023 Feb;62(2):159-65. PMID: 36794365]

'''Authors:''' Takahashi N, Tanaka S, Umezawa R, Takanami K, Takeda K, Yamamoto T, Suzuki Y, Katsuta Y, Kadoya N, Jingu K.

'''Institution:''' Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Japan.

'''Abstract:'''
'''Background:''' Radiomics is a method for extracting a large amount of information from images and used to predict treatment outcomes, side effects and diagnosis. In this study, we developed and validated a radiomic model of [18F]FDG-PET/CT for predicting progression-free survival (PFS) of definitive chemoradiotherapy (dCRT) for patients with esophageal cancer.

'''Material and Methods:''' Patients with stage II - III esophageal cancer who underwent [18F]FDG-PET/CT within 45 days before dCRT between 2005 and 2017 were included. Patients were randomly assigned to a training set (85 patients) and a validation set (45 patients). Radiomic parameters inside the area of standard uptake value ≥ 3 were calculated. The open-source software [http://www.slicer.org '''3D Slicer'''] and Pyradiomics were used for segmentation and calculating radiomic parameters, respectively. Eight hundred sixty radiomic parameters and general information were investigated.In the training set, a radiomic model for PFS was made from the LASSO Cox regression model and Rad-score was calculated. In the validation set, the model was applied to Kaplan-Meier curves. The median value of Rad-score in the training set was used as a cutoff value in the validation set. JMP was used for statistical analysis. RStudio was used for the LASSO Cox regression model. p < 0.05 was defined as significant.

'''Results:''' The median follow-up periods were 21.9 months for all patients and 63.4 months for survivors. The 5-year PFS rate was 24.0%. In the training set, the LASSO Cox regression model selects 6 parameters and made a model. The low Rad-score group had significantly better PFS than that the high Rad-score group (p = 0.019). In the validation set, the low Rad-score group had significantly better PFS than that the high Rad-score group (p = 0.040).

'''Conclusions:''' The [18F]FDG-PET/CT radiomic model could predict PFS for patients with esophageal cancer who received dCRT.
|}

==Minimizing Magnetic Resonance Image Geometric Distortion at 7 Tesla for Frameless Presurgical Planning Using Skin-Adhered Fiducials==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36301228 Med Phys. 2023 Feb;50(2):694-701. PMID: 36301228]

'''Authors:''' Kirby KM, Koons EK, Welker KM, Fagan AJ.

'''Institution:''' Department of Radiology, Mayo Clinic, Rochester, MN, USA.

'''Abstract:'''
'''Background:''' 7T MRI offers significant benefits to spatial and contrast resolution compared to lower field strengths. This superior image quality can help better delineate targets in stereotactic neurosurgical procedures; however, the potential for increased geometric distortions at 7T has impaired its widespread use for these applications. Image geometric distortions can be due to distortions of B0 arising from tissue magnetic susceptibility effects or inherent field inhomogeneities, and nonlinearity of the magnetic field gradients.

'''Purpose:''' The purpose of this study was to investigate the use of 7T MRI for neurosurgical frameless stereotactic navigation procedures. Image geometric distortions at the skin surface in 7T images were minimized and compared to results from clinical 3T frameless imaging protocols.

'''Methods:''' A 3D-printed grid phantom filled with oil was designed to perform a fine calibration of the 7T imaging gradients, and an oil-filled head phantom with internal targets was used to determine ground truth (from computed tomography [CT]) positioning errors. Three volunteers and the head phantom were imaged consecutively at 3T and 7T. Ten skin-adhesive fiducial markers were placed on each subject's exposed skin surface at standard clinical placement locations for frameless procedures. Imaging sequences included MPRAGE (three bandwidths at 7T: 400, 690, and 1020 Hz/pixel, and one at 3T: 400 Hz/pixel), T2 SPACE, and T2 SPACE FLAIR acquisitions. An additional GRE field map was acquired on both scanners using a multi-echo GRE sequence. Custom Matlab code was used to perform additional distortion correction of the images using the unwrapped field maps. Fiducial localization was performed with [http://www.slicer.org '''3D Slicer'''], with absolute fiducial positioning errors determined in phantom experiments following rigid registration to the CT images. For human experiments, 3T and 7T images were registered and relative differences in fiducial locations were compared using two-tailed paired t-tests.

'''Results:''' Phantom measurements at 7T yielded gradient distance scaling errors of 1.1%, 2.2%, and 1.0% along the x-, y-, and z-axes, respectively. These system miscalibrations were traced back to phantom manufacturing deviations in the sphericity of the vendor's gradient calibration phantom. Correction factors along each gradient axis were applied, and afterward, geometric distortions of less than 1 mm were obtained in the 7T MR head phantom images for the 1020 Hz/pixel bandwidth MPRAGE sequence. For the human subjects, four fiducial locations were excluded from the analysis due to patient positioning differences. Differences between 3T and 7T MPRAGE with low/medium/high bandwidth were 2.2 /2.6/2.3 mm, respectively, before the correction, reducing to 1.6/1.3/1.0 mm after the correction (p < 0.001). T2 SPACE and T2 SPACE FLAIR yielded a similar pattern when the correction was applied, decreasing from 2.1 to 0.8 mm, and 2.6 to 1.0 mm, respectively.

'''Conclusions:''' 7T MRI can be used to perform frameless presurgical planning with skin-adhesive fiducials. Geometric distortions can be reduced to a clinically relevant level (errors < ∼1 mm) with no significant susceptibility-related distortions, by using high receiver bandwidth, ensuring gradients are properly calibrated, and placing skin fiducials in areas where distortions from patient positioning are minimal.
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==Acute Colonic Pseudo-Obstruction Secondary to Renal Calculus: A Case Report and Review of Pathophysiology==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36777972 Cureus. 2023 Feb 7;15(2):e34756. PMID: 36777972] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9905947/pdf/cureus-0015-00000034756.pdf PDF]

'''Authors:''' Gillies M, AlDujaili T.

'''Institution:''' General Surgery, Goulburn Valley Health, Shepparton, Australia

'''Abstract:''' Acute colonic pseudo-obstruction (ACPO) is obstruction of the large bowel without a mechanical cause. The exact mechanism remains incompletely understood but is thought to result from disruption to the autonomic regulation of the colon, typically in the context of hospitalized patients with medical illness, precipitating medications, or recent surgical intervention. This paper presents an unusual case of ACPO in an ambulatory patient with a recently passed renal calculus, explores the anatomy and physiology underlying the autonomic dysfunction theory of ACPO pathogenesis in the context of the case, and provides a 3D reconstruction of the patient's CT to illustrate the abrupt caliber change at the splenic flexure characteristic of ACPO.

'''Keywords:''' 3d reconstruction; acute colonic pseudo-obstruction; ogilvie's syndrome; renal calculi; [http://www.slicer.org '''3D Slicer'''] software.
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==A Novel Stereotactic Aspiration Technique for Intracerebral Hemorrhage==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36270590 World Neurosurg. 2023 Feb;170:e28-e36. PMID: 36270590]

'''Authors:''' Xu HZ, Guo J, Wang C, Liu X, Song ZQ, Chen RF, Qiu B, Wang Q, Huang Y.

'''Institution:''' Department of Neurosurgery, Civil Aviation General Hospital, Beijing, China.

'''Abstract:'''

'''Background:''' Minimally invasive surgery is effective and recommended for treatment of intracerebral hemorrhage; however, neurosurgeons in grass-root hospitals in underdeveloped countries lack effective and precise minimally invasive surgery techniques. The aim of this study was to present a technique of computed tomography angiography-based three-dimensional-printed navigation mold-guided stereotactic aspiration and demonstrate its clinical application using a hard needle in a series of patients.

'''Methods:''' The novel stereotactic aspiration technique was performed in 18 patients with spontaneous intracerebral hemorrhage at our center, and clinical outcomes were reported. We compared the volume of hematoma measured by 3 different methods: ABC/2 formula, manual segmentation with OsiriX, and manual segmentation with [http://www.slicer.org '''3D Slicer'''].

'''Results:''' The surgery was completed safely within an average operative time of 15.11 minutes, achieving the goal of <15 mL residual clot volume or >70% clot removal in all patients. No intracranial rebleeding or infection was observed postoperatively. At the end of the 6-month follow-up, 61.11% (11/18) of patients achieved a modified Rankin Scale score <3. There was overall better agreement of hematoma measurement using segmentation with [http://www.slicer.org '''3D Slicer'''] rather than ABC/2 measurement or hematoma measurement using segmentation with OsiriX.

'''Conclusions:''' Our novel method of stereotactic aspiration benefited patients in this study with good percent clot removal, few surgery-related complications, and a favorable prognosis. Manual segmentation with [http://www.slicer.org '''3D Slicer'''] could be used to provide the neurosurgeon with dependable information about hematoma volume. This cheap and convenient technique may be applied in grass-root hospitals in underdeveloped countries. Assessment in multicenter prospective clinical trials is needed.
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==Morphological Evaluation of the Normal and Hydrocephalic Third Ventricle on Cranial Magnetic Resonance Imaging in Children: A Retrospective Study==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35994062 Pediatr Radiol. 2023 Feb;53(2):282-96. PMID: 35994062]

'''Authors:''' Isıklar S, Turan Ozdemir S, Ozkaya G, Ozpar R, Parlak M.

'''Institution:''' Medical Imaging Techniques Program, Vocational School of Health Services, Bursa Uludag University, 16240, Bursa, Turkey.

'''Abstract:'''
'''Background:''' Third ventricle morphological changes reflect changes in the ventricular system in pediatric hydrocephalus, so visual inspection of the third ventricle shape is standard practice. However, normal pediatric reference data are not available.

'''Objective:''' To investigate both the normal development of the third ventricle in the 0-18-year age group and changes in its biometry due to hydrocephalus.

'''Materials and Methods:''' For this retrospective study, we selected individuals ages 0-18 years who had magnetic resonance imaging (MRI) from 2012 to 2020. We included 700 children (331 girls) who had three-dimensional (3-D) T1-weighted sequences without and 25 with hydrocephalus (11 girls). We measured the distances between the anatomical structures limiting the third ventricle by dividing the third ventricle into anterior and posterior regions. We made seven linear measurements and three index calculations using 3DSlicer and MRICloud pipeline, and we analyzed the results of 23 age groups in normal and hydrocephalic patients using SPSS (v. 23).

'''Results:''' Salient findings are: (1) The posterior part of the third ventricle is more affected by both developmental and hydrocephalus-related changes. (2) For third ventricle measurements, gender was insignificant while age was significant. (3) Normal third ventricular volumetric development showed a segmental increase in the 0-18 age range. The hydrocephalic third ventricle volume cut-off value in this age group was 3 cm3.

'''Conclusion:''' This study describes third ventricle morphometry using a linear measurement method. The ratios defined in the midsagittal plane were clinically useful for diagnosing the hydrocephalic third ventricle. The linear and volumetric reference data and ratios are expected to help increase diagnostic accuracy in distinguishing normal and hydrocephalic third ventricles.
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==Henri IV of France's Larynx 3D Reconstitution==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36149490 Eur Arch Otorhinolaryngol. 2023 Feb;280(2):919-24. PMID: 36149490]

'''Authors:''' Baudouin R, Amelot A, Laprie Y, Crevier-Buchman L, Maeda S, Huynh-Charlier I, Hans S, Charlier P.

'''Institution:''' Department of Otolaryngology-Head & Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Université Paris Saclay), Montigny-le-Bretonneux, France.

'''Abstract:''' Objectives: King Henri IV of France (reign from 1589 to 1610) was one of the most important kings of France. Embalmed and buried in Saint-Denis, his remains were beheaded in 1793. His head (including his larynx) survived in successive private collections until its definitive identification in 2010. The purpose of the study was to provide a morphologic study of the larynx with a 3D reconstitution.

'''Methods:''' A flexible endoscopy was performed via the mouth and via the trachea. Measures of the larynx (vocal folds lengths, thickness, width, larynx height) were collected from the CT-scan by a panel of experts blind each other. The segmentation of the laryngeal anatomical components (vocal folds, cartilages) was performed using [http://www.slicer.org '''3D Slicer''']. Mesh smoothing and 3D reconstitution were performed using Fusion 360®. Reconstitution was discussed between the experts. Decision was made by consensus after discussion.

'''Results:''' Cricoid, thyroid, arytenoid cartilages, vocal folds and hyoid bone were identified and a computed 3D reconstitution of the larynx was made. The laryngeal 3D model appeared morphologically similar to a living subject. Measures were similar but smaller than those of a modern subject.

'''Conclusions:''' The 3D reconstitution of the larynx of Henri IV of France was conducted from the CT-scan of his mummified head. This work constitutes a first valuable morphologic analysis of a larynx from an embalmed individual. This anatomical work is the first step towards the reconstruction of the voice of this historical character, which we hope to concretize with computer modeling tools in a second step.
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==Development and External Validation of a Novel Nomogram to Predict Prostate Cancer in Biopsy-Naïve Patients With PSA <10 Ng/Ml and PI-RADS v2.1 = 3 Lesions==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35920264 Cancer Med. 2023 Feb;12(3):2560-71. PMID: 35920264] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9939143/pdf/CAM4-12-2560.pdf PDF]

'''Authors:''' Hu C, Sun J, Xu Z, Zhang Z, Zhou Q, Xu J, Chen H, Wang C, Ouyang J.

'''Institution:''' Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.

'''Abstract:'''
'''Objective:''' To develop and externally validate a novel nomogram in biopsy-naïve patients with prostate-specific antigen (PSA) <10 ng/ml and PI-RADS v2.1 = 3 lesions.

'''Methods:''' We retrospectively collected 307 men that underwent initial biopsy from October 2015 to January 2022 in Cohort 1 (The First Affiliated Hospital of Soochow University). External cohort (Cohort 2, Kunshan Hospital) included 109 men that met our criteria from July 2016 to June 2021. By [http://www.slicer.org '''3D Slicer'''] Software, the volume of all lesions was divided into two subgroups (PI-RADS v2.1 = 3a and 3b). Logistic regression analysis was performed to screen for variables and construct nomogram by analyzing clinical data from Cohort 1. Receiver operating characteristics curve analysis, calibration plot and decision curve analysis (DCA) were plotted to validate the nomogram in external cohort.

'''Results:''' A total of 70 (22.8%) patients was diagnosed with prostate cancer in Institution 1. Among them, 34 (11.1%) had clinically significant prostate cancer (csPCa). Age, prostate-specific antigen density, digital rectal examination, PI-RADS v2.1 = 3 subgroups (3a and 3b) and apparent diffusion coefficient (ADC, <750 mm2 /s) were predictive factors for prostate cancer (PCa) and csPCa. High area under the curve of the nomogram was found in Cohort 1 and Cohort 2 for PCa (0.857 vs. 0.850) and for csPCa (0.896 vs. 0.893). Calibration curves showed excellent agreement between the predicted probability and actual risk for the models in internal and external validation. The DCA demonstrated net benefit of our nomogram.

'''Conclusion:''' Until now, this is the first nomogram that predicts PCa and csPCa in biopsy-naïve patients with PSA <10 ng/ml and PI-RADS v2.1 = 3 lesions. Furthermore, PI-RADS v2.1 = 3 subgroups were considered to be an independent risk factor in our model. Our nomogram may assist urologists in biopsy decision making for these so-called "double gray zone" patients.
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==A Three-Dimensionally Printed Otological Model for Cholesteatoma Mastoidectomy Training==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35789285 Eur Arch Otorhinolaryngol. 2023 Feb;280(2):671-80. PMID: 35789285]

'''Authors:''' de Souza MA, Bento RF, Lopes PT.

'''Institution:''' Otolaryngology Department, University of São Paulo School of Medicine, São Paulo, Brazil.

'''Abstract:'''
'''purpose:''' To relate the creation and expert validation (face and content validity) of an affordable three-dimensional (3D) printed model of temporal bones with chronic otitis media with cholesteatoma (COMC) as a simulator for mastoidectomy.

'''Methods:''' We performed computed tomography (CT) of the temporal bones of a patient with COMC followed at the University of São Paulo (USP) Hospital with [http://www.slicer.org '''3D Slicer'''] to create a 3-D model of the affected bone using light-curing resin and silicone (cholesteatoma). The final 3-D printed images were scored by 10 otologists using a customized version of the Michigan Standard Simulation Scale Experience (MiSSES). Internal consistency and inter-rater reliability were assessed using Cronbach's α and intraclass correlations.

'''Results:''' Otologists consistently scored the model positively for fidelity, educational value, reactions, and the overall model quality. Nine otologists agreed that the model was a good educational device for surgical training of COMC. All experts deemed the model ready-or nearly ready-for use. The final cost of the model, including raw materials and manufacturing, was 120 USD.

'''Conclusions:''' Using 3D printing technology, we created the first anatomically accurate, low-cost, disease-reproducing 3D model of temporal bones for mastoidectomy training for cholesteatoma.
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==Development of a Navigable 3D Virtual Model of Temporal Bone Anatomy==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36704866 J Vis Commun Med. 2023 Jan 26:1-5. PMID: 36704866] | [https://www.tandfonline.com/doi/full/10.1080/17453054.2023.2169110 PDF]

'''Authors:''' Sareen K.

'''Institution:''' Sant Parmanand Hospital, New Delhi, India.

'''Abstract:'''
'''Background:''' Computed Tomography (CT) scanning offers an accurate structural definition of bones, blood vessels, and soft tissues; however, mental integration of cross-sectional 2D CT images for a 3D understanding of complex anatomical structures becomes difficult when the field of view is confined to the temporal bone. This project tried to provide a feasible solution to this problem by creating a navigable 3D virtual model which may aid in better comprehension of the temporal bone anatomy.

'''Methods:''' A helical-CT scan was used to obtain high-resolution cross-sectional slices of a cadaveric human temporal bone. Using the volume-rendering capabilities of [http://www.slicer.org '''3D Slicer'''], which involves volume data management, cropping of the data set, and threshold painting, detailed anatomical structures were segmented based on the intensity captured from different regions. This volumetric data was converted to an interactive virtual model using Blender®.

'''Results:''' The final product is a web page that allows interaction and navigation with a 3D annotated model of the temporal bone, which can be accessed from any device with a web browser.

'''Conclusion:''' This model can function as a training tool for students, teachers, and practitioners to understand and review the complex anatomy of the temporal bone.
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==Maxillary Antral Pseudocyst Drift after Osteotome Sinus Floor Elevation with Simultaneous Implant Placement: A Case Report and Literature Review==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36769568 J Clin Med. 2023 Jan 24;12(3):920. PMID: 36769568] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9917374/pdf/jcm-12-00920.pdf PDF]

'''Authors:''' Wang P, Huang N, Ren J, Gong P, Long J, Huang B.

'''Institution:''' West China School of Stomatology, Sichuan University, Chengdu, China.

'''Abstract:''' This report describes maxillary antral pseudocyst drift after maxillary sinus floor augmentation through osteotome sinus floor elevation with simultaneous implant placement. [http://www.slicer.org '''3D Slicer'''] was used to measure the pseudocyst and maxilla for the placement of the implants; follow-up visits were scheduled at 6, 12, and 22 months. No adverse effects were observed during or after surgery, and all implants exhibited osseointegration without mobility. At 6 months after surgery, the pseudocyst had moved posterolaterally from the preoperative position near the anterior medial maxillary sinus, then returned to its original position at 12 months. However, it had remigrated to the posterolateral position at 22 months. The preoperative volume of the pseudocyst was 3.795 mm3; it was 2.370, 3.439, and 2.930 mm3 at 6, 12, and 22 months after surgery, respectively. The changes in pseudocyst drift and volume did not have a substantial negative influence on the implants, presumably because of cystic attachment and the recurrence of multiple pseudocysts at different locations. The risks associated with changes in a pseudocyst can be avoided, if an appropriate treatment plan is selected.
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==Radiomic Analysis Based on Magnetic Resonance Imaging for Predicting PD-L2 Expression in Hepatocellular Carcinoma==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36672315 Cancers (Basel). 2023 Jan 5;15(2):365. PMID: 36672315] | [http://www.ncbi.nlm.nih.gov/pmc/articles/pmc9856314/ PDF]

'''Authors:''' Tao YY, Shi Y, Gong XQ, Li L, Li ZM, Yang L, Zhang XM.

'''Institution:''' Medical Imaging Key Laboratory of Sichuan Province, Interventional Medical Center, Department of Radiology, Medical Research Center, Affiliated Hospital of North Sichuan Medical College, Nanchong, China.

'''Abstract:''' Hepatocellular carcinoma (HCC) is the sixth most common malignant tumour and the third leading cause of cancer death in the world. The emerging field of radiomics involves extracting many clinical image features that cannot be recognized by the human eye to provide information for precise treatment decision making. Radiomics has shown its importance in HCC identification, histological grading, microvascular invasion (MVI) status, treatment response, and prognosis, but there is no report on the preoperative prediction of programmed death ligand-2 (PD-L2) expression in HCC. The purpose of this study was to investigate the value of MRI radiomic features for the non-invasive prediction of immunotherapy target PD-L2 expression in hepatocellular carcinoma (HCC). A total of 108 patients with HCC confirmed by pathology were retrospectively analysed. Immunohistochemical analysis was used to evaluate the expression level of PD-L2. [http://www.slicer.org '''3D Slicer'''] software was used to manually delineate volumes of interest (VOIs) and extract radiomic features on preoperative T2-weighted, arterial-phase, and portal venous-phase MR images. Least absolute shrinkage and selection operator (LASSO) was performed to find the best radiomic features. Multivariable logistic regression models were constructed and validated using fivefold cross-validation. The area under the receiver characteristic curve (AUC) was used to evaluate the predictive performance of each model. The results show that among the 108 cases of HCC, 50 cases had high PD-L2 expression, and 58 cases had low PD-L2 expression. Radiomic features correlated with PD-L2 expression. The T2-weighted, arterial-phase, and portal venous-phase and combined MRI radiomics models showed AUCs of 0.789 (95% CI: 0.702-0.875), 0.727 (95% CI: 0.632-0.823), 0.770 (95% CI: 0.682-0.875), and 0.871 (95% CI: 0.803-0.939), respectively. The combined model showed the best performance. The results of this study suggest that prediction based on the radiomic characteristics of MRI could noninvasively predict the expression of PD-L2 in HCC before surgery and provide a reference for the selection of immune checkpoint blockade therapy.
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==Correlation Between Unilateral Internal Carotid Artery Stenosis and Asymmetric Distribution of Enlarged Perivascular Spaces in Patients With Acute Cerebral Infarction==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36649988 Zhonghua Yi Xue Za Zhi. 2023 Jan 17;103(3):178-185. PMID: 36649988]

'''Authors:''' Jian XL, Zhang M, Yun WW.

'''Abstract:'''
'''Objective:''' To explore the correlation between unilateral internal carotid artery (ICA) stenosis and asymmetrical distribution of enlarged perivascular spaces (EPVS) in patients with acute cerebral infarction.

'''Methods:''' Acute cerebral infarction patients with unilateral ICA stenosis hospitalized in Changzhou Second People's Hospital from October 2020 to December 2021 were collected. Routine cranial MRI and CT angiography were completed for each patient. The [http://www.slicer.org '''3D Slicer'''] software was used to quantitatively analyze the volume of patient's EPVS. Patients were divided into moderate stenosis group and severe stenosis/occlusion group according to the degree of ICA stenosis. Baseline data were compared between the two groups. Patients were further divided into three groups: moderate stenosis, severe stenosis and occlusion groups, and the ipsilateral and contralateral EPVS volume of ICA stenosis patients was compared. The asymmetry index (AI) was calculated for EPVS in the basal ganglia region (BG-EPVS) and EPVS in the centrum semiovale (CSO-EPVS). Patients with AI≥0.2 were included in the EPVS asymmetry group, while the rest were in the EPVS symmetry group, and the degree of unilateral ICA stenosis was compared between the two groups. Multivariate logistic regression model was used to analyze the relationship between ICA severe stenosis/occlusion and the asymmetric distribution of BG-EPVS.

'''Results:''' A total of 122 patients (96 males and 26 females) were enrolled, aged (70±10) years, with 81 cases in the unilateral ICA severe stenosis/occlusion group (46 cases of severe stenosis and 35 of occlusion) and 41 cases in the moderate stenosis group. Patients in the unilateral ICA severe stenosis/occlusion group had greater BG-EPVS volume [(4.08±0.76) mm3]and proportion of asymmetric distribution of BG-EPVS [75.3%(61/81)] than those of the moderate stenosis group [(3.12±0.85) mm3 and 39.0% (16/41)], with statistically significant differences (both P<0.001). The BG-EPVS volumes of the ipsilateral side of the stenosis in the severe stenosis group and the occlusion group [(3.34±0.86) mm3 and (3.93±0.60) mm3] were significantly greater than those of the contralateral side [(2.65±1.28) mm3 and (3.21±0.88) mm3], with statistically significant differences (both P<0.001). Correlation analysis indicated that the degree of unilateral ICA stenosis was positively correlated with the BG-EPVS volume on the stenosis side (r=0.62, P<0.001). Further comparison of the degree of unilateral ICA stenosis between the EPVS symmetric and asymmetric groups showed that the proportion of unilateral ICA severe stenosis/occlusion in the BG-EPVS asymmetry group was higher than that in the symmetric group [79.2%(61/77) vs 44.4%(20/45),P<0.001]. Multivariate logistic regression analysis showed that unilateral ICA severe stenosis/occlusion (OR=4.280, 95%CI: 1.743-10.508, P =0.002) and age (OR=1.055, 95%CI: 1.001-1.112, P=0.044) were risk factors for asymmetric distribution of BG-EPVS.

'''Conclusions:''' The severe stenosis/occlusion of the unilateral ICA and age are the risk factors for the asymmetric distribution of the BG-EPVS in patients with acute cerebral infarction. The ipsilateral EPVS volume of unilateral ICA stenosis is larger than that of the contralateral side, and the degree of ICA stenosis is positively correlated with the severity of BG-EPVS.
|}

==Radiomics to Predict the Mortality of Patients With Rheumatoid Arthritis-Associated Interstitial Lung Disease: A Proof-of-Concept Study==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36698825 Front Med (Lausanne). 2023 Jan 9;9:1069486. PMID: 36698825] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9870287/pdf/fmed-09-1069486.pdf PDF]

'''Authors:''' Venerito V, Manfredi A, Lopalco G, Lavista M, Cassone G, Scardapane A, Sebastiani M, Iannone F.

'''Institution:''' Rheumatology Unit, Department of Emergency and Organ Transplantation, University of Bari Aldo Moro, Bari, Italy.

'''Abstract:''' Objectives: Patients with rheumatoid arthritis (RA) and interstitial lung disease (ILD) have increased mortality compared to the general population and factors capable of predicting RA-ILD long-term clinical outcomes are lacking. In oncology, radiomics allows the quantification of tumour phenotype by analysing the characteristics of medical images. Using specific software, it is possible to segment organs on high-resolution computed tomography (HRCT) images and extract many features that may uncover disease characteristics that are not detected by the naked eye. We aimed to investigate whether features from whole lung radiomic analysis of HRCT may alone predict mortality in RA-ILD patients.

'''Methods:''' High-resolution computed tomographies of RA patients from January 2012 to March 2022 were analyzed. The time between the first available HRCT and the last follow-up visit or ILD-related death was recorded. We performed a volumetric analysis in [http://www.slicer.org '''3D Slicer'''], automatically segmenting the whole lungs and trachea via the Lung CT Analyzer. A LASSO-Cox model was carried out by considering ILD-related death as the outcome variable and extracting radiomic features as exposure variables.

'''Results:''' We retrieved the HRCTs of 30 RA-ILD patients. The median survival time (interquartile range) was 48 months (36-120 months). Thirteen out of 30 (43.33%) patients died during the observation period. Whole line segmentation was fast and reliable. The model included either the median grey level intensity within the whole lung segmentation [high-resolution (HR) 9.35, 95% CI 1.56-55.86] as a positive predictor of death and the 10th percentile of the number of included voxels (HR 0.20, 95% CI 0.05-0.84), the voxel-based pre-processing information (HR 0.23, 95% CI 0.06-0.82) and the flatness (HR 0.42, 95% CI 0.18-0.98), negatively correlating to mortality. The correlation of grey level values to their respective voxels (HR 1.52 95% CI 0.82-2.83) was also retained as a confounder.

'''Conclusion:''' Radiomic analysis may predict RA-ILD patients' mortality and may promote HRCT as a digital biomarker regardless of the clinical characteristics of the disease.
|}

==Evaluation of the Prognosis of Acute Subdural Hematoma According to the Density Differences Between Gray and White Matter==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36686517 Front Neurol. 2023 Jan 6;13:1024018. PMID: 36686517] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9853902/ PDF]

'''Authors:''' Li Z, Feng Y, Wang P, Han S, Zhang K, Zhang C, Lu S, Lv C, Zhu F, Bie L.

'''Institution:''' Department of Neurosurgery of the First Clinical Hospital, Jilin University, Changchun, China.

'''Abstract:'''
'''Objective:''' Acute subdural hematoma (ASDH) is a common neurological emergency, and its appearance on head-computed tomographic (CT) imaging helps guide clinical treatment. To provide a basis for clinical decision-making, we analyzed that the density difference between the gray and white matter of the CT image is associated with the prognosis of patients with ASDH.

'''Methods:''' We analyzed the data of 194 patients who had ASDH as a result of closed traumatic brain injury (TBI) between 2018 and 2021. The patients were subdivided into surgical and non-surgical groups, and the non-surgical group was further subdivided into "diffused [hematoma]" and "non-diffused" groups. The control group's CT scans were normal. The [http://www.slicer.org '''3D Slicer'''] software was used to quantitatively analyze the density of gray and white matter depicted in the CT images.

'''Results:''' Imaging evaluation showed that the median difference in density between the gray and white matter on the injured side was 4.12 HU (IQR, 3.91-4.22 HU; p < 0.001) and on the non-injured side was 4.07 HU (IQR, 3.90-4.19 HU; p < 0.001), and the hematoma needs to be surgically removed. The median density difference value of the gray and white matter on the injured side was 3.74 HU (IQR, 3.53-4.01 HU; p < 0.001) and on the non-injured side was 3.71 HU (IQR, 3.69-3.73 HU; p < 0.001), and the hematoma could diffuse in a short time.

'''Conclusion:''' Quantitative analysis of the density differences in the gray and white matter of the CT images can be used to evaluate the clinical prognosis of patients with ASDH.
|}

==The Knosp Criteria Revisited: 3-Dimensional Volumetric Analysis as a Predictive Tool for Extent of Resection in Complex Endoscopic Pituitary Surgery==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36170168 Front Oncol. Neurosurgery. 2023 Jan 1;92(1):179-85. PMID: 36170168]

'''Authors:''' DiRisio AC, Feng R, Shuman WH, Platt S, Price G, Dullea JT, Gilja S, D'Andrea MR, Delman BN, Bederson JB, Shrivastava RK.

'''Institution:''' Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.

'''Abstract:'''
'''Background:''' The Knosp criteria have been the historical standard for predicting cavernous sinus invasion, and therefore extent of surgical resection, of pituitary macroadenomas. Few studies have sought to reappraise the utility of this tool after recent advances in visualization and modeling of tumors in complex endoscopic surgery.

'''Objective:''' To evaluate our proposed alternative method, using 3-dimensional (3D) volumetric imaging, and whether it can better predict extent of resection in nonfunctional pituitary adenomas.

'''Methods:''' Patients who underwent endoscopic transsphenoidal resection of pituitary macroadenomas at our institution were reviewed. Information was collected on neurological, endocrine, and visual function. Volumetric segmentation was performed using [http://www.slicer.org '''3D Slicer'''] software. Relationship of tumor volume, clinical features, and Knosp grade on extent of resection was examined.

'''Results:''' One hundred forty patients were identified who had transsphenoidal resection of nonfunctional pituitary adenomas. Macroadenomas had a median volume of 6 cm3 (IQR 3.4-8.7), and 17% had a unilateral Knosp grade of at least 3B. On multiple logistic regression, only smaller log-transformed preoperative tumor volume was independently associated with increased odds of gross total resection (GTR; odds ratio: 0.27, 95% CI: 0.07-0.89, P < .05) when controlling for tumor proliferative status, age, and sex (area under the curve 0.67). The Knosp criteria did not independently predict GTR in this cohort (P > .05, area under the curve 0.46).

'''Conclusion:''' Increasing use of volumetric 3D imaging may better anticipate extent of resection compared with the Knosp grade metric and may have a greater positive predictive value for GTR. More research is needed to validate these findings and implement them using automated methods.
|}

==Differentiation of Lung Metastases Originated From Different Primary Tumors Using Radiomics Features Based on CT Imaging==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35577699 Acad Radiol. 2023 Jan;30(1):40-6. PMID: 35577699]

'''Authors:''' Shang H, Li J, Jiao T, Fang C, Li K, Yin D, Zeng Q.

'''Institution:''' Department of Radiology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, No. 16766 Jingshi Road, Jinan, Shandong, China.

'''Abstract:''' Rationale and objectives: To explore the feasibility of differentiating three predominant metastatic tumor types using lung computed tomography (CT) radiomics features based on supervised machine learning.

'''Materials and Methods:''' This retrospective analysis included 252 lung metastases (LM) (from 78 patients), which were divided into the training (n = 176) and test (n = 76) cohort randomly. The metastases originated from colorectal cancer (n = 97), breast cancer (n = 87), and renal carcinoma (n = 68). An additional 77 LM (from 35 patients) were used for external validation. All radiomics features were extracted from lung CT using an open-source software, [http://www.slicer.org '''3D Slicer''']. The least absolute shrinkage and selection operator (LASSO) method selected the optimal radiomics features to build the model. Random forest and support vector machine (SVM) were selected to build three-class and two-class models. The performance of the classification model was evaluated with the area under the receiver operating characteristic curve (AUC) by two strategies: one-versus-rest and one-versus-one.

'''Results:''' Eight hundred and fifty-one quantitative radiomics features were extracted from lung CT. By LASSO, 23 optimal features were extracted in three-class, and 25, 29, and 35 features in two-class for differentiating every two of three LM (colorectal cancer vs. renal carcinoma, colorectal cancer vs. breast cancer, and breast cancer vs. renal carcinoma, respectively). The AUCs of the three-class model were 0.83 for colorectal cancer, 0.79 for breast cancer, and 0.91 for renal carcinoma in the test cohort. In the external validation cohort, the AUCs were 0.77, 0.83, and 0.81, respectively. Swarmplot shows the distribution of radiomics features among three different LM types. In the two-class model, high accuracy and AUC were obtained by SVM. The AUC of discriminating colorectal cancer LM from renal carcinoma LM was 0.84, and breast cancer LM from colorectal cancer LM and renal carcinoma LM were 0.80 and 0.94, respectively. The AUCs were 0.77, 0.78, and 0.84 in the external validation cohort.

'''Conclusion:''' Quantitative radiomics features based on Lung CT exhibited good discriminative performance in LM of primary colorectal cancer, breast cancer, and renal carcinoma.
|}

==MRI Radiomic Features of Peritumoral Edema May Predict the Recurrence Sites of Glioblastoma Multiforme==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36686829 Front Oncol. 2023 Jan 4;12:1042498. PMID: 36686829] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9845721/pdf/fonc-12-1042498.pdf PDF]

'''Authors:''' Long H, Zhang P, Bi Y, Yang C, Wu M, He D, Huang S, Yang K, Qi S, Wang J.

'''Institution:''' Department of Neurosurgery, Nanfang Hospital, Southern Medical University, Guangzhou, China.

'''Abstract:'''

'''Background and Purpose:''' As one of the most aggressive malignant tumor in the central nervous system, the main cause of poor outcome of glioblastoma (GBM) is recurrence, a non-invasive method which can predict the area of recurrence pre-operation is necessary.To investigate whether there is radiological heterogeneity within peritumoral edema and identify the reproducible radiomic features predictive of the sites of recurrence of glioblastoma(GBM), which may be of value to optimize patients' management.

'''Materials and Methods:''' The clinical information and MR images (contrast-enhanced T1 weighted and FLAIR sequences) of 22 patients who have been histologically proven glioblastoma, were retrospectively evaluated. Kaplan-Meier methods was used for survival analysis. Oedematous regions were manually segmented by an expert into recurrence region, non-recurrence region. A set of 94 radiomic features were obtained from each region using the function of analyzing MR image of [http://www.slicer.org '''3D Slicer''']. Paired t test was performed to identify the features existing significant difference. Subsequently, the data of two patients from TCGA database was used to evaluate whether these features have clinical value.

'''Results:''' Ten features with significant differences between the recurrence and non-recurrence subregions were identified and verified on two individual patients from the TCGA database with pathologically confirmed diagnosis of GBM.

'''Conclusions:''' Our results suggested that heterogeneity does exist in peritumoral edema, indicating that the radiomic features of peritumoral edema from routine MR images can be utilized to predict the sites of GBM recurrence. Our findings may further guide the surgical treatment strategy for GBM.
|}

==Clinical Study on Application of 3D Slicer Software Assisted Domestic Frameless Stereotactic Robot in Biopsy of Intracranial Lesions==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36603886 Zhonghua Wai Ke Za Zhi. 2023 Jan 1;61(1):61-65. PMID: 36603886] | [http://www.ncbi.nlm.nih.gov/pmc/articles/pmc9849352/ PDF]

'''Authors:''' Chen H, Yan X, He F, Ding SC, Diao JF, Guo H, Cao SM, Yang CJ, Yin F.

'''Institution:''' Department of Neurosurgery, Aerospace Central Hospital, Beijing, China.

'''Abstract:'''
'''Objective:''' To examine the application value of [http://www.slicer.org '''3D Slicer'''] software assisted domestic frameless stereotactic robot in biopsy of intracranial lesions.

'''Methods:''' A retrospective analysis was performed on 80 patients who admitted consecutively and underwent intracerebral lesions biopsy with the domestic frameless stereotactic robot at Department of Neurosurgery, Aerospace Central Hospital from January 2019 to December 2021. There were 36 males and 44 females, with a mean age of (38.5±18.0) years (range: 6 to 71 years). Before surgery only enhanced T1-weighted three-dimensional magnetization prepared gradient echo sequences and diffusion tensor imaging scans were performed. Self-reconstruction of intracranial lesions, cerebral cortex and blood vessels was carried out using 3D Slicer software system after the DICOM format imaging data of 80 patients were collected. These imaging data were merged to the workstation of the domestic frameless stereotactic robot for preoperative surgical planning and the surgical puncture path was designed to avoid blood vessels in the brain functional area, cerebral cortex and sulcus.

'''Results:''' All frameless stereotactic biopsy were successfully performed. Postoperative pathological diagnosis included 50 cases of diffuse astrocytic and oligodendroglioma, 15 cases of lymphoma, 5 cases of metastatic tumors, 5 cases of inflammatory demyelinating disease, 2 cases of inflammatory granuloma, 1 case of hemangioma, 1 case of acute lymphoblastic leukemia intracranial invasion and 1 case of seminoma. The positive diagnosis rate was 100% (80/80). Postoperative imaging confirmed that the puncture path and target were accurately implemented according to the preoperative planning, and the target error was (1.32±0.44) mm (range: 0.55 to 1.99 mm). One case of puncture-related bleeding occurred at the target after surgery and improved after treatment.

'''Conclusion:''' The three-dimensional multimodal images reconstructed by the 3D Slicer software before operation could help the surgeons make the preoperative planning and reduce the risk of stereotactic brain biopsy.
|}

==Liver Cirrhosis and Tumor Location Can Affect the Range of Intrahepatic Microwave Ablation Zone==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36854449 Int J Hyperthermia. 2023;40(1):2181843. PMID: 36854449] | [https://www.tandfonline.com/doi/epdf/10.1080/02656736.2023.2181843?needAccess=true&role=button PDF]

'''Authors:''' Ding WZ, Wei H, Wu JP, Cheng ZG, Han ZY, Liu FY, Yu J, Liang P.

'''Institution:''' Fifth Medical Center of Chinese, PLA General Hospital, Beijing, China.

'''Abstract:'''
'''Background:''' The range of an ablation zone (AZ) plays a crucial role in the treatment effect of microwave ablation (MWA). The aim of this study was to analyze the factors influencing the AZ range.

'''Methods:''' Fourteen factors in four areas were included: patient-related factors (sex, age), disease-related factors (tumor location, liver cirrhosis), serological factors (ALT, AST, total protein, albumin, total bilirubin, direct bilirubin, and platelets), and MWA parameters (ablation time, power, and needle type). Multiple sequence MRI was used to delineate AZ by three radiologists using [http://www.slicer.org '''3D Slicer''']. MATLAB was used to calculate the AZ length, width, and area of the largest section. Linear regression analysis was used to analyze influencing factors. Moreover, a subgroup analysis was conducted for patients with viral hepatitis.

'''Result:''' 220 patients with 290 tumors were included between 2010-2021. In addition to MWA parameters, cirrhosis and tumor location were significant factors that influenced AZ (p < 0.001). The standardized coefficient (beta) of cirrhosis (cirrhosis vs. non-cirrhosis) was positive, which meant cirrhosis would lead to a decrease in AZ range. The beta of tumor location (near the hepatic hilar zone, intermediate zone, and periphery zone) was negative, indicating that AZ range decreased as the tumor location approached the hepatic hilum. For viral hepatitis patients, Fibrosis 4 (FIB4) score was a significant factor influencing AZ (p < 0.001), and the beta was negative, indicating that AZ range decreased as FIB4 increased.

'''Conclusion:''' Liver cirrhosis, tumor location, and FIB4 affect the AZ range and should be considered when planning MWA parameters.
|}

==A Magnetic Resonance Imaging Based Radiomics Model to Predict Mitosis Cycles in Intracranial Meningioma==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36653482 Sci Rep. 2023 Jan 18;13(1):969. PMID: 36653482] | [http://www.ncbi.nlm.nih.gov/pmc/articles/pmc9849352/ PDF]

'''Authors:'''Krähling H, Musigmann M, Akkurt BH, Sartoretti T, Sartoretti E, Henssen DJHA, Stummer W, Heindel W, Brokinkel B, Mannil M.

'''Institution:''' University Clinic for Radiology, University Hospital Muenster, Westfälische Wilhelms-University Muenster, Muenster, Germany.

'''Abstract:''' The aim of this study was to develop a magnetic resonance imaging (MRI) based radiomics model to predict mitosis cycles in intracranial meningioma grading prior to surgery. Preoperative contrast-enhanced T1-weighted (T1CE) cerebral MRI data of 167 meningioma patients between 2015 and 2020 were obtained, preprocessed and segmented using the [http://www.slicer.org '''3D Slicer'''] software and the PyRadiomics plugin. In total 145 radiomics features of the T1CE MRI images were computed. The criterion on the basis of which the feature selection was made is whether the number of mitoses per 10 high power field (HPF) is greater than or equal to zero. Our analyses show that machine learning algorithms can be used to make accurate predictions about whether the number of mitoses per 10 HPF is greater than or equal to zero. We obtained our best model using Ridge regression for feature pre-selection, followed by stepwise logistic regression for final model construction. Using independent test data, this model resulted in an AUC (Area under the Curve) of 0.8523, an accuracy of 0.7941, a sensitivity of 0.8182, a specificity of 0.7500 and a Cohen's Kappa of 0.5576. We analyzed the performance of this model as a function of the number of mitoses per 10 HPF. The model performs well for cases with zero mitoses as well as for cases with more than one mitosis per 10 HPF. The worst model performance (accuracy = 0.6250) is obtained for cases with one mitosis per 10 HPF. Our results show that MRI-based radiomics may be a promising approach to predict the mitosis cycles in intracranial meningioma prior to surgery. Specifically, our approach may offer a non-invasive means of detecting the early stages of a malignant process in meningiomas prior to the onset of clinical symptoms.
|}

==Advantages of a Training Course for Surgical Planning in Virtual Reality for Oral and Maxillofacial Surgery: Crossover Study==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36656632 JMIR Serious Games. 2023 Jan 19;11:e40541. PMID: 36656632] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9947820/?report=printable PDF]

'''Authors:''' Ulbrich M, Van den Bosch V, Bönsch A, Gruber LJ, Ooms M, Melchior C, Motmaen I, Wilpert C, Rashad A, Kuhlen TW, Hölzle F, Puladi B.

'''Institution:''' Department of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Aachen, Germany.

'''Abstract:'''
'''Background:''' As an integral part of computer-assisted surgery, virtual surgical planning (VSP) leads to significantly better surgery results, such as for oral and maxillofacial reconstruction with microvascular grafts of the fibula or iliac crest. It is performed on a 2D computer desktop screen (DS) based on preoperative medical imaging. However, in this environment, VSP is associated with shortcomings, such as a time-consuming planning process and the requirement of a learning process. Therefore, a virtual reality (VR)-based VSP application has great potential to reduce or even overcome these shortcomings due to the benefits of visuospatial vision, bimanual interaction, and full immersion. However, the efficacy of such a VR environment has not yet been investigated.

'''Objective:''' This study aimed to demonstrate the possible advantages of a VR environment through a substep of VSP, specifically the segmentation of the fibula (calf bone) and os coxae (hip bone), by conducting a training course in both DS and VR environments and comparing the results.

'''Methods:''' During the training course, 6 novices were taught how to use a software application in a DS environment, [http://www.slicer.org '''3D Slicer''']) and in a VR environment (Elucis) for the segmentation of the fibula and os coxae, and they were asked to carry out the maneuvers as accurately and quickly as possible. Overall, 13 fibula and 13 os coxae were segmented for each participant in both methods (VR and DS), resulting in 156 different models (78 fibula and 78 os coxae) per method (VR and DS) and 312 models in total. The individual learning processes in both environments were compared using objective criteria (time and segmentation performance) and self-reported questionnaires. The models resulting from the segmentation were compared mathematically (Hausdorff distance and Dice coefficient) and evaluated by 2 experienced radiologists in a blinded manner.

'''Results:''' A much faster learning curve was observed for the VR environment than the DS environment (β=.86 vs β=.25). This nearly doubled the segmentation speed (cm3/min) by the end of training, leading to a shorter time (P<.001) to reach a qualitative result. However, there was no qualitative difference between the models for VR and DS (P=.99). The VR environment was perceived by participants as more intuitive and less exhausting, and was favored over the DS environment.

'''Conclusions:''' The more rapid learning process and the ability to work faster in the VR environment could save time and reduce the VSP workload, providing certain advantages over the DS environment.
|}

==Lesion Size and Long-Term Cognitive Outcome After Pediatric Stroke: A Comparison Between Two Techniques to Assess Lesion Size==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36641854 Eur J Paediatr Neurol. 2023 Jan 7;42:126-32. PMID: 36641854]

'''Authors:''' Everts R, Bertato S, Steinlin M, Slavova N, Grunt S, Steiner L.

'''Institution:''' Division of Neuropediatrics, Development and Rehabilitation, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.

'''Abstract:'''
'''Background:''' There is little consensus on how lesion size impacts long-term cognitive outcome after pediatric arterial ischemic stroke (AIS). This study, therefore, compared two techniques to assessed lesion size in the chronic phase after AIS and determined their measurement agreement in relation to cognitive functions in patients after pediatric stroke.

'''Methods:''' Twenty-five patients after pediatric AIS were examined in the chronic phase (>2 years after stroke) in respect to intelligence, memory, executive functions, visuo-motor functions, motor abilities, and disease-specific outcome. Lesion size was measured using the ABC/2 formula and segmentation technique ([http://www.slicer.org '''3D Slicer''']). Correlation analysis determined the association between volumetry techniques and outcome measures in respect to long-term cognitive outcome.

'''Results:''' The measurements from the ABC/2 and segmentation technique were strongly correlated (r = 0.878, p < .001) and displayed agreement in particular for small lesions. Lesion size from both techniques was significantly correlated with disease-specific outcome (p < .001) and processing speed (p < .005) after controlling for age at stroke and multiple comparison.

'''Conclusion:''' The two techniques showed convergent validity and were both significantly correlated with long-term outcome after pediatric AIS. Compared to the time-consuming segmentation technique, ABC/2 facilitates clinical and research work as it requires relatively little time and is easy to apply.
|}

==Association Between Emphysema and Other Pulmonary Computed Tomography Patterns in COVID-19 Pneumonia==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36358023 J Med Virol. 2023 Jan;95(1):e28293. PMID: 36358023] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9828029/pdf/JMV-95-0.pdf PDF]

'''Authors:''' Han K, Wang J, Zou Y, Zhang Y, Zhou L, Yin Y.

'''Institution:''' Fetal-Neonatal Neuroimaging and Developmental Science Center, Division of Newborn Medicine, Boston Children's Hospital, Boston, USA.

'''Abstract:''' To evaluate the chest computed tomography (CT) findings of patients with Corona Virus Disease 2019 (COVID-19) on admission to hospital. And then correlate CT pulmonary infiltrates involvement with the findings of emphysema. We analyzed the different infiltrates of COVID-19 pneumonia using emphysema as the grade of pneumonia. We applied open-source assisted software, [http://www.slicer.org '''3D Slicer'''] to model the lungs and lesions of 66 patients with COVID-19, which were retrospectively included. we divided the 66 COVID-19 patients into the following two groups: (A) 12 patients with less than 10% emphysema in the low-attenuation area less than -950 Hounsfield units (%LAA-950), (B) 54 patients with greater than or equal to 10% emphysema in %LAA-950. Imaging findings were assessed retrospectively by two authors and then pulmonary infiltrates and emphysema volumes were measured on CT using [http://www.slicer.org '''3D Slicer'''] software. Differences between pulmonary infiltrates, emphysema, Collapsed, affected of patients with CT findings were assessed by Kruskal-Wallis and Wilcoxon test, respectively. Statistical significance was set at p < 0.05. The left lung (A) affected left lung 20.00/affected right lung 18.50, (B) affected left lung 13.00/affected right lung 11.50 was most frequently involved region in COVID-19. In addition, collapsed left lung, (A) collapsed left lung 4.95/collapsed right lung 4.65, (B) collapsed left lung 3.65/collapsed right lung 3.15 was also more severe than the right one. There were significant differences between the Group A and Group B in terms of the percentage of CT involvement in each lung region (p < 0.05), except for the inflated affected total lung (p = 0.152). The median percentage of collapsed left lung in the Group A was 20.00 (14.00-30.00), right lung was 18.50 (13.00-30.25) and the total was 19.00 (13.00-30.00), while the median percentage of collapsed left lung in the Group B was 13.00 (10.00-14.75), right lung was 11.50 (10.00-15.00) and the total was 12.50 (10.00-15.00). The percentage of affected left lung is an independent predictor of emphysema in COVID-19 patients. We need to focus on the left lung of the patient as it is more affected. The people with lower levels of emphysema may have more collapsed segments. The more collapsed segments may lead to more serious clinical feature.
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==A High-Resolution Pediatric Female Whole-Body Numerical Model With Comparison to a Male Model==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36595234 Phys Med Biol. 2023 Jan 13;68(2). PMID: 36595234]

'''Authors:''' Ntolkeras G, Jeong H, Zöllei L, Dmytriw AA, Purvaziri A, Lev MH, Grant PE, Bonmassar G.

'''Institution:''' Fetal-Neonatal Neuroimaging and Developmental Science Center, Division of Newborn Medicine, Boston Children's Hospital, Boston, USA.

'''Abstract:'''
'''Objective:''' Numerical models are central in designing and testing novel medical devices and in studying how different anatomical changes may affect physiology. Despite the numerous adult models available, there are only a few whole-body pediatric numerical models with significant limitations. In addition, there is a limited representation of both male and female biological sexes in the available pediatric models despite the fact that sex significantly affects body development, especially in a highly dynamic population. As a result, we developed Athena, a realistic female whole-body pediatric numerical model with high-resolution and anatomical detail.

'''Approach:''' We segmented different body tissues through Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) images of a healthy 3.5 year-old female child using 3D Slicer. We validated the high anatomical accuracy segmentation through two experienced sub-specialty-certified neuro-radiologists and the inter and intra-operator variability of the segmentation results comparing sex differences in organ metrics with physiologic values. Finally, we compared Athena with Martin, a similar male model, showing differences in anatomy, organ metrics, and MRI dosimetric exposure.

'''Main results:'''We segmented 267 tissue compartments, which included 50 brain tissue labels. The tissue metrics of Athena displayed no deviation from the literature value of healthy children. We show the variability of brain metrics in the male and female models. Finally, we offer an example of computing Specific Absorption Rate and Joule heating in a toddler/preschooler at 7T MRI.

'''Significance:''' This study introduces a female realistic high-resolution numerical model using MRI and CT scans of a 3.5 year-old female child, the use of which includes but is not limited to radiofrequency safety studies for medical devices (e.g. an implantable medical device safety in MRI), neurostimulation studies, and radiation dosimetry studies. This model will be open source and available on the Athinoula A. Martinos Center for Biomedical Imaging website.
|}

==Anatomical Morphology and Related Angles of Foramen Ovale: A Three-dimensional Computed Tomography Reconstruction==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36597246 J Coll Physicians Surg Pak. 2023 Jan;33(1):109-11. PMID: 36597246]

'''Authors:''' Cheng Z, Hu YL, Sun YX, Liang LZ, Pan DD, Wang DW.

'''Institution:''' Department of Neurosurgery, The Second Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, China.

'''Abstract:''' This study aimed to report the three-dimensional reconstruction of the foramen ovale (FO) based on computed tomography angiography and describe its shape and related angles. A retrospective analysis of 199 adult patients who were hospitalised at the Department of Neurosurgery, The Second Affiliated Hospital of Bengbu Medical College, Bengbu, China, from January to December 2020 was conducted. The original DICOM files of patients' computed tomography scans were processed by [http://www.slicer.org '''3D Slicer'''] software to reconstruct the three-dimensional skull. The morphological characteristics of the FO on both sides were analysed. Their size, related angles and volumes, and the differences between the two sides and gender were compared. A total of 398 FO from 199 patients were studied. The most frequent shape of the FO was oval, accounting for 54.27%. The mean lengths of the right and the left sides were 5.40±1.51 and 5.10±1.18mm, respectively. The mean width on the right and left sides was 3.23±1.16 and 3.33±1.19 mm, respectively. The FO is most commonly oval in shape. Clinicians may use the anatomical characteristics regarding the size and shape of the FO for diagnosis and treatment.
|}

Main Page/SlicerCommunity/2023

2023-09-11T18:56:52Z

Marianna: /* Clinical Study of Puncture Technique in Single Division of the Trigeminal Ganglion Intumescentia */

{{:Main_Page/SlicerCommunity}}

__TOC__

=2023=
==Dosimetric Assessment of Gadolinium-159 for Hepatic Radioembolization: Tomographic Images and Monte Carlo Simulation==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37393764 Appl Radiat Isot. 2023 Sep;199:110916. PMID: 37393764]

'''Authors:''' Musa AS, Abdul Hadi MFR, Hashikin NAA, Ashour NI, Ying CK.

'''Institution:''' School of Physics, Universiti Sains Malaysia, Penang, Malaysia.

'''Abstract:'''
A common therapeutic radionuclide used in hepatic radioembolization is yttrium-90 (90Y). However, the absence of gamma emissions makes it difficult to verify the post-treatment distribution of 90Y microspheres. Gadolinium-159 (159Gd) has physical properties that are suitable for therapy and post-treatment imaging in hepatic radioembolization procedures. The current study is innovative for conducting a dosimetric investigation of the use of 159Gd in hepatic radioembolization by simulating tomographic images using the Geant4 application for tomographic emission (GATE) Monte Carlo (MC) simulation. For registration and segmentation, tomographic images of five patients with hepatocellular carcinoma (HCC) who had undergone transarterial radioembolization (TARE) therapy were processed using a [http://www.slicer.org '''3D Slicer''']. The tomographic images with 159Gd and 90Y separately were simulated using the GATE MC Package. The output of simulation (dose image) was uploaded to [http://www.slicer.org '''3D Slicer'''] to compute the absorbed dose for each organ of interests. 159Gd were able to provide a recommended dose of 120 Gy to the tumour, with normal liver and lungs absorbed doses close to that of 90Y and less than the respective maximum permitted doses of 70 Gy and 30 Gy, respectively. Compared to 90Y, 159Gd requires higher administered activity approximately 4.92 times to achieve a tumour dose of 120 Gy. Thus; this research gives new insights into the use of 159Gd as a theranostic radioisotope, with the potential to be used as a90Y alternative for liver radioembolization.
|}

==The Cranial Capacity of the Saudi Population Measured Using 3D Computed Tomography Scans==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37482378 Neurosciences (Riyadh). 2023 Jul;28(3):184-89. PMID: 37482378]

'''Authors:''' Alshamrani KA.

'''Institution:''' Department of Radiological sciences, Faculty of Applied Medical Science, and from Health Research Centre, Najran University, Najran, Kingdom of Saudi Arabia.

'''Abstract:'''
Objectives: To measure the cranial capacity of members of the Saudi adult population across ages and genders.

Methods: This was a retrospective cross-sectional study that used 488 Computed Tomography (CT) scans of heads (of which 275 males) to measure cranial volume. The CT slices 0.625 mm thick were uploaded using the freely available [http://www.slicer.org '''3D Slicer'''] software, which then reconstructed the images and built a 3D module.

Results: The mean (±SD) cranial capacity of the males was 1481.6 (±110) cm3 (range: 1241-1723 cm3), whereas the cranial capacity of the females was 1375.4 (±104) cm3 (range: 1203-1678 cm3). This study showed that the males had a mean cranial capacity that was 7% greater than that of the females in this study. The average cranial capacity of the males between the ages of 31 and 40 years was statistically significantly larger to that of the males aged 61-80 (p<0.05).

Conclusion: This study demonstrated that the average cranial capacity of the males was larger than that of the females. These study results can help to determine the normal cranial capacity of adults in Saudi Arabia. Further work should be carried out to aid in establishing reference data for the Saudi population.
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==The Tracheal System of the Common Wasp (Vespula Vulgaris) - a Micro-CT Study==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37451536 J Insect Physiol. 2023 Jul 13;149:104547. PMID: 37451536]

'''Authors:''' Bell GD, Corps N, Mortimer D, Gretton S, Bury N, Connett GJ.

'''Institution:''' School of (EAST) Engineering, Arts, Science and Technology, University of Suffolk, James Hehir Building, UK.

'''Abstract:'''
X-ray micro-CT has been used to study the tracheal system of Pre and Post hibernation Queen wasps (Vespula vulgaris) and their workers. We have compared our findings in wasps with Snodgrass's description of the tracheal system of the honeybee as characterised by anatomical dissection. Our images, whilst broadly similar, identify the tracheal system as being considerably more complex than previously suggested. One of the 30 wasps imaged had a markedly different, previously undescribed tracheal system. Since completing this study, a large micro-CT study from the American Museum of Natural History (AMNH) has been published. This used different software, [http://www.slicer.org '''3D Slicer'''] and analysed 16bit digital data. We have compared our methods with that described in the AMNH publication, adopted their suggested nomenclature and have made recommendations for future studies.
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==Augmented Reality Presentation of the Extracranial Facial Nerve: An Innovation in Parotid Surgery==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37328316 Br J Oral Maxillofac Surg. 2023 Jul;61(6):428-36. PMID: 37328316]

'''Authors:''' Saadya A, Chegini S, Morley S, McGurk M.

'''Institution:''' University College London Hospital, UK.

'''Abstract:'''
Surgeons used to be unaware of the facial nerve's position during parotid surgery. Now, with special magnetic resonance imaging (MRI) sequences, it can be located and converted into a 3D model displayed on an augmented reality (AR) device for surgeons to study and manipulate. This study explores the accuracy and usefulness of the technique for the treatment of benign and malignant parotid tumours. A total of 20 patients with parotid tumours had 3-Tesla MRI scans, and their anatomical structures were segmented using [http://www.slicer.org '''3D Slicer'''] software. The structures were imported into a Microsoft HoloLens 2® device, displayed in 3D, and shown to the patient for consent. Intraoperative video recording was used to record the position of the facial nerve in relation to the tumour. The predicted path of the nerve taken from the 3D model was combined with surgical observation and video recording in all cases. The imaging proved to have application in both benign and malignant disease. It also improved the process of informed patient consent. Three-dimensional MRI imaging of the facial nerve within the parotid gland and its display in a 3D model is an innovative technique for parotid surgery. Surgeons can now see the nerve's position and tailor their approach to each patient's tumour, providing personalised care. The technique eliminates the surgeon's blind spot and is a significant advantage in parotid surgery.
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==Magnetic Resonance Imaging in Naso-Oropharyngeal Carcinoma: Role of Texture Analysis in the Assessment of Response to Radiochemotherapy, a Preliminary Study==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37336860/ Radiol Med. 2023 Jul;128(7):839-52. PMID: 37336860] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10317900/pdf/11547_2023_Article_1653.pdf PDF]

'''Authors:''' Bicci E, Nardi C, Calamandrei L, Barcali E, Pietragalla M, Calistri L, Desideri I, Mungai F, Bonasera L, Miele V.

'''Institution:''' Department of Experimental and Clinical Biomedical Sciences, Radiodiagnostic Unit #2, University of Florence, Florence, Italy.

'''Abstract:'''
Objective: Identifying MRI texture parameters able to distinguish inflammation, fibrosis, and residual cancer in patients with naso-oropharynx carcinoma after radiochemotherapy (RT-CHT).

Material and methods: In this single-centre, observational, retrospective study, texture analysis was performed on ADC maps and post-gadolinium T1 images of patients with histological diagnosis of naso-oropharyngeal carcinoma treated with RT-CHT. An initial cohort of 99 patients was selected; 57 of them were later excluded. The final cohort of 42 patients was divided into 3 groups (inflammation, fibrosis, and residual cancer) according to MRI, 18F-FDG-PET/CT performed 3-4 months after RT-CHT, and biopsy. Pre-RT-CHT lesions and the corresponding anatomic area post-RT-CHT were segmented with [http://www.slicer.org '''3D Slicer'''] software from which 107 textural features were derived. T-Student and Wilcoxon signed-rank tests were performed, and features with p-value < 0.01 were considered statistically significant. Cut-off values-obtained by ROC curves-to discriminate post-RT-CHT non-tumoural changes from residual cancer were calculated for the parameters statistically associated to the diseased status at follow-up.

Results: Two features-Energy and Grey Level Non-Uniformity-were statistically significant on T1 images in the comparison between 'positive' (residual cancer) and 'negative' patients (inflammation and fibrosis). Energy was also found to be statistically significant in both patients with fibrosis and residual cancer. Grey Level Non-Uniformity was significant in the differentiation between residual cancer and inflammation. Five features were statistically significant on ADC maps in the differentiation between 'positive' and 'negative' patients. The reduction in values of such features between pre- and post-RT-CHT was correlated with a good response to therapy.

Conclusions: Texture analysis on post-gadolinium T1 images and ADC maps can differentiate residual cancer from fibrosis and inflammation in early follow-up of naso-oropharyngeal carcinoma treated with RT-CHT.
|}

==BabelBrain: An Open-Source Application for Prospective Modeling of Transcranial Focused Ultrasound for Neuromodulation Applications==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37155375/ IEEE Trans Ultrason Ferroelectr Freq Control. 2023 Jul;70(7):587-99. PMID: 37155375]

'''Authors:''' Pichardo S.

'''Institution:''' Department of Radiology, University of Calgary, Calgary, Canada.

'''Abstract:'''
BabelBrain is an open-source standalone graphic-user-interface application designed for studies of neuromodulation using transcranial-focused ultrasound (FUS). It calculates the transmitted acoustic field in the brain tissue, taking into account the distortion effects caused by the skull barrier. The simulation is prepared using scans from magnetic resonance imaging (MRI) and, if available, computed tomography (CT) and zero-echo time MRI scans. It also calculates the thermal effects based on a given ultrasound regime, such as the total duration of exposure, the duty cycle, and acoustic intensity. The tool is designed to work in tandem with neuronavigation and visualization software, such as [http://www.slicer.org '''3D Slicer''']. It uses image processing to prepare domains for ultrasound simulation and uses the BabelViscoFDTD library for transcranial modeling calculations. BabelBrain supports multiple GPU backends, including Metal, OpenCL, and CUDA, and works on all major operating systems including Linux, macOS, and Windows. This tool is particularly optimized for Apple ARM64 systems, which are common in brain imaging research. The article presents the modeling pipeline used in BabelBrain and a numerical study where different methods of acoustic properties mapping were tested to select the best method that can reproduce the transcranial pressure transmission efficiency reported in the literature.
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==Volumetric Analysis of the Sinus and Orbit in Silent Sinus Syndrome After Endoscopic Sinus Surgery==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/36939460/ Otolaryngol Head Neck Surg. 2023 Jul;169(1):151-156. PMID: 36939460]

'''Authors:'''
Amin D, Chitguppi C, Xu V, Haghshenas C, Gorniak R, Rabinowitz M, Toskala E, Rosen M, Nyquist G.

'''Institution:''' Department of Otolaryngology-Head & Neck Surgery, Thomas Jefferson University, Philadelphia, PA, USA.

'''Abstract:'''
Objective: The term "silent sinus syndrome" (SSS) describes spontaneous enophthalmos secondary to subclinical maxillary sinus atelectasis. Debate remains on whether treatment with endoscopic maxillary antrostomy alone is adequate in reversing atelectasis and globe displacement. This study aims to determine the degree of volume change of the diseased sinus and orbit as well as the change in orbital height in patients treated with endoscopic antrostomy without orbital floor augmentation.

Study design: Retrospective review with image analysis.

Setting: Single tertiary care institution.

Methods: Three-dimensional (3D) analysis of computed tomographic imaging data was performed using [http://www.slicer.org '''3D Slicer''']. 3D models of the maxillary sinus and orbit of the diseased and normal sides were created, and volume measurements were calculated using the segmentation program.

Results: Thirteen patients with SSS who underwent endoscopic sinus surgery (ESS) and had follow-up computed tomographic imaging were analyzed. After endoscopic antrostomy, the mean volume of the diseased maxillary sinus significantly increased by 9.82%, from 6.37 to 7.00 cm3 (p = .0302). There was no significant change in mean orbital volume; however, the mean orbital height decreased by 5.67%, from 38.09 to 35.93 mm from pretreatment to posttreatment samples (p = .0101). All patients had resolution of clinical or radiographic enophthalmos and orbital displacement with ESS alone.

Conclusion: Endoscopic maxillary antrostomy alone in the treatment of SSS significantly increased maxillary sinus volume and decreased diseased orbital height. These changes were associated with clinical and radiographic improvement in globe displacement. These findings support performing ESS alone, reserving orbital augmentation for patients who do not exhibit adequate clinical improvement.
|}

==Safety and Efficacy of Thoracic Endovascular Aortic Repair for Acute Stanford Type B Aortic Dissection With Retrograde Type a Intramural Hematoma==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/36921645/ J Vasc Surg. 2023 Jul;78(1):61-69.e4. PMID: 36921645] | [https://www.jvascsurg.org/action/showPdf?pii=S0741-5214%2823%2900438-X PDF]

'''Authors:''' Wang J, Li M, Li J, He H, Zhou Y, Li X, Li Q, Gu F, Ye Z, Dardik A, Shu C.

'''Institution:''' Department of Vascular Surgery, Second Xiangya Hospital, Central South University, Changsha, China; Institute of Vascular Diseases, Central South University, Changsha, China.

'''Abstract:'''
Objective: The aim of this study was to evaluate safety and efficacy of thoracic endovascular aortic repair (TEVAR) for acute Stanford type B aortic dissection (TBAD) with retrograde type A intramural hematoma (TAIMH).

Methods: Patients with acute TBAD with retrograde TAIMH treated with TEVAR between January 1, 2014, to March 31, 2022, were retrospectively reviewed. Aortic diameter and distance were measured using the [http://www.slicer.org '''3D Slicer'''] image computing platform. Patients' characteristics, procedural, in-hospital and follow-up data, and aortic remodeling were analyzed.

Results: Fifty-two patients (average age, 52.6 years; 42 males [80.8%]) were included. The median interval from symptom onset to TEVAR was 11 days (interquartile range, 7.0-16.8 days). The maximal diameter of the ascending aorta (AA) was <50 mm, and the hematoma thickness in the AA was ≤10 mm in all patients. Both the in-hospital and 30-day mortality rates were 0%. The 30-day complication rate was 11.5%. The overall cumulative survival rates were 100% at 1 year, 97.1% at 3 years, and 92.6% at 5 years. Four of 52 patients (7.7%) developed retrograde type A aortic dissection at 10 days to 4 months postoperatively, and one of 52 patients (1.9%) developed an isolated AA dissection 4 months postoperatively; these five patients were treated and alive at late follow-up in March 2022. The rates of cumulative freedom from thoracic aortic re-intervention were 93.7% at 1 year and 90.7% at 5 years. Positive AA remodeling was observed in 92.3% (48/52) of patients during follow-up. The maximal diameter of AA (mean ± standard error of mean) at admission was 42.7 ± 0.8 mm, which decreased to 39.5 ± 0.9 mm at last follow-up. The maximal AA hematoma thickness at admission was 7.6 ± 0.3 mm, which reduced to 2.2 ± 0.9 mm at last follow-up.

Conclusions: For selected patients of acute Stanford TBAD with retrograde TAIMH, endovascular repair may be a safe, effective, and durable alternative treatment, if the maximum diameter of the AA is <50 mm and the intramural hematoma thickness in the AA is ≤10 mm.
|}

==The Traction Force of the Pulled Limb in Hip Arthroscopic Surgery Is Determined by Stiffness Coefficient Which Is Significantly Related to Muscle Volume==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/36477348/ Knee Surg Sports Traumatol Arthrosc. 2023 Jul;31(7):2708-2715. PMID: 36477348]

'''Authors:''' Yin Y, Xue S, Zhang X, Yang G, Xu Y, Wang J, Huang H.

'''Institution:''' Department of Sports Medicine, Beijing Key Laboratory of Sports Injuries, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing, People's Republic of China.

'''Abstract:'''
Purpose: To verify the relationship between muscle volume, lateral centre-edge angle (LCEA), alpha angle (AA), body mass index (BMI) and Beighton score with stiffness coefficient (SC). To analyse the difference of traction force at different physical states of hip joint capsule.

Methods: Thirty-six patients who underwent hip arthroscopy operation were included. The volumes of some related muscles were measured in MRI images by [http://www.slicer.org '''3D Slicer''']. We recorded and tested differences in traction force of five joint capsule physical states, including before (State 1) and after joint capsule puncture (State 2), after the establishment of anterolateral and mid-anterior approaches (State 3) and after incision of the joint capsule through these two approaches (States 4, 5). The correlation between muscle volume, BMI, LCEA, AA and SC was verified by Spearman test. Poisson regression was used to explain confounding variables.

Results: The average force at State 1 was 531.8 N. There were significant differences in traction force between these five states (p < 0.001). There was a significant positive correlation between muscle volumes and SC (p < 0.001). BMI had no correlation with SC (n.s.). The preoperative LCEA of the affected side was correlated with SC (p = 0.043). AA and SC were not correlated (n.s.).

Conclusion: The physical states of the hip joint capsule affected traction force. Muscle volume rather than BMI is an ideal index to estimate preoperative traction force. LCEA affected traction force, whilst AA and Beighton score did not. Measuring the muscle volume can help estimate the most suitable traction force for the patient.
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==Three-Dimensional Assessment of Tongue Cancer Prognosis by Preoperative MRI==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/35426211/ Oral Dis. 2023 Jul;29(5):2006-2011. PMID: 35426211]

'''Authors:''' Li C, Zhu L, Guo Y, Ji T, Ren Z.

'''Institution:''' Department of Oral and Maxillofacial Head and Neck Oncology, The Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

'''Abstract:'''
Purpose: To obtain the relative volume by measuring the tongue volume and the lesion volume, and further explore its relationship with the prognosis of patients, hoping to supplement the TNM staging with a new index.

Methods: ITK-SANP software was used to outline the patients' MRI. After MRI reconstruction and measurement, [http://www.slicer.org '''3D Slicer'''] software was used to estimate tumor volume.

Results: A total of 64 patients with tongue cancer who met the inclusion criteria were included in the study. The estimated tumor volume after MRI reconstruction revealed a significant and robust correlation with tumor stage (p < 0.05, Rs = 0.6207) and a substantial and medium correlation with early lymph node metastasis (p < 0.05, Rs = 0.4873).

Conclusions: We classified tongue cancer into three grades based on tumor volume (Stage I, tumors smaller than 1500 mm³; Stage II, tumors 1500-9000 mm³; and Stage III, tumors larger than 9000 mm³), and such grading could be used as a reference for tumor staging, lymph node metastasis, and patient prognosis to a certain extent.
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==Multimodal Measurements of Levator Bowl Volume in Nulligravid Asymptomatic Women: Endovaginal Ultrasound Versus MRI==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36656345 Int Urogynecol J. 2023 Jul;34(7):1627-33. PMID: 36656345]

'''Authors:''' Chill HH, Martin LC, Abramowitch SD, Rostaminia G.

'''Institution:''' Female Pelvic Medicine and Reconstructive Surgery (FPMRS), Division of Urogynecology, University of Chicago, Northshore University HealthSystem, Skokie, IL, USA.

'''Abstract:''' Introduction and hypothesis: Measurements of levator bowl volume using advanced imaging, may be predictive of pelvic floor muscle function. The aim of this study was to compare the volume of the levator bowl using both magnetic resonance imaging (MRI) and endovaginal ultrasound (EVU) of healthy asymptomatic women.

'''Methods:''' All participants underwent a comprehensive interview including completion of the Pelvic Floor Distress Inventory Questionnaire-20 questionnaire, pelvic examination with a pelvic organ prolapse quantification evaluation, MRI, and EVU. The pelvic floor was segmented using [http://www.slicer.org '''3D Slicer'''] and the MRI segmentations were trimmed using two methods: soft-tissue landmarks and the field of view (FOV) of the ultrasound volume. The levator bowl volume of the 3D segmented shapes was measured using Blender's 3D printing toolkit. Normality was tested using the Shapiro-Wilks test and comparisons were made using self-paired t tests.

'''Results:''' The final analysis included 19 patients. Levator bowl volume measured via MRI was larger than that measured in EVU (46.1 ± 7.9 cm3 vs 27.4 ± 5.9 cm3, p<0.001). Reducing the FOV of the MRI to that of EVU caused the MRI volume to be much closer to the EVU volume (35.5 ± 3.3 cm3 vs 27.4 ± 5.9 cm3, p<0.001); however, it remained significantly larger.

'''Conclusion:''' Levator bowl volume measured using MRI was larger than that measured using EVU no matter the method of delineation of the levator muscles. Although EVU is safe, cheap, and easy to perform, it captures a smaller volume of levator bowel than MRI.
|}

==Pectoralis Muscle Area Measured at T4 Level Is Closely Associated With Adverse COVID-19 Outcomes in Hospitalized Patients==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37259659 J Musculoskelet Neuronal Interact. 2023 Jun 1;23(2):196-204. PMID: 37259659] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10233225/pdf/JMNI-23-196.pdf PDF]

'''Authors:''' Tekin ZN, Dogruoz Karatekin B, Dogan MB, Bilgi Z.

'''Institution:''' Istanbul Medeniyet University, Goztepe Prof Dr Suleyman Yalcin City Hospital, Radiology, Istanbul, Turkey.

'''Abstract:'''
Objectives: Skeletal muscle area (SMA) at T4 level on chest computed tomography (CT) is a newly available method that can be used as a surrogate sarcopenia marker. The objective of this study is to evaluate association of SMA with adverse COVID-19 outcomes in hospitalized patients.

Methods: Hospitalized COVID-19 patients were prospectively recorded in a database containing age, gender, date of admission, date of outcome (discharge, mortality, presence of intensive care unit (ICU) stay, additional coding information (comorbidities, superimposed conditions). Admission CT-scans were retrospectively evaluated for segmentation (bilateral pectoralis major/minor, erector spinae, levator scapulae, rhomboideus minor and major and transversospinalis muscles) and SMA calculation using [http://www.slicer.org '''3D Slicer'''] software.

Results: 167 cases were evaluated (68 male, 72 female, 140 survived, 27 dead). Muscle area was lower in patients with ICU stay (p=0.023, p=0.018, p=0.008) and mortality outcome (p=0.004, p=0.007, p=0.002) for pectoralis, back and SMA. In multivariate Cox-regression analysis, hazard ratio (HR) value for the pectoralis muscle area value below 2800 mm2 was found to be 3.138(95% CI: 1.171-8.413) for mortality and 2.361(95% CI: 1.012-5.505) for ICU.

Conclusions: Pectoralis muscle area measured at T4 level with 3-D slicer was closely associated with adverse outcomes (mortality, ICU stay) in hospitalized COVID-19 patients. Since early treatment methods for COVID-19 are being evaluated, this method may be a useful adjunct to clinical decision making in regard to prioritization.
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==Precise Location of the Ventricular Catheter Tip in Ventriculoperitoneal Shunt Placement Guided by 3D Printed Individualized Guide==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37086587/ Clin Neurol Neurosurg. 2023 Jun;229:107730. PMID: 37086587]

'''Authors:''' Tian Q, Yi J, Wu Y, Wang S, Qu Y, Cai Q.

'''Institution:''' Department of Neurosurgery, Tangdu hospital, Air Force Medical University, Shaanxi, China.

'''Abstract:'''
Objective: Improper placement of the ventricular catheter tip is the most common cause of shunting disorders after ventriculoperitoneal shunt (VPS) placement surgery. Here, through two illustrative cases, we described a novel method of precise ventricular catheter tip location.

Methods: [http://www.slicer.org '''3D Slicer'''] software was used to define the ventricle puncture path and determine the ventricle catheter tip location preoperatively, and the 3D individualized guide model was printed.

Results: The ventricular puncture was performed under the guidance of the 3D guide to achieve precise ventricle catheter tip location intraoperatively.

Conclusions: This technique is safe, simple, efficient and cost-effective, which facilitates its clinical implementation and promotion.
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==PIRET-A Platform for Treatment Planning in Electroporation-Based Therapies==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37015676/ IEEE Trans Biomed Eng. 2023 Jun;70(6):1902-10. PMID: 37015676]

'''Authors:''' Perera-Bel E, Aycock KN, Salameh ZS, Gomez-Barea M, Davalos RV, Ivorra A, Ballester MAG.

'''Institution:''' BCN MedTech, Department of Information and Communication Technologies, Universitat Pompeu Fabra, Barcelona, Spain.

'''Abstract:'''
Tissue electroporation is the basis of several therapies. Electroporation is performed by briefly exposing tissues to high electric fields. It is generally accepted that electroporation is effective where an electric field magnitude threshold is overreached. However, it is difficult to preoperatively estimate the field distribution because it is highly dependent on anatomy and treatment parameters.

Objective: We developed PIRET, a platform to predict the treatment volume in electroporation-based therapies.

Methods: The platform seamlessly integrates tools to build patient-specific models where the electric field is simulated to predict the treatment volume. Patient anatomy is segmented from medical images and 3D reconstruction aids in placing the electrodes and setting up treatment parameters.

Results: Four canine patients that had been treated with high-frequency irreversible electroporation were retrospectively planned with PIRET and with a workflow commonly used in previous studies, which uses different general-purpose segmentation, [http://www.slicer.org '''3D Slicer'''] and modeling software (3Matic and COMSOL Multiphysics). PIRET outperformed the other workflow by 65 minutes (× 1.7 faster), thanks to the improved user experience during treatment setup and model building. Both approaches computed similarly accurate electric field distributions, with average Dice scores higher than 0.93.

Conclusion: A platform which integrates all the required tools for electroporation treatment planning is presented. Treatment plan can be performed rapidly with minimal user interaction in a stand-alone platform.

Significance: This platform is, to the best of our knowledge, the most complete software for treatment planning of irreversible electroporation. It can potentially be used for other electroporation applications.
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==Surgically Assisted Maxillary Expansion With or Without Pterygoid Disjunction Alters Maxillomandibular Positioning==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/35426586/ Oral Maxillofac Surg. 2023 Jun;27(2):269-281. PMID: 35426586]

'''Authors:''' Carvalho FSR, Soares ECS, de Medeiros JR, Júnior JMM, Hyppolito JOP, de Barros Silva PG, Ribeiro TR, Costa FWG.

'''Institution:''' Department of Oral and Maxillofacial Surgery, Federal University of Ceará Campus Sobral, Brazil.

'''Abstract:'''
Purpose: This study aimed to analyze alterations in mandibular positioning after surgically assisted maxillary expansion (SARME) with and without pterygoid disjunction (PD).

Methods: Cone-beam computed tomography scans of 24 healthy individuals (18-45 years old) with transverse deficiency, superior to 5 mm, underwent SARME with or without PD. The aspects prospectively assessed were (1) alignment and position of the head (ITK-Snap and [http://www.slicer.org '''3D Slicer'''] software); (2) McNamara's and Steiner-Tweed-Wits' cephalometric analysis (Dolphin Imaging®); and (3) colorimetric evaluation based on 3D correspondence analysis ([http://www.slicer.org '''3D Slicer'''] software).

Results: A decrease in 1-NA and 1-SN angles as well as an increased occlusal plane in both groups was observed. Superior-inferior and anteroposterior spatial displacements of the chin were statistically significant in the PD group. Altered colorimetric patterns were also observed in the PD group.

Conclusions: This study found more evident tooth inclination in the group without PD; mandibular alterations were more evident in the PD group. Further studies with 3D analysis are strongly recommended for more comprehensive results.
|}

==ERCP 2.0: Biliary 3D-Reconstruction in Patients With Malignant Hilar Stricture==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37379653 Clin Res Hepatol Gastroenterol. 2023 Jun 26;47(7):102172. PMID: 37379653]

'''Authors:''' Becq A, Szewczyk J, Salin G, Chartier M, Chaput U, Leenhardt R, Dray X, Arrive L, Camus M.

'''Institution:''' Department of Gastroenterology, Henri-Mondor University Hospital, AP-HP, EA 7375, Université Paris Est Créteil, France.

'''Abstract:'''
Background: Endoscopic retrograde cholangiopancreatography (ERCP) for malignant hilar strictures is challenging. The correlation between Magnetic resonance cholangiopancreatography (MRCP) and per ERCP 2D fluoroscopic images is not obvious. The aim of this study was to evaluate the feasibility and potential usefulness of MRCP-based handmade biliary 3D reconstruction in this setting.

Methods: Methods Patients who underwent MRCP followed by ERCP for biliary drainage of a malignant hilar stricture at our institution between 2018 and 2020 were reviewed. A handmade 3D segmentation using [http://www.slicer.org '''3D Slicer'''] (Kitware, France) was fashioned and reviewed with an expert radiologist. The primary outcome was the feasibility of biliary segmentation.

Results: A total of 16 patients were included. The mean age was 70.1 (+/- 8.6) years-old and 68.8% had hilar cholangiocarcinoma. Handmade segmentation was successful in all cases. The agreement between the MRCP interpretation and the 3D reconstruction was 37.5%, as per the Bismuth classification. 3D reconstruction available prior to ERCP could have helped guide for better stent placement in 11 cases (68.8%).

Conclusions: MRCP-based biliary 3D segmentation-reconstruction, in patients with malignant hilar stricture is feasible and seems to provide a better anatomical understanding compared to MRCP and could help improve endoscopic management.
|}

==3D Printing Personalized Guide Plate in the Management of Recurrent Intramuscular Venous Malformations: A Single Center Experience==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/36967547/ Phlebology. 2023 Jun;38(5):307-314. PMID: 36967547]

'''Authors:''' Han T, Jiang S, Xiong J, Cui J, Shen W.

'''Institution:''' Department of Burns and Plastic Surgery, Children's Hospital of Nanjing Medical University, Nanjing, China.

'''Abstract:'''
Objective: This study aimed to investigate the feasibility and effectiveness of 3D printing personalized guide plate in the management of recurrent intramuscular venous malformations (IVM).

Methods: Fifteen patients with recurrent IVM were retrospectively assessed. [http://www.slicer.org '''3D Slicer'''] software was used to extract and reconstruct the imaging data from CT and/or MRI to highlight the morphology, size, and puncture depth of the lesion. With the guidance of personalized plate, complete excision of the IVM was adopted along the pre-marked (methylene blue, MB) margin.

Results: Personalized guide plate matched involved extremity well, and MB-puncture approach was consistent with preoperative design. All IVMs were removed radically in one single session. Complete pain relief was obtained in all cases postoperatively.

Conclusion: The application of 3D printing guide plate can be safe, effective, and reliable to confirming the precise margin of IVM, renders a promising technique with a high practical value in resection of recurrent lesion.
|}

==White Matter Hyperintensities: A Possible Link Between Sarcopenia and Cognitive Impairment in Patients With Mild to Moderate Alzheimer's Disease==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37330930 Eur Geriatr Med. 2023 Jun 18. PMID: 37330930]

'''Authors:''' Weng X, Liu S, Li M, Zhang Y, Zhu J, Liu C, Hu H.

'''Institution:''' Department of Neurology, The Second Affiliated Hospital of Soochow University, Jiangsu, China.

'''Abstract:'''
Purpose: Alzheimer's disease (AD) has been reported to be associated with sarcopenia. White matter hyperintensities (WMH) are common in AD patients. However, the effect of WMH on sarcopenia in AD remains unclear. We hence aimed to investigate the possible association between regional WMH volumes and sarcopenic parameters in AD.

Methods: 57 mild to moderate AD patients and 22 normal controls (NC) were enrolled. Sarcopenic parameters were assessed, including appendicular skeletal mass index (ASMI), grip strength, 5-times sit-to-stand (5-STS) time, and gait speed. The volumes of periventricular hyperintensities (PVH) and deep white matter hyperintensities (DWMH) were quantified using [http://www.slicer.org '''3D Slicer'''] software.

Results: AD subjects exhibited a lower ASMI, a slower gait speed, an increased 5-STS time, and larger volumes of PVH and DWMH than those in the NC group. In AD subjects, total WMH and PVH volumes were related to cognitive impairment, particularly executive function decline. Moreover, total WMH volume and PVH volume were negatively correlated with gait speed across various clinical stages of AD. Multiple linear regression analysis showed that PVH volume was independently associated with 5-STS time and gait speed, whereas DWMH volume was only independently associated with gait speed.

Conclusion: WMH volume was associated with cognitive decline and various sarcopenic parameters. It thereby suggested that WMH may serve as the connection between sarcopenia and cognitive dysfunction in AD. Further studies are needed to confirm these findings and to determine whether sarcopenia interventions reduce WMH volume and improve cognitive function in AD.
|}

==CT Angiography Radiomics Combining Traditional Risk Factors to Predict Brain Arteriovenous Malformation Rupture: a Machine Learning, Multicenter Study==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37311939 Transl Stroke Res. 2023 Jun 13. PMID: 37311939]

'''Authors:''' Zhang S, Wang J, Sun S, Zhang Q, Zhai Y, Wang X, Ge P, Shi Z, Zhang D.

'''Institution:''' Department of Neurosurgery, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.

'''Abstract:'''
This study aimed to develop a machine learning model for predicting brain arteriovenous malformation (bAVM) rupture using a combination of traditional risk factors and radiomics features. This multicenter retrospective study enrolled 586 patients with unruptured bAVMs from 2010 to 2020. All patients were grouped into the hemorrhage (n = 368) and non-hemorrhage (n = 218) groups. The bAVM nidus were segmented on CT angiography images using [http://www.slicer.org '''3D Slicer'''] software, and radiomic features were extracted using Pyradiomics. The dataset included a training set and an independent testing set. The machine learning model was developed on the training set and validated on the testing set by merging numerous base estimators and a final estimator based on the stacking method. The area under the receiver operating characteristic (ROC) curve, precision, and the f1 score were evaluated to determine the performance of the model. A total of 1790 radiomics features and 8 traditional risk factors were contained in the original dataset, and 241 features remained for model training after L1 regularization filtering. The base estimator of the ensemble model was Logistic Regression, whereas the final estimator was Random Forest. In the training set, the area under the ROC curve of the model was 0.982 (0.967-0.996) and 0.893 (0.826-0.960) in the testing set. This study indicated that radiomics features are a valuable addition to traditional risk factors for predicting bAVM rupture. In the meantime, ensemble learning can effectively improve the performance of a prediction model.
|}

==Real-Time Integration Between Microsoft HoloLens 2 and 3D Slicer With Demonstration in Pedicle Screw Placement Planning==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37310561 Int J Comput Assist Radiol Surg. 2023 Jun 13. PMID: 37310561]

'''Authors:''' Pose-Díez-de-la-Lastra A, Ungi T, Morton D, Fichtinger G, Pascau J.

'''Institution:''' Departamento de Bioingeniería, Universidad Carlos III de Madrid, Spain.

'''Abstract:'''
Purpose: Up to date, there has been a lack of software infrastructure to connect [http://www.slicer.org '''3D Slicer'''] to any augmented reality (AR) device. This work describes a novel connection approach using Microsoft HoloLens 2 and OpenIGTLink, with a demonstration in pedicle screw placement planning.

Methods: We developed an AR application in Unity that is wirelessly rendered onto Microsoft HoloLens 2 using Holographic Remoting. Simultaneously, Unity connects to [http://www.slicer.org '''3D Slicer'''] using the OpenIGTLink communication protocol. Geometrical transform and image messages are transferred between both platforms in real time. Through the AR glasses, a user visualizes a patient's computed tomography overlaid onto virtual 3D models showing anatomical structures. We technically evaluated the system by measuring message transference latency between the platforms. Its functionality was assessed in pedicle screw placement planning. Six volunteers planned pedicle screws' position and orientation with the AR system and on a 2D desktop planner. We compared the placement accuracy of each screw with both methods. Finally, we administered a questionnaire to all participants to assess their experience with the AR system.

Results: The latency in message exchange is sufficiently low to enable real-time communication between the platforms. The AR method was non-inferior to the 2D desktop planner, with a mean error of 2.1 ± 1.4 mm. Moreover, 98% of the screw placements performed with the AR system were successful, according to the Gertzbein-Robbins scale. The average questionnaire outcomes were 4.5/5.

Conclusions: Real-time communication between Microsoft HoloLens 2 and 3D Slicer is feasible and supports accurate planning for pedicle screw placement.
|}

==Delirium After Traumatic Brain Injury: Prediction by Location and Size of Brain Lesion==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37317796 Ann Rehabil Med. 2023 Jun;47(3):214-21. PMID: 37317796] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10326395/pdf/arm-23008.pdf PDF]

'''Authors:''' Han SJ, Suh JH, Lee JY, Kim SJ.

'''Institution:''' Department of Rehabilitation Medicine, College of Medicine, Ewha Womans University, Seoul, Korea.

'''Abstract:'''
Objective: To examine (1) the location of brain lesion that would predict post-traumatic delirium and (2) the association between volume of brain lesion and occurrence of delirium in patients with traumatic brain injury (TBI).

Methods: A retrospective study was conducted by reviewing medical records of 68 TBI patients, categorized into two groups: the delirious group (n=38) and non-delirious group (n=30). The location and volume of TBI were investigated with the [http://www.slicer.org '''3D Slicer'''] software.

Results: The TBI region in the delirious group mainly involved the frontal or temporal lobe (p=0.038). All 36 delirious patients had brain injury on the right side (p=0.046). The volume of hemorrhage in the delirious group was larger by about 95 mL compared to the non-delirious group, but this difference was not statistically significant (p=0.382).

Conclusion: Patients with delirium after TBI had significantly different injury site and side, but not lesion size compared to patients without delirium.
|}

==Mitral Paravalvular Leak 3D Printing from 3D-Transesophageal Echocardiography==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37288866 Anatol J Cardiol. 2023 Jun 7. PMID: 37288866] | [https://doi.org/10.14744/AnatolJCardiol.2023.3008 PDF]

'''Authors:''' Jedrzejek M, Kozlowski M, Peszek-Przybyla E, Jadczyk T, Pysz P, Wojakowski W, Smolka G.

'''Institution:''' Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland.

'''Abstract:'''
Background: Paravalvular leaks can be detected in almost 15% of patients after mitral valve prosthesis implantation. This complication can result in congestive heart failure and hemolysis. Despite advancements in non-invasive imaging, percutaneous closure of paravalvular leaks is not always successful. Therefore, efforts are made to improve treatment outcomes by using 3D-printed models of defects as pre-procedural support for interventional cardiologists.

Methods: Retrospectively, 3D-transesophageal echocardiography recordings of 8 patients with clinically significant mitral paravalvular leaks were analyzed. Qlab Software was used to export DICOM images of each paravalvular leak channel, including surrounding tissue. Image segmentation was performed in [http://www.slicer.org '''3D Slicer'''], a free, open-source software package used for imaging research. Models were printed to actual size with the poly jet Stratasys Objet 30 printer with a transparent, rigid material.

Results: Duration of model preparation and printing, as well as the total cost, was calculated. Mean total time of model preparation was 430.5 ± 196 minutes.

Conclusion: 3D-printing from 3D-transesophageal echocardiography is technically feasible. Both shape and location of paravalvular leaks are preserved during model preparation and printing. It remains to be tested if 3D-printing would improve outcomes of percutaneous paravalvular leaks closure.
|}

==Prediction of Ki-67 Expression in Gastrointestinal Stromal Tumors Using Radiomics of Plain and Multiphase Contrast-Enhanced CT==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37266658 Eur Radiol. 2023 Jun 2. PMID: 37266658]

'''Authors:''' Liu Y, He C, Fang W, Peng L, Shi F 4, Xia Y, Zhou Q, Zhang R 5, Li C.

'''Institution:''' Medical Imaging Department, Chongqing University Central Hospital, Chongqing Emergency Medical Center, Chongqing, China.

'''Abstract:'''
Objective: To study the value of radiomics models based on plain and multiphase contrast-enhanced CT to predict Ki-67 expression in gastrointestinal stromal tumors (GISTs).

Methods: A total of 215 patients with GISTs were retrospectively analyzed, including 150 patients in one hospital as the training set and 65 patients in another hospital as the external verification set. The tumor at the largest level of CT images was delineated as the region of interest (ROI). The maximum diameter of the ROI was defined as the tumor size. A total of 851 radiomics features were extracted from each ROI by [http://www.slicer.org '''3D Slicer'''] Radiomics. After dimensionality reduction, three machine learning classification algorithms including logistic regression (LR), random forest (RF), and support vector machine (SVM) were used for Ki-67 expression prediction. Using a multivariable logistic model, a nomogram was established to predict the expression of Ki-67 individually.

Results: Delong tests showed that the SVM models had the highest accuracy in the arterial phase (Z value 0.217-1.139) and venous phase (Z value 0.022-1.396). For the plain phase, LR and SVM models had the highest accuracy (Z value 0.874-1.824, 1.139-1.763). For the delayed phase, LR models had the highest accuracy (Z value 0.056-1.824). For the combined phase, RF models had the highest accuracy (Z value 0.232-1.978). There was no significant difference among the above models for KI-67 expression prediction (Z value 0.022-1.978). A nomogram was developed with a C-index of 0.913 (95% CI, 0.878 to 0.956).

Conclusions: Radiomics of both plain and enhanced CT images could accurately predict the expression of Ki-67 in GIST. For patients who were not suitable to use contrast agents, plain scan could be used as an alternative.
|}

==Accuracy of Imaging Software for 3d Rendering of Tooth Structures, Usable in Clinical Settings==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37272346 Int J Comput Dent. 2023 Jun 5;0(0):0. PMID: 37272346]

'''Authors:''' Ronsivalle V, Venezia P, Migliorati M, Grippaudo C, Barbato E, Nucci L, Isola G, Leonardi RM, Lo Giudice A.

'''Institution:''' Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Policlinico Universitario "Vittorio Emanuele-G. Rodolico", Catania, Italy.

'''Abstract:'''
Aim: The aim of this study was to evaluate the segmentation accuracy of dentition testing four free-source semi-automatic software.

Materials and methods: A total of 20 cone-beam computed tomography (CBCT) were selected to perform semi-automatic segmentation of maxillary and mandibular dentition. The software tested were Invesalius, ITK-Snap, [http://www.slicer.org '''3D Slicer'''] and Seg3D. Each tooth model was also manually segmented (Mimics software) and set as the gold standard (GS) reference of the investigation. A specific 3D imaging technology was used to perform the superimposition between the teeth models obtained with semi-automatic software and the GS model, and to perform the surface-to-surface matching analysis. The accuracy of semi-automatic segmentation was evaluated calculating the volumetric mean differences (mean bias and limits of agreement) and the percentage of matching of the tooth models compared to the manual segmentation (GS). Qualitative assessments were performed using color-coded maps. All data were statistically analysed to perform software comparisons.

Result: Statistically significant differences were found in the volumetric and matching percentage data (p < 0,05). Invesalius was the most accurate software for 3D rendering of the dentition with a volumetric bias (Mimics) ranging from 4,59 mm3 to 85,79 mm3; instead, ITK-SNAP showed the higher volumetric bias, ranging from 30,22 mm3 to 319,83 mm3. The dis-matched area was mainly located at the radicular region of the teeth. Volumetric data showed excellent inter-software reliability with coefficient values ranging from 0,951 to 0,997.

Conclusion: Different semi-automatic software algorithms could generate different patterns of inaccuracy error in the segmentation of teeth.
|}

==A Retrospective Three-Dimensional Study of the Mandibular Growth During Preoperative Orthodontics in Late Adolescent Patients With Skeletal Class III Malocclusion==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37271262 J Stomatol Oral Maxillofac Surg. 2023 Jun 2;124(5):101526. PMID: 37271262]

'''Authors:''' Yuan M, Zheng Z, Li H, Wang P, Liu Y, Bi R.

'''Institution:''' State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthognathic and TMJ Surgery, West China Hospital of Stomatology, Sichuan University, China.

'''Abstract:'''
Introduction: The mandible's ongoing development presents a contraindication for combined orthodontic-orthognathic treatment. The aim of this study was to evaluate the mandibular stability before and after preoperative orthodontic treatment in late adolescent patients with skeletal Class III malocclusion and to investigate the most appropriate time to start preoperative orthodontic treatment.

Material and methods: The study population consisted of 58 adolescents, aged between 15 and 21 years, with skeletal Class III malocclusion; the adolescents underwent CT scans at the beginning (T1) and the end (T2) of preoperative orthodontic treatment. The CT data were analyzed using ITK-SNAP and [http://www.slicer.org '''3D Slicer'''] software, and the effects of age and gender on mandibular development were investigated.

Results: In these 58 patients, there were no significant local bone alterations in the condyle and anterior chin point between T1 and T2 and no significant changes in the mandibular branch height, mandibular body length, condylar distance, and mandibular angle distance (p>0.05). The mandibular growth at the angel of mandible was statistically significant (p<0.05), but it was not clinically significant because the mean value of the growth was small (right: 0.416±0.986 mm, left: 0.328±0.886 mm). No effect of age and gender on mandibular development was observed.

Conclusion: The mandibular morphology was stable during preoperative orthodontic treatment in patients at the late adolescent stage. This study provides evidence for the possibility of early implementation of preoperative orthodontics.
|}

==Assessment of Variabilities in Lung-Contouring Methods on CBCT Preclinical Radiomics Outputs==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37345013 Cancers (Basel). 2023 May 9;15(10):2677. PMID: 37345013] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10216427/pdf/cancers-15-02677.pdf PDF]

'''Authors:''' Brown KH, Illyuk J, Ghita M, Walls GM, McGarry CK, Butterworth KT.

'''Institution:''' Patrick G. Johnston Centre for Cancer Research, Queen's University Belfast, UK.

'''Abstract:'''
Radiomics image analysis has the potential to uncover disease characteristics for the development of predictive signatures and personalised radiotherapy treatment. Inter-observer and inter-software delineation variabilities are known to have downstream effects on radiomics features, reducing the reliability of the analysis. The purpose of this study was to investigate the impact of these variabilities on radiomics outputs from preclinical cone-beam computed tomography (CBCT) scans. Inter-observer variabilities were assessed using manual and semi-automated contours of mouse lungs (n = 16). Inter-software variabilities were determined between two tools ([http://www.slicer.org '''3D Slicer'''] and ITK-SNAP). The contours were compared using Dice similarity coefficient (DSC) scores and the 95th percentile of the Hausdorff distance (HD95p) metrics. The good reliability of the radiomics outputs was defined using intraclass correlation coefficients (ICC) and their 95% confidence intervals. The median DSC scores were high (0.82-0.94), and the HD95p metrics were within the submillimetre range for all comparisons. the shape and NGTDM features were impacted the most. Manual contours had the most reliable features (73%), followed by semi-automated (66%) and inter-software (51%) variabilities. From a total of 842 features, 314 robust features overlapped across all contouring methodologies. In addition, our results have a 70% overlap with features identified from clinical inter-observer studies.
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==A Training Tool for Clinicians in Segmenting Medical Images to Make 3D Models==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37342255 Ann Surg Open. 2023 May 23;4(2):e275. PMID: 37342255] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7614675/pdf/EMS170894.pdf PDF]

'''Authors:''' Chegini S, Tahim A, Liu M, Chooi Y, Edwards E, Clarkson M, Schilling C.

'''Institution:''' Department of Head and Neck Surgery, University College London Hospital, London, UK.

'''Abstract:'''
Introduction: 3D models produced from medical imaging can be used to plan treatment, design prosthesis, teach and for communication. Despite the clinical benefit, few clinicians have experience of how 3D models are produced.This is the first study evaluating a training tool to teach clinicians to produce 3D models and reporting the perceived impact on their clinical practice.

Method: Following ethical approval, 10 clinicians completed a bespoke training tool, comprising written and video material alongside online support. Each clinician and 2 technicians (included as control) were sent 3 CT scans and asked to produce 6 fibula 3D models using an open-source software, [http://www.slicer.org '''3D Slicer''']. The produced models were compared to those produced by the technicians using Hausdorff distance calculation. Thematic analysis was used to study the post-intervention questionnaire.

Results: The mean Hausdorff distance between the final model produced by the clinicians and technicians was 0.65mm SD0.54mm. The first model made by clinicians took a mean time of 1hr 25mins and the final model took 16:04mins (5:00-46:00mins). 100% of learners reported finding the training tool useful and will employ it in future practice.

Discussion: The training tool described in this paper is able to successfully train clinicians to produce fibula models from CT scans. Learners were able to produce comparable models to technicians within an acceptable timeframe. This does not replace technicians. However, the learners perceived this training will allow them to use this technology in more cases, with appropriate case selection and they appreciate the limits of this technology.
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==3D Slicer Combined With Neuroendoscope in Treatment of a Distal Segment Aneurysm of the Anterior Choroidal Artery Complicated Intraventricular Hemorrhage: A Case Report and Literature Review==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37251467 Heliyon. 2023 May 18;9(6):e16193. PMID: 37251467] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10220353/pdf/main.pdf PDF]

'''Authors:''' Zhou L, Ren Y, Li Z, Zhang H, Wei H, Song P, Cheng L, Wang W, Gao L, Lei P, Hua Q, Chen Q, Zhou J, Li G, Cai Q.

'''Institution:''' Department of Neurosurgery, Renmin Hospital of Wuhan University, Wuhan, China.

'''Abstract:'''
Introduction: Pure ventricular hemorrhage is often secondary to Moyamoya disease, rarely caused by rupture of ventricular aneurysm. The surgical treatment of the latter is very challenging. [http://www.slicer.org '''3D Slicer'''] reconstruction technology can accurately locate small intracranial lesions and combined with minimally invasive surgery with transcranial neuroendoscope is a new attempt to treat the above diseases.

Case presentation: We report a case of pure intraventricular hemorrhage secondary to rupture of a distal segment aneurysm of the anterior choroidal artery. Brain computed tomography (CT) before admission showed pure ventricular hemorrhage, and brain CT angiography (CTA) before operation showed a distal segment aneurysm of the anterior choroidal artery. We used [http://www.slicer.org '''3D Slicer'''] reconstruction and precise location of the focus before the operation and used the minimally invasive surgery technique with transcranial neuroendoscope to completely remove the hematoma in the ventricle, and found the responsible aneurysm located in the ventricle.

Conclusion: Pure intraventricular hemorrhage requires vigilance against the distal segment aneurysm of the anterior choroidal artery. At present, conventional microscopic craniotomy and intravascular interventional therapy have limitations, and [http://www.slicer.org '''3D Slicer'''] reconstruction and precise positioning technology combined with transcranial neuroendoscope minimally invasive surgery may be a good choice.
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==Application of Preoperative Multimodal Image Fusion Technique in Microvascular Decompression Surgery via Suboccipital Retrosigmoid Approach==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36716853 World Neurosurg. 2023 May;173:e37-e47. PMID: 36716853] | [https://pdf.sciencedirectassets.com/280061/AIP/1-s2.0-S1878875023001031/main.pdf PDF]

'''Authors:''' Liao CC, Wu KH, Chen G.

'''Institution:''' Department of Neurosurgery, Zhuhai People's Hospital (Zhuhai Hospital Affiliated with Jinan University,China), Zhuhai, China.

'''Abstract:'''
'''Objective:''' To explore the application value of preoperative multimodal image fusion technique in microvascular decompression (MVD) surgery via the suboccipital retrosigmoid approach.

'''Methods:''' Comprehensive data of 13 patients with primary trigeminal neuralgia (TN) and 13 patients with hemifacial spasm (HFS) treated by MVD surgery via the suboccipital retrosigmoid approach at the Department of Neurosurgery in Zhuhai People's Hospital from January 2021 to December 2021 were retrospectively analyzed. Preoperatively, all patients underwent cranial thin-section computed tomography and magnetic resonance examinations. Three-dimensional (3D) digital images of the skull, brainstem, nerves, and blood vessels were constructed by the [http://www.slicer.org '''3D Slicer'''] software or RadiAnt DICOM Viewer, which were then applied to design the surgical approach and surgical plan. The multimodal image fusion results, clinical characteristics, intraoperative data, surgical outcomes, and complications of all patients were summarized.

'''Results:''' The 3D digital images after fusion reconstruction can vividly show the anatomical relationship between the skull, brainstem, nerves, and blood vessels and was helpful to tailor the surgical strategy. All 26 patients underwent a smooth surgery. During the surgery, the key points were accurately located, the corners of the transverse sinus and sigmoid sinus were completely exposed, and no venous sinus injury occurred in all 26 patients. The key point was approximately located at the top point of the digastric groove, 12.3 ± 0.46 mm vertically above and 6.3 ± 0.6 mm laterally to the Frankfurt horizontal plane. The average cranial opening time was 30.4 (±3.6) min, and the mean operating time was 104.7 (±12.1) min. The diameter of the bone window was about 2.0 cm-3.0 cm, and the bone flap was restored. Among the 13 patients with primary TN, 12 (92.3%) exhibited complete relief of pain and 1 had significant relief. Complications of surgery included facial sensory numbness in 1 case, vertigo in 2 cases, and herpes at the corners of the mouth in 1 case. Of the 13 patients with HFS, 12 (92.3%) had complete relief of facial twitching symptoms and 1 had significant relief, and the complications included mild facial palsy in 2 (15.4%) cases and facial sensory numbness in another 2 (15.4%) cases. The mean follow-up time after surgery ranged from 6-16 months, and 1 of 26 patients experienced recurrence of HFS during the follow-up period.

'''Conclusions:''' Preoperative multimodal image fusion technology can provide adequate preoperative assessment for patients and assistance in designing surgical approaches, which is an important guideline for MVD surgery via the suboccipital retrosigmoid approach for primary TN and facial muscle spasm.
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==An Interactive App with Multi-parametric MRI - Whole-Mount Histology Correlation for Enhanced Prostate MRI Training of Radiology Residents==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37137744 Acad Radiol. 2023 May 1:S1076-6332(23)00183-6. PMID: 37137744]

'''Authors:''' Chatterjee A, Szasz T, Munakami M, Karademir I, Yusufishaq MS, Martens S, Wheeler C, Antic T, Thomas S, Karczmar GS, Oto A.

'''Institution:''' Department of Radiology, University of Chicago, Chicago, IL, USA.

'''Abstract:'''
Rationale and objectives: To validate the educational value of a newly created learning application in enhancing prostate MRI training of radiologists for detecting prostate cancer using an observer study.

Materials and methods: An interactive learning app, LearnRadiology, was developed using a web-based framework to display multi-parametric prostate MRI images with whole-mount histology for 20 cases curated for unique pathology and teaching points. Twenty new prostate MRI cases, different from the ones used in the web app, were uploaded on [http://www.slicer.org '''3D Slicer''']. Three radiologists (R1: radiologist; R2, R3: residents) blinded to pathology results were asked to mark areas suspected of cancer and provide a confidence score (1-5, with 5 being high confidence level). Then after a minimum memory washout period of 1 month, the same radiologists used the learning app and then repeated the same observer study. The diagnostic performance for detecting cancers before and after accessing the learning app was measured by correlating MRI with whole-mount pathology by an independent reviewer.

Results: The 20 subjects included in the observer study had 39 cancer lesions (13 Gleason 3 + 3, 17 Gleason 3 + 4, 7 Gleason 4 + 3, and 2 Gleason 4 + 5 lesions). The sensitivity (R1: 54% → 64%, P = 0.08; R2: 44% → 59%, P = 0.03; R3: 62% → 72%, P = 0.04) and positive predictive value (R1: 68% → 76%, P = 0.23; R2: 52% → 79%, P = 0.01; R3: 48% → 65%, P = 0.04) for all 3 radiologists improved after using the teaching app. The confidence score for true positive cancer lesion also improved significantly (R1: 4.0 ± 1.0 → 4.3 ± 0.8; R2: 3.1 ± 0.8 → 4.0 ± 1.1; R3: 2.8 ± 1.2 → 4.1 ± 1.1; P < 0.05).

Conclusion: The web-based and interactive LearnRadiology app learning resource can support medical student and postgraduate education by improving diagnostic performance of trainees for detecting prostate cancer.
|}

==3D Printed Guide Tube System for Acute Neuropixels Probe Recordings in Non-Human Primates==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37105161 J Neural Eng. 2023 May 11;20(3):036009. PMID: 37105161] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10172811/pdf/jne_20_3_036009.pdf PDF]

'''Authors:''' Bauer DL, Pobiel B, Hilber K, Verma AK, Wang J, Vitek J, Johnson M, Johnson L.

'''Institution:''' Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, USA.

'''Abstract:'''
Objective.
Neuropixels (NP) probes are a significant advance in electrophysiological recording technology that enable monitoring of hundreds of neurons in the brain simultaneously at different depths. Application of this technology has been predominately in rodents, however widespread use in non-human primates (NHPs) such as rhesus macaques has been limited. In this study we sought to overcome two overarching challenges that impede acute NP implantation in NHPs: (1) traditional microdrive systems that mount to cephalic chambers are commonly used to access cortical areas for microelectrode recordings but are not designed to accommodate NP probes, and (2) NHPs have thick dura mater and tissue growth within the cephalic chambers which poses a challenge for insertion of the extremely fragile NP probe.
Approach.
In this study we present a novel NP guide tube system that can be adapted to commercial microdrive systems and demonstrate an implant method using the NP guide tube system. This system was developed using a combination of CAD design, 3D printing, and small part machining. Software programs, [http://www.slicer.org '''3D Slicer'''] and SolidWorks were used to target cortical areas, approximate recording depths and locations, and for in-silico implant testing.
Main results.
We performedin vivotesting to validate our methodology, successfully implanting, explanting, and reimplanting NP probes. We collected stable neurophysiological recordings in the premotor cortex of a rhesus macaque at rest and during performance of a reaching task.Significance.In this study we demonstrate a robust Neuropixels implant system that allows multiple penetrations with the same NP probe and share design files that will facilitate the adoption of this powerful recording technology for NHP studies.
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==Diagnostic Value of 18F-FDG PET/CT-Based Radiomics Nomogram in Bone Marrow Involvement of Pediatric Neuroblastoma==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/36117128 Acad Radiol. 2023 May;30(5):940-51. PMID: 36117128]

'''Authors:''' Feng L, Yang X, Lu X, Kan Y, Wang C, Zhang H, Wang W, Yang J.

'''Institution:''' Department of Nuclear Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing, China.

'''Abstract:'''
Objectives: To develop and validate an 18F-FDG PET/CT-based radiomics nomogram and evaluate the value of the 18F-FDG PET/CT-based radiomics nomogram for the diagnosis of bone marrow involvement (BMI) in pediatric neuroblastoma.

Materials and methods: A total of 144 patients with neuroblastoma (100 in the training cohort and 44 in the validation cohort) were retrospectively included. The PET/CT images of patients were visually assessed. The results of bone marrow aspirates or biopsies were used as the gold standard for BMI. Radiomics features and conventional PET parameters were extracted using [http://www.slicer.org '''3D Slicer''']. Features were selected by the least absolute shrinkage and selection operator regression, and radiomics signature was constructed. Univariate and multivariate logistic regression analyses were applied to identify the independent clinical risk factors and construct the clinical model. Other different models, including the conventional PET model, combined PET-clinical model and combined radiomics model, were built using logistic regression. The combined radiomics model was based on clinical factors, conventional PET parameters and radiomics signature, which was presented as a radiomics nomogram. The diagnostic performance of the different models was evaluated by receiver operating characteristic (ROC) curves and decision curve analysis (DCA).

Results: By visual assessment, BMI was observed in 80 patients. Four conventional PET parameters (SUVmax, SUVmean, metabolic tumor volume, and total lesion glycolysis) were extracted. And 15 radiomics features were selected to build the radiomics signature. The 11q aberration, neuron-specific enolase and vanillylmandelic acid were identified as the independent clinical risk factors to establish the clinical model. The radiomics nomogram incorporating the radiomics signature, the independent clinical risk factors and SUVmean demonstrated the best diagnostic value for identifying BMI, with an area under the curve (AUC) of 0.963 and 0.931 in the training and validation cohorts, respectively. And the DCA demonstrated that the radiomics nomogram was clinically useful.

Conclusion: The 18F-FDG PET/CT-based radiomics nomogram which incorporates radiomics signature, independent clinical risk factors and conventional PET parameters could improve the diagnostic performance for BMI of pediatric neuroblastoma without additional medical costs and radiation exposure.
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==Opportunistic Screening for Osteoporosis Using CT Scans of the Knee: A Pilot Study==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37203533 Stud Health Technol Inform. 2023 May 18;302:909-910. PMID: 37203533]

'''Authors:''' Elmahdy M, Sebro R.

'''Institution:''' Department of Radiology, Mayo Clinic, Jacksonville, FL, USA.

'''Abstract:'''
Knee CT scans are used for planning for total knee arthroplasties in patients who are often simultaneously at risk for frailty fractures due to low bone mineral density. We retrospectively identified 200 patients (85.5% female) with concurrent CT scans of the knee and Dual energy x-ray absorptiometry (DXA). The mean CT attenuation of the distal femur, proximal tibia and fibula, and patella, were calculated using volumetric 3-dimensional segmentation using [http://www.slicer.org '''3D Slicer''']. Data were split randomly into training 80% and test 20% datasets. The optimal CT attenuation threshold for the proximal fibula was obtained in the training dataset and evaluated in the test dataset. A support vector machine (SVM) with radial basis function (RBF) using C-classification was trained and tuned using 5-fold cross-validation in the training dataset and then evaluated in the test dataset. The SVM had a higher area-under-the curve (AUC) of 0.937 and better performance to detect osteoporosis/osteopenia than the CT attenuation of the fibula (AUC of 0.717) (P=0.015). Opportunistic screening for osteoporosis/osteopenia could be accomplished using CT scans of the knee.
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==Sustainable 3D Printing of Oral Films With Tunable Characteristics Using CMC-Based Inks From Durian Rind Wastes==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/36933810 Eur J Pharm Biopharm. 2023 May;186:30-42. PMID: 36933810]

'''Authors:''' Panraksa P, Rachtanapun P, Thipchai P, Lesniewska E, Brachais CH, Debeaufort F, Chambin O, Jantrawut P.

'''Institution:''' Department of Pharmaceutical Sciences, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, Thailand.

'''Abstract:'''
With the growing interest in environmentally friendly and personalized medicines, new concept for combining three-dimensional printing (3DP) with natural-based biomaterials derived from agro-food wastes has emerged. This approach provides sustainable solutions for agricultural waste management and potential for developing of novel pharmaceutical products with tunable characteristics. This work demonstrated the feasibility of fabricating personalized theophylline films with four different structures (Full, Grid, Star, and Hilbert) using syringe extrusion 3DP and carboxymethyl cellulose (CMC) derived from durian rind wastes. Our findings suggested that all the CMC-based inks with shear thinning properties capable of being extruded smoothly through a small nozzle could potentially be used to fabricate the films with various complex printing patterns and high structural fidelity. The results also demonstrated that the film characteristics and release profiles could be easily modified by simply changing the slicing parameters (e.g., infill density and printing pattern). Amongst all formulations, Grid film, which was 3D-printed with 40 % infill and a grid pattern, demonstrated a highly porous structure with high total pore volume. The voids between printing layers in Grid film increased theophylline release (up to 90 % in 45 min) through improved wetting and water penetration. All findings in this study provide significant insight into how to modify film characteristics simply by digitally changing the printing pattern in [http://www.slicer.org '''3D Slicer'''] software without creating a new CAD model. This approach could help to simplify the 3DP process so that non-specialist users can easily implement it in community pharmacies or hospital on demand.
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==An Automated Landmark Method to Describe Geometric Changes in the Human Mandible During Growth==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/36893681 Arch Oral Biol. 2023 May;149:105663. PMID: 36893681]

'''Authors:''' Fournier G, Maret D, Telmon N, Savall F.

'''Institution:''' Faculté de Chirurgie Dentaire, Université Paul Sabatier, Centre Hospitalier Universitaire, Toulouse, France.

'''Abstract:'''
Objective: The principal aim of this study was to assess an automatic landmarking approach to human mandibles based on the atlas method. The secondary aim was to identify the areas of greatest variation in the mandibles of middle-aged to older adults.

Design: Our sample consisted of 160 mandibles from computed tomography scans of 80 men and 80 women aged between 40 and 79 years. Eleven anatomical landmarks were placed manually on mandibles. The automated landmarking through point cloud alignment and correspondence (ALPACA) method implemented in [http://www.slicer.org '''3D Slicer'''] was used to automatically place landmarks to all meshes. Euclidean distances, normalized centroid size, and Procrustes ANOVA were calculated for both methods. A pseudo-landmarks approach was followed using ALPACA to identify areas of changes among our sample.

Results: The ALPACA method showed significant differences in Euclidean distances for all landmarks compared to the manual method. A mean Euclidean distance of 1.7 mm was found for the ALPACA method and 0.99 mm for the manual method. Both methods found that sex, age, and size had a significant effect on mandibular shape. The greatest variations were observed in the condyle, ramus, and symphysis regions.

Conclusion: The results obtained using the ALPACA method are acceptable and promising. This approach can automatically place landmarks with an average accuracy of less than 2 mm, which may be sufficient in most anthropometric analyses. In the light of our results, however, odontological application such as occlusal analysis is not recommended.
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==Three-Dimensional Volume Rendering of Pelvic Floor Anatomy with Focus on Fibroids in Relation to the Lower Urogenital Tract Based on Cross-Sectional MRI Images==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37171621 J Med Syst. 2023 May 12;47(1):62. PMID: 37171621] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10181971/pdf/10916_2023_Article_1947.pdf PDF]

'''Authors:''' Fan KS, Durnea C, Nygaard CC, Khalil M, Doumouchtsis SK.

'''Institution:''' Institute for Medical and Biomedical Education, St. George's University of London, London, UK.

'''Abstract:'''
We aimed to assess the feasibility of developing three-dimensional (3D) models of pelvic organs using cross-sectional MRI images of patients with uterine fibroids and urinary symptoms and of obtaining anatomical information unavailable in 2D imaging modalities. We also aimed to compare two image processing applications. We performed a feasibility study analysing MRI scans from three women, aged 30 to 58 years old, with fibroids and urinary symptoms. Cross-sectional images were used to render 3D models of pelvic anatomy, including bladder, uterus and fibroids, using [http://www.slicer.org '''3D Slicer'''] and OsiriX. Dimensions, volumes and anatomical relationships of the pelvic organs were evaluated. Comparisons between anatomical landmarks and measurements obtained from the two image processing applications were undertaken. Rendered 3D pelvic models yielded detailed anatomical information and data on spatial relationships that were unobtainable from cross-sectional images. Models were rendered in sufficient resolution to aid understanding of spatial relationships between urinary bladder, uterus and fibroid(s). Measurements of fibroid volumes ranged from 5,336 to 418,012 mm3 and distances between the fibroid and urinary bladder ranged from 0.10 to 83.60 mm. Statistical analysis of measurements showed no significant differences in measurements between the two image processing applications. To date, limited data exist on the use of 3D volume reconstructions of routine MRI scans, to investigate pelvic pathologies such as fibroids in women with urinary symptoms. This study suggests that post-MRI image processing can provide additional information over standard MRI. Further studies are required to assess the role of these data in clinical practice, surgical planning and training. Three-dimensional reconstruction of routine two-dimensional magnetic resonance imaging provides additional anatomical information and may improve our understanding of anatomical relationships, their role in clinical presentations and possibly guide clinical and surgical management.
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==The First Endovascular Rat Glioma Model for Pre-Clinical Evaluation of Intra-Arterial Therapeutics==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37157800 Interv Neuroradiol. 2023 May 8:15910199231169597. PMID: 37157800]

'''Authors:''' Lim J, Baig AA, Donnelly BM, Chaves LD, Pol SU, Koenigsknecht C, Pionessa D, Levy BR, Gutierrez L, Tutino VM, Levy EI, Siddiqui AH.

'''Institution:''' Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA.

'''Abstract:'''
Background: Several translational animal models have been described assessing intra-arterial (IA) treatments for malignant gliomas. We describe the first endovascular animal model that allows testing of IA drug delivery as a first-line treatment, which is difficult to do in actual patients. We report a unique protocol for vascular access and IA delivery in the rat model that, unlike prior reports, does not require direct puncture and opening of proximal cerebrovasculature which carries risk of ischemia in the animal brain post-delivery.

Methods: Wistar rats underwent left femoral artery catherization with a Balt Magic 1.2F catheter or Marathon Flow directed 1.5F Microcatheter with an Asahi Chikai 0.008 micro-guidewire which was navigated to the left internal carotid artery under x-ray. 25% mannitol was administered to test blood brain barrier breakdown (BBBB). Additional rats were implanted with C6 glioma cells in the left frontal lobe. C6 Glioma-Implanted Rats (C6GRs) were monitored for overall survival and tumor growth. Tumor volumes from MRI images were calculated utilizing [http://www.slicer.org '''3D Slicer''']. Additional rats underwent femoral artery catheterization with Bevacizumab, carboplatin, or irinotecan injected into the left internal carotid artery to test feasibility and safety.

Results: A successful endovascular access and BBBB protocol was established. BBBB was confirmed with positive Evans blue staining. 10 rats were successfully implanted with C6 gliomas with confirmed growths on MRI. Overall survival was 19.75 ± 2.21 days. 5 rats were utilized for the development of our femoral catheterization protocol and BBBB testing. With regards to IA chemotherapy dosage testing, control rats tolerated targeted 10 mg/kg of bevascizumab, 2.4 mg/kg of carboplatin, and 15 mg/kg of irinotecan IA ICA injections without any complications.

Conclusions: We present the first endovascular IA rat glioma model that allows selective catheterization of the intracranial vasculature and assessment of IA therapies for gliomas without need for access and sacrifice of proximal cerebrovasculature.
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==Muscle Magnetic Resonance Characterization of STIM1 Tubular Aggregate Myopathy Using Unsupervised Learning==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37155641 PLoS One. 2023 May 8;18(5):e0285422. PMID: 37155641] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10166478/pdf/pone.0285422.pd PDF]

'''Authors:''' Lupi A, Spolaor S, Favero A, Bello L, Stramare R, Pegoraro E, Nobile MS.

'''Institution:''' Institute of Radiology, Department of Medicine-DIMED, University of Padua, Padua, Italy.

'''Abstract:'''
Purpose: Congenital myopathies are a heterogeneous group of diseases affecting the skeletal muscles and characterized by high clinical, genetic, and histological variability. Magnetic Resonance (MR) is a valuable tool for the assessment of involved muscles (i.e., fatty replacement and oedema) and disease progression. Machine Learning is becoming increasingly applied for diagnostic purposes, but to our knowledge, Self-Organizing Maps (SOMs) have never been used for the identification of the patterns in these diseases. The aim of this study is to evaluate if SOMs may discriminate between muscles with fatty replacement (S), oedema (E) or neither (N).

Methods: MR studies of a family affected by tubular aggregates myopathy (TAM) with the histologically proven autosomal dominant mutation of the STIM1 gene, were examined: for each patient, in two MR assessments (i.e., t0 and t1, the latter after 5 years), fifty-three muscles were evaluated for muscular fatty replacement on the T1w images, and for oedema on the STIR images, for reference. Sixty radiomic features were collected from each muscle at t0 and t1 MR assessment using [http://www.slicer.org '''3D Slicer'''] software, in order to obtain data from images. A SOM was created to analyze all datasets using three clusters (i.e., 0, 1 and 2) and results were compared with radiological evaluation.

Results: Six patients with TAM STIM1-mutation were included. At t0 MR assessments, all patients showed widespread fatty replacement that intensifies at t1, while oedema mainly affected the muscles of the legs and appears stable at follow-up. All muscles with oedema showed fatty replacement, too. At t0 SOM grid clustering shows almost all N muscles in Cluster 0 and most of the E muscles in Cluster 1; at t1 almost all E muscles appear in Cluster 1.

Conclusion: Our unsupervised learning model appears to be able to recognize muscles altered by the presence of edema and fatty replacement.
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==Quantifying the Effect of an Endo-Vaginal Probe on Position of the Pelvic Floor Viscera and Muscles==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37145123 Int Urogynecol J. 2023 May 5. PMID: 37145123]

'''Authors:''' Chill HH, Martin LC, Abramowitch SD, Rostaminia G.

'''Institution:''' Female Pelvic Medicine and Reconstructive Surgery (FPMRS) Division, University of Chicago Pritzker School of Medicine, Northshore University HealthSystem, Skokie, IL, USA.

'''Abstract:'''
Introduction and hypothesis: Endovaginal ultrasound has long been hypothesized to have a significant effect on locations of what it visualizes. However, little work has directly quantified its effect. This study aimed to quantify it.

Methods: This cross-sectional study consisted of 20 healthy asymptomatic volunteers who underwent both endovaginal ultrasound and MRI. The urethra, vagina, rectum, pelvic floor, and pubic bone were segmented in both ultrasound and MRI using [http://www.slicer.org '''3D Slicer''']. Then, using [http://www.slicer.org '''3D Slicer''']'s transform tool the volumes were rigidly aligned based on the posterior curvature of the pubic bone. The organs were then split into thirds along their long axis to compare their distal, middle, and proximal sections. Using Houdini, we compared the location of the centroid of each of the urethra, vagina, and rectum and the surface-to-surface difference of the urethra and rectum. The anterior curvature of the pelvic floor was also compared. Normality of all variables was assessed by Shapiro-Wilk test.

Results: The largest amount of surface-to-surface distance was observed in the proximal region for the urethra and rectum. Across all three organs, the majority of the deviation was in the anterior direction for geometries obtained from ultrasound versus those from MRI. For each subject, the trace defining the midline of the levator plate was more anterior for ultrasound compared to MRI.

Conclusions: While it has often been assumed that placing a probe in the vagina probably distorts the anatomy, this study quantified the distortion and displacement of the pelvic viscera. This allows for better interpretation of clinical and research findings based on this modality.
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==Laser Interstitial Thermal Therapy in the Treatment of Brain Metastases: The Relationship Between Changes in Postoperative Magnetic Resonance Imaging Characteristics and Tumor Recurrence==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36823478 Acta Neurochir (Wien). 2023 May;165(5):1379-1387. PMID: 36823478]

'''Authors:''' Xue Z, Guan X, Yuan L, Kang P, Zhang C, Li D, Jia G, Jia W.

'''Institution:''' Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, China.

'''Abstract:'''
'''Background:''' Laser interstitial thermal therapy (LITT) has been used to treat brain metastases (BMs) in several countries, and its safety and effectiveness have been confirmed. In most cases, magnetic resonance imaging (MRI) reveals an increase in tumor volume with an enhanced margin after LITT. However, little is known about the relationship between this MRI change and tumor recurrence.

'''Objective:''' We report the first case series of BMs treated by LITT in China to evaluate the clinical characteristics and predictive factors of tumor recurrence.

'''Material and Methods:''' Patients with less than four brain metastatic lesions and a Karnofsky performance status (KPS) > 70 were eligible for study inclusion. Standard LITT procedures were performed, and a follow-up MRI was performed to analyze the radiographic changes, especially the volume ratio of the enhanced margin and the whole lesion on MRI at 30 days postoperatively. All the volume-related data were delineated and calculated using [http://www.slicer.org '''3D Slicer'''] software. Related predictors were also collected to evaluate the correlation with local tumor control.

'''Results:''' Eighteen patients with nineteen lesions were enrolled for treatment and follow-up. Primary tumor histology included pulmonary carcinoma (n = 11) and breast cancer (n = 4). On average, the tumor size measured 3.01 cm3 (range, 0.40-7.40 cm3), the total ablation time was 13.58 min (range, 2.88-37.15 min), and the complete ablation rate was 92.4% (range, 29.2-100%). Comparing 3s0-day follow-up MRI results with preoperative MRI findings, 18 lesions showed a 2.28-fold (range, 1.21-4.88) volume increase; all the lesions displayed an enhanced component with a volume ratio of 42.35% (range, 10.14-100%). Five patients experienced tumor recurrence, and the local tumor control rates at 90 days and 180 days of follow-up were 68.4% and 66.7%, respectively. Univariate analysis indicated that the primary tumor, ablation rate, and enhanced volume ratio (EVR) > 40% in the 30-day MRI were associated with tumor recurrence, whereas multivariate analysis showed that only EVR > 40% was a predictive factor of local control.

'''Conclusion:''' LITT is a minimally invasive method used to ablate brain metastases which can be used as the first-line treatment for BM patients under certain indications. After LITT, most tumors showed volume enlargement on the 30-day MRI scan, and EVR > 40% on the 30-day MRI may indicate late tumor recurrence.
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==Image Data and Computational Grids for Computing Brain Shift and Solving the Electrocorticography Forward Problem==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37128587/ Data Brief. 2023 Apr 7;48:109122. PMID: 37128587] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10147975/pdf/main.pdf PDF]

'''Authors:''' Zwick BF, Safdar S, Bourantas GC, Joldes GR, Hyde DE, Warfield SK, Wittek A, Miller K.

'''Institution:''' Intelligent Systems for Medicine Laboratory, The University of Western Australia, 35 Stirling Highway, Perth, WA, Australia.

'''Abstract:'''
This article describes the dataset applied in the research reported in NeuroImage article "Patient-specific solution of the electrocorticography forward problem in deforming brain" [1] that is available for download from the Zenodo data repository (https://zenodo.org/record/7687631) [2]. Preoperative structural and diffusion-weighted magnetic resonance (MR) and postoperative computed tomography (CT) images of a 12-year-old female epilepsy patient under evaluation for surgical intervention were obtained retrospectively from Boston Children's Hospital. We used these images to conduct the analysis at The University of Western Australia's Intelligent Systems for Medicine Laboratory using SlicerCBM [3], our open-source software extension for the [http://www.slicer.org '''3D Slicer'''] medical imaging platform. As part of the analysis, we processed the images to extract the patient-specific brain geometry; created computational grids, including a tetrahedral grid for the meshless solution of the biomechanical model and a regular hexahedral grid for the finite element solution of the electrocorticography forward problem; predicted the postoperative MRI and DTI that correspond to the brain configuration deformed by the placement of subdural electrodes using biomechanics-based image warping; and solved the patient-specific electrocorticography forward problem to compute the electric potential distribution within the patient's head using the original preoperative and predicted postoperative image data. The well-established and open-source file formats used in this dataset, including Nearly Raw Raster Data (NRRD) files for images, STL files for surface geometry, and Visualization Toolkit (VTK) files for computational grids, allow other research groups to easily reuse the data presented herein to solve the electrocorticography forward problem accounting for the brain shift caused by implantation of subdural grid electrodes.
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==ImFinite Element Analysis of a Healthy Knee Joint at Deep Squatting for the Study of Tibiofemoral and Patellofemoral Contact==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37143926 J Orthop. 2023 Apr 21;40:7-16. PMID: 37143926]

'''Authors:''' Kothurkar R, Lekurwale R, Gad M, Rathod CM.

'''Institution:''' Department of Mechanical Engineering, K. J. Somaiya College of Engineering, Mumbai, India.

'''Abstract:'''
Background: In non-western countries, deep squatting is a daily activity, and prolonged deep squatting is common among occupational squatters. Household tasks, taking a bath, socializing, using toilets, and performing religious acts are among the activities frequently carried out while squatting by the Asian population. High knee loading is responsible for a knee injury and osteoarthritis. Finite element analysis is an effective tool to determine stresses on the knee joint.

Methods: Magnetic Resonance Imaging (MRI) and Computed Tomographic (CT) images were acquired of one adult without knee injuries. The CT images were acquired at the fully extended knee and one more set of images was acquired with the knee at a deeply flexed knee position. The MRI was acquired with the fully extended knee. 3 Dimensional models of bones were created using CT and soft tissue using MRI with the help of [http://www.slicer.org '''3D Slicer'''] software. Kinematics and finite element analysis of the knee was performed for standing and deep squatting posture using Ansys Workbench 2022.

Results: High peak stresses were observed at deep squatting compared to standing along with the reduction in the contact area. Peak von Mises stresses on femoral cartilage, tibial cartilage, patellar cartilage, and meniscus were increased from 3.3 MPa to 19.9 MPa, 2.9 MPa to 12.4 MPa, 1.5 MPa to 16.7 MPa and 15.8 MPa to 32.8 MPa respectively during deep squatting. Posterior translation of 7.01 mm, and 12.58 mm was observed for medial and lateral femoral condyle respectively from full extension to 153° knee flexion.

Conclusions: Increased stresses in the knee joint at deep squat posture may cause cartilage damage. A sustained deep squat posture should be avoided for healthy knee joints. More posterior translations of the medial femoral condyle at higher knee flexion angle warrant further investigation.
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==A Comparison of Machine Learning Models for Survival Prediction of Patients with Glioma Using Radiomic Features from MRI Scans==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37362372/ Indian J Radiol Imaging. 2023 Apr 28;33(3):338-343. PMID: 37362372] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10289839/pdf/10-1055-s-0043-1767786.pdf PDF]

'''Authors:''' Manjunath M, Saravanakumar S, Kiran S, Chatterjee J.

'''Institution:''' Department of Biotechnology, People's Education Society University, Bangalore, Karnataka, India.

'''Abstract:'''
Background Glioma is a primary, malignant, highly aggressive brain tumor, with patients having an average life expectancy of 14 to 16 months after diagnosis. Magnetic resonance imaging (MRI) scans of these patients can be used to extract and analyze quantifiable features with potential clinical significance. We hypothesize that there is a correlation between radiomic features extracted from MRI scans and survival. Along with clinical data, the radiomic features could be used in survival prediction of patients, providing beneficial information for clinicians to design personalized treatment plans. Methods In our study, we have utilized [http://www.slicer.org '''3D Slicer'''] for tumor segmentation and feature extraction and performed survival prediction of patients with glioma using four different machine learning models. Results and Conclusion Among the models compared, we have achieved a maximum prediction accuracy of 64.4% using the k-nearest neighbors model, which was trained and tested on a combination of clinical data and radiomic features extracted from MRI images provided in the BraTS 2020 dataset.
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==Circular RNA hsa_circ_0000690 as a Potential Biomarker for Diagnosis and Prognosis of Intracranial Aneurysm: Closely Relating to the Volume of Hemorrhage==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36879365 Brain Behav. Apr;13(4):e2929. PMID: 36879365] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10097068/pdf/BRB3-13-e2929.pdf PDF]

'''Authors:'''Huang Y, Cao H, Qi X, Guan C, Que S.

'''Institution:''' Department of Neurosurgery, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, Fujian, China.

'''Abstract:'''

'''Purpose:''' This study aimed to explore circular RNA (circRNA) hsa_circ_0000690 as a potential biomarker for diagnosis and prognosis of intracranial aneurysm (IA) and its relationship with clinical factors and complications of IA.

'''Material/Methods:''' 216 IA patients admitted to the neurosurgery department of our hospital from January 2019 to December 2020 were selected as the experimental group, and 186 healthy volunteers were selected as the control group. The expression of hsa_circ_0000690 in peripheral blood was detected by quantitative real-time PCR, and its diagnostic value was assessed by receiver operating characteristic curve. Relationship between hsa_circ_0000690 and clinical factors of IA was assessed by chi-square test. Nonparametric test was used in univariate analysis, and regression analysis was used in multivariate analysis. Multivariate Cox proportional hazards regression analysis was used to analyze the survival time.

'''Results:''' CircRNA hsa_circ_0000690 of IA patients was relatively lower than that in the control group (p < .001). The AUC of hsa_circ_0000690 was 0.752, the specificity was 0.780, and sensitivity was 0.620, with diagnostic threshold of 0.0449. In addition, hsa_circ_0000690 expression was correlated with Glasgow Coma Scale, the volume of subarachnoid hemorrhage, modified Fisher scale, Hunt-Hess levels and surgical type. For hydrocephalus and delayed cerebral ischemia, hsa_circ_0000690 was significant in univariate analysis, but nonsignificant in multivariate analysis. For prognosis, hsa_circ_0000690 was significantly associated with modified Rankin Scales after surgery for 3 months, but not associated with survival time.

'''Conclusions:''' The expression of hsa_circ_0000690 can act as a diagnostic marker for IA and predict the prognosis of 3 months after operation and is closely related to the volume of hemorrhage.

'''Keywords:''' [http://www.slicer.org '''3D Slicer''']; biomarker; circRNA; diagnosis; intracranial aneurysm; prognosis; subarachnoid hemorrhage
|}

==Can Quantitative Peritumoral CT Radiomics Features Predict the Prognosis of Patients With Non-Small Cell Lung Cancer? A Systematic Review==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36307554 Eur Radiol. 2023 Mar;33(3):2105-17. PMID: 36307554] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9935659/pdf/330_2022_Article_9174.pdf PDF]

'''Authors:''' Wu L, Lou X, Kong N, Xu M, Gao C.

'''Institution:''' Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China.

'''Abstract:''' Objectives: To provide an overarching evaluation of the value of peritumoral CT radiomics features for predicting the prognosis of non-small cell lung cancer and to assess the quality of the available studies.

'''Methods:''' The PubMed, Embase, Web of Science, and Cochrane Library databases were searched for studies predicting the prognosis in patients with non-small cell lung cancer (NSCLC) using CT-based peritumoral radiomics features. Information about the patient, CT-scanner, and radiomics analyses were all extracted for the included studies. Study quality was assessed using the Radiomics Quality Score (RQS) and the Prediction Model Risk of Bias Assessment Tool (PROBAST).

'''Results:''' Thirteen studies were included with 2942 patients from 2017 to 2022. Only one study was prospective, and the others were all retrospectively designed. Manual segmentation and multicenter studies were performed by 69% and 46% of the included studies, respectively. [http://www.slicer.org '''3D Slicer'''] and MATLAB software were most commonly used for the segmentation of lesions and extraction of features. The peritumoral region was most frequently defined as dilated from the tumor boundary of 15 mm, 20 mm, or 30 mm. The median RQS of the studies was 13 (range 4-19), while all of included studies were assessed as having a high risk of bias (ROB) overall.

'''Conclusions:''' Peritumoral radiomics features based on CT images showed promise in predicting the prognosis of NSCLC, although well-designed studies and further biological validation are still needed.

'''Key points:''' Peritumoral radiomics features based on CT images are promising and encouraging for predicting the prognosis of non-small cell lung cancer. The peritumoral region was often dilated from the tumor boundary of 15 mm or 20 mm because these were considered safe margins. The median Radiomics Quality Score of the included studies was 13 (range 4-19), and all of studies were considered to have a high risk of bias overall.
|}

==Three Dimensional Assessment of Radiographic Changes after Indirect Pulp Capping using Silver Diamine Fluoride with or without Potassium Iodide in Young Permanent Teeth (12-month RCT)==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36878216 Caries Res. 2023;57(2):177-188. PMID: 36878216]

'''Authors:''' Baraka MMAL, Cevidanes L, Tekeya M, Bakry N, Ruellas A, Botero T, Benavides E, Fontana M.

'''Institution:''' Department of Experimental Oncology, European Institute of Oncology, IRCCS, 20139 Milan, Italy.

'''Abstract:''' The aim was to have a three-dimensional evaluation of radiographic changes after indirect pulp capping (IPC) with silver diamine fluoride (SDF) with or without potassium iodide (KI) and resin modified glass ionomer cement (RMGIC) in deep carious young permanent molars using cone beam computed tomography (CBCT). 108 first permanent molars with deep occlusal cavitated caries lesions, in forty-nine 6-9-year-old children, were randomly allocated to one of 3 groups (n=36) and treated with SDF+KI, SDF and RMGIC as IPC materials. CBCT scans were taken at 0 and at 12-months to assess tertiary dentin formation (volume and grey level intensity), increase in root length, and pathological changes as secondary caries, periapical radiolucency, internal resorption and obliteration of the pulp. The three-dimensional image analysis procedures were performed using ITK-SNAP and [http://www.slicer.org '''3D Slicer'''] CMF. Comparisons were made using analysis of variance with a fixed effect for treatment and random effects for patient, and patient-by-treatment to account for within-patient correlations. A two-sided 5% significance level was used. There were no significant differences among the three groups regarding tertiary dentin volume (p=0.712) and grey level intensity (p=0.660), increase in root length (p=0.365), prevention of secondary caries (p=0.63) and periapical radiolucency (p=0.80) in the analysed 69 CBCT scans. The study did not find differences among the groups regarding quality and quantity of tertiary dentin formed, increase in root length, absence of secondary caries and other signs of failure as shown by CBCT.

'''Clinical Significance:''' The results show no significant differences in radiographic outcomes (quality and quantity of tertiary dentin formed, increase in root length, absence of secondary caries and other signs of failure) when using SDF+KI, SDF and RMGIC in IPC. The results of this study can help guide treatment decision making regarding use of SDF and SDF+KI as IPC materials in deep cavitated lesions.
|}

==Cross-Sectional Reliability and Concurrent Validity of a Quantitative 2-Dimensional Ultrasound Image Analysis of Effusion and Synovial Hypertrophy in Knee Osteoarthritis==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37008822/ Osteoarthr Cartil Open. 2023 Mar 16;5(2):100356. PMID: 37008822] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10060736/pdf/main.pdf PDF]

'''Authors:''' Dima R, Birmingham TB, Philpott HT, Bryant D, Fenster A, Appleton CT.

'''Institution:''' Faculty of Health Sciences, University of Western Ontario, London, ON, Canada.

'''Abstract:'''
Objective: Effusion-synovitis is related to pain and progression in knee osteoarthritis (OA), but current gold standard ultrasound (US) measures are limited to semi-quantitative grading of joint distension or 1-dimensional thickness measures. A novel quantitative 2-dimensional image analysis methodology is applied to US images of effusion-synovitis; reliability and concurrent validity was assessed in patients with knee OA.

Methods: Cross sectional analysis of US images collected from 51 patients with symptomatic knee OA were processed in ImageJ and segmented in [http://www.slicer.org '''3D Slicer'''] to produce a binary mask of the supra-patellar synovitis region of interest (ROI). Area measures (mm2) of total synovitis, effusion and hypertrophy components were exported. Intra-rater reliability and test-retest reliability (1-14 days washout) were estimated with intra-class correlation coefficients (ICCs). Concurrent validity was measured by Spearman correlations between quantitative measures and gold standard OMERACT and caliper measurements of synovitis.

Results: Intra-rater reliability for hypertrophy area was estimated at 0.98, 0.99 for effusion area, and 0.99 for total synovitis area. The test-retest reliability for total synovitis area was 0.63 (SEM 87.8 mm2), 0.59 for hypertrophy area (SEM 21.0 mm2), and 0.64 for effusion area (SEM 73.8 mm2). Correlation between total synovitis area and OMERACT grade was 0.84, 0.81 between total synovitis area and effusion-synovitis calipers, and 0.81 between total effusion area and effusion calipers.

Conclusion: This new research tool for image analysis demonstrated excellent intra-rater reliability, good concurrent validity, and moderate test-retest reliability. Quantitative 2D US measures of effusion-synovitis and its individual components may enhance the study and management of knee OA.
|}

==Patient-Specific Needle Guidance Templates Drilled Intraprocedurally for Image Guided Intervention: Feasibility Study in Swine==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36173542 Int J Comput Assist Radiol Surg. 2023 Mar;18(3):537-44. PMID: 36173542]

'''Authors:''' Glossop N, Bale R, Xu S, Pritchard WF, Karanian JW, Wood BJ.

'''Institution:''' Queen's University, Kingston, ON, Canada.

'''Abstract:'''
'''purpose:''' Thermal ablation of large tumors may benefit from simultaneous placement of multiple needles, but accurate placement becomes challenging as the number of needles increases. The aim of this work was to evaluate use of personalized needle guidance grid templates based on intraprocedural CT and fabricated at the point of care to implement ablation treatment plans with multiple needles in vivo.

'''Methods:''' A plastic frame was designed to hold two parallel plastic guide plates in a rigid relationship, fixed over the abdomen by a mounting arm. Steel ball targets (1.5 mm) were implanted under ultrasound in the livers of two domestic swine under general anesthesia. Following breath-hold CT of the subject and frame, the targets and frame were identified using customized [http://www.slicer.org '''3D Slicer''']-based planning software. Multiple needle trajectories targeting the balls were planned, including complex off-plane trajectories. A machining program for drilling the hole pattern corresponding to the planned needle trajectories was generated. The pattern was drilled in the two plates with a numerical-controlled milling machine in the suite. The plates were attached to the frame and needles passed through the paired holes to the calculated depth. Placement accuracy was defined as needle tip-to-target distance on post-placement CT.

'''Results:''' The planning process and manufacturing required approximately 6 and 15 min, respectively. Needles were rapidly inserted (n = 11) to the target points without complications or traversing nontarget anatomy. The mean needle tip-to-target distance error was 3.4 ± 2.2, range 0-7 mm.

'''Conclusion:''' Rapid and accurate needle placement was feasible using a subject-specific, custom-drilled, needle guidance grid template fabricated intraprocedurally. Targeting accuracy and performance were similar to more complex and expensive tracking systems which may enable accurate intraprocedural implementation of treatment plans in the liver or other organs. This may be of value in complex ablation cases or in areas where more advanced guidance systems are not available.
|}

==Automatic Landmark Identification in Cone-Beam Computed Tomography==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36811276 Orthod Craniofac Res. 2023 Feb 21. PMID: 36811276]

'''Authors:''' Gillot M, Miranda F, Baquero B, Ruellas A, Gurgel M, Al Turkestani N, Anchling L, Hutin N, Biggs E, Yatabe M, Paniagua B, Fillion-Robin JC, Allemang D, Bianchi J, Cevidanes L, Prieto JC.

'''Institution:''' Department of Orthodontics and Pediatric Dentistry, School of Dental Medicine, University of Michigan, Ann Arbor, MI, USA.

'''Abstract:'''
'''Objective:''' To present and validate an open-source fully automated landmark placement (ALICBCT) tool for cone-beam computed tomography scans.

'''Material and Methods:''' One hundred and forty-three large and medium field of view cone-beam computed tomography (CBCT) were used to train and test a novel approach, called ALICBCT that reformulates landmark detection as a classification problem through a virtual agent placed inside volumetric images. The landmark agents were trained to navigate in a multi-scale volumetric space to reach the estimated landmark position. The agent movements decision relies on a combination of DenseNet feature network and fully connected layers. For each CBCT, 32 ground truth landmark positions were identified by 2 clinician experts. After validation of the 32 landmarks, new models were trained to identify a total of 119 landmarks that are commonly used in clinical studies for the quantification of changes in bone morphology and tooth position.

'''Results:''' Our method achieved a high accuracy with an average of 1.54±0.87 mm error for the 32 landmark positions with rare failures, taking an average of 4.2s computation time to identify each landmark in one large 3D-CBCT scan using a conventional GPU.

'''Conclusion:''' The ALICBCT algorithm is a robust automatic identification tool that has been deployed for clinical and research use as an extension in the 3D Slicer platform allowing continuous updates for increased precision.
|}

==Development and In-Silico and Ex-Vivo Validation of a Software for a Semi-Automated Segmentation of the Round Window Niche to Design a Patient Specific Implant to Treat Inner Ear Disorders==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36826970 J Imaging. 2023 Feb 20;9(2):51. PMID: 36826970] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9965310/pdf/jimaging-09-00051.pdf PDF]

'''Authors:''' Matin-Mann F, Gao Z, Wei C, Repp F, Artukarslan EN, John S, Alcacer Labrador D, Lenarz T, Scheper V.

'''Institution:''' Lower Saxony Center for Biomedical Engineering, Implant Research and Development (NIFE), Department of Otorhinolaryngology, Head and Neck Surgery, Hannover Medical School, Hannover, Germany.

'''Abstract:''' The aim of this study was to develop and validate a semi-automated segmentation approach that identifies the round window niche (RWN) and round window membrane (RWM) for use in the development of patient individualized round window niche implants (RNI) to treat inner ear disorders. Twenty cone beam computed tomography (CBCT) datasets of unilateral temporal bones of patients were included in the study. Defined anatomical landmarks such as the RWM were used to develop a customized [http://www.slicer.org '''3D Slicer'''] plugin for semi-automated segmentation of the RWN. Two otolaryngologists (User 1 and User 2) segmented the datasets manually and semi-automatically using the developed software. Both methods were compared in-silico regarding the resulting RWM area and RWN volume. Finally, the developed software was validated ex-vivo in N = 3 body donor implantation tests with additively manufactured RNI. The independently segmented temporal bones of the different Users showed a strong consistency in the volume of the RWN and the area of the RWM. The volume of the semi-automated RWN segmentations were 48 ± 11% smaller on average than the manual segmentations and the area of the RWM of the semi-automated segmentations was 21 ± 17% smaller on average than the manual segmentation. All additively manufactured implants, based on the semi-automated segmentation method could be implanted successfully in a pressure-tight fit into the RWN. The implants based on the manual segmentations failed to fit into the RWN and this suggests that the larger manual segmentations were over-segmentations. This study presents a semi-automated approach for segmenting the RWN and RWM in temporal bone CBCT scans that is efficient, fast, accurate, and not dependent on trained users. In addition, the manual segmentation, often positioned as the gold-standard, actually failed to pass the implantation validation.
|}

==Design and Analysis of HSC-BPPV Diagnostic Maneuver Based on Virtual Simulation==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36873445 Front Neurol. 2023 Feb 17;14:1132343. PMID: 36873445] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9981954/pdf/fneur-14-1132343.pdf PDF]

'''Authors:''' Li Y, Yang X.

'''Institution:''' Department of Research Center, Third Affiliated Hospital of Shanghai University, Wenzhou Third Clinical Institute Affiliated to Wenzhou Medical University, Wenzhou People's Hospital, Wenzhou, China.

'''Abstract:'''
'''Background:''' The preferred supine roll test for the diagnosis of horizontal semicircular canal BPPV has several disadvantages, including difficulty in locating the affected ear, inconsistent nystagmus performance on repeated testing, and lack of a typical latency period, resulting in insensitive diagnosis.

Objectives: To investigate novel diagnostic techniques with more scientific design, more accessible application, and better diagnostic sensitivity and specificity.

'''Materials and Methods:''' Based on clinical microscopic CT data, we created a virtual simulation model of BPPV using Unity software. The physical simulation of the traditional supine roll test was performed to observe and analyse the movement of the otoliths, whose initial position was the typical stable position. In addition, the normal vectors of the plane and crista ampullaris of the horizontal semicircular canal were measured using [http://www.slicer.org '''3D Slicer'''] software. Based on this, we analyzed the critical steps for designing diagnostic maneuvers for BPPV in the horizontal semicircular canal. For a more accurate diagnosis of horizontal semicircular canal BPPV, it is critical to rotate the horizontal semicircular canal to be parallel to gravity. It is also necessary to move the otolith by swinging the head. As a result, we developed two diagnostic maneuvers: the 60° roll test and the prone roll test. We also performed simulations to observe otolith movement and predict nystagmus performance.

'''Conclusions:''' The 60° roll test and the prone roll test can complement the supine roll test. Compared to the supine roll test, they not only effectively differentiate canalolithiasis from cupulolithiasis, but also make it easier to determine the position of the otoliths, and the characteristics of the nystagmus are more pronounced. Significant diagnostic features have significant potential benefits for home and telemedicine.
|}

==The Simplified Tailor-Made Workflows for a [http://www.slicer.org '''3D Slicer''']-Based Craniofacial Implant Design==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36801943 Sci Rep. 2023 Feb 17;13(1):2850. PMID: 36801943] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9938178/pdf/41598_2023_Article_30117.pdf PDF]

'''Authors:''' Tantisatirapong S, Khunakornpattanakarn S, Suesatsakul T, Boonpratatong A, Benjamin I, Tongmeesee S, Kangkorn T, Chanwimalueang

'''Institution:''' Department of Biomedical Engineering, Faculty of Engineering, Srinakharinwirot University, Nakhon Nayok, Thailand.

'''Abstract:''' A specific design of craniofacial implant model is vital and urgent for patients with traumatic head injury. The mirror technique is commonly used for modeling these implants, but it requires the presence of a healthy skull region opposite to the defect. To address this limitation, we propose three processing workflows for modeling craniofacial implants: the mirror method, the baffle planner, and the baffle-based mirror guideline. These workflows are based on extension modules on the [http://www.slicer.org '''3D Slicer'''] platform and were developed to simplify the modeling process for a variety of craniofacial scenarios. To evaluate the effectiveness of these proposed workflows, we investigated craniofacial CT datasets collected from four accidental cases. The designed implant models were created using the three proposed workflows and compared to reference models created by an experienced neurosurgeon. The spatial properties of the models were evaluated using performance metrics. Our results show that the mirror method is suitable for cases where a healthy skull region can be completely reflected to the defect region. The baffle planner module offers a flexible prototype model that can be fit independently to any defect location, but it requires customized refinement of contour and thickness to fill the missing region seamlessly and relies on the user's experience and expertise. The proposed baffle-based mirror guideline method strengthens the baffle planner method by tracing the mirrored surface. Overall, our study suggests that the three proposed workflows for craniofacial implant modeling simplify the process and can be practically applied to a variety of craniofacial scenarios. These findings have the potential to improve the care of patients with traumatic head injuries and could be used by neurosurgeons and other medical professionals.
|}

==Predicting Transient Ischemic Attack Risk in Patients With Mild Carotid Stenosis Using Machine Learning and CT Radiomics==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36846119 Front Neurol. 2023 Feb 8;14:1105616. PMID: 36846119] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9944715/pdf/fneur-14-1105616.pdf PDF]

'''Authors:''' Xia H, Yuan L, Zhao W, Zhang C, Zhao L, Hou J, Luan Y, Bi Y, Feng Y.

'''Institution:''' Department of Vascular Surgery, The First Affiliated Hospital of Kunming Medical University, Kunming, China.

'''Abstract:'''
'''Objective:''' This study aims to establish a radiomics-based machine learning model that predicts the risk of transient ischemic attack in patients with mild carotid stenosis (30-50% North American Symptomatic Carotid Endarterectomy Trial) using extracted computed tomography radiomics features and clinical information.

'''Methods:''' A total of 179 patients underwent carotid computed tomography angiography (CTA), and 219 carotid arteries with a plaque at the carotid bifurcation or proximal to the internal carotid artery were selected. The patients were divided into two groups; patients with symptoms of transient ischemic attack after CTA and patients without symptoms of transient ischemic attack after CTA. Then we performed random sampling methods stratified by the predictive outcome to obtain the training set (N = 165) and testing set (N = 66). [http://www.slicer.org '''3D Slicer'''] was employed to select the site of plaque on the computed tomography image as the volume of interest. An open-source package PyRadiomics in Python was used to extract radiomics features from the volume of interests. The random forest and logistic regression models were used to screen feature variables, and five classification algorithms were used, including random forest, eXtreme Gradient Boosting, logistic regression, support vector machine, and k-nearest neighbors. Data on radiomic feature information, clinical information, and the combination of these pieces of information were used to generate the model that predicts the risk of transient ischemic attack in patients with mild carotid artery stenosis (30-50% North American Symptomatic Carotid Endarterectomy Trial).

'''Results:''' The random forest model that was built based on the radiomics and clinical feature information had the highest accuracy (area under curve = 0.879; 95% confidence interval, 0.787-0.979). The combined model outperformed the clinical model, whereas the combined model showed no significant difference from the radiomics model.

'''Conclusion:''' The random forest model constructed with both radiomics and clinical information can accurately predict and improve discriminative power of computed tomography angiography in identifying ischemic symptoms in patients with carotid atherosclerosis. This model can aid in guiding the follow-up treatment of patients at high risk.
|}

==Deep Learning Enabled Multi-Organ Segmentation of Mouse Embryos==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36802342 Biol Open. 2023 Feb 15;12(2):bio059698. PMID: 36802342] | [https://cob.silverchair-cdn.com/cob/content_public/journal/bio/12/2/10.1242_bio.059698/2/bio059698.pdf PDF]

'''Authors:''' Rolfe SM, Whikehart SM, Maga AM.

'''Institution:''' Center for Developmental Biology and Regenerative Medicine, Seattle Children's Research Institute, Seattle, WA, USA.

'''Abstract:''' The International Mouse Phenotyping Consortium (IMPC) has generated a large repository of three-dimensional (3D) imaging data from mouse embryos, providing a rich resource for investigating phenotype/genotype interactions. While the data is freely available, the computing resources and human effort required to segment these images for analysis of individual structures can create a significant hurdle for research. In this paper, we present an open source, deep learning-enabled tool, Mouse Embryo Multi-Organ Segmentation (MEMOS), that estimates a segmentation of 50 anatomical structures with a support for manually reviewing, editing, and analyzing the estimated segmentation in a single application. MEMOS is implemented as an extension on the [http://www.slicer.org '''3D Slicer'''] platform and is designed to be accessible to researchers without coding experience. We validate the performance of MEMOS-generated segmentations through comparison to state-of-the-art atlas-based segmentation and quantification of previously reported anatomical abnormalities in a Cbx4 knockout strain. This article has an associated First Person interview with the first author of the paper.
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==Development and Validation of an 18FFDG-PET/CT Radiomic Model for Predicting Progression-Free Survival for Patients With Stage II - III Thoracic Esophageal Squamous Cell Carcinoma Who Are Treated With Definitive Chemoradiotherapy==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36794365 Acta Oncol. 2023 Feb;62(2):159-65. PMID: 36794365]

'''Authors:''' Takahashi N, Tanaka S, Umezawa R, Takanami K, Takeda K, Yamamoto T, Suzuki Y, Katsuta Y, Kadoya N, Jingu K.

'''Institution:''' Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Japan.

'''Abstract:'''
'''Background:''' Radiomics is a method for extracting a large amount of information from images and used to predict treatment outcomes, side effects and diagnosis. In this study, we developed and validated a radiomic model of [18F]FDG-PET/CT for predicting progression-free survival (PFS) of definitive chemoradiotherapy (dCRT) for patients with esophageal cancer.

'''Material and Methods:''' Patients with stage II - III esophageal cancer who underwent [18F]FDG-PET/CT within 45 days before dCRT between 2005 and 2017 were included. Patients were randomly assigned to a training set (85 patients) and a validation set (45 patients). Radiomic parameters inside the area of standard uptake value ≥ 3 were calculated. The open-source software [http://www.slicer.org '''3D Slicer'''] and Pyradiomics were used for segmentation and calculating radiomic parameters, respectively. Eight hundred sixty radiomic parameters and general information were investigated.In the training set, a radiomic model for PFS was made from the LASSO Cox regression model and Rad-score was calculated. In the validation set, the model was applied to Kaplan-Meier curves. The median value of Rad-score in the training set was used as a cutoff value in the validation set. JMP was used for statistical analysis. RStudio was used for the LASSO Cox regression model. p < 0.05 was defined as significant.

'''Results:''' The median follow-up periods were 21.9 months for all patients and 63.4 months for survivors. The 5-year PFS rate was 24.0%. In the training set, the LASSO Cox regression model selects 6 parameters and made a model. The low Rad-score group had significantly better PFS than that the high Rad-score group (p = 0.019). In the validation set, the low Rad-score group had significantly better PFS than that the high Rad-score group (p = 0.040).

'''Conclusions:''' The [18F]FDG-PET/CT radiomic model could predict PFS for patients with esophageal cancer who received dCRT.
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==Minimizing Magnetic Resonance Image Geometric Distortion at 7 Tesla for Frameless Presurgical Planning Using Skin-Adhered Fiducials==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36301228 Med Phys. 2023 Feb;50(2):694-701. PMID: 36301228]

'''Authors:''' Kirby KM, Koons EK, Welker KM, Fagan AJ.

'''Institution:''' Department of Radiology, Mayo Clinic, Rochester, MN, USA.

'''Abstract:'''
'''Background:''' 7T MRI offers significant benefits to spatial and contrast resolution compared to lower field strengths. This superior image quality can help better delineate targets in stereotactic neurosurgical procedures; however, the potential for increased geometric distortions at 7T has impaired its widespread use for these applications. Image geometric distortions can be due to distortions of B0 arising from tissue magnetic susceptibility effects or inherent field inhomogeneities, and nonlinearity of the magnetic field gradients.

'''Purpose:''' The purpose of this study was to investigate the use of 7T MRI for neurosurgical frameless stereotactic navigation procedures. Image geometric distortions at the skin surface in 7T images were minimized and compared to results from clinical 3T frameless imaging protocols.

'''Methods:''' A 3D-printed grid phantom filled with oil was designed to perform a fine calibration of the 7T imaging gradients, and an oil-filled head phantom with internal targets was used to determine ground truth (from computed tomography [CT]) positioning errors. Three volunteers and the head phantom were imaged consecutively at 3T and 7T. Ten skin-adhesive fiducial markers were placed on each subject's exposed skin surface at standard clinical placement locations for frameless procedures. Imaging sequences included MPRAGE (three bandwidths at 7T: 400, 690, and 1020 Hz/pixel, and one at 3T: 400 Hz/pixel), T2 SPACE, and T2 SPACE FLAIR acquisitions. An additional GRE field map was acquired on both scanners using a multi-echo GRE sequence. Custom Matlab code was used to perform additional distortion correction of the images using the unwrapped field maps. Fiducial localization was performed with [http://www.slicer.org '''3D Slicer'''], with absolute fiducial positioning errors determined in phantom experiments following rigid registration to the CT images. For human experiments, 3T and 7T images were registered and relative differences in fiducial locations were compared using two-tailed paired t-tests.

'''Results:''' Phantom measurements at 7T yielded gradient distance scaling errors of 1.1%, 2.2%, and 1.0% along the x-, y-, and z-axes, respectively. These system miscalibrations were traced back to phantom manufacturing deviations in the sphericity of the vendor's gradient calibration phantom. Correction factors along each gradient axis were applied, and afterward, geometric distortions of less than 1 mm were obtained in the 7T MR head phantom images for the 1020 Hz/pixel bandwidth MPRAGE sequence. For the human subjects, four fiducial locations were excluded from the analysis due to patient positioning differences. Differences between 3T and 7T MPRAGE with low/medium/high bandwidth were 2.2 /2.6/2.3 mm, respectively, before the correction, reducing to 1.6/1.3/1.0 mm after the correction (p < 0.001). T2 SPACE and T2 SPACE FLAIR yielded a similar pattern when the correction was applied, decreasing from 2.1 to 0.8 mm, and 2.6 to 1.0 mm, respectively.

'''Conclusions:''' 7T MRI can be used to perform frameless presurgical planning with skin-adhesive fiducials. Geometric distortions can be reduced to a clinically relevant level (errors < ∼1 mm) with no significant susceptibility-related distortions, by using high receiver bandwidth, ensuring gradients are properly calibrated, and placing skin fiducials in areas where distortions from patient positioning are minimal.
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==Acute Colonic Pseudo-Obstruction Secondary to Renal Calculus: A Case Report and Review of Pathophysiology==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36777972 Cureus. 2023 Feb 7;15(2):e34756. PMID: 36777972] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9905947/pdf/cureus-0015-00000034756.pdf PDF]

'''Authors:''' Gillies M, AlDujaili T.

'''Institution:''' General Surgery, Goulburn Valley Health, Shepparton, Australia

'''Abstract:''' Acute colonic pseudo-obstruction (ACPO) is obstruction of the large bowel without a mechanical cause. The exact mechanism remains incompletely understood but is thought to result from disruption to the autonomic regulation of the colon, typically in the context of hospitalized patients with medical illness, precipitating medications, or recent surgical intervention. This paper presents an unusual case of ACPO in an ambulatory patient with a recently passed renal calculus, explores the anatomy and physiology underlying the autonomic dysfunction theory of ACPO pathogenesis in the context of the case, and provides a 3D reconstruction of the patient's CT to illustrate the abrupt caliber change at the splenic flexure characteristic of ACPO.

'''Keywords:''' 3d reconstruction; acute colonic pseudo-obstruction; ogilvie's syndrome; renal calculi; [http://www.slicer.org '''3D Slicer'''] software.
|}

==A Novel Stereotactic Aspiration Technique for Intracerebral Hemorrhage==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36270590 World Neurosurg. 2023 Feb;170:e28-e36. PMID: 36270590]

'''Authors:''' Xu HZ, Guo J, Wang C, Liu X, Song ZQ, Chen RF, Qiu B, Wang Q, Huang Y.

'''Institution:''' Department of Neurosurgery, Civil Aviation General Hospital, Beijing, China.

'''Abstract:'''

'''Background:''' Minimally invasive surgery is effective and recommended for treatment of intracerebral hemorrhage; however, neurosurgeons in grass-root hospitals in underdeveloped countries lack effective and precise minimally invasive surgery techniques. The aim of this study was to present a technique of computed tomography angiography-based three-dimensional-printed navigation mold-guided stereotactic aspiration and demonstrate its clinical application using a hard needle in a series of patients.

'''Methods:''' The novel stereotactic aspiration technique was performed in 18 patients with spontaneous intracerebral hemorrhage at our center, and clinical outcomes were reported. We compared the volume of hematoma measured by 3 different methods: ABC/2 formula, manual segmentation with OsiriX, and manual segmentation with [http://www.slicer.org '''3D Slicer'''].

'''Results:''' The surgery was completed safely within an average operative time of 15.11 minutes, achieving the goal of <15 mL residual clot volume or >70% clot removal in all patients. No intracranial rebleeding or infection was observed postoperatively. At the end of the 6-month follow-up, 61.11% (11/18) of patients achieved a modified Rankin Scale score <3. There was overall better agreement of hematoma measurement using segmentation with [http://www.slicer.org '''3D Slicer'''] rather than ABC/2 measurement or hematoma measurement using segmentation with OsiriX.

'''Conclusions:''' Our novel method of stereotactic aspiration benefited patients in this study with good percent clot removal, few surgery-related complications, and a favorable prognosis. Manual segmentation with [http://www.slicer.org '''3D Slicer'''] could be used to provide the neurosurgeon with dependable information about hematoma volume. This cheap and convenient technique may be applied in grass-root hospitals in underdeveloped countries. Assessment in multicenter prospective clinical trials is needed.
|}

==Morphological Evaluation of the Normal and Hydrocephalic Third Ventricle on Cranial Magnetic Resonance Imaging in Children: A Retrospective Study==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35994062 Pediatr Radiol. 2023 Feb;53(2):282-96. PMID: 35994062]

'''Authors:''' Isıklar S, Turan Ozdemir S, Ozkaya G, Ozpar R, Parlak M.

'''Institution:''' Medical Imaging Techniques Program, Vocational School of Health Services, Bursa Uludag University, 16240, Bursa, Turkey.

'''Abstract:'''
'''Background:''' Third ventricle morphological changes reflect changes in the ventricular system in pediatric hydrocephalus, so visual inspection of the third ventricle shape is standard practice. However, normal pediatric reference data are not available.

'''Objective:''' To investigate both the normal development of the third ventricle in the 0-18-year age group and changes in its biometry due to hydrocephalus.

'''Materials and Methods:''' For this retrospective study, we selected individuals ages 0-18 years who had magnetic resonance imaging (MRI) from 2012 to 2020. We included 700 children (331 girls) who had three-dimensional (3-D) T1-weighted sequences without and 25 with hydrocephalus (11 girls). We measured the distances between the anatomical structures limiting the third ventricle by dividing the third ventricle into anterior and posterior regions. We made seven linear measurements and three index calculations using 3DSlicer and MRICloud pipeline, and we analyzed the results of 23 age groups in normal and hydrocephalic patients using SPSS (v. 23).

'''Results:''' Salient findings are: (1) The posterior part of the third ventricle is more affected by both developmental and hydrocephalus-related changes. (2) For third ventricle measurements, gender was insignificant while age was significant. (3) Normal third ventricular volumetric development showed a segmental increase in the 0-18 age range. The hydrocephalic third ventricle volume cut-off value in this age group was 3 cm3.

'''Conclusion:''' This study describes third ventricle morphometry using a linear measurement method. The ratios defined in the midsagittal plane were clinically useful for diagnosing the hydrocephalic third ventricle. The linear and volumetric reference data and ratios are expected to help increase diagnostic accuracy in distinguishing normal and hydrocephalic third ventricles.
|}

==Henri IV of France's Larynx 3D Reconstitution==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36149490 Eur Arch Otorhinolaryngol. 2023 Feb;280(2):919-24. PMID: 36149490]

'''Authors:''' Baudouin R, Amelot A, Laprie Y, Crevier-Buchman L, Maeda S, Huynh-Charlier I, Hans S, Charlier P.

'''Institution:''' Department of Otolaryngology-Head & Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Université Paris Saclay), Montigny-le-Bretonneux, France.

'''Abstract:''' Objectives: King Henri IV of France (reign from 1589 to 1610) was one of the most important kings of France. Embalmed and buried in Saint-Denis, his remains were beheaded in 1793. His head (including his larynx) survived in successive private collections until its definitive identification in 2010. The purpose of the study was to provide a morphologic study of the larynx with a 3D reconstitution.

'''Methods:''' A flexible endoscopy was performed via the mouth and via the trachea. Measures of the larynx (vocal folds lengths, thickness, width, larynx height) were collected from the CT-scan by a panel of experts blind each other. The segmentation of the laryngeal anatomical components (vocal folds, cartilages) was performed using [http://www.slicer.org '''3D Slicer''']. Mesh smoothing and 3D reconstitution were performed using Fusion 360®. Reconstitution was discussed between the experts. Decision was made by consensus after discussion.

'''Results:''' Cricoid, thyroid, arytenoid cartilages, vocal folds and hyoid bone were identified and a computed 3D reconstitution of the larynx was made. The laryngeal 3D model appeared morphologically similar to a living subject. Measures were similar but smaller than those of a modern subject.

'''Conclusions:''' The 3D reconstitution of the larynx of Henri IV of France was conducted from the CT-scan of his mummified head. This work constitutes a first valuable morphologic analysis of a larynx from an embalmed individual. This anatomical work is the first step towards the reconstruction of the voice of this historical character, which we hope to concretize with computer modeling tools in a second step.
|}

==Development and External Validation of a Novel Nomogram to Predict Prostate Cancer in Biopsy-Naïve Patients With PSA <10 Ng/Ml and PI-RADS v2.1 = 3 Lesions==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35920264 Cancer Med. 2023 Feb;12(3):2560-71. PMID: 35920264] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9939143/pdf/CAM4-12-2560.pdf PDF]

'''Authors:''' Hu C, Sun J, Xu Z, Zhang Z, Zhou Q, Xu J, Chen H, Wang C, Ouyang J.

'''Institution:''' Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.

'''Abstract:'''
'''Objective:''' To develop and externally validate a novel nomogram in biopsy-naïve patients with prostate-specific antigen (PSA) <10 ng/ml and PI-RADS v2.1 = 3 lesions.

'''Methods:''' We retrospectively collected 307 men that underwent initial biopsy from October 2015 to January 2022 in Cohort 1 (The First Affiliated Hospital of Soochow University). External cohort (Cohort 2, Kunshan Hospital) included 109 men that met our criteria from July 2016 to June 2021. By [http://www.slicer.org '''3D Slicer'''] Software, the volume of all lesions was divided into two subgroups (PI-RADS v2.1 = 3a and 3b). Logistic regression analysis was performed to screen for variables and construct nomogram by analyzing clinical data from Cohort 1. Receiver operating characteristics curve analysis, calibration plot and decision curve analysis (DCA) were plotted to validate the nomogram in external cohort.

'''Results:''' A total of 70 (22.8%) patients was diagnosed with prostate cancer in Institution 1. Among them, 34 (11.1%) had clinically significant prostate cancer (csPCa). Age, prostate-specific antigen density, digital rectal examination, PI-RADS v2.1 = 3 subgroups (3a and 3b) and apparent diffusion coefficient (ADC, <750 mm2 /s) were predictive factors for prostate cancer (PCa) and csPCa. High area under the curve of the nomogram was found in Cohort 1 and Cohort 2 for PCa (0.857 vs. 0.850) and for csPCa (0.896 vs. 0.893). Calibration curves showed excellent agreement between the predicted probability and actual risk for the models in internal and external validation. The DCA demonstrated net benefit of our nomogram.

'''Conclusion:''' Until now, this is the first nomogram that predicts PCa and csPCa in biopsy-naïve patients with PSA <10 ng/ml and PI-RADS v2.1 = 3 lesions. Furthermore, PI-RADS v2.1 = 3 subgroups were considered to be an independent risk factor in our model. Our nomogram may assist urologists in biopsy decision making for these so-called "double gray zone" patients.
|}

==A Three-Dimensionally Printed Otological Model for Cholesteatoma Mastoidectomy Training==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35789285 Eur Arch Otorhinolaryngol. 2023 Feb;280(2):671-80. PMID: 35789285]

'''Authors:''' de Souza MA, Bento RF, Lopes PT.

'''Institution:''' Otolaryngology Department, University of São Paulo School of Medicine, São Paulo, Brazil.

'''Abstract:'''
'''purpose:''' To relate the creation and expert validation (face and content validity) of an affordable three-dimensional (3D) printed model of temporal bones with chronic otitis media with cholesteatoma (COMC) as a simulator for mastoidectomy.

'''Methods:''' We performed computed tomography (CT) of the temporal bones of a patient with COMC followed at the University of São Paulo (USP) Hospital with [http://www.slicer.org '''3D Slicer'''] to create a 3-D model of the affected bone using light-curing resin and silicone (cholesteatoma). The final 3-D printed images were scored by 10 otologists using a customized version of the Michigan Standard Simulation Scale Experience (MiSSES). Internal consistency and inter-rater reliability were assessed using Cronbach's α and intraclass correlations.

'''Results:''' Otologists consistently scored the model positively for fidelity, educational value, reactions, and the overall model quality. Nine otologists agreed that the model was a good educational device for surgical training of COMC. All experts deemed the model ready-or nearly ready-for use. The final cost of the model, including raw materials and manufacturing, was 120 USD.

'''Conclusions:''' Using 3D printing technology, we created the first anatomically accurate, low-cost, disease-reproducing 3D model of temporal bones for mastoidectomy training for cholesteatoma.
|}

==Development of a Navigable 3D Virtual Model of Temporal Bone Anatomy==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36704866 J Vis Commun Med. 2023 Jan 26:1-5. PMID: 36704866] | [https://www.tandfonline.com/doi/full/10.1080/17453054.2023.2169110 PDF]

'''Authors:''' Sareen K.

'''Institution:''' Sant Parmanand Hospital, New Delhi, India.

'''Abstract:'''
'''Background:''' Computed Tomography (CT) scanning offers an accurate structural definition of bones, blood vessels, and soft tissues; however, mental integration of cross-sectional 2D CT images for a 3D understanding of complex anatomical structures becomes difficult when the field of view is confined to the temporal bone. This project tried to provide a feasible solution to this problem by creating a navigable 3D virtual model which may aid in better comprehension of the temporal bone anatomy.

'''Methods:''' A helical-CT scan was used to obtain high-resolution cross-sectional slices of a cadaveric human temporal bone. Using the volume-rendering capabilities of [http://www.slicer.org '''3D Slicer'''], which involves volume data management, cropping of the data set, and threshold painting, detailed anatomical structures were segmented based on the intensity captured from different regions. This volumetric data was converted to an interactive virtual model using Blender®.

'''Results:''' The final product is a web page that allows interaction and navigation with a 3D annotated model of the temporal bone, which can be accessed from any device with a web browser.

'''Conclusion:''' This model can function as a training tool for students, teachers, and practitioners to understand and review the complex anatomy of the temporal bone.
|}

==Maxillary Antral Pseudocyst Drift after Osteotome Sinus Floor Elevation with Simultaneous Implant Placement: A Case Report and Literature Review==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36769568 J Clin Med. 2023 Jan 24;12(3):920. PMID: 36769568] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9917374/pdf/jcm-12-00920.pdf PDF]

'''Authors:''' Wang P, Huang N, Ren J, Gong P, Long J, Huang B.

'''Institution:''' West China School of Stomatology, Sichuan University, Chengdu, China.

'''Abstract:''' This report describes maxillary antral pseudocyst drift after maxillary sinus floor augmentation through osteotome sinus floor elevation with simultaneous implant placement. [http://www.slicer.org '''3D Slicer'''] was used to measure the pseudocyst and maxilla for the placement of the implants; follow-up visits were scheduled at 6, 12, and 22 months. No adverse effects were observed during or after surgery, and all implants exhibited osseointegration without mobility. At 6 months after surgery, the pseudocyst had moved posterolaterally from the preoperative position near the anterior medial maxillary sinus, then returned to its original position at 12 months. However, it had remigrated to the posterolateral position at 22 months. The preoperative volume of the pseudocyst was 3.795 mm3; it was 2.370, 3.439, and 2.930 mm3 at 6, 12, and 22 months after surgery, respectively. The changes in pseudocyst drift and volume did not have a substantial negative influence on the implants, presumably because of cystic attachment and the recurrence of multiple pseudocysts at different locations. The risks associated with changes in a pseudocyst can be avoided, if an appropriate treatment plan is selected.
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==Radiomic Analysis Based on Magnetic Resonance Imaging for Predicting PD-L2 Expression in Hepatocellular Carcinoma==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36672315 Cancers (Basel). 2023 Jan 5;15(2):365. PMID: 36672315] | [http://www.ncbi.nlm.nih.gov/pmc/articles/pmc9856314/ PDF]

'''Authors:''' Tao YY, Shi Y, Gong XQ, Li L, Li ZM, Yang L, Zhang XM.

'''Institution:''' Medical Imaging Key Laboratory of Sichuan Province, Interventional Medical Center, Department of Radiology, Medical Research Center, Affiliated Hospital of North Sichuan Medical College, Nanchong, China.

'''Abstract:''' Hepatocellular carcinoma (HCC) is the sixth most common malignant tumour and the third leading cause of cancer death in the world. The emerging field of radiomics involves extracting many clinical image features that cannot be recognized by the human eye to provide information for precise treatment decision making. Radiomics has shown its importance in HCC identification, histological grading, microvascular invasion (MVI) status, treatment response, and prognosis, but there is no report on the preoperative prediction of programmed death ligand-2 (PD-L2) expression in HCC. The purpose of this study was to investigate the value of MRI radiomic features for the non-invasive prediction of immunotherapy target PD-L2 expression in hepatocellular carcinoma (HCC). A total of 108 patients with HCC confirmed by pathology were retrospectively analysed. Immunohistochemical analysis was used to evaluate the expression level of PD-L2. [http://www.slicer.org '''3D Slicer'''] software was used to manually delineate volumes of interest (VOIs) and extract radiomic features on preoperative T2-weighted, arterial-phase, and portal venous-phase MR images. Least absolute shrinkage and selection operator (LASSO) was performed to find the best radiomic features. Multivariable logistic regression models were constructed and validated using fivefold cross-validation. The area under the receiver characteristic curve (AUC) was used to evaluate the predictive performance of each model. The results show that among the 108 cases of HCC, 50 cases had high PD-L2 expression, and 58 cases had low PD-L2 expression. Radiomic features correlated with PD-L2 expression. The T2-weighted, arterial-phase, and portal venous-phase and combined MRI radiomics models showed AUCs of 0.789 (95% CI: 0.702-0.875), 0.727 (95% CI: 0.632-0.823), 0.770 (95% CI: 0.682-0.875), and 0.871 (95% CI: 0.803-0.939), respectively. The combined model showed the best performance. The results of this study suggest that prediction based on the radiomic characteristics of MRI could noninvasively predict the expression of PD-L2 in HCC before surgery and provide a reference for the selection of immune checkpoint blockade therapy.
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==Correlation Between Unilateral Internal Carotid Artery Stenosis and Asymmetric Distribution of Enlarged Perivascular Spaces in Patients With Acute Cerebral Infarction==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36649988 Zhonghua Yi Xue Za Zhi. 2023 Jan 17;103(3):178-185. PMID: 36649988]

'''Authors:''' Jian XL, Zhang M, Yun WW.

'''Abstract:'''
'''Objective:''' To explore the correlation between unilateral internal carotid artery (ICA) stenosis and asymmetrical distribution of enlarged perivascular spaces (EPVS) in patients with acute cerebral infarction.

'''Methods:''' Acute cerebral infarction patients with unilateral ICA stenosis hospitalized in Changzhou Second People's Hospital from October 2020 to December 2021 were collected. Routine cranial MRI and CT angiography were completed for each patient. The [http://www.slicer.org '''3D Slicer'''] software was used to quantitatively analyze the volume of patient's EPVS. Patients were divided into moderate stenosis group and severe stenosis/occlusion group according to the degree of ICA stenosis. Baseline data were compared between the two groups. Patients were further divided into three groups: moderate stenosis, severe stenosis and occlusion groups, and the ipsilateral and contralateral EPVS volume of ICA stenosis patients was compared. The asymmetry index (AI) was calculated for EPVS in the basal ganglia region (BG-EPVS) and EPVS in the centrum semiovale (CSO-EPVS). Patients with AI≥0.2 were included in the EPVS asymmetry group, while the rest were in the EPVS symmetry group, and the degree of unilateral ICA stenosis was compared between the two groups. Multivariate logistic regression model was used to analyze the relationship between ICA severe stenosis/occlusion and the asymmetric distribution of BG-EPVS.

'''Results:''' A total of 122 patients (96 males and 26 females) were enrolled, aged (70±10) years, with 81 cases in the unilateral ICA severe stenosis/occlusion group (46 cases of severe stenosis and 35 of occlusion) and 41 cases in the moderate stenosis group. Patients in the unilateral ICA severe stenosis/occlusion group had greater BG-EPVS volume [(4.08±0.76) mm3]and proportion of asymmetric distribution of BG-EPVS [75.3%(61/81)] than those of the moderate stenosis group [(3.12±0.85) mm3 and 39.0% (16/41)], with statistically significant differences (both P<0.001). The BG-EPVS volumes of the ipsilateral side of the stenosis in the severe stenosis group and the occlusion group [(3.34±0.86) mm3 and (3.93±0.60) mm3] were significantly greater than those of the contralateral side [(2.65±1.28) mm3 and (3.21±0.88) mm3], with statistically significant differences (both P<0.001). Correlation analysis indicated that the degree of unilateral ICA stenosis was positively correlated with the BG-EPVS volume on the stenosis side (r=0.62, P<0.001). Further comparison of the degree of unilateral ICA stenosis between the EPVS symmetric and asymmetric groups showed that the proportion of unilateral ICA severe stenosis/occlusion in the BG-EPVS asymmetry group was higher than that in the symmetric group [79.2%(61/77) vs 44.4%(20/45),P<0.001]. Multivariate logistic regression analysis showed that unilateral ICA severe stenosis/occlusion (OR=4.280, 95%CI: 1.743-10.508, P =0.002) and age (OR=1.055, 95%CI: 1.001-1.112, P=0.044) were risk factors for asymmetric distribution of BG-EPVS.

'''Conclusions:''' The severe stenosis/occlusion of the unilateral ICA and age are the risk factors for the asymmetric distribution of the BG-EPVS in patients with acute cerebral infarction. The ipsilateral EPVS volume of unilateral ICA stenosis is larger than that of the contralateral side, and the degree of ICA stenosis is positively correlated with the severity of BG-EPVS.
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==Radiomics to Predict the Mortality of Patients With Rheumatoid Arthritis-Associated Interstitial Lung Disease: A Proof-of-Concept Study==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36698825 Front Med (Lausanne). 2023 Jan 9;9:1069486. PMID: 36698825] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9870287/pdf/fmed-09-1069486.pdf PDF]

'''Authors:''' Venerito V, Manfredi A, Lopalco G, Lavista M, Cassone G, Scardapane A, Sebastiani M, Iannone F.

'''Institution:''' Rheumatology Unit, Department of Emergency and Organ Transplantation, University of Bari Aldo Moro, Bari, Italy.

'''Abstract:''' Objectives: Patients with rheumatoid arthritis (RA) and interstitial lung disease (ILD) have increased mortality compared to the general population and factors capable of predicting RA-ILD long-term clinical outcomes are lacking. In oncology, radiomics allows the quantification of tumour phenotype by analysing the characteristics of medical images. Using specific software, it is possible to segment organs on high-resolution computed tomography (HRCT) images and extract many features that may uncover disease characteristics that are not detected by the naked eye. We aimed to investigate whether features from whole lung radiomic analysis of HRCT may alone predict mortality in RA-ILD patients.

'''Methods:''' High-resolution computed tomographies of RA patients from January 2012 to March 2022 were analyzed. The time between the first available HRCT and the last follow-up visit or ILD-related death was recorded. We performed a volumetric analysis in [http://www.slicer.org '''3D Slicer'''], automatically segmenting the whole lungs and trachea via the Lung CT Analyzer. A LASSO-Cox model was carried out by considering ILD-related death as the outcome variable and extracting radiomic features as exposure variables.

'''Results:''' We retrieved the HRCTs of 30 RA-ILD patients. The median survival time (interquartile range) was 48 months (36-120 months). Thirteen out of 30 (43.33%) patients died during the observation period. Whole line segmentation was fast and reliable. The model included either the median grey level intensity within the whole lung segmentation [high-resolution (HR) 9.35, 95% CI 1.56-55.86] as a positive predictor of death and the 10th percentile of the number of included voxels (HR 0.20, 95% CI 0.05-0.84), the voxel-based pre-processing information (HR 0.23, 95% CI 0.06-0.82) and the flatness (HR 0.42, 95% CI 0.18-0.98), negatively correlating to mortality. The correlation of grey level values to their respective voxels (HR 1.52 95% CI 0.82-2.83) was also retained as a confounder.

'''Conclusion:''' Radiomic analysis may predict RA-ILD patients' mortality and may promote HRCT as a digital biomarker regardless of the clinical characteristics of the disease.
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==Evaluation of the Prognosis of Acute Subdural Hematoma According to the Density Differences Between Gray and White Matter==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36686517 Front Neurol. 2023 Jan 6;13:1024018. PMID: 36686517] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9853902/ PDF]

'''Authors:''' Li Z, Feng Y, Wang P, Han S, Zhang K, Zhang C, Lu S, Lv C, Zhu F, Bie L.

'''Institution:''' Department of Neurosurgery of the First Clinical Hospital, Jilin University, Changchun, China.

'''Abstract:'''
'''Objective:''' Acute subdural hematoma (ASDH) is a common neurological emergency, and its appearance on head-computed tomographic (CT) imaging helps guide clinical treatment. To provide a basis for clinical decision-making, we analyzed that the density difference between the gray and white matter of the CT image is associated with the prognosis of patients with ASDH.

'''Methods:''' We analyzed the data of 194 patients who had ASDH as a result of closed traumatic brain injury (TBI) between 2018 and 2021. The patients were subdivided into surgical and non-surgical groups, and the non-surgical group was further subdivided into "diffused [hematoma]" and "non-diffused" groups. The control group's CT scans were normal. The [http://www.slicer.org '''3D Slicer'''] software was used to quantitatively analyze the density of gray and white matter depicted in the CT images.

'''Results:''' Imaging evaluation showed that the median difference in density between the gray and white matter on the injured side was 4.12 HU (IQR, 3.91-4.22 HU; p < 0.001) and on the non-injured side was 4.07 HU (IQR, 3.90-4.19 HU; p < 0.001), and the hematoma needs to be surgically removed. The median density difference value of the gray and white matter on the injured side was 3.74 HU (IQR, 3.53-4.01 HU; p < 0.001) and on the non-injured side was 3.71 HU (IQR, 3.69-3.73 HU; p < 0.001), and the hematoma could diffuse in a short time.

'''Conclusion:''' Quantitative analysis of the density differences in the gray and white matter of the CT images can be used to evaluate the clinical prognosis of patients with ASDH.
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==The Knosp Criteria Revisited: 3-Dimensional Volumetric Analysis as a Predictive Tool for Extent of Resection in Complex Endoscopic Pituitary Surgery==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36170168 Front Oncol. Neurosurgery. 2023 Jan 1;92(1):179-85. PMID: 36170168]

'''Authors:''' DiRisio AC, Feng R, Shuman WH, Platt S, Price G, Dullea JT, Gilja S, D'Andrea MR, Delman BN, Bederson JB, Shrivastava RK.

'''Institution:''' Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.

'''Abstract:'''
'''Background:''' The Knosp criteria have been the historical standard for predicting cavernous sinus invasion, and therefore extent of surgical resection, of pituitary macroadenomas. Few studies have sought to reappraise the utility of this tool after recent advances in visualization and modeling of tumors in complex endoscopic surgery.

'''Objective:''' To evaluate our proposed alternative method, using 3-dimensional (3D) volumetric imaging, and whether it can better predict extent of resection in nonfunctional pituitary adenomas.

'''Methods:''' Patients who underwent endoscopic transsphenoidal resection of pituitary macroadenomas at our institution were reviewed. Information was collected on neurological, endocrine, and visual function. Volumetric segmentation was performed using [http://www.slicer.org '''3D Slicer'''] software. Relationship of tumor volume, clinical features, and Knosp grade on extent of resection was examined.

'''Results:''' One hundred forty patients were identified who had transsphenoidal resection of nonfunctional pituitary adenomas. Macroadenomas had a median volume of 6 cm3 (IQR 3.4-8.7), and 17% had a unilateral Knosp grade of at least 3B. On multiple logistic regression, only smaller log-transformed preoperative tumor volume was independently associated with increased odds of gross total resection (GTR; odds ratio: 0.27, 95% CI: 0.07-0.89, P < .05) when controlling for tumor proliferative status, age, and sex (area under the curve 0.67). The Knosp criteria did not independently predict GTR in this cohort (P > .05, area under the curve 0.46).

'''Conclusion:''' Increasing use of volumetric 3D imaging may better anticipate extent of resection compared with the Knosp grade metric and may have a greater positive predictive value for GTR. More research is needed to validate these findings and implement them using automated methods.
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==Differentiation of Lung Metastases Originated From Different Primary Tumors Using Radiomics Features Based on CT Imaging==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35577699 Acad Radiol. 2023 Jan;30(1):40-6. PMID: 35577699]

'''Authors:''' Shang H, Li J, Jiao T, Fang C, Li K, Yin D, Zeng Q.

'''Institution:''' Department of Radiology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, No. 16766 Jingshi Road, Jinan, Shandong, China.

'''Abstract:''' Rationale and objectives: To explore the feasibility of differentiating three predominant metastatic tumor types using lung computed tomography (CT) radiomics features based on supervised machine learning.

'''Materials and Methods:''' This retrospective analysis included 252 lung metastases (LM) (from 78 patients), which were divided into the training (n = 176) and test (n = 76) cohort randomly. The metastases originated from colorectal cancer (n = 97), breast cancer (n = 87), and renal carcinoma (n = 68). An additional 77 LM (from 35 patients) were used for external validation. All radiomics features were extracted from lung CT using an open-source software, [http://www.slicer.org '''3D Slicer''']. The least absolute shrinkage and selection operator (LASSO) method selected the optimal radiomics features to build the model. Random forest and support vector machine (SVM) were selected to build three-class and two-class models. The performance of the classification model was evaluated with the area under the receiver operating characteristic curve (AUC) by two strategies: one-versus-rest and one-versus-one.

'''Results:''' Eight hundred and fifty-one quantitative radiomics features were extracted from lung CT. By LASSO, 23 optimal features were extracted in three-class, and 25, 29, and 35 features in two-class for differentiating every two of three LM (colorectal cancer vs. renal carcinoma, colorectal cancer vs. breast cancer, and breast cancer vs. renal carcinoma, respectively). The AUCs of the three-class model were 0.83 for colorectal cancer, 0.79 for breast cancer, and 0.91 for renal carcinoma in the test cohort. In the external validation cohort, the AUCs were 0.77, 0.83, and 0.81, respectively. Swarmplot shows the distribution of radiomics features among three different LM types. In the two-class model, high accuracy and AUC were obtained by SVM. The AUC of discriminating colorectal cancer LM from renal carcinoma LM was 0.84, and breast cancer LM from colorectal cancer LM and renal carcinoma LM were 0.80 and 0.94, respectively. The AUCs were 0.77, 0.78, and 0.84 in the external validation cohort.

'''Conclusion:''' Quantitative radiomics features based on Lung CT exhibited good discriminative performance in LM of primary colorectal cancer, breast cancer, and renal carcinoma.
|}

==MRI Radiomic Features of Peritumoral Edema May Predict the Recurrence Sites of Glioblastoma Multiforme==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36686829 Front Oncol. 2023 Jan 4;12:1042498. PMID: 36686829] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9845721/pdf/fonc-12-1042498.pdf PDF]

'''Authors:''' Long H, Zhang P, Bi Y, Yang C, Wu M, He D, Huang S, Yang K, Qi S, Wang J.

'''Institution:''' Department of Neurosurgery, Nanfang Hospital, Southern Medical University, Guangzhou, China.

'''Abstract:'''

'''Background and Purpose:''' As one of the most aggressive malignant tumor in the central nervous system, the main cause of poor outcome of glioblastoma (GBM) is recurrence, a non-invasive method which can predict the area of recurrence pre-operation is necessary.To investigate whether there is radiological heterogeneity within peritumoral edema and identify the reproducible radiomic features predictive of the sites of recurrence of glioblastoma(GBM), which may be of value to optimize patients' management.

'''Materials and Methods:''' The clinical information and MR images (contrast-enhanced T1 weighted and FLAIR sequences) of 22 patients who have been histologically proven glioblastoma, were retrospectively evaluated. Kaplan-Meier methods was used for survival analysis. Oedematous regions were manually segmented by an expert into recurrence region, non-recurrence region. A set of 94 radiomic features were obtained from each region using the function of analyzing MR image of [http://www.slicer.org '''3D Slicer''']. Paired t test was performed to identify the features existing significant difference. Subsequently, the data of two patients from TCGA database was used to evaluate whether these features have clinical value.

'''Results:''' Ten features with significant differences between the recurrence and non-recurrence subregions were identified and verified on two individual patients from the TCGA database with pathologically confirmed diagnosis of GBM.

'''Conclusions:''' Our results suggested that heterogeneity does exist in peritumoral edema, indicating that the radiomic features of peritumoral edema from routine MR images can be utilized to predict the sites of GBM recurrence. Our findings may further guide the surgical treatment strategy for GBM.
|}

==Clinical Study on Application of 3D Slicer Software Assisted Domestic Frameless Stereotactic Robot in Biopsy of Intracranial Lesions==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36603886 Zhonghua Wai Ke Za Zhi. 2023 Jan 1;61(1):61-65. PMID: 36603886] | [http://www.ncbi.nlm.nih.gov/pmc/articles/pmc9849352/ PDF]

'''Authors:''' Chen H, Yan X, He F, Ding SC, Diao JF, Guo H, Cao SM, Yang CJ, Yin F.

'''Institution:''' Department of Neurosurgery, Aerospace Central Hospital, Beijing, China.

'''Abstract:'''
'''Objective:''' To examine the application value of [http://www.slicer.org '''3D Slicer'''] software assisted domestic frameless stereotactic robot in biopsy of intracranial lesions.

'''Methods:''' A retrospective analysis was performed on 80 patients who admitted consecutively and underwent intracerebral lesions biopsy with the domestic frameless stereotactic robot at Department of Neurosurgery, Aerospace Central Hospital from January 2019 to December 2021. There were 36 males and 44 females, with a mean age of (38.5±18.0) years (range: 6 to 71 years). Before surgery only enhanced T1-weighted three-dimensional magnetization prepared gradient echo sequences and diffusion tensor imaging scans were performed. Self-reconstruction of intracranial lesions, cerebral cortex and blood vessels was carried out using 3D Slicer software system after the DICOM format imaging data of 80 patients were collected. These imaging data were merged to the workstation of the domestic frameless stereotactic robot for preoperative surgical planning and the surgical puncture path was designed to avoid blood vessels in the brain functional area, cerebral cortex and sulcus.

'''Results:''' All frameless stereotactic biopsy were successfully performed. Postoperative pathological diagnosis included 50 cases of diffuse astrocytic and oligodendroglioma, 15 cases of lymphoma, 5 cases of metastatic tumors, 5 cases of inflammatory demyelinating disease, 2 cases of inflammatory granuloma, 1 case of hemangioma, 1 case of acute lymphoblastic leukemia intracranial invasion and 1 case of seminoma. The positive diagnosis rate was 100% (80/80). Postoperative imaging confirmed that the puncture path and target were accurately implemented according to the preoperative planning, and the target error was (1.32±0.44) mm (range: 0.55 to 1.99 mm). One case of puncture-related bleeding occurred at the target after surgery and improved after treatment.

'''Conclusion:''' The three-dimensional multimodal images reconstructed by the 3D Slicer software before operation could help the surgeons make the preoperative planning and reduce the risk of stereotactic brain biopsy.
|}

==Liver Cirrhosis and Tumor Location Can Affect the Range of Intrahepatic Microwave Ablation Zone==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36854449 Int J Hyperthermia. 2023;40(1):2181843. PMID: 36854449] | [https://www.tandfonline.com/doi/epdf/10.1080/02656736.2023.2181843?needAccess=true&role=button PDF]

'''Authors:''' Ding WZ, Wei H, Wu JP, Cheng ZG, Han ZY, Liu FY, Yu J, Liang P.

'''Institution:''' Fifth Medical Center of Chinese, PLA General Hospital, Beijing, China.

'''Abstract:'''
'''Background:''' The range of an ablation zone (AZ) plays a crucial role in the treatment effect of microwave ablation (MWA). The aim of this study was to analyze the factors influencing the AZ range.

'''Methods:''' Fourteen factors in four areas were included: patient-related factors (sex, age), disease-related factors (tumor location, liver cirrhosis), serological factors (ALT, AST, total protein, albumin, total bilirubin, direct bilirubin, and platelets), and MWA parameters (ablation time, power, and needle type). Multiple sequence MRI was used to delineate AZ by three radiologists using [http://www.slicer.org '''3D Slicer''']. MATLAB was used to calculate the AZ length, width, and area of the largest section. Linear regression analysis was used to analyze influencing factors. Moreover, a subgroup analysis was conducted for patients with viral hepatitis.

'''Result:''' 220 patients with 290 tumors were included between 2010-2021. In addition to MWA parameters, cirrhosis and tumor location were significant factors that influenced AZ (p < 0.001). The standardized coefficient (beta) of cirrhosis (cirrhosis vs. non-cirrhosis) was positive, which meant cirrhosis would lead to a decrease in AZ range. The beta of tumor location (near the hepatic hilar zone, intermediate zone, and periphery zone) was negative, indicating that AZ range decreased as the tumor location approached the hepatic hilum. For viral hepatitis patients, Fibrosis 4 (FIB4) score was a significant factor influencing AZ (p < 0.001), and the beta was negative, indicating that AZ range decreased as FIB4 increased.

'''Conclusion:''' Liver cirrhosis, tumor location, and FIB4 affect the AZ range and should be considered when planning MWA parameters.
|}

==A Magnetic Resonance Imaging Based Radiomics Model to Predict Mitosis Cycles in Intracranial Meningioma==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36653482 Sci Rep. 2023 Jan 18;13(1):969. PMID: 36653482] | [http://www.ncbi.nlm.nih.gov/pmc/articles/pmc9849352/ PDF]

'''Authors:'''Krähling H, Musigmann M, Akkurt BH, Sartoretti T, Sartoretti E, Henssen DJHA, Stummer W, Heindel W, Brokinkel B, Mannil M.

'''Institution:''' University Clinic for Radiology, University Hospital Muenster, Westfälische Wilhelms-University Muenster, Muenster, Germany.

'''Abstract:''' The aim of this study was to develop a magnetic resonance imaging (MRI) based radiomics model to predict mitosis cycles in intracranial meningioma grading prior to surgery. Preoperative contrast-enhanced T1-weighted (T1CE) cerebral MRI data of 167 meningioma patients between 2015 and 2020 were obtained, preprocessed and segmented using the [http://www.slicer.org '''3D Slicer'''] software and the PyRadiomics plugin. In total 145 radiomics features of the T1CE MRI images were computed. The criterion on the basis of which the feature selection was made is whether the number of mitoses per 10 high power field (HPF) is greater than or equal to zero. Our analyses show that machine learning algorithms can be used to make accurate predictions about whether the number of mitoses per 10 HPF is greater than or equal to zero. We obtained our best model using Ridge regression for feature pre-selection, followed by stepwise logistic regression for final model construction. Using independent test data, this model resulted in an AUC (Area under the Curve) of 0.8523, an accuracy of 0.7941, a sensitivity of 0.8182, a specificity of 0.7500 and a Cohen's Kappa of 0.5576. We analyzed the performance of this model as a function of the number of mitoses per 10 HPF. The model performs well for cases with zero mitoses as well as for cases with more than one mitosis per 10 HPF. The worst model performance (accuracy = 0.6250) is obtained for cases with one mitosis per 10 HPF. Our results show that MRI-based radiomics may be a promising approach to predict the mitosis cycles in intracranial meningioma prior to surgery. Specifically, our approach may offer a non-invasive means of detecting the early stages of a malignant process in meningiomas prior to the onset of clinical symptoms.
|}

==Advantages of a Training Course for Surgical Planning in Virtual Reality for Oral and Maxillofacial Surgery: Crossover Study==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36656632 JMIR Serious Games. 2023 Jan 19;11:e40541. PMID: 36656632] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9947820/?report=printable PDF]

'''Authors:''' Ulbrich M, Van den Bosch V, Bönsch A, Gruber LJ, Ooms M, Melchior C, Motmaen I, Wilpert C, Rashad A, Kuhlen TW, Hölzle F, Puladi B.

'''Institution:''' Department of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Aachen, Germany.

'''Abstract:'''
'''Background:''' As an integral part of computer-assisted surgery, virtual surgical planning (VSP) leads to significantly better surgery results, such as for oral and maxillofacial reconstruction with microvascular grafts of the fibula or iliac crest. It is performed on a 2D computer desktop screen (DS) based on preoperative medical imaging. However, in this environment, VSP is associated with shortcomings, such as a time-consuming planning process and the requirement of a learning process. Therefore, a virtual reality (VR)-based VSP application has great potential to reduce or even overcome these shortcomings due to the benefits of visuospatial vision, bimanual interaction, and full immersion. However, the efficacy of such a VR environment has not yet been investigated.

'''Objective:''' This study aimed to demonstrate the possible advantages of a VR environment through a substep of VSP, specifically the segmentation of the fibula (calf bone) and os coxae (hip bone), by conducting a training course in both DS and VR environments and comparing the results.

'''Methods:''' During the training course, 6 novices were taught how to use a software application in a DS environment, [http://www.slicer.org '''3D Slicer''']) and in a VR environment (Elucis) for the segmentation of the fibula and os coxae, and they were asked to carry out the maneuvers as accurately and quickly as possible. Overall, 13 fibula and 13 os coxae were segmented for each participant in both methods (VR and DS), resulting in 156 different models (78 fibula and 78 os coxae) per method (VR and DS) and 312 models in total. The individual learning processes in both environments were compared using objective criteria (time and segmentation performance) and self-reported questionnaires. The models resulting from the segmentation were compared mathematically (Hausdorff distance and Dice coefficient) and evaluated by 2 experienced radiologists in a blinded manner.

'''Results:''' A much faster learning curve was observed for the VR environment than the DS environment (β=.86 vs β=.25). This nearly doubled the segmentation speed (cm3/min) by the end of training, leading to a shorter time (P<.001) to reach a qualitative result. However, there was no qualitative difference between the models for VR and DS (P=.99). The VR environment was perceived by participants as more intuitive and less exhausting, and was favored over the DS environment.

'''Conclusions:''' The more rapid learning process and the ability to work faster in the VR environment could save time and reduce the VSP workload, providing certain advantages over the DS environment.
|}

==Lesion Size and Long-Term Cognitive Outcome After Pediatric Stroke: A Comparison Between Two Techniques to Assess Lesion Size==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36641854 Eur J Paediatr Neurol. 2023 Jan 7;42:126-32. PMID: 36641854]

'''Authors:''' Everts R, Bertato S, Steinlin M, Slavova N, Grunt S, Steiner L.

'''Institution:''' Division of Neuropediatrics, Development and Rehabilitation, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.

'''Abstract:'''
'''Background:''' There is little consensus on how lesion size impacts long-term cognitive outcome after pediatric arterial ischemic stroke (AIS). This study, therefore, compared two techniques to assessed lesion size in the chronic phase after AIS and determined their measurement agreement in relation to cognitive functions in patients after pediatric stroke.

'''Methods:''' Twenty-five patients after pediatric AIS were examined in the chronic phase (>2 years after stroke) in respect to intelligence, memory, executive functions, visuo-motor functions, motor abilities, and disease-specific outcome. Lesion size was measured using the ABC/2 formula and segmentation technique ([http://www.slicer.org '''3D Slicer''']). Correlation analysis determined the association between volumetry techniques and outcome measures in respect to long-term cognitive outcome.

'''Results:''' The measurements from the ABC/2 and segmentation technique were strongly correlated (r = 0.878, p < .001) and displayed agreement in particular for small lesions. Lesion size from both techniques was significantly correlated with disease-specific outcome (p < .001) and processing speed (p < .005) after controlling for age at stroke and multiple comparison.

'''Conclusion:''' The two techniques showed convergent validity and were both significantly correlated with long-term outcome after pediatric AIS. Compared to the time-consuming segmentation technique, ABC/2 facilitates clinical and research work as it requires relatively little time and is easy to apply.
|}

==Association Between Emphysema and Other Pulmonary Computed Tomography Patterns in COVID-19 Pneumonia==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36358023 J Med Virol. 2023 Jan;95(1):e28293. PMID: 36358023] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9828029/pdf/JMV-95-0.pdf PDF]

'''Authors:''' Han K, Wang J, Zou Y, Zhang Y, Zhou L, Yin Y.

'''Institution:''' Fetal-Neonatal Neuroimaging and Developmental Science Center, Division of Newborn Medicine, Boston Children's Hospital, Boston, USA.

'''Abstract:''' To evaluate the chest computed tomography (CT) findings of patients with Corona Virus Disease 2019 (COVID-19) on admission to hospital. And then correlate CT pulmonary infiltrates involvement with the findings of emphysema. We analyzed the different infiltrates of COVID-19 pneumonia using emphysema as the grade of pneumonia. We applied open-source assisted software, [http://www.slicer.org '''3D Slicer'''] to model the lungs and lesions of 66 patients with COVID-19, which were retrospectively included. we divided the 66 COVID-19 patients into the following two groups: (A) 12 patients with less than 10% emphysema in the low-attenuation area less than -950 Hounsfield units (%LAA-950), (B) 54 patients with greater than or equal to 10% emphysema in %LAA-950. Imaging findings were assessed retrospectively by two authors and then pulmonary infiltrates and emphysema volumes were measured on CT using [http://www.slicer.org '''3D Slicer'''] software. Differences between pulmonary infiltrates, emphysema, Collapsed, affected of patients with CT findings were assessed by Kruskal-Wallis and Wilcoxon test, respectively. Statistical significance was set at p < 0.05. The left lung (A) affected left lung 20.00/affected right lung 18.50, (B) affected left lung 13.00/affected right lung 11.50 was most frequently involved region in COVID-19. In addition, collapsed left lung, (A) collapsed left lung 4.95/collapsed right lung 4.65, (B) collapsed left lung 3.65/collapsed right lung 3.15 was also more severe than the right one. There were significant differences between the Group A and Group B in terms of the percentage of CT involvement in each lung region (p < 0.05), except for the inflated affected total lung (p = 0.152). The median percentage of collapsed left lung in the Group A was 20.00 (14.00-30.00), right lung was 18.50 (13.00-30.25) and the total was 19.00 (13.00-30.00), while the median percentage of collapsed left lung in the Group B was 13.00 (10.00-14.75), right lung was 11.50 (10.00-15.00) and the total was 12.50 (10.00-15.00). The percentage of affected left lung is an independent predictor of emphysema in COVID-19 patients. We need to focus on the left lung of the patient as it is more affected. The people with lower levels of emphysema may have more collapsed segments. The more collapsed segments may lead to more serious clinical feature.
|}

==A High-Resolution Pediatric Female Whole-Body Numerical Model With Comparison to a Male Model==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36595234 Phys Med Biol. 2023 Jan 13;68(2). PMID: 36595234]

'''Authors:''' Ntolkeras G, Jeong H, Zöllei L, Dmytriw AA, Purvaziri A, Lev MH, Grant PE, Bonmassar G.

'''Institution:''' Fetal-Neonatal Neuroimaging and Developmental Science Center, Division of Newborn Medicine, Boston Children's Hospital, Boston, USA.

'''Abstract:'''
'''Objective:''' Numerical models are central in designing and testing novel medical devices and in studying how different anatomical changes may affect physiology. Despite the numerous adult models available, there are only a few whole-body pediatric numerical models with significant limitations. In addition, there is a limited representation of both male and female biological sexes in the available pediatric models despite the fact that sex significantly affects body development, especially in a highly dynamic population. As a result, we developed Athena, a realistic female whole-body pediatric numerical model with high-resolution and anatomical detail.

'''Approach:''' We segmented different body tissues through Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) images of a healthy 3.5 year-old female child using 3D Slicer. We validated the high anatomical accuracy segmentation through two experienced sub-specialty-certified neuro-radiologists and the inter and intra-operator variability of the segmentation results comparing sex differences in organ metrics with physiologic values. Finally, we compared Athena with Martin, a similar male model, showing differences in anatomy, organ metrics, and MRI dosimetric exposure.

'''Main results:'''We segmented 267 tissue compartments, which included 50 brain tissue labels. The tissue metrics of Athena displayed no deviation from the literature value of healthy children. We show the variability of brain metrics in the male and female models. Finally, we offer an example of computing Specific Absorption Rate and Joule heating in a toddler/preschooler at 7T MRI.

'''Significance:''' This study introduces a female realistic high-resolution numerical model using MRI and CT scans of a 3.5 year-old female child, the use of which includes but is not limited to radiofrequency safety studies for medical devices (e.g. an implantable medical device safety in MRI), neurostimulation studies, and radiation dosimetry studies. This model will be open source and available on the Athinoula A. Martinos Center for Biomedical Imaging website.
|}

==Anatomical Morphology and Related Angles of Foramen Ovale: A Three-dimensional Computed Tomography Reconstruction==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36597246 J Coll Physicians Surg Pak. 2023 Jan;33(1):109-11. PMID: 36597246]

'''Authors:''' Cheng Z, Hu YL, Sun YX, Liang LZ, Pan DD, Wang DW.

'''Institution:''' Department of Neurosurgery, The Second Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, China.

'''Abstract:''' This study aimed to report the three-dimensional reconstruction of the foramen ovale (FO) based on computed tomography angiography and describe its shape and related angles. A retrospective analysis of 199 adult patients who were hospitalised at the Department of Neurosurgery, The Second Affiliated Hospital of Bengbu Medical College, Bengbu, China, from January to December 2020 was conducted. The original DICOM files of patients' computed tomography scans were processed by [http://www.slicer.org '''3D Slicer'''] software to reconstruct the three-dimensional skull. The morphological characteristics of the FO on both sides were analysed. Their size, related angles and volumes, and the differences between the two sides and gender were compared. A total of 398 FO from 199 patients were studied. The most frequent shape of the FO was oval, accounting for 54.27%. The mean lengths of the right and the left sides were 5.40±1.51 and 5.10±1.18mm, respectively. The mean width on the right and left sides was 3.23±1.16 and 3.33±1.19 mm, respectively. The FO is most commonly oval in shape. Clinicians may use the anatomical characteristics regarding the size and shape of the FO for diagnosis and treatment.
|}

Main Page/SlicerCommunity/2023

2023-09-11T18:55:32Z

Marianna: /* A Retrospective Three-Dimensional Study of the Mandibular Growth During Preoperative Orthodontics in Late Adolescent Patients With Skeletal Class III Malocclusion */

{{:Main_Page/SlicerCommunity}}

__TOC__

=2023=
==Dosimetric Assessment of Gadolinium-159 for Hepatic Radioembolization: Tomographic Images and Monte Carlo Simulation==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37393764 Appl Radiat Isot. 2023 Sep;199:110916. PMID: 37393764]

'''Authors:''' Musa AS, Abdul Hadi MFR, Hashikin NAA, Ashour NI, Ying CK.

'''Institution:''' School of Physics, Universiti Sains Malaysia, Penang, Malaysia.

'''Abstract:'''
A common therapeutic radionuclide used in hepatic radioembolization is yttrium-90 (90Y). However, the absence of gamma emissions makes it difficult to verify the post-treatment distribution of 90Y microspheres. Gadolinium-159 (159Gd) has physical properties that are suitable for therapy and post-treatment imaging in hepatic radioembolization procedures. The current study is innovative for conducting a dosimetric investigation of the use of 159Gd in hepatic radioembolization by simulating tomographic images using the Geant4 application for tomographic emission (GATE) Monte Carlo (MC) simulation. For registration and segmentation, tomographic images of five patients with hepatocellular carcinoma (HCC) who had undergone transarterial radioembolization (TARE) therapy were processed using a [http://www.slicer.org '''3D Slicer''']. The tomographic images with 159Gd and 90Y separately were simulated using the GATE MC Package. The output of simulation (dose image) was uploaded to [http://www.slicer.org '''3D Slicer'''] to compute the absorbed dose for each organ of interests. 159Gd were able to provide a recommended dose of 120 Gy to the tumour, with normal liver and lungs absorbed doses close to that of 90Y and less than the respective maximum permitted doses of 70 Gy and 30 Gy, respectively. Compared to 90Y, 159Gd requires higher administered activity approximately 4.92 times to achieve a tumour dose of 120 Gy. Thus; this research gives new insights into the use of 159Gd as a theranostic radioisotope, with the potential to be used as a90Y alternative for liver radioembolization.
|}

==The Cranial Capacity of the Saudi Population Measured Using 3D Computed Tomography Scans==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37482378 Neurosciences (Riyadh). 2023 Jul;28(3):184-89. PMID: 37482378]

'''Authors:''' Alshamrani KA.

'''Institution:''' Department of Radiological sciences, Faculty of Applied Medical Science, and from Health Research Centre, Najran University, Najran, Kingdom of Saudi Arabia.

'''Abstract:'''
Objectives: To measure the cranial capacity of members of the Saudi adult population across ages and genders.

Methods: This was a retrospective cross-sectional study that used 488 Computed Tomography (CT) scans of heads (of which 275 males) to measure cranial volume. The CT slices 0.625 mm thick were uploaded using the freely available [http://www.slicer.org '''3D Slicer'''] software, which then reconstructed the images and built a 3D module.

Results: The mean (±SD) cranial capacity of the males was 1481.6 (±110) cm3 (range: 1241-1723 cm3), whereas the cranial capacity of the females was 1375.4 (±104) cm3 (range: 1203-1678 cm3). This study showed that the males had a mean cranial capacity that was 7% greater than that of the females in this study. The average cranial capacity of the males between the ages of 31 and 40 years was statistically significantly larger to that of the males aged 61-80 (p<0.05).

Conclusion: This study demonstrated that the average cranial capacity of the males was larger than that of the females. These study results can help to determine the normal cranial capacity of adults in Saudi Arabia. Further work should be carried out to aid in establishing reference data for the Saudi population.
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==The Tracheal System of the Common Wasp (Vespula Vulgaris) - a Micro-CT Study==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37451536 J Insect Physiol. 2023 Jul 13;149:104547. PMID: 37451536]

'''Authors:''' Bell GD, Corps N, Mortimer D, Gretton S, Bury N, Connett GJ.

'''Institution:''' School of (EAST) Engineering, Arts, Science and Technology, University of Suffolk, James Hehir Building, UK.

'''Abstract:'''
X-ray micro-CT has been used to study the tracheal system of Pre and Post hibernation Queen wasps (Vespula vulgaris) and their workers. We have compared our findings in wasps with Snodgrass's description of the tracheal system of the honeybee as characterised by anatomical dissection. Our images, whilst broadly similar, identify the tracheal system as being considerably more complex than previously suggested. One of the 30 wasps imaged had a markedly different, previously undescribed tracheal system. Since completing this study, a large micro-CT study from the American Museum of Natural History (AMNH) has been published. This used different software, [http://www.slicer.org '''3D Slicer'''] and analysed 16bit digital data. We have compared our methods with that described in the AMNH publication, adopted their suggested nomenclature and have made recommendations for future studies.
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==Augmented Reality Presentation of the Extracranial Facial Nerve: An Innovation in Parotid Surgery==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37328316 Br J Oral Maxillofac Surg. 2023 Jul;61(6):428-36. PMID: 37328316]

'''Authors:''' Saadya A, Chegini S, Morley S, McGurk M.

'''Institution:''' University College London Hospital, UK.

'''Abstract:'''
Surgeons used to be unaware of the facial nerve's position during parotid surgery. Now, with special magnetic resonance imaging (MRI) sequences, it can be located and converted into a 3D model displayed on an augmented reality (AR) device for surgeons to study and manipulate. This study explores the accuracy and usefulness of the technique for the treatment of benign and malignant parotid tumours. A total of 20 patients with parotid tumours had 3-Tesla MRI scans, and their anatomical structures were segmented using [http://www.slicer.org '''3D Slicer'''] software. The structures were imported into a Microsoft HoloLens 2® device, displayed in 3D, and shown to the patient for consent. Intraoperative video recording was used to record the position of the facial nerve in relation to the tumour. The predicted path of the nerve taken from the 3D model was combined with surgical observation and video recording in all cases. The imaging proved to have application in both benign and malignant disease. It also improved the process of informed patient consent. Three-dimensional MRI imaging of the facial nerve within the parotid gland and its display in a 3D model is an innovative technique for parotid surgery. Surgeons can now see the nerve's position and tailor their approach to each patient's tumour, providing personalised care. The technique eliminates the surgeon's blind spot and is a significant advantage in parotid surgery.
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==Magnetic Resonance Imaging in Naso-Oropharyngeal Carcinoma: Role of Texture Analysis in the Assessment of Response to Radiochemotherapy, a Preliminary Study==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37336860/ Radiol Med. 2023 Jul;128(7):839-52. PMID: 37336860] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10317900/pdf/11547_2023_Article_1653.pdf PDF]

'''Authors:''' Bicci E, Nardi C, Calamandrei L, Barcali E, Pietragalla M, Calistri L, Desideri I, Mungai F, Bonasera L, Miele V.

'''Institution:''' Department of Experimental and Clinical Biomedical Sciences, Radiodiagnostic Unit #2, University of Florence, Florence, Italy.

'''Abstract:'''
Objective: Identifying MRI texture parameters able to distinguish inflammation, fibrosis, and residual cancer in patients with naso-oropharynx carcinoma after radiochemotherapy (RT-CHT).

Material and methods: In this single-centre, observational, retrospective study, texture analysis was performed on ADC maps and post-gadolinium T1 images of patients with histological diagnosis of naso-oropharyngeal carcinoma treated with RT-CHT. An initial cohort of 99 patients was selected; 57 of them were later excluded. The final cohort of 42 patients was divided into 3 groups (inflammation, fibrosis, and residual cancer) according to MRI, 18F-FDG-PET/CT performed 3-4 months after RT-CHT, and biopsy. Pre-RT-CHT lesions and the corresponding anatomic area post-RT-CHT were segmented with [http://www.slicer.org '''3D Slicer'''] software from which 107 textural features were derived. T-Student and Wilcoxon signed-rank tests were performed, and features with p-value < 0.01 were considered statistically significant. Cut-off values-obtained by ROC curves-to discriminate post-RT-CHT non-tumoural changes from residual cancer were calculated for the parameters statistically associated to the diseased status at follow-up.

Results: Two features-Energy and Grey Level Non-Uniformity-were statistically significant on T1 images in the comparison between 'positive' (residual cancer) and 'negative' patients (inflammation and fibrosis). Energy was also found to be statistically significant in both patients with fibrosis and residual cancer. Grey Level Non-Uniformity was significant in the differentiation between residual cancer and inflammation. Five features were statistically significant on ADC maps in the differentiation between 'positive' and 'negative' patients. The reduction in values of such features between pre- and post-RT-CHT was correlated with a good response to therapy.

Conclusions: Texture analysis on post-gadolinium T1 images and ADC maps can differentiate residual cancer from fibrosis and inflammation in early follow-up of naso-oropharyngeal carcinoma treated with RT-CHT.
|}

==BabelBrain: An Open-Source Application for Prospective Modeling of Transcranial Focused Ultrasound for Neuromodulation Applications==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37155375/ IEEE Trans Ultrason Ferroelectr Freq Control. 2023 Jul;70(7):587-99. PMID: 37155375]

'''Authors:''' Pichardo S.

'''Institution:''' Department of Radiology, University of Calgary, Calgary, Canada.

'''Abstract:'''
BabelBrain is an open-source standalone graphic-user-interface application designed for studies of neuromodulation using transcranial-focused ultrasound (FUS). It calculates the transmitted acoustic field in the brain tissue, taking into account the distortion effects caused by the skull barrier. The simulation is prepared using scans from magnetic resonance imaging (MRI) and, if available, computed tomography (CT) and zero-echo time MRI scans. It also calculates the thermal effects based on a given ultrasound regime, such as the total duration of exposure, the duty cycle, and acoustic intensity. The tool is designed to work in tandem with neuronavigation and visualization software, such as [http://www.slicer.org '''3D Slicer''']. It uses image processing to prepare domains for ultrasound simulation and uses the BabelViscoFDTD library for transcranial modeling calculations. BabelBrain supports multiple GPU backends, including Metal, OpenCL, and CUDA, and works on all major operating systems including Linux, macOS, and Windows. This tool is particularly optimized for Apple ARM64 systems, which are common in brain imaging research. The article presents the modeling pipeline used in BabelBrain and a numerical study where different methods of acoustic properties mapping were tested to select the best method that can reproduce the transcranial pressure transmission efficiency reported in the literature.
|}

==Volumetric Analysis of the Sinus and Orbit in Silent Sinus Syndrome After Endoscopic Sinus Surgery==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/36939460/ Otolaryngol Head Neck Surg. 2023 Jul;169(1):151-156. PMID: 36939460]

'''Authors:'''
Amin D, Chitguppi C, Xu V, Haghshenas C, Gorniak R, Rabinowitz M, Toskala E, Rosen M, Nyquist G.

'''Institution:''' Department of Otolaryngology-Head & Neck Surgery, Thomas Jefferson University, Philadelphia, PA, USA.

'''Abstract:'''
Objective: The term "silent sinus syndrome" (SSS) describes spontaneous enophthalmos secondary to subclinical maxillary sinus atelectasis. Debate remains on whether treatment with endoscopic maxillary antrostomy alone is adequate in reversing atelectasis and globe displacement. This study aims to determine the degree of volume change of the diseased sinus and orbit as well as the change in orbital height in patients treated with endoscopic antrostomy without orbital floor augmentation.

Study design: Retrospective review with image analysis.

Setting: Single tertiary care institution.

Methods: Three-dimensional (3D) analysis of computed tomographic imaging data was performed using [http://www.slicer.org '''3D Slicer''']. 3D models of the maxillary sinus and orbit of the diseased and normal sides were created, and volume measurements were calculated using the segmentation program.

Results: Thirteen patients with SSS who underwent endoscopic sinus surgery (ESS) and had follow-up computed tomographic imaging were analyzed. After endoscopic antrostomy, the mean volume of the diseased maxillary sinus significantly increased by 9.82%, from 6.37 to 7.00 cm3 (p = .0302). There was no significant change in mean orbital volume; however, the mean orbital height decreased by 5.67%, from 38.09 to 35.93 mm from pretreatment to posttreatment samples (p = .0101). All patients had resolution of clinical or radiographic enophthalmos and orbital displacement with ESS alone.

Conclusion: Endoscopic maxillary antrostomy alone in the treatment of SSS significantly increased maxillary sinus volume and decreased diseased orbital height. These changes were associated with clinical and radiographic improvement in globe displacement. These findings support performing ESS alone, reserving orbital augmentation for patients who do not exhibit adequate clinical improvement.
|}

==Safety and Efficacy of Thoracic Endovascular Aortic Repair for Acute Stanford Type B Aortic Dissection With Retrograde Type a Intramural Hematoma==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/36921645/ J Vasc Surg. 2023 Jul;78(1):61-69.e4. PMID: 36921645] | [https://www.jvascsurg.org/action/showPdf?pii=S0741-5214%2823%2900438-X PDF]

'''Authors:''' Wang J, Li M, Li J, He H, Zhou Y, Li X, Li Q, Gu F, Ye Z, Dardik A, Shu C.

'''Institution:''' Department of Vascular Surgery, Second Xiangya Hospital, Central South University, Changsha, China; Institute of Vascular Diseases, Central South University, Changsha, China.

'''Abstract:'''
Objective: The aim of this study was to evaluate safety and efficacy of thoracic endovascular aortic repair (TEVAR) for acute Stanford type B aortic dissection (TBAD) with retrograde type A intramural hematoma (TAIMH).

Methods: Patients with acute TBAD with retrograde TAIMH treated with TEVAR between January 1, 2014, to March 31, 2022, were retrospectively reviewed. Aortic diameter and distance were measured using the [http://www.slicer.org '''3D Slicer'''] image computing platform. Patients' characteristics, procedural, in-hospital and follow-up data, and aortic remodeling were analyzed.

Results: Fifty-two patients (average age, 52.6 years; 42 males [80.8%]) were included. The median interval from symptom onset to TEVAR was 11 days (interquartile range, 7.0-16.8 days). The maximal diameter of the ascending aorta (AA) was <50 mm, and the hematoma thickness in the AA was ≤10 mm in all patients. Both the in-hospital and 30-day mortality rates were 0%. The 30-day complication rate was 11.5%. The overall cumulative survival rates were 100% at 1 year, 97.1% at 3 years, and 92.6% at 5 years. Four of 52 patients (7.7%) developed retrograde type A aortic dissection at 10 days to 4 months postoperatively, and one of 52 patients (1.9%) developed an isolated AA dissection 4 months postoperatively; these five patients were treated and alive at late follow-up in March 2022. The rates of cumulative freedom from thoracic aortic re-intervention were 93.7% at 1 year and 90.7% at 5 years. Positive AA remodeling was observed in 92.3% (48/52) of patients during follow-up. The maximal diameter of AA (mean ± standard error of mean) at admission was 42.7 ± 0.8 mm, which decreased to 39.5 ± 0.9 mm at last follow-up. The maximal AA hematoma thickness at admission was 7.6 ± 0.3 mm, which reduced to 2.2 ± 0.9 mm at last follow-up.

Conclusions: For selected patients of acute Stanford TBAD with retrograde TAIMH, endovascular repair may be a safe, effective, and durable alternative treatment, if the maximum diameter of the AA is <50 mm and the intramural hematoma thickness in the AA is ≤10 mm.
|}

==The Traction Force of the Pulled Limb in Hip Arthroscopic Surgery Is Determined by Stiffness Coefficient Which Is Significantly Related to Muscle Volume==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/36477348/ Knee Surg Sports Traumatol Arthrosc. 2023 Jul;31(7):2708-2715. PMID: 36477348]

'''Authors:''' Yin Y, Xue S, Zhang X, Yang G, Xu Y, Wang J, Huang H.

'''Institution:''' Department of Sports Medicine, Beijing Key Laboratory of Sports Injuries, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing, People's Republic of China.

'''Abstract:'''
Purpose: To verify the relationship between muscle volume, lateral centre-edge angle (LCEA), alpha angle (AA), body mass index (BMI) and Beighton score with stiffness coefficient (SC). To analyse the difference of traction force at different physical states of hip joint capsule.

Methods: Thirty-six patients who underwent hip arthroscopy operation were included. The volumes of some related muscles were measured in MRI images by [http://www.slicer.org '''3D Slicer''']. We recorded and tested differences in traction force of five joint capsule physical states, including before (State 1) and after joint capsule puncture (State 2), after the establishment of anterolateral and mid-anterior approaches (State 3) and after incision of the joint capsule through these two approaches (States 4, 5). The correlation between muscle volume, BMI, LCEA, AA and SC was verified by Spearman test. Poisson regression was used to explain confounding variables.

Results: The average force at State 1 was 531.8 N. There were significant differences in traction force between these five states (p < 0.001). There was a significant positive correlation between muscle volumes and SC (p < 0.001). BMI had no correlation with SC (n.s.). The preoperative LCEA of the affected side was correlated with SC (p = 0.043). AA and SC were not correlated (n.s.).

Conclusion: The physical states of the hip joint capsule affected traction force. Muscle volume rather than BMI is an ideal index to estimate preoperative traction force. LCEA affected traction force, whilst AA and Beighton score did not. Measuring the muscle volume can help estimate the most suitable traction force for the patient.
|}

==Three-Dimensional Assessment of Tongue Cancer Prognosis by Preoperative MRI==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/35426211/ Oral Dis. 2023 Jul;29(5):2006-2011. PMID: 35426211]

'''Authors:''' Li C, Zhu L, Guo Y, Ji T, Ren Z.

'''Institution:''' Department of Oral and Maxillofacial Head and Neck Oncology, The Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

'''Abstract:'''
Purpose: To obtain the relative volume by measuring the tongue volume and the lesion volume, and further explore its relationship with the prognosis of patients, hoping to supplement the TNM staging with a new index.

Methods: ITK-SANP software was used to outline the patients' MRI. After MRI reconstruction and measurement, [http://www.slicer.org '''3D Slicer'''] software was used to estimate tumor volume.

Results: A total of 64 patients with tongue cancer who met the inclusion criteria were included in the study. The estimated tumor volume after MRI reconstruction revealed a significant and robust correlation with tumor stage (p < 0.05, Rs = 0.6207) and a substantial and medium correlation with early lymph node metastasis (p < 0.05, Rs = 0.4873).

Conclusions: We classified tongue cancer into three grades based on tumor volume (Stage I, tumors smaller than 1500 mm³; Stage II, tumors 1500-9000 mm³; and Stage III, tumors larger than 9000 mm³), and such grading could be used as a reference for tumor staging, lymph node metastasis, and patient prognosis to a certain extent.
|}

==Multimodal Measurements of Levator Bowl Volume in Nulligravid Asymptomatic Women: Endovaginal Ultrasound Versus MRI==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36656345 Int Urogynecol J. 2023 Jul;34(7):1627-33. PMID: 36656345]

'''Authors:''' Chill HH, Martin LC, Abramowitch SD, Rostaminia G.

'''Institution:''' Female Pelvic Medicine and Reconstructive Surgery (FPMRS), Division of Urogynecology, University of Chicago, Northshore University HealthSystem, Skokie, IL, USA.

'''Abstract:''' Introduction and hypothesis: Measurements of levator bowl volume using advanced imaging, may be predictive of pelvic floor muscle function. The aim of this study was to compare the volume of the levator bowl using both magnetic resonance imaging (MRI) and endovaginal ultrasound (EVU) of healthy asymptomatic women.

'''Methods:''' All participants underwent a comprehensive interview including completion of the Pelvic Floor Distress Inventory Questionnaire-20 questionnaire, pelvic examination with a pelvic organ prolapse quantification evaluation, MRI, and EVU. The pelvic floor was segmented using [http://www.slicer.org '''3D Slicer'''] and the MRI segmentations were trimmed using two methods: soft-tissue landmarks and the field of view (FOV) of the ultrasound volume. The levator bowl volume of the 3D segmented shapes was measured using Blender's 3D printing toolkit. Normality was tested using the Shapiro-Wilks test and comparisons were made using self-paired t tests.

'''Results:''' The final analysis included 19 patients. Levator bowl volume measured via MRI was larger than that measured in EVU (46.1 ± 7.9 cm3 vs 27.4 ± 5.9 cm3, p<0.001). Reducing the FOV of the MRI to that of EVU caused the MRI volume to be much closer to the EVU volume (35.5 ± 3.3 cm3 vs 27.4 ± 5.9 cm3, p<0.001); however, it remained significantly larger.

'''Conclusion:''' Levator bowl volume measured using MRI was larger than that measured using EVU no matter the method of delineation of the levator muscles. Although EVU is safe, cheap, and easy to perform, it captures a smaller volume of levator bowel than MRI.
|}

==Pectoralis Muscle Area Measured at T4 Level Is Closely Associated With Adverse COVID-19 Outcomes in Hospitalized Patients==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37259659 J Musculoskelet Neuronal Interact. 2023 Jun 1;23(2):196-204. PMID: 37259659] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10233225/pdf/JMNI-23-196.pdf PDF]

'''Authors:''' Tekin ZN, Dogruoz Karatekin B, Dogan MB, Bilgi Z.

'''Institution:''' Istanbul Medeniyet University, Goztepe Prof Dr Suleyman Yalcin City Hospital, Radiology, Istanbul, Turkey.

'''Abstract:'''
Objectives: Skeletal muscle area (SMA) at T4 level on chest computed tomography (CT) is a newly available method that can be used as a surrogate sarcopenia marker. The objective of this study is to evaluate association of SMA with adverse COVID-19 outcomes in hospitalized patients.

Methods: Hospitalized COVID-19 patients were prospectively recorded in a database containing age, gender, date of admission, date of outcome (discharge, mortality, presence of intensive care unit (ICU) stay, additional coding information (comorbidities, superimposed conditions). Admission CT-scans were retrospectively evaluated for segmentation (bilateral pectoralis major/minor, erector spinae, levator scapulae, rhomboideus minor and major and transversospinalis muscles) and SMA calculation using [http://www.slicer.org '''3D Slicer'''] software.

Results: 167 cases were evaluated (68 male, 72 female, 140 survived, 27 dead). Muscle area was lower in patients with ICU stay (p=0.023, p=0.018, p=0.008) and mortality outcome (p=0.004, p=0.007, p=0.002) for pectoralis, back and SMA. In multivariate Cox-regression analysis, hazard ratio (HR) value for the pectoralis muscle area value below 2800 mm2 was found to be 3.138(95% CI: 1.171-8.413) for mortality and 2.361(95% CI: 1.012-5.505) for ICU.

Conclusions: Pectoralis muscle area measured at T4 level with 3-D slicer was closely associated with adverse outcomes (mortality, ICU stay) in hospitalized COVID-19 patients. Since early treatment methods for COVID-19 are being evaluated, this method may be a useful adjunct to clinical decision making in regard to prioritization.
|}

==Precise Location of the Ventricular Catheter Tip in Ventriculoperitoneal Shunt Placement Guided by 3D Printed Individualized Guide==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37086587/ Clin Neurol Neurosurg. 2023 Jun;229:107730. PMID: 37086587]

'''Authors:''' Tian Q, Yi J, Wu Y, Wang S, Qu Y, Cai Q.

'''Institution:''' Department of Neurosurgery, Tangdu hospital, Air Force Medical University, Shaanxi, China.

'''Abstract:'''
Objective: Improper placement of the ventricular catheter tip is the most common cause of shunting disorders after ventriculoperitoneal shunt (VPS) placement surgery. Here, through two illustrative cases, we described a novel method of precise ventricular catheter tip location.

Methods: [http://www.slicer.org '''3D Slicer'''] software was used to define the ventricle puncture path and determine the ventricle catheter tip location preoperatively, and the 3D individualized guide model was printed.

Results: The ventricular puncture was performed under the guidance of the 3D guide to achieve precise ventricle catheter tip location intraoperatively.

Conclusions: This technique is safe, simple, efficient and cost-effective, which facilitates its clinical implementation and promotion.
|}

==PIRET-A Platform for Treatment Planning in Electroporation-Based Therapies==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37015676/ IEEE Trans Biomed Eng. 2023 Jun;70(6):1902-10. PMID: 37015676]

'''Authors:''' Perera-Bel E, Aycock KN, Salameh ZS, Gomez-Barea M, Davalos RV, Ivorra A, Ballester MAG.

'''Institution:''' BCN MedTech, Department of Information and Communication Technologies, Universitat Pompeu Fabra, Barcelona, Spain.

'''Abstract:'''
Tissue electroporation is the basis of several therapies. Electroporation is performed by briefly exposing tissues to high electric fields. It is generally accepted that electroporation is effective where an electric field magnitude threshold is overreached. However, it is difficult to preoperatively estimate the field distribution because it is highly dependent on anatomy and treatment parameters.

Objective: We developed PIRET, a platform to predict the treatment volume in electroporation-based therapies.

Methods: The platform seamlessly integrates tools to build patient-specific models where the electric field is simulated to predict the treatment volume. Patient anatomy is segmented from medical images and 3D reconstruction aids in placing the electrodes and setting up treatment parameters.

Results: Four canine patients that had been treated with high-frequency irreversible electroporation were retrospectively planned with PIRET and with a workflow commonly used in previous studies, which uses different general-purpose segmentation, [http://www.slicer.org '''3D Slicer'''] and modeling software (3Matic and COMSOL Multiphysics). PIRET outperformed the other workflow by 65 minutes (× 1.7 faster), thanks to the improved user experience during treatment setup and model building. Both approaches computed similarly accurate electric field distributions, with average Dice scores higher than 0.93.

Conclusion: A platform which integrates all the required tools for electroporation treatment planning is presented. Treatment plan can be performed rapidly with minimal user interaction in a stand-alone platform.

Significance: This platform is, to the best of our knowledge, the most complete software for treatment planning of irreversible electroporation. It can potentially be used for other electroporation applications.
|}

==Surgically Assisted Maxillary Expansion With or Without Pterygoid Disjunction Alters Maxillomandibular Positioning==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/35426586/ Oral Maxillofac Surg. 2023 Jun;27(2):269-281. PMID: 35426586]

'''Authors:''' Carvalho FSR, Soares ECS, de Medeiros JR, Júnior JMM, Hyppolito JOP, de Barros Silva PG, Ribeiro TR, Costa FWG.

'''Institution:''' Department of Oral and Maxillofacial Surgery, Federal University of Ceará Campus Sobral, Brazil.

'''Abstract:'''
Purpose: This study aimed to analyze alterations in mandibular positioning after surgically assisted maxillary expansion (SARME) with and without pterygoid disjunction (PD).

Methods: Cone-beam computed tomography scans of 24 healthy individuals (18-45 years old) with transverse deficiency, superior to 5 mm, underwent SARME with or without PD. The aspects prospectively assessed were (1) alignment and position of the head (ITK-Snap and [http://www.slicer.org '''3D Slicer'''] software); (2) McNamara's and Steiner-Tweed-Wits' cephalometric analysis (Dolphin Imaging®); and (3) colorimetric evaluation based on 3D correspondence analysis ([http://www.slicer.org '''3D Slicer'''] software).

Results: A decrease in 1-NA and 1-SN angles as well as an increased occlusal plane in both groups was observed. Superior-inferior and anteroposterior spatial displacements of the chin were statistically significant in the PD group. Altered colorimetric patterns were also observed in the PD group.

Conclusions: This study found more evident tooth inclination in the group without PD; mandibular alterations were more evident in the PD group. Further studies with 3D analysis are strongly recommended for more comprehensive results.
|}

==ERCP 2.0: Biliary 3D-Reconstruction in Patients With Malignant Hilar Stricture==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37379653 Clin Res Hepatol Gastroenterol. 2023 Jun 26;47(7):102172. PMID: 37379653]

'''Authors:''' Becq A, Szewczyk J, Salin G, Chartier M, Chaput U, Leenhardt R, Dray X, Arrive L, Camus M.

'''Institution:''' Department of Gastroenterology, Henri-Mondor University Hospital, AP-HP, EA 7375, Université Paris Est Créteil, France.

'''Abstract:'''
Background: Endoscopic retrograde cholangiopancreatography (ERCP) for malignant hilar strictures is challenging. The correlation between Magnetic resonance cholangiopancreatography (MRCP) and per ERCP 2D fluoroscopic images is not obvious. The aim of this study was to evaluate the feasibility and potential usefulness of MRCP-based handmade biliary 3D reconstruction in this setting.

Methods: Methods Patients who underwent MRCP followed by ERCP for biliary drainage of a malignant hilar stricture at our institution between 2018 and 2020 were reviewed. A handmade 3D segmentation using [http://www.slicer.org '''3D Slicer'''] (Kitware, France) was fashioned and reviewed with an expert radiologist. The primary outcome was the feasibility of biliary segmentation.

Results: A total of 16 patients were included. The mean age was 70.1 (+/- 8.6) years-old and 68.8% had hilar cholangiocarcinoma. Handmade segmentation was successful in all cases. The agreement between the MRCP interpretation and the 3D reconstruction was 37.5%, as per the Bismuth classification. 3D reconstruction available prior to ERCP could have helped guide for better stent placement in 11 cases (68.8%).

Conclusions: MRCP-based biliary 3D segmentation-reconstruction, in patients with malignant hilar stricture is feasible and seems to provide a better anatomical understanding compared to MRCP and could help improve endoscopic management.
|}

==3D Printing Personalized Guide Plate in the Management of Recurrent Intramuscular Venous Malformations: A Single Center Experience==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/36967547/ Phlebology. 2023 Jun;38(5):307-314. PMID: 36967547]

'''Authors:''' Han T, Jiang S, Xiong J, Cui J, Shen W.

'''Institution:''' Department of Burns and Plastic Surgery, Children's Hospital of Nanjing Medical University, Nanjing, China.

'''Abstract:'''
Objective: This study aimed to investigate the feasibility and effectiveness of 3D printing personalized guide plate in the management of recurrent intramuscular venous malformations (IVM).

Methods: Fifteen patients with recurrent IVM were retrospectively assessed. [http://www.slicer.org '''3D Slicer'''] software was used to extract and reconstruct the imaging data from CT and/or MRI to highlight the morphology, size, and puncture depth of the lesion. With the guidance of personalized plate, complete excision of the IVM was adopted along the pre-marked (methylene blue, MB) margin.

Results: Personalized guide plate matched involved extremity well, and MB-puncture approach was consistent with preoperative design. All IVMs were removed radically in one single session. Complete pain relief was obtained in all cases postoperatively.

Conclusion: The application of 3D printing guide plate can be safe, effective, and reliable to confirming the precise margin of IVM, renders a promising technique with a high practical value in resection of recurrent lesion.
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==White Matter Hyperintensities: A Possible Link Between Sarcopenia and Cognitive Impairment in Patients With Mild to Moderate Alzheimer's Disease==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37330930 Eur Geriatr Med. 2023 Jun 18. PMID: 37330930]

'''Authors:''' Weng X, Liu S, Li M, Zhang Y, Zhu J, Liu C, Hu H.

'''Institution:''' Department of Neurology, The Second Affiliated Hospital of Soochow University, Jiangsu, China.

'''Abstract:'''
Purpose: Alzheimer's disease (AD) has been reported to be associated with sarcopenia. White matter hyperintensities (WMH) are common in AD patients. However, the effect of WMH on sarcopenia in AD remains unclear. We hence aimed to investigate the possible association between regional WMH volumes and sarcopenic parameters in AD.

Methods: 57 mild to moderate AD patients and 22 normal controls (NC) were enrolled. Sarcopenic parameters were assessed, including appendicular skeletal mass index (ASMI), grip strength, 5-times sit-to-stand (5-STS) time, and gait speed. The volumes of periventricular hyperintensities (PVH) and deep white matter hyperintensities (DWMH) were quantified using [http://www.slicer.org '''3D Slicer'''] software.

Results: AD subjects exhibited a lower ASMI, a slower gait speed, an increased 5-STS time, and larger volumes of PVH and DWMH than those in the NC group. In AD subjects, total WMH and PVH volumes were related to cognitive impairment, particularly executive function decline. Moreover, total WMH volume and PVH volume were negatively correlated with gait speed across various clinical stages of AD. Multiple linear regression analysis showed that PVH volume was independently associated with 5-STS time and gait speed, whereas DWMH volume was only independently associated with gait speed.

Conclusion: WMH volume was associated with cognitive decline and various sarcopenic parameters. It thereby suggested that WMH may serve as the connection between sarcopenia and cognitive dysfunction in AD. Further studies are needed to confirm these findings and to determine whether sarcopenia interventions reduce WMH volume and improve cognitive function in AD.
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==CT Angiography Radiomics Combining Traditional Risk Factors to Predict Brain Arteriovenous Malformation Rupture: a Machine Learning, Multicenter Study==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37311939 Transl Stroke Res. 2023 Jun 13. PMID: 37311939]

'''Authors:''' Zhang S, Wang J, Sun S, Zhang Q, Zhai Y, Wang X, Ge P, Shi Z, Zhang D.

'''Institution:''' Department of Neurosurgery, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.

'''Abstract:'''
This study aimed to develop a machine learning model for predicting brain arteriovenous malformation (bAVM) rupture using a combination of traditional risk factors and radiomics features. This multicenter retrospective study enrolled 586 patients with unruptured bAVMs from 2010 to 2020. All patients were grouped into the hemorrhage (n = 368) and non-hemorrhage (n = 218) groups. The bAVM nidus were segmented on CT angiography images using [http://www.slicer.org '''3D Slicer'''] software, and radiomic features were extracted using Pyradiomics. The dataset included a training set and an independent testing set. The machine learning model was developed on the training set and validated on the testing set by merging numerous base estimators and a final estimator based on the stacking method. The area under the receiver operating characteristic (ROC) curve, precision, and the f1 score were evaluated to determine the performance of the model. A total of 1790 radiomics features and 8 traditional risk factors were contained in the original dataset, and 241 features remained for model training after L1 regularization filtering. The base estimator of the ensemble model was Logistic Regression, whereas the final estimator was Random Forest. In the training set, the area under the ROC curve of the model was 0.982 (0.967-0.996) and 0.893 (0.826-0.960) in the testing set. This study indicated that radiomics features are a valuable addition to traditional risk factors for predicting bAVM rupture. In the meantime, ensemble learning can effectively improve the performance of a prediction model.
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==Real-Time Integration Between Microsoft HoloLens 2 and 3D Slicer With Demonstration in Pedicle Screw Placement Planning==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37310561 Int J Comput Assist Radiol Surg. 2023 Jun 13. PMID: 37310561]

'''Authors:''' Pose-Díez-de-la-Lastra A, Ungi T, Morton D, Fichtinger G, Pascau J.

'''Institution:''' Departamento de Bioingeniería, Universidad Carlos III de Madrid, Spain.

'''Abstract:'''
Purpose: Up to date, there has been a lack of software infrastructure to connect [http://www.slicer.org '''3D Slicer'''] to any augmented reality (AR) device. This work describes a novel connection approach using Microsoft HoloLens 2 and OpenIGTLink, with a demonstration in pedicle screw placement planning.

Methods: We developed an AR application in Unity that is wirelessly rendered onto Microsoft HoloLens 2 using Holographic Remoting. Simultaneously, Unity connects to [http://www.slicer.org '''3D Slicer'''] using the OpenIGTLink communication protocol. Geometrical transform and image messages are transferred between both platforms in real time. Through the AR glasses, a user visualizes a patient's computed tomography overlaid onto virtual 3D models showing anatomical structures. We technically evaluated the system by measuring message transference latency between the platforms. Its functionality was assessed in pedicle screw placement planning. Six volunteers planned pedicle screws' position and orientation with the AR system and on a 2D desktop planner. We compared the placement accuracy of each screw with both methods. Finally, we administered a questionnaire to all participants to assess their experience with the AR system.

Results: The latency in message exchange is sufficiently low to enable real-time communication between the platforms. The AR method was non-inferior to the 2D desktop planner, with a mean error of 2.1 ± 1.4 mm. Moreover, 98% of the screw placements performed with the AR system were successful, according to the Gertzbein-Robbins scale. The average questionnaire outcomes were 4.5/5.

Conclusions: Real-time communication between Microsoft HoloLens 2 and 3D Slicer is feasible and supports accurate planning for pedicle screw placement.
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==Delirium After Traumatic Brain Injury: Prediction by Location and Size of Brain Lesion==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37317796 Ann Rehabil Med. 2023 Jun;47(3):214-21. PMID: 37317796] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10326395/pdf/arm-23008.pdf PDF]

'''Authors:''' Han SJ, Suh JH, Lee JY, Kim SJ.

'''Institution:''' Department of Rehabilitation Medicine, College of Medicine, Ewha Womans University, Seoul, Korea.

'''Abstract:'''
Objective: To examine (1) the location of brain lesion that would predict post-traumatic delirium and (2) the association between volume of brain lesion and occurrence of delirium in patients with traumatic brain injury (TBI).

Methods: A retrospective study was conducted by reviewing medical records of 68 TBI patients, categorized into two groups: the delirious group (n=38) and non-delirious group (n=30). The location and volume of TBI were investigated with the [http://www.slicer.org '''3D Slicer'''] software.

Results: The TBI region in the delirious group mainly involved the frontal or temporal lobe (p=0.038). All 36 delirious patients had brain injury on the right side (p=0.046). The volume of hemorrhage in the delirious group was larger by about 95 mL compared to the non-delirious group, but this difference was not statistically significant (p=0.382).

Conclusion: Patients with delirium after TBI had significantly different injury site and side, but not lesion size compared to patients without delirium.
|}

==Mitral Paravalvular Leak 3D Printing from 3D-Transesophageal Echocardiography==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37288866 Anatol J Cardiol. 2023 Jun 7. PMID: 37288866] | [https://doi.org/10.14744/AnatolJCardiol.2023.3008 PDF]

'''Authors:''' Jedrzejek M, Kozlowski M, Peszek-Przybyla E, Jadczyk T, Pysz P, Wojakowski W, Smolka G.

'''Institution:''' Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland.

'''Abstract:'''
Background: Paravalvular leaks can be detected in almost 15% of patients after mitral valve prosthesis implantation. This complication can result in congestive heart failure and hemolysis. Despite advancements in non-invasive imaging, percutaneous closure of paravalvular leaks is not always successful. Therefore, efforts are made to improve treatment outcomes by using 3D-printed models of defects as pre-procedural support for interventional cardiologists.

Methods: Retrospectively, 3D-transesophageal echocardiography recordings of 8 patients with clinically significant mitral paravalvular leaks were analyzed. Qlab Software was used to export DICOM images of each paravalvular leak channel, including surrounding tissue. Image segmentation was performed in [http://www.slicer.org '''3D Slicer'''], a free, open-source software package used for imaging research. Models were printed to actual size with the poly jet Stratasys Objet 30 printer with a transparent, rigid material.

Results: Duration of model preparation and printing, as well as the total cost, was calculated. Mean total time of model preparation was 430.5 ± 196 minutes.

Conclusion: 3D-printing from 3D-transesophageal echocardiography is technically feasible. Both shape and location of paravalvular leaks are preserved during model preparation and printing. It remains to be tested if 3D-printing would improve outcomes of percutaneous paravalvular leaks closure.
|}

==Prediction of Ki-67 Expression in Gastrointestinal Stromal Tumors Using Radiomics of Plain and Multiphase Contrast-Enhanced CT==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37266658 Eur Radiol. 2023 Jun 2. PMID: 37266658]

'''Authors:''' Liu Y, He C, Fang W, Peng L, Shi F 4, Xia Y, Zhou Q, Zhang R 5, Li C.

'''Institution:''' Medical Imaging Department, Chongqing University Central Hospital, Chongqing Emergency Medical Center, Chongqing, China.

'''Abstract:'''
Objective: To study the value of radiomics models based on plain and multiphase contrast-enhanced CT to predict Ki-67 expression in gastrointestinal stromal tumors (GISTs).

Methods: A total of 215 patients with GISTs were retrospectively analyzed, including 150 patients in one hospital as the training set and 65 patients in another hospital as the external verification set. The tumor at the largest level of CT images was delineated as the region of interest (ROI). The maximum diameter of the ROI was defined as the tumor size. A total of 851 radiomics features were extracted from each ROI by [http://www.slicer.org '''3D Slicer'''] Radiomics. After dimensionality reduction, three machine learning classification algorithms including logistic regression (LR), random forest (RF), and support vector machine (SVM) were used for Ki-67 expression prediction. Using a multivariable logistic model, a nomogram was established to predict the expression of Ki-67 individually.

Results: Delong tests showed that the SVM models had the highest accuracy in the arterial phase (Z value 0.217-1.139) and venous phase (Z value 0.022-1.396). For the plain phase, LR and SVM models had the highest accuracy (Z value 0.874-1.824, 1.139-1.763). For the delayed phase, LR models had the highest accuracy (Z value 0.056-1.824). For the combined phase, RF models had the highest accuracy (Z value 0.232-1.978). There was no significant difference among the above models for KI-67 expression prediction (Z value 0.022-1.978). A nomogram was developed with a C-index of 0.913 (95% CI, 0.878 to 0.956).

Conclusions: Radiomics of both plain and enhanced CT images could accurately predict the expression of Ki-67 in GIST. For patients who were not suitable to use contrast agents, plain scan could be used as an alternative.
|}

==Accuracy of Imaging Software for 3d Rendering of Tooth Structures, Usable in Clinical Settings==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37272346 Int J Comput Dent. 2023 Jun 5;0(0):0. PMID: 37272346]

'''Authors:''' Ronsivalle V, Venezia P, Migliorati M, Grippaudo C, Barbato E, Nucci L, Isola G, Leonardi RM, Lo Giudice A.

'''Institution:''' Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Policlinico Universitario "Vittorio Emanuele-G. Rodolico", Catania, Italy.

'''Abstract:'''
Aim: The aim of this study was to evaluate the segmentation accuracy of dentition testing four free-source semi-automatic software.

Materials and methods: A total of 20 cone-beam computed tomography (CBCT) were selected to perform semi-automatic segmentation of maxillary and mandibular dentition. The software tested were Invesalius, ITK-Snap, [http://www.slicer.org '''3D Slicer'''] and Seg3D. Each tooth model was also manually segmented (Mimics software) and set as the gold standard (GS) reference of the investigation. A specific 3D imaging technology was used to perform the superimposition between the teeth models obtained with semi-automatic software and the GS model, and to perform the surface-to-surface matching analysis. The accuracy of semi-automatic segmentation was evaluated calculating the volumetric mean differences (mean bias and limits of agreement) and the percentage of matching of the tooth models compared to the manual segmentation (GS). Qualitative assessments were performed using color-coded maps. All data were statistically analysed to perform software comparisons.

Result: Statistically significant differences were found in the volumetric and matching percentage data (p < 0,05). Invesalius was the most accurate software for 3D rendering of the dentition with a volumetric bias (Mimics) ranging from 4,59 mm3 to 85,79 mm3; instead, ITK-SNAP showed the higher volumetric bias, ranging from 30,22 mm3 to 319,83 mm3. The dis-matched area was mainly located at the radicular region of the teeth. Volumetric data showed excellent inter-software reliability with coefficient values ranging from 0,951 to 0,997.

Conclusion: Different semi-automatic software algorithms could generate different patterns of inaccuracy error in the segmentation of teeth.
|}

==A Retrospective Three-Dimensional Study of the Mandibular Growth During Preoperative Orthodontics in Late Adolescent Patients With Skeletal Class III Malocclusion==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37271262 J Stomatol Oral Maxillofac Surg. 2023 Jun 2;124(5):101526. PMID: 37271262]

'''Authors:''' Yuan M, Zheng Z, Li H, Wang P, Liu Y, Bi R.

'''Institution:''' State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthognathic and TMJ Surgery, West China Hospital of Stomatology, Sichuan University, China.

'''Abstract:'''
Introduction: The mandible's ongoing development presents a contraindication for combined orthodontic-orthognathic treatment. The aim of this study was to evaluate the mandibular stability before and after preoperative orthodontic treatment in late adolescent patients with skeletal Class III malocclusion and to investigate the most appropriate time to start preoperative orthodontic treatment.

Material and methods: The study population consisted of 58 adolescents, aged between 15 and 21 years, with skeletal Class III malocclusion; the adolescents underwent CT scans at the beginning (T1) and the end (T2) of preoperative orthodontic treatment. The CT data were analyzed using ITK-SNAP and [http://www.slicer.org '''3D Slicer'''] software, and the effects of age and gender on mandibular development were investigated.

Results: In these 58 patients, there were no significant local bone alterations in the condyle and anterior chin point between T1 and T2 and no significant changes in the mandibular branch height, mandibular body length, condylar distance, and mandibular angle distance (p>0.05). The mandibular growth at the angel of mandible was statistically significant (p<0.05), but it was not clinically significant because the mean value of the growth was small (right: 0.416±0.986 mm, left: 0.328±0.886 mm). No effect of age and gender on mandibular development was observed.

Conclusion: The mandibular morphology was stable during preoperative orthodontic treatment in patients at the late adolescent stage. This study provides evidence for the possibility of early implementation of preoperative orthodontics.
|}

==Assessment of Variabilities in Lung-Contouring Methods on CBCT Preclinical Radiomics Outputs==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37345013 Cancers (Basel). 2023 May 9;15(10):2677. PMID: 37345013] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10216427/pdf/cancers-15-02677.pdf PDF]

'''Authors:''' Brown KH, Illyuk J, Ghita M, Walls GM, McGarry CK, Butterworth KT.

'''Institution:''' Patrick G. Johnston Centre for Cancer Research, Queen's University Belfast, UK.

'''Abstract:'''
Radiomics image analysis has the potential to uncover disease characteristics for the development of predictive signatures and personalised radiotherapy treatment. Inter-observer and inter-software delineation variabilities are known to have downstream effects on radiomics features, reducing the reliability of the analysis. The purpose of this study was to investigate the impact of these variabilities on radiomics outputs from preclinical cone-beam computed tomography (CBCT) scans. Inter-observer variabilities were assessed using manual and semi-automated contours of mouse lungs (n = 16). Inter-software variabilities were determined between two tools ([http://www.slicer.org '''3D Slicer'''] and ITK-SNAP). The contours were compared using Dice similarity coefficient (DSC) scores and the 95th percentile of the Hausdorff distance (HD95p) metrics. The good reliability of the radiomics outputs was defined using intraclass correlation coefficients (ICC) and their 95% confidence intervals. The median DSC scores were high (0.82-0.94), and the HD95p metrics were within the submillimetre range for all comparisons. the shape and NGTDM features were impacted the most. Manual contours had the most reliable features (73%), followed by semi-automated (66%) and inter-software (51%) variabilities. From a total of 842 features, 314 robust features overlapped across all contouring methodologies. In addition, our results have a 70% overlap with features identified from clinical inter-observer studies.
|}

==A Training Tool for Clinicians in Segmenting Medical Images to Make 3D Models==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37342255 Ann Surg Open. 2023 May 23;4(2):e275. PMID: 37342255] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7614675/pdf/EMS170894.pdf PDF]

'''Authors:''' Chegini S, Tahim A, Liu M, Chooi Y, Edwards E, Clarkson M, Schilling C.

'''Institution:''' Department of Head and Neck Surgery, University College London Hospital, London, UK.

'''Abstract:'''
Introduction: 3D models produced from medical imaging can be used to plan treatment, design prosthesis, teach and for communication. Despite the clinical benefit, few clinicians have experience of how 3D models are produced.This is the first study evaluating a training tool to teach clinicians to produce 3D models and reporting the perceived impact on their clinical practice.

Method: Following ethical approval, 10 clinicians completed a bespoke training tool, comprising written and video material alongside online support. Each clinician and 2 technicians (included as control) were sent 3 CT scans and asked to produce 6 fibula 3D models using an open-source software, [http://www.slicer.org '''3D Slicer''']. The produced models were compared to those produced by the technicians using Hausdorff distance calculation. Thematic analysis was used to study the post-intervention questionnaire.

Results: The mean Hausdorff distance between the final model produced by the clinicians and technicians was 0.65mm SD0.54mm. The first model made by clinicians took a mean time of 1hr 25mins and the final model took 16:04mins (5:00-46:00mins). 100% of learners reported finding the training tool useful and will employ it in future practice.

Discussion: The training tool described in this paper is able to successfully train clinicians to produce fibula models from CT scans. Learners were able to produce comparable models to technicians within an acceptable timeframe. This does not replace technicians. However, the learners perceived this training will allow them to use this technology in more cases, with appropriate case selection and they appreciate the limits of this technology.
|}

==3D Slicer Combined With Neuroendoscope in Treatment of a Distal Segment Aneurysm of the Anterior Choroidal Artery Complicated Intraventricular Hemorrhage: A Case Report and Literature Review==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37251467 Heliyon. 2023 May 18;9(6):e16193. PMID: 37251467] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10220353/pdf/main.pdf PDF]

'''Authors:''' Zhou L, Ren Y, Li Z, Zhang H, Wei H, Song P, Cheng L, Wang W, Gao L, Lei P, Hua Q, Chen Q, Zhou J, Li G, Cai Q.

'''Institution:''' Department of Neurosurgery, Renmin Hospital of Wuhan University, Wuhan, China.

'''Abstract:'''
Introduction: Pure ventricular hemorrhage is often secondary to Moyamoya disease, rarely caused by rupture of ventricular aneurysm. The surgical treatment of the latter is very challenging. [http://www.slicer.org '''3D Slicer'''] reconstruction technology can accurately locate small intracranial lesions and combined with minimally invasive surgery with transcranial neuroendoscope is a new attempt to treat the above diseases.

Case presentation: We report a case of pure intraventricular hemorrhage secondary to rupture of a distal segment aneurysm of the anterior choroidal artery. Brain computed tomography (CT) before admission showed pure ventricular hemorrhage, and brain CT angiography (CTA) before operation showed a distal segment aneurysm of the anterior choroidal artery. We used [http://www.slicer.org '''3D Slicer'''] reconstruction and precise location of the focus before the operation and used the minimally invasive surgery technique with transcranial neuroendoscope to completely remove the hematoma in the ventricle, and found the responsible aneurysm located in the ventricle.

Conclusion: Pure intraventricular hemorrhage requires vigilance against the distal segment aneurysm of the anterior choroidal artery. At present, conventional microscopic craniotomy and intravascular interventional therapy have limitations, and [http://www.slicer.org '''3D Slicer'''] reconstruction and precise positioning technology combined with transcranial neuroendoscope minimally invasive surgery may be a good choice.
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==Application of Preoperative Multimodal Image Fusion Technique in Microvascular Decompression Surgery via Suboccipital Retrosigmoid Approach==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36716853 World Neurosurg. 2023 May;173:e37-e47. PMID: 36716853] | [https://pdf.sciencedirectassets.com/280061/AIP/1-s2.0-S1878875023001031/main.pdf PDF]

'''Authors:''' Liao CC, Wu KH, Chen G.

'''Institution:''' Department of Neurosurgery, Zhuhai People's Hospital (Zhuhai Hospital Affiliated with Jinan University,China), Zhuhai, China.

'''Abstract:'''
'''Objective:''' To explore the application value of preoperative multimodal image fusion technique in microvascular decompression (MVD) surgery via the suboccipital retrosigmoid approach.

'''Methods:''' Comprehensive data of 13 patients with primary trigeminal neuralgia (TN) and 13 patients with hemifacial spasm (HFS) treated by MVD surgery via the suboccipital retrosigmoid approach at the Department of Neurosurgery in Zhuhai People's Hospital from January 2021 to December 2021 were retrospectively analyzed. Preoperatively, all patients underwent cranial thin-section computed tomography and magnetic resonance examinations. Three-dimensional (3D) digital images of the skull, brainstem, nerves, and blood vessels were constructed by the [http://www.slicer.org '''3D Slicer'''] software or RadiAnt DICOM Viewer, which were then applied to design the surgical approach and surgical plan. The multimodal image fusion results, clinical characteristics, intraoperative data, surgical outcomes, and complications of all patients were summarized.

'''Results:''' The 3D digital images after fusion reconstruction can vividly show the anatomical relationship between the skull, brainstem, nerves, and blood vessels and was helpful to tailor the surgical strategy. All 26 patients underwent a smooth surgery. During the surgery, the key points were accurately located, the corners of the transverse sinus and sigmoid sinus were completely exposed, and no venous sinus injury occurred in all 26 patients. The key point was approximately located at the top point of the digastric groove, 12.3 ± 0.46 mm vertically above and 6.3 ± 0.6 mm laterally to the Frankfurt horizontal plane. The average cranial opening time was 30.4 (±3.6) min, and the mean operating time was 104.7 (±12.1) min. The diameter of the bone window was about 2.0 cm-3.0 cm, and the bone flap was restored. Among the 13 patients with primary TN, 12 (92.3%) exhibited complete relief of pain and 1 had significant relief. Complications of surgery included facial sensory numbness in 1 case, vertigo in 2 cases, and herpes at the corners of the mouth in 1 case. Of the 13 patients with HFS, 12 (92.3%) had complete relief of facial twitching symptoms and 1 had significant relief, and the complications included mild facial palsy in 2 (15.4%) cases and facial sensory numbness in another 2 (15.4%) cases. The mean follow-up time after surgery ranged from 6-16 months, and 1 of 26 patients experienced recurrence of HFS during the follow-up period.

'''Conclusions:''' Preoperative multimodal image fusion technology can provide adequate preoperative assessment for patients and assistance in designing surgical approaches, which is an important guideline for MVD surgery via the suboccipital retrosigmoid approach for primary TN and facial muscle spasm.
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==An Interactive App with Multi-parametric MRI - Whole-Mount Histology Correlation for Enhanced Prostate MRI Training of Radiology Residents==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37137744 Acad Radiol. 2023 May 1:S1076-6332(23)00183-6. PMID: 37137744]

'''Authors:''' Chatterjee A, Szasz T, Munakami M, Karademir I, Yusufishaq MS, Martens S, Wheeler C, Antic T, Thomas S, Karczmar GS, Oto A.

'''Institution:''' Department of Radiology, University of Chicago, Chicago, IL, USA.

'''Abstract:'''
Rationale and objectives: To validate the educational value of a newly created learning application in enhancing prostate MRI training of radiologists for detecting prostate cancer using an observer study.

Materials and methods: An interactive learning app, LearnRadiology, was developed using a web-based framework to display multi-parametric prostate MRI images with whole-mount histology for 20 cases curated for unique pathology and teaching points. Twenty new prostate MRI cases, different from the ones used in the web app, were uploaded on [http://www.slicer.org '''3D Slicer''']. Three radiologists (R1: radiologist; R2, R3: residents) blinded to pathology results were asked to mark areas suspected of cancer and provide a confidence score (1-5, with 5 being high confidence level). Then after a minimum memory washout period of 1 month, the same radiologists used the learning app and then repeated the same observer study. The diagnostic performance for detecting cancers before and after accessing the learning app was measured by correlating MRI with whole-mount pathology by an independent reviewer.

Results: The 20 subjects included in the observer study had 39 cancer lesions (13 Gleason 3 + 3, 17 Gleason 3 + 4, 7 Gleason 4 + 3, and 2 Gleason 4 + 5 lesions). The sensitivity (R1: 54% → 64%, P = 0.08; R2: 44% → 59%, P = 0.03; R3: 62% → 72%, P = 0.04) and positive predictive value (R1: 68% → 76%, P = 0.23; R2: 52% → 79%, P = 0.01; R3: 48% → 65%, P = 0.04) for all 3 radiologists improved after using the teaching app. The confidence score for true positive cancer lesion also improved significantly (R1: 4.0 ± 1.0 → 4.3 ± 0.8; R2: 3.1 ± 0.8 → 4.0 ± 1.1; R3: 2.8 ± 1.2 → 4.1 ± 1.1; P < 0.05).

Conclusion: The web-based and interactive LearnRadiology app learning resource can support medical student and postgraduate education by improving diagnostic performance of trainees for detecting prostate cancer.
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==3D Printed Guide Tube System for Acute Neuropixels Probe Recordings in Non-Human Primates==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37105161 J Neural Eng. 2023 May 11;20(3):036009. PMID: 37105161] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10172811/pdf/jne_20_3_036009.pdf PDF]

'''Authors:''' Bauer DL, Pobiel B, Hilber K, Verma AK, Wang J, Vitek J, Johnson M, Johnson L.

'''Institution:''' Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, USA.

'''Abstract:'''
Objective.
Neuropixels (NP) probes are a significant advance in electrophysiological recording technology that enable monitoring of hundreds of neurons in the brain simultaneously at different depths. Application of this technology has been predominately in rodents, however widespread use in non-human primates (NHPs) such as rhesus macaques has been limited. In this study we sought to overcome two overarching challenges that impede acute NP implantation in NHPs: (1) traditional microdrive systems that mount to cephalic chambers are commonly used to access cortical areas for microelectrode recordings but are not designed to accommodate NP probes, and (2) NHPs have thick dura mater and tissue growth within the cephalic chambers which poses a challenge for insertion of the extremely fragile NP probe.
Approach.
In this study we present a novel NP guide tube system that can be adapted to commercial microdrive systems and demonstrate an implant method using the NP guide tube system. This system was developed using a combination of CAD design, 3D printing, and small part machining. Software programs, [http://www.slicer.org '''3D Slicer'''] and SolidWorks were used to target cortical areas, approximate recording depths and locations, and for in-silico implant testing.
Main results.
We performedin vivotesting to validate our methodology, successfully implanting, explanting, and reimplanting NP probes. We collected stable neurophysiological recordings in the premotor cortex of a rhesus macaque at rest and during performance of a reaching task.Significance.In this study we demonstrate a robust Neuropixels implant system that allows multiple penetrations with the same NP probe and share design files that will facilitate the adoption of this powerful recording technology for NHP studies.
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==Diagnostic Value of 18F-FDG PET/CT-Based Radiomics Nomogram in Bone Marrow Involvement of Pediatric Neuroblastoma==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/36117128 Acad Radiol. 2023 May;30(5):940-51. PMID: 36117128]

'''Authors:''' Feng L, Yang X, Lu X, Kan Y, Wang C, Zhang H, Wang W, Yang J.

'''Institution:''' Department of Nuclear Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing, China.

'''Abstract:'''
Objectives: To develop and validate an 18F-FDG PET/CT-based radiomics nomogram and evaluate the value of the 18F-FDG PET/CT-based radiomics nomogram for the diagnosis of bone marrow involvement (BMI) in pediatric neuroblastoma.

Materials and methods: A total of 144 patients with neuroblastoma (100 in the training cohort and 44 in the validation cohort) were retrospectively included. The PET/CT images of patients were visually assessed. The results of bone marrow aspirates or biopsies were used as the gold standard for BMI. Radiomics features and conventional PET parameters were extracted using [http://www.slicer.org '''3D Slicer''']. Features were selected by the least absolute shrinkage and selection operator regression, and radiomics signature was constructed. Univariate and multivariate logistic regression analyses were applied to identify the independent clinical risk factors and construct the clinical model. Other different models, including the conventional PET model, combined PET-clinical model and combined radiomics model, were built using logistic regression. The combined radiomics model was based on clinical factors, conventional PET parameters and radiomics signature, which was presented as a radiomics nomogram. The diagnostic performance of the different models was evaluated by receiver operating characteristic (ROC) curves and decision curve analysis (DCA).

Results: By visual assessment, BMI was observed in 80 patients. Four conventional PET parameters (SUVmax, SUVmean, metabolic tumor volume, and total lesion glycolysis) were extracted. And 15 radiomics features were selected to build the radiomics signature. The 11q aberration, neuron-specific enolase and vanillylmandelic acid were identified as the independent clinical risk factors to establish the clinical model. The radiomics nomogram incorporating the radiomics signature, the independent clinical risk factors and SUVmean demonstrated the best diagnostic value for identifying BMI, with an area under the curve (AUC) of 0.963 and 0.931 in the training and validation cohorts, respectively. And the DCA demonstrated that the radiomics nomogram was clinically useful.

Conclusion: The 18F-FDG PET/CT-based radiomics nomogram which incorporates radiomics signature, independent clinical risk factors and conventional PET parameters could improve the diagnostic performance for BMI of pediatric neuroblastoma without additional medical costs and radiation exposure.
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==Opportunistic Screening for Osteoporosis Using CT Scans of the Knee: A Pilot Study==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37203533 Stud Health Technol Inform. 2023 May 18;302:909-910. PMID: 37203533]

'''Authors:''' Elmahdy M, Sebro R.

'''Institution:''' Department of Radiology, Mayo Clinic, Jacksonville, FL, USA.

'''Abstract:'''
Knee CT scans are used for planning for total knee arthroplasties in patients who are often simultaneously at risk for frailty fractures due to low bone mineral density. We retrospectively identified 200 patients (85.5% female) with concurrent CT scans of the knee and Dual energy x-ray absorptiometry (DXA). The mean CT attenuation of the distal femur, proximal tibia and fibula, and patella, were calculated using volumetric 3-dimensional segmentation using [http://www.slicer.org '''3D Slicer''']. Data were split randomly into training 80% and test 20% datasets. The optimal CT attenuation threshold for the proximal fibula was obtained in the training dataset and evaluated in the test dataset. A support vector machine (SVM) with radial basis function (RBF) using C-classification was trained and tuned using 5-fold cross-validation in the training dataset and then evaluated in the test dataset. The SVM had a higher area-under-the curve (AUC) of 0.937 and better performance to detect osteoporosis/osteopenia than the CT attenuation of the fibula (AUC of 0.717) (P=0.015). Opportunistic screening for osteoporosis/osteopenia could be accomplished using CT scans of the knee.
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==Sustainable 3D Printing of Oral Films With Tunable Characteristics Using CMC-Based Inks From Durian Rind Wastes==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/36933810 Eur J Pharm Biopharm. 2023 May;186:30-42. PMID: 36933810]

'''Authors:''' Panraksa P, Rachtanapun P, Thipchai P, Lesniewska E, Brachais CH, Debeaufort F, Chambin O, Jantrawut P.

'''Institution:''' Department of Pharmaceutical Sciences, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, Thailand.

'''Abstract:'''
With the growing interest in environmentally friendly and personalized medicines, new concept for combining three-dimensional printing (3DP) with natural-based biomaterials derived from agro-food wastes has emerged. This approach provides sustainable solutions for agricultural waste management and potential for developing of novel pharmaceutical products with tunable characteristics. This work demonstrated the feasibility of fabricating personalized theophylline films with four different structures (Full, Grid, Star, and Hilbert) using syringe extrusion 3DP and carboxymethyl cellulose (CMC) derived from durian rind wastes. Our findings suggested that all the CMC-based inks with shear thinning properties capable of being extruded smoothly through a small nozzle could potentially be used to fabricate the films with various complex printing patterns and high structural fidelity. The results also demonstrated that the film characteristics and release profiles could be easily modified by simply changing the slicing parameters (e.g., infill density and printing pattern). Amongst all formulations, Grid film, which was 3D-printed with 40 % infill and a grid pattern, demonstrated a highly porous structure with high total pore volume. The voids between printing layers in Grid film increased theophylline release (up to 90 % in 45 min) through improved wetting and water penetration. All findings in this study provide significant insight into how to modify film characteristics simply by digitally changing the printing pattern in [http://www.slicer.org '''3D Slicer'''] software without creating a new CAD model. This approach could help to simplify the 3DP process so that non-specialist users can easily implement it in community pharmacies or hospital on demand.
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==An Automated Landmark Method to Describe Geometric Changes in the Human Mandible During Growth==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/36893681 Arch Oral Biol. 2023 May;149:105663. PMID: 36893681]

'''Authors:''' Fournier G, Maret D, Telmon N, Savall F.

'''Institution:''' Faculté de Chirurgie Dentaire, Université Paul Sabatier, Centre Hospitalier Universitaire, Toulouse, France.

'''Abstract:'''
Objective: The principal aim of this study was to assess an automatic landmarking approach to human mandibles based on the atlas method. The secondary aim was to identify the areas of greatest variation in the mandibles of middle-aged to older adults.

Design: Our sample consisted of 160 mandibles from computed tomography scans of 80 men and 80 women aged between 40 and 79 years. Eleven anatomical landmarks were placed manually on mandibles. The automated landmarking through point cloud alignment and correspondence (ALPACA) method implemented in [http://www.slicer.org '''3D Slicer'''] was used to automatically place landmarks to all meshes. Euclidean distances, normalized centroid size, and Procrustes ANOVA were calculated for both methods. A pseudo-landmarks approach was followed using ALPACA to identify areas of changes among our sample.

Results: The ALPACA method showed significant differences in Euclidean distances for all landmarks compared to the manual method. A mean Euclidean distance of 1.7 mm was found for the ALPACA method and 0.99 mm for the manual method. Both methods found that sex, age, and size had a significant effect on mandibular shape. The greatest variations were observed in the condyle, ramus, and symphysis regions.

Conclusion: The results obtained using the ALPACA method are acceptable and promising. This approach can automatically place landmarks with an average accuracy of less than 2 mm, which may be sufficient in most anthropometric analyses. In the light of our results, however, odontological application such as occlusal analysis is not recommended.
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==Clinical Study of Puncture Technique in Single Division of the Trigeminal Ganglion Intumescentia==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37183316 Pain Pract. 2023 May 14. PMID: 37183316] | [https://onlinelibrary.wiley.com/doi/epdf/10.1111/papr.13239 PDF]

'''Authors:''' Zhang L, Guo Y, Xu J, He Y, Qi Z, Chen H, Zhang H.

'''Institution:''' Department of Neurosurgery, Jianhu Hospital Affiliated to Nantong University, Yancheng, China.

'''Abstract:'''
Objective: We explored the feasibility of single-division puncture in the ophthalmic division, maxillary division, and mandibular division of the trigeminal ganglion intumescentia (TGI) and the feasibility of radiofrequency treatment of trigeminal neuralgia.

Methods: According to the previous anatomical image studies, [http://www.slicer.org '''3D Slicer'''] software was used to analyze the CT images of the patients. The trigeminal ganglion fossa (TGF) was used as the imaging sign. TGI was identified in the sagittal plane along the fiber. The puncture path starts from the TGI center-foramen ovale line, extending outward to the epidermis as the needle insertion point, and extending inward to the division boundary. For lateral puncture, which is blocked by the mandible, the positions of closed mouth, open mouth, and over-open mouth were used. Multiple targets were generated using straight electrodes and curved electrodes to achieve full coverage of TGI. According to the preoperative design, general anesthesia surgery was performed. Xper CT was used for imaging, and the puncture was guided by Xper Guide. Radiofrequency treatment of TGI was conducted.

Results: In total, 45 patients with trigeminal neuralgia underwent 50 single-division TGI punctures. The procedure was smooth and the compliance with the design was good. Continuous radiofrequency (CRF) was performed, the VAS scores were 25 times at 70°C, 19 times at 65°C, two times at 60°C, and two times at 50°C (both in the ophthalmic division). Pulsed radiofrequency (PRF) was conducted two times. Within 24 h after the procedure, the VAS scores were all 0. From 1 to 7 days after the procedure, pain recurrence was found in three cases, of whom two cases received pulsed radiofrequency treatment. Patients were followed up for 1-24 months and there were no recurrence. After continuous radiofrequency at 65-70°C, the moderate tactile loss was observed, and nearly half of the patients had food residues on the surgical side after 6 months. After continuous radiofrequency at 60°C, there was mild tactile loss and no food residue. The tactile sensation was slightly decreased after continuous radiofrequency at 50°C, and the tactile sensation was normal the next day.

Conclusion: Trigeminal ganglion intumescentia single-division radiofrequency is effective and feasible for the treatment of trigeminal neuralgia.
|}

==Three-Dimensional Volume Rendering of Pelvic Floor Anatomy with Focus on Fibroids in Relation to the Lower Urogenital Tract Based on Cross-Sectional MRI Images==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37171621 J Med Syst. 2023 May 12;47(1):62. PMID: 37171621] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10181971/pdf/10916_2023_Article_1947.pdf PDF]

'''Authors:''' Fan KS, Durnea C, Nygaard CC, Khalil M, Doumouchtsis SK.

'''Institution:''' Institute for Medical and Biomedical Education, St. George's University of London, London, UK.

'''Abstract:'''
We aimed to assess the feasibility of developing three-dimensional (3D) models of pelvic organs using cross-sectional MRI images of patients with uterine fibroids and urinary symptoms and of obtaining anatomical information unavailable in 2D imaging modalities. We also aimed to compare two image processing applications. We performed a feasibility study analysing MRI scans from three women, aged 30 to 58 years old, with fibroids and urinary symptoms. Cross-sectional images were used to render 3D models of pelvic anatomy, including bladder, uterus and fibroids, using [http://www.slicer.org '''3D Slicer'''] and OsiriX. Dimensions, volumes and anatomical relationships of the pelvic organs were evaluated. Comparisons between anatomical landmarks and measurements obtained from the two image processing applications were undertaken. Rendered 3D pelvic models yielded detailed anatomical information and data on spatial relationships that were unobtainable from cross-sectional images. Models were rendered in sufficient resolution to aid understanding of spatial relationships between urinary bladder, uterus and fibroid(s). Measurements of fibroid volumes ranged from 5,336 to 418,012 mm3 and distances between the fibroid and urinary bladder ranged from 0.10 to 83.60 mm. Statistical analysis of measurements showed no significant differences in measurements between the two image processing applications. To date, limited data exist on the use of 3D volume reconstructions of routine MRI scans, to investigate pelvic pathologies such as fibroids in women with urinary symptoms. This study suggests that post-MRI image processing can provide additional information over standard MRI. Further studies are required to assess the role of these data in clinical practice, surgical planning and training. Three-dimensional reconstruction of routine two-dimensional magnetic resonance imaging provides additional anatomical information and may improve our understanding of anatomical relationships, their role in clinical presentations and possibly guide clinical and surgical management.
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==The First Endovascular Rat Glioma Model for Pre-Clinical Evaluation of Intra-Arterial Therapeutics==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37157800 Interv Neuroradiol. 2023 May 8:15910199231169597. PMID: 37157800]

'''Authors:''' Lim J, Baig AA, Donnelly BM, Chaves LD, Pol SU, Koenigsknecht C, Pionessa D, Levy BR, Gutierrez L, Tutino VM, Levy EI, Siddiqui AH.

'''Institution:''' Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA.

'''Abstract:'''
Background: Several translational animal models have been described assessing intra-arterial (IA) treatments for malignant gliomas. We describe the first endovascular animal model that allows testing of IA drug delivery as a first-line treatment, which is difficult to do in actual patients. We report a unique protocol for vascular access and IA delivery in the rat model that, unlike prior reports, does not require direct puncture and opening of proximal cerebrovasculature which carries risk of ischemia in the animal brain post-delivery.

Methods: Wistar rats underwent left femoral artery catherization with a Balt Magic 1.2F catheter or Marathon Flow directed 1.5F Microcatheter with an Asahi Chikai 0.008 micro-guidewire which was navigated to the left internal carotid artery under x-ray. 25% mannitol was administered to test blood brain barrier breakdown (BBBB). Additional rats were implanted with C6 glioma cells in the left frontal lobe. C6 Glioma-Implanted Rats (C6GRs) were monitored for overall survival and tumor growth. Tumor volumes from MRI images were calculated utilizing [http://www.slicer.org '''3D Slicer''']. Additional rats underwent femoral artery catheterization with Bevacizumab, carboplatin, or irinotecan injected into the left internal carotid artery to test feasibility and safety.

Results: A successful endovascular access and BBBB protocol was established. BBBB was confirmed with positive Evans blue staining. 10 rats were successfully implanted with C6 gliomas with confirmed growths on MRI. Overall survival was 19.75 ± 2.21 days. 5 rats were utilized for the development of our femoral catheterization protocol and BBBB testing. With regards to IA chemotherapy dosage testing, control rats tolerated targeted 10 mg/kg of bevascizumab, 2.4 mg/kg of carboplatin, and 15 mg/kg of irinotecan IA ICA injections without any complications.

Conclusions: We present the first endovascular IA rat glioma model that allows selective catheterization of the intracranial vasculature and assessment of IA therapies for gliomas without need for access and sacrifice of proximal cerebrovasculature.
|}

==Muscle Magnetic Resonance Characterization of STIM1 Tubular Aggregate Myopathy Using Unsupervised Learning==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37155641 PLoS One. 2023 May 8;18(5):e0285422. PMID: 37155641] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10166478/pdf/pone.0285422.pd PDF]

'''Authors:''' Lupi A, Spolaor S, Favero A, Bello L, Stramare R, Pegoraro E, Nobile MS.

'''Institution:''' Institute of Radiology, Department of Medicine-DIMED, University of Padua, Padua, Italy.

'''Abstract:'''
Purpose: Congenital myopathies are a heterogeneous group of diseases affecting the skeletal muscles and characterized by high clinical, genetic, and histological variability. Magnetic Resonance (MR) is a valuable tool for the assessment of involved muscles (i.e., fatty replacement and oedema) and disease progression. Machine Learning is becoming increasingly applied for diagnostic purposes, but to our knowledge, Self-Organizing Maps (SOMs) have never been used for the identification of the patterns in these diseases. The aim of this study is to evaluate if SOMs may discriminate between muscles with fatty replacement (S), oedema (E) or neither (N).

Methods: MR studies of a family affected by tubular aggregates myopathy (TAM) with the histologically proven autosomal dominant mutation of the STIM1 gene, were examined: for each patient, in two MR assessments (i.e., t0 and t1, the latter after 5 years), fifty-three muscles were evaluated for muscular fatty replacement on the T1w images, and for oedema on the STIR images, for reference. Sixty radiomic features were collected from each muscle at t0 and t1 MR assessment using [http://www.slicer.org '''3D Slicer'''] software, in order to obtain data from images. A SOM was created to analyze all datasets using three clusters (i.e., 0, 1 and 2) and results were compared with radiological evaluation.

Results: Six patients with TAM STIM1-mutation were included. At t0 MR assessments, all patients showed widespread fatty replacement that intensifies at t1, while oedema mainly affected the muscles of the legs and appears stable at follow-up. All muscles with oedema showed fatty replacement, too. At t0 SOM grid clustering shows almost all N muscles in Cluster 0 and most of the E muscles in Cluster 1; at t1 almost all E muscles appear in Cluster 1.

Conclusion: Our unsupervised learning model appears to be able to recognize muscles altered by the presence of edema and fatty replacement.
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==Quantifying the Effect of an Endo-Vaginal Probe on Position of the Pelvic Floor Viscera and Muscles==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37145123 Int Urogynecol J. 2023 May 5. PMID: 37145123]

'''Authors:''' Chill HH, Martin LC, Abramowitch SD, Rostaminia G.

'''Institution:''' Female Pelvic Medicine and Reconstructive Surgery (FPMRS) Division, University of Chicago Pritzker School of Medicine, Northshore University HealthSystem, Skokie, IL, USA.

'''Abstract:'''
Introduction and hypothesis: Endovaginal ultrasound has long been hypothesized to have a significant effect on locations of what it visualizes. However, little work has directly quantified its effect. This study aimed to quantify it.

Methods: This cross-sectional study consisted of 20 healthy asymptomatic volunteers who underwent both endovaginal ultrasound and MRI. The urethra, vagina, rectum, pelvic floor, and pubic bone were segmented in both ultrasound and MRI using [http://www.slicer.org '''3D Slicer''']. Then, using [http://www.slicer.org '''3D Slicer''']'s transform tool the volumes were rigidly aligned based on the posterior curvature of the pubic bone. The organs were then split into thirds along their long axis to compare their distal, middle, and proximal sections. Using Houdini, we compared the location of the centroid of each of the urethra, vagina, and rectum and the surface-to-surface difference of the urethra and rectum. The anterior curvature of the pelvic floor was also compared. Normality of all variables was assessed by Shapiro-Wilk test.

Results: The largest amount of surface-to-surface distance was observed in the proximal region for the urethra and rectum. Across all three organs, the majority of the deviation was in the anterior direction for geometries obtained from ultrasound versus those from MRI. For each subject, the trace defining the midline of the levator plate was more anterior for ultrasound compared to MRI.

Conclusions: While it has often been assumed that placing a probe in the vagina probably distorts the anatomy, this study quantified the distortion and displacement of the pelvic viscera. This allows for better interpretation of clinical and research findings based on this modality.
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==Laser Interstitial Thermal Therapy in the Treatment of Brain Metastases: The Relationship Between Changes in Postoperative Magnetic Resonance Imaging Characteristics and Tumor Recurrence==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36823478 Acta Neurochir (Wien). 2023 May;165(5):1379-1387. PMID: 36823478]

'''Authors:''' Xue Z, Guan X, Yuan L, Kang P, Zhang C, Li D, Jia G, Jia W.

'''Institution:''' Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, China.

'''Abstract:'''
'''Background:''' Laser interstitial thermal therapy (LITT) has been used to treat brain metastases (BMs) in several countries, and its safety and effectiveness have been confirmed. In most cases, magnetic resonance imaging (MRI) reveals an increase in tumor volume with an enhanced margin after LITT. However, little is known about the relationship between this MRI change and tumor recurrence.

'''Objective:''' We report the first case series of BMs treated by LITT in China to evaluate the clinical characteristics and predictive factors of tumor recurrence.

'''Material and Methods:''' Patients with less than four brain metastatic lesions and a Karnofsky performance status (KPS) > 70 were eligible for study inclusion. Standard LITT procedures were performed, and a follow-up MRI was performed to analyze the radiographic changes, especially the volume ratio of the enhanced margin and the whole lesion on MRI at 30 days postoperatively. All the volume-related data were delineated and calculated using [http://www.slicer.org '''3D Slicer'''] software. Related predictors were also collected to evaluate the correlation with local tumor control.

'''Results:''' Eighteen patients with nineteen lesions were enrolled for treatment and follow-up. Primary tumor histology included pulmonary carcinoma (n = 11) and breast cancer (n = 4). On average, the tumor size measured 3.01 cm3 (range, 0.40-7.40 cm3), the total ablation time was 13.58 min (range, 2.88-37.15 min), and the complete ablation rate was 92.4% (range, 29.2-100%). Comparing 3s0-day follow-up MRI results with preoperative MRI findings, 18 lesions showed a 2.28-fold (range, 1.21-4.88) volume increase; all the lesions displayed an enhanced component with a volume ratio of 42.35% (range, 10.14-100%). Five patients experienced tumor recurrence, and the local tumor control rates at 90 days and 180 days of follow-up were 68.4% and 66.7%, respectively. Univariate analysis indicated that the primary tumor, ablation rate, and enhanced volume ratio (EVR) > 40% in the 30-day MRI were associated with tumor recurrence, whereas multivariate analysis showed that only EVR > 40% was a predictive factor of local control.

'''Conclusion:''' LITT is a minimally invasive method used to ablate brain metastases which can be used as the first-line treatment for BM patients under certain indications. After LITT, most tumors showed volume enlargement on the 30-day MRI scan, and EVR > 40% on the 30-day MRI may indicate late tumor recurrence.
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==Image Data and Computational Grids for Computing Brain Shift and Solving the Electrocorticography Forward Problem==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37128587/ Data Brief. 2023 Apr 7;48:109122. PMID: 37128587] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10147975/pdf/main.pdf PDF]

'''Authors:''' Zwick BF, Safdar S, Bourantas GC, Joldes GR, Hyde DE, Warfield SK, Wittek A, Miller K.

'''Institution:''' Intelligent Systems for Medicine Laboratory, The University of Western Australia, 35 Stirling Highway, Perth, WA, Australia.

'''Abstract:'''
This article describes the dataset applied in the research reported in NeuroImage article "Patient-specific solution of the electrocorticography forward problem in deforming brain" [1] that is available for download from the Zenodo data repository (https://zenodo.org/record/7687631) [2]. Preoperative structural and diffusion-weighted magnetic resonance (MR) and postoperative computed tomography (CT) images of a 12-year-old female epilepsy patient under evaluation for surgical intervention were obtained retrospectively from Boston Children's Hospital. We used these images to conduct the analysis at The University of Western Australia's Intelligent Systems for Medicine Laboratory using SlicerCBM [3], our open-source software extension for the [http://www.slicer.org '''3D Slicer'''] medical imaging platform. As part of the analysis, we processed the images to extract the patient-specific brain geometry; created computational grids, including a tetrahedral grid for the meshless solution of the biomechanical model and a regular hexahedral grid for the finite element solution of the electrocorticography forward problem; predicted the postoperative MRI and DTI that correspond to the brain configuration deformed by the placement of subdural electrodes using biomechanics-based image warping; and solved the patient-specific electrocorticography forward problem to compute the electric potential distribution within the patient's head using the original preoperative and predicted postoperative image data. The well-established and open-source file formats used in this dataset, including Nearly Raw Raster Data (NRRD) files for images, STL files for surface geometry, and Visualization Toolkit (VTK) files for computational grids, allow other research groups to easily reuse the data presented herein to solve the electrocorticography forward problem accounting for the brain shift caused by implantation of subdural grid electrodes.
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==ImFinite Element Analysis of a Healthy Knee Joint at Deep Squatting for the Study of Tibiofemoral and Patellofemoral Contact==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37143926 J Orthop. 2023 Apr 21;40:7-16. PMID: 37143926]

'''Authors:''' Kothurkar R, Lekurwale R, Gad M, Rathod CM.

'''Institution:''' Department of Mechanical Engineering, K. J. Somaiya College of Engineering, Mumbai, India.

'''Abstract:'''
Background: In non-western countries, deep squatting is a daily activity, and prolonged deep squatting is common among occupational squatters. Household tasks, taking a bath, socializing, using toilets, and performing religious acts are among the activities frequently carried out while squatting by the Asian population. High knee loading is responsible for a knee injury and osteoarthritis. Finite element analysis is an effective tool to determine stresses on the knee joint.

Methods: Magnetic Resonance Imaging (MRI) and Computed Tomographic (CT) images were acquired of one adult without knee injuries. The CT images were acquired at the fully extended knee and one more set of images was acquired with the knee at a deeply flexed knee position. The MRI was acquired with the fully extended knee. 3 Dimensional models of bones were created using CT and soft tissue using MRI with the help of [http://www.slicer.org '''3D Slicer'''] software. Kinematics and finite element analysis of the knee was performed for standing and deep squatting posture using Ansys Workbench 2022.

Results: High peak stresses were observed at deep squatting compared to standing along with the reduction in the contact area. Peak von Mises stresses on femoral cartilage, tibial cartilage, patellar cartilage, and meniscus were increased from 3.3 MPa to 19.9 MPa, 2.9 MPa to 12.4 MPa, 1.5 MPa to 16.7 MPa and 15.8 MPa to 32.8 MPa respectively during deep squatting. Posterior translation of 7.01 mm, and 12.58 mm was observed for medial and lateral femoral condyle respectively from full extension to 153° knee flexion.

Conclusions: Increased stresses in the knee joint at deep squat posture may cause cartilage damage. A sustained deep squat posture should be avoided for healthy knee joints. More posterior translations of the medial femoral condyle at higher knee flexion angle warrant further investigation.
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==A Comparison of Machine Learning Models for Survival Prediction of Patients with Glioma Using Radiomic Features from MRI Scans==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37362372/ Indian J Radiol Imaging. 2023 Apr 28;33(3):338-343. PMID: 37362372] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10289839/pdf/10-1055-s-0043-1767786.pdf PDF]

'''Authors:''' Manjunath M, Saravanakumar S, Kiran S, Chatterjee J.

'''Institution:''' Department of Biotechnology, People's Education Society University, Bangalore, Karnataka, India.

'''Abstract:'''
Background Glioma is a primary, malignant, highly aggressive brain tumor, with patients having an average life expectancy of 14 to 16 months after diagnosis. Magnetic resonance imaging (MRI) scans of these patients can be used to extract and analyze quantifiable features with potential clinical significance. We hypothesize that there is a correlation between radiomic features extracted from MRI scans and survival. Along with clinical data, the radiomic features could be used in survival prediction of patients, providing beneficial information for clinicians to design personalized treatment plans. Methods In our study, we have utilized [http://www.slicer.org '''3D Slicer'''] for tumor segmentation and feature extraction and performed survival prediction of patients with glioma using four different machine learning models. Results and Conclusion Among the models compared, we have achieved a maximum prediction accuracy of 64.4% using the k-nearest neighbors model, which was trained and tested on a combination of clinical data and radiomic features extracted from MRI images provided in the BraTS 2020 dataset.
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==Circular RNA hsa_circ_0000690 as a Potential Biomarker for Diagnosis and Prognosis of Intracranial Aneurysm: Closely Relating to the Volume of Hemorrhage==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36879365 Brain Behav. Apr;13(4):e2929. PMID: 36879365] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10097068/pdf/BRB3-13-e2929.pdf PDF]

'''Authors:'''Huang Y, Cao H, Qi X, Guan C, Que S.

'''Institution:''' Department of Neurosurgery, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, Fujian, China.

'''Abstract:'''

'''Purpose:''' This study aimed to explore circular RNA (circRNA) hsa_circ_0000690 as a potential biomarker for diagnosis and prognosis of intracranial aneurysm (IA) and its relationship with clinical factors and complications of IA.

'''Material/Methods:''' 216 IA patients admitted to the neurosurgery department of our hospital from January 2019 to December 2020 were selected as the experimental group, and 186 healthy volunteers were selected as the control group. The expression of hsa_circ_0000690 in peripheral blood was detected by quantitative real-time PCR, and its diagnostic value was assessed by receiver operating characteristic curve. Relationship between hsa_circ_0000690 and clinical factors of IA was assessed by chi-square test. Nonparametric test was used in univariate analysis, and regression analysis was used in multivariate analysis. Multivariate Cox proportional hazards regression analysis was used to analyze the survival time.

'''Results:''' CircRNA hsa_circ_0000690 of IA patients was relatively lower than that in the control group (p < .001). The AUC of hsa_circ_0000690 was 0.752, the specificity was 0.780, and sensitivity was 0.620, with diagnostic threshold of 0.0449. In addition, hsa_circ_0000690 expression was correlated with Glasgow Coma Scale, the volume of subarachnoid hemorrhage, modified Fisher scale, Hunt-Hess levels and surgical type. For hydrocephalus and delayed cerebral ischemia, hsa_circ_0000690 was significant in univariate analysis, but nonsignificant in multivariate analysis. For prognosis, hsa_circ_0000690 was significantly associated with modified Rankin Scales after surgery for 3 months, but not associated with survival time.

'''Conclusions:''' The expression of hsa_circ_0000690 can act as a diagnostic marker for IA and predict the prognosis of 3 months after operation and is closely related to the volume of hemorrhage.

'''Keywords:''' [http://www.slicer.org '''3D Slicer''']; biomarker; circRNA; diagnosis; intracranial aneurysm; prognosis; subarachnoid hemorrhage
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==Can Quantitative Peritumoral CT Radiomics Features Predict the Prognosis of Patients With Non-Small Cell Lung Cancer? A Systematic Review==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36307554 Eur Radiol. 2023 Mar;33(3):2105-17. PMID: 36307554] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9935659/pdf/330_2022_Article_9174.pdf PDF]

'''Authors:''' Wu L, Lou X, Kong N, Xu M, Gao C.

'''Institution:''' Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China.

'''Abstract:''' Objectives: To provide an overarching evaluation of the value of peritumoral CT radiomics features for predicting the prognosis of non-small cell lung cancer and to assess the quality of the available studies.

'''Methods:''' The PubMed, Embase, Web of Science, and Cochrane Library databases were searched for studies predicting the prognosis in patients with non-small cell lung cancer (NSCLC) using CT-based peritumoral radiomics features. Information about the patient, CT-scanner, and radiomics analyses were all extracted for the included studies. Study quality was assessed using the Radiomics Quality Score (RQS) and the Prediction Model Risk of Bias Assessment Tool (PROBAST).

'''Results:''' Thirteen studies were included with 2942 patients from 2017 to 2022. Only one study was prospective, and the others were all retrospectively designed. Manual segmentation and multicenter studies were performed by 69% and 46% of the included studies, respectively. [http://www.slicer.org '''3D Slicer'''] and MATLAB software were most commonly used for the segmentation of lesions and extraction of features. The peritumoral region was most frequently defined as dilated from the tumor boundary of 15 mm, 20 mm, or 30 mm. The median RQS of the studies was 13 (range 4-19), while all of included studies were assessed as having a high risk of bias (ROB) overall.

'''Conclusions:''' Peritumoral radiomics features based on CT images showed promise in predicting the prognosis of NSCLC, although well-designed studies and further biological validation are still needed.

'''Key points:''' Peritumoral radiomics features based on CT images are promising and encouraging for predicting the prognosis of non-small cell lung cancer. The peritumoral region was often dilated from the tumor boundary of 15 mm or 20 mm because these were considered safe margins. The median Radiomics Quality Score of the included studies was 13 (range 4-19), and all of studies were considered to have a high risk of bias overall.
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==Three Dimensional Assessment of Radiographic Changes after Indirect Pulp Capping using Silver Diamine Fluoride with or without Potassium Iodide in Young Permanent Teeth (12-month RCT)==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36878216 Caries Res. 2023;57(2):177-188. PMID: 36878216]

'''Authors:''' Baraka MMAL, Cevidanes L, Tekeya M, Bakry N, Ruellas A, Botero T, Benavides E, Fontana M.

'''Institution:''' Department of Experimental Oncology, European Institute of Oncology, IRCCS, 20139 Milan, Italy.

'''Abstract:''' The aim was to have a three-dimensional evaluation of radiographic changes after indirect pulp capping (IPC) with silver diamine fluoride (SDF) with or without potassium iodide (KI) and resin modified glass ionomer cement (RMGIC) in deep carious young permanent molars using cone beam computed tomography (CBCT). 108 first permanent molars with deep occlusal cavitated caries lesions, in forty-nine 6-9-year-old children, were randomly allocated to one of 3 groups (n=36) and treated with SDF+KI, SDF and RMGIC as IPC materials. CBCT scans were taken at 0 and at 12-months to assess tertiary dentin formation (volume and grey level intensity), increase in root length, and pathological changes as secondary caries, periapical radiolucency, internal resorption and obliteration of the pulp. The three-dimensional image analysis procedures were performed using ITK-SNAP and [http://www.slicer.org '''3D Slicer'''] CMF. Comparisons were made using analysis of variance with a fixed effect for treatment and random effects for patient, and patient-by-treatment to account for within-patient correlations. A two-sided 5% significance level was used. There were no significant differences among the three groups regarding tertiary dentin volume (p=0.712) and grey level intensity (p=0.660), increase in root length (p=0.365), prevention of secondary caries (p=0.63) and periapical radiolucency (p=0.80) in the analysed 69 CBCT scans. The study did not find differences among the groups regarding quality and quantity of tertiary dentin formed, increase in root length, absence of secondary caries and other signs of failure as shown by CBCT.

'''Clinical Significance:''' The results show no significant differences in radiographic outcomes (quality and quantity of tertiary dentin formed, increase in root length, absence of secondary caries and other signs of failure) when using SDF+KI, SDF and RMGIC in IPC. The results of this study can help guide treatment decision making regarding use of SDF and SDF+KI as IPC materials in deep cavitated lesions.
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==Cross-Sectional Reliability and Concurrent Validity of a Quantitative 2-Dimensional Ultrasound Image Analysis of Effusion and Synovial Hypertrophy in Knee Osteoarthritis==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37008822/ Osteoarthr Cartil Open. 2023 Mar 16;5(2):100356. PMID: 37008822] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10060736/pdf/main.pdf PDF]

'''Authors:''' Dima R, Birmingham TB, Philpott HT, Bryant D, Fenster A, Appleton CT.

'''Institution:''' Faculty of Health Sciences, University of Western Ontario, London, ON, Canada.

'''Abstract:'''
Objective: Effusion-synovitis is related to pain and progression in knee osteoarthritis (OA), but current gold standard ultrasound (US) measures are limited to semi-quantitative grading of joint distension or 1-dimensional thickness measures. A novel quantitative 2-dimensional image analysis methodology is applied to US images of effusion-synovitis; reliability and concurrent validity was assessed in patients with knee OA.

Methods: Cross sectional analysis of US images collected from 51 patients with symptomatic knee OA were processed in ImageJ and segmented in [http://www.slicer.org '''3D Slicer'''] to produce a binary mask of the supra-patellar synovitis region of interest (ROI). Area measures (mm2) of total synovitis, effusion and hypertrophy components were exported. Intra-rater reliability and test-retest reliability (1-14 days washout) were estimated with intra-class correlation coefficients (ICCs). Concurrent validity was measured by Spearman correlations between quantitative measures and gold standard OMERACT and caliper measurements of synovitis.

Results: Intra-rater reliability for hypertrophy area was estimated at 0.98, 0.99 for effusion area, and 0.99 for total synovitis area. The test-retest reliability for total synovitis area was 0.63 (SEM 87.8 mm2), 0.59 for hypertrophy area (SEM 21.0 mm2), and 0.64 for effusion area (SEM 73.8 mm2). Correlation between total synovitis area and OMERACT grade was 0.84, 0.81 between total synovitis area and effusion-synovitis calipers, and 0.81 between total effusion area and effusion calipers.

Conclusion: This new research tool for image analysis demonstrated excellent intra-rater reliability, good concurrent validity, and moderate test-retest reliability. Quantitative 2D US measures of effusion-synovitis and its individual components may enhance the study and management of knee OA.
|}

==Patient-Specific Needle Guidance Templates Drilled Intraprocedurally for Image Guided Intervention: Feasibility Study in Swine==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36173542 Int J Comput Assist Radiol Surg. 2023 Mar;18(3):537-44. PMID: 36173542]

'''Authors:''' Glossop N, Bale R, Xu S, Pritchard WF, Karanian JW, Wood BJ.

'''Institution:''' Queen's University, Kingston, ON, Canada.

'''Abstract:'''
'''purpose:''' Thermal ablation of large tumors may benefit from simultaneous placement of multiple needles, but accurate placement becomes challenging as the number of needles increases. The aim of this work was to evaluate use of personalized needle guidance grid templates based on intraprocedural CT and fabricated at the point of care to implement ablation treatment plans with multiple needles in vivo.

'''Methods:''' A plastic frame was designed to hold two parallel plastic guide plates in a rigid relationship, fixed over the abdomen by a mounting arm. Steel ball targets (1.5 mm) were implanted under ultrasound in the livers of two domestic swine under general anesthesia. Following breath-hold CT of the subject and frame, the targets and frame were identified using customized [http://www.slicer.org '''3D Slicer''']-based planning software. Multiple needle trajectories targeting the balls were planned, including complex off-plane trajectories. A machining program for drilling the hole pattern corresponding to the planned needle trajectories was generated. The pattern was drilled in the two plates with a numerical-controlled milling machine in the suite. The plates were attached to the frame and needles passed through the paired holes to the calculated depth. Placement accuracy was defined as needle tip-to-target distance on post-placement CT.

'''Results:''' The planning process and manufacturing required approximately 6 and 15 min, respectively. Needles were rapidly inserted (n = 11) to the target points without complications or traversing nontarget anatomy. The mean needle tip-to-target distance error was 3.4 ± 2.2, range 0-7 mm.

'''Conclusion:''' Rapid and accurate needle placement was feasible using a subject-specific, custom-drilled, needle guidance grid template fabricated intraprocedurally. Targeting accuracy and performance were similar to more complex and expensive tracking systems which may enable accurate intraprocedural implementation of treatment plans in the liver or other organs. This may be of value in complex ablation cases or in areas where more advanced guidance systems are not available.
|}

==Automatic Landmark Identification in Cone-Beam Computed Tomography==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36811276 Orthod Craniofac Res. 2023 Feb 21. PMID: 36811276]

'''Authors:''' Gillot M, Miranda F, Baquero B, Ruellas A, Gurgel M, Al Turkestani N, Anchling L, Hutin N, Biggs E, Yatabe M, Paniagua B, Fillion-Robin JC, Allemang D, Bianchi J, Cevidanes L, Prieto JC.

'''Institution:''' Department of Orthodontics and Pediatric Dentistry, School of Dental Medicine, University of Michigan, Ann Arbor, MI, USA.

'''Abstract:'''
'''Objective:''' To present and validate an open-source fully automated landmark placement (ALICBCT) tool for cone-beam computed tomography scans.

'''Material and Methods:''' One hundred and forty-three large and medium field of view cone-beam computed tomography (CBCT) were used to train and test a novel approach, called ALICBCT that reformulates landmark detection as a classification problem through a virtual agent placed inside volumetric images. The landmark agents were trained to navigate in a multi-scale volumetric space to reach the estimated landmark position. The agent movements decision relies on a combination of DenseNet feature network and fully connected layers. For each CBCT, 32 ground truth landmark positions were identified by 2 clinician experts. After validation of the 32 landmarks, new models were trained to identify a total of 119 landmarks that are commonly used in clinical studies for the quantification of changes in bone morphology and tooth position.

'''Results:''' Our method achieved a high accuracy with an average of 1.54±0.87 mm error for the 32 landmark positions with rare failures, taking an average of 4.2s computation time to identify each landmark in one large 3D-CBCT scan using a conventional GPU.

'''Conclusion:''' The ALICBCT algorithm is a robust automatic identification tool that has been deployed for clinical and research use as an extension in the 3D Slicer platform allowing continuous updates for increased precision.
|}

==Development and In-Silico and Ex-Vivo Validation of a Software for a Semi-Automated Segmentation of the Round Window Niche to Design a Patient Specific Implant to Treat Inner Ear Disorders==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36826970 J Imaging. 2023 Feb 20;9(2):51. PMID: 36826970] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9965310/pdf/jimaging-09-00051.pdf PDF]

'''Authors:''' Matin-Mann F, Gao Z, Wei C, Repp F, Artukarslan EN, John S, Alcacer Labrador D, Lenarz T, Scheper V.

'''Institution:''' Lower Saxony Center for Biomedical Engineering, Implant Research and Development (NIFE), Department of Otorhinolaryngology, Head and Neck Surgery, Hannover Medical School, Hannover, Germany.

'''Abstract:''' The aim of this study was to develop and validate a semi-automated segmentation approach that identifies the round window niche (RWN) and round window membrane (RWM) for use in the development of patient individualized round window niche implants (RNI) to treat inner ear disorders. Twenty cone beam computed tomography (CBCT) datasets of unilateral temporal bones of patients were included in the study. Defined anatomical landmarks such as the RWM were used to develop a customized [http://www.slicer.org '''3D Slicer'''] plugin for semi-automated segmentation of the RWN. Two otolaryngologists (User 1 and User 2) segmented the datasets manually and semi-automatically using the developed software. Both methods were compared in-silico regarding the resulting RWM area and RWN volume. Finally, the developed software was validated ex-vivo in N = 3 body donor implantation tests with additively manufactured RNI. The independently segmented temporal bones of the different Users showed a strong consistency in the volume of the RWN and the area of the RWM. The volume of the semi-automated RWN segmentations were 48 ± 11% smaller on average than the manual segmentations and the area of the RWM of the semi-automated segmentations was 21 ± 17% smaller on average than the manual segmentation. All additively manufactured implants, based on the semi-automated segmentation method could be implanted successfully in a pressure-tight fit into the RWN. The implants based on the manual segmentations failed to fit into the RWN and this suggests that the larger manual segmentations were over-segmentations. This study presents a semi-automated approach for segmenting the RWN and RWM in temporal bone CBCT scans that is efficient, fast, accurate, and not dependent on trained users. In addition, the manual segmentation, often positioned as the gold-standard, actually failed to pass the implantation validation.
|}

==Design and Analysis of HSC-BPPV Diagnostic Maneuver Based on Virtual Simulation==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36873445 Front Neurol. 2023 Feb 17;14:1132343. PMID: 36873445] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9981954/pdf/fneur-14-1132343.pdf PDF]

'''Authors:''' Li Y, Yang X.

'''Institution:''' Department of Research Center, Third Affiliated Hospital of Shanghai University, Wenzhou Third Clinical Institute Affiliated to Wenzhou Medical University, Wenzhou People's Hospital, Wenzhou, China.

'''Abstract:'''
'''Background:''' The preferred supine roll test for the diagnosis of horizontal semicircular canal BPPV has several disadvantages, including difficulty in locating the affected ear, inconsistent nystagmus performance on repeated testing, and lack of a typical latency period, resulting in insensitive diagnosis.

Objectives: To investigate novel diagnostic techniques with more scientific design, more accessible application, and better diagnostic sensitivity and specificity.

'''Materials and Methods:''' Based on clinical microscopic CT data, we created a virtual simulation model of BPPV using Unity software. The physical simulation of the traditional supine roll test was performed to observe and analyse the movement of the otoliths, whose initial position was the typical stable position. In addition, the normal vectors of the plane and crista ampullaris of the horizontal semicircular canal were measured using [http://www.slicer.org '''3D Slicer'''] software. Based on this, we analyzed the critical steps for designing diagnostic maneuvers for BPPV in the horizontal semicircular canal. For a more accurate diagnosis of horizontal semicircular canal BPPV, it is critical to rotate the horizontal semicircular canal to be parallel to gravity. It is also necessary to move the otolith by swinging the head. As a result, we developed two diagnostic maneuvers: the 60° roll test and the prone roll test. We also performed simulations to observe otolith movement and predict nystagmus performance.

'''Conclusions:''' The 60° roll test and the prone roll test can complement the supine roll test. Compared to the supine roll test, they not only effectively differentiate canalolithiasis from cupulolithiasis, but also make it easier to determine the position of the otoliths, and the characteristics of the nystagmus are more pronounced. Significant diagnostic features have significant potential benefits for home and telemedicine.
|}

==The Simplified Tailor-Made Workflows for a [http://www.slicer.org '''3D Slicer''']-Based Craniofacial Implant Design==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36801943 Sci Rep. 2023 Feb 17;13(1):2850. PMID: 36801943] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9938178/pdf/41598_2023_Article_30117.pdf PDF]

'''Authors:''' Tantisatirapong S, Khunakornpattanakarn S, Suesatsakul T, Boonpratatong A, Benjamin I, Tongmeesee S, Kangkorn T, Chanwimalueang

'''Institution:''' Department of Biomedical Engineering, Faculty of Engineering, Srinakharinwirot University, Nakhon Nayok, Thailand.

'''Abstract:''' A specific design of craniofacial implant model is vital and urgent for patients with traumatic head injury. The mirror technique is commonly used for modeling these implants, but it requires the presence of a healthy skull region opposite to the defect. To address this limitation, we propose three processing workflows for modeling craniofacial implants: the mirror method, the baffle planner, and the baffle-based mirror guideline. These workflows are based on extension modules on the [http://www.slicer.org '''3D Slicer'''] platform and were developed to simplify the modeling process for a variety of craniofacial scenarios. To evaluate the effectiveness of these proposed workflows, we investigated craniofacial CT datasets collected from four accidental cases. The designed implant models were created using the three proposed workflows and compared to reference models created by an experienced neurosurgeon. The spatial properties of the models were evaluated using performance metrics. Our results show that the mirror method is suitable for cases where a healthy skull region can be completely reflected to the defect region. The baffle planner module offers a flexible prototype model that can be fit independently to any defect location, but it requires customized refinement of contour and thickness to fill the missing region seamlessly and relies on the user's experience and expertise. The proposed baffle-based mirror guideline method strengthens the baffle planner method by tracing the mirrored surface. Overall, our study suggests that the three proposed workflows for craniofacial implant modeling simplify the process and can be practically applied to a variety of craniofacial scenarios. These findings have the potential to improve the care of patients with traumatic head injuries and could be used by neurosurgeons and other medical professionals.
|}

==Predicting Transient Ischemic Attack Risk in Patients With Mild Carotid Stenosis Using Machine Learning and CT Radiomics==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36846119 Front Neurol. 2023 Feb 8;14:1105616. PMID: 36846119] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9944715/pdf/fneur-14-1105616.pdf PDF]

'''Authors:''' Xia H, Yuan L, Zhao W, Zhang C, Zhao L, Hou J, Luan Y, Bi Y, Feng Y.

'''Institution:''' Department of Vascular Surgery, The First Affiliated Hospital of Kunming Medical University, Kunming, China.

'''Abstract:'''
'''Objective:''' This study aims to establish a radiomics-based machine learning model that predicts the risk of transient ischemic attack in patients with mild carotid stenosis (30-50% North American Symptomatic Carotid Endarterectomy Trial) using extracted computed tomography radiomics features and clinical information.

'''Methods:''' A total of 179 patients underwent carotid computed tomography angiography (CTA), and 219 carotid arteries with a plaque at the carotid bifurcation or proximal to the internal carotid artery were selected. The patients were divided into two groups; patients with symptoms of transient ischemic attack after CTA and patients without symptoms of transient ischemic attack after CTA. Then we performed random sampling methods stratified by the predictive outcome to obtain the training set (N = 165) and testing set (N = 66). [http://www.slicer.org '''3D Slicer'''] was employed to select the site of plaque on the computed tomography image as the volume of interest. An open-source package PyRadiomics in Python was used to extract radiomics features from the volume of interests. The random forest and logistic regression models were used to screen feature variables, and five classification algorithms were used, including random forest, eXtreme Gradient Boosting, logistic regression, support vector machine, and k-nearest neighbors. Data on radiomic feature information, clinical information, and the combination of these pieces of information were used to generate the model that predicts the risk of transient ischemic attack in patients with mild carotid artery stenosis (30-50% North American Symptomatic Carotid Endarterectomy Trial).

'''Results:''' The random forest model that was built based on the radiomics and clinical feature information had the highest accuracy (area under curve = 0.879; 95% confidence interval, 0.787-0.979). The combined model outperformed the clinical model, whereas the combined model showed no significant difference from the radiomics model.

'''Conclusion:''' The random forest model constructed with both radiomics and clinical information can accurately predict and improve discriminative power of computed tomography angiography in identifying ischemic symptoms in patients with carotid atherosclerosis. This model can aid in guiding the follow-up treatment of patients at high risk.
|}

==Deep Learning Enabled Multi-Organ Segmentation of Mouse Embryos==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36802342 Biol Open. 2023 Feb 15;12(2):bio059698. PMID: 36802342] | [https://cob.silverchair-cdn.com/cob/content_public/journal/bio/12/2/10.1242_bio.059698/2/bio059698.pdf PDF]

'''Authors:''' Rolfe SM, Whikehart SM, Maga AM.

'''Institution:''' Center for Developmental Biology and Regenerative Medicine, Seattle Children's Research Institute, Seattle, WA, USA.

'''Abstract:''' The International Mouse Phenotyping Consortium (IMPC) has generated a large repository of three-dimensional (3D) imaging data from mouse embryos, providing a rich resource for investigating phenotype/genotype interactions. While the data is freely available, the computing resources and human effort required to segment these images for analysis of individual structures can create a significant hurdle for research. In this paper, we present an open source, deep learning-enabled tool, Mouse Embryo Multi-Organ Segmentation (MEMOS), that estimates a segmentation of 50 anatomical structures with a support for manually reviewing, editing, and analyzing the estimated segmentation in a single application. MEMOS is implemented as an extension on the [http://www.slicer.org '''3D Slicer'''] platform and is designed to be accessible to researchers without coding experience. We validate the performance of MEMOS-generated segmentations through comparison to state-of-the-art atlas-based segmentation and quantification of previously reported anatomical abnormalities in a Cbx4 knockout strain. This article has an associated First Person interview with the first author of the paper.
|}

==Development and Validation of an 18FFDG-PET/CT Radiomic Model for Predicting Progression-Free Survival for Patients With Stage II - III Thoracic Esophageal Squamous Cell Carcinoma Who Are Treated With Definitive Chemoradiotherapy==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36794365 Acta Oncol. 2023 Feb;62(2):159-65. PMID: 36794365]

'''Authors:''' Takahashi N, Tanaka S, Umezawa R, Takanami K, Takeda K, Yamamoto T, Suzuki Y, Katsuta Y, Kadoya N, Jingu K.

'''Institution:''' Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Japan.

'''Abstract:'''
'''Background:''' Radiomics is a method for extracting a large amount of information from images and used to predict treatment outcomes, side effects and diagnosis. In this study, we developed and validated a radiomic model of [18F]FDG-PET/CT for predicting progression-free survival (PFS) of definitive chemoradiotherapy (dCRT) for patients with esophageal cancer.

'''Material and Methods:''' Patients with stage II - III esophageal cancer who underwent [18F]FDG-PET/CT within 45 days before dCRT between 2005 and 2017 were included. Patients were randomly assigned to a training set (85 patients) and a validation set (45 patients). Radiomic parameters inside the area of standard uptake value ≥ 3 were calculated. The open-source software [http://www.slicer.org '''3D Slicer'''] and Pyradiomics were used for segmentation and calculating radiomic parameters, respectively. Eight hundred sixty radiomic parameters and general information were investigated.In the training set, a radiomic model for PFS was made from the LASSO Cox regression model and Rad-score was calculated. In the validation set, the model was applied to Kaplan-Meier curves. The median value of Rad-score in the training set was used as a cutoff value in the validation set. JMP was used for statistical analysis. RStudio was used for the LASSO Cox regression model. p < 0.05 was defined as significant.

'''Results:''' The median follow-up periods were 21.9 months for all patients and 63.4 months for survivors. The 5-year PFS rate was 24.0%. In the training set, the LASSO Cox regression model selects 6 parameters and made a model. The low Rad-score group had significantly better PFS than that the high Rad-score group (p = 0.019). In the validation set, the low Rad-score group had significantly better PFS than that the high Rad-score group (p = 0.040).

'''Conclusions:''' The [18F]FDG-PET/CT radiomic model could predict PFS for patients with esophageal cancer who received dCRT.
|}

==Minimizing Magnetic Resonance Image Geometric Distortion at 7 Tesla for Frameless Presurgical Planning Using Skin-Adhered Fiducials==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36301228 Med Phys. 2023 Feb;50(2):694-701. PMID: 36301228]

'''Authors:''' Kirby KM, Koons EK, Welker KM, Fagan AJ.

'''Institution:''' Department of Radiology, Mayo Clinic, Rochester, MN, USA.

'''Abstract:'''
'''Background:''' 7T MRI offers significant benefits to spatial and contrast resolution compared to lower field strengths. This superior image quality can help better delineate targets in stereotactic neurosurgical procedures; however, the potential for increased geometric distortions at 7T has impaired its widespread use for these applications. Image geometric distortions can be due to distortions of B0 arising from tissue magnetic susceptibility effects or inherent field inhomogeneities, and nonlinearity of the magnetic field gradients.

'''Purpose:''' The purpose of this study was to investigate the use of 7T MRI for neurosurgical frameless stereotactic navigation procedures. Image geometric distortions at the skin surface in 7T images were minimized and compared to results from clinical 3T frameless imaging protocols.

'''Methods:''' A 3D-printed grid phantom filled with oil was designed to perform a fine calibration of the 7T imaging gradients, and an oil-filled head phantom with internal targets was used to determine ground truth (from computed tomography [CT]) positioning errors. Three volunteers and the head phantom were imaged consecutively at 3T and 7T. Ten skin-adhesive fiducial markers were placed on each subject's exposed skin surface at standard clinical placement locations for frameless procedures. Imaging sequences included MPRAGE (three bandwidths at 7T: 400, 690, and 1020 Hz/pixel, and one at 3T: 400 Hz/pixel), T2 SPACE, and T2 SPACE FLAIR acquisitions. An additional GRE field map was acquired on both scanners using a multi-echo GRE sequence. Custom Matlab code was used to perform additional distortion correction of the images using the unwrapped field maps. Fiducial localization was performed with [http://www.slicer.org '''3D Slicer'''], with absolute fiducial positioning errors determined in phantom experiments following rigid registration to the CT images. For human experiments, 3T and 7T images were registered and relative differences in fiducial locations were compared using two-tailed paired t-tests.

'''Results:''' Phantom measurements at 7T yielded gradient distance scaling errors of 1.1%, 2.2%, and 1.0% along the x-, y-, and z-axes, respectively. These system miscalibrations were traced back to phantom manufacturing deviations in the sphericity of the vendor's gradient calibration phantom. Correction factors along each gradient axis were applied, and afterward, geometric distortions of less than 1 mm were obtained in the 7T MR head phantom images for the 1020 Hz/pixel bandwidth MPRAGE sequence. For the human subjects, four fiducial locations were excluded from the analysis due to patient positioning differences. Differences between 3T and 7T MPRAGE with low/medium/high bandwidth were 2.2 /2.6/2.3 mm, respectively, before the correction, reducing to 1.6/1.3/1.0 mm after the correction (p < 0.001). T2 SPACE and T2 SPACE FLAIR yielded a similar pattern when the correction was applied, decreasing from 2.1 to 0.8 mm, and 2.6 to 1.0 mm, respectively.

'''Conclusions:''' 7T MRI can be used to perform frameless presurgical planning with skin-adhesive fiducials. Geometric distortions can be reduced to a clinically relevant level (errors < ∼1 mm) with no significant susceptibility-related distortions, by using high receiver bandwidth, ensuring gradients are properly calibrated, and placing skin fiducials in areas where distortions from patient positioning are minimal.
|}

==Acute Colonic Pseudo-Obstruction Secondary to Renal Calculus: A Case Report and Review of Pathophysiology==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36777972 Cureus. 2023 Feb 7;15(2):e34756. PMID: 36777972] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9905947/pdf/cureus-0015-00000034756.pdf PDF]

'''Authors:''' Gillies M, AlDujaili T.

'''Institution:''' General Surgery, Goulburn Valley Health, Shepparton, Australia

'''Abstract:''' Acute colonic pseudo-obstruction (ACPO) is obstruction of the large bowel without a mechanical cause. The exact mechanism remains incompletely understood but is thought to result from disruption to the autonomic regulation of the colon, typically in the context of hospitalized patients with medical illness, precipitating medications, or recent surgical intervention. This paper presents an unusual case of ACPO in an ambulatory patient with a recently passed renal calculus, explores the anatomy and physiology underlying the autonomic dysfunction theory of ACPO pathogenesis in the context of the case, and provides a 3D reconstruction of the patient's CT to illustrate the abrupt caliber change at the splenic flexure characteristic of ACPO.

'''Keywords:''' 3d reconstruction; acute colonic pseudo-obstruction; ogilvie's syndrome; renal calculi; [http://www.slicer.org '''3D Slicer'''] software.
|}

==A Novel Stereotactic Aspiration Technique for Intracerebral Hemorrhage==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36270590 World Neurosurg. 2023 Feb;170:e28-e36. PMID: 36270590]

'''Authors:''' Xu HZ, Guo J, Wang C, Liu X, Song ZQ, Chen RF, Qiu B, Wang Q, Huang Y.

'''Institution:''' Department of Neurosurgery, Civil Aviation General Hospital, Beijing, China.

'''Abstract:'''

'''Background:''' Minimally invasive surgery is effective and recommended for treatment of intracerebral hemorrhage; however, neurosurgeons in grass-root hospitals in underdeveloped countries lack effective and precise minimally invasive surgery techniques. The aim of this study was to present a technique of computed tomography angiography-based three-dimensional-printed navigation mold-guided stereotactic aspiration and demonstrate its clinical application using a hard needle in a series of patients.

'''Methods:''' The novel stereotactic aspiration technique was performed in 18 patients with spontaneous intracerebral hemorrhage at our center, and clinical outcomes were reported. We compared the volume of hematoma measured by 3 different methods: ABC/2 formula, manual segmentation with OsiriX, and manual segmentation with [http://www.slicer.org '''3D Slicer'''].

'''Results:''' The surgery was completed safely within an average operative time of 15.11 minutes, achieving the goal of <15 mL residual clot volume or >70% clot removal in all patients. No intracranial rebleeding or infection was observed postoperatively. At the end of the 6-month follow-up, 61.11% (11/18) of patients achieved a modified Rankin Scale score <3. There was overall better agreement of hematoma measurement using segmentation with [http://www.slicer.org '''3D Slicer'''] rather than ABC/2 measurement or hematoma measurement using segmentation with OsiriX.

'''Conclusions:''' Our novel method of stereotactic aspiration benefited patients in this study with good percent clot removal, few surgery-related complications, and a favorable prognosis. Manual segmentation with [http://www.slicer.org '''3D Slicer'''] could be used to provide the neurosurgeon with dependable information about hematoma volume. This cheap and convenient technique may be applied in grass-root hospitals in underdeveloped countries. Assessment in multicenter prospective clinical trials is needed.
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==Morphological Evaluation of the Normal and Hydrocephalic Third Ventricle on Cranial Magnetic Resonance Imaging in Children: A Retrospective Study==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35994062 Pediatr Radiol. 2023 Feb;53(2):282-96. PMID: 35994062]

'''Authors:''' Isıklar S, Turan Ozdemir S, Ozkaya G, Ozpar R, Parlak M.

'''Institution:''' Medical Imaging Techniques Program, Vocational School of Health Services, Bursa Uludag University, 16240, Bursa, Turkey.

'''Abstract:'''
'''Background:''' Third ventricle morphological changes reflect changes in the ventricular system in pediatric hydrocephalus, so visual inspection of the third ventricle shape is standard practice. However, normal pediatric reference data are not available.

'''Objective:''' To investigate both the normal development of the third ventricle in the 0-18-year age group and changes in its biometry due to hydrocephalus.

'''Materials and Methods:''' For this retrospective study, we selected individuals ages 0-18 years who had magnetic resonance imaging (MRI) from 2012 to 2020. We included 700 children (331 girls) who had three-dimensional (3-D) T1-weighted sequences without and 25 with hydrocephalus (11 girls). We measured the distances between the anatomical structures limiting the third ventricle by dividing the third ventricle into anterior and posterior regions. We made seven linear measurements and three index calculations using 3DSlicer and MRICloud pipeline, and we analyzed the results of 23 age groups in normal and hydrocephalic patients using SPSS (v. 23).

'''Results:''' Salient findings are: (1) The posterior part of the third ventricle is more affected by both developmental and hydrocephalus-related changes. (2) For third ventricle measurements, gender was insignificant while age was significant. (3) Normal third ventricular volumetric development showed a segmental increase in the 0-18 age range. The hydrocephalic third ventricle volume cut-off value in this age group was 3 cm3.

'''Conclusion:''' This study describes third ventricle morphometry using a linear measurement method. The ratios defined in the midsagittal plane were clinically useful for diagnosing the hydrocephalic third ventricle. The linear and volumetric reference data and ratios are expected to help increase diagnostic accuracy in distinguishing normal and hydrocephalic third ventricles.
|}

==Henri IV of France's Larynx 3D Reconstitution==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36149490 Eur Arch Otorhinolaryngol. 2023 Feb;280(2):919-24. PMID: 36149490]

'''Authors:''' Baudouin R, Amelot A, Laprie Y, Crevier-Buchman L, Maeda S, Huynh-Charlier I, Hans S, Charlier P.

'''Institution:''' Department of Otolaryngology-Head & Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Université Paris Saclay), Montigny-le-Bretonneux, France.

'''Abstract:''' Objectives: King Henri IV of France (reign from 1589 to 1610) was one of the most important kings of France. Embalmed and buried in Saint-Denis, his remains were beheaded in 1793. His head (including his larynx) survived in successive private collections until its definitive identification in 2010. The purpose of the study was to provide a morphologic study of the larynx with a 3D reconstitution.

'''Methods:''' A flexible endoscopy was performed via the mouth and via the trachea. Measures of the larynx (vocal folds lengths, thickness, width, larynx height) were collected from the CT-scan by a panel of experts blind each other. The segmentation of the laryngeal anatomical components (vocal folds, cartilages) was performed using [http://www.slicer.org '''3D Slicer''']. Mesh smoothing and 3D reconstitution were performed using Fusion 360®. Reconstitution was discussed between the experts. Decision was made by consensus after discussion.

'''Results:''' Cricoid, thyroid, arytenoid cartilages, vocal folds and hyoid bone were identified and a computed 3D reconstitution of the larynx was made. The laryngeal 3D model appeared morphologically similar to a living subject. Measures were similar but smaller than those of a modern subject.

'''Conclusions:''' The 3D reconstitution of the larynx of Henri IV of France was conducted from the CT-scan of his mummified head. This work constitutes a first valuable morphologic analysis of a larynx from an embalmed individual. This anatomical work is the first step towards the reconstruction of the voice of this historical character, which we hope to concretize with computer modeling tools in a second step.
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==Development and External Validation of a Novel Nomogram to Predict Prostate Cancer in Biopsy-Naïve Patients With PSA <10 Ng/Ml and PI-RADS v2.1 = 3 Lesions==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35920264 Cancer Med. 2023 Feb;12(3):2560-71. PMID: 35920264] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9939143/pdf/CAM4-12-2560.pdf PDF]

'''Authors:''' Hu C, Sun J, Xu Z, Zhang Z, Zhou Q, Xu J, Chen H, Wang C, Ouyang J.

'''Institution:''' Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.

'''Abstract:'''
'''Objective:''' To develop and externally validate a novel nomogram in biopsy-naïve patients with prostate-specific antigen (PSA) <10 ng/ml and PI-RADS v2.1 = 3 lesions.

'''Methods:''' We retrospectively collected 307 men that underwent initial biopsy from October 2015 to January 2022 in Cohort 1 (The First Affiliated Hospital of Soochow University). External cohort (Cohort 2, Kunshan Hospital) included 109 men that met our criteria from July 2016 to June 2021. By [http://www.slicer.org '''3D Slicer'''] Software, the volume of all lesions was divided into two subgroups (PI-RADS v2.1 = 3a and 3b). Logistic regression analysis was performed to screen for variables and construct nomogram by analyzing clinical data from Cohort 1. Receiver operating characteristics curve analysis, calibration plot and decision curve analysis (DCA) were plotted to validate the nomogram in external cohort.

'''Results:''' A total of 70 (22.8%) patients was diagnosed with prostate cancer in Institution 1. Among them, 34 (11.1%) had clinically significant prostate cancer (csPCa). Age, prostate-specific antigen density, digital rectal examination, PI-RADS v2.1 = 3 subgroups (3a and 3b) and apparent diffusion coefficient (ADC, <750 mm2 /s) were predictive factors for prostate cancer (PCa) and csPCa. High area under the curve of the nomogram was found in Cohort 1 and Cohort 2 for PCa (0.857 vs. 0.850) and for csPCa (0.896 vs. 0.893). Calibration curves showed excellent agreement between the predicted probability and actual risk for the models in internal and external validation. The DCA demonstrated net benefit of our nomogram.

'''Conclusion:''' Until now, this is the first nomogram that predicts PCa and csPCa in biopsy-naïve patients with PSA <10 ng/ml and PI-RADS v2.1 = 3 lesions. Furthermore, PI-RADS v2.1 = 3 subgroups were considered to be an independent risk factor in our model. Our nomogram may assist urologists in biopsy decision making for these so-called "double gray zone" patients.
|}

==A Three-Dimensionally Printed Otological Model for Cholesteatoma Mastoidectomy Training==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35789285 Eur Arch Otorhinolaryngol. 2023 Feb;280(2):671-80. PMID: 35789285]

'''Authors:''' de Souza MA, Bento RF, Lopes PT.

'''Institution:''' Otolaryngology Department, University of São Paulo School of Medicine, São Paulo, Brazil.

'''Abstract:'''
'''purpose:''' To relate the creation and expert validation (face and content validity) of an affordable three-dimensional (3D) printed model of temporal bones with chronic otitis media with cholesteatoma (COMC) as a simulator for mastoidectomy.

'''Methods:''' We performed computed tomography (CT) of the temporal bones of a patient with COMC followed at the University of São Paulo (USP) Hospital with [http://www.slicer.org '''3D Slicer'''] to create a 3-D model of the affected bone using light-curing resin and silicone (cholesteatoma). The final 3-D printed images were scored by 10 otologists using a customized version of the Michigan Standard Simulation Scale Experience (MiSSES). Internal consistency and inter-rater reliability were assessed using Cronbach's α and intraclass correlations.

'''Results:''' Otologists consistently scored the model positively for fidelity, educational value, reactions, and the overall model quality. Nine otologists agreed that the model was a good educational device for surgical training of COMC. All experts deemed the model ready-or nearly ready-for use. The final cost of the model, including raw materials and manufacturing, was 120 USD.

'''Conclusions:''' Using 3D printing technology, we created the first anatomically accurate, low-cost, disease-reproducing 3D model of temporal bones for mastoidectomy training for cholesteatoma.
|}

==Development of a Navigable 3D Virtual Model of Temporal Bone Anatomy==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36704866 J Vis Commun Med. 2023 Jan 26:1-5. PMID: 36704866] | [https://www.tandfonline.com/doi/full/10.1080/17453054.2023.2169110 PDF]

'''Authors:''' Sareen K.

'''Institution:''' Sant Parmanand Hospital, New Delhi, India.

'''Abstract:'''
'''Background:''' Computed Tomography (CT) scanning offers an accurate structural definition of bones, blood vessels, and soft tissues; however, mental integration of cross-sectional 2D CT images for a 3D understanding of complex anatomical structures becomes difficult when the field of view is confined to the temporal bone. This project tried to provide a feasible solution to this problem by creating a navigable 3D virtual model which may aid in better comprehension of the temporal bone anatomy.

'''Methods:''' A helical-CT scan was used to obtain high-resolution cross-sectional slices of a cadaveric human temporal bone. Using the volume-rendering capabilities of [http://www.slicer.org '''3D Slicer'''], which involves volume data management, cropping of the data set, and threshold painting, detailed anatomical structures were segmented based on the intensity captured from different regions. This volumetric data was converted to an interactive virtual model using Blender®.

'''Results:''' The final product is a web page that allows interaction and navigation with a 3D annotated model of the temporal bone, which can be accessed from any device with a web browser.

'''Conclusion:''' This model can function as a training tool for students, teachers, and practitioners to understand and review the complex anatomy of the temporal bone.
|}

==Maxillary Antral Pseudocyst Drift after Osteotome Sinus Floor Elevation with Simultaneous Implant Placement: A Case Report and Literature Review==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36769568 J Clin Med. 2023 Jan 24;12(3):920. PMID: 36769568] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9917374/pdf/jcm-12-00920.pdf PDF]

'''Authors:''' Wang P, Huang N, Ren J, Gong P, Long J, Huang B.

'''Institution:''' West China School of Stomatology, Sichuan University, Chengdu, China.

'''Abstract:''' This report describes maxillary antral pseudocyst drift after maxillary sinus floor augmentation through osteotome sinus floor elevation with simultaneous implant placement. [http://www.slicer.org '''3D Slicer'''] was used to measure the pseudocyst and maxilla for the placement of the implants; follow-up visits were scheduled at 6, 12, and 22 months. No adverse effects were observed during or after surgery, and all implants exhibited osseointegration without mobility. At 6 months after surgery, the pseudocyst had moved posterolaterally from the preoperative position near the anterior medial maxillary sinus, then returned to its original position at 12 months. However, it had remigrated to the posterolateral position at 22 months. The preoperative volume of the pseudocyst was 3.795 mm3; it was 2.370, 3.439, and 2.930 mm3 at 6, 12, and 22 months after surgery, respectively. The changes in pseudocyst drift and volume did not have a substantial negative influence on the implants, presumably because of cystic attachment and the recurrence of multiple pseudocysts at different locations. The risks associated with changes in a pseudocyst can be avoided, if an appropriate treatment plan is selected.
|}

==Radiomic Analysis Based on Magnetic Resonance Imaging for Predicting PD-L2 Expression in Hepatocellular Carcinoma==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36672315 Cancers (Basel). 2023 Jan 5;15(2):365. PMID: 36672315] | [http://www.ncbi.nlm.nih.gov/pmc/articles/pmc9856314/ PDF]

'''Authors:''' Tao YY, Shi Y, Gong XQ, Li L, Li ZM, Yang L, Zhang XM.

'''Institution:''' Medical Imaging Key Laboratory of Sichuan Province, Interventional Medical Center, Department of Radiology, Medical Research Center, Affiliated Hospital of North Sichuan Medical College, Nanchong, China.

'''Abstract:''' Hepatocellular carcinoma (HCC) is the sixth most common malignant tumour and the third leading cause of cancer death in the world. The emerging field of radiomics involves extracting many clinical image features that cannot be recognized by the human eye to provide information for precise treatment decision making. Radiomics has shown its importance in HCC identification, histological grading, microvascular invasion (MVI) status, treatment response, and prognosis, but there is no report on the preoperative prediction of programmed death ligand-2 (PD-L2) expression in HCC. The purpose of this study was to investigate the value of MRI radiomic features for the non-invasive prediction of immunotherapy target PD-L2 expression in hepatocellular carcinoma (HCC). A total of 108 patients with HCC confirmed by pathology were retrospectively analysed. Immunohistochemical analysis was used to evaluate the expression level of PD-L2. [http://www.slicer.org '''3D Slicer'''] software was used to manually delineate volumes of interest (VOIs) and extract radiomic features on preoperative T2-weighted, arterial-phase, and portal venous-phase MR images. Least absolute shrinkage and selection operator (LASSO) was performed to find the best radiomic features. Multivariable logistic regression models were constructed and validated using fivefold cross-validation. The area under the receiver characteristic curve (AUC) was used to evaluate the predictive performance of each model. The results show that among the 108 cases of HCC, 50 cases had high PD-L2 expression, and 58 cases had low PD-L2 expression. Radiomic features correlated with PD-L2 expression. The T2-weighted, arterial-phase, and portal venous-phase and combined MRI radiomics models showed AUCs of 0.789 (95% CI: 0.702-0.875), 0.727 (95% CI: 0.632-0.823), 0.770 (95% CI: 0.682-0.875), and 0.871 (95% CI: 0.803-0.939), respectively. The combined model showed the best performance. The results of this study suggest that prediction based on the radiomic characteristics of MRI could noninvasively predict the expression of PD-L2 in HCC before surgery and provide a reference for the selection of immune checkpoint blockade therapy.
|}

==Correlation Between Unilateral Internal Carotid Artery Stenosis and Asymmetric Distribution of Enlarged Perivascular Spaces in Patients With Acute Cerebral Infarction==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36649988 Zhonghua Yi Xue Za Zhi. 2023 Jan 17;103(3):178-185. PMID: 36649988]

'''Authors:''' Jian XL, Zhang M, Yun WW.

'''Abstract:'''
'''Objective:''' To explore the correlation between unilateral internal carotid artery (ICA) stenosis and asymmetrical distribution of enlarged perivascular spaces (EPVS) in patients with acute cerebral infarction.

'''Methods:''' Acute cerebral infarction patients with unilateral ICA stenosis hospitalized in Changzhou Second People's Hospital from October 2020 to December 2021 were collected. Routine cranial MRI and CT angiography were completed for each patient. The [http://www.slicer.org '''3D Slicer'''] software was used to quantitatively analyze the volume of patient's EPVS. Patients were divided into moderate stenosis group and severe stenosis/occlusion group according to the degree of ICA stenosis. Baseline data were compared between the two groups. Patients were further divided into three groups: moderate stenosis, severe stenosis and occlusion groups, and the ipsilateral and contralateral EPVS volume of ICA stenosis patients was compared. The asymmetry index (AI) was calculated for EPVS in the basal ganglia region (BG-EPVS) and EPVS in the centrum semiovale (CSO-EPVS). Patients with AI≥0.2 were included in the EPVS asymmetry group, while the rest were in the EPVS symmetry group, and the degree of unilateral ICA stenosis was compared between the two groups. Multivariate logistic regression model was used to analyze the relationship between ICA severe stenosis/occlusion and the asymmetric distribution of BG-EPVS.

'''Results:''' A total of 122 patients (96 males and 26 females) were enrolled, aged (70±10) years, with 81 cases in the unilateral ICA severe stenosis/occlusion group (46 cases of severe stenosis and 35 of occlusion) and 41 cases in the moderate stenosis group. Patients in the unilateral ICA severe stenosis/occlusion group had greater BG-EPVS volume [(4.08±0.76) mm3]and proportion of asymmetric distribution of BG-EPVS [75.3%(61/81)] than those of the moderate stenosis group [(3.12±0.85) mm3 and 39.0% (16/41)], with statistically significant differences (both P<0.001). The BG-EPVS volumes of the ipsilateral side of the stenosis in the severe stenosis group and the occlusion group [(3.34±0.86) mm3 and (3.93±0.60) mm3] were significantly greater than those of the contralateral side [(2.65±1.28) mm3 and (3.21±0.88) mm3], with statistically significant differences (both P<0.001). Correlation analysis indicated that the degree of unilateral ICA stenosis was positively correlated with the BG-EPVS volume on the stenosis side (r=0.62, P<0.001). Further comparison of the degree of unilateral ICA stenosis between the EPVS symmetric and asymmetric groups showed that the proportion of unilateral ICA severe stenosis/occlusion in the BG-EPVS asymmetry group was higher than that in the symmetric group [79.2%(61/77) vs 44.4%(20/45),P<0.001]. Multivariate logistic regression analysis showed that unilateral ICA severe stenosis/occlusion (OR=4.280, 95%CI: 1.743-10.508, P =0.002) and age (OR=1.055, 95%CI: 1.001-1.112, P=0.044) were risk factors for asymmetric distribution of BG-EPVS.

'''Conclusions:''' The severe stenosis/occlusion of the unilateral ICA and age are the risk factors for the asymmetric distribution of the BG-EPVS in patients with acute cerebral infarction. The ipsilateral EPVS volume of unilateral ICA stenosis is larger than that of the contralateral side, and the degree of ICA stenosis is positively correlated with the severity of BG-EPVS.
|}

==Radiomics to Predict the Mortality of Patients With Rheumatoid Arthritis-Associated Interstitial Lung Disease: A Proof-of-Concept Study==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36698825 Front Med (Lausanne). 2023 Jan 9;9:1069486. PMID: 36698825] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9870287/pdf/fmed-09-1069486.pdf PDF]

'''Authors:''' Venerito V, Manfredi A, Lopalco G, Lavista M, Cassone G, Scardapane A, Sebastiani M, Iannone F.

'''Institution:''' Rheumatology Unit, Department of Emergency and Organ Transplantation, University of Bari Aldo Moro, Bari, Italy.

'''Abstract:''' Objectives: Patients with rheumatoid arthritis (RA) and interstitial lung disease (ILD) have increased mortality compared to the general population and factors capable of predicting RA-ILD long-term clinical outcomes are lacking. In oncology, radiomics allows the quantification of tumour phenotype by analysing the characteristics of medical images. Using specific software, it is possible to segment organs on high-resolution computed tomography (HRCT) images and extract many features that may uncover disease characteristics that are not detected by the naked eye. We aimed to investigate whether features from whole lung radiomic analysis of HRCT may alone predict mortality in RA-ILD patients.

'''Methods:''' High-resolution computed tomographies of RA patients from January 2012 to March 2022 were analyzed. The time between the first available HRCT and the last follow-up visit or ILD-related death was recorded. We performed a volumetric analysis in [http://www.slicer.org '''3D Slicer'''], automatically segmenting the whole lungs and trachea via the Lung CT Analyzer. A LASSO-Cox model was carried out by considering ILD-related death as the outcome variable and extracting radiomic features as exposure variables.

'''Results:''' We retrieved the HRCTs of 30 RA-ILD patients. The median survival time (interquartile range) was 48 months (36-120 months). Thirteen out of 30 (43.33%) patients died during the observation period. Whole line segmentation was fast and reliable. The model included either the median grey level intensity within the whole lung segmentation [high-resolution (HR) 9.35, 95% CI 1.56-55.86] as a positive predictor of death and the 10th percentile of the number of included voxels (HR 0.20, 95% CI 0.05-0.84), the voxel-based pre-processing information (HR 0.23, 95% CI 0.06-0.82) and the flatness (HR 0.42, 95% CI 0.18-0.98), negatively correlating to mortality. The correlation of grey level values to their respective voxels (HR 1.52 95% CI 0.82-2.83) was also retained as a confounder.

'''Conclusion:''' Radiomic analysis may predict RA-ILD patients' mortality and may promote HRCT as a digital biomarker regardless of the clinical characteristics of the disease.
|}

==Evaluation of the Prognosis of Acute Subdural Hematoma According to the Density Differences Between Gray and White Matter==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36686517 Front Neurol. 2023 Jan 6;13:1024018. PMID: 36686517] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9853902/ PDF]

'''Authors:''' Li Z, Feng Y, Wang P, Han S, Zhang K, Zhang C, Lu S, Lv C, Zhu F, Bie L.

'''Institution:''' Department of Neurosurgery of the First Clinical Hospital, Jilin University, Changchun, China.

'''Abstract:'''
'''Objective:''' Acute subdural hematoma (ASDH) is a common neurological emergency, and its appearance on head-computed tomographic (CT) imaging helps guide clinical treatment. To provide a basis for clinical decision-making, we analyzed that the density difference between the gray and white matter of the CT image is associated with the prognosis of patients with ASDH.

'''Methods:''' We analyzed the data of 194 patients who had ASDH as a result of closed traumatic brain injury (TBI) between 2018 and 2021. The patients were subdivided into surgical and non-surgical groups, and the non-surgical group was further subdivided into "diffused [hematoma]" and "non-diffused" groups. The control group's CT scans were normal. The [http://www.slicer.org '''3D Slicer'''] software was used to quantitatively analyze the density of gray and white matter depicted in the CT images.

'''Results:''' Imaging evaluation showed that the median difference in density between the gray and white matter on the injured side was 4.12 HU (IQR, 3.91-4.22 HU; p < 0.001) and on the non-injured side was 4.07 HU (IQR, 3.90-4.19 HU; p < 0.001), and the hematoma needs to be surgically removed. The median density difference value of the gray and white matter on the injured side was 3.74 HU (IQR, 3.53-4.01 HU; p < 0.001) and on the non-injured side was 3.71 HU (IQR, 3.69-3.73 HU; p < 0.001), and the hematoma could diffuse in a short time.

'''Conclusion:''' Quantitative analysis of the density differences in the gray and white matter of the CT images can be used to evaluate the clinical prognosis of patients with ASDH.
|}

==The Knosp Criteria Revisited: 3-Dimensional Volumetric Analysis as a Predictive Tool for Extent of Resection in Complex Endoscopic Pituitary Surgery==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36170168 Front Oncol. Neurosurgery. 2023 Jan 1;92(1):179-85. PMID: 36170168]

'''Authors:''' DiRisio AC, Feng R, Shuman WH, Platt S, Price G, Dullea JT, Gilja S, D'Andrea MR, Delman BN, Bederson JB, Shrivastava RK.

'''Institution:''' Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.

'''Abstract:'''
'''Background:''' The Knosp criteria have been the historical standard for predicting cavernous sinus invasion, and therefore extent of surgical resection, of pituitary macroadenomas. Few studies have sought to reappraise the utility of this tool after recent advances in visualization and modeling of tumors in complex endoscopic surgery.

'''Objective:''' To evaluate our proposed alternative method, using 3-dimensional (3D) volumetric imaging, and whether it can better predict extent of resection in nonfunctional pituitary adenomas.

'''Methods:''' Patients who underwent endoscopic transsphenoidal resection of pituitary macroadenomas at our institution were reviewed. Information was collected on neurological, endocrine, and visual function. Volumetric segmentation was performed using [http://www.slicer.org '''3D Slicer'''] software. Relationship of tumor volume, clinical features, and Knosp grade on extent of resection was examined.

'''Results:''' One hundred forty patients were identified who had transsphenoidal resection of nonfunctional pituitary adenomas. Macroadenomas had a median volume of 6 cm3 (IQR 3.4-8.7), and 17% had a unilateral Knosp grade of at least 3B. On multiple logistic regression, only smaller log-transformed preoperative tumor volume was independently associated with increased odds of gross total resection (GTR; odds ratio: 0.27, 95% CI: 0.07-0.89, P < .05) when controlling for tumor proliferative status, age, and sex (area under the curve 0.67). The Knosp criteria did not independently predict GTR in this cohort (P > .05, area under the curve 0.46).

'''Conclusion:''' Increasing use of volumetric 3D imaging may better anticipate extent of resection compared with the Knosp grade metric and may have a greater positive predictive value for GTR. More research is needed to validate these findings and implement them using automated methods.
|}

==Differentiation of Lung Metastases Originated From Different Primary Tumors Using Radiomics Features Based on CT Imaging==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35577699 Acad Radiol. 2023 Jan;30(1):40-6. PMID: 35577699]

'''Authors:''' Shang H, Li J, Jiao T, Fang C, Li K, Yin D, Zeng Q.

'''Institution:''' Department of Radiology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, No. 16766 Jingshi Road, Jinan, Shandong, China.

'''Abstract:''' Rationale and objectives: To explore the feasibility of differentiating three predominant metastatic tumor types using lung computed tomography (CT) radiomics features based on supervised machine learning.

'''Materials and Methods:''' This retrospective analysis included 252 lung metastases (LM) (from 78 patients), which were divided into the training (n = 176) and test (n = 76) cohort randomly. The metastases originated from colorectal cancer (n = 97), breast cancer (n = 87), and renal carcinoma (n = 68). An additional 77 LM (from 35 patients) were used for external validation. All radiomics features were extracted from lung CT using an open-source software, [http://www.slicer.org '''3D Slicer''']. The least absolute shrinkage and selection operator (LASSO) method selected the optimal radiomics features to build the model. Random forest and support vector machine (SVM) were selected to build three-class and two-class models. The performance of the classification model was evaluated with the area under the receiver operating characteristic curve (AUC) by two strategies: one-versus-rest and one-versus-one.

'''Results:''' Eight hundred and fifty-one quantitative radiomics features were extracted from lung CT. By LASSO, 23 optimal features were extracted in three-class, and 25, 29, and 35 features in two-class for differentiating every two of three LM (colorectal cancer vs. renal carcinoma, colorectal cancer vs. breast cancer, and breast cancer vs. renal carcinoma, respectively). The AUCs of the three-class model were 0.83 for colorectal cancer, 0.79 for breast cancer, and 0.91 for renal carcinoma in the test cohort. In the external validation cohort, the AUCs were 0.77, 0.83, and 0.81, respectively. Swarmplot shows the distribution of radiomics features among three different LM types. In the two-class model, high accuracy and AUC were obtained by SVM. The AUC of discriminating colorectal cancer LM from renal carcinoma LM was 0.84, and breast cancer LM from colorectal cancer LM and renal carcinoma LM were 0.80 and 0.94, respectively. The AUCs were 0.77, 0.78, and 0.84 in the external validation cohort.

'''Conclusion:''' Quantitative radiomics features based on Lung CT exhibited good discriminative performance in LM of primary colorectal cancer, breast cancer, and renal carcinoma.
|}

==MRI Radiomic Features of Peritumoral Edema May Predict the Recurrence Sites of Glioblastoma Multiforme==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36686829 Front Oncol. 2023 Jan 4;12:1042498. PMID: 36686829] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9845721/pdf/fonc-12-1042498.pdf PDF]

'''Authors:''' Long H, Zhang P, Bi Y, Yang C, Wu M, He D, Huang S, Yang K, Qi S, Wang J.

'''Institution:''' Department of Neurosurgery, Nanfang Hospital, Southern Medical University, Guangzhou, China.

'''Abstract:'''

'''Background and Purpose:''' As one of the most aggressive malignant tumor in the central nervous system, the main cause of poor outcome of glioblastoma (GBM) is recurrence, a non-invasive method which can predict the area of recurrence pre-operation is necessary.To investigate whether there is radiological heterogeneity within peritumoral edema and identify the reproducible radiomic features predictive of the sites of recurrence of glioblastoma(GBM), which may be of value to optimize patients' management.

'''Materials and Methods:''' The clinical information and MR images (contrast-enhanced T1 weighted and FLAIR sequences) of 22 patients who have been histologically proven glioblastoma, were retrospectively evaluated. Kaplan-Meier methods was used for survival analysis. Oedematous regions were manually segmented by an expert into recurrence region, non-recurrence region. A set of 94 radiomic features were obtained from each region using the function of analyzing MR image of [http://www.slicer.org '''3D Slicer''']. Paired t test was performed to identify the features existing significant difference. Subsequently, the data of two patients from TCGA database was used to evaluate whether these features have clinical value.

'''Results:''' Ten features with significant differences between the recurrence and non-recurrence subregions were identified and verified on two individual patients from the TCGA database with pathologically confirmed diagnosis of GBM.

'''Conclusions:''' Our results suggested that heterogeneity does exist in peritumoral edema, indicating that the radiomic features of peritumoral edema from routine MR images can be utilized to predict the sites of GBM recurrence. Our findings may further guide the surgical treatment strategy for GBM.
|}

==Clinical Study on Application of 3D Slicer Software Assisted Domestic Frameless Stereotactic Robot in Biopsy of Intracranial Lesions==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36603886 Zhonghua Wai Ke Za Zhi. 2023 Jan 1;61(1):61-65. PMID: 36603886] | [http://www.ncbi.nlm.nih.gov/pmc/articles/pmc9849352/ PDF]

'''Authors:''' Chen H, Yan X, He F, Ding SC, Diao JF, Guo H, Cao SM, Yang CJ, Yin F.

'''Institution:''' Department of Neurosurgery, Aerospace Central Hospital, Beijing, China.

'''Abstract:'''
'''Objective:''' To examine the application value of [http://www.slicer.org '''3D Slicer'''] software assisted domestic frameless stereotactic robot in biopsy of intracranial lesions.

'''Methods:''' A retrospective analysis was performed on 80 patients who admitted consecutively and underwent intracerebral lesions biopsy with the domestic frameless stereotactic robot at Department of Neurosurgery, Aerospace Central Hospital from January 2019 to December 2021. There were 36 males and 44 females, with a mean age of (38.5±18.0) years (range: 6 to 71 years). Before surgery only enhanced T1-weighted three-dimensional magnetization prepared gradient echo sequences and diffusion tensor imaging scans were performed. Self-reconstruction of intracranial lesions, cerebral cortex and blood vessels was carried out using 3D Slicer software system after the DICOM format imaging data of 80 patients were collected. These imaging data were merged to the workstation of the domestic frameless stereotactic robot for preoperative surgical planning and the surgical puncture path was designed to avoid blood vessels in the brain functional area, cerebral cortex and sulcus.

'''Results:''' All frameless stereotactic biopsy were successfully performed. Postoperative pathological diagnosis included 50 cases of diffuse astrocytic and oligodendroglioma, 15 cases of lymphoma, 5 cases of metastatic tumors, 5 cases of inflammatory demyelinating disease, 2 cases of inflammatory granuloma, 1 case of hemangioma, 1 case of acute lymphoblastic leukemia intracranial invasion and 1 case of seminoma. The positive diagnosis rate was 100% (80/80). Postoperative imaging confirmed that the puncture path and target were accurately implemented according to the preoperative planning, and the target error was (1.32±0.44) mm (range: 0.55 to 1.99 mm). One case of puncture-related bleeding occurred at the target after surgery and improved after treatment.

'''Conclusion:''' The three-dimensional multimodal images reconstructed by the 3D Slicer software before operation could help the surgeons make the preoperative planning and reduce the risk of stereotactic brain biopsy.
|}

==Liver Cirrhosis and Tumor Location Can Affect the Range of Intrahepatic Microwave Ablation Zone==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36854449 Int J Hyperthermia. 2023;40(1):2181843. PMID: 36854449] | [https://www.tandfonline.com/doi/epdf/10.1080/02656736.2023.2181843?needAccess=true&role=button PDF]

'''Authors:''' Ding WZ, Wei H, Wu JP, Cheng ZG, Han ZY, Liu FY, Yu J, Liang P.

'''Institution:''' Fifth Medical Center of Chinese, PLA General Hospital, Beijing, China.

'''Abstract:'''
'''Background:''' The range of an ablation zone (AZ) plays a crucial role in the treatment effect of microwave ablation (MWA). The aim of this study was to analyze the factors influencing the AZ range.

'''Methods:''' Fourteen factors in four areas were included: patient-related factors (sex, age), disease-related factors (tumor location, liver cirrhosis), serological factors (ALT, AST, total protein, albumin, total bilirubin, direct bilirubin, and platelets), and MWA parameters (ablation time, power, and needle type). Multiple sequence MRI was used to delineate AZ by three radiologists using [http://www.slicer.org '''3D Slicer''']. MATLAB was used to calculate the AZ length, width, and area of the largest section. Linear regression analysis was used to analyze influencing factors. Moreover, a subgroup analysis was conducted for patients with viral hepatitis.

'''Result:''' 220 patients with 290 tumors were included between 2010-2021. In addition to MWA parameters, cirrhosis and tumor location were significant factors that influenced AZ (p < 0.001). The standardized coefficient (beta) of cirrhosis (cirrhosis vs. non-cirrhosis) was positive, which meant cirrhosis would lead to a decrease in AZ range. The beta of tumor location (near the hepatic hilar zone, intermediate zone, and periphery zone) was negative, indicating that AZ range decreased as the tumor location approached the hepatic hilum. For viral hepatitis patients, Fibrosis 4 (FIB4) score was a significant factor influencing AZ (p < 0.001), and the beta was negative, indicating that AZ range decreased as FIB4 increased.

'''Conclusion:''' Liver cirrhosis, tumor location, and FIB4 affect the AZ range and should be considered when planning MWA parameters.
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==A Magnetic Resonance Imaging Based Radiomics Model to Predict Mitosis Cycles in Intracranial Meningioma==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36653482 Sci Rep. 2023 Jan 18;13(1):969. PMID: 36653482] | [http://www.ncbi.nlm.nih.gov/pmc/articles/pmc9849352/ PDF]

'''Authors:'''Krähling H, Musigmann M, Akkurt BH, Sartoretti T, Sartoretti E, Henssen DJHA, Stummer W, Heindel W, Brokinkel B, Mannil M.

'''Institution:''' University Clinic for Radiology, University Hospital Muenster, Westfälische Wilhelms-University Muenster, Muenster, Germany.

'''Abstract:''' The aim of this study was to develop a magnetic resonance imaging (MRI) based radiomics model to predict mitosis cycles in intracranial meningioma grading prior to surgery. Preoperative contrast-enhanced T1-weighted (T1CE) cerebral MRI data of 167 meningioma patients between 2015 and 2020 were obtained, preprocessed and segmented using the [http://www.slicer.org '''3D Slicer'''] software and the PyRadiomics plugin. In total 145 radiomics features of the T1CE MRI images were computed. The criterion on the basis of which the feature selection was made is whether the number of mitoses per 10 high power field (HPF) is greater than or equal to zero. Our analyses show that machine learning algorithms can be used to make accurate predictions about whether the number of mitoses per 10 HPF is greater than or equal to zero. We obtained our best model using Ridge regression for feature pre-selection, followed by stepwise logistic regression for final model construction. Using independent test data, this model resulted in an AUC (Area under the Curve) of 0.8523, an accuracy of 0.7941, a sensitivity of 0.8182, a specificity of 0.7500 and a Cohen's Kappa of 0.5576. We analyzed the performance of this model as a function of the number of mitoses per 10 HPF. The model performs well for cases with zero mitoses as well as for cases with more than one mitosis per 10 HPF. The worst model performance (accuracy = 0.6250) is obtained for cases with one mitosis per 10 HPF. Our results show that MRI-based radiomics may be a promising approach to predict the mitosis cycles in intracranial meningioma prior to surgery. Specifically, our approach may offer a non-invasive means of detecting the early stages of a malignant process in meningiomas prior to the onset of clinical symptoms.
|}

==Advantages of a Training Course for Surgical Planning in Virtual Reality for Oral and Maxillofacial Surgery: Crossover Study==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36656632 JMIR Serious Games. 2023 Jan 19;11:e40541. PMID: 36656632] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9947820/?report=printable PDF]

'''Authors:''' Ulbrich M, Van den Bosch V, Bönsch A, Gruber LJ, Ooms M, Melchior C, Motmaen I, Wilpert C, Rashad A, Kuhlen TW, Hölzle F, Puladi B.

'''Institution:''' Department of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Aachen, Germany.

'''Abstract:'''
'''Background:''' As an integral part of computer-assisted surgery, virtual surgical planning (VSP) leads to significantly better surgery results, such as for oral and maxillofacial reconstruction with microvascular grafts of the fibula or iliac crest. It is performed on a 2D computer desktop screen (DS) based on preoperative medical imaging. However, in this environment, VSP is associated with shortcomings, such as a time-consuming planning process and the requirement of a learning process. Therefore, a virtual reality (VR)-based VSP application has great potential to reduce or even overcome these shortcomings due to the benefits of visuospatial vision, bimanual interaction, and full immersion. However, the efficacy of such a VR environment has not yet been investigated.

'''Objective:''' This study aimed to demonstrate the possible advantages of a VR environment through a substep of VSP, specifically the segmentation of the fibula (calf bone) and os coxae (hip bone), by conducting a training course in both DS and VR environments and comparing the results.

'''Methods:''' During the training course, 6 novices were taught how to use a software application in a DS environment, [http://www.slicer.org '''3D Slicer''']) and in a VR environment (Elucis) for the segmentation of the fibula and os coxae, and they were asked to carry out the maneuvers as accurately and quickly as possible. Overall, 13 fibula and 13 os coxae were segmented for each participant in both methods (VR and DS), resulting in 156 different models (78 fibula and 78 os coxae) per method (VR and DS) and 312 models in total. The individual learning processes in both environments were compared using objective criteria (time and segmentation performance) and self-reported questionnaires. The models resulting from the segmentation were compared mathematically (Hausdorff distance and Dice coefficient) and evaluated by 2 experienced radiologists in a blinded manner.

'''Results:''' A much faster learning curve was observed for the VR environment than the DS environment (β=.86 vs β=.25). This nearly doubled the segmentation speed (cm3/min) by the end of training, leading to a shorter time (P<.001) to reach a qualitative result. However, there was no qualitative difference between the models for VR and DS (P=.99). The VR environment was perceived by participants as more intuitive and less exhausting, and was favored over the DS environment.

'''Conclusions:''' The more rapid learning process and the ability to work faster in the VR environment could save time and reduce the VSP workload, providing certain advantages over the DS environment.
|}

==Lesion Size and Long-Term Cognitive Outcome After Pediatric Stroke: A Comparison Between Two Techniques to Assess Lesion Size==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36641854 Eur J Paediatr Neurol. 2023 Jan 7;42:126-32. PMID: 36641854]

'''Authors:''' Everts R, Bertato S, Steinlin M, Slavova N, Grunt S, Steiner L.

'''Institution:''' Division of Neuropediatrics, Development and Rehabilitation, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.

'''Abstract:'''
'''Background:''' There is little consensus on how lesion size impacts long-term cognitive outcome after pediatric arterial ischemic stroke (AIS). This study, therefore, compared two techniques to assessed lesion size in the chronic phase after AIS and determined their measurement agreement in relation to cognitive functions in patients after pediatric stroke.

'''Methods:''' Twenty-five patients after pediatric AIS were examined in the chronic phase (>2 years after stroke) in respect to intelligence, memory, executive functions, visuo-motor functions, motor abilities, and disease-specific outcome. Lesion size was measured using the ABC/2 formula and segmentation technique ([http://www.slicer.org '''3D Slicer''']). Correlation analysis determined the association between volumetry techniques and outcome measures in respect to long-term cognitive outcome.

'''Results:''' The measurements from the ABC/2 and segmentation technique were strongly correlated (r = 0.878, p < .001) and displayed agreement in particular for small lesions. Lesion size from both techniques was significantly correlated with disease-specific outcome (p < .001) and processing speed (p < .005) after controlling for age at stroke and multiple comparison.

'''Conclusion:''' The two techniques showed convergent validity and were both significantly correlated with long-term outcome after pediatric AIS. Compared to the time-consuming segmentation technique, ABC/2 facilitates clinical and research work as it requires relatively little time and is easy to apply.
|}

==Association Between Emphysema and Other Pulmonary Computed Tomography Patterns in COVID-19 Pneumonia==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36358023 J Med Virol. 2023 Jan;95(1):e28293. PMID: 36358023] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9828029/pdf/JMV-95-0.pdf PDF]

'''Authors:''' Han K, Wang J, Zou Y, Zhang Y, Zhou L, Yin Y.

'''Institution:''' Fetal-Neonatal Neuroimaging and Developmental Science Center, Division of Newborn Medicine, Boston Children's Hospital, Boston, USA.

'''Abstract:''' To evaluate the chest computed tomography (CT) findings of patients with Corona Virus Disease 2019 (COVID-19) on admission to hospital. And then correlate CT pulmonary infiltrates involvement with the findings of emphysema. We analyzed the different infiltrates of COVID-19 pneumonia using emphysema as the grade of pneumonia. We applied open-source assisted software, [http://www.slicer.org '''3D Slicer'''] to model the lungs and lesions of 66 patients with COVID-19, which were retrospectively included. we divided the 66 COVID-19 patients into the following two groups: (A) 12 patients with less than 10% emphysema in the low-attenuation area less than -950 Hounsfield units (%LAA-950), (B) 54 patients with greater than or equal to 10% emphysema in %LAA-950. Imaging findings were assessed retrospectively by two authors and then pulmonary infiltrates and emphysema volumes were measured on CT using [http://www.slicer.org '''3D Slicer'''] software. Differences between pulmonary infiltrates, emphysema, Collapsed, affected of patients with CT findings were assessed by Kruskal-Wallis and Wilcoxon test, respectively. Statistical significance was set at p < 0.05. The left lung (A) affected left lung 20.00/affected right lung 18.50, (B) affected left lung 13.00/affected right lung 11.50 was most frequently involved region in COVID-19. In addition, collapsed left lung, (A) collapsed left lung 4.95/collapsed right lung 4.65, (B) collapsed left lung 3.65/collapsed right lung 3.15 was also more severe than the right one. There were significant differences between the Group A and Group B in terms of the percentage of CT involvement in each lung region (p < 0.05), except for the inflated affected total lung (p = 0.152). The median percentage of collapsed left lung in the Group A was 20.00 (14.00-30.00), right lung was 18.50 (13.00-30.25) and the total was 19.00 (13.00-30.00), while the median percentage of collapsed left lung in the Group B was 13.00 (10.00-14.75), right lung was 11.50 (10.00-15.00) and the total was 12.50 (10.00-15.00). The percentage of affected left lung is an independent predictor of emphysema in COVID-19 patients. We need to focus on the left lung of the patient as it is more affected. The people with lower levels of emphysema may have more collapsed segments. The more collapsed segments may lead to more serious clinical feature.
|}

==A High-Resolution Pediatric Female Whole-Body Numerical Model With Comparison to a Male Model==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36595234 Phys Med Biol. 2023 Jan 13;68(2). PMID: 36595234]

'''Authors:''' Ntolkeras G, Jeong H, Zöllei L, Dmytriw AA, Purvaziri A, Lev MH, Grant PE, Bonmassar G.

'''Institution:''' Fetal-Neonatal Neuroimaging and Developmental Science Center, Division of Newborn Medicine, Boston Children's Hospital, Boston, USA.

'''Abstract:'''
'''Objective:''' Numerical models are central in designing and testing novel medical devices and in studying how different anatomical changes may affect physiology. Despite the numerous adult models available, there are only a few whole-body pediatric numerical models with significant limitations. In addition, there is a limited representation of both male and female biological sexes in the available pediatric models despite the fact that sex significantly affects body development, especially in a highly dynamic population. As a result, we developed Athena, a realistic female whole-body pediatric numerical model with high-resolution and anatomical detail.

'''Approach:''' We segmented different body tissues through Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) images of a healthy 3.5 year-old female child using 3D Slicer. We validated the high anatomical accuracy segmentation through two experienced sub-specialty-certified neuro-radiologists and the inter and intra-operator variability of the segmentation results comparing sex differences in organ metrics with physiologic values. Finally, we compared Athena with Martin, a similar male model, showing differences in anatomy, organ metrics, and MRI dosimetric exposure.

'''Main results:'''We segmented 267 tissue compartments, which included 50 brain tissue labels. The tissue metrics of Athena displayed no deviation from the literature value of healthy children. We show the variability of brain metrics in the male and female models. Finally, we offer an example of computing Specific Absorption Rate and Joule heating in a toddler/preschooler at 7T MRI.

'''Significance:''' This study introduces a female realistic high-resolution numerical model using MRI and CT scans of a 3.5 year-old female child, the use of which includes but is not limited to radiofrequency safety studies for medical devices (e.g. an implantable medical device safety in MRI), neurostimulation studies, and radiation dosimetry studies. This model will be open source and available on the Athinoula A. Martinos Center for Biomedical Imaging website.
|}

==Anatomical Morphology and Related Angles of Foramen Ovale: A Three-dimensional Computed Tomography Reconstruction==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36597246 J Coll Physicians Surg Pak. 2023 Jan;33(1):109-11. PMID: 36597246]

'''Authors:''' Cheng Z, Hu YL, Sun YX, Liang LZ, Pan DD, Wang DW.

'''Institution:''' Department of Neurosurgery, The Second Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, China.

'''Abstract:''' This study aimed to report the three-dimensional reconstruction of the foramen ovale (FO) based on computed tomography angiography and describe its shape and related angles. A retrospective analysis of 199 adult patients who were hospitalised at the Department of Neurosurgery, The Second Affiliated Hospital of Bengbu Medical College, Bengbu, China, from January to December 2020 was conducted. The original DICOM files of patients' computed tomography scans were processed by [http://www.slicer.org '''3D Slicer'''] software to reconstruct the three-dimensional skull. The morphological characteristics of the FO on both sides were analysed. Their size, related angles and volumes, and the differences between the two sides and gender were compared. A total of 398 FO from 199 patients were studied. The most frequent shape of the FO was oval, accounting for 54.27%. The mean lengths of the right and the left sides were 5.40±1.51 and 5.10±1.18mm, respectively. The mean width on the right and left sides was 3.23±1.16 and 3.33±1.19 mm, respectively. The FO is most commonly oval in shape. Clinicians may use the anatomical characteristics regarding the size and shape of the FO for diagnosis and treatment.
|}

Main Page/SlicerCommunity/2023

2023-09-11T18:54:36Z

Marianna: /* Delirium After Traumatic Brain Injury: Prediction by Location and Size of Brain Lesion */

{{:Main_Page/SlicerCommunity}}

__TOC__

=2023=
==Dosimetric Assessment of Gadolinium-159 for Hepatic Radioembolization: Tomographic Images and Monte Carlo Simulation==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37393764 Appl Radiat Isot. 2023 Sep;199:110916. PMID: 37393764]

'''Authors:''' Musa AS, Abdul Hadi MFR, Hashikin NAA, Ashour NI, Ying CK.

'''Institution:''' School of Physics, Universiti Sains Malaysia, Penang, Malaysia.

'''Abstract:'''
A common therapeutic radionuclide used in hepatic radioembolization is yttrium-90 (90Y). However, the absence of gamma emissions makes it difficult to verify the post-treatment distribution of 90Y microspheres. Gadolinium-159 (159Gd) has physical properties that are suitable for therapy and post-treatment imaging in hepatic radioembolization procedures. The current study is innovative for conducting a dosimetric investigation of the use of 159Gd in hepatic radioembolization by simulating tomographic images using the Geant4 application for tomographic emission (GATE) Monte Carlo (MC) simulation. For registration and segmentation, tomographic images of five patients with hepatocellular carcinoma (HCC) who had undergone transarterial radioembolization (TARE) therapy were processed using a [http://www.slicer.org '''3D Slicer''']. The tomographic images with 159Gd and 90Y separately were simulated using the GATE MC Package. The output of simulation (dose image) was uploaded to [http://www.slicer.org '''3D Slicer'''] to compute the absorbed dose for each organ of interests. 159Gd were able to provide a recommended dose of 120 Gy to the tumour, with normal liver and lungs absorbed doses close to that of 90Y and less than the respective maximum permitted doses of 70 Gy and 30 Gy, respectively. Compared to 90Y, 159Gd requires higher administered activity approximately 4.92 times to achieve a tumour dose of 120 Gy. Thus; this research gives new insights into the use of 159Gd as a theranostic radioisotope, with the potential to be used as a90Y alternative for liver radioembolization.
|}

==The Cranial Capacity of the Saudi Population Measured Using 3D Computed Tomography Scans==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37482378 Neurosciences (Riyadh). 2023 Jul;28(3):184-89. PMID: 37482378]

'''Authors:''' Alshamrani KA.

'''Institution:''' Department of Radiological sciences, Faculty of Applied Medical Science, and from Health Research Centre, Najran University, Najran, Kingdom of Saudi Arabia.

'''Abstract:'''
Objectives: To measure the cranial capacity of members of the Saudi adult population across ages and genders.

Methods: This was a retrospective cross-sectional study that used 488 Computed Tomography (CT) scans of heads (of which 275 males) to measure cranial volume. The CT slices 0.625 mm thick were uploaded using the freely available [http://www.slicer.org '''3D Slicer'''] software, which then reconstructed the images and built a 3D module.

Results: The mean (±SD) cranial capacity of the males was 1481.6 (±110) cm3 (range: 1241-1723 cm3), whereas the cranial capacity of the females was 1375.4 (±104) cm3 (range: 1203-1678 cm3). This study showed that the males had a mean cranial capacity that was 7% greater than that of the females in this study. The average cranial capacity of the males between the ages of 31 and 40 years was statistically significantly larger to that of the males aged 61-80 (p<0.05).

Conclusion: This study demonstrated that the average cranial capacity of the males was larger than that of the females. These study results can help to determine the normal cranial capacity of adults in Saudi Arabia. Further work should be carried out to aid in establishing reference data for the Saudi population.
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==The Tracheal System of the Common Wasp (Vespula Vulgaris) - a Micro-CT Study==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37451536 J Insect Physiol. 2023 Jul 13;149:104547. PMID: 37451536]

'''Authors:''' Bell GD, Corps N, Mortimer D, Gretton S, Bury N, Connett GJ.

'''Institution:''' School of (EAST) Engineering, Arts, Science and Technology, University of Suffolk, James Hehir Building, UK.

'''Abstract:'''
X-ray micro-CT has been used to study the tracheal system of Pre and Post hibernation Queen wasps (Vespula vulgaris) and their workers. We have compared our findings in wasps with Snodgrass's description of the tracheal system of the honeybee as characterised by anatomical dissection. Our images, whilst broadly similar, identify the tracheal system as being considerably more complex than previously suggested. One of the 30 wasps imaged had a markedly different, previously undescribed tracheal system. Since completing this study, a large micro-CT study from the American Museum of Natural History (AMNH) has been published. This used different software, [http://www.slicer.org '''3D Slicer'''] and analysed 16bit digital data. We have compared our methods with that described in the AMNH publication, adopted their suggested nomenclature and have made recommendations for future studies.
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==Augmented Reality Presentation of the Extracranial Facial Nerve: An Innovation in Parotid Surgery==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37328316 Br J Oral Maxillofac Surg. 2023 Jul;61(6):428-36. PMID: 37328316]

'''Authors:''' Saadya A, Chegini S, Morley S, McGurk M.

'''Institution:''' University College London Hospital, UK.

'''Abstract:'''
Surgeons used to be unaware of the facial nerve's position during parotid surgery. Now, with special magnetic resonance imaging (MRI) sequences, it can be located and converted into a 3D model displayed on an augmented reality (AR) device for surgeons to study and manipulate. This study explores the accuracy and usefulness of the technique for the treatment of benign and malignant parotid tumours. A total of 20 patients with parotid tumours had 3-Tesla MRI scans, and their anatomical structures were segmented using [http://www.slicer.org '''3D Slicer'''] software. The structures were imported into a Microsoft HoloLens 2® device, displayed in 3D, and shown to the patient for consent. Intraoperative video recording was used to record the position of the facial nerve in relation to the tumour. The predicted path of the nerve taken from the 3D model was combined with surgical observation and video recording in all cases. The imaging proved to have application in both benign and malignant disease. It also improved the process of informed patient consent. Three-dimensional MRI imaging of the facial nerve within the parotid gland and its display in a 3D model is an innovative technique for parotid surgery. Surgeons can now see the nerve's position and tailor their approach to each patient's tumour, providing personalised care. The technique eliminates the surgeon's blind spot and is a significant advantage in parotid surgery.
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==Magnetic Resonance Imaging in Naso-Oropharyngeal Carcinoma: Role of Texture Analysis in the Assessment of Response to Radiochemotherapy, a Preliminary Study==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37336860/ Radiol Med. 2023 Jul;128(7):839-52. PMID: 37336860] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10317900/pdf/11547_2023_Article_1653.pdf PDF]

'''Authors:''' Bicci E, Nardi C, Calamandrei L, Barcali E, Pietragalla M, Calistri L, Desideri I, Mungai F, Bonasera L, Miele V.

'''Institution:''' Department of Experimental and Clinical Biomedical Sciences, Radiodiagnostic Unit #2, University of Florence, Florence, Italy.

'''Abstract:'''
Objective: Identifying MRI texture parameters able to distinguish inflammation, fibrosis, and residual cancer in patients with naso-oropharynx carcinoma after radiochemotherapy (RT-CHT).

Material and methods: In this single-centre, observational, retrospective study, texture analysis was performed on ADC maps and post-gadolinium T1 images of patients with histological diagnosis of naso-oropharyngeal carcinoma treated with RT-CHT. An initial cohort of 99 patients was selected; 57 of them were later excluded. The final cohort of 42 patients was divided into 3 groups (inflammation, fibrosis, and residual cancer) according to MRI, 18F-FDG-PET/CT performed 3-4 months after RT-CHT, and biopsy. Pre-RT-CHT lesions and the corresponding anatomic area post-RT-CHT were segmented with [http://www.slicer.org '''3D Slicer'''] software from which 107 textural features were derived. T-Student and Wilcoxon signed-rank tests were performed, and features with p-value < 0.01 were considered statistically significant. Cut-off values-obtained by ROC curves-to discriminate post-RT-CHT non-tumoural changes from residual cancer were calculated for the parameters statistically associated to the diseased status at follow-up.

Results: Two features-Energy and Grey Level Non-Uniformity-were statistically significant on T1 images in the comparison between 'positive' (residual cancer) and 'negative' patients (inflammation and fibrosis). Energy was also found to be statistically significant in both patients with fibrosis and residual cancer. Grey Level Non-Uniformity was significant in the differentiation between residual cancer and inflammation. Five features were statistically significant on ADC maps in the differentiation between 'positive' and 'negative' patients. The reduction in values of such features between pre- and post-RT-CHT was correlated with a good response to therapy.

Conclusions: Texture analysis on post-gadolinium T1 images and ADC maps can differentiate residual cancer from fibrosis and inflammation in early follow-up of naso-oropharyngeal carcinoma treated with RT-CHT.
|}

==BabelBrain: An Open-Source Application for Prospective Modeling of Transcranial Focused Ultrasound for Neuromodulation Applications==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37155375/ IEEE Trans Ultrason Ferroelectr Freq Control. 2023 Jul;70(7):587-99. PMID: 37155375]

'''Authors:''' Pichardo S.

'''Institution:''' Department of Radiology, University of Calgary, Calgary, Canada.

'''Abstract:'''
BabelBrain is an open-source standalone graphic-user-interface application designed for studies of neuromodulation using transcranial-focused ultrasound (FUS). It calculates the transmitted acoustic field in the brain tissue, taking into account the distortion effects caused by the skull barrier. The simulation is prepared using scans from magnetic resonance imaging (MRI) and, if available, computed tomography (CT) and zero-echo time MRI scans. It also calculates the thermal effects based on a given ultrasound regime, such as the total duration of exposure, the duty cycle, and acoustic intensity. The tool is designed to work in tandem with neuronavigation and visualization software, such as [http://www.slicer.org '''3D Slicer''']. It uses image processing to prepare domains for ultrasound simulation and uses the BabelViscoFDTD library for transcranial modeling calculations. BabelBrain supports multiple GPU backends, including Metal, OpenCL, and CUDA, and works on all major operating systems including Linux, macOS, and Windows. This tool is particularly optimized for Apple ARM64 systems, which are common in brain imaging research. The article presents the modeling pipeline used in BabelBrain and a numerical study where different methods of acoustic properties mapping were tested to select the best method that can reproduce the transcranial pressure transmission efficiency reported in the literature.
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==Volumetric Analysis of the Sinus and Orbit in Silent Sinus Syndrome After Endoscopic Sinus Surgery==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/36939460/ Otolaryngol Head Neck Surg. 2023 Jul;169(1):151-156. PMID: 36939460]

'''Authors:'''
Amin D, Chitguppi C, Xu V, Haghshenas C, Gorniak R, Rabinowitz M, Toskala E, Rosen M, Nyquist G.

'''Institution:''' Department of Otolaryngology-Head & Neck Surgery, Thomas Jefferson University, Philadelphia, PA, USA.

'''Abstract:'''
Objective: The term "silent sinus syndrome" (SSS) describes spontaneous enophthalmos secondary to subclinical maxillary sinus atelectasis. Debate remains on whether treatment with endoscopic maxillary antrostomy alone is adequate in reversing atelectasis and globe displacement. This study aims to determine the degree of volume change of the diseased sinus and orbit as well as the change in orbital height in patients treated with endoscopic antrostomy without orbital floor augmentation.

Study design: Retrospective review with image analysis.

Setting: Single tertiary care institution.

Methods: Three-dimensional (3D) analysis of computed tomographic imaging data was performed using [http://www.slicer.org '''3D Slicer''']. 3D models of the maxillary sinus and orbit of the diseased and normal sides were created, and volume measurements were calculated using the segmentation program.

Results: Thirteen patients with SSS who underwent endoscopic sinus surgery (ESS) and had follow-up computed tomographic imaging were analyzed. After endoscopic antrostomy, the mean volume of the diseased maxillary sinus significantly increased by 9.82%, from 6.37 to 7.00 cm3 (p = .0302). There was no significant change in mean orbital volume; however, the mean orbital height decreased by 5.67%, from 38.09 to 35.93 mm from pretreatment to posttreatment samples (p = .0101). All patients had resolution of clinical or radiographic enophthalmos and orbital displacement with ESS alone.

Conclusion: Endoscopic maxillary antrostomy alone in the treatment of SSS significantly increased maxillary sinus volume and decreased diseased orbital height. These changes were associated with clinical and radiographic improvement in globe displacement. These findings support performing ESS alone, reserving orbital augmentation for patients who do not exhibit adequate clinical improvement.
|}

==Safety and Efficacy of Thoracic Endovascular Aortic Repair for Acute Stanford Type B Aortic Dissection With Retrograde Type a Intramural Hematoma==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/36921645/ J Vasc Surg. 2023 Jul;78(1):61-69.e4. PMID: 36921645] | [https://www.jvascsurg.org/action/showPdf?pii=S0741-5214%2823%2900438-X PDF]

'''Authors:''' Wang J, Li M, Li J, He H, Zhou Y, Li X, Li Q, Gu F, Ye Z, Dardik A, Shu C.

'''Institution:''' Department of Vascular Surgery, Second Xiangya Hospital, Central South University, Changsha, China; Institute of Vascular Diseases, Central South University, Changsha, China.

'''Abstract:'''
Objective: The aim of this study was to evaluate safety and efficacy of thoracic endovascular aortic repair (TEVAR) for acute Stanford type B aortic dissection (TBAD) with retrograde type A intramural hematoma (TAIMH).

Methods: Patients with acute TBAD with retrograde TAIMH treated with TEVAR between January 1, 2014, to March 31, 2022, were retrospectively reviewed. Aortic diameter and distance were measured using the [http://www.slicer.org '''3D Slicer'''] image computing platform. Patients' characteristics, procedural, in-hospital and follow-up data, and aortic remodeling were analyzed.

Results: Fifty-two patients (average age, 52.6 years; 42 males [80.8%]) were included. The median interval from symptom onset to TEVAR was 11 days (interquartile range, 7.0-16.8 days). The maximal diameter of the ascending aorta (AA) was <50 mm, and the hematoma thickness in the AA was ≤10 mm in all patients. Both the in-hospital and 30-day mortality rates were 0%. The 30-day complication rate was 11.5%. The overall cumulative survival rates were 100% at 1 year, 97.1% at 3 years, and 92.6% at 5 years. Four of 52 patients (7.7%) developed retrograde type A aortic dissection at 10 days to 4 months postoperatively, and one of 52 patients (1.9%) developed an isolated AA dissection 4 months postoperatively; these five patients were treated and alive at late follow-up in March 2022. The rates of cumulative freedom from thoracic aortic re-intervention were 93.7% at 1 year and 90.7% at 5 years. Positive AA remodeling was observed in 92.3% (48/52) of patients during follow-up. The maximal diameter of AA (mean ± standard error of mean) at admission was 42.7 ± 0.8 mm, which decreased to 39.5 ± 0.9 mm at last follow-up. The maximal AA hematoma thickness at admission was 7.6 ± 0.3 mm, which reduced to 2.2 ± 0.9 mm at last follow-up.

Conclusions: For selected patients of acute Stanford TBAD with retrograde TAIMH, endovascular repair may be a safe, effective, and durable alternative treatment, if the maximum diameter of the AA is <50 mm and the intramural hematoma thickness in the AA is ≤10 mm.
|}

==The Traction Force of the Pulled Limb in Hip Arthroscopic Surgery Is Determined by Stiffness Coefficient Which Is Significantly Related to Muscle Volume==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/36477348/ Knee Surg Sports Traumatol Arthrosc. 2023 Jul;31(7):2708-2715. PMID: 36477348]

'''Authors:''' Yin Y, Xue S, Zhang X, Yang G, Xu Y, Wang J, Huang H.

'''Institution:''' Department of Sports Medicine, Beijing Key Laboratory of Sports Injuries, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing, People's Republic of China.

'''Abstract:'''
Purpose: To verify the relationship between muscle volume, lateral centre-edge angle (LCEA), alpha angle (AA), body mass index (BMI) and Beighton score with stiffness coefficient (SC). To analyse the difference of traction force at different physical states of hip joint capsule.

Methods: Thirty-six patients who underwent hip arthroscopy operation were included. The volumes of some related muscles were measured in MRI images by [http://www.slicer.org '''3D Slicer''']. We recorded and tested differences in traction force of five joint capsule physical states, including before (State 1) and after joint capsule puncture (State 2), after the establishment of anterolateral and mid-anterior approaches (State 3) and after incision of the joint capsule through these two approaches (States 4, 5). The correlation between muscle volume, BMI, LCEA, AA and SC was verified by Spearman test. Poisson regression was used to explain confounding variables.

Results: The average force at State 1 was 531.8 N. There were significant differences in traction force between these five states (p < 0.001). There was a significant positive correlation between muscle volumes and SC (p < 0.001). BMI had no correlation with SC (n.s.). The preoperative LCEA of the affected side was correlated with SC (p = 0.043). AA and SC were not correlated (n.s.).

Conclusion: The physical states of the hip joint capsule affected traction force. Muscle volume rather than BMI is an ideal index to estimate preoperative traction force. LCEA affected traction force, whilst AA and Beighton score did not. Measuring the muscle volume can help estimate the most suitable traction force for the patient.
|}

==Three-Dimensional Assessment of Tongue Cancer Prognosis by Preoperative MRI==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/35426211/ Oral Dis. 2023 Jul;29(5):2006-2011. PMID: 35426211]

'''Authors:''' Li C, Zhu L, Guo Y, Ji T, Ren Z.

'''Institution:''' Department of Oral and Maxillofacial Head and Neck Oncology, The Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

'''Abstract:'''
Purpose: To obtain the relative volume by measuring the tongue volume and the lesion volume, and further explore its relationship with the prognosis of patients, hoping to supplement the TNM staging with a new index.

Methods: ITK-SANP software was used to outline the patients' MRI. After MRI reconstruction and measurement, [http://www.slicer.org '''3D Slicer'''] software was used to estimate tumor volume.

Results: A total of 64 patients with tongue cancer who met the inclusion criteria were included in the study. The estimated tumor volume after MRI reconstruction revealed a significant and robust correlation with tumor stage (p < 0.05, Rs = 0.6207) and a substantial and medium correlation with early lymph node metastasis (p < 0.05, Rs = 0.4873).

Conclusions: We classified tongue cancer into three grades based on tumor volume (Stage I, tumors smaller than 1500 mm³; Stage II, tumors 1500-9000 mm³; and Stage III, tumors larger than 9000 mm³), and such grading could be used as a reference for tumor staging, lymph node metastasis, and patient prognosis to a certain extent.
|}

==Multimodal Measurements of Levator Bowl Volume in Nulligravid Asymptomatic Women: Endovaginal Ultrasound Versus MRI==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36656345 Int Urogynecol J. 2023 Jul;34(7):1627-33. PMID: 36656345]

'''Authors:''' Chill HH, Martin LC, Abramowitch SD, Rostaminia G.

'''Institution:''' Female Pelvic Medicine and Reconstructive Surgery (FPMRS), Division of Urogynecology, University of Chicago, Northshore University HealthSystem, Skokie, IL, USA.

'''Abstract:''' Introduction and hypothesis: Measurements of levator bowl volume using advanced imaging, may be predictive of pelvic floor muscle function. The aim of this study was to compare the volume of the levator bowl using both magnetic resonance imaging (MRI) and endovaginal ultrasound (EVU) of healthy asymptomatic women.

'''Methods:''' All participants underwent a comprehensive interview including completion of the Pelvic Floor Distress Inventory Questionnaire-20 questionnaire, pelvic examination with a pelvic organ prolapse quantification evaluation, MRI, and EVU. The pelvic floor was segmented using [http://www.slicer.org '''3D Slicer'''] and the MRI segmentations were trimmed using two methods: soft-tissue landmarks and the field of view (FOV) of the ultrasound volume. The levator bowl volume of the 3D segmented shapes was measured using Blender's 3D printing toolkit. Normality was tested using the Shapiro-Wilks test and comparisons were made using self-paired t tests.

'''Results:''' The final analysis included 19 patients. Levator bowl volume measured via MRI was larger than that measured in EVU (46.1 ± 7.9 cm3 vs 27.4 ± 5.9 cm3, p<0.001). Reducing the FOV of the MRI to that of EVU caused the MRI volume to be much closer to the EVU volume (35.5 ± 3.3 cm3 vs 27.4 ± 5.9 cm3, p<0.001); however, it remained significantly larger.

'''Conclusion:''' Levator bowl volume measured using MRI was larger than that measured using EVU no matter the method of delineation of the levator muscles. Although EVU is safe, cheap, and easy to perform, it captures a smaller volume of levator bowel than MRI.
|}

==Pectoralis Muscle Area Measured at T4 Level Is Closely Associated With Adverse COVID-19 Outcomes in Hospitalized Patients==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37259659 J Musculoskelet Neuronal Interact. 2023 Jun 1;23(2):196-204. PMID: 37259659] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10233225/pdf/JMNI-23-196.pdf PDF]

'''Authors:''' Tekin ZN, Dogruoz Karatekin B, Dogan MB, Bilgi Z.

'''Institution:''' Istanbul Medeniyet University, Goztepe Prof Dr Suleyman Yalcin City Hospital, Radiology, Istanbul, Turkey.

'''Abstract:'''
Objectives: Skeletal muscle area (SMA) at T4 level on chest computed tomography (CT) is a newly available method that can be used as a surrogate sarcopenia marker. The objective of this study is to evaluate association of SMA with adverse COVID-19 outcomes in hospitalized patients.

Methods: Hospitalized COVID-19 patients were prospectively recorded in a database containing age, gender, date of admission, date of outcome (discharge, mortality, presence of intensive care unit (ICU) stay, additional coding information (comorbidities, superimposed conditions). Admission CT-scans were retrospectively evaluated for segmentation (bilateral pectoralis major/minor, erector spinae, levator scapulae, rhomboideus minor and major and transversospinalis muscles) and SMA calculation using [http://www.slicer.org '''3D Slicer'''] software.

Results: 167 cases were evaluated (68 male, 72 female, 140 survived, 27 dead). Muscle area was lower in patients with ICU stay (p=0.023, p=0.018, p=0.008) and mortality outcome (p=0.004, p=0.007, p=0.002) for pectoralis, back and SMA. In multivariate Cox-regression analysis, hazard ratio (HR) value for the pectoralis muscle area value below 2800 mm2 was found to be 3.138(95% CI: 1.171-8.413) for mortality and 2.361(95% CI: 1.012-5.505) for ICU.

Conclusions: Pectoralis muscle area measured at T4 level with 3-D slicer was closely associated with adverse outcomes (mortality, ICU stay) in hospitalized COVID-19 patients. Since early treatment methods for COVID-19 are being evaluated, this method may be a useful adjunct to clinical decision making in regard to prioritization.
|}

==Precise Location of the Ventricular Catheter Tip in Ventriculoperitoneal Shunt Placement Guided by 3D Printed Individualized Guide==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37086587/ Clin Neurol Neurosurg. 2023 Jun;229:107730. PMID: 37086587]

'''Authors:''' Tian Q, Yi J, Wu Y, Wang S, Qu Y, Cai Q.

'''Institution:''' Department of Neurosurgery, Tangdu hospital, Air Force Medical University, Shaanxi, China.

'''Abstract:'''
Objective: Improper placement of the ventricular catheter tip is the most common cause of shunting disorders after ventriculoperitoneal shunt (VPS) placement surgery. Here, through two illustrative cases, we described a novel method of precise ventricular catheter tip location.

Methods: [http://www.slicer.org '''3D Slicer'''] software was used to define the ventricle puncture path and determine the ventricle catheter tip location preoperatively, and the 3D individualized guide model was printed.

Results: The ventricular puncture was performed under the guidance of the 3D guide to achieve precise ventricle catheter tip location intraoperatively.

Conclusions: This technique is safe, simple, efficient and cost-effective, which facilitates its clinical implementation and promotion.
|}

==PIRET-A Platform for Treatment Planning in Electroporation-Based Therapies==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37015676/ IEEE Trans Biomed Eng. 2023 Jun;70(6):1902-10. PMID: 37015676]

'''Authors:''' Perera-Bel E, Aycock KN, Salameh ZS, Gomez-Barea M, Davalos RV, Ivorra A, Ballester MAG.

'''Institution:''' BCN MedTech, Department of Information and Communication Technologies, Universitat Pompeu Fabra, Barcelona, Spain.

'''Abstract:'''
Tissue electroporation is the basis of several therapies. Electroporation is performed by briefly exposing tissues to high electric fields. It is generally accepted that electroporation is effective where an electric field magnitude threshold is overreached. However, it is difficult to preoperatively estimate the field distribution because it is highly dependent on anatomy and treatment parameters.

Objective: We developed PIRET, a platform to predict the treatment volume in electroporation-based therapies.

Methods: The platform seamlessly integrates tools to build patient-specific models where the electric field is simulated to predict the treatment volume. Patient anatomy is segmented from medical images and 3D reconstruction aids in placing the electrodes and setting up treatment parameters.

Results: Four canine patients that had been treated with high-frequency irreversible electroporation were retrospectively planned with PIRET and with a workflow commonly used in previous studies, which uses different general-purpose segmentation, [http://www.slicer.org '''3D Slicer'''] and modeling software (3Matic and COMSOL Multiphysics). PIRET outperformed the other workflow by 65 minutes (× 1.7 faster), thanks to the improved user experience during treatment setup and model building. Both approaches computed similarly accurate electric field distributions, with average Dice scores higher than 0.93.

Conclusion: A platform which integrates all the required tools for electroporation treatment planning is presented. Treatment plan can be performed rapidly with minimal user interaction in a stand-alone platform.

Significance: This platform is, to the best of our knowledge, the most complete software for treatment planning of irreversible electroporation. It can potentially be used for other electroporation applications.
|}

==Surgically Assisted Maxillary Expansion With or Without Pterygoid Disjunction Alters Maxillomandibular Positioning==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/35426586/ Oral Maxillofac Surg. 2023 Jun;27(2):269-281. PMID: 35426586]

'''Authors:''' Carvalho FSR, Soares ECS, de Medeiros JR, Júnior JMM, Hyppolito JOP, de Barros Silva PG, Ribeiro TR, Costa FWG.

'''Institution:''' Department of Oral and Maxillofacial Surgery, Federal University of Ceará Campus Sobral, Brazil.

'''Abstract:'''
Purpose: This study aimed to analyze alterations in mandibular positioning after surgically assisted maxillary expansion (SARME) with and without pterygoid disjunction (PD).

Methods: Cone-beam computed tomography scans of 24 healthy individuals (18-45 years old) with transverse deficiency, superior to 5 mm, underwent SARME with or without PD. The aspects prospectively assessed were (1) alignment and position of the head (ITK-Snap and [http://www.slicer.org '''3D Slicer'''] software); (2) McNamara's and Steiner-Tweed-Wits' cephalometric analysis (Dolphin Imaging®); and (3) colorimetric evaluation based on 3D correspondence analysis ([http://www.slicer.org '''3D Slicer'''] software).

Results: A decrease in 1-NA and 1-SN angles as well as an increased occlusal plane in both groups was observed. Superior-inferior and anteroposterior spatial displacements of the chin were statistically significant in the PD group. Altered colorimetric patterns were also observed in the PD group.

Conclusions: This study found more evident tooth inclination in the group without PD; mandibular alterations were more evident in the PD group. Further studies with 3D analysis are strongly recommended for more comprehensive results.
|}

==ERCP 2.0: Biliary 3D-Reconstruction in Patients With Malignant Hilar Stricture==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37379653 Clin Res Hepatol Gastroenterol. 2023 Jun 26;47(7):102172. PMID: 37379653]

'''Authors:''' Becq A, Szewczyk J, Salin G, Chartier M, Chaput U, Leenhardt R, Dray X, Arrive L, Camus M.

'''Institution:''' Department of Gastroenterology, Henri-Mondor University Hospital, AP-HP, EA 7375, Université Paris Est Créteil, France.

'''Abstract:'''
Background: Endoscopic retrograde cholangiopancreatography (ERCP) for malignant hilar strictures is challenging. The correlation between Magnetic resonance cholangiopancreatography (MRCP) and per ERCP 2D fluoroscopic images is not obvious. The aim of this study was to evaluate the feasibility and potential usefulness of MRCP-based handmade biliary 3D reconstruction in this setting.

Methods: Methods Patients who underwent MRCP followed by ERCP for biliary drainage of a malignant hilar stricture at our institution between 2018 and 2020 were reviewed. A handmade 3D segmentation using [http://www.slicer.org '''3D Slicer'''] (Kitware, France) was fashioned and reviewed with an expert radiologist. The primary outcome was the feasibility of biliary segmentation.

Results: A total of 16 patients were included. The mean age was 70.1 (+/- 8.6) years-old and 68.8% had hilar cholangiocarcinoma. Handmade segmentation was successful in all cases. The agreement between the MRCP interpretation and the 3D reconstruction was 37.5%, as per the Bismuth classification. 3D reconstruction available prior to ERCP could have helped guide for better stent placement in 11 cases (68.8%).

Conclusions: MRCP-based biliary 3D segmentation-reconstruction, in patients with malignant hilar stricture is feasible and seems to provide a better anatomical understanding compared to MRCP and could help improve endoscopic management.
|}

==3D Printing Personalized Guide Plate in the Management of Recurrent Intramuscular Venous Malformations: A Single Center Experience==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/36967547/ Phlebology. 2023 Jun;38(5):307-314. PMID: 36967547]

'''Authors:''' Han T, Jiang S, Xiong J, Cui J, Shen W.

'''Institution:''' Department of Burns and Plastic Surgery, Children's Hospital of Nanjing Medical University, Nanjing, China.

'''Abstract:'''
Objective: This study aimed to investigate the feasibility and effectiveness of 3D printing personalized guide plate in the management of recurrent intramuscular venous malformations (IVM).

Methods: Fifteen patients with recurrent IVM were retrospectively assessed. [http://www.slicer.org '''3D Slicer'''] software was used to extract and reconstruct the imaging data from CT and/or MRI to highlight the morphology, size, and puncture depth of the lesion. With the guidance of personalized plate, complete excision of the IVM was adopted along the pre-marked (methylene blue, MB) margin.

Results: Personalized guide plate matched involved extremity well, and MB-puncture approach was consistent with preoperative design. All IVMs were removed radically in one single session. Complete pain relief was obtained in all cases postoperatively.

Conclusion: The application of 3D printing guide plate can be safe, effective, and reliable to confirming the precise margin of IVM, renders a promising technique with a high practical value in resection of recurrent lesion.
|}

==White Matter Hyperintensities: A Possible Link Between Sarcopenia and Cognitive Impairment in Patients With Mild to Moderate Alzheimer's Disease==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37330930 Eur Geriatr Med. 2023 Jun 18. PMID: 37330930]

'''Authors:''' Weng X, Liu S, Li M, Zhang Y, Zhu J, Liu C, Hu H.

'''Institution:''' Department of Neurology, The Second Affiliated Hospital of Soochow University, Jiangsu, China.

'''Abstract:'''
Purpose: Alzheimer's disease (AD) has been reported to be associated with sarcopenia. White matter hyperintensities (WMH) are common in AD patients. However, the effect of WMH on sarcopenia in AD remains unclear. We hence aimed to investigate the possible association between regional WMH volumes and sarcopenic parameters in AD.

Methods: 57 mild to moderate AD patients and 22 normal controls (NC) were enrolled. Sarcopenic parameters were assessed, including appendicular skeletal mass index (ASMI), grip strength, 5-times sit-to-stand (5-STS) time, and gait speed. The volumes of periventricular hyperintensities (PVH) and deep white matter hyperintensities (DWMH) were quantified using [http://www.slicer.org '''3D Slicer'''] software.

Results: AD subjects exhibited a lower ASMI, a slower gait speed, an increased 5-STS time, and larger volumes of PVH and DWMH than those in the NC group. In AD subjects, total WMH and PVH volumes were related to cognitive impairment, particularly executive function decline. Moreover, total WMH volume and PVH volume were negatively correlated with gait speed across various clinical stages of AD. Multiple linear regression analysis showed that PVH volume was independently associated with 5-STS time and gait speed, whereas DWMH volume was only independently associated with gait speed.

Conclusion: WMH volume was associated with cognitive decline and various sarcopenic parameters. It thereby suggested that WMH may serve as the connection between sarcopenia and cognitive dysfunction in AD. Further studies are needed to confirm these findings and to determine whether sarcopenia interventions reduce WMH volume and improve cognitive function in AD.
|}

==CT Angiography Radiomics Combining Traditional Risk Factors to Predict Brain Arteriovenous Malformation Rupture: a Machine Learning, Multicenter Study==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37311939 Transl Stroke Res. 2023 Jun 13. PMID: 37311939]

'''Authors:''' Zhang S, Wang J, Sun S, Zhang Q, Zhai Y, Wang X, Ge P, Shi Z, Zhang D.

'''Institution:''' Department of Neurosurgery, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.

'''Abstract:'''
This study aimed to develop a machine learning model for predicting brain arteriovenous malformation (bAVM) rupture using a combination of traditional risk factors and radiomics features. This multicenter retrospective study enrolled 586 patients with unruptured bAVMs from 2010 to 2020. All patients were grouped into the hemorrhage (n = 368) and non-hemorrhage (n = 218) groups. The bAVM nidus were segmented on CT angiography images using [http://www.slicer.org '''3D Slicer'''] software, and radiomic features were extracted using Pyradiomics. The dataset included a training set and an independent testing set. The machine learning model was developed on the training set and validated on the testing set by merging numerous base estimators and a final estimator based on the stacking method. The area under the receiver operating characteristic (ROC) curve, precision, and the f1 score were evaluated to determine the performance of the model. A total of 1790 radiomics features and 8 traditional risk factors were contained in the original dataset, and 241 features remained for model training after L1 regularization filtering. The base estimator of the ensemble model was Logistic Regression, whereas the final estimator was Random Forest. In the training set, the area under the ROC curve of the model was 0.982 (0.967-0.996) and 0.893 (0.826-0.960) in the testing set. This study indicated that radiomics features are a valuable addition to traditional risk factors for predicting bAVM rupture. In the meantime, ensemble learning can effectively improve the performance of a prediction model.
|}

==Real-Time Integration Between Microsoft HoloLens 2 and 3D Slicer With Demonstration in Pedicle Screw Placement Planning==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37310561 Int J Comput Assist Radiol Surg. 2023 Jun 13. PMID: 37310561]

'''Authors:''' Pose-Díez-de-la-Lastra A, Ungi T, Morton D, Fichtinger G, Pascau J.

'''Institution:''' Departamento de Bioingeniería, Universidad Carlos III de Madrid, Spain.

'''Abstract:'''
Purpose: Up to date, there has been a lack of software infrastructure to connect [http://www.slicer.org '''3D Slicer'''] to any augmented reality (AR) device. This work describes a novel connection approach using Microsoft HoloLens 2 and OpenIGTLink, with a demonstration in pedicle screw placement planning.

Methods: We developed an AR application in Unity that is wirelessly rendered onto Microsoft HoloLens 2 using Holographic Remoting. Simultaneously, Unity connects to [http://www.slicer.org '''3D Slicer'''] using the OpenIGTLink communication protocol. Geometrical transform and image messages are transferred between both platforms in real time. Through the AR glasses, a user visualizes a patient's computed tomography overlaid onto virtual 3D models showing anatomical structures. We technically evaluated the system by measuring message transference latency between the platforms. Its functionality was assessed in pedicle screw placement planning. Six volunteers planned pedicle screws' position and orientation with the AR system and on a 2D desktop planner. We compared the placement accuracy of each screw with both methods. Finally, we administered a questionnaire to all participants to assess their experience with the AR system.

Results: The latency in message exchange is sufficiently low to enable real-time communication between the platforms. The AR method was non-inferior to the 2D desktop planner, with a mean error of 2.1 ± 1.4 mm. Moreover, 98% of the screw placements performed with the AR system were successful, according to the Gertzbein-Robbins scale. The average questionnaire outcomes were 4.5/5.

Conclusions: Real-time communication between Microsoft HoloLens 2 and 3D Slicer is feasible and supports accurate planning for pedicle screw placement.
|}

==Delirium After Traumatic Brain Injury: Prediction by Location and Size of Brain Lesion==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37317796 Ann Rehabil Med. 2023 Jun;47(3):214-21. PMID: 37317796] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10326395/pdf/arm-23008.pdf PDF]

'''Authors:''' Han SJ, Suh JH, Lee JY, Kim SJ.

'''Institution:''' Department of Rehabilitation Medicine, College of Medicine, Ewha Womans University, Seoul, Korea.

'''Abstract:'''
Objective: To examine (1) the location of brain lesion that would predict post-traumatic delirium and (2) the association between volume of brain lesion and occurrence of delirium in patients with traumatic brain injury (TBI).

Methods: A retrospective study was conducted by reviewing medical records of 68 TBI patients, categorized into two groups: the delirious group (n=38) and non-delirious group (n=30). The location and volume of TBI were investigated with the [http://www.slicer.org '''3D Slicer'''] software.

Results: The TBI region in the delirious group mainly involved the frontal or temporal lobe (p=0.038). All 36 delirious patients had brain injury on the right side (p=0.046). The volume of hemorrhage in the delirious group was larger by about 95 mL compared to the non-delirious group, but this difference was not statistically significant (p=0.382).

Conclusion: Patients with delirium after TBI had significantly different injury site and side, but not lesion size compared to patients without delirium.
|}

==Mitral Paravalvular Leak 3D Printing from 3D-Transesophageal Echocardiography==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37288866 Anatol J Cardiol. 2023 Jun 7. PMID: 37288866] | [https://doi.org/10.14744/AnatolJCardiol.2023.3008 PDF]

'''Authors:''' Jedrzejek M, Kozlowski M, Peszek-Przybyla E, Jadczyk T, Pysz P, Wojakowski W, Smolka G.

'''Institution:''' Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland.

'''Abstract:'''
Background: Paravalvular leaks can be detected in almost 15% of patients after mitral valve prosthesis implantation. This complication can result in congestive heart failure and hemolysis. Despite advancements in non-invasive imaging, percutaneous closure of paravalvular leaks is not always successful. Therefore, efforts are made to improve treatment outcomes by using 3D-printed models of defects as pre-procedural support for interventional cardiologists.

Methods: Retrospectively, 3D-transesophageal echocardiography recordings of 8 patients with clinically significant mitral paravalvular leaks were analyzed. Qlab Software was used to export DICOM images of each paravalvular leak channel, including surrounding tissue. Image segmentation was performed in [http://www.slicer.org '''3D Slicer'''], a free, open-source software package used for imaging research. Models were printed to actual size with the poly jet Stratasys Objet 30 printer with a transparent, rigid material.

Results: Duration of model preparation and printing, as well as the total cost, was calculated. Mean total time of model preparation was 430.5 ± 196 minutes.

Conclusion: 3D-printing from 3D-transesophageal echocardiography is technically feasible. Both shape and location of paravalvular leaks are preserved during model preparation and printing. It remains to be tested if 3D-printing would improve outcomes of percutaneous paravalvular leaks closure.
|}

==Prediction of Ki-67 Expression in Gastrointestinal Stromal Tumors Using Radiomics of Plain and Multiphase Contrast-Enhanced CT==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37266658 Eur Radiol. 2023 Jun 2. PMID: 37266658]

'''Authors:''' Liu Y, He C, Fang W, Peng L, Shi F 4, Xia Y, Zhou Q, Zhang R 5, Li C.

'''Institution:''' Medical Imaging Department, Chongqing University Central Hospital, Chongqing Emergency Medical Center, Chongqing, China.

'''Abstract:'''
Objective: To study the value of radiomics models based on plain and multiphase contrast-enhanced CT to predict Ki-67 expression in gastrointestinal stromal tumors (GISTs).

Methods: A total of 215 patients with GISTs were retrospectively analyzed, including 150 patients in one hospital as the training set and 65 patients in another hospital as the external verification set. The tumor at the largest level of CT images was delineated as the region of interest (ROI). The maximum diameter of the ROI was defined as the tumor size. A total of 851 radiomics features were extracted from each ROI by [http://www.slicer.org '''3D Slicer'''] Radiomics. After dimensionality reduction, three machine learning classification algorithms including logistic regression (LR), random forest (RF), and support vector machine (SVM) were used for Ki-67 expression prediction. Using a multivariable logistic model, a nomogram was established to predict the expression of Ki-67 individually.

Results: Delong tests showed that the SVM models had the highest accuracy in the arterial phase (Z value 0.217-1.139) and venous phase (Z value 0.022-1.396). For the plain phase, LR and SVM models had the highest accuracy (Z value 0.874-1.824, 1.139-1.763). For the delayed phase, LR models had the highest accuracy (Z value 0.056-1.824). For the combined phase, RF models had the highest accuracy (Z value 0.232-1.978). There was no significant difference among the above models for KI-67 expression prediction (Z value 0.022-1.978). A nomogram was developed with a C-index of 0.913 (95% CI, 0.878 to 0.956).

Conclusions: Radiomics of both plain and enhanced CT images could accurately predict the expression of Ki-67 in GIST. For patients who were not suitable to use contrast agents, plain scan could be used as an alternative.
|}

==Accuracy of Imaging Software for 3d Rendering of Tooth Structures, Usable in Clinical Settings==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37272346 Int J Comput Dent. 2023 Jun 5;0(0):0. PMID: 37272346]

'''Authors:''' Ronsivalle V, Venezia P, Migliorati M, Grippaudo C, Barbato E, Nucci L, Isola G, Leonardi RM, Lo Giudice A.

'''Institution:''' Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Policlinico Universitario "Vittorio Emanuele-G. Rodolico", Catania, Italy.

'''Abstract:'''
Aim: The aim of this study was to evaluate the segmentation accuracy of dentition testing four free-source semi-automatic software.

Materials and methods: A total of 20 cone-beam computed tomography (CBCT) were selected to perform semi-automatic segmentation of maxillary and mandibular dentition. The software tested were Invesalius, ITK-Snap, [http://www.slicer.org '''3D Slicer'''] and Seg3D. Each tooth model was also manually segmented (Mimics software) and set as the gold standard (GS) reference of the investigation. A specific 3D imaging technology was used to perform the superimposition between the teeth models obtained with semi-automatic software and the GS model, and to perform the surface-to-surface matching analysis. The accuracy of semi-automatic segmentation was evaluated calculating the volumetric mean differences (mean bias and limits of agreement) and the percentage of matching of the tooth models compared to the manual segmentation (GS). Qualitative assessments were performed using color-coded maps. All data were statistically analysed to perform software comparisons.

Result: Statistically significant differences were found in the volumetric and matching percentage data (p < 0,05). Invesalius was the most accurate software for 3D rendering of the dentition with a volumetric bias (Mimics) ranging from 4,59 mm3 to 85,79 mm3; instead, ITK-SNAP showed the higher volumetric bias, ranging from 30,22 mm3 to 319,83 mm3. The dis-matched area was mainly located at the radicular region of the teeth. Volumetric data showed excellent inter-software reliability with coefficient values ranging from 0,951 to 0,997.

Conclusion: Different semi-automatic software algorithms could generate different patterns of inaccuracy error in the segmentation of teeth.
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==A Retrospective Three-Dimensional Study of the Mandibular Growth During Preoperative Orthodontics in Late Adolescent Patients With Skeletal Class III Malocclusion==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37271262 J Stomatol Oral Maxillofac Surg. 2023 Jun 2:101526. PMID: 37271262]

'''Authors:''' Yuan M, Zheng Z, Li H, Wang P, Liu Y, Bi R.

'''Institution:''' State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthognathic and TMJ Surgery, West China Hospital of Stomatology, Sichuan University, China.

'''Abstract:'''
Introduction: The mandible's ongoing development presents a contraindication for combined orthodontic-orthognathic treatment. The aim of this study was to evaluate the mandibular stability before and after preoperative orthodontic treatment in late adolescent patients with skeletal Class III malocclusion and to investigate the most appropriate time to start preoperative orthodontic treatment.

Material and methods: The study population consisted of 58 adolescents, aged between 15 and 21 years, with skeletal Class III malocclusion; the adolescents underwent CT scans at the beginning (T1) and the end (T2) of preoperative orthodontic treatment. The CT data were analyzed using ITK-SNAP and [http://www.slicer.org '''3D Slicer'''] software, and the effects of age and gender on mandibular development were investigated.

Results: In these 58 patients, there were no significant local bone alterations in the condyle and anterior chin point between T1 and T2 and no significant changes in the mandibular branch height, mandibular body length, condylar distance, and mandibular angle distance (p>0.05). The mandibular growth at the angel of mandible was statistically significant (p<0.05), but it was not clinically significant because the mean value of the growth was small (right: 0.416±0.986 mm, left: 0.328±0.886 mm). No effect of age and gender on mandibular development was observed.

Conclusion: The mandibular morphology was stable during preoperative orthodontic treatment in patients at the late adolescent stage. This study provides evidence for the possibility of early implementation of preoperative orthodontics.
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==Assessment of Variabilities in Lung-Contouring Methods on CBCT Preclinical Radiomics Outputs==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37345013 Cancers (Basel). 2023 May 9;15(10):2677. PMID: 37345013] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10216427/pdf/cancers-15-02677.pdf PDF]

'''Authors:''' Brown KH, Illyuk J, Ghita M, Walls GM, McGarry CK, Butterworth KT.

'''Institution:''' Patrick G. Johnston Centre for Cancer Research, Queen's University Belfast, UK.

'''Abstract:'''
Radiomics image analysis has the potential to uncover disease characteristics for the development of predictive signatures and personalised radiotherapy treatment. Inter-observer and inter-software delineation variabilities are known to have downstream effects on radiomics features, reducing the reliability of the analysis. The purpose of this study was to investigate the impact of these variabilities on radiomics outputs from preclinical cone-beam computed tomography (CBCT) scans. Inter-observer variabilities were assessed using manual and semi-automated contours of mouse lungs (n = 16). Inter-software variabilities were determined between two tools ([http://www.slicer.org '''3D Slicer'''] and ITK-SNAP). The contours were compared using Dice similarity coefficient (DSC) scores and the 95th percentile of the Hausdorff distance (HD95p) metrics. The good reliability of the radiomics outputs was defined using intraclass correlation coefficients (ICC) and their 95% confidence intervals. The median DSC scores were high (0.82-0.94), and the HD95p metrics were within the submillimetre range for all comparisons. the shape and NGTDM features were impacted the most. Manual contours had the most reliable features (73%), followed by semi-automated (66%) and inter-software (51%) variabilities. From a total of 842 features, 314 robust features overlapped across all contouring methodologies. In addition, our results have a 70% overlap with features identified from clinical inter-observer studies.
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==A Training Tool for Clinicians in Segmenting Medical Images to Make 3D Models==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37342255 Ann Surg Open. 2023 May 23;4(2):e275. PMID: 37342255] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7614675/pdf/EMS170894.pdf PDF]

'''Authors:''' Chegini S, Tahim A, Liu M, Chooi Y, Edwards E, Clarkson M, Schilling C.

'''Institution:''' Department of Head and Neck Surgery, University College London Hospital, London, UK.

'''Abstract:'''
Introduction: 3D models produced from medical imaging can be used to plan treatment, design prosthesis, teach and for communication. Despite the clinical benefit, few clinicians have experience of how 3D models are produced.This is the first study evaluating a training tool to teach clinicians to produce 3D models and reporting the perceived impact on their clinical practice.

Method: Following ethical approval, 10 clinicians completed a bespoke training tool, comprising written and video material alongside online support. Each clinician and 2 technicians (included as control) were sent 3 CT scans and asked to produce 6 fibula 3D models using an open-source software, [http://www.slicer.org '''3D Slicer''']. The produced models were compared to those produced by the technicians using Hausdorff distance calculation. Thematic analysis was used to study the post-intervention questionnaire.

Results: The mean Hausdorff distance between the final model produced by the clinicians and technicians was 0.65mm SD0.54mm. The first model made by clinicians took a mean time of 1hr 25mins and the final model took 16:04mins (5:00-46:00mins). 100% of learners reported finding the training tool useful and will employ it in future practice.

Discussion: The training tool described in this paper is able to successfully train clinicians to produce fibula models from CT scans. Learners were able to produce comparable models to technicians within an acceptable timeframe. This does not replace technicians. However, the learners perceived this training will allow them to use this technology in more cases, with appropriate case selection and they appreciate the limits of this technology.
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==3D Slicer Combined With Neuroendoscope in Treatment of a Distal Segment Aneurysm of the Anterior Choroidal Artery Complicated Intraventricular Hemorrhage: A Case Report and Literature Review==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37251467 Heliyon. 2023 May 18;9(6):e16193. PMID: 37251467] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10220353/pdf/main.pdf PDF]

'''Authors:''' Zhou L, Ren Y, Li Z, Zhang H, Wei H, Song P, Cheng L, Wang W, Gao L, Lei P, Hua Q, Chen Q, Zhou J, Li G, Cai Q.

'''Institution:''' Department of Neurosurgery, Renmin Hospital of Wuhan University, Wuhan, China.

'''Abstract:'''
Introduction: Pure ventricular hemorrhage is often secondary to Moyamoya disease, rarely caused by rupture of ventricular aneurysm. The surgical treatment of the latter is very challenging. [http://www.slicer.org '''3D Slicer'''] reconstruction technology can accurately locate small intracranial lesions and combined with minimally invasive surgery with transcranial neuroendoscope is a new attempt to treat the above diseases.

Case presentation: We report a case of pure intraventricular hemorrhage secondary to rupture of a distal segment aneurysm of the anterior choroidal artery. Brain computed tomography (CT) before admission showed pure ventricular hemorrhage, and brain CT angiography (CTA) before operation showed a distal segment aneurysm of the anterior choroidal artery. We used [http://www.slicer.org '''3D Slicer'''] reconstruction and precise location of the focus before the operation and used the minimally invasive surgery technique with transcranial neuroendoscope to completely remove the hematoma in the ventricle, and found the responsible aneurysm located in the ventricle.

Conclusion: Pure intraventricular hemorrhage requires vigilance against the distal segment aneurysm of the anterior choroidal artery. At present, conventional microscopic craniotomy and intravascular interventional therapy have limitations, and [http://www.slicer.org '''3D Slicer'''] reconstruction and precise positioning technology combined with transcranial neuroendoscope minimally invasive surgery may be a good choice.
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==Application of Preoperative Multimodal Image Fusion Technique in Microvascular Decompression Surgery via Suboccipital Retrosigmoid Approach==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36716853 World Neurosurg. 2023 May;173:e37-e47. PMID: 36716853] | [https://pdf.sciencedirectassets.com/280061/AIP/1-s2.0-S1878875023001031/main.pdf PDF]

'''Authors:''' Liao CC, Wu KH, Chen G.

'''Institution:''' Department of Neurosurgery, Zhuhai People's Hospital (Zhuhai Hospital Affiliated with Jinan University,China), Zhuhai, China.

'''Abstract:'''
'''Objective:''' To explore the application value of preoperative multimodal image fusion technique in microvascular decompression (MVD) surgery via the suboccipital retrosigmoid approach.

'''Methods:''' Comprehensive data of 13 patients with primary trigeminal neuralgia (TN) and 13 patients with hemifacial spasm (HFS) treated by MVD surgery via the suboccipital retrosigmoid approach at the Department of Neurosurgery in Zhuhai People's Hospital from January 2021 to December 2021 were retrospectively analyzed. Preoperatively, all patients underwent cranial thin-section computed tomography and magnetic resonance examinations. Three-dimensional (3D) digital images of the skull, brainstem, nerves, and blood vessels were constructed by the [http://www.slicer.org '''3D Slicer'''] software or RadiAnt DICOM Viewer, which were then applied to design the surgical approach and surgical plan. The multimodal image fusion results, clinical characteristics, intraoperative data, surgical outcomes, and complications of all patients were summarized.

'''Results:''' The 3D digital images after fusion reconstruction can vividly show the anatomical relationship between the skull, brainstem, nerves, and blood vessels and was helpful to tailor the surgical strategy. All 26 patients underwent a smooth surgery. During the surgery, the key points were accurately located, the corners of the transverse sinus and sigmoid sinus were completely exposed, and no venous sinus injury occurred in all 26 patients. The key point was approximately located at the top point of the digastric groove, 12.3 ± 0.46 mm vertically above and 6.3 ± 0.6 mm laterally to the Frankfurt horizontal plane. The average cranial opening time was 30.4 (±3.6) min, and the mean operating time was 104.7 (±12.1) min. The diameter of the bone window was about 2.0 cm-3.0 cm, and the bone flap was restored. Among the 13 patients with primary TN, 12 (92.3%) exhibited complete relief of pain and 1 had significant relief. Complications of surgery included facial sensory numbness in 1 case, vertigo in 2 cases, and herpes at the corners of the mouth in 1 case. Of the 13 patients with HFS, 12 (92.3%) had complete relief of facial twitching symptoms and 1 had significant relief, and the complications included mild facial palsy in 2 (15.4%) cases and facial sensory numbness in another 2 (15.4%) cases. The mean follow-up time after surgery ranged from 6-16 months, and 1 of 26 patients experienced recurrence of HFS during the follow-up period.

'''Conclusions:''' Preoperative multimodal image fusion technology can provide adequate preoperative assessment for patients and assistance in designing surgical approaches, which is an important guideline for MVD surgery via the suboccipital retrosigmoid approach for primary TN and facial muscle spasm.
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==An Interactive App with Multi-parametric MRI - Whole-Mount Histology Correlation for Enhanced Prostate MRI Training of Radiology Residents==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37137744 Acad Radiol. 2023 May 1:S1076-6332(23)00183-6. PMID: 37137744]

'''Authors:''' Chatterjee A, Szasz T, Munakami M, Karademir I, Yusufishaq MS, Martens S, Wheeler C, Antic T, Thomas S, Karczmar GS, Oto A.

'''Institution:''' Department of Radiology, University of Chicago, Chicago, IL, USA.

'''Abstract:'''
Rationale and objectives: To validate the educational value of a newly created learning application in enhancing prostate MRI training of radiologists for detecting prostate cancer using an observer study.

Materials and methods: An interactive learning app, LearnRadiology, was developed using a web-based framework to display multi-parametric prostate MRI images with whole-mount histology for 20 cases curated for unique pathology and teaching points. Twenty new prostate MRI cases, different from the ones used in the web app, were uploaded on [http://www.slicer.org '''3D Slicer''']. Three radiologists (R1: radiologist; R2, R3: residents) blinded to pathology results were asked to mark areas suspected of cancer and provide a confidence score (1-5, with 5 being high confidence level). Then after a minimum memory washout period of 1 month, the same radiologists used the learning app and then repeated the same observer study. The diagnostic performance for detecting cancers before and after accessing the learning app was measured by correlating MRI with whole-mount pathology by an independent reviewer.

Results: The 20 subjects included in the observer study had 39 cancer lesions (13 Gleason 3 + 3, 17 Gleason 3 + 4, 7 Gleason 4 + 3, and 2 Gleason 4 + 5 lesions). The sensitivity (R1: 54% → 64%, P = 0.08; R2: 44% → 59%, P = 0.03; R3: 62% → 72%, P = 0.04) and positive predictive value (R1: 68% → 76%, P = 0.23; R2: 52% → 79%, P = 0.01; R3: 48% → 65%, P = 0.04) for all 3 radiologists improved after using the teaching app. The confidence score for true positive cancer lesion also improved significantly (R1: 4.0 ± 1.0 → 4.3 ± 0.8; R2: 3.1 ± 0.8 → 4.0 ± 1.1; R3: 2.8 ± 1.2 → 4.1 ± 1.1; P < 0.05).

Conclusion: The web-based and interactive LearnRadiology app learning resource can support medical student and postgraduate education by improving diagnostic performance of trainees for detecting prostate cancer.
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==3D Printed Guide Tube System for Acute Neuropixels Probe Recordings in Non-Human Primates==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37105161 J Neural Eng. 2023 May 11;20(3):036009. PMID: 37105161] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10172811/pdf/jne_20_3_036009.pdf PDF]

'''Authors:''' Bauer DL, Pobiel B, Hilber K, Verma AK, Wang J, Vitek J, Johnson M, Johnson L.

'''Institution:''' Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, USA.

'''Abstract:'''
Objective.
Neuropixels (NP) probes are a significant advance in electrophysiological recording technology that enable monitoring of hundreds of neurons in the brain simultaneously at different depths. Application of this technology has been predominately in rodents, however widespread use in non-human primates (NHPs) such as rhesus macaques has been limited. In this study we sought to overcome two overarching challenges that impede acute NP implantation in NHPs: (1) traditional microdrive systems that mount to cephalic chambers are commonly used to access cortical areas for microelectrode recordings but are not designed to accommodate NP probes, and (2) NHPs have thick dura mater and tissue growth within the cephalic chambers which poses a challenge for insertion of the extremely fragile NP probe.
Approach.
In this study we present a novel NP guide tube system that can be adapted to commercial microdrive systems and demonstrate an implant method using the NP guide tube system. This system was developed using a combination of CAD design, 3D printing, and small part machining. Software programs, [http://www.slicer.org '''3D Slicer'''] and SolidWorks were used to target cortical areas, approximate recording depths and locations, and for in-silico implant testing.
Main results.
We performedin vivotesting to validate our methodology, successfully implanting, explanting, and reimplanting NP probes. We collected stable neurophysiological recordings in the premotor cortex of a rhesus macaque at rest and during performance of a reaching task.Significance.In this study we demonstrate a robust Neuropixels implant system that allows multiple penetrations with the same NP probe and share design files that will facilitate the adoption of this powerful recording technology for NHP studies.
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==Diagnostic Value of 18F-FDG PET/CT-Based Radiomics Nomogram in Bone Marrow Involvement of Pediatric Neuroblastoma==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/36117128 Acad Radiol. 2023 May;30(5):940-51. PMID: 36117128]

'''Authors:''' Feng L, Yang X, Lu X, Kan Y, Wang C, Zhang H, Wang W, Yang J.

'''Institution:''' Department of Nuclear Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing, China.

'''Abstract:'''
Objectives: To develop and validate an 18F-FDG PET/CT-based radiomics nomogram and evaluate the value of the 18F-FDG PET/CT-based radiomics nomogram for the diagnosis of bone marrow involvement (BMI) in pediatric neuroblastoma.

Materials and methods: A total of 144 patients with neuroblastoma (100 in the training cohort and 44 in the validation cohort) were retrospectively included. The PET/CT images of patients were visually assessed. The results of bone marrow aspirates or biopsies were used as the gold standard for BMI. Radiomics features and conventional PET parameters were extracted using [http://www.slicer.org '''3D Slicer''']. Features were selected by the least absolute shrinkage and selection operator regression, and radiomics signature was constructed. Univariate and multivariate logistic regression analyses were applied to identify the independent clinical risk factors and construct the clinical model. Other different models, including the conventional PET model, combined PET-clinical model and combined radiomics model, were built using logistic regression. The combined radiomics model was based on clinical factors, conventional PET parameters and radiomics signature, which was presented as a radiomics nomogram. The diagnostic performance of the different models was evaluated by receiver operating characteristic (ROC) curves and decision curve analysis (DCA).

Results: By visual assessment, BMI was observed in 80 patients. Four conventional PET parameters (SUVmax, SUVmean, metabolic tumor volume, and total lesion glycolysis) were extracted. And 15 radiomics features were selected to build the radiomics signature. The 11q aberration, neuron-specific enolase and vanillylmandelic acid were identified as the independent clinical risk factors to establish the clinical model. The radiomics nomogram incorporating the radiomics signature, the independent clinical risk factors and SUVmean demonstrated the best diagnostic value for identifying BMI, with an area under the curve (AUC) of 0.963 and 0.931 in the training and validation cohorts, respectively. And the DCA demonstrated that the radiomics nomogram was clinically useful.

Conclusion: The 18F-FDG PET/CT-based radiomics nomogram which incorporates radiomics signature, independent clinical risk factors and conventional PET parameters could improve the diagnostic performance for BMI of pediatric neuroblastoma without additional medical costs and radiation exposure.
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==Opportunistic Screening for Osteoporosis Using CT Scans of the Knee: A Pilot Study==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37203533 Stud Health Technol Inform. 2023 May 18;302:909-910. PMID: 37203533]

'''Authors:''' Elmahdy M, Sebro R.

'''Institution:''' Department of Radiology, Mayo Clinic, Jacksonville, FL, USA.

'''Abstract:'''
Knee CT scans are used for planning for total knee arthroplasties in patients who are often simultaneously at risk for frailty fractures due to low bone mineral density. We retrospectively identified 200 patients (85.5% female) with concurrent CT scans of the knee and Dual energy x-ray absorptiometry (DXA). The mean CT attenuation of the distal femur, proximal tibia and fibula, and patella, were calculated using volumetric 3-dimensional segmentation using [http://www.slicer.org '''3D Slicer''']. Data were split randomly into training 80% and test 20% datasets. The optimal CT attenuation threshold for the proximal fibula was obtained in the training dataset and evaluated in the test dataset. A support vector machine (SVM) with radial basis function (RBF) using C-classification was trained and tuned using 5-fold cross-validation in the training dataset and then evaluated in the test dataset. The SVM had a higher area-under-the curve (AUC) of 0.937 and better performance to detect osteoporosis/osteopenia than the CT attenuation of the fibula (AUC of 0.717) (P=0.015). Opportunistic screening for osteoporosis/osteopenia could be accomplished using CT scans of the knee.
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==Sustainable 3D Printing of Oral Films With Tunable Characteristics Using CMC-Based Inks From Durian Rind Wastes==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/36933810 Eur J Pharm Biopharm. 2023 May;186:30-42. PMID: 36933810]

'''Authors:''' Panraksa P, Rachtanapun P, Thipchai P, Lesniewska E, Brachais CH, Debeaufort F, Chambin O, Jantrawut P.

'''Institution:''' Department of Pharmaceutical Sciences, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, Thailand.

'''Abstract:'''
With the growing interest in environmentally friendly and personalized medicines, new concept for combining three-dimensional printing (3DP) with natural-based biomaterials derived from agro-food wastes has emerged. This approach provides sustainable solutions for agricultural waste management and potential for developing of novel pharmaceutical products with tunable characteristics. This work demonstrated the feasibility of fabricating personalized theophylline films with four different structures (Full, Grid, Star, and Hilbert) using syringe extrusion 3DP and carboxymethyl cellulose (CMC) derived from durian rind wastes. Our findings suggested that all the CMC-based inks with shear thinning properties capable of being extruded smoothly through a small nozzle could potentially be used to fabricate the films with various complex printing patterns and high structural fidelity. The results also demonstrated that the film characteristics and release profiles could be easily modified by simply changing the slicing parameters (e.g., infill density and printing pattern). Amongst all formulations, Grid film, which was 3D-printed with 40 % infill and a grid pattern, demonstrated a highly porous structure with high total pore volume. The voids between printing layers in Grid film increased theophylline release (up to 90 % in 45 min) through improved wetting and water penetration. All findings in this study provide significant insight into how to modify film characteristics simply by digitally changing the printing pattern in [http://www.slicer.org '''3D Slicer'''] software without creating a new CAD model. This approach could help to simplify the 3DP process so that non-specialist users can easily implement it in community pharmacies or hospital on demand.
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==An Automated Landmark Method to Describe Geometric Changes in the Human Mandible During Growth==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/36893681 Arch Oral Biol. 2023 May;149:105663. PMID: 36893681]

'''Authors:''' Fournier G, Maret D, Telmon N, Savall F.

'''Institution:''' Faculté de Chirurgie Dentaire, Université Paul Sabatier, Centre Hospitalier Universitaire, Toulouse, France.

'''Abstract:'''
Objective: The principal aim of this study was to assess an automatic landmarking approach to human mandibles based on the atlas method. The secondary aim was to identify the areas of greatest variation in the mandibles of middle-aged to older adults.

Design: Our sample consisted of 160 mandibles from computed tomography scans of 80 men and 80 women aged between 40 and 79 years. Eleven anatomical landmarks were placed manually on mandibles. The automated landmarking through point cloud alignment and correspondence (ALPACA) method implemented in [http://www.slicer.org '''3D Slicer'''] was used to automatically place landmarks to all meshes. Euclidean distances, normalized centroid size, and Procrustes ANOVA were calculated for both methods. A pseudo-landmarks approach was followed using ALPACA to identify areas of changes among our sample.

Results: The ALPACA method showed significant differences in Euclidean distances for all landmarks compared to the manual method. A mean Euclidean distance of 1.7 mm was found for the ALPACA method and 0.99 mm for the manual method. Both methods found that sex, age, and size had a significant effect on mandibular shape. The greatest variations were observed in the condyle, ramus, and symphysis regions.

Conclusion: The results obtained using the ALPACA method are acceptable and promising. This approach can automatically place landmarks with an average accuracy of less than 2 mm, which may be sufficient in most anthropometric analyses. In the light of our results, however, odontological application such as occlusal analysis is not recommended.
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==Clinical Study of Puncture Technique in Single Division of the Trigeminal Ganglion Intumescentia==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37183316 Pain Pract. 2023 May 14. PMID: 37183316] | [https://onlinelibrary.wiley.com/doi/epdf/10.1111/papr.13239 PDF]

'''Authors:''' Zhang L, Guo Y, Xu J, He Y, Qi Z, Chen H, Zhang H.

'''Institution:''' Department of Neurosurgery, Jianhu Hospital Affiliated to Nantong University, Yancheng, China.

'''Abstract:'''
Objective: We explored the feasibility of single-division puncture in the ophthalmic division, maxillary division, and mandibular division of the trigeminal ganglion intumescentia (TGI) and the feasibility of radiofrequency treatment of trigeminal neuralgia.

Methods: According to the previous anatomical image studies, [http://www.slicer.org '''3D Slicer'''] software was used to analyze the CT images of the patients. The trigeminal ganglion fossa (TGF) was used as the imaging sign. TGI was identified in the sagittal plane along the fiber. The puncture path starts from the TGI center-foramen ovale line, extending outward to the epidermis as the needle insertion point, and extending inward to the division boundary. For lateral puncture, which is blocked by the mandible, the positions of closed mouth, open mouth, and over-open mouth were used. Multiple targets were generated using straight electrodes and curved electrodes to achieve full coverage of TGI. According to the preoperative design, general anesthesia surgery was performed. Xper CT was used for imaging, and the puncture was guided by Xper Guide. Radiofrequency treatment of TGI was conducted.

Results: In total, 45 patients with trigeminal neuralgia underwent 50 single-division TGI punctures. The procedure was smooth and the compliance with the design was good. Continuous radiofrequency (CRF) was performed, the VAS scores were 25 times at 70°C, 19 times at 65°C, two times at 60°C, and two times at 50°C (both in the ophthalmic division). Pulsed radiofrequency (PRF) was conducted two times. Within 24 h after the procedure, the VAS scores were all 0. From 1 to 7 days after the procedure, pain recurrence was found in three cases, of whom two cases received pulsed radiofrequency treatment. Patients were followed up for 1-24 months and there were no recurrence. After continuous radiofrequency at 65-70°C, the moderate tactile loss was observed, and nearly half of the patients had food residues on the surgical side after 6 months. After continuous radiofrequency at 60°C, there was mild tactile loss and no food residue. The tactile sensation was slightly decreased after continuous radiofrequency at 50°C, and the tactile sensation was normal the next day.

Conclusion: Trigeminal ganglion intumescentia single-division radiofrequency is effective and feasible for the treatment of trigeminal neuralgia.
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==Three-Dimensional Volume Rendering of Pelvic Floor Anatomy with Focus on Fibroids in Relation to the Lower Urogenital Tract Based on Cross-Sectional MRI Images==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37171621 J Med Syst. 2023 May 12;47(1):62. PMID: 37171621] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10181971/pdf/10916_2023_Article_1947.pdf PDF]

'''Authors:''' Fan KS, Durnea C, Nygaard CC, Khalil M, Doumouchtsis SK.

'''Institution:''' Institute for Medical and Biomedical Education, St. George's University of London, London, UK.

'''Abstract:'''
We aimed to assess the feasibility of developing three-dimensional (3D) models of pelvic organs using cross-sectional MRI images of patients with uterine fibroids and urinary symptoms and of obtaining anatomical information unavailable in 2D imaging modalities. We also aimed to compare two image processing applications. We performed a feasibility study analysing MRI scans from three women, aged 30 to 58 years old, with fibroids and urinary symptoms. Cross-sectional images were used to render 3D models of pelvic anatomy, including bladder, uterus and fibroids, using [http://www.slicer.org '''3D Slicer'''] and OsiriX. Dimensions, volumes and anatomical relationships of the pelvic organs were evaluated. Comparisons between anatomical landmarks and measurements obtained from the two image processing applications were undertaken. Rendered 3D pelvic models yielded detailed anatomical information and data on spatial relationships that were unobtainable from cross-sectional images. Models were rendered in sufficient resolution to aid understanding of spatial relationships between urinary bladder, uterus and fibroid(s). Measurements of fibroid volumes ranged from 5,336 to 418,012 mm3 and distances between the fibroid and urinary bladder ranged from 0.10 to 83.60 mm. Statistical analysis of measurements showed no significant differences in measurements between the two image processing applications. To date, limited data exist on the use of 3D volume reconstructions of routine MRI scans, to investigate pelvic pathologies such as fibroids in women with urinary symptoms. This study suggests that post-MRI image processing can provide additional information over standard MRI. Further studies are required to assess the role of these data in clinical practice, surgical planning and training. Three-dimensional reconstruction of routine two-dimensional magnetic resonance imaging provides additional anatomical information and may improve our understanding of anatomical relationships, their role in clinical presentations and possibly guide clinical and surgical management.
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==The First Endovascular Rat Glioma Model for Pre-Clinical Evaluation of Intra-Arterial Therapeutics==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37157800 Interv Neuroradiol. 2023 May 8:15910199231169597. PMID: 37157800]

'''Authors:''' Lim J, Baig AA, Donnelly BM, Chaves LD, Pol SU, Koenigsknecht C, Pionessa D, Levy BR, Gutierrez L, Tutino VM, Levy EI, Siddiqui AH.

'''Institution:''' Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA.

'''Abstract:'''
Background: Several translational animal models have been described assessing intra-arterial (IA) treatments for malignant gliomas. We describe the first endovascular animal model that allows testing of IA drug delivery as a first-line treatment, which is difficult to do in actual patients. We report a unique protocol for vascular access and IA delivery in the rat model that, unlike prior reports, does not require direct puncture and opening of proximal cerebrovasculature which carries risk of ischemia in the animal brain post-delivery.

Methods: Wistar rats underwent left femoral artery catherization with a Balt Magic 1.2F catheter or Marathon Flow directed 1.5F Microcatheter with an Asahi Chikai 0.008 micro-guidewire which was navigated to the left internal carotid artery under x-ray. 25% mannitol was administered to test blood brain barrier breakdown (BBBB). Additional rats were implanted with C6 glioma cells in the left frontal lobe. C6 Glioma-Implanted Rats (C6GRs) were monitored for overall survival and tumor growth. Tumor volumes from MRI images were calculated utilizing [http://www.slicer.org '''3D Slicer''']. Additional rats underwent femoral artery catheterization with Bevacizumab, carboplatin, or irinotecan injected into the left internal carotid artery to test feasibility and safety.

Results: A successful endovascular access and BBBB protocol was established. BBBB was confirmed with positive Evans blue staining. 10 rats were successfully implanted with C6 gliomas with confirmed growths on MRI. Overall survival was 19.75 ± 2.21 days. 5 rats were utilized for the development of our femoral catheterization protocol and BBBB testing. With regards to IA chemotherapy dosage testing, control rats tolerated targeted 10 mg/kg of bevascizumab, 2.4 mg/kg of carboplatin, and 15 mg/kg of irinotecan IA ICA injections without any complications.

Conclusions: We present the first endovascular IA rat glioma model that allows selective catheterization of the intracranial vasculature and assessment of IA therapies for gliomas without need for access and sacrifice of proximal cerebrovasculature.
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==Muscle Magnetic Resonance Characterization of STIM1 Tubular Aggregate Myopathy Using Unsupervised Learning==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37155641 PLoS One. 2023 May 8;18(5):e0285422. PMID: 37155641] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10166478/pdf/pone.0285422.pd PDF]

'''Authors:''' Lupi A, Spolaor S, Favero A, Bello L, Stramare R, Pegoraro E, Nobile MS.

'''Institution:''' Institute of Radiology, Department of Medicine-DIMED, University of Padua, Padua, Italy.

'''Abstract:'''
Purpose: Congenital myopathies are a heterogeneous group of diseases affecting the skeletal muscles and characterized by high clinical, genetic, and histological variability. Magnetic Resonance (MR) is a valuable tool for the assessment of involved muscles (i.e., fatty replacement and oedema) and disease progression. Machine Learning is becoming increasingly applied for diagnostic purposes, but to our knowledge, Self-Organizing Maps (SOMs) have never been used for the identification of the patterns in these diseases. The aim of this study is to evaluate if SOMs may discriminate between muscles with fatty replacement (S), oedema (E) or neither (N).

Methods: MR studies of a family affected by tubular aggregates myopathy (TAM) with the histologically proven autosomal dominant mutation of the STIM1 gene, were examined: for each patient, in two MR assessments (i.e., t0 and t1, the latter after 5 years), fifty-three muscles were evaluated for muscular fatty replacement on the T1w images, and for oedema on the STIR images, for reference. Sixty radiomic features were collected from each muscle at t0 and t1 MR assessment using [http://www.slicer.org '''3D Slicer'''] software, in order to obtain data from images. A SOM was created to analyze all datasets using three clusters (i.e., 0, 1 and 2) and results were compared with radiological evaluation.

Results: Six patients with TAM STIM1-mutation were included. At t0 MR assessments, all patients showed widespread fatty replacement that intensifies at t1, while oedema mainly affected the muscles of the legs and appears stable at follow-up. All muscles with oedema showed fatty replacement, too. At t0 SOM grid clustering shows almost all N muscles in Cluster 0 and most of the E muscles in Cluster 1; at t1 almost all E muscles appear in Cluster 1.

Conclusion: Our unsupervised learning model appears to be able to recognize muscles altered by the presence of edema and fatty replacement.
|}

==Quantifying the Effect of an Endo-Vaginal Probe on Position of the Pelvic Floor Viscera and Muscles==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37145123 Int Urogynecol J. 2023 May 5. PMID: 37145123]

'''Authors:''' Chill HH, Martin LC, Abramowitch SD, Rostaminia G.

'''Institution:''' Female Pelvic Medicine and Reconstructive Surgery (FPMRS) Division, University of Chicago Pritzker School of Medicine, Northshore University HealthSystem, Skokie, IL, USA.

'''Abstract:'''
Introduction and hypothesis: Endovaginal ultrasound has long been hypothesized to have a significant effect on locations of what it visualizes. However, little work has directly quantified its effect. This study aimed to quantify it.

Methods: This cross-sectional study consisted of 20 healthy asymptomatic volunteers who underwent both endovaginal ultrasound and MRI. The urethra, vagina, rectum, pelvic floor, and pubic bone were segmented in both ultrasound and MRI using [http://www.slicer.org '''3D Slicer''']. Then, using [http://www.slicer.org '''3D Slicer''']'s transform tool the volumes were rigidly aligned based on the posterior curvature of the pubic bone. The organs were then split into thirds along their long axis to compare their distal, middle, and proximal sections. Using Houdini, we compared the location of the centroid of each of the urethra, vagina, and rectum and the surface-to-surface difference of the urethra and rectum. The anterior curvature of the pelvic floor was also compared. Normality of all variables was assessed by Shapiro-Wilk test.

Results: The largest amount of surface-to-surface distance was observed in the proximal region for the urethra and rectum. Across all three organs, the majority of the deviation was in the anterior direction for geometries obtained from ultrasound versus those from MRI. For each subject, the trace defining the midline of the levator plate was more anterior for ultrasound compared to MRI.

Conclusions: While it has often been assumed that placing a probe in the vagina probably distorts the anatomy, this study quantified the distortion and displacement of the pelvic viscera. This allows for better interpretation of clinical and research findings based on this modality.
|}

==Laser Interstitial Thermal Therapy in the Treatment of Brain Metastases: The Relationship Between Changes in Postoperative Magnetic Resonance Imaging Characteristics and Tumor Recurrence==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36823478 Acta Neurochir (Wien). 2023 May;165(5):1379-1387. PMID: 36823478]

'''Authors:''' Xue Z, Guan X, Yuan L, Kang P, Zhang C, Li D, Jia G, Jia W.

'''Institution:''' Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, China.

'''Abstract:'''
'''Background:''' Laser interstitial thermal therapy (LITT) has been used to treat brain metastases (BMs) in several countries, and its safety and effectiveness have been confirmed. In most cases, magnetic resonance imaging (MRI) reveals an increase in tumor volume with an enhanced margin after LITT. However, little is known about the relationship between this MRI change and tumor recurrence.

'''Objective:''' We report the first case series of BMs treated by LITT in China to evaluate the clinical characteristics and predictive factors of tumor recurrence.

'''Material and Methods:''' Patients with less than four brain metastatic lesions and a Karnofsky performance status (KPS) > 70 were eligible for study inclusion. Standard LITT procedures were performed, and a follow-up MRI was performed to analyze the radiographic changes, especially the volume ratio of the enhanced margin and the whole lesion on MRI at 30 days postoperatively. All the volume-related data were delineated and calculated using [http://www.slicer.org '''3D Slicer'''] software. Related predictors were also collected to evaluate the correlation with local tumor control.

'''Results:''' Eighteen patients with nineteen lesions were enrolled for treatment and follow-up. Primary tumor histology included pulmonary carcinoma (n = 11) and breast cancer (n = 4). On average, the tumor size measured 3.01 cm3 (range, 0.40-7.40 cm3), the total ablation time was 13.58 min (range, 2.88-37.15 min), and the complete ablation rate was 92.4% (range, 29.2-100%). Comparing 3s0-day follow-up MRI results with preoperative MRI findings, 18 lesions showed a 2.28-fold (range, 1.21-4.88) volume increase; all the lesions displayed an enhanced component with a volume ratio of 42.35% (range, 10.14-100%). Five patients experienced tumor recurrence, and the local tumor control rates at 90 days and 180 days of follow-up were 68.4% and 66.7%, respectively. Univariate analysis indicated that the primary tumor, ablation rate, and enhanced volume ratio (EVR) > 40% in the 30-day MRI were associated with tumor recurrence, whereas multivariate analysis showed that only EVR > 40% was a predictive factor of local control.

'''Conclusion:''' LITT is a minimally invasive method used to ablate brain metastases which can be used as the first-line treatment for BM patients under certain indications. After LITT, most tumors showed volume enlargement on the 30-day MRI scan, and EVR > 40% on the 30-day MRI may indicate late tumor recurrence.
|}

==Image Data and Computational Grids for Computing Brain Shift and Solving the Electrocorticography Forward Problem==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37128587/ Data Brief. 2023 Apr 7;48:109122. PMID: 37128587] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10147975/pdf/main.pdf PDF]

'''Authors:''' Zwick BF, Safdar S, Bourantas GC, Joldes GR, Hyde DE, Warfield SK, Wittek A, Miller K.

'''Institution:''' Intelligent Systems for Medicine Laboratory, The University of Western Australia, 35 Stirling Highway, Perth, WA, Australia.

'''Abstract:'''
This article describes the dataset applied in the research reported in NeuroImage article "Patient-specific solution of the electrocorticography forward problem in deforming brain" [1] that is available for download from the Zenodo data repository (https://zenodo.org/record/7687631) [2]. Preoperative structural and diffusion-weighted magnetic resonance (MR) and postoperative computed tomography (CT) images of a 12-year-old female epilepsy patient under evaluation for surgical intervention were obtained retrospectively from Boston Children's Hospital. We used these images to conduct the analysis at The University of Western Australia's Intelligent Systems for Medicine Laboratory using SlicerCBM [3], our open-source software extension for the [http://www.slicer.org '''3D Slicer'''] medical imaging platform. As part of the analysis, we processed the images to extract the patient-specific brain geometry; created computational grids, including a tetrahedral grid for the meshless solution of the biomechanical model and a regular hexahedral grid for the finite element solution of the electrocorticography forward problem; predicted the postoperative MRI and DTI that correspond to the brain configuration deformed by the placement of subdural electrodes using biomechanics-based image warping; and solved the patient-specific electrocorticography forward problem to compute the electric potential distribution within the patient's head using the original preoperative and predicted postoperative image data. The well-established and open-source file formats used in this dataset, including Nearly Raw Raster Data (NRRD) files for images, STL files for surface geometry, and Visualization Toolkit (VTK) files for computational grids, allow other research groups to easily reuse the data presented herein to solve the electrocorticography forward problem accounting for the brain shift caused by implantation of subdural grid electrodes.
|}

==ImFinite Element Analysis of a Healthy Knee Joint at Deep Squatting for the Study of Tibiofemoral and Patellofemoral Contact==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37143926 J Orthop. 2023 Apr 21;40:7-16. PMID: 37143926]

'''Authors:''' Kothurkar R, Lekurwale R, Gad M, Rathod CM.

'''Institution:''' Department of Mechanical Engineering, K. J. Somaiya College of Engineering, Mumbai, India.

'''Abstract:'''
Background: In non-western countries, deep squatting is a daily activity, and prolonged deep squatting is common among occupational squatters. Household tasks, taking a bath, socializing, using toilets, and performing religious acts are among the activities frequently carried out while squatting by the Asian population. High knee loading is responsible for a knee injury and osteoarthritis. Finite element analysis is an effective tool to determine stresses on the knee joint.

Methods: Magnetic Resonance Imaging (MRI) and Computed Tomographic (CT) images were acquired of one adult without knee injuries. The CT images were acquired at the fully extended knee and one more set of images was acquired with the knee at a deeply flexed knee position. The MRI was acquired with the fully extended knee. 3 Dimensional models of bones were created using CT and soft tissue using MRI with the help of [http://www.slicer.org '''3D Slicer'''] software. Kinematics and finite element analysis of the knee was performed for standing and deep squatting posture using Ansys Workbench 2022.

Results: High peak stresses were observed at deep squatting compared to standing along with the reduction in the contact area. Peak von Mises stresses on femoral cartilage, tibial cartilage, patellar cartilage, and meniscus were increased from 3.3 MPa to 19.9 MPa, 2.9 MPa to 12.4 MPa, 1.5 MPa to 16.7 MPa and 15.8 MPa to 32.8 MPa respectively during deep squatting. Posterior translation of 7.01 mm, and 12.58 mm was observed for medial and lateral femoral condyle respectively from full extension to 153° knee flexion.

Conclusions: Increased stresses in the knee joint at deep squat posture may cause cartilage damage. A sustained deep squat posture should be avoided for healthy knee joints. More posterior translations of the medial femoral condyle at higher knee flexion angle warrant further investigation.
|}

==A Comparison of Machine Learning Models for Survival Prediction of Patients with Glioma Using Radiomic Features from MRI Scans==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37362372/ Indian J Radiol Imaging. 2023 Apr 28;33(3):338-343. PMID: 37362372] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10289839/pdf/10-1055-s-0043-1767786.pdf PDF]

'''Authors:''' Manjunath M, Saravanakumar S, Kiran S, Chatterjee J.

'''Institution:''' Department of Biotechnology, People's Education Society University, Bangalore, Karnataka, India.

'''Abstract:'''
Background Glioma is a primary, malignant, highly aggressive brain tumor, with patients having an average life expectancy of 14 to 16 months after diagnosis. Magnetic resonance imaging (MRI) scans of these patients can be used to extract and analyze quantifiable features with potential clinical significance. We hypothesize that there is a correlation between radiomic features extracted from MRI scans and survival. Along with clinical data, the radiomic features could be used in survival prediction of patients, providing beneficial information for clinicians to design personalized treatment plans. Methods In our study, we have utilized [http://www.slicer.org '''3D Slicer'''] for tumor segmentation and feature extraction and performed survival prediction of patients with glioma using four different machine learning models. Results and Conclusion Among the models compared, we have achieved a maximum prediction accuracy of 64.4% using the k-nearest neighbors model, which was trained and tested on a combination of clinical data and radiomic features extracted from MRI images provided in the BraTS 2020 dataset.
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==Circular RNA hsa_circ_0000690 as a Potential Biomarker for Diagnosis and Prognosis of Intracranial Aneurysm: Closely Relating to the Volume of Hemorrhage==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36879365 Brain Behav. Apr;13(4):e2929. PMID: 36879365] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10097068/pdf/BRB3-13-e2929.pdf PDF]

'''Authors:'''Huang Y, Cao H, Qi X, Guan C, Que S.

'''Institution:''' Department of Neurosurgery, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, Fujian, China.

'''Abstract:'''

'''Purpose:''' This study aimed to explore circular RNA (circRNA) hsa_circ_0000690 as a potential biomarker for diagnosis and prognosis of intracranial aneurysm (IA) and its relationship with clinical factors and complications of IA.

'''Material/Methods:''' 216 IA patients admitted to the neurosurgery department of our hospital from January 2019 to December 2020 were selected as the experimental group, and 186 healthy volunteers were selected as the control group. The expression of hsa_circ_0000690 in peripheral blood was detected by quantitative real-time PCR, and its diagnostic value was assessed by receiver operating characteristic curve. Relationship between hsa_circ_0000690 and clinical factors of IA was assessed by chi-square test. Nonparametric test was used in univariate analysis, and regression analysis was used in multivariate analysis. Multivariate Cox proportional hazards regression analysis was used to analyze the survival time.

'''Results:''' CircRNA hsa_circ_0000690 of IA patients was relatively lower than that in the control group (p < .001). The AUC of hsa_circ_0000690 was 0.752, the specificity was 0.780, and sensitivity was 0.620, with diagnostic threshold of 0.0449. In addition, hsa_circ_0000690 expression was correlated with Glasgow Coma Scale, the volume of subarachnoid hemorrhage, modified Fisher scale, Hunt-Hess levels and surgical type. For hydrocephalus and delayed cerebral ischemia, hsa_circ_0000690 was significant in univariate analysis, but nonsignificant in multivariate analysis. For prognosis, hsa_circ_0000690 was significantly associated with modified Rankin Scales after surgery for 3 months, but not associated with survival time.

'''Conclusions:''' The expression of hsa_circ_0000690 can act as a diagnostic marker for IA and predict the prognosis of 3 months after operation and is closely related to the volume of hemorrhage.

'''Keywords:''' [http://www.slicer.org '''3D Slicer''']; biomarker; circRNA; diagnosis; intracranial aneurysm; prognosis; subarachnoid hemorrhage
|}

==Can Quantitative Peritumoral CT Radiomics Features Predict the Prognosis of Patients With Non-Small Cell Lung Cancer? A Systematic Review==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36307554 Eur Radiol. 2023 Mar;33(3):2105-17. PMID: 36307554] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9935659/pdf/330_2022_Article_9174.pdf PDF]

'''Authors:''' Wu L, Lou X, Kong N, Xu M, Gao C.

'''Institution:''' Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China.

'''Abstract:''' Objectives: To provide an overarching evaluation of the value of peritumoral CT radiomics features for predicting the prognosis of non-small cell lung cancer and to assess the quality of the available studies.

'''Methods:''' The PubMed, Embase, Web of Science, and Cochrane Library databases were searched for studies predicting the prognosis in patients with non-small cell lung cancer (NSCLC) using CT-based peritumoral radiomics features. Information about the patient, CT-scanner, and radiomics analyses were all extracted for the included studies. Study quality was assessed using the Radiomics Quality Score (RQS) and the Prediction Model Risk of Bias Assessment Tool (PROBAST).

'''Results:''' Thirteen studies were included with 2942 patients from 2017 to 2022. Only one study was prospective, and the others were all retrospectively designed. Manual segmentation and multicenter studies were performed by 69% and 46% of the included studies, respectively. [http://www.slicer.org '''3D Slicer'''] and MATLAB software were most commonly used for the segmentation of lesions and extraction of features. The peritumoral region was most frequently defined as dilated from the tumor boundary of 15 mm, 20 mm, or 30 mm. The median RQS of the studies was 13 (range 4-19), while all of included studies were assessed as having a high risk of bias (ROB) overall.

'''Conclusions:''' Peritumoral radiomics features based on CT images showed promise in predicting the prognosis of NSCLC, although well-designed studies and further biological validation are still needed.

'''Key points:''' Peritumoral radiomics features based on CT images are promising and encouraging for predicting the prognosis of non-small cell lung cancer. The peritumoral region was often dilated from the tumor boundary of 15 mm or 20 mm because these were considered safe margins. The median Radiomics Quality Score of the included studies was 13 (range 4-19), and all of studies were considered to have a high risk of bias overall.
|}

==Three Dimensional Assessment of Radiographic Changes after Indirect Pulp Capping using Silver Diamine Fluoride with or without Potassium Iodide in Young Permanent Teeth (12-month RCT)==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36878216 Caries Res. 2023;57(2):177-188. PMID: 36878216]

'''Authors:''' Baraka MMAL, Cevidanes L, Tekeya M, Bakry N, Ruellas A, Botero T, Benavides E, Fontana M.

'''Institution:''' Department of Experimental Oncology, European Institute of Oncology, IRCCS, 20139 Milan, Italy.

'''Abstract:''' The aim was to have a three-dimensional evaluation of radiographic changes after indirect pulp capping (IPC) with silver diamine fluoride (SDF) with or without potassium iodide (KI) and resin modified glass ionomer cement (RMGIC) in deep carious young permanent molars using cone beam computed tomography (CBCT). 108 first permanent molars with deep occlusal cavitated caries lesions, in forty-nine 6-9-year-old children, were randomly allocated to one of 3 groups (n=36) and treated with SDF+KI, SDF and RMGIC as IPC materials. CBCT scans were taken at 0 and at 12-months to assess tertiary dentin formation (volume and grey level intensity), increase in root length, and pathological changes as secondary caries, periapical radiolucency, internal resorption and obliteration of the pulp. The three-dimensional image analysis procedures were performed using ITK-SNAP and [http://www.slicer.org '''3D Slicer'''] CMF. Comparisons were made using analysis of variance with a fixed effect for treatment and random effects for patient, and patient-by-treatment to account for within-patient correlations. A two-sided 5% significance level was used. There were no significant differences among the three groups regarding tertiary dentin volume (p=0.712) and grey level intensity (p=0.660), increase in root length (p=0.365), prevention of secondary caries (p=0.63) and periapical radiolucency (p=0.80) in the analysed 69 CBCT scans. The study did not find differences among the groups regarding quality and quantity of tertiary dentin formed, increase in root length, absence of secondary caries and other signs of failure as shown by CBCT.

'''Clinical Significance:''' The results show no significant differences in radiographic outcomes (quality and quantity of tertiary dentin formed, increase in root length, absence of secondary caries and other signs of failure) when using SDF+KI, SDF and RMGIC in IPC. The results of this study can help guide treatment decision making regarding use of SDF and SDF+KI as IPC materials in deep cavitated lesions.
|}

==Cross-Sectional Reliability and Concurrent Validity of a Quantitative 2-Dimensional Ultrasound Image Analysis of Effusion and Synovial Hypertrophy in Knee Osteoarthritis==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37008822/ Osteoarthr Cartil Open. 2023 Mar 16;5(2):100356. PMID: 37008822] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10060736/pdf/main.pdf PDF]

'''Authors:''' Dima R, Birmingham TB, Philpott HT, Bryant D, Fenster A, Appleton CT.

'''Institution:''' Faculty of Health Sciences, University of Western Ontario, London, ON, Canada.

'''Abstract:'''
Objective: Effusion-synovitis is related to pain and progression in knee osteoarthritis (OA), but current gold standard ultrasound (US) measures are limited to semi-quantitative grading of joint distension or 1-dimensional thickness measures. A novel quantitative 2-dimensional image analysis methodology is applied to US images of effusion-synovitis; reliability and concurrent validity was assessed in patients with knee OA.

Methods: Cross sectional analysis of US images collected from 51 patients with symptomatic knee OA were processed in ImageJ and segmented in [http://www.slicer.org '''3D Slicer'''] to produce a binary mask of the supra-patellar synovitis region of interest (ROI). Area measures (mm2) of total synovitis, effusion and hypertrophy components were exported. Intra-rater reliability and test-retest reliability (1-14 days washout) were estimated with intra-class correlation coefficients (ICCs). Concurrent validity was measured by Spearman correlations between quantitative measures and gold standard OMERACT and caliper measurements of synovitis.

Results: Intra-rater reliability for hypertrophy area was estimated at 0.98, 0.99 for effusion area, and 0.99 for total synovitis area. The test-retest reliability for total synovitis area was 0.63 (SEM 87.8 mm2), 0.59 for hypertrophy area (SEM 21.0 mm2), and 0.64 for effusion area (SEM 73.8 mm2). Correlation between total synovitis area and OMERACT grade was 0.84, 0.81 between total synovitis area and effusion-synovitis calipers, and 0.81 between total effusion area and effusion calipers.

Conclusion: This new research tool for image analysis demonstrated excellent intra-rater reliability, good concurrent validity, and moderate test-retest reliability. Quantitative 2D US measures of effusion-synovitis and its individual components may enhance the study and management of knee OA.
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==Patient-Specific Needle Guidance Templates Drilled Intraprocedurally for Image Guided Intervention: Feasibility Study in Swine==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36173542 Int J Comput Assist Radiol Surg. 2023 Mar;18(3):537-44. PMID: 36173542]

'''Authors:''' Glossop N, Bale R, Xu S, Pritchard WF, Karanian JW, Wood BJ.

'''Institution:''' Queen's University, Kingston, ON, Canada.

'''Abstract:'''
'''purpose:''' Thermal ablation of large tumors may benefit from simultaneous placement of multiple needles, but accurate placement becomes challenging as the number of needles increases. The aim of this work was to evaluate use of personalized needle guidance grid templates based on intraprocedural CT and fabricated at the point of care to implement ablation treatment plans with multiple needles in vivo.

'''Methods:''' A plastic frame was designed to hold two parallel plastic guide plates in a rigid relationship, fixed over the abdomen by a mounting arm. Steel ball targets (1.5 mm) were implanted under ultrasound in the livers of two domestic swine under general anesthesia. Following breath-hold CT of the subject and frame, the targets and frame were identified using customized [http://www.slicer.org '''3D Slicer''']-based planning software. Multiple needle trajectories targeting the balls were planned, including complex off-plane trajectories. A machining program for drilling the hole pattern corresponding to the planned needle trajectories was generated. The pattern was drilled in the two plates with a numerical-controlled milling machine in the suite. The plates were attached to the frame and needles passed through the paired holes to the calculated depth. Placement accuracy was defined as needle tip-to-target distance on post-placement CT.

'''Results:''' The planning process and manufacturing required approximately 6 and 15 min, respectively. Needles were rapidly inserted (n = 11) to the target points without complications or traversing nontarget anatomy. The mean needle tip-to-target distance error was 3.4 ± 2.2, range 0-7 mm.

'''Conclusion:''' Rapid and accurate needle placement was feasible using a subject-specific, custom-drilled, needle guidance grid template fabricated intraprocedurally. Targeting accuracy and performance were similar to more complex and expensive tracking systems which may enable accurate intraprocedural implementation of treatment plans in the liver or other organs. This may be of value in complex ablation cases or in areas where more advanced guidance systems are not available.
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==Automatic Landmark Identification in Cone-Beam Computed Tomography==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36811276 Orthod Craniofac Res. 2023 Feb 21. PMID: 36811276]

'''Authors:''' Gillot M, Miranda F, Baquero B, Ruellas A, Gurgel M, Al Turkestani N, Anchling L, Hutin N, Biggs E, Yatabe M, Paniagua B, Fillion-Robin JC, Allemang D, Bianchi J, Cevidanes L, Prieto JC.

'''Institution:''' Department of Orthodontics and Pediatric Dentistry, School of Dental Medicine, University of Michigan, Ann Arbor, MI, USA.

'''Abstract:'''
'''Objective:''' To present and validate an open-source fully automated landmark placement (ALICBCT) tool for cone-beam computed tomography scans.

'''Material and Methods:''' One hundred and forty-three large and medium field of view cone-beam computed tomography (CBCT) were used to train and test a novel approach, called ALICBCT that reformulates landmark detection as a classification problem through a virtual agent placed inside volumetric images. The landmark agents were trained to navigate in a multi-scale volumetric space to reach the estimated landmark position. The agent movements decision relies on a combination of DenseNet feature network and fully connected layers. For each CBCT, 32 ground truth landmark positions were identified by 2 clinician experts. After validation of the 32 landmarks, new models were trained to identify a total of 119 landmarks that are commonly used in clinical studies for the quantification of changes in bone morphology and tooth position.

'''Results:''' Our method achieved a high accuracy with an average of 1.54±0.87 mm error for the 32 landmark positions with rare failures, taking an average of 4.2s computation time to identify each landmark in one large 3D-CBCT scan using a conventional GPU.

'''Conclusion:''' The ALICBCT algorithm is a robust automatic identification tool that has been deployed for clinical and research use as an extension in the 3D Slicer platform allowing continuous updates for increased precision.
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==Development and In-Silico and Ex-Vivo Validation of a Software for a Semi-Automated Segmentation of the Round Window Niche to Design a Patient Specific Implant to Treat Inner Ear Disorders==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36826970 J Imaging. 2023 Feb 20;9(2):51. PMID: 36826970] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9965310/pdf/jimaging-09-00051.pdf PDF]

'''Authors:''' Matin-Mann F, Gao Z, Wei C, Repp F, Artukarslan EN, John S, Alcacer Labrador D, Lenarz T, Scheper V.

'''Institution:''' Lower Saxony Center for Biomedical Engineering, Implant Research and Development (NIFE), Department of Otorhinolaryngology, Head and Neck Surgery, Hannover Medical School, Hannover, Germany.

'''Abstract:''' The aim of this study was to develop and validate a semi-automated segmentation approach that identifies the round window niche (RWN) and round window membrane (RWM) for use in the development of patient individualized round window niche implants (RNI) to treat inner ear disorders. Twenty cone beam computed tomography (CBCT) datasets of unilateral temporal bones of patients were included in the study. Defined anatomical landmarks such as the RWM were used to develop a customized [http://www.slicer.org '''3D Slicer'''] plugin for semi-automated segmentation of the RWN. Two otolaryngologists (User 1 and User 2) segmented the datasets manually and semi-automatically using the developed software. Both methods were compared in-silico regarding the resulting RWM area and RWN volume. Finally, the developed software was validated ex-vivo in N = 3 body donor implantation tests with additively manufactured RNI. The independently segmented temporal bones of the different Users showed a strong consistency in the volume of the RWN and the area of the RWM. The volume of the semi-automated RWN segmentations were 48 ± 11% smaller on average than the manual segmentations and the area of the RWM of the semi-automated segmentations was 21 ± 17% smaller on average than the manual segmentation. All additively manufactured implants, based on the semi-automated segmentation method could be implanted successfully in a pressure-tight fit into the RWN. The implants based on the manual segmentations failed to fit into the RWN and this suggests that the larger manual segmentations were over-segmentations. This study presents a semi-automated approach for segmenting the RWN and RWM in temporal bone CBCT scans that is efficient, fast, accurate, and not dependent on trained users. In addition, the manual segmentation, often positioned as the gold-standard, actually failed to pass the implantation validation.
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==Design and Analysis of HSC-BPPV Diagnostic Maneuver Based on Virtual Simulation==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36873445 Front Neurol. 2023 Feb 17;14:1132343. PMID: 36873445] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9981954/pdf/fneur-14-1132343.pdf PDF]

'''Authors:''' Li Y, Yang X.

'''Institution:''' Department of Research Center, Third Affiliated Hospital of Shanghai University, Wenzhou Third Clinical Institute Affiliated to Wenzhou Medical University, Wenzhou People's Hospital, Wenzhou, China.

'''Abstract:'''
'''Background:''' The preferred supine roll test for the diagnosis of horizontal semicircular canal BPPV has several disadvantages, including difficulty in locating the affected ear, inconsistent nystagmus performance on repeated testing, and lack of a typical latency period, resulting in insensitive diagnosis.

Objectives: To investigate novel diagnostic techniques with more scientific design, more accessible application, and better diagnostic sensitivity and specificity.

'''Materials and Methods:''' Based on clinical microscopic CT data, we created a virtual simulation model of BPPV using Unity software. The physical simulation of the traditional supine roll test was performed to observe and analyse the movement of the otoliths, whose initial position was the typical stable position. In addition, the normal vectors of the plane and crista ampullaris of the horizontal semicircular canal were measured using [http://www.slicer.org '''3D Slicer'''] software. Based on this, we analyzed the critical steps for designing diagnostic maneuvers for BPPV in the horizontal semicircular canal. For a more accurate diagnosis of horizontal semicircular canal BPPV, it is critical to rotate the horizontal semicircular canal to be parallel to gravity. It is also necessary to move the otolith by swinging the head. As a result, we developed two diagnostic maneuvers: the 60° roll test and the prone roll test. We also performed simulations to observe otolith movement and predict nystagmus performance.

'''Conclusions:''' The 60° roll test and the prone roll test can complement the supine roll test. Compared to the supine roll test, they not only effectively differentiate canalolithiasis from cupulolithiasis, but also make it easier to determine the position of the otoliths, and the characteristics of the nystagmus are more pronounced. Significant diagnostic features have significant potential benefits for home and telemedicine.
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==The Simplified Tailor-Made Workflows for a [http://www.slicer.org '''3D Slicer''']-Based Craniofacial Implant Design==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36801943 Sci Rep. 2023 Feb 17;13(1):2850. PMID: 36801943] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9938178/pdf/41598_2023_Article_30117.pdf PDF]

'''Authors:''' Tantisatirapong S, Khunakornpattanakarn S, Suesatsakul T, Boonpratatong A, Benjamin I, Tongmeesee S, Kangkorn T, Chanwimalueang

'''Institution:''' Department of Biomedical Engineering, Faculty of Engineering, Srinakharinwirot University, Nakhon Nayok, Thailand.

'''Abstract:''' A specific design of craniofacial implant model is vital and urgent for patients with traumatic head injury. The mirror technique is commonly used for modeling these implants, but it requires the presence of a healthy skull region opposite to the defect. To address this limitation, we propose three processing workflows for modeling craniofacial implants: the mirror method, the baffle planner, and the baffle-based mirror guideline. These workflows are based on extension modules on the [http://www.slicer.org '''3D Slicer'''] platform and were developed to simplify the modeling process for a variety of craniofacial scenarios. To evaluate the effectiveness of these proposed workflows, we investigated craniofacial CT datasets collected from four accidental cases. The designed implant models were created using the three proposed workflows and compared to reference models created by an experienced neurosurgeon. The spatial properties of the models were evaluated using performance metrics. Our results show that the mirror method is suitable for cases where a healthy skull region can be completely reflected to the defect region. The baffle planner module offers a flexible prototype model that can be fit independently to any defect location, but it requires customized refinement of contour and thickness to fill the missing region seamlessly and relies on the user's experience and expertise. The proposed baffle-based mirror guideline method strengthens the baffle planner method by tracing the mirrored surface. Overall, our study suggests that the three proposed workflows for craniofacial implant modeling simplify the process and can be practically applied to a variety of craniofacial scenarios. These findings have the potential to improve the care of patients with traumatic head injuries and could be used by neurosurgeons and other medical professionals.
|}

==Predicting Transient Ischemic Attack Risk in Patients With Mild Carotid Stenosis Using Machine Learning and CT Radiomics==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36846119 Front Neurol. 2023 Feb 8;14:1105616. PMID: 36846119] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9944715/pdf/fneur-14-1105616.pdf PDF]

'''Authors:''' Xia H, Yuan L, Zhao W, Zhang C, Zhao L, Hou J, Luan Y, Bi Y, Feng Y.

'''Institution:''' Department of Vascular Surgery, The First Affiliated Hospital of Kunming Medical University, Kunming, China.

'''Abstract:'''
'''Objective:''' This study aims to establish a radiomics-based machine learning model that predicts the risk of transient ischemic attack in patients with mild carotid stenosis (30-50% North American Symptomatic Carotid Endarterectomy Trial) using extracted computed tomography radiomics features and clinical information.

'''Methods:''' A total of 179 patients underwent carotid computed tomography angiography (CTA), and 219 carotid arteries with a plaque at the carotid bifurcation or proximal to the internal carotid artery were selected. The patients were divided into two groups; patients with symptoms of transient ischemic attack after CTA and patients without symptoms of transient ischemic attack after CTA. Then we performed random sampling methods stratified by the predictive outcome to obtain the training set (N = 165) and testing set (N = 66). [http://www.slicer.org '''3D Slicer'''] was employed to select the site of plaque on the computed tomography image as the volume of interest. An open-source package PyRadiomics in Python was used to extract radiomics features from the volume of interests. The random forest and logistic regression models were used to screen feature variables, and five classification algorithms were used, including random forest, eXtreme Gradient Boosting, logistic regression, support vector machine, and k-nearest neighbors. Data on radiomic feature information, clinical information, and the combination of these pieces of information were used to generate the model that predicts the risk of transient ischemic attack in patients with mild carotid artery stenosis (30-50% North American Symptomatic Carotid Endarterectomy Trial).

'''Results:''' The random forest model that was built based on the radiomics and clinical feature information had the highest accuracy (area under curve = 0.879; 95% confidence interval, 0.787-0.979). The combined model outperformed the clinical model, whereas the combined model showed no significant difference from the radiomics model.

'''Conclusion:''' The random forest model constructed with both radiomics and clinical information can accurately predict and improve discriminative power of computed tomography angiography in identifying ischemic symptoms in patients with carotid atherosclerosis. This model can aid in guiding the follow-up treatment of patients at high risk.
|}

==Deep Learning Enabled Multi-Organ Segmentation of Mouse Embryos==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36802342 Biol Open. 2023 Feb 15;12(2):bio059698. PMID: 36802342] | [https://cob.silverchair-cdn.com/cob/content_public/journal/bio/12/2/10.1242_bio.059698/2/bio059698.pdf PDF]

'''Authors:''' Rolfe SM, Whikehart SM, Maga AM.

'''Institution:''' Center for Developmental Biology and Regenerative Medicine, Seattle Children's Research Institute, Seattle, WA, USA.

'''Abstract:''' The International Mouse Phenotyping Consortium (IMPC) has generated a large repository of three-dimensional (3D) imaging data from mouse embryos, providing a rich resource for investigating phenotype/genotype interactions. While the data is freely available, the computing resources and human effort required to segment these images for analysis of individual structures can create a significant hurdle for research. In this paper, we present an open source, deep learning-enabled tool, Mouse Embryo Multi-Organ Segmentation (MEMOS), that estimates a segmentation of 50 anatomical structures with a support for manually reviewing, editing, and analyzing the estimated segmentation in a single application. MEMOS is implemented as an extension on the [http://www.slicer.org '''3D Slicer'''] platform and is designed to be accessible to researchers without coding experience. We validate the performance of MEMOS-generated segmentations through comparison to state-of-the-art atlas-based segmentation and quantification of previously reported anatomical abnormalities in a Cbx4 knockout strain. This article has an associated First Person interview with the first author of the paper.
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==Development and Validation of an 18FFDG-PET/CT Radiomic Model for Predicting Progression-Free Survival for Patients With Stage II - III Thoracic Esophageal Squamous Cell Carcinoma Who Are Treated With Definitive Chemoradiotherapy==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36794365 Acta Oncol. 2023 Feb;62(2):159-65. PMID: 36794365]

'''Authors:''' Takahashi N, Tanaka S, Umezawa R, Takanami K, Takeda K, Yamamoto T, Suzuki Y, Katsuta Y, Kadoya N, Jingu K.

'''Institution:''' Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Japan.

'''Abstract:'''
'''Background:''' Radiomics is a method for extracting a large amount of information from images and used to predict treatment outcomes, side effects and diagnosis. In this study, we developed and validated a radiomic model of [18F]FDG-PET/CT for predicting progression-free survival (PFS) of definitive chemoradiotherapy (dCRT) for patients with esophageal cancer.

'''Material and Methods:''' Patients with stage II - III esophageal cancer who underwent [18F]FDG-PET/CT within 45 days before dCRT between 2005 and 2017 were included. Patients were randomly assigned to a training set (85 patients) and a validation set (45 patients). Radiomic parameters inside the area of standard uptake value ≥ 3 were calculated. The open-source software [http://www.slicer.org '''3D Slicer'''] and Pyradiomics were used for segmentation and calculating radiomic parameters, respectively. Eight hundred sixty radiomic parameters and general information were investigated.In the training set, a radiomic model for PFS was made from the LASSO Cox regression model and Rad-score was calculated. In the validation set, the model was applied to Kaplan-Meier curves. The median value of Rad-score in the training set was used as a cutoff value in the validation set. JMP was used for statistical analysis. RStudio was used for the LASSO Cox regression model. p < 0.05 was defined as significant.

'''Results:''' The median follow-up periods were 21.9 months for all patients and 63.4 months for survivors. The 5-year PFS rate was 24.0%. In the training set, the LASSO Cox regression model selects 6 parameters and made a model. The low Rad-score group had significantly better PFS than that the high Rad-score group (p = 0.019). In the validation set, the low Rad-score group had significantly better PFS than that the high Rad-score group (p = 0.040).

'''Conclusions:''' The [18F]FDG-PET/CT radiomic model could predict PFS for patients with esophageal cancer who received dCRT.
|}

==Minimizing Magnetic Resonance Image Geometric Distortion at 7 Tesla for Frameless Presurgical Planning Using Skin-Adhered Fiducials==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36301228 Med Phys. 2023 Feb;50(2):694-701. PMID: 36301228]

'''Authors:''' Kirby KM, Koons EK, Welker KM, Fagan AJ.

'''Institution:''' Department of Radiology, Mayo Clinic, Rochester, MN, USA.

'''Abstract:'''
'''Background:''' 7T MRI offers significant benefits to spatial and contrast resolution compared to lower field strengths. This superior image quality can help better delineate targets in stereotactic neurosurgical procedures; however, the potential for increased geometric distortions at 7T has impaired its widespread use for these applications. Image geometric distortions can be due to distortions of B0 arising from tissue magnetic susceptibility effects or inherent field inhomogeneities, and nonlinearity of the magnetic field gradients.

'''Purpose:''' The purpose of this study was to investigate the use of 7T MRI for neurosurgical frameless stereotactic navigation procedures. Image geometric distortions at the skin surface in 7T images were minimized and compared to results from clinical 3T frameless imaging protocols.

'''Methods:''' A 3D-printed grid phantom filled with oil was designed to perform a fine calibration of the 7T imaging gradients, and an oil-filled head phantom with internal targets was used to determine ground truth (from computed tomography [CT]) positioning errors. Three volunteers and the head phantom were imaged consecutively at 3T and 7T. Ten skin-adhesive fiducial markers were placed on each subject's exposed skin surface at standard clinical placement locations for frameless procedures. Imaging sequences included MPRAGE (three bandwidths at 7T: 400, 690, and 1020 Hz/pixel, and one at 3T: 400 Hz/pixel), T2 SPACE, and T2 SPACE FLAIR acquisitions. An additional GRE field map was acquired on both scanners using a multi-echo GRE sequence. Custom Matlab code was used to perform additional distortion correction of the images using the unwrapped field maps. Fiducial localization was performed with [http://www.slicer.org '''3D Slicer'''], with absolute fiducial positioning errors determined in phantom experiments following rigid registration to the CT images. For human experiments, 3T and 7T images were registered and relative differences in fiducial locations were compared using two-tailed paired t-tests.

'''Results:''' Phantom measurements at 7T yielded gradient distance scaling errors of 1.1%, 2.2%, and 1.0% along the x-, y-, and z-axes, respectively. These system miscalibrations were traced back to phantom manufacturing deviations in the sphericity of the vendor's gradient calibration phantom. Correction factors along each gradient axis were applied, and afterward, geometric distortions of less than 1 mm were obtained in the 7T MR head phantom images for the 1020 Hz/pixel bandwidth MPRAGE sequence. For the human subjects, four fiducial locations were excluded from the analysis due to patient positioning differences. Differences between 3T and 7T MPRAGE with low/medium/high bandwidth were 2.2 /2.6/2.3 mm, respectively, before the correction, reducing to 1.6/1.3/1.0 mm after the correction (p < 0.001). T2 SPACE and T2 SPACE FLAIR yielded a similar pattern when the correction was applied, decreasing from 2.1 to 0.8 mm, and 2.6 to 1.0 mm, respectively.

'''Conclusions:''' 7T MRI can be used to perform frameless presurgical planning with skin-adhesive fiducials. Geometric distortions can be reduced to a clinically relevant level (errors < ∼1 mm) with no significant susceptibility-related distortions, by using high receiver bandwidth, ensuring gradients are properly calibrated, and placing skin fiducials in areas where distortions from patient positioning are minimal.
|}

==Acute Colonic Pseudo-Obstruction Secondary to Renal Calculus: A Case Report and Review of Pathophysiology==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36777972 Cureus. 2023 Feb 7;15(2):e34756. PMID: 36777972] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9905947/pdf/cureus-0015-00000034756.pdf PDF]

'''Authors:''' Gillies M, AlDujaili T.

'''Institution:''' General Surgery, Goulburn Valley Health, Shepparton, Australia

'''Abstract:''' Acute colonic pseudo-obstruction (ACPO) is obstruction of the large bowel without a mechanical cause. The exact mechanism remains incompletely understood but is thought to result from disruption to the autonomic regulation of the colon, typically in the context of hospitalized patients with medical illness, precipitating medications, or recent surgical intervention. This paper presents an unusual case of ACPO in an ambulatory patient with a recently passed renal calculus, explores the anatomy and physiology underlying the autonomic dysfunction theory of ACPO pathogenesis in the context of the case, and provides a 3D reconstruction of the patient's CT to illustrate the abrupt caliber change at the splenic flexure characteristic of ACPO.

'''Keywords:''' 3d reconstruction; acute colonic pseudo-obstruction; ogilvie's syndrome; renal calculi; [http://www.slicer.org '''3D Slicer'''] software.
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==A Novel Stereotactic Aspiration Technique for Intracerebral Hemorrhage==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36270590 World Neurosurg. 2023 Feb;170:e28-e36. PMID: 36270590]

'''Authors:''' Xu HZ, Guo J, Wang C, Liu X, Song ZQ, Chen RF, Qiu B, Wang Q, Huang Y.

'''Institution:''' Department of Neurosurgery, Civil Aviation General Hospital, Beijing, China.

'''Abstract:'''

'''Background:''' Minimally invasive surgery is effective and recommended for treatment of intracerebral hemorrhage; however, neurosurgeons in grass-root hospitals in underdeveloped countries lack effective and precise minimally invasive surgery techniques. The aim of this study was to present a technique of computed tomography angiography-based three-dimensional-printed navigation mold-guided stereotactic aspiration and demonstrate its clinical application using a hard needle in a series of patients.

'''Methods:''' The novel stereotactic aspiration technique was performed in 18 patients with spontaneous intracerebral hemorrhage at our center, and clinical outcomes were reported. We compared the volume of hematoma measured by 3 different methods: ABC/2 formula, manual segmentation with OsiriX, and manual segmentation with [http://www.slicer.org '''3D Slicer'''].

'''Results:''' The surgery was completed safely within an average operative time of 15.11 minutes, achieving the goal of <15 mL residual clot volume or >70% clot removal in all patients. No intracranial rebleeding or infection was observed postoperatively. At the end of the 6-month follow-up, 61.11% (11/18) of patients achieved a modified Rankin Scale score <3. There was overall better agreement of hematoma measurement using segmentation with [http://www.slicer.org '''3D Slicer'''] rather than ABC/2 measurement or hematoma measurement using segmentation with OsiriX.

'''Conclusions:''' Our novel method of stereotactic aspiration benefited patients in this study with good percent clot removal, few surgery-related complications, and a favorable prognosis. Manual segmentation with [http://www.slicer.org '''3D Slicer'''] could be used to provide the neurosurgeon with dependable information about hematoma volume. This cheap and convenient technique may be applied in grass-root hospitals in underdeveloped countries. Assessment in multicenter prospective clinical trials is needed.
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==Morphological Evaluation of the Normal and Hydrocephalic Third Ventricle on Cranial Magnetic Resonance Imaging in Children: A Retrospective Study==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35994062 Pediatr Radiol. 2023 Feb;53(2):282-96. PMID: 35994062]

'''Authors:''' Isıklar S, Turan Ozdemir S, Ozkaya G, Ozpar R, Parlak M.

'''Institution:''' Medical Imaging Techniques Program, Vocational School of Health Services, Bursa Uludag University, 16240, Bursa, Turkey.

'''Abstract:'''
'''Background:''' Third ventricle morphological changes reflect changes in the ventricular system in pediatric hydrocephalus, so visual inspection of the third ventricle shape is standard practice. However, normal pediatric reference data are not available.

'''Objective:''' To investigate both the normal development of the third ventricle in the 0-18-year age group and changes in its biometry due to hydrocephalus.

'''Materials and Methods:''' For this retrospective study, we selected individuals ages 0-18 years who had magnetic resonance imaging (MRI) from 2012 to 2020. We included 700 children (331 girls) who had three-dimensional (3-D) T1-weighted sequences without and 25 with hydrocephalus (11 girls). We measured the distances between the anatomical structures limiting the third ventricle by dividing the third ventricle into anterior and posterior regions. We made seven linear measurements and three index calculations using 3DSlicer and MRICloud pipeline, and we analyzed the results of 23 age groups in normal and hydrocephalic patients using SPSS (v. 23).

'''Results:''' Salient findings are: (1) The posterior part of the third ventricle is more affected by both developmental and hydrocephalus-related changes. (2) For third ventricle measurements, gender was insignificant while age was significant. (3) Normal third ventricular volumetric development showed a segmental increase in the 0-18 age range. The hydrocephalic third ventricle volume cut-off value in this age group was 3 cm3.

'''Conclusion:''' This study describes third ventricle morphometry using a linear measurement method. The ratios defined in the midsagittal plane were clinically useful for diagnosing the hydrocephalic third ventricle. The linear and volumetric reference data and ratios are expected to help increase diagnostic accuracy in distinguishing normal and hydrocephalic third ventricles.
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==Henri IV of France's Larynx 3D Reconstitution==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36149490 Eur Arch Otorhinolaryngol. 2023 Feb;280(2):919-24. PMID: 36149490]

'''Authors:''' Baudouin R, Amelot A, Laprie Y, Crevier-Buchman L, Maeda S, Huynh-Charlier I, Hans S, Charlier P.

'''Institution:''' Department of Otolaryngology-Head & Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Université Paris Saclay), Montigny-le-Bretonneux, France.

'''Abstract:''' Objectives: King Henri IV of France (reign from 1589 to 1610) was one of the most important kings of France. Embalmed and buried in Saint-Denis, his remains were beheaded in 1793. His head (including his larynx) survived in successive private collections until its definitive identification in 2010. The purpose of the study was to provide a morphologic study of the larynx with a 3D reconstitution.

'''Methods:''' A flexible endoscopy was performed via the mouth and via the trachea. Measures of the larynx (vocal folds lengths, thickness, width, larynx height) were collected from the CT-scan by a panel of experts blind each other. The segmentation of the laryngeal anatomical components (vocal folds, cartilages) was performed using [http://www.slicer.org '''3D Slicer''']. Mesh smoothing and 3D reconstitution were performed using Fusion 360®. Reconstitution was discussed between the experts. Decision was made by consensus after discussion.

'''Results:''' Cricoid, thyroid, arytenoid cartilages, vocal folds and hyoid bone were identified and a computed 3D reconstitution of the larynx was made. The laryngeal 3D model appeared morphologically similar to a living subject. Measures were similar but smaller than those of a modern subject.

'''Conclusions:''' The 3D reconstitution of the larynx of Henri IV of France was conducted from the CT-scan of his mummified head. This work constitutes a first valuable morphologic analysis of a larynx from an embalmed individual. This anatomical work is the first step towards the reconstruction of the voice of this historical character, which we hope to concretize with computer modeling tools in a second step.
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==Development and External Validation of a Novel Nomogram to Predict Prostate Cancer in Biopsy-Naïve Patients With PSA <10 Ng/Ml and PI-RADS v2.1 = 3 Lesions==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35920264 Cancer Med. 2023 Feb;12(3):2560-71. PMID: 35920264] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9939143/pdf/CAM4-12-2560.pdf PDF]

'''Authors:''' Hu C, Sun J, Xu Z, Zhang Z, Zhou Q, Xu J, Chen H, Wang C, Ouyang J.

'''Institution:''' Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.

'''Abstract:'''
'''Objective:''' To develop and externally validate a novel nomogram in biopsy-naïve patients with prostate-specific antigen (PSA) <10 ng/ml and PI-RADS v2.1 = 3 lesions.

'''Methods:''' We retrospectively collected 307 men that underwent initial biopsy from October 2015 to January 2022 in Cohort 1 (The First Affiliated Hospital of Soochow University). External cohort (Cohort 2, Kunshan Hospital) included 109 men that met our criteria from July 2016 to June 2021. By [http://www.slicer.org '''3D Slicer'''] Software, the volume of all lesions was divided into two subgroups (PI-RADS v2.1 = 3a and 3b). Logistic regression analysis was performed to screen for variables and construct nomogram by analyzing clinical data from Cohort 1. Receiver operating characteristics curve analysis, calibration plot and decision curve analysis (DCA) were plotted to validate the nomogram in external cohort.

'''Results:''' A total of 70 (22.8%) patients was diagnosed with prostate cancer in Institution 1. Among them, 34 (11.1%) had clinically significant prostate cancer (csPCa). Age, prostate-specific antigen density, digital rectal examination, PI-RADS v2.1 = 3 subgroups (3a and 3b) and apparent diffusion coefficient (ADC, <750 mm2 /s) were predictive factors for prostate cancer (PCa) and csPCa. High area under the curve of the nomogram was found in Cohort 1 and Cohort 2 for PCa (0.857 vs. 0.850) and for csPCa (0.896 vs. 0.893). Calibration curves showed excellent agreement between the predicted probability and actual risk for the models in internal and external validation. The DCA demonstrated net benefit of our nomogram.

'''Conclusion:''' Until now, this is the first nomogram that predicts PCa and csPCa in biopsy-naïve patients with PSA <10 ng/ml and PI-RADS v2.1 = 3 lesions. Furthermore, PI-RADS v2.1 = 3 subgroups were considered to be an independent risk factor in our model. Our nomogram may assist urologists in biopsy decision making for these so-called "double gray zone" patients.
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==A Three-Dimensionally Printed Otological Model for Cholesteatoma Mastoidectomy Training==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35789285 Eur Arch Otorhinolaryngol. 2023 Feb;280(2):671-80. PMID: 35789285]

'''Authors:''' de Souza MA, Bento RF, Lopes PT.

'''Institution:''' Otolaryngology Department, University of São Paulo School of Medicine, São Paulo, Brazil.

'''Abstract:'''
'''purpose:''' To relate the creation and expert validation (face and content validity) of an affordable three-dimensional (3D) printed model of temporal bones with chronic otitis media with cholesteatoma (COMC) as a simulator for mastoidectomy.

'''Methods:''' We performed computed tomography (CT) of the temporal bones of a patient with COMC followed at the University of São Paulo (USP) Hospital with [http://www.slicer.org '''3D Slicer'''] to create a 3-D model of the affected bone using light-curing resin and silicone (cholesteatoma). The final 3-D printed images were scored by 10 otologists using a customized version of the Michigan Standard Simulation Scale Experience (MiSSES). Internal consistency and inter-rater reliability were assessed using Cronbach's α and intraclass correlations.

'''Results:''' Otologists consistently scored the model positively for fidelity, educational value, reactions, and the overall model quality. Nine otologists agreed that the model was a good educational device for surgical training of COMC. All experts deemed the model ready-or nearly ready-for use. The final cost of the model, including raw materials and manufacturing, was 120 USD.

'''Conclusions:''' Using 3D printing technology, we created the first anatomically accurate, low-cost, disease-reproducing 3D model of temporal bones for mastoidectomy training for cholesteatoma.
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==Development of a Navigable 3D Virtual Model of Temporal Bone Anatomy==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36704866 J Vis Commun Med. 2023 Jan 26:1-5. PMID: 36704866] | [https://www.tandfonline.com/doi/full/10.1080/17453054.2023.2169110 PDF]

'''Authors:''' Sareen K.

'''Institution:''' Sant Parmanand Hospital, New Delhi, India.

'''Abstract:'''
'''Background:''' Computed Tomography (CT) scanning offers an accurate structural definition of bones, blood vessels, and soft tissues; however, mental integration of cross-sectional 2D CT images for a 3D understanding of complex anatomical structures becomes difficult when the field of view is confined to the temporal bone. This project tried to provide a feasible solution to this problem by creating a navigable 3D virtual model which may aid in better comprehension of the temporal bone anatomy.

'''Methods:''' A helical-CT scan was used to obtain high-resolution cross-sectional slices of a cadaveric human temporal bone. Using the volume-rendering capabilities of [http://www.slicer.org '''3D Slicer'''], which involves volume data management, cropping of the data set, and threshold painting, detailed anatomical structures were segmented based on the intensity captured from different regions. This volumetric data was converted to an interactive virtual model using Blender®.

'''Results:''' The final product is a web page that allows interaction and navigation with a 3D annotated model of the temporal bone, which can be accessed from any device with a web browser.

'''Conclusion:''' This model can function as a training tool for students, teachers, and practitioners to understand and review the complex anatomy of the temporal bone.
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==Maxillary Antral Pseudocyst Drift after Osteotome Sinus Floor Elevation with Simultaneous Implant Placement: A Case Report and Literature Review==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36769568 J Clin Med. 2023 Jan 24;12(3):920. PMID: 36769568] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9917374/pdf/jcm-12-00920.pdf PDF]

'''Authors:''' Wang P, Huang N, Ren J, Gong P, Long J, Huang B.

'''Institution:''' West China School of Stomatology, Sichuan University, Chengdu, China.

'''Abstract:''' This report describes maxillary antral pseudocyst drift after maxillary sinus floor augmentation through osteotome sinus floor elevation with simultaneous implant placement. [http://www.slicer.org '''3D Slicer'''] was used to measure the pseudocyst and maxilla for the placement of the implants; follow-up visits were scheduled at 6, 12, and 22 months. No adverse effects were observed during or after surgery, and all implants exhibited osseointegration without mobility. At 6 months after surgery, the pseudocyst had moved posterolaterally from the preoperative position near the anterior medial maxillary sinus, then returned to its original position at 12 months. However, it had remigrated to the posterolateral position at 22 months. The preoperative volume of the pseudocyst was 3.795 mm3; it was 2.370, 3.439, and 2.930 mm3 at 6, 12, and 22 months after surgery, respectively. The changes in pseudocyst drift and volume did not have a substantial negative influence on the implants, presumably because of cystic attachment and the recurrence of multiple pseudocysts at different locations. The risks associated with changes in a pseudocyst can be avoided, if an appropriate treatment plan is selected.
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==Radiomic Analysis Based on Magnetic Resonance Imaging for Predicting PD-L2 Expression in Hepatocellular Carcinoma==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36672315 Cancers (Basel). 2023 Jan 5;15(2):365. PMID: 36672315] | [http://www.ncbi.nlm.nih.gov/pmc/articles/pmc9856314/ PDF]

'''Authors:''' Tao YY, Shi Y, Gong XQ, Li L, Li ZM, Yang L, Zhang XM.

'''Institution:''' Medical Imaging Key Laboratory of Sichuan Province, Interventional Medical Center, Department of Radiology, Medical Research Center, Affiliated Hospital of North Sichuan Medical College, Nanchong, China.

'''Abstract:''' Hepatocellular carcinoma (HCC) is the sixth most common malignant tumour and the third leading cause of cancer death in the world. The emerging field of radiomics involves extracting many clinical image features that cannot be recognized by the human eye to provide information for precise treatment decision making. Radiomics has shown its importance in HCC identification, histological grading, microvascular invasion (MVI) status, treatment response, and prognosis, but there is no report on the preoperative prediction of programmed death ligand-2 (PD-L2) expression in HCC. The purpose of this study was to investigate the value of MRI radiomic features for the non-invasive prediction of immunotherapy target PD-L2 expression in hepatocellular carcinoma (HCC). A total of 108 patients with HCC confirmed by pathology were retrospectively analysed. Immunohistochemical analysis was used to evaluate the expression level of PD-L2. [http://www.slicer.org '''3D Slicer'''] software was used to manually delineate volumes of interest (VOIs) and extract radiomic features on preoperative T2-weighted, arterial-phase, and portal venous-phase MR images. Least absolute shrinkage and selection operator (LASSO) was performed to find the best radiomic features. Multivariable logistic regression models were constructed and validated using fivefold cross-validation. The area under the receiver characteristic curve (AUC) was used to evaluate the predictive performance of each model. The results show that among the 108 cases of HCC, 50 cases had high PD-L2 expression, and 58 cases had low PD-L2 expression. Radiomic features correlated with PD-L2 expression. The T2-weighted, arterial-phase, and portal venous-phase and combined MRI radiomics models showed AUCs of 0.789 (95% CI: 0.702-0.875), 0.727 (95% CI: 0.632-0.823), 0.770 (95% CI: 0.682-0.875), and 0.871 (95% CI: 0.803-0.939), respectively. The combined model showed the best performance. The results of this study suggest that prediction based on the radiomic characteristics of MRI could noninvasively predict the expression of PD-L2 in HCC before surgery and provide a reference for the selection of immune checkpoint blockade therapy.
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==Correlation Between Unilateral Internal Carotid Artery Stenosis and Asymmetric Distribution of Enlarged Perivascular Spaces in Patients With Acute Cerebral Infarction==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36649988 Zhonghua Yi Xue Za Zhi. 2023 Jan 17;103(3):178-185. PMID: 36649988]

'''Authors:''' Jian XL, Zhang M, Yun WW.

'''Abstract:'''
'''Objective:''' To explore the correlation between unilateral internal carotid artery (ICA) stenosis and asymmetrical distribution of enlarged perivascular spaces (EPVS) in patients with acute cerebral infarction.

'''Methods:''' Acute cerebral infarction patients with unilateral ICA stenosis hospitalized in Changzhou Second People's Hospital from October 2020 to December 2021 were collected. Routine cranial MRI and CT angiography were completed for each patient. The [http://www.slicer.org '''3D Slicer'''] software was used to quantitatively analyze the volume of patient's EPVS. Patients were divided into moderate stenosis group and severe stenosis/occlusion group according to the degree of ICA stenosis. Baseline data were compared between the two groups. Patients were further divided into three groups: moderate stenosis, severe stenosis and occlusion groups, and the ipsilateral and contralateral EPVS volume of ICA stenosis patients was compared. The asymmetry index (AI) was calculated for EPVS in the basal ganglia region (BG-EPVS) and EPVS in the centrum semiovale (CSO-EPVS). Patients with AI≥0.2 were included in the EPVS asymmetry group, while the rest were in the EPVS symmetry group, and the degree of unilateral ICA stenosis was compared between the two groups. Multivariate logistic regression model was used to analyze the relationship between ICA severe stenosis/occlusion and the asymmetric distribution of BG-EPVS.

'''Results:''' A total of 122 patients (96 males and 26 females) were enrolled, aged (70±10) years, with 81 cases in the unilateral ICA severe stenosis/occlusion group (46 cases of severe stenosis and 35 of occlusion) and 41 cases in the moderate stenosis group. Patients in the unilateral ICA severe stenosis/occlusion group had greater BG-EPVS volume [(4.08±0.76) mm3]and proportion of asymmetric distribution of BG-EPVS [75.3%(61/81)] than those of the moderate stenosis group [(3.12±0.85) mm3 and 39.0% (16/41)], with statistically significant differences (both P<0.001). The BG-EPVS volumes of the ipsilateral side of the stenosis in the severe stenosis group and the occlusion group [(3.34±0.86) mm3 and (3.93±0.60) mm3] were significantly greater than those of the contralateral side [(2.65±1.28) mm3 and (3.21±0.88) mm3], with statistically significant differences (both P<0.001). Correlation analysis indicated that the degree of unilateral ICA stenosis was positively correlated with the BG-EPVS volume on the stenosis side (r=0.62, P<0.001). Further comparison of the degree of unilateral ICA stenosis between the EPVS symmetric and asymmetric groups showed that the proportion of unilateral ICA severe stenosis/occlusion in the BG-EPVS asymmetry group was higher than that in the symmetric group [79.2%(61/77) vs 44.4%(20/45),P<0.001]. Multivariate logistic regression analysis showed that unilateral ICA severe stenosis/occlusion (OR=4.280, 95%CI: 1.743-10.508, P =0.002) and age (OR=1.055, 95%CI: 1.001-1.112, P=0.044) were risk factors for asymmetric distribution of BG-EPVS.

'''Conclusions:''' The severe stenosis/occlusion of the unilateral ICA and age are the risk factors for the asymmetric distribution of the BG-EPVS in patients with acute cerebral infarction. The ipsilateral EPVS volume of unilateral ICA stenosis is larger than that of the contralateral side, and the degree of ICA stenosis is positively correlated with the severity of BG-EPVS.
|}

==Radiomics to Predict the Mortality of Patients With Rheumatoid Arthritis-Associated Interstitial Lung Disease: A Proof-of-Concept Study==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36698825 Front Med (Lausanne). 2023 Jan 9;9:1069486. PMID: 36698825] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9870287/pdf/fmed-09-1069486.pdf PDF]

'''Authors:''' Venerito V, Manfredi A, Lopalco G, Lavista M, Cassone G, Scardapane A, Sebastiani M, Iannone F.

'''Institution:''' Rheumatology Unit, Department of Emergency and Organ Transplantation, University of Bari Aldo Moro, Bari, Italy.

'''Abstract:''' Objectives: Patients with rheumatoid arthritis (RA) and interstitial lung disease (ILD) have increased mortality compared to the general population and factors capable of predicting RA-ILD long-term clinical outcomes are lacking. In oncology, radiomics allows the quantification of tumour phenotype by analysing the characteristics of medical images. Using specific software, it is possible to segment organs on high-resolution computed tomography (HRCT) images and extract many features that may uncover disease characteristics that are not detected by the naked eye. We aimed to investigate whether features from whole lung radiomic analysis of HRCT may alone predict mortality in RA-ILD patients.

'''Methods:''' High-resolution computed tomographies of RA patients from January 2012 to March 2022 were analyzed. The time between the first available HRCT and the last follow-up visit or ILD-related death was recorded. We performed a volumetric analysis in [http://www.slicer.org '''3D Slicer'''], automatically segmenting the whole lungs and trachea via the Lung CT Analyzer. A LASSO-Cox model was carried out by considering ILD-related death as the outcome variable and extracting radiomic features as exposure variables.

'''Results:''' We retrieved the HRCTs of 30 RA-ILD patients. The median survival time (interquartile range) was 48 months (36-120 months). Thirteen out of 30 (43.33%) patients died during the observation period. Whole line segmentation was fast and reliable. The model included either the median grey level intensity within the whole lung segmentation [high-resolution (HR) 9.35, 95% CI 1.56-55.86] as a positive predictor of death and the 10th percentile of the number of included voxels (HR 0.20, 95% CI 0.05-0.84), the voxel-based pre-processing information (HR 0.23, 95% CI 0.06-0.82) and the flatness (HR 0.42, 95% CI 0.18-0.98), negatively correlating to mortality. The correlation of grey level values to their respective voxels (HR 1.52 95% CI 0.82-2.83) was also retained as a confounder.

'''Conclusion:''' Radiomic analysis may predict RA-ILD patients' mortality and may promote HRCT as a digital biomarker regardless of the clinical characteristics of the disease.
|}

==Evaluation of the Prognosis of Acute Subdural Hematoma According to the Density Differences Between Gray and White Matter==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36686517 Front Neurol. 2023 Jan 6;13:1024018. PMID: 36686517] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9853902/ PDF]

'''Authors:''' Li Z, Feng Y, Wang P, Han S, Zhang K, Zhang C, Lu S, Lv C, Zhu F, Bie L.

'''Institution:''' Department of Neurosurgery of the First Clinical Hospital, Jilin University, Changchun, China.

'''Abstract:'''
'''Objective:''' Acute subdural hematoma (ASDH) is a common neurological emergency, and its appearance on head-computed tomographic (CT) imaging helps guide clinical treatment. To provide a basis for clinical decision-making, we analyzed that the density difference between the gray and white matter of the CT image is associated with the prognosis of patients with ASDH.

'''Methods:''' We analyzed the data of 194 patients who had ASDH as a result of closed traumatic brain injury (TBI) between 2018 and 2021. The patients were subdivided into surgical and non-surgical groups, and the non-surgical group was further subdivided into "diffused [hematoma]" and "non-diffused" groups. The control group's CT scans were normal. The [http://www.slicer.org '''3D Slicer'''] software was used to quantitatively analyze the density of gray and white matter depicted in the CT images.

'''Results:''' Imaging evaluation showed that the median difference in density between the gray and white matter on the injured side was 4.12 HU (IQR, 3.91-4.22 HU; p < 0.001) and on the non-injured side was 4.07 HU (IQR, 3.90-4.19 HU; p < 0.001), and the hematoma needs to be surgically removed. The median density difference value of the gray and white matter on the injured side was 3.74 HU (IQR, 3.53-4.01 HU; p < 0.001) and on the non-injured side was 3.71 HU (IQR, 3.69-3.73 HU; p < 0.001), and the hematoma could diffuse in a short time.

'''Conclusion:''' Quantitative analysis of the density differences in the gray and white matter of the CT images can be used to evaluate the clinical prognosis of patients with ASDH.
|}

==The Knosp Criteria Revisited: 3-Dimensional Volumetric Analysis as a Predictive Tool for Extent of Resection in Complex Endoscopic Pituitary Surgery==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36170168 Front Oncol. Neurosurgery. 2023 Jan 1;92(1):179-85. PMID: 36170168]

'''Authors:''' DiRisio AC, Feng R, Shuman WH, Platt S, Price G, Dullea JT, Gilja S, D'Andrea MR, Delman BN, Bederson JB, Shrivastava RK.

'''Institution:''' Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.

'''Abstract:'''
'''Background:''' The Knosp criteria have been the historical standard for predicting cavernous sinus invasion, and therefore extent of surgical resection, of pituitary macroadenomas. Few studies have sought to reappraise the utility of this tool after recent advances in visualization and modeling of tumors in complex endoscopic surgery.

'''Objective:''' To evaluate our proposed alternative method, using 3-dimensional (3D) volumetric imaging, and whether it can better predict extent of resection in nonfunctional pituitary adenomas.

'''Methods:''' Patients who underwent endoscopic transsphenoidal resection of pituitary macroadenomas at our institution were reviewed. Information was collected on neurological, endocrine, and visual function. Volumetric segmentation was performed using [http://www.slicer.org '''3D Slicer'''] software. Relationship of tumor volume, clinical features, and Knosp grade on extent of resection was examined.

'''Results:''' One hundred forty patients were identified who had transsphenoidal resection of nonfunctional pituitary adenomas. Macroadenomas had a median volume of 6 cm3 (IQR 3.4-8.7), and 17% had a unilateral Knosp grade of at least 3B. On multiple logistic regression, only smaller log-transformed preoperative tumor volume was independently associated with increased odds of gross total resection (GTR; odds ratio: 0.27, 95% CI: 0.07-0.89, P < .05) when controlling for tumor proliferative status, age, and sex (area under the curve 0.67). The Knosp criteria did not independently predict GTR in this cohort (P > .05, area under the curve 0.46).

'''Conclusion:''' Increasing use of volumetric 3D imaging may better anticipate extent of resection compared with the Knosp grade metric and may have a greater positive predictive value for GTR. More research is needed to validate these findings and implement them using automated methods.
|}

==Differentiation of Lung Metastases Originated From Different Primary Tumors Using Radiomics Features Based on CT Imaging==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35577699 Acad Radiol. 2023 Jan;30(1):40-6. PMID: 35577699]

'''Authors:''' Shang H, Li J, Jiao T, Fang C, Li K, Yin D, Zeng Q.

'''Institution:''' Department of Radiology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, No. 16766 Jingshi Road, Jinan, Shandong, China.

'''Abstract:''' Rationale and objectives: To explore the feasibility of differentiating three predominant metastatic tumor types using lung computed tomography (CT) radiomics features based on supervised machine learning.

'''Materials and Methods:''' This retrospective analysis included 252 lung metastases (LM) (from 78 patients), which were divided into the training (n = 176) and test (n = 76) cohort randomly. The metastases originated from colorectal cancer (n = 97), breast cancer (n = 87), and renal carcinoma (n = 68). An additional 77 LM (from 35 patients) were used for external validation. All radiomics features were extracted from lung CT using an open-source software, [http://www.slicer.org '''3D Slicer''']. The least absolute shrinkage and selection operator (LASSO) method selected the optimal radiomics features to build the model. Random forest and support vector machine (SVM) were selected to build three-class and two-class models. The performance of the classification model was evaluated with the area under the receiver operating characteristic curve (AUC) by two strategies: one-versus-rest and one-versus-one.

'''Results:''' Eight hundred and fifty-one quantitative radiomics features were extracted from lung CT. By LASSO, 23 optimal features were extracted in three-class, and 25, 29, and 35 features in two-class for differentiating every two of three LM (colorectal cancer vs. renal carcinoma, colorectal cancer vs. breast cancer, and breast cancer vs. renal carcinoma, respectively). The AUCs of the three-class model were 0.83 for colorectal cancer, 0.79 for breast cancer, and 0.91 for renal carcinoma in the test cohort. In the external validation cohort, the AUCs were 0.77, 0.83, and 0.81, respectively. Swarmplot shows the distribution of radiomics features among three different LM types. In the two-class model, high accuracy and AUC were obtained by SVM. The AUC of discriminating colorectal cancer LM from renal carcinoma LM was 0.84, and breast cancer LM from colorectal cancer LM and renal carcinoma LM were 0.80 and 0.94, respectively. The AUCs were 0.77, 0.78, and 0.84 in the external validation cohort.

'''Conclusion:''' Quantitative radiomics features based on Lung CT exhibited good discriminative performance in LM of primary colorectal cancer, breast cancer, and renal carcinoma.
|}

==MRI Radiomic Features of Peritumoral Edema May Predict the Recurrence Sites of Glioblastoma Multiforme==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36686829 Front Oncol. 2023 Jan 4;12:1042498. PMID: 36686829] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9845721/pdf/fonc-12-1042498.pdf PDF]

'''Authors:''' Long H, Zhang P, Bi Y, Yang C, Wu M, He D, Huang S, Yang K, Qi S, Wang J.

'''Institution:''' Department of Neurosurgery, Nanfang Hospital, Southern Medical University, Guangzhou, China.

'''Abstract:'''

'''Background and Purpose:''' As one of the most aggressive malignant tumor in the central nervous system, the main cause of poor outcome of glioblastoma (GBM) is recurrence, a non-invasive method which can predict the area of recurrence pre-operation is necessary.To investigate whether there is radiological heterogeneity within peritumoral edema and identify the reproducible radiomic features predictive of the sites of recurrence of glioblastoma(GBM), which may be of value to optimize patients' management.

'''Materials and Methods:''' The clinical information and MR images (contrast-enhanced T1 weighted and FLAIR sequences) of 22 patients who have been histologically proven glioblastoma, were retrospectively evaluated. Kaplan-Meier methods was used for survival analysis. Oedematous regions were manually segmented by an expert into recurrence region, non-recurrence region. A set of 94 radiomic features were obtained from each region using the function of analyzing MR image of [http://www.slicer.org '''3D Slicer''']. Paired t test was performed to identify the features existing significant difference. Subsequently, the data of two patients from TCGA database was used to evaluate whether these features have clinical value.

'''Results:''' Ten features with significant differences between the recurrence and non-recurrence subregions were identified and verified on two individual patients from the TCGA database with pathologically confirmed diagnosis of GBM.

'''Conclusions:''' Our results suggested that heterogeneity does exist in peritumoral edema, indicating that the radiomic features of peritumoral edema from routine MR images can be utilized to predict the sites of GBM recurrence. Our findings may further guide the surgical treatment strategy for GBM.
|}

==Clinical Study on Application of 3D Slicer Software Assisted Domestic Frameless Stereotactic Robot in Biopsy of Intracranial Lesions==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36603886 Zhonghua Wai Ke Za Zhi. 2023 Jan 1;61(1):61-65. PMID: 36603886] | [http://www.ncbi.nlm.nih.gov/pmc/articles/pmc9849352/ PDF]

'''Authors:''' Chen H, Yan X, He F, Ding SC, Diao JF, Guo H, Cao SM, Yang CJ, Yin F.

'''Institution:''' Department of Neurosurgery, Aerospace Central Hospital, Beijing, China.

'''Abstract:'''
'''Objective:''' To examine the application value of [http://www.slicer.org '''3D Slicer'''] software assisted domestic frameless stereotactic robot in biopsy of intracranial lesions.

'''Methods:''' A retrospective analysis was performed on 80 patients who admitted consecutively and underwent intracerebral lesions biopsy with the domestic frameless stereotactic robot at Department of Neurosurgery, Aerospace Central Hospital from January 2019 to December 2021. There were 36 males and 44 females, with a mean age of (38.5±18.0) years (range: 6 to 71 years). Before surgery only enhanced T1-weighted three-dimensional magnetization prepared gradient echo sequences and diffusion tensor imaging scans were performed. Self-reconstruction of intracranial lesions, cerebral cortex and blood vessels was carried out using 3D Slicer software system after the DICOM format imaging data of 80 patients were collected. These imaging data were merged to the workstation of the domestic frameless stereotactic robot for preoperative surgical planning and the surgical puncture path was designed to avoid blood vessels in the brain functional area, cerebral cortex and sulcus.

'''Results:''' All frameless stereotactic biopsy were successfully performed. Postoperative pathological diagnosis included 50 cases of diffuse astrocytic and oligodendroglioma, 15 cases of lymphoma, 5 cases of metastatic tumors, 5 cases of inflammatory demyelinating disease, 2 cases of inflammatory granuloma, 1 case of hemangioma, 1 case of acute lymphoblastic leukemia intracranial invasion and 1 case of seminoma. The positive diagnosis rate was 100% (80/80). Postoperative imaging confirmed that the puncture path and target were accurately implemented according to the preoperative planning, and the target error was (1.32±0.44) mm (range: 0.55 to 1.99 mm). One case of puncture-related bleeding occurred at the target after surgery and improved after treatment.

'''Conclusion:''' The three-dimensional multimodal images reconstructed by the 3D Slicer software before operation could help the surgeons make the preoperative planning and reduce the risk of stereotactic brain biopsy.
|}

==Liver Cirrhosis and Tumor Location Can Affect the Range of Intrahepatic Microwave Ablation Zone==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36854449 Int J Hyperthermia. 2023;40(1):2181843. PMID: 36854449] | [https://www.tandfonline.com/doi/epdf/10.1080/02656736.2023.2181843?needAccess=true&role=button PDF]

'''Authors:''' Ding WZ, Wei H, Wu JP, Cheng ZG, Han ZY, Liu FY, Yu J, Liang P.

'''Institution:''' Fifth Medical Center of Chinese, PLA General Hospital, Beijing, China.

'''Abstract:'''
'''Background:''' The range of an ablation zone (AZ) plays a crucial role in the treatment effect of microwave ablation (MWA). The aim of this study was to analyze the factors influencing the AZ range.

'''Methods:''' Fourteen factors in four areas were included: patient-related factors (sex, age), disease-related factors (tumor location, liver cirrhosis), serological factors (ALT, AST, total protein, albumin, total bilirubin, direct bilirubin, and platelets), and MWA parameters (ablation time, power, and needle type). Multiple sequence MRI was used to delineate AZ by three radiologists using [http://www.slicer.org '''3D Slicer''']. MATLAB was used to calculate the AZ length, width, and area of the largest section. Linear regression analysis was used to analyze influencing factors. Moreover, a subgroup analysis was conducted for patients with viral hepatitis.

'''Result:''' 220 patients with 290 tumors were included between 2010-2021. In addition to MWA parameters, cirrhosis and tumor location were significant factors that influenced AZ (p < 0.001). The standardized coefficient (beta) of cirrhosis (cirrhosis vs. non-cirrhosis) was positive, which meant cirrhosis would lead to a decrease in AZ range. The beta of tumor location (near the hepatic hilar zone, intermediate zone, and periphery zone) was negative, indicating that AZ range decreased as the tumor location approached the hepatic hilum. For viral hepatitis patients, Fibrosis 4 (FIB4) score was a significant factor influencing AZ (p < 0.001), and the beta was negative, indicating that AZ range decreased as FIB4 increased.

'''Conclusion:''' Liver cirrhosis, tumor location, and FIB4 affect the AZ range and should be considered when planning MWA parameters.
|}

==A Magnetic Resonance Imaging Based Radiomics Model to Predict Mitosis Cycles in Intracranial Meningioma==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36653482 Sci Rep. 2023 Jan 18;13(1):969. PMID: 36653482] | [http://www.ncbi.nlm.nih.gov/pmc/articles/pmc9849352/ PDF]

'''Authors:'''Krähling H, Musigmann M, Akkurt BH, Sartoretti T, Sartoretti E, Henssen DJHA, Stummer W, Heindel W, Brokinkel B, Mannil M.

'''Institution:''' University Clinic for Radiology, University Hospital Muenster, Westfälische Wilhelms-University Muenster, Muenster, Germany.

'''Abstract:''' The aim of this study was to develop a magnetic resonance imaging (MRI) based radiomics model to predict mitosis cycles in intracranial meningioma grading prior to surgery. Preoperative contrast-enhanced T1-weighted (T1CE) cerebral MRI data of 167 meningioma patients between 2015 and 2020 were obtained, preprocessed and segmented using the [http://www.slicer.org '''3D Slicer'''] software and the PyRadiomics plugin. In total 145 radiomics features of the T1CE MRI images were computed. The criterion on the basis of which the feature selection was made is whether the number of mitoses per 10 high power field (HPF) is greater than or equal to zero. Our analyses show that machine learning algorithms can be used to make accurate predictions about whether the number of mitoses per 10 HPF is greater than or equal to zero. We obtained our best model using Ridge regression for feature pre-selection, followed by stepwise logistic regression for final model construction. Using independent test data, this model resulted in an AUC (Area under the Curve) of 0.8523, an accuracy of 0.7941, a sensitivity of 0.8182, a specificity of 0.7500 and a Cohen's Kappa of 0.5576. We analyzed the performance of this model as a function of the number of mitoses per 10 HPF. The model performs well for cases with zero mitoses as well as for cases with more than one mitosis per 10 HPF. The worst model performance (accuracy = 0.6250) is obtained for cases with one mitosis per 10 HPF. Our results show that MRI-based radiomics may be a promising approach to predict the mitosis cycles in intracranial meningioma prior to surgery. Specifically, our approach may offer a non-invasive means of detecting the early stages of a malignant process in meningiomas prior to the onset of clinical symptoms.
|}

==Advantages of a Training Course for Surgical Planning in Virtual Reality for Oral and Maxillofacial Surgery: Crossover Study==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36656632 JMIR Serious Games. 2023 Jan 19;11:e40541. PMID: 36656632] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9947820/?report=printable PDF]

'''Authors:''' Ulbrich M, Van den Bosch V, Bönsch A, Gruber LJ, Ooms M, Melchior C, Motmaen I, Wilpert C, Rashad A, Kuhlen TW, Hölzle F, Puladi B.

'''Institution:''' Department of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Aachen, Germany.

'''Abstract:'''
'''Background:''' As an integral part of computer-assisted surgery, virtual surgical planning (VSP) leads to significantly better surgery results, such as for oral and maxillofacial reconstruction with microvascular grafts of the fibula or iliac crest. It is performed on a 2D computer desktop screen (DS) based on preoperative medical imaging. However, in this environment, VSP is associated with shortcomings, such as a time-consuming planning process and the requirement of a learning process. Therefore, a virtual reality (VR)-based VSP application has great potential to reduce or even overcome these shortcomings due to the benefits of visuospatial vision, bimanual interaction, and full immersion. However, the efficacy of such a VR environment has not yet been investigated.

'''Objective:''' This study aimed to demonstrate the possible advantages of a VR environment through a substep of VSP, specifically the segmentation of the fibula (calf bone) and os coxae (hip bone), by conducting a training course in both DS and VR environments and comparing the results.

'''Methods:''' During the training course, 6 novices were taught how to use a software application in a DS environment, [http://www.slicer.org '''3D Slicer''']) and in a VR environment (Elucis) for the segmentation of the fibula and os coxae, and they were asked to carry out the maneuvers as accurately and quickly as possible. Overall, 13 fibula and 13 os coxae were segmented for each participant in both methods (VR and DS), resulting in 156 different models (78 fibula and 78 os coxae) per method (VR and DS) and 312 models in total. The individual learning processes in both environments were compared using objective criteria (time and segmentation performance) and self-reported questionnaires. The models resulting from the segmentation were compared mathematically (Hausdorff distance and Dice coefficient) and evaluated by 2 experienced radiologists in a blinded manner.

'''Results:''' A much faster learning curve was observed for the VR environment than the DS environment (β=.86 vs β=.25). This nearly doubled the segmentation speed (cm3/min) by the end of training, leading to a shorter time (P<.001) to reach a qualitative result. However, there was no qualitative difference between the models for VR and DS (P=.99). The VR environment was perceived by participants as more intuitive and less exhausting, and was favored over the DS environment.

'''Conclusions:''' The more rapid learning process and the ability to work faster in the VR environment could save time and reduce the VSP workload, providing certain advantages over the DS environment.
|}

==Lesion Size and Long-Term Cognitive Outcome After Pediatric Stroke: A Comparison Between Two Techniques to Assess Lesion Size==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36641854 Eur J Paediatr Neurol. 2023 Jan 7;42:126-32. PMID: 36641854]

'''Authors:''' Everts R, Bertato S, Steinlin M, Slavova N, Grunt S, Steiner L.

'''Institution:''' Division of Neuropediatrics, Development and Rehabilitation, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.

'''Abstract:'''
'''Background:''' There is little consensus on how lesion size impacts long-term cognitive outcome after pediatric arterial ischemic stroke (AIS). This study, therefore, compared two techniques to assessed lesion size in the chronic phase after AIS and determined their measurement agreement in relation to cognitive functions in patients after pediatric stroke.

'''Methods:''' Twenty-five patients after pediatric AIS were examined in the chronic phase (>2 years after stroke) in respect to intelligence, memory, executive functions, visuo-motor functions, motor abilities, and disease-specific outcome. Lesion size was measured using the ABC/2 formula and segmentation technique ([http://www.slicer.org '''3D Slicer''']). Correlation analysis determined the association between volumetry techniques and outcome measures in respect to long-term cognitive outcome.

'''Results:''' The measurements from the ABC/2 and segmentation technique were strongly correlated (r = 0.878, p < .001) and displayed agreement in particular for small lesions. Lesion size from both techniques was significantly correlated with disease-specific outcome (p < .001) and processing speed (p < .005) after controlling for age at stroke and multiple comparison.

'''Conclusion:''' The two techniques showed convergent validity and were both significantly correlated with long-term outcome after pediatric AIS. Compared to the time-consuming segmentation technique, ABC/2 facilitates clinical and research work as it requires relatively little time and is easy to apply.
|}

==Association Between Emphysema and Other Pulmonary Computed Tomography Patterns in COVID-19 Pneumonia==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36358023 J Med Virol. 2023 Jan;95(1):e28293. PMID: 36358023] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9828029/pdf/JMV-95-0.pdf PDF]

'''Authors:''' Han K, Wang J, Zou Y, Zhang Y, Zhou L, Yin Y.

'''Institution:''' Fetal-Neonatal Neuroimaging and Developmental Science Center, Division of Newborn Medicine, Boston Children's Hospital, Boston, USA.

'''Abstract:''' To evaluate the chest computed tomography (CT) findings of patients with Corona Virus Disease 2019 (COVID-19) on admission to hospital. And then correlate CT pulmonary infiltrates involvement with the findings of emphysema. We analyzed the different infiltrates of COVID-19 pneumonia using emphysema as the grade of pneumonia. We applied open-source assisted software, [http://www.slicer.org '''3D Slicer'''] to model the lungs and lesions of 66 patients with COVID-19, which were retrospectively included. we divided the 66 COVID-19 patients into the following two groups: (A) 12 patients with less than 10% emphysema in the low-attenuation area less than -950 Hounsfield units (%LAA-950), (B) 54 patients with greater than or equal to 10% emphysema in %LAA-950. Imaging findings were assessed retrospectively by two authors and then pulmonary infiltrates and emphysema volumes were measured on CT using [http://www.slicer.org '''3D Slicer'''] software. Differences between pulmonary infiltrates, emphysema, Collapsed, affected of patients with CT findings were assessed by Kruskal-Wallis and Wilcoxon test, respectively. Statistical significance was set at p < 0.05. The left lung (A) affected left lung 20.00/affected right lung 18.50, (B) affected left lung 13.00/affected right lung 11.50 was most frequently involved region in COVID-19. In addition, collapsed left lung, (A) collapsed left lung 4.95/collapsed right lung 4.65, (B) collapsed left lung 3.65/collapsed right lung 3.15 was also more severe than the right one. There were significant differences between the Group A and Group B in terms of the percentage of CT involvement in each lung region (p < 0.05), except for the inflated affected total lung (p = 0.152). The median percentage of collapsed left lung in the Group A was 20.00 (14.00-30.00), right lung was 18.50 (13.00-30.25) and the total was 19.00 (13.00-30.00), while the median percentage of collapsed left lung in the Group B was 13.00 (10.00-14.75), right lung was 11.50 (10.00-15.00) and the total was 12.50 (10.00-15.00). The percentage of affected left lung is an independent predictor of emphysema in COVID-19 patients. We need to focus on the left lung of the patient as it is more affected. The people with lower levels of emphysema may have more collapsed segments. The more collapsed segments may lead to more serious clinical feature.
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==A High-Resolution Pediatric Female Whole-Body Numerical Model With Comparison to a Male Model==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36595234 Phys Med Biol. 2023 Jan 13;68(2). PMID: 36595234]

'''Authors:''' Ntolkeras G, Jeong H, Zöllei L, Dmytriw AA, Purvaziri A, Lev MH, Grant PE, Bonmassar G.

'''Institution:''' Fetal-Neonatal Neuroimaging and Developmental Science Center, Division of Newborn Medicine, Boston Children's Hospital, Boston, USA.

'''Abstract:'''
'''Objective:''' Numerical models are central in designing and testing novel medical devices and in studying how different anatomical changes may affect physiology. Despite the numerous adult models available, there are only a few whole-body pediatric numerical models with significant limitations. In addition, there is a limited representation of both male and female biological sexes in the available pediatric models despite the fact that sex significantly affects body development, especially in a highly dynamic population. As a result, we developed Athena, a realistic female whole-body pediatric numerical model with high-resolution and anatomical detail.

'''Approach:''' We segmented different body tissues through Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) images of a healthy 3.5 year-old female child using 3D Slicer. We validated the high anatomical accuracy segmentation through two experienced sub-specialty-certified neuro-radiologists and the inter and intra-operator variability of the segmentation results comparing sex differences in organ metrics with physiologic values. Finally, we compared Athena with Martin, a similar male model, showing differences in anatomy, organ metrics, and MRI dosimetric exposure.

'''Main results:'''We segmented 267 tissue compartments, which included 50 brain tissue labels. The tissue metrics of Athena displayed no deviation from the literature value of healthy children. We show the variability of brain metrics in the male and female models. Finally, we offer an example of computing Specific Absorption Rate and Joule heating in a toddler/preschooler at 7T MRI.

'''Significance:''' This study introduces a female realistic high-resolution numerical model using MRI and CT scans of a 3.5 year-old female child, the use of which includes but is not limited to radiofrequency safety studies for medical devices (e.g. an implantable medical device safety in MRI), neurostimulation studies, and radiation dosimetry studies. This model will be open source and available on the Athinoula A. Martinos Center for Biomedical Imaging website.
|}

==Anatomical Morphology and Related Angles of Foramen Ovale: A Three-dimensional Computed Tomography Reconstruction==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36597246 J Coll Physicians Surg Pak. 2023 Jan;33(1):109-11. PMID: 36597246]

'''Authors:''' Cheng Z, Hu YL, Sun YX, Liang LZ, Pan DD, Wang DW.

'''Institution:''' Department of Neurosurgery, The Second Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, China.

'''Abstract:''' This study aimed to report the three-dimensional reconstruction of the foramen ovale (FO) based on computed tomography angiography and describe its shape and related angles. A retrospective analysis of 199 adult patients who were hospitalised at the Department of Neurosurgery, The Second Affiliated Hospital of Bengbu Medical College, Bengbu, China, from January to December 2020 was conducted. The original DICOM files of patients' computed tomography scans were processed by [http://www.slicer.org '''3D Slicer'''] software to reconstruct the three-dimensional skull. The morphological characteristics of the FO on both sides were analysed. Their size, related angles and volumes, and the differences between the two sides and gender were compared. A total of 398 FO from 199 patients were studied. The most frequent shape of the FO was oval, accounting for 54.27%. The mean lengths of the right and the left sides were 5.40±1.51 and 5.10±1.18mm, respectively. The mean width on the right and left sides was 3.23±1.16 and 3.33±1.19 mm, respectively. The FO is most commonly oval in shape. Clinicians may use the anatomical characteristics regarding the size and shape of the FO for diagnosis and treatment.
|}

Main Page/SlicerCommunity/2023

2023-07-25T17:20:56Z

Marianna: /* 2023 */

{{:Main_Page/SlicerCommunity}}

__TOC__

=2023=
==Dosimetric Assessment of Gadolinium-159 for Hepatic Radioembolization: Tomographic Images and Monte Carlo Simulation==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37393764 Appl Radiat Isot. 2023 Sep;199:110916. PMID: 37393764]

'''Authors:''' Musa AS, Abdul Hadi MFR, Hashikin NAA, Ashour NI, Ying CK.

'''Institution:''' School of Physics, Universiti Sains Malaysia, Penang, Malaysia.

'''Abstract:'''
A common therapeutic radionuclide used in hepatic radioembolization is yttrium-90 (90Y). However, the absence of gamma emissions makes it difficult to verify the post-treatment distribution of 90Y microspheres. Gadolinium-159 (159Gd) has physical properties that are suitable for therapy and post-treatment imaging in hepatic radioembolization procedures. The current study is innovative for conducting a dosimetric investigation of the use of 159Gd in hepatic radioembolization by simulating tomographic images using the Geant4 application for tomographic emission (GATE) Monte Carlo (MC) simulation. For registration and segmentation, tomographic images of five patients with hepatocellular carcinoma (HCC) who had undergone transarterial radioembolization (TARE) therapy were processed using a [http://www.slicer.org '''3D Slicer''']. The tomographic images with 159Gd and 90Y separately were simulated using the GATE MC Package. The output of simulation (dose image) was uploaded to [http://www.slicer.org '''3D Slicer'''] to compute the absorbed dose for each organ of interests. 159Gd were able to provide a recommended dose of 120 Gy to the tumour, with normal liver and lungs absorbed doses close to that of 90Y and less than the respective maximum permitted doses of 70 Gy and 30 Gy, respectively. Compared to 90Y, 159Gd requires higher administered activity approximately 4.92 times to achieve a tumour dose of 120 Gy. Thus; this research gives new insights into the use of 159Gd as a theranostic radioisotope, with the potential to be used as a90Y alternative for liver radioembolization.
|}

==The Cranial Capacity of the Saudi Population Measured Using 3D Computed Tomography Scans==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37482378 Neurosciences (Riyadh). 2023 Jul;28(3):184-89. PMID: 37482378]

'''Authors:''' Alshamrani KA.

'''Institution:''' Department of Radiological sciences, Faculty of Applied Medical Science, and from Health Research Centre, Najran University, Najran, Kingdom of Saudi Arabia.

'''Abstract:'''
Objectives: To measure the cranial capacity of members of the Saudi adult population across ages and genders.

Methods: This was a retrospective cross-sectional study that used 488 Computed Tomography (CT) scans of heads (of which 275 males) to measure cranial volume. The CT slices 0.625 mm thick were uploaded using the freely available [http://www.slicer.org '''3D Slicer'''] software, which then reconstructed the images and built a 3D module.

Results: The mean (±SD) cranial capacity of the males was 1481.6 (±110) cm3 (range: 1241-1723 cm3), whereas the cranial capacity of the females was 1375.4 (±104) cm3 (range: 1203-1678 cm3). This study showed that the males had a mean cranial capacity that was 7% greater than that of the females in this study. The average cranial capacity of the males between the ages of 31 and 40 years was statistically significantly larger to that of the males aged 61-80 (p<0.05).

Conclusion: This study demonstrated that the average cranial capacity of the males was larger than that of the females. These study results can help to determine the normal cranial capacity of adults in Saudi Arabia. Further work should be carried out to aid in establishing reference data for the Saudi population.
|}

==The Tracheal System of the Common Wasp (Vespula Vulgaris) - a Micro-CT Study==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37451536 J Insect Physiol. 2023 Jul 13;149:104547. PMID: 37451536]

'''Authors:''' Bell GD, Corps N, Mortimer D, Gretton S, Bury N, Connett GJ.

'''Institution:''' School of (EAST) Engineering, Arts, Science and Technology, University of Suffolk, James Hehir Building, UK.

'''Abstract:'''
X-ray micro-CT has been used to study the tracheal system of Pre and Post hibernation Queen wasps (Vespula vulgaris) and their workers. We have compared our findings in wasps with Snodgrass's description of the tracheal system of the honeybee as characterised by anatomical dissection. Our images, whilst broadly similar, identify the tracheal system as being considerably more complex than previously suggested. One of the 30 wasps imaged had a markedly different, previously undescribed tracheal system. Since completing this study, a large micro-CT study from the American Museum of Natural History (AMNH) has been published. This used different software, [http://www.slicer.org '''3D Slicer'''] and analysed 16bit digital data. We have compared our methods with that described in the AMNH publication, adopted their suggested nomenclature and have made recommendations for future studies.
|}
==Augmented Reality Presentation of the Extracranial Facial Nerve: An Innovation in Parotid Surgery==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37328316 Br J Oral Maxillofac Surg. 2023 Jul;61(6):428-36. PMID: 37328316]

'''Authors:''' Saadya A, Chegini S, Morley S, McGurk M.

'''Institution:''' University College London Hospital, UK.

'''Abstract:'''
Surgeons used to be unaware of the facial nerve's position during parotid surgery. Now, with special magnetic resonance imaging (MRI) sequences, it can be located and converted into a 3D model displayed on an augmented reality (AR) device for surgeons to study and manipulate. This study explores the accuracy and usefulness of the technique for the treatment of benign and malignant parotid tumours. A total of 20 patients with parotid tumours had 3-Tesla MRI scans, and their anatomical structures were segmented using [http://www.slicer.org '''3D Slicer'''] software. The structures were imported into a Microsoft HoloLens 2® device, displayed in 3D, and shown to the patient for consent. Intraoperative video recording was used to record the position of the facial nerve in relation to the tumour. The predicted path of the nerve taken from the 3D model was combined with surgical observation and video recording in all cases. The imaging proved to have application in both benign and malignant disease. It also improved the process of informed patient consent. Three-dimensional MRI imaging of the facial nerve within the parotid gland and its display in a 3D model is an innovative technique for parotid surgery. Surgeons can now see the nerve's position and tailor their approach to each patient's tumour, providing personalised care. The technique eliminates the surgeon's blind spot and is a significant advantage in parotid surgery.
|}

==Magnetic Resonance Imaging in Naso-Oropharyngeal Carcinoma: Role of Texture Analysis in the Assessment of Response to Radiochemotherapy, a Preliminary Study==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37336860/ Radiol Med. 2023 Jul;128(7):839-52. PMID: 37336860] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10317900/pdf/11547_2023_Article_1653.pdf PDF]

'''Authors:''' Bicci E, Nardi C, Calamandrei L, Barcali E, Pietragalla M, Calistri L, Desideri I, Mungai F, Bonasera L, Miele V.

'''Institution:''' Department of Experimental and Clinical Biomedical Sciences, Radiodiagnostic Unit #2, University of Florence, Florence, Italy.

'''Abstract:'''
Objective: Identifying MRI texture parameters able to distinguish inflammation, fibrosis, and residual cancer in patients with naso-oropharynx carcinoma after radiochemotherapy (RT-CHT).

Material and methods: In this single-centre, observational, retrospective study, texture analysis was performed on ADC maps and post-gadolinium T1 images of patients with histological diagnosis of naso-oropharyngeal carcinoma treated with RT-CHT. An initial cohort of 99 patients was selected; 57 of them were later excluded. The final cohort of 42 patients was divided into 3 groups (inflammation, fibrosis, and residual cancer) according to MRI, 18F-FDG-PET/CT performed 3-4 months after RT-CHT, and biopsy. Pre-RT-CHT lesions and the corresponding anatomic area post-RT-CHT were segmented with [http://www.slicer.org '''3D Slicer'''] software from which 107 textural features were derived. T-Student and Wilcoxon signed-rank tests were performed, and features with p-value < 0.01 were considered statistically significant. Cut-off values-obtained by ROC curves-to discriminate post-RT-CHT non-tumoural changes from residual cancer were calculated for the parameters statistically associated to the diseased status at follow-up.

Results: Two features-Energy and Grey Level Non-Uniformity-were statistically significant on T1 images in the comparison between 'positive' (residual cancer) and 'negative' patients (inflammation and fibrosis). Energy was also found to be statistically significant in both patients with fibrosis and residual cancer. Grey Level Non-Uniformity was significant in the differentiation between residual cancer and inflammation. Five features were statistically significant on ADC maps in the differentiation between 'positive' and 'negative' patients. The reduction in values of such features between pre- and post-RT-CHT was correlated with a good response to therapy.

Conclusions: Texture analysis on post-gadolinium T1 images and ADC maps can differentiate residual cancer from fibrosis and inflammation in early follow-up of naso-oropharyngeal carcinoma treated with RT-CHT.
|}

==BabelBrain: An Open-Source Application for Prospective Modeling of Transcranial Focused Ultrasound for Neuromodulation Applications==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37155375/ IEEE Trans Ultrason Ferroelectr Freq Control. 2023 Jul;70(7):587-99. PMID: 37155375]

'''Authors:''' Pichardo S.

'''Institution:''' Department of Radiology, University of Calgary, Calgary, Canada.

'''Abstract:'''
BabelBrain is an open-source standalone graphic-user-interface application designed for studies of neuromodulation using transcranial-focused ultrasound (FUS). It calculates the transmitted acoustic field in the brain tissue, taking into account the distortion effects caused by the skull barrier. The simulation is prepared using scans from magnetic resonance imaging (MRI) and, if available, computed tomography (CT) and zero-echo time MRI scans. It also calculates the thermal effects based on a given ultrasound regime, such as the total duration of exposure, the duty cycle, and acoustic intensity. The tool is designed to work in tandem with neuronavigation and visualization software, such as [http://www.slicer.org '''3D Slicer''']. It uses image processing to prepare domains for ultrasound simulation and uses the BabelViscoFDTD library for transcranial modeling calculations. BabelBrain supports multiple GPU backends, including Metal, OpenCL, and CUDA, and works on all major operating systems including Linux, macOS, and Windows. This tool is particularly optimized for Apple ARM64 systems, which are common in brain imaging research. The article presents the modeling pipeline used in BabelBrain and a numerical study where different methods of acoustic properties mapping were tested to select the best method that can reproduce the transcranial pressure transmission efficiency reported in the literature.
|}

==Volumetric Analysis of the Sinus and Orbit in Silent Sinus Syndrome After Endoscopic Sinus Surgery==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/36939460/ Otolaryngol Head Neck Surg. 2023 Jul;169(1):151-156. PMID: 36939460]

'''Authors:'''
Amin D, Chitguppi C, Xu V, Haghshenas C, Gorniak R, Rabinowitz M, Toskala E, Rosen M, Nyquist G.

'''Institution:''' Department of Otolaryngology-Head & Neck Surgery, Thomas Jefferson University, Philadelphia, PA, USA.

'''Abstract:'''
Objective: The term "silent sinus syndrome" (SSS) describes spontaneous enophthalmos secondary to subclinical maxillary sinus atelectasis. Debate remains on whether treatment with endoscopic maxillary antrostomy alone is adequate in reversing atelectasis and globe displacement. This study aims to determine the degree of volume change of the diseased sinus and orbit as well as the change in orbital height in patients treated with endoscopic antrostomy without orbital floor augmentation.

Study design: Retrospective review with image analysis.

Setting: Single tertiary care institution.

Methods: Three-dimensional (3D) analysis of computed tomographic imaging data was performed using [http://www.slicer.org '''3D Slicer''']. 3D models of the maxillary sinus and orbit of the diseased and normal sides were created, and volume measurements were calculated using the segmentation program.

Results: Thirteen patients with SSS who underwent endoscopic sinus surgery (ESS) and had follow-up computed tomographic imaging were analyzed. After endoscopic antrostomy, the mean volume of the diseased maxillary sinus significantly increased by 9.82%, from 6.37 to 7.00 cm3 (p = .0302). There was no significant change in mean orbital volume; however, the mean orbital height decreased by 5.67%, from 38.09 to 35.93 mm from pretreatment to posttreatment samples (p = .0101). All patients had resolution of clinical or radiographic enophthalmos and orbital displacement with ESS alone.

Conclusion: Endoscopic maxillary antrostomy alone in the treatment of SSS significantly increased maxillary sinus volume and decreased diseased orbital height. These changes were associated with clinical and radiographic improvement in globe displacement. These findings support performing ESS alone, reserving orbital augmentation for patients who do not exhibit adequate clinical improvement.
|}

==Safety and Efficacy of Thoracic Endovascular Aortic Repair for Acute Stanford Type B Aortic Dissection With Retrograde Type a Intramural Hematoma==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/36921645/ J Vasc Surg. 2023 Jul;78(1):61-69.e4. PMID: 36921645] | [https://www.jvascsurg.org/action/showPdf?pii=S0741-5214%2823%2900438-X PDF]

'''Authors:''' Wang J, Li M, Li J, He H, Zhou Y, Li X, Li Q, Gu F, Ye Z, Dardik A, Shu C.

'''Institution:''' Department of Vascular Surgery, Second Xiangya Hospital, Central South University, Changsha, China; Institute of Vascular Diseases, Central South University, Changsha, China.

'''Abstract:'''
Objective: The aim of this study was to evaluate safety and efficacy of thoracic endovascular aortic repair (TEVAR) for acute Stanford type B aortic dissection (TBAD) with retrograde type A intramural hematoma (TAIMH).

Methods: Patients with acute TBAD with retrograde TAIMH treated with TEVAR between January 1, 2014, to March 31, 2022, were retrospectively reviewed. Aortic diameter and distance were measured using the [http://www.slicer.org '''3D Slicer'''] image computing platform. Patients' characteristics, procedural, in-hospital and follow-up data, and aortic remodeling were analyzed.

Results: Fifty-two patients (average age, 52.6 years; 42 males [80.8%]) were included. The median interval from symptom onset to TEVAR was 11 days (interquartile range, 7.0-16.8 days). The maximal diameter of the ascending aorta (AA) was <50 mm, and the hematoma thickness in the AA was ≤10 mm in all patients. Both the in-hospital and 30-day mortality rates were 0%. The 30-day complication rate was 11.5%. The overall cumulative survival rates were 100% at 1 year, 97.1% at 3 years, and 92.6% at 5 years. Four of 52 patients (7.7%) developed retrograde type A aortic dissection at 10 days to 4 months postoperatively, and one of 52 patients (1.9%) developed an isolated AA dissection 4 months postoperatively; these five patients were treated and alive at late follow-up in March 2022. The rates of cumulative freedom from thoracic aortic re-intervention were 93.7% at 1 year and 90.7% at 5 years. Positive AA remodeling was observed in 92.3% (48/52) of patients during follow-up. The maximal diameter of AA (mean ± standard error of mean) at admission was 42.7 ± 0.8 mm, which decreased to 39.5 ± 0.9 mm at last follow-up. The maximal AA hematoma thickness at admission was 7.6 ± 0.3 mm, which reduced to 2.2 ± 0.9 mm at last follow-up.

Conclusions: For selected patients of acute Stanford TBAD with retrograde TAIMH, endovascular repair may be a safe, effective, and durable alternative treatment, if the maximum diameter of the AA is <50 mm and the intramural hematoma thickness in the AA is ≤10 mm.
|}

==The Traction Force of the Pulled Limb in Hip Arthroscopic Surgery Is Determined by Stiffness Coefficient Which Is Significantly Related to Muscle Volume==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/36477348/ Knee Surg Sports Traumatol Arthrosc. 2023 Jul;31(7):2708-2715. PMID: 36477348]

'''Authors:''' Yin Y, Xue S, Zhang X, Yang G, Xu Y, Wang J, Huang H.

'''Institution:''' Department of Sports Medicine, Beijing Key Laboratory of Sports Injuries, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing, People's Republic of China.

'''Abstract:'''
Purpose: To verify the relationship between muscle volume, lateral centre-edge angle (LCEA), alpha angle (AA), body mass index (BMI) and Beighton score with stiffness coefficient (SC). To analyse the difference of traction force at different physical states of hip joint capsule.

Methods: Thirty-six patients who underwent hip arthroscopy operation were included. The volumes of some related muscles were measured in MRI images by [http://www.slicer.org '''3D Slicer''']. We recorded and tested differences in traction force of five joint capsule physical states, including before (State 1) and after joint capsule puncture (State 2), after the establishment of anterolateral and mid-anterior approaches (State 3) and after incision of the joint capsule through these two approaches (States 4, 5). The correlation between muscle volume, BMI, LCEA, AA and SC was verified by Spearman test. Poisson regression was used to explain confounding variables.

Results: The average force at State 1 was 531.8 N. There were significant differences in traction force between these five states (p < 0.001). There was a significant positive correlation between muscle volumes and SC (p < 0.001). BMI had no correlation with SC (n.s.). The preoperative LCEA of the affected side was correlated with SC (p = 0.043). AA and SC were not correlated (n.s.).

Conclusion: The physical states of the hip joint capsule affected traction force. Muscle volume rather than BMI is an ideal index to estimate preoperative traction force. LCEA affected traction force, whilst AA and Beighton score did not. Measuring the muscle volume can help estimate the most suitable traction force for the patient.
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==Three-Dimensional Assessment of Tongue Cancer Prognosis by Preoperative MRI==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/35426211/ Oral Dis. 2023 Jul;29(5):2006-2011. PMID: 35426211]

'''Authors:''' Li C, Zhu L, Guo Y, Ji T, Ren Z.

'''Institution:''' Department of Oral and Maxillofacial Head and Neck Oncology, The Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

'''Abstract:'''
Purpose: To obtain the relative volume by measuring the tongue volume and the lesion volume, and further explore its relationship with the prognosis of patients, hoping to supplement the TNM staging with a new index.

Methods: ITK-SANP software was used to outline the patients' MRI. After MRI reconstruction and measurement, [http://www.slicer.org '''3D Slicer'''] software was used to estimate tumor volume.

Results: A total of 64 patients with tongue cancer who met the inclusion criteria were included in the study. The estimated tumor volume after MRI reconstruction revealed a significant and robust correlation with tumor stage (p < 0.05, Rs = 0.6207) and a substantial and medium correlation with early lymph node metastasis (p < 0.05, Rs = 0.4873).

Conclusions: We classified tongue cancer into three grades based on tumor volume (Stage I, tumors smaller than 1500 mm³; Stage II, tumors 1500-9000 mm³; and Stage III, tumors larger than 9000 mm³), and such grading could be used as a reference for tumor staging, lymph node metastasis, and patient prognosis to a certain extent.
|}

==Multimodal Measurements of Levator Bowl Volume in Nulligravid Asymptomatic Women: Endovaginal Ultrasound Versus MRI==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36656345 Int Urogynecol J. 2023 Jul;34(7):1627-33. PMID: 36656345]

'''Authors:''' Chill HH, Martin LC, Abramowitch SD, Rostaminia G.

'''Institution:''' Female Pelvic Medicine and Reconstructive Surgery (FPMRS), Division of Urogynecology, University of Chicago, Northshore University HealthSystem, Skokie, IL, USA.

'''Abstract:''' Introduction and hypothesis: Measurements of levator bowl volume using advanced imaging, may be predictive of pelvic floor muscle function. The aim of this study was to compare the volume of the levator bowl using both magnetic resonance imaging (MRI) and endovaginal ultrasound (EVU) of healthy asymptomatic women.

'''Methods:''' All participants underwent a comprehensive interview including completion of the Pelvic Floor Distress Inventory Questionnaire-20 questionnaire, pelvic examination with a pelvic organ prolapse quantification evaluation, MRI, and EVU. The pelvic floor was segmented using [http://www.slicer.org '''3D Slicer'''] and the MRI segmentations were trimmed using two methods: soft-tissue landmarks and the field of view (FOV) of the ultrasound volume. The levator bowl volume of the 3D segmented shapes was measured using Blender's 3D printing toolkit. Normality was tested using the Shapiro-Wilks test and comparisons were made using self-paired t tests.

'''Results:''' The final analysis included 19 patients. Levator bowl volume measured via MRI was larger than that measured in EVU (46.1 ± 7.9 cm3 vs 27.4 ± 5.9 cm3, p<0.001). Reducing the FOV of the MRI to that of EVU caused the MRI volume to be much closer to the EVU volume (35.5 ± 3.3 cm3 vs 27.4 ± 5.9 cm3, p<0.001); however, it remained significantly larger.

'''Conclusion:''' Levator bowl volume measured using MRI was larger than that measured using EVU no matter the method of delineation of the levator muscles. Although EVU is safe, cheap, and easy to perform, it captures a smaller volume of levator bowel than MRI.
|}

==Pectoralis Muscle Area Measured at T4 Level Is Closely Associated With Adverse COVID-19 Outcomes in Hospitalized Patients==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37259659 J Musculoskelet Neuronal Interact. 2023 Jun 1;23(2):196-204. PMID: 37259659] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10233225/pdf/JMNI-23-196.pdf PDF]

'''Authors:''' Tekin ZN, Dogruoz Karatekin B, Dogan MB, Bilgi Z.

'''Institution:''' Istanbul Medeniyet University, Goztepe Prof Dr Suleyman Yalcin City Hospital, Radiology, Istanbul, Turkey.

'''Abstract:'''
Objectives: Skeletal muscle area (SMA) at T4 level on chest computed tomography (CT) is a newly available method that can be used as a surrogate sarcopenia marker. The objective of this study is to evaluate association of SMA with adverse COVID-19 outcomes in hospitalized patients.

Methods: Hospitalized COVID-19 patients were prospectively recorded in a database containing age, gender, date of admission, date of outcome (discharge, mortality, presence of intensive care unit (ICU) stay, additional coding information (comorbidities, superimposed conditions). Admission CT-scans were retrospectively evaluated for segmentation (bilateral pectoralis major/minor, erector spinae, levator scapulae, rhomboideus minor and major and transversospinalis muscles) and SMA calculation using [http://www.slicer.org '''3D Slicer'''] software.

Results: 167 cases were evaluated (68 male, 72 female, 140 survived, 27 dead). Muscle area was lower in patients with ICU stay (p=0.023, p=0.018, p=0.008) and mortality outcome (p=0.004, p=0.007, p=0.002) for pectoralis, back and SMA. In multivariate Cox-regression analysis, hazard ratio (HR) value for the pectoralis muscle area value below 2800 mm2 was found to be 3.138(95% CI: 1.171-8.413) for mortality and 2.361(95% CI: 1.012-5.505) for ICU.

Conclusions: Pectoralis muscle area measured at T4 level with 3-D slicer was closely associated with adverse outcomes (mortality, ICU stay) in hospitalized COVID-19 patients. Since early treatment methods for COVID-19 are being evaluated, this method may be a useful adjunct to clinical decision making in regard to prioritization.
|}

==Precise Location of the Ventricular Catheter Tip in Ventriculoperitoneal Shunt Placement Guided by 3D Printed Individualized Guide==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37086587/ Clin Neurol Neurosurg. 2023 Jun;229:107730. PMID: 37086587]

'''Authors:''' Tian Q, Yi J, Wu Y, Wang S, Qu Y, Cai Q.

'''Institution:''' Department of Neurosurgery, Tangdu hospital, Air Force Medical University, Shaanxi, China.

'''Abstract:'''
Objective: Improper placement of the ventricular catheter tip is the most common cause of shunting disorders after ventriculoperitoneal shunt (VPS) placement surgery. Here, through two illustrative cases, we described a novel method of precise ventricular catheter tip location.

Methods: [http://www.slicer.org '''3D Slicer'''] software was used to define the ventricle puncture path and determine the ventricle catheter tip location preoperatively, and the 3D individualized guide model was printed.

Results: The ventricular puncture was performed under the guidance of the 3D guide to achieve precise ventricle catheter tip location intraoperatively.

Conclusions: This technique is safe, simple, efficient and cost-effective, which facilitates its clinical implementation and promotion.
|}

==PIRET-A Platform for Treatment Planning in Electroporation-Based Therapies==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37015676/ IEEE Trans Biomed Eng. 2023 Jun;70(6):1902-10. PMID: 37015676]

'''Authors:''' Perera-Bel E, Aycock KN, Salameh ZS, Gomez-Barea M, Davalos RV, Ivorra A, Ballester MAG.

'''Institution:''' BCN MedTech, Department of Information and Communication Technologies, Universitat Pompeu Fabra, Barcelona, Spain.

'''Abstract:'''
Tissue electroporation is the basis of several therapies. Electroporation is performed by briefly exposing tissues to high electric fields. It is generally accepted that electroporation is effective where an electric field magnitude threshold is overreached. However, it is difficult to preoperatively estimate the field distribution because it is highly dependent on anatomy and treatment parameters.

Objective: We developed PIRET, a platform to predict the treatment volume in electroporation-based therapies.

Methods: The platform seamlessly integrates tools to build patient-specific models where the electric field is simulated to predict the treatment volume. Patient anatomy is segmented from medical images and 3D reconstruction aids in placing the electrodes and setting up treatment parameters.

Results: Four canine patients that had been treated with high-frequency irreversible electroporation were retrospectively planned with PIRET and with a workflow commonly used in previous studies, which uses different general-purpose segmentation, [http://www.slicer.org '''3D Slicer'''] and modeling software (3Matic and COMSOL Multiphysics). PIRET outperformed the other workflow by 65 minutes (× 1.7 faster), thanks to the improved user experience during treatment setup and model building. Both approaches computed similarly accurate electric field distributions, with average Dice scores higher than 0.93.

Conclusion: A platform which integrates all the required tools for electroporation treatment planning is presented. Treatment plan can be performed rapidly with minimal user interaction in a stand-alone platform.

Significance: This platform is, to the best of our knowledge, the most complete software for treatment planning of irreversible electroporation. It can potentially be used for other electroporation applications.
|}

==Surgically Assisted Maxillary Expansion With or Without Pterygoid Disjunction Alters Maxillomandibular Positioning==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/35426586/ Oral Maxillofac Surg. 2023 Jun;27(2):269-281. PMID: 35426586]

'''Authors:''' Carvalho FSR, Soares ECS, de Medeiros JR, Júnior JMM, Hyppolito JOP, de Barros Silva PG, Ribeiro TR, Costa FWG.

'''Institution:''' Department of Oral and Maxillofacial Surgery, Federal University of Ceará Campus Sobral, Brazil.

'''Abstract:'''
Purpose: This study aimed to analyze alterations in mandibular positioning after surgically assisted maxillary expansion (SARME) with and without pterygoid disjunction (PD).

Methods: Cone-beam computed tomography scans of 24 healthy individuals (18-45 years old) with transverse deficiency, superior to 5 mm, underwent SARME with or without PD. The aspects prospectively assessed were (1) alignment and position of the head (ITK-Snap and [http://www.slicer.org '''3D Slicer'''] software); (2) McNamara's and Steiner-Tweed-Wits' cephalometric analysis (Dolphin Imaging®); and (3) colorimetric evaluation based on 3D correspondence analysis ([http://www.slicer.org '''3D Slicer'''] software).

Results: A decrease in 1-NA and 1-SN angles as well as an increased occlusal plane in both groups was observed. Superior-inferior and anteroposterior spatial displacements of the chin were statistically significant in the PD group. Altered colorimetric patterns were also observed in the PD group.

Conclusions: This study found more evident tooth inclination in the group without PD; mandibular alterations were more evident in the PD group. Further studies with 3D analysis are strongly recommended for more comprehensive results.
|}

==ERCP 2.0: Biliary 3D-Reconstruction in Patients With Malignant Hilar Stricture==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37379653 Clin Res Hepatol Gastroenterol. 2023 Jun 26;47(7):102172. PMID: 37379653]

'''Authors:''' Becq A, Szewczyk J, Salin G, Chartier M, Chaput U, Leenhardt R, Dray X, Arrive L, Camus M.

'''Institution:''' Department of Gastroenterology, Henri-Mondor University Hospital, AP-HP, EA 7375, Université Paris Est Créteil, France.

'''Abstract:'''
Background: Endoscopic retrograde cholangiopancreatography (ERCP) for malignant hilar strictures is challenging. The correlation between Magnetic resonance cholangiopancreatography (MRCP) and per ERCP 2D fluoroscopic images is not obvious. The aim of this study was to evaluate the feasibility and potential usefulness of MRCP-based handmade biliary 3D reconstruction in this setting.

Methods: Methods Patients who underwent MRCP followed by ERCP for biliary drainage of a malignant hilar stricture at our institution between 2018 and 2020 were reviewed. A handmade 3D segmentation using [http://www.slicer.org '''3D Slicer'''] (Kitware, France) was fashioned and reviewed with an expert radiologist. The primary outcome was the feasibility of biliary segmentation.

Results: A total of 16 patients were included. The mean age was 70.1 (+/- 8.6) years-old and 68.8% had hilar cholangiocarcinoma. Handmade segmentation was successful in all cases. The agreement between the MRCP interpretation and the 3D reconstruction was 37.5%, as per the Bismuth classification. 3D reconstruction available prior to ERCP could have helped guide for better stent placement in 11 cases (68.8%).

Conclusions: MRCP-based biliary 3D segmentation-reconstruction, in patients with malignant hilar stricture is feasible and seems to provide a better anatomical understanding compared to MRCP and could help improve endoscopic management.
|}

==3D Printing Personalized Guide Plate in the Management of Recurrent Intramuscular Venous Malformations: A Single Center Experience==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/36967547/ Phlebology. 2023 Jun;38(5):307-314. PMID: 36967547]

'''Authors:''' Han T, Jiang S, Xiong J, Cui J, Shen W.

'''Institution:''' Department of Burns and Plastic Surgery, Children's Hospital of Nanjing Medical University, Nanjing, China.

'''Abstract:'''
Objective: This study aimed to investigate the feasibility and effectiveness of 3D printing personalized guide plate in the management of recurrent intramuscular venous malformations (IVM).

Methods: Fifteen patients with recurrent IVM were retrospectively assessed. [http://www.slicer.org '''3D Slicer'''] software was used to extract and reconstruct the imaging data from CT and/or MRI to highlight the morphology, size, and puncture depth of the lesion. With the guidance of personalized plate, complete excision of the IVM was adopted along the pre-marked (methylene blue, MB) margin.

Results: Personalized guide plate matched involved extremity well, and MB-puncture approach was consistent with preoperative design. All IVMs were removed radically in one single session. Complete pain relief was obtained in all cases postoperatively.

Conclusion: The application of 3D printing guide plate can be safe, effective, and reliable to confirming the precise margin of IVM, renders a promising technique with a high practical value in resection of recurrent lesion.
|}

==White Matter Hyperintensities: A Possible Link Between Sarcopenia and Cognitive Impairment in Patients With Mild to Moderate Alzheimer's Disease==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37330930 Eur Geriatr Med. 2023 Jun 18. PMID: 37330930]

'''Authors:''' Weng X, Liu S, Li M, Zhang Y, Zhu J, Liu C, Hu H.

'''Institution:''' Department of Neurology, The Second Affiliated Hospital of Soochow University, Jiangsu, China.

'''Abstract:'''
Purpose: Alzheimer's disease (AD) has been reported to be associated with sarcopenia. White matter hyperintensities (WMH) are common in AD patients. However, the effect of WMH on sarcopenia in AD remains unclear. We hence aimed to investigate the possible association between regional WMH volumes and sarcopenic parameters in AD.

Methods: 57 mild to moderate AD patients and 22 normal controls (NC) were enrolled. Sarcopenic parameters were assessed, including appendicular skeletal mass index (ASMI), grip strength, 5-times sit-to-stand (5-STS) time, and gait speed. The volumes of periventricular hyperintensities (PVH) and deep white matter hyperintensities (DWMH) were quantified using [http://www.slicer.org '''3D Slicer'''] software.

Results: AD subjects exhibited a lower ASMI, a slower gait speed, an increased 5-STS time, and larger volumes of PVH and DWMH than those in the NC group. In AD subjects, total WMH and PVH volumes were related to cognitive impairment, particularly executive function decline. Moreover, total WMH volume and PVH volume were negatively correlated with gait speed across various clinical stages of AD. Multiple linear regression analysis showed that PVH volume was independently associated with 5-STS time and gait speed, whereas DWMH volume was only independently associated with gait speed.

Conclusion: WMH volume was associated with cognitive decline and various sarcopenic parameters. It thereby suggested that WMH may serve as the connection between sarcopenia and cognitive dysfunction in AD. Further studies are needed to confirm these findings and to determine whether sarcopenia interventions reduce WMH volume and improve cognitive function in AD.
|}

==CT Angiography Radiomics Combining Traditional Risk Factors to Predict Brain Arteriovenous Malformation Rupture: a Machine Learning, Multicenter Study==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37311939 Transl Stroke Res. 2023 Jun 13. PMID: 37311939]

'''Authors:''' Zhang S, Wang J, Sun S, Zhang Q, Zhai Y, Wang X, Ge P, Shi Z, Zhang D.

'''Institution:''' Department of Neurosurgery, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.

'''Abstract:'''
This study aimed to develop a machine learning model for predicting brain arteriovenous malformation (bAVM) rupture using a combination of traditional risk factors and radiomics features. This multicenter retrospective study enrolled 586 patients with unruptured bAVMs from 2010 to 2020. All patients were grouped into the hemorrhage (n = 368) and non-hemorrhage (n = 218) groups. The bAVM nidus were segmented on CT angiography images using [http://www.slicer.org '''3D Slicer'''] software, and radiomic features were extracted using Pyradiomics. The dataset included a training set and an independent testing set. The machine learning model was developed on the training set and validated on the testing set by merging numerous base estimators and a final estimator based on the stacking method. The area under the receiver operating characteristic (ROC) curve, precision, and the f1 score were evaluated to determine the performance of the model. A total of 1790 radiomics features and 8 traditional risk factors were contained in the original dataset, and 241 features remained for model training after L1 regularization filtering. The base estimator of the ensemble model was Logistic Regression, whereas the final estimator was Random Forest. In the training set, the area under the ROC curve of the model was 0.982 (0.967-0.996) and 0.893 (0.826-0.960) in the testing set. This study indicated that radiomics features are a valuable addition to traditional risk factors for predicting bAVM rupture. In the meantime, ensemble learning can effectively improve the performance of a prediction model.
|}

==Real-Time Integration Between Microsoft HoloLens 2 and 3D Slicer With Demonstration in Pedicle Screw Placement Planning==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37310561 Int J Comput Assist Radiol Surg. 2023 Jun 13. PMID: 37310561]

'''Authors:''' Pose-Díez-de-la-Lastra A, Ungi T, Morton D, Fichtinger G, Pascau J.

'''Institution:''' Departamento de Bioingeniería, Universidad Carlos III de Madrid, Spain.

'''Abstract:'''
Purpose: Up to date, there has been a lack of software infrastructure to connect [http://www.slicer.org '''3D Slicer'''] to any augmented reality (AR) device. This work describes a novel connection approach using Microsoft HoloLens 2 and OpenIGTLink, with a demonstration in pedicle screw placement planning.

Methods: We developed an AR application in Unity that is wirelessly rendered onto Microsoft HoloLens 2 using Holographic Remoting. Simultaneously, Unity connects to [http://www.slicer.org '''3D Slicer'''] using the OpenIGTLink communication protocol. Geometrical transform and image messages are transferred between both platforms in real time. Through the AR glasses, a user visualizes a patient's computed tomography overlaid onto virtual 3D models showing anatomical structures. We technically evaluated the system by measuring message transference latency between the platforms. Its functionality was assessed in pedicle screw placement planning. Six volunteers planned pedicle screws' position and orientation with the AR system and on a 2D desktop planner. We compared the placement accuracy of each screw with both methods. Finally, we administered a questionnaire to all participants to assess their experience with the AR system.

Results: The latency in message exchange is sufficiently low to enable real-time communication between the platforms. The AR method was non-inferior to the 2D desktop planner, with a mean error of 2.1 ± 1.4 mm. Moreover, 98% of the screw placements performed with the AR system were successful, according to the Gertzbein-Robbins scale. The average questionnaire outcomes were 4.5/5.

Conclusions: Real-time communication between Microsoft HoloLens 2 and 3D Slicer is feasible and supports accurate planning for pedicle screw placement.
|}

==Delirium After Traumatic Brain Injury: Prediction by Location and Size of Brain Lesion==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37317796 Ann Rehabil Med. 2023 Jun 7. PMID: 37317796] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10326395/pdf/arm-23008.pdf PDF]

'''Authors:''' Han SJ, Suh JH, Lee JY, Kim SJ.

'''Institution:''' Department of Rehabilitation Medicine, College of Medicine, Ewha Womans University, Seoul, Korea.

'''Abstract:'''
Objective: To examine (1) the location of brain lesion that would predict post-traumatic delirium and (2) the association between volume of brain lesion and occurrence of delirium in patients with traumatic brain injury (TBI).

Methods: A retrospective study was conducted by reviewing medical records of 68 TBI patients, categorized into two groups: the delirious group (n=38) and non-delirious group (n=30). The location and volume of TBI were investigated with the [http://www.slicer.org '''3D Slicer'''] software.

Results: The TBI region in the delirious group mainly involved the frontal or temporal lobe (p=0.038). All 36 delirious patients had brain injury on the right side (p=0.046). The volume of hemorrhage in the delirious group was larger by about 95 mL compared to the non-delirious group, but this difference was not statistically significant (p=0.382).

Conclusion: Patients with delirium after TBI had significantly different injury site and side, but not lesion size compared to patients without delirium.
|}

==Mitral Paravalvular Leak 3D Printing from 3D-Transesophageal Echocardiography==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37288866 Anatol J Cardiol. 2023 Jun 7. PMID: 37288866] | [https://doi.org/10.14744/AnatolJCardiol.2023.3008 PDF]

'''Authors:''' Jedrzejek M, Kozlowski M, Peszek-Przybyla E, Jadczyk T, Pysz P, Wojakowski W, Smolka G.

'''Institution:''' Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland.

'''Abstract:'''
Background: Paravalvular leaks can be detected in almost 15% of patients after mitral valve prosthesis implantation. This complication can result in congestive heart failure and hemolysis. Despite advancements in non-invasive imaging, percutaneous closure of paravalvular leaks is not always successful. Therefore, efforts are made to improve treatment outcomes by using 3D-printed models of defects as pre-procedural support for interventional cardiologists.

Methods: Retrospectively, 3D-transesophageal echocardiography recordings of 8 patients with clinically significant mitral paravalvular leaks were analyzed. Qlab Software was used to export DICOM images of each paravalvular leak channel, including surrounding tissue. Image segmentation was performed in [http://www.slicer.org '''3D Slicer'''], a free, open-source software package used for imaging research. Models were printed to actual size with the poly jet Stratasys Objet 30 printer with a transparent, rigid material.

Results: Duration of model preparation and printing, as well as the total cost, was calculated. Mean total time of model preparation was 430.5 ± 196 minutes.

Conclusion: 3D-printing from 3D-transesophageal echocardiography is technically feasible. Both shape and location of paravalvular leaks are preserved during model preparation and printing. It remains to be tested if 3D-printing would improve outcomes of percutaneous paravalvular leaks closure.
|}

==Prediction of Ki-67 Expression in Gastrointestinal Stromal Tumors Using Radiomics of Plain and Multiphase Contrast-Enhanced CT==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37266658 Eur Radiol. 2023 Jun 2. PMID: 37266658]

'''Authors:''' Liu Y, He C, Fang W, Peng L, Shi F 4, Xia Y, Zhou Q, Zhang R 5, Li C.

'''Institution:''' Medical Imaging Department, Chongqing University Central Hospital, Chongqing Emergency Medical Center, Chongqing, China.

'''Abstract:'''
Objective: To study the value of radiomics models based on plain and multiphase contrast-enhanced CT to predict Ki-67 expression in gastrointestinal stromal tumors (GISTs).

Methods: A total of 215 patients with GISTs were retrospectively analyzed, including 150 patients in one hospital as the training set and 65 patients in another hospital as the external verification set. The tumor at the largest level of CT images was delineated as the region of interest (ROI). The maximum diameter of the ROI was defined as the tumor size. A total of 851 radiomics features were extracted from each ROI by [http://www.slicer.org '''3D Slicer'''] Radiomics. After dimensionality reduction, three machine learning classification algorithms including logistic regression (LR), random forest (RF), and support vector machine (SVM) were used for Ki-67 expression prediction. Using a multivariable logistic model, a nomogram was established to predict the expression of Ki-67 individually.

Results: Delong tests showed that the SVM models had the highest accuracy in the arterial phase (Z value 0.217-1.139) and venous phase (Z value 0.022-1.396). For the plain phase, LR and SVM models had the highest accuracy (Z value 0.874-1.824, 1.139-1.763). For the delayed phase, LR models had the highest accuracy (Z value 0.056-1.824). For the combined phase, RF models had the highest accuracy (Z value 0.232-1.978). There was no significant difference among the above models for KI-67 expression prediction (Z value 0.022-1.978). A nomogram was developed with a C-index of 0.913 (95% CI, 0.878 to 0.956).

Conclusions: Radiomics of both plain and enhanced CT images could accurately predict the expression of Ki-67 in GIST. For patients who were not suitable to use contrast agents, plain scan could be used as an alternative.
|}

==Accuracy of Imaging Software for 3d Rendering of Tooth Structures, Usable in Clinical Settings==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37272346 Int J Comput Dent. 2023 Jun 5;0(0):0. PMID: 37272346]

'''Authors:''' Ronsivalle V, Venezia P, Migliorati M, Grippaudo C, Barbato E, Nucci L, Isola G, Leonardi RM, Lo Giudice A.

'''Institution:''' Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Policlinico Universitario "Vittorio Emanuele-G. Rodolico", Catania, Italy.

'''Abstract:'''
Aim: The aim of this study was to evaluate the segmentation accuracy of dentition testing four free-source semi-automatic software.

Materials and methods: A total of 20 cone-beam computed tomography (CBCT) were selected to perform semi-automatic segmentation of maxillary and mandibular dentition. The software tested were Invesalius, ITK-Snap, [http://www.slicer.org '''3D Slicer'''] and Seg3D. Each tooth model was also manually segmented (Mimics software) and set as the gold standard (GS) reference of the investigation. A specific 3D imaging technology was used to perform the superimposition between the teeth models obtained with semi-automatic software and the GS model, and to perform the surface-to-surface matching analysis. The accuracy of semi-automatic segmentation was evaluated calculating the volumetric mean differences (mean bias and limits of agreement) and the percentage of matching of the tooth models compared to the manual segmentation (GS). Qualitative assessments were performed using color-coded maps. All data were statistically analysed to perform software comparisons.

Result: Statistically significant differences were found in the volumetric and matching percentage data (p < 0,05). Invesalius was the most accurate software for 3D rendering of the dentition with a volumetric bias (Mimics) ranging from 4,59 mm3 to 85,79 mm3; instead, ITK-SNAP showed the higher volumetric bias, ranging from 30,22 mm3 to 319,83 mm3. The dis-matched area was mainly located at the radicular region of the teeth. Volumetric data showed excellent inter-software reliability with coefficient values ranging from 0,951 to 0,997.

Conclusion: Different semi-automatic software algorithms could generate different patterns of inaccuracy error in the segmentation of teeth.
|}

==A Retrospective Three-Dimensional Study of the Mandibular Growth During Preoperative Orthodontics in Late Adolescent Patients With Skeletal Class III Malocclusion==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37271262 J Stomatol Oral Maxillofac Surg. 2023 Jun 2:101526. PMID: 37271262]

'''Authors:''' Yuan M, Zheng Z, Li H, Wang P, Liu Y, Bi R.

'''Institution:''' State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthognathic and TMJ Surgery, West China Hospital of Stomatology, Sichuan University, China.

'''Abstract:'''
Introduction: The mandible's ongoing development presents a contraindication for combined orthodontic-orthognathic treatment. The aim of this study was to evaluate the mandibular stability before and after preoperative orthodontic treatment in late adolescent patients with skeletal Class III malocclusion and to investigate the most appropriate time to start preoperative orthodontic treatment.

Material and methods: The study population consisted of 58 adolescents, aged between 15 and 21 years, with skeletal Class III malocclusion; the adolescents underwent CT scans at the beginning (T1) and the end (T2) of preoperative orthodontic treatment. The CT data were analyzed using ITK-SNAP and [http://www.slicer.org '''3D Slicer'''] software, and the effects of age and gender on mandibular development were investigated.

Results: In these 58 patients, there were no significant local bone alterations in the condyle and anterior chin point between T1 and T2 and no significant changes in the mandibular branch height, mandibular body length, condylar distance, and mandibular angle distance (p>0.05). The mandibular growth at the angel of mandible was statistically significant (p<0.05), but it was not clinically significant because the mean value of the growth was small (right: 0.416±0.986 mm, left: 0.328±0.886 mm). No effect of age and gender on mandibular development was observed.

Conclusion: The mandibular morphology was stable during preoperative orthodontic treatment in patients at the late adolescent stage. This study provides evidence for the possibility of early implementation of preoperative orthodontics.
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==Assessment of Variabilities in Lung-Contouring Methods on CBCT Preclinical Radiomics Outputs==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37345013 Cancers (Basel). 2023 May 9;15(10):2677. PMID: 37345013] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10216427/pdf/cancers-15-02677.pdf PDF]

'''Authors:''' Brown KH, Illyuk J, Ghita M, Walls GM, McGarry CK, Butterworth KT.

'''Institution:''' Patrick G. Johnston Centre for Cancer Research, Queen's University Belfast, UK.

'''Abstract:'''
Radiomics image analysis has the potential to uncover disease characteristics for the development of predictive signatures and personalised radiotherapy treatment. Inter-observer and inter-software delineation variabilities are known to have downstream effects on radiomics features, reducing the reliability of the analysis. The purpose of this study was to investigate the impact of these variabilities on radiomics outputs from preclinical cone-beam computed tomography (CBCT) scans. Inter-observer variabilities were assessed using manual and semi-automated contours of mouse lungs (n = 16). Inter-software variabilities were determined between two tools ([http://www.slicer.org '''3D Slicer'''] and ITK-SNAP). The contours were compared using Dice similarity coefficient (DSC) scores and the 95th percentile of the Hausdorff distance (HD95p) metrics. The good reliability of the radiomics outputs was defined using intraclass correlation coefficients (ICC) and their 95% confidence intervals. The median DSC scores were high (0.82-0.94), and the HD95p metrics were within the submillimetre range for all comparisons. the shape and NGTDM features were impacted the most. Manual contours had the most reliable features (73%), followed by semi-automated (66%) and inter-software (51%) variabilities. From a total of 842 features, 314 robust features overlapped across all contouring methodologies. In addition, our results have a 70% overlap with features identified from clinical inter-observer studies.
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==A Training Tool for Clinicians in Segmenting Medical Images to Make 3D Models==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37342255 Ann Surg Open. 2023 May 23;4(2):e275. PMID: 37342255] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7614675/pdf/EMS170894.pdf PDF]

'''Authors:''' Chegini S, Tahim A, Liu M, Chooi Y, Edwards E, Clarkson M, Schilling C.

'''Institution:''' Department of Head and Neck Surgery, University College London Hospital, London, UK.

'''Abstract:'''
Introduction: 3D models produced from medical imaging can be used to plan treatment, design prosthesis, teach and for communication. Despite the clinical benefit, few clinicians have experience of how 3D models are produced.This is the first study evaluating a training tool to teach clinicians to produce 3D models and reporting the perceived impact on their clinical practice.

Method: Following ethical approval, 10 clinicians completed a bespoke training tool, comprising written and video material alongside online support. Each clinician and 2 technicians (included as control) were sent 3 CT scans and asked to produce 6 fibula 3D models using an open-source software, [http://www.slicer.org '''3D Slicer''']. The produced models were compared to those produced by the technicians using Hausdorff distance calculation. Thematic analysis was used to study the post-intervention questionnaire.

Results: The mean Hausdorff distance between the final model produced by the clinicians and technicians was 0.65mm SD0.54mm. The first model made by clinicians took a mean time of 1hr 25mins and the final model took 16:04mins (5:00-46:00mins). 100% of learners reported finding the training tool useful and will employ it in future practice.

Discussion: The training tool described in this paper is able to successfully train clinicians to produce fibula models from CT scans. Learners were able to produce comparable models to technicians within an acceptable timeframe. This does not replace technicians. However, the learners perceived this training will allow them to use this technology in more cases, with appropriate case selection and they appreciate the limits of this technology.
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==3D Slicer Combined With Neuroendoscope in Treatment of a Distal Segment Aneurysm of the Anterior Choroidal Artery Complicated Intraventricular Hemorrhage: A Case Report and Literature Review==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37251467 Heliyon. 2023 May 18;9(6):e16193. PMID: 37251467] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10220353/pdf/main.pdf PDF]

'''Authors:''' Zhou L, Ren Y, Li Z, Zhang H, Wei H, Song P, Cheng L, Wang W, Gao L, Lei P, Hua Q, Chen Q, Zhou J, Li G, Cai Q.

'''Institution:''' Department of Neurosurgery, Renmin Hospital of Wuhan University, Wuhan, China.

'''Abstract:'''
Introduction: Pure ventricular hemorrhage is often secondary to Moyamoya disease, rarely caused by rupture of ventricular aneurysm. The surgical treatment of the latter is very challenging. [http://www.slicer.org '''3D Slicer'''] reconstruction technology can accurately locate small intracranial lesions and combined with minimally invasive surgery with transcranial neuroendoscope is a new attempt to treat the above diseases.

Case presentation: We report a case of pure intraventricular hemorrhage secondary to rupture of a distal segment aneurysm of the anterior choroidal artery. Brain computed tomography (CT) before admission showed pure ventricular hemorrhage, and brain CT angiography (CTA) before operation showed a distal segment aneurysm of the anterior choroidal artery. We used [http://www.slicer.org '''3D Slicer'''] reconstruction and precise location of the focus before the operation and used the minimally invasive surgery technique with transcranial neuroendoscope to completely remove the hematoma in the ventricle, and found the responsible aneurysm located in the ventricle.

Conclusion: Pure intraventricular hemorrhage requires vigilance against the distal segment aneurysm of the anterior choroidal artery. At present, conventional microscopic craniotomy and intravascular interventional therapy have limitations, and [http://www.slicer.org '''3D Slicer'''] reconstruction and precise positioning technology combined with transcranial neuroendoscope minimally invasive surgery may be a good choice.
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==Application of Preoperative Multimodal Image Fusion Technique in Microvascular Decompression Surgery via Suboccipital Retrosigmoid Approach==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36716853 World Neurosurg. 2023 May;173:e37-e47. PMID: 36716853] | [https://pdf.sciencedirectassets.com/280061/AIP/1-s2.0-S1878875023001031/main.pdf PDF]

'''Authors:''' Liao CC, Wu KH, Chen G.

'''Institution:''' Department of Neurosurgery, Zhuhai People's Hospital (Zhuhai Hospital Affiliated with Jinan University,China), Zhuhai, China.

'''Abstract:'''
'''Objective:''' To explore the application value of preoperative multimodal image fusion technique in microvascular decompression (MVD) surgery via the suboccipital retrosigmoid approach.

'''Methods:''' Comprehensive data of 13 patients with primary trigeminal neuralgia (TN) and 13 patients with hemifacial spasm (HFS) treated by MVD surgery via the suboccipital retrosigmoid approach at the Department of Neurosurgery in Zhuhai People's Hospital from January 2021 to December 2021 were retrospectively analyzed. Preoperatively, all patients underwent cranial thin-section computed tomography and magnetic resonance examinations. Three-dimensional (3D) digital images of the skull, brainstem, nerves, and blood vessels were constructed by the [http://www.slicer.org '''3D Slicer'''] software or RadiAnt DICOM Viewer, which were then applied to design the surgical approach and surgical plan. The multimodal image fusion results, clinical characteristics, intraoperative data, surgical outcomes, and complications of all patients were summarized.

'''Results:''' The 3D digital images after fusion reconstruction can vividly show the anatomical relationship between the skull, brainstem, nerves, and blood vessels and was helpful to tailor the surgical strategy. All 26 patients underwent a smooth surgery. During the surgery, the key points were accurately located, the corners of the transverse sinus and sigmoid sinus were completely exposed, and no venous sinus injury occurred in all 26 patients. The key point was approximately located at the top point of the digastric groove, 12.3 ± 0.46 mm vertically above and 6.3 ± 0.6 mm laterally to the Frankfurt horizontal plane. The average cranial opening time was 30.4 (±3.6) min, and the mean operating time was 104.7 (±12.1) min. The diameter of the bone window was about 2.0 cm-3.0 cm, and the bone flap was restored. Among the 13 patients with primary TN, 12 (92.3%) exhibited complete relief of pain and 1 had significant relief. Complications of surgery included facial sensory numbness in 1 case, vertigo in 2 cases, and herpes at the corners of the mouth in 1 case. Of the 13 patients with HFS, 12 (92.3%) had complete relief of facial twitching symptoms and 1 had significant relief, and the complications included mild facial palsy in 2 (15.4%) cases and facial sensory numbness in another 2 (15.4%) cases. The mean follow-up time after surgery ranged from 6-16 months, and 1 of 26 patients experienced recurrence of HFS during the follow-up period.

'''Conclusions:''' Preoperative multimodal image fusion technology can provide adequate preoperative assessment for patients and assistance in designing surgical approaches, which is an important guideline for MVD surgery via the suboccipital retrosigmoid approach for primary TN and facial muscle spasm.
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==An Interactive App with Multi-parametric MRI - Whole-Mount Histology Correlation for Enhanced Prostate MRI Training of Radiology Residents==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37137744 Acad Radiol. 2023 May 1:S1076-6332(23)00183-6. PMID: 37137744]

'''Authors:''' Chatterjee A, Szasz T, Munakami M, Karademir I, Yusufishaq MS, Martens S, Wheeler C, Antic T, Thomas S, Karczmar GS, Oto A.

'''Institution:''' Department of Radiology, University of Chicago, Chicago, IL, USA.

'''Abstract:'''
Rationale and objectives: To validate the educational value of a newly created learning application in enhancing prostate MRI training of radiologists for detecting prostate cancer using an observer study.

Materials and methods: An interactive learning app, LearnRadiology, was developed using a web-based framework to display multi-parametric prostate MRI images with whole-mount histology for 20 cases curated for unique pathology and teaching points. Twenty new prostate MRI cases, different from the ones used in the web app, were uploaded on [http://www.slicer.org '''3D Slicer''']. Three radiologists (R1: radiologist; R2, R3: residents) blinded to pathology results were asked to mark areas suspected of cancer and provide a confidence score (1-5, with 5 being high confidence level). Then after a minimum memory washout period of 1 month, the same radiologists used the learning app and then repeated the same observer study. The diagnostic performance for detecting cancers before and after accessing the learning app was measured by correlating MRI with whole-mount pathology by an independent reviewer.

Results: The 20 subjects included in the observer study had 39 cancer lesions (13 Gleason 3 + 3, 17 Gleason 3 + 4, 7 Gleason 4 + 3, and 2 Gleason 4 + 5 lesions). The sensitivity (R1: 54% → 64%, P = 0.08; R2: 44% → 59%, P = 0.03; R3: 62% → 72%, P = 0.04) and positive predictive value (R1: 68% → 76%, P = 0.23; R2: 52% → 79%, P = 0.01; R3: 48% → 65%, P = 0.04) for all 3 radiologists improved after using the teaching app. The confidence score for true positive cancer lesion also improved significantly (R1: 4.0 ± 1.0 → 4.3 ± 0.8; R2: 3.1 ± 0.8 → 4.0 ± 1.1; R3: 2.8 ± 1.2 → 4.1 ± 1.1; P < 0.05).

Conclusion: The web-based and interactive LearnRadiology app learning resource can support medical student and postgraduate education by improving diagnostic performance of trainees for detecting prostate cancer.
|}

==3D Printed Guide Tube System for Acute Neuropixels Probe Recordings in Non-Human Primates==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37105161 J Neural Eng. 2023 May 11;20(3):036009. PMID: 37105161] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10172811/pdf/jne_20_3_036009.pdf PDF]

'''Authors:''' Bauer DL, Pobiel B, Hilber K, Verma AK, Wang J, Vitek J, Johnson M, Johnson L.

'''Institution:''' Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, USA.

'''Abstract:'''
Objective.
Neuropixels (NP) probes are a significant advance in electrophysiological recording technology that enable monitoring of hundreds of neurons in the brain simultaneously at different depths. Application of this technology has been predominately in rodents, however widespread use in non-human primates (NHPs) such as rhesus macaques has been limited. In this study we sought to overcome two overarching challenges that impede acute NP implantation in NHPs: (1) traditional microdrive systems that mount to cephalic chambers are commonly used to access cortical areas for microelectrode recordings but are not designed to accommodate NP probes, and (2) NHPs have thick dura mater and tissue growth within the cephalic chambers which poses a challenge for insertion of the extremely fragile NP probe.
Approach.
In this study we present a novel NP guide tube system that can be adapted to commercial microdrive systems and demonstrate an implant method using the NP guide tube system. This system was developed using a combination of CAD design, 3D printing, and small part machining. Software programs, [http://www.slicer.org '''3D Slicer'''] and SolidWorks were used to target cortical areas, approximate recording depths and locations, and for in-silico implant testing.
Main results.
We performedin vivotesting to validate our methodology, successfully implanting, explanting, and reimplanting NP probes. We collected stable neurophysiological recordings in the premotor cortex of a rhesus macaque at rest and during performance of a reaching task.Significance.In this study we demonstrate a robust Neuropixels implant system that allows multiple penetrations with the same NP probe and share design files that will facilitate the adoption of this powerful recording technology for NHP studies.
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==Diagnostic Value of 18F-FDG PET/CT-Based Radiomics Nomogram in Bone Marrow Involvement of Pediatric Neuroblastoma==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/36117128 Acad Radiol. 2023 May;30(5):940-51. PMID: 36117128]

'''Authors:''' Feng L, Yang X, Lu X, Kan Y, Wang C, Zhang H, Wang W, Yang J.

'''Institution:''' Department of Nuclear Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing, China.

'''Abstract:'''
Objectives: To develop and validate an 18F-FDG PET/CT-based radiomics nomogram and evaluate the value of the 18F-FDG PET/CT-based radiomics nomogram for the diagnosis of bone marrow involvement (BMI) in pediatric neuroblastoma.

Materials and methods: A total of 144 patients with neuroblastoma (100 in the training cohort and 44 in the validation cohort) were retrospectively included. The PET/CT images of patients were visually assessed. The results of bone marrow aspirates or biopsies were used as the gold standard for BMI. Radiomics features and conventional PET parameters were extracted using [http://www.slicer.org '''3D Slicer''']. Features were selected by the least absolute shrinkage and selection operator regression, and radiomics signature was constructed. Univariate and multivariate logistic regression analyses were applied to identify the independent clinical risk factors and construct the clinical model. Other different models, including the conventional PET model, combined PET-clinical model and combined radiomics model, were built using logistic regression. The combined radiomics model was based on clinical factors, conventional PET parameters and radiomics signature, which was presented as a radiomics nomogram. The diagnostic performance of the different models was evaluated by receiver operating characteristic (ROC) curves and decision curve analysis (DCA).

Results: By visual assessment, BMI was observed in 80 patients. Four conventional PET parameters (SUVmax, SUVmean, metabolic tumor volume, and total lesion glycolysis) were extracted. And 15 radiomics features were selected to build the radiomics signature. The 11q aberration, neuron-specific enolase and vanillylmandelic acid were identified as the independent clinical risk factors to establish the clinical model. The radiomics nomogram incorporating the radiomics signature, the independent clinical risk factors and SUVmean demonstrated the best diagnostic value for identifying BMI, with an area under the curve (AUC) of 0.963 and 0.931 in the training and validation cohorts, respectively. And the DCA demonstrated that the radiomics nomogram was clinically useful.

Conclusion: The 18F-FDG PET/CT-based radiomics nomogram which incorporates radiomics signature, independent clinical risk factors and conventional PET parameters could improve the diagnostic performance for BMI of pediatric neuroblastoma without additional medical costs and radiation exposure.
|}

==Opportunistic Screening for Osteoporosis Using CT Scans of the Knee: A Pilot Study==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37203533 Stud Health Technol Inform. 2023 May 18;302:909-910. PMID: 37203533]

'''Authors:''' Elmahdy M, Sebro R.

'''Institution:''' Department of Radiology, Mayo Clinic, Jacksonville, FL, USA.

'''Abstract:'''
Knee CT scans are used for planning for total knee arthroplasties in patients who are often simultaneously at risk for frailty fractures due to low bone mineral density. We retrospectively identified 200 patients (85.5% female) with concurrent CT scans of the knee and Dual energy x-ray absorptiometry (DXA). The mean CT attenuation of the distal femur, proximal tibia and fibula, and patella, were calculated using volumetric 3-dimensional segmentation using [http://www.slicer.org '''3D Slicer''']. Data were split randomly into training 80% and test 20% datasets. The optimal CT attenuation threshold for the proximal fibula was obtained in the training dataset and evaluated in the test dataset. A support vector machine (SVM) with radial basis function (RBF) using C-classification was trained and tuned using 5-fold cross-validation in the training dataset and then evaluated in the test dataset. The SVM had a higher area-under-the curve (AUC) of 0.937 and better performance to detect osteoporosis/osteopenia than the CT attenuation of the fibula (AUC of 0.717) (P=0.015). Opportunistic screening for osteoporosis/osteopenia could be accomplished using CT scans of the knee.
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==Sustainable 3D Printing of Oral Films With Tunable Characteristics Using CMC-Based Inks From Durian Rind Wastes==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/36933810 Eur J Pharm Biopharm. 2023 May;186:30-42. PMID: 36933810]

'''Authors:''' Panraksa P, Rachtanapun P, Thipchai P, Lesniewska E, Brachais CH, Debeaufort F, Chambin O, Jantrawut P.

'''Institution:''' Department of Pharmaceutical Sciences, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, Thailand.

'''Abstract:'''
With the growing interest in environmentally friendly and personalized medicines, new concept for combining three-dimensional printing (3DP) with natural-based biomaterials derived from agro-food wastes has emerged. This approach provides sustainable solutions for agricultural waste management and potential for developing of novel pharmaceutical products with tunable characteristics. This work demonstrated the feasibility of fabricating personalized theophylline films with four different structures (Full, Grid, Star, and Hilbert) using syringe extrusion 3DP and carboxymethyl cellulose (CMC) derived from durian rind wastes. Our findings suggested that all the CMC-based inks with shear thinning properties capable of being extruded smoothly through a small nozzle could potentially be used to fabricate the films with various complex printing patterns and high structural fidelity. The results also demonstrated that the film characteristics and release profiles could be easily modified by simply changing the slicing parameters (e.g., infill density and printing pattern). Amongst all formulations, Grid film, which was 3D-printed with 40 % infill and a grid pattern, demonstrated a highly porous structure with high total pore volume. The voids between printing layers in Grid film increased theophylline release (up to 90 % in 45 min) through improved wetting and water penetration. All findings in this study provide significant insight into how to modify film characteristics simply by digitally changing the printing pattern in [http://www.slicer.org '''3D Slicer'''] software without creating a new CAD model. This approach could help to simplify the 3DP process so that non-specialist users can easily implement it in community pharmacies or hospital on demand.
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==An Automated Landmark Method to Describe Geometric Changes in the Human Mandible During Growth==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/36893681 Arch Oral Biol. 2023 May;149:105663. PMID: 36893681]

'''Authors:''' Fournier G, Maret D, Telmon N, Savall F.

'''Institution:''' Faculté de Chirurgie Dentaire, Université Paul Sabatier, Centre Hospitalier Universitaire, Toulouse, France.

'''Abstract:'''
Objective: The principal aim of this study was to assess an automatic landmarking approach to human mandibles based on the atlas method. The secondary aim was to identify the areas of greatest variation in the mandibles of middle-aged to older adults.

Design: Our sample consisted of 160 mandibles from computed tomography scans of 80 men and 80 women aged between 40 and 79 years. Eleven anatomical landmarks were placed manually on mandibles. The automated landmarking through point cloud alignment and correspondence (ALPACA) method implemented in [http://www.slicer.org '''3D Slicer'''] was used to automatically place landmarks to all meshes. Euclidean distances, normalized centroid size, and Procrustes ANOVA were calculated for both methods. A pseudo-landmarks approach was followed using ALPACA to identify areas of changes among our sample.

Results: The ALPACA method showed significant differences in Euclidean distances for all landmarks compared to the manual method. A mean Euclidean distance of 1.7 mm was found for the ALPACA method and 0.99 mm for the manual method. Both methods found that sex, age, and size had a significant effect on mandibular shape. The greatest variations were observed in the condyle, ramus, and symphysis regions.

Conclusion: The results obtained using the ALPACA method are acceptable and promising. This approach can automatically place landmarks with an average accuracy of less than 2 mm, which may be sufficient in most anthropometric analyses. In the light of our results, however, odontological application such as occlusal analysis is not recommended.
|}

==Clinical Study of Puncture Technique in Single Division of the Trigeminal Ganglion Intumescentia==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37183316 Pain Pract. 2023 May 14. PMID: 37183316] | [https://onlinelibrary.wiley.com/doi/epdf/10.1111/papr.13239 PDF]

'''Authors:''' Zhang L, Guo Y, Xu J, He Y, Qi Z, Chen H, Zhang H.

'''Institution:''' Department of Neurosurgery, Jianhu Hospital Affiliated to Nantong University, Yancheng, China.

'''Abstract:'''
Objective: We explored the feasibility of single-division puncture in the ophthalmic division, maxillary division, and mandibular division of the trigeminal ganglion intumescentia (TGI) and the feasibility of radiofrequency treatment of trigeminal neuralgia.

Methods: According to the previous anatomical image studies, [http://www.slicer.org '''3D Slicer'''] software was used to analyze the CT images of the patients. The trigeminal ganglion fossa (TGF) was used as the imaging sign. TGI was identified in the sagittal plane along the fiber. The puncture path starts from the TGI center-foramen ovale line, extending outward to the epidermis as the needle insertion point, and extending inward to the division boundary. For lateral puncture, which is blocked by the mandible, the positions of closed mouth, open mouth, and over-open mouth were used. Multiple targets were generated using straight electrodes and curved electrodes to achieve full coverage of TGI. According to the preoperative design, general anesthesia surgery was performed. Xper CT was used for imaging, and the puncture was guided by Xper Guide. Radiofrequency treatment of TGI was conducted.

Results: In total, 45 patients with trigeminal neuralgia underwent 50 single-division TGI punctures. The procedure was smooth and the compliance with the design was good. Continuous radiofrequency (CRF) was performed, the VAS scores were 25 times at 70°C, 19 times at 65°C, two times at 60°C, and two times at 50°C (both in the ophthalmic division). Pulsed radiofrequency (PRF) was conducted two times. Within 24 h after the procedure, the VAS scores were all 0. From 1 to 7 days after the procedure, pain recurrence was found in three cases, of whom two cases received pulsed radiofrequency treatment. Patients were followed up for 1-24 months and there were no recurrence. After continuous radiofrequency at 65-70°C, the moderate tactile loss was observed, and nearly half of the patients had food residues on the surgical side after 6 months. After continuous radiofrequency at 60°C, there was mild tactile loss and no food residue. The tactile sensation was slightly decreased after continuous radiofrequency at 50°C, and the tactile sensation was normal the next day.

Conclusion: Trigeminal ganglion intumescentia single-division radiofrequency is effective and feasible for the treatment of trigeminal neuralgia.
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==Three-Dimensional Volume Rendering of Pelvic Floor Anatomy with Focus on Fibroids in Relation to the Lower Urogenital Tract Based on Cross-Sectional MRI Images==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37171621 J Med Syst. 2023 May 12;47(1):62. PMID: 37171621] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10181971/pdf/10916_2023_Article_1947.pdf PDF]

'''Authors:''' Fan KS, Durnea C, Nygaard CC, Khalil M, Doumouchtsis SK.

'''Institution:''' Institute for Medical and Biomedical Education, St. George's University of London, London, UK.

'''Abstract:'''
We aimed to assess the feasibility of developing three-dimensional (3D) models of pelvic organs using cross-sectional MRI images of patients with uterine fibroids and urinary symptoms and of obtaining anatomical information unavailable in 2D imaging modalities. We also aimed to compare two image processing applications. We performed a feasibility study analysing MRI scans from three women, aged 30 to 58 years old, with fibroids and urinary symptoms. Cross-sectional images were used to render 3D models of pelvic anatomy, including bladder, uterus and fibroids, using [http://www.slicer.org '''3D Slicer'''] and OsiriX. Dimensions, volumes and anatomical relationships of the pelvic organs were evaluated. Comparisons between anatomical landmarks and measurements obtained from the two image processing applications were undertaken. Rendered 3D pelvic models yielded detailed anatomical information and data on spatial relationships that were unobtainable from cross-sectional images. Models were rendered in sufficient resolution to aid understanding of spatial relationships between urinary bladder, uterus and fibroid(s). Measurements of fibroid volumes ranged from 5,336 to 418,012 mm3 and distances between the fibroid and urinary bladder ranged from 0.10 to 83.60 mm. Statistical analysis of measurements showed no significant differences in measurements between the two image processing applications. To date, limited data exist on the use of 3D volume reconstructions of routine MRI scans, to investigate pelvic pathologies such as fibroids in women with urinary symptoms. This study suggests that post-MRI image processing can provide additional information over standard MRI. Further studies are required to assess the role of these data in clinical practice, surgical planning and training. Three-dimensional reconstruction of routine two-dimensional magnetic resonance imaging provides additional anatomical information and may improve our understanding of anatomical relationships, their role in clinical presentations and possibly guide clinical and surgical management.
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==The First Endovascular Rat Glioma Model for Pre-Clinical Evaluation of Intra-Arterial Therapeutics==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37157800 Interv Neuroradiol. 2023 May 8:15910199231169597. PMID: 37157800]

'''Authors:''' Lim J, Baig AA, Donnelly BM, Chaves LD, Pol SU, Koenigsknecht C, Pionessa D, Levy BR, Gutierrez L, Tutino VM, Levy EI, Siddiqui AH.

'''Institution:''' Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA.

'''Abstract:'''
Background: Several translational animal models have been described assessing intra-arterial (IA) treatments for malignant gliomas. We describe the first endovascular animal model that allows testing of IA drug delivery as a first-line treatment, which is difficult to do in actual patients. We report a unique protocol for vascular access and IA delivery in the rat model that, unlike prior reports, does not require direct puncture and opening of proximal cerebrovasculature which carries risk of ischemia in the animal brain post-delivery.

Methods: Wistar rats underwent left femoral artery catherization with a Balt Magic 1.2F catheter or Marathon Flow directed 1.5F Microcatheter with an Asahi Chikai 0.008 micro-guidewire which was navigated to the left internal carotid artery under x-ray. 25% mannitol was administered to test blood brain barrier breakdown (BBBB). Additional rats were implanted with C6 glioma cells in the left frontal lobe. C6 Glioma-Implanted Rats (C6GRs) were monitored for overall survival and tumor growth. Tumor volumes from MRI images were calculated utilizing [http://www.slicer.org '''3D Slicer''']. Additional rats underwent femoral artery catheterization with Bevacizumab, carboplatin, or irinotecan injected into the left internal carotid artery to test feasibility and safety.

Results: A successful endovascular access and BBBB protocol was established. BBBB was confirmed with positive Evans blue staining. 10 rats were successfully implanted with C6 gliomas with confirmed growths on MRI. Overall survival was 19.75 ± 2.21 days. 5 rats were utilized for the development of our femoral catheterization protocol and BBBB testing. With regards to IA chemotherapy dosage testing, control rats tolerated targeted 10 mg/kg of bevascizumab, 2.4 mg/kg of carboplatin, and 15 mg/kg of irinotecan IA ICA injections without any complications.

Conclusions: We present the first endovascular IA rat glioma model that allows selective catheterization of the intracranial vasculature and assessment of IA therapies for gliomas without need for access and sacrifice of proximal cerebrovasculature.
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==Muscle Magnetic Resonance Characterization of STIM1 Tubular Aggregate Myopathy Using Unsupervised Learning==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37155641 PLoS One. 2023 May 8;18(5):e0285422. PMID: 37155641] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10166478/pdf/pone.0285422.pd PDF]

'''Authors:''' Lupi A, Spolaor S, Favero A, Bello L, Stramare R, Pegoraro E, Nobile MS.

'''Institution:''' Institute of Radiology, Department of Medicine-DIMED, University of Padua, Padua, Italy.

'''Abstract:'''
Purpose: Congenital myopathies are a heterogeneous group of diseases affecting the skeletal muscles and characterized by high clinical, genetic, and histological variability. Magnetic Resonance (MR) is a valuable tool for the assessment of involved muscles (i.e., fatty replacement and oedema) and disease progression. Machine Learning is becoming increasingly applied for diagnostic purposes, but to our knowledge, Self-Organizing Maps (SOMs) have never been used for the identification of the patterns in these diseases. The aim of this study is to evaluate if SOMs may discriminate between muscles with fatty replacement (S), oedema (E) or neither (N).

Methods: MR studies of a family affected by tubular aggregates myopathy (TAM) with the histologically proven autosomal dominant mutation of the STIM1 gene, were examined: for each patient, in two MR assessments (i.e., t0 and t1, the latter after 5 years), fifty-three muscles were evaluated for muscular fatty replacement on the T1w images, and for oedema on the STIR images, for reference. Sixty radiomic features were collected from each muscle at t0 and t1 MR assessment using [http://www.slicer.org '''3D Slicer'''] software, in order to obtain data from images. A SOM was created to analyze all datasets using three clusters (i.e., 0, 1 and 2) and results were compared with radiological evaluation.

Results: Six patients with TAM STIM1-mutation were included. At t0 MR assessments, all patients showed widespread fatty replacement that intensifies at t1, while oedema mainly affected the muscles of the legs and appears stable at follow-up. All muscles with oedema showed fatty replacement, too. At t0 SOM grid clustering shows almost all N muscles in Cluster 0 and most of the E muscles in Cluster 1; at t1 almost all E muscles appear in Cluster 1.

Conclusion: Our unsupervised learning model appears to be able to recognize muscles altered by the presence of edema and fatty replacement.
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==Quantifying the Effect of an Endo-Vaginal Probe on Position of the Pelvic Floor Viscera and Muscles==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37145123 Int Urogynecol J. 2023 May 5. PMID: 37145123]

'''Authors:''' Chill HH, Martin LC, Abramowitch SD, Rostaminia G.

'''Institution:''' Female Pelvic Medicine and Reconstructive Surgery (FPMRS) Division, University of Chicago Pritzker School of Medicine, Northshore University HealthSystem, Skokie, IL, USA.

'''Abstract:'''
Introduction and hypothesis: Endovaginal ultrasound has long been hypothesized to have a significant effect on locations of what it visualizes. However, little work has directly quantified its effect. This study aimed to quantify it.

Methods: This cross-sectional study consisted of 20 healthy asymptomatic volunteers who underwent both endovaginal ultrasound and MRI. The urethra, vagina, rectum, pelvic floor, and pubic bone were segmented in both ultrasound and MRI using [http://www.slicer.org '''3D Slicer''']. Then, using [http://www.slicer.org '''3D Slicer''']'s transform tool the volumes were rigidly aligned based on the posterior curvature of the pubic bone. The organs were then split into thirds along their long axis to compare their distal, middle, and proximal sections. Using Houdini, we compared the location of the centroid of each of the urethra, vagina, and rectum and the surface-to-surface difference of the urethra and rectum. The anterior curvature of the pelvic floor was also compared. Normality of all variables was assessed by Shapiro-Wilk test.

Results: The largest amount of surface-to-surface distance was observed in the proximal region for the urethra and rectum. Across all three organs, the majority of the deviation was in the anterior direction for geometries obtained from ultrasound versus those from MRI. For each subject, the trace defining the midline of the levator plate was more anterior for ultrasound compared to MRI.

Conclusions: While it has often been assumed that placing a probe in the vagina probably distorts the anatomy, this study quantified the distortion and displacement of the pelvic viscera. This allows for better interpretation of clinical and research findings based on this modality.
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==Laser Interstitial Thermal Therapy in the Treatment of Brain Metastases: The Relationship Between Changes in Postoperative Magnetic Resonance Imaging Characteristics and Tumor Recurrence==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36823478 Acta Neurochir (Wien). 2023 May;165(5):1379-1387. PMID: 36823478]

'''Authors:''' Xue Z, Guan X, Yuan L, Kang P, Zhang C, Li D, Jia G, Jia W.

'''Institution:''' Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, China.

'''Abstract:'''
'''Background:''' Laser interstitial thermal therapy (LITT) has been used to treat brain metastases (BMs) in several countries, and its safety and effectiveness have been confirmed. In most cases, magnetic resonance imaging (MRI) reveals an increase in tumor volume with an enhanced margin after LITT. However, little is known about the relationship between this MRI change and tumor recurrence.

'''Objective:''' We report the first case series of BMs treated by LITT in China to evaluate the clinical characteristics and predictive factors of tumor recurrence.

'''Material and Methods:''' Patients with less than four brain metastatic lesions and a Karnofsky performance status (KPS) > 70 were eligible for study inclusion. Standard LITT procedures were performed, and a follow-up MRI was performed to analyze the radiographic changes, especially the volume ratio of the enhanced margin and the whole lesion on MRI at 30 days postoperatively. All the volume-related data were delineated and calculated using [http://www.slicer.org '''3D Slicer'''] software. Related predictors were also collected to evaluate the correlation with local tumor control.

'''Results:''' Eighteen patients with nineteen lesions were enrolled for treatment and follow-up. Primary tumor histology included pulmonary carcinoma (n = 11) and breast cancer (n = 4). On average, the tumor size measured 3.01 cm3 (range, 0.40-7.40 cm3), the total ablation time was 13.58 min (range, 2.88-37.15 min), and the complete ablation rate was 92.4% (range, 29.2-100%). Comparing 3s0-day follow-up MRI results with preoperative MRI findings, 18 lesions showed a 2.28-fold (range, 1.21-4.88) volume increase; all the lesions displayed an enhanced component with a volume ratio of 42.35% (range, 10.14-100%). Five patients experienced tumor recurrence, and the local tumor control rates at 90 days and 180 days of follow-up were 68.4% and 66.7%, respectively. Univariate analysis indicated that the primary tumor, ablation rate, and enhanced volume ratio (EVR) > 40% in the 30-day MRI were associated with tumor recurrence, whereas multivariate analysis showed that only EVR > 40% was a predictive factor of local control.

'''Conclusion:''' LITT is a minimally invasive method used to ablate brain metastases which can be used as the first-line treatment for BM patients under certain indications. After LITT, most tumors showed volume enlargement on the 30-day MRI scan, and EVR > 40% on the 30-day MRI may indicate late tumor recurrence.
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==Image Data and Computational Grids for Computing Brain Shift and Solving the Electrocorticography Forward Problem==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37128587/ Data Brief. 2023 Apr 7;48:109122. PMID: 37128587] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10147975/pdf/main.pdf PDF]

'''Authors:''' Zwick BF, Safdar S, Bourantas GC, Joldes GR, Hyde DE, Warfield SK, Wittek A, Miller K.

'''Institution:''' Intelligent Systems for Medicine Laboratory, The University of Western Australia, 35 Stirling Highway, Perth, WA, Australia.

'''Abstract:'''
This article describes the dataset applied in the research reported in NeuroImage article "Patient-specific solution of the electrocorticography forward problem in deforming brain" [1] that is available for download from the Zenodo data repository (https://zenodo.org/record/7687631) [2]. Preoperative structural and diffusion-weighted magnetic resonance (MR) and postoperative computed tomography (CT) images of a 12-year-old female epilepsy patient under evaluation for surgical intervention were obtained retrospectively from Boston Children's Hospital. We used these images to conduct the analysis at The University of Western Australia's Intelligent Systems for Medicine Laboratory using SlicerCBM [3], our open-source software extension for the [http://www.slicer.org '''3D Slicer'''] medical imaging platform. As part of the analysis, we processed the images to extract the patient-specific brain geometry; created computational grids, including a tetrahedral grid for the meshless solution of the biomechanical model and a regular hexahedral grid for the finite element solution of the electrocorticography forward problem; predicted the postoperative MRI and DTI that correspond to the brain configuration deformed by the placement of subdural electrodes using biomechanics-based image warping; and solved the patient-specific electrocorticography forward problem to compute the electric potential distribution within the patient's head using the original preoperative and predicted postoperative image data. The well-established and open-source file formats used in this dataset, including Nearly Raw Raster Data (NRRD) files for images, STL files for surface geometry, and Visualization Toolkit (VTK) files for computational grids, allow other research groups to easily reuse the data presented herein to solve the electrocorticography forward problem accounting for the brain shift caused by implantation of subdural grid electrodes.
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==ImFinite Element Analysis of a Healthy Knee Joint at Deep Squatting for the Study of Tibiofemoral and Patellofemoral Contact==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37143926 J Orthop. 2023 Apr 21;40:7-16. PMID: 37143926]

'''Authors:''' Kothurkar R, Lekurwale R, Gad M, Rathod CM.

'''Institution:''' Department of Mechanical Engineering, K. J. Somaiya College of Engineering, Mumbai, India.

'''Abstract:'''
Background: In non-western countries, deep squatting is a daily activity, and prolonged deep squatting is common among occupational squatters. Household tasks, taking a bath, socializing, using toilets, and performing religious acts are among the activities frequently carried out while squatting by the Asian population. High knee loading is responsible for a knee injury and osteoarthritis. Finite element analysis is an effective tool to determine stresses on the knee joint.

Methods: Magnetic Resonance Imaging (MRI) and Computed Tomographic (CT) images were acquired of one adult without knee injuries. The CT images were acquired at the fully extended knee and one more set of images was acquired with the knee at a deeply flexed knee position. The MRI was acquired with the fully extended knee. 3 Dimensional models of bones were created using CT and soft tissue using MRI with the help of [http://www.slicer.org '''3D Slicer'''] software. Kinematics and finite element analysis of the knee was performed for standing and deep squatting posture using Ansys Workbench 2022.

Results: High peak stresses were observed at deep squatting compared to standing along with the reduction in the contact area. Peak von Mises stresses on femoral cartilage, tibial cartilage, patellar cartilage, and meniscus were increased from 3.3 MPa to 19.9 MPa, 2.9 MPa to 12.4 MPa, 1.5 MPa to 16.7 MPa and 15.8 MPa to 32.8 MPa respectively during deep squatting. Posterior translation of 7.01 mm, and 12.58 mm was observed for medial and lateral femoral condyle respectively from full extension to 153° knee flexion.

Conclusions: Increased stresses in the knee joint at deep squat posture may cause cartilage damage. A sustained deep squat posture should be avoided for healthy knee joints. More posterior translations of the medial femoral condyle at higher knee flexion angle warrant further investigation.
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==A Comparison of Machine Learning Models for Survival Prediction of Patients with Glioma Using Radiomic Features from MRI Scans==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37362372/ Indian J Radiol Imaging. 2023 Apr 28;33(3):338-343. PMID: 37362372] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10289839/pdf/10-1055-s-0043-1767786.pdf PDF]

'''Authors:''' Manjunath M, Saravanakumar S, Kiran S, Chatterjee J.

'''Institution:''' Department of Biotechnology, People's Education Society University, Bangalore, Karnataka, India.

'''Abstract:'''
Background Glioma is a primary, malignant, highly aggressive brain tumor, with patients having an average life expectancy of 14 to 16 months after diagnosis. Magnetic resonance imaging (MRI) scans of these patients can be used to extract and analyze quantifiable features with potential clinical significance. We hypothesize that there is a correlation between radiomic features extracted from MRI scans and survival. Along with clinical data, the radiomic features could be used in survival prediction of patients, providing beneficial information for clinicians to design personalized treatment plans. Methods In our study, we have utilized [http://www.slicer.org '''3D Slicer'''] for tumor segmentation and feature extraction and performed survival prediction of patients with glioma using four different machine learning models. Results and Conclusion Among the models compared, we have achieved a maximum prediction accuracy of 64.4% using the k-nearest neighbors model, which was trained and tested on a combination of clinical data and radiomic features extracted from MRI images provided in the BraTS 2020 dataset.
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==Circular RNA hsa_circ_0000690 as a Potential Biomarker for Diagnosis and Prognosis of Intracranial Aneurysm: Closely Relating to the Volume of Hemorrhage==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36879365 Brain Behav. Apr;13(4):e2929. PMID: 36879365] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10097068/pdf/BRB3-13-e2929.pdf PDF]

'''Authors:'''Huang Y, Cao H, Qi X, Guan C, Que S.

'''Institution:''' Department of Neurosurgery, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, Fujian, China.

'''Abstract:'''

'''Purpose:''' This study aimed to explore circular RNA (circRNA) hsa_circ_0000690 as a potential biomarker for diagnosis and prognosis of intracranial aneurysm (IA) and its relationship with clinical factors and complications of IA.

'''Material/Methods:''' 216 IA patients admitted to the neurosurgery department of our hospital from January 2019 to December 2020 were selected as the experimental group, and 186 healthy volunteers were selected as the control group. The expression of hsa_circ_0000690 in peripheral blood was detected by quantitative real-time PCR, and its diagnostic value was assessed by receiver operating characteristic curve. Relationship between hsa_circ_0000690 and clinical factors of IA was assessed by chi-square test. Nonparametric test was used in univariate analysis, and regression analysis was used in multivariate analysis. Multivariate Cox proportional hazards regression analysis was used to analyze the survival time.

'''Results:''' CircRNA hsa_circ_0000690 of IA patients was relatively lower than that in the control group (p < .001). The AUC of hsa_circ_0000690 was 0.752, the specificity was 0.780, and sensitivity was 0.620, with diagnostic threshold of 0.0449. In addition, hsa_circ_0000690 expression was correlated with Glasgow Coma Scale, the volume of subarachnoid hemorrhage, modified Fisher scale, Hunt-Hess levels and surgical type. For hydrocephalus and delayed cerebral ischemia, hsa_circ_0000690 was significant in univariate analysis, but nonsignificant in multivariate analysis. For prognosis, hsa_circ_0000690 was significantly associated with modified Rankin Scales after surgery for 3 months, but not associated with survival time.

'''Conclusions:''' The expression of hsa_circ_0000690 can act as a diagnostic marker for IA and predict the prognosis of 3 months after operation and is closely related to the volume of hemorrhage.

'''Keywords:''' [http://www.slicer.org '''3D Slicer''']; biomarker; circRNA; diagnosis; intracranial aneurysm; prognosis; subarachnoid hemorrhage
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==Can Quantitative Peritumoral CT Radiomics Features Predict the Prognosis of Patients With Non-Small Cell Lung Cancer? A Systematic Review==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36307554 Eur Radiol. 2023 Mar;33(3):2105-17. PMID: 36307554] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9935659/pdf/330_2022_Article_9174.pdf PDF]

'''Authors:''' Wu L, Lou X, Kong N, Xu M, Gao C.

'''Institution:''' Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China.

'''Abstract:''' Objectives: To provide an overarching evaluation of the value of peritumoral CT radiomics features for predicting the prognosis of non-small cell lung cancer and to assess the quality of the available studies.

'''Methods:''' The PubMed, Embase, Web of Science, and Cochrane Library databases were searched for studies predicting the prognosis in patients with non-small cell lung cancer (NSCLC) using CT-based peritumoral radiomics features. Information about the patient, CT-scanner, and radiomics analyses were all extracted for the included studies. Study quality was assessed using the Radiomics Quality Score (RQS) and the Prediction Model Risk of Bias Assessment Tool (PROBAST).

'''Results:''' Thirteen studies were included with 2942 patients from 2017 to 2022. Only one study was prospective, and the others were all retrospectively designed. Manual segmentation and multicenter studies were performed by 69% and 46% of the included studies, respectively. [http://www.slicer.org '''3D Slicer'''] and MATLAB software were most commonly used for the segmentation of lesions and extraction of features. The peritumoral region was most frequently defined as dilated from the tumor boundary of 15 mm, 20 mm, or 30 mm. The median RQS of the studies was 13 (range 4-19), while all of included studies were assessed as having a high risk of bias (ROB) overall.

'''Conclusions:''' Peritumoral radiomics features based on CT images showed promise in predicting the prognosis of NSCLC, although well-designed studies and further biological validation are still needed.

'''Key points:''' Peritumoral radiomics features based on CT images are promising and encouraging for predicting the prognosis of non-small cell lung cancer. The peritumoral region was often dilated from the tumor boundary of 15 mm or 20 mm because these were considered safe margins. The median Radiomics Quality Score of the included studies was 13 (range 4-19), and all of studies were considered to have a high risk of bias overall.
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==Three Dimensional Assessment of Radiographic Changes after Indirect Pulp Capping using Silver Diamine Fluoride with or without Potassium Iodide in Young Permanent Teeth (12-month RCT)==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36878216 Caries Res. 2023;57(2):177-188. PMID: 36878216]

'''Authors:''' Baraka MMAL, Cevidanes L, Tekeya M, Bakry N, Ruellas A, Botero T, Benavides E, Fontana M.

'''Institution:''' Department of Experimental Oncology, European Institute of Oncology, IRCCS, 20139 Milan, Italy.

'''Abstract:''' The aim was to have a three-dimensional evaluation of radiographic changes after indirect pulp capping (IPC) with silver diamine fluoride (SDF) with or without potassium iodide (KI) and resin modified glass ionomer cement (RMGIC) in deep carious young permanent molars using cone beam computed tomography (CBCT). 108 first permanent molars with deep occlusal cavitated caries lesions, in forty-nine 6-9-year-old children, were randomly allocated to one of 3 groups (n=36) and treated with SDF+KI, SDF and RMGIC as IPC materials. CBCT scans were taken at 0 and at 12-months to assess tertiary dentin formation (volume and grey level intensity), increase in root length, and pathological changes as secondary caries, periapical radiolucency, internal resorption and obliteration of the pulp. The three-dimensional image analysis procedures were performed using ITK-SNAP and [http://www.slicer.org '''3D Slicer'''] CMF. Comparisons were made using analysis of variance with a fixed effect for treatment and random effects for patient, and patient-by-treatment to account for within-patient correlations. A two-sided 5% significance level was used. There were no significant differences among the three groups regarding tertiary dentin volume (p=0.712) and grey level intensity (p=0.660), increase in root length (p=0.365), prevention of secondary caries (p=0.63) and periapical radiolucency (p=0.80) in the analysed 69 CBCT scans. The study did not find differences among the groups regarding quality and quantity of tertiary dentin formed, increase in root length, absence of secondary caries and other signs of failure as shown by CBCT.

'''Clinical Significance:''' The results show no significant differences in radiographic outcomes (quality and quantity of tertiary dentin formed, increase in root length, absence of secondary caries and other signs of failure) when using SDF+KI, SDF and RMGIC in IPC. The results of this study can help guide treatment decision making regarding use of SDF and SDF+KI as IPC materials in deep cavitated lesions.
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==Cross-Sectional Reliability and Concurrent Validity of a Quantitative 2-Dimensional Ultrasound Image Analysis of Effusion and Synovial Hypertrophy in Knee Osteoarthritis==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37008822/ Osteoarthr Cartil Open. 2023 Mar 16;5(2):100356. PMID: 37008822] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10060736/pdf/main.pdf PDF]

'''Authors:''' Dima R, Birmingham TB, Philpott HT, Bryant D, Fenster A, Appleton CT.

'''Institution:''' Faculty of Health Sciences, University of Western Ontario, London, ON, Canada.

'''Abstract:'''
Objective: Effusion-synovitis is related to pain and progression in knee osteoarthritis (OA), but current gold standard ultrasound (US) measures are limited to semi-quantitative grading of joint distension or 1-dimensional thickness measures. A novel quantitative 2-dimensional image analysis methodology is applied to US images of effusion-synovitis; reliability and concurrent validity was assessed in patients with knee OA.

Methods: Cross sectional analysis of US images collected from 51 patients with symptomatic knee OA were processed in ImageJ and segmented in [http://www.slicer.org '''3D Slicer'''] to produce a binary mask of the supra-patellar synovitis region of interest (ROI). Area measures (mm2) of total synovitis, effusion and hypertrophy components were exported. Intra-rater reliability and test-retest reliability (1-14 days washout) were estimated with intra-class correlation coefficients (ICCs). Concurrent validity was measured by Spearman correlations between quantitative measures and gold standard OMERACT and caliper measurements of synovitis.

Results: Intra-rater reliability for hypertrophy area was estimated at 0.98, 0.99 for effusion area, and 0.99 for total synovitis area. The test-retest reliability for total synovitis area was 0.63 (SEM 87.8 mm2), 0.59 for hypertrophy area (SEM 21.0 mm2), and 0.64 for effusion area (SEM 73.8 mm2). Correlation between total synovitis area and OMERACT grade was 0.84, 0.81 between total synovitis area and effusion-synovitis calipers, and 0.81 between total effusion area and effusion calipers.

Conclusion: This new research tool for image analysis demonstrated excellent intra-rater reliability, good concurrent validity, and moderate test-retest reliability. Quantitative 2D US measures of effusion-synovitis and its individual components may enhance the study and management of knee OA.
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==Patient-Specific Needle Guidance Templates Drilled Intraprocedurally for Image Guided Intervention: Feasibility Study in Swine==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36173542 Int J Comput Assist Radiol Surg. 2023 Mar;18(3):537-44. PMID: 36173542]

'''Authors:''' Glossop N, Bale R, Xu S, Pritchard WF, Karanian JW, Wood BJ.

'''Institution:''' Queen's University, Kingston, ON, Canada.

'''Abstract:'''
'''purpose:''' Thermal ablation of large tumors may benefit from simultaneous placement of multiple needles, but accurate placement becomes challenging as the number of needles increases. The aim of this work was to evaluate use of personalized needle guidance grid templates based on intraprocedural CT and fabricated at the point of care to implement ablation treatment plans with multiple needles in vivo.

'''Methods:''' A plastic frame was designed to hold two parallel plastic guide plates in a rigid relationship, fixed over the abdomen by a mounting arm. Steel ball targets (1.5 mm) were implanted under ultrasound in the livers of two domestic swine under general anesthesia. Following breath-hold CT of the subject and frame, the targets and frame were identified using customized [http://www.slicer.org '''3D Slicer''']-based planning software. Multiple needle trajectories targeting the balls were planned, including complex off-plane trajectories. A machining program for drilling the hole pattern corresponding to the planned needle trajectories was generated. The pattern was drilled in the two plates with a numerical-controlled milling machine in the suite. The plates were attached to the frame and needles passed through the paired holes to the calculated depth. Placement accuracy was defined as needle tip-to-target distance on post-placement CT.

'''Results:''' The planning process and manufacturing required approximately 6 and 15 min, respectively. Needles were rapidly inserted (n = 11) to the target points without complications or traversing nontarget anatomy. The mean needle tip-to-target distance error was 3.4 ± 2.2, range 0-7 mm.

'''Conclusion:''' Rapid and accurate needle placement was feasible using a subject-specific, custom-drilled, needle guidance grid template fabricated intraprocedurally. Targeting accuracy and performance were similar to more complex and expensive tracking systems which may enable accurate intraprocedural implementation of treatment plans in the liver or other organs. This may be of value in complex ablation cases or in areas where more advanced guidance systems are not available.
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==Automatic Landmark Identification in Cone-Beam Computed Tomography==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36811276 Orthod Craniofac Res. 2023 Feb 21. PMID: 36811276]

'''Authors:''' Gillot M, Miranda F, Baquero B, Ruellas A, Gurgel M, Al Turkestani N, Anchling L, Hutin N, Biggs E, Yatabe M, Paniagua B, Fillion-Robin JC, Allemang D, Bianchi J, Cevidanes L, Prieto JC.

'''Institution:''' Department of Orthodontics and Pediatric Dentistry, School of Dental Medicine, University of Michigan, Ann Arbor, MI, USA.

'''Abstract:'''
'''Objective:''' To present and validate an open-source fully automated landmark placement (ALICBCT) tool for cone-beam computed tomography scans.

'''Material and Methods:''' One hundred and forty-three large and medium field of view cone-beam computed tomography (CBCT) were used to train and test a novel approach, called ALICBCT that reformulates landmark detection as a classification problem through a virtual agent placed inside volumetric images. The landmark agents were trained to navigate in a multi-scale volumetric space to reach the estimated landmark position. The agent movements decision relies on a combination of DenseNet feature network and fully connected layers. For each CBCT, 32 ground truth landmark positions were identified by 2 clinician experts. After validation of the 32 landmarks, new models were trained to identify a total of 119 landmarks that are commonly used in clinical studies for the quantification of changes in bone morphology and tooth position.

'''Results:''' Our method achieved a high accuracy with an average of 1.54±0.87 mm error for the 32 landmark positions with rare failures, taking an average of 4.2s computation time to identify each landmark in one large 3D-CBCT scan using a conventional GPU.

'''Conclusion:''' The ALICBCT algorithm is a robust automatic identification tool that has been deployed for clinical and research use as an extension in the 3D Slicer platform allowing continuous updates for increased precision.
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==Development and In-Silico and Ex-Vivo Validation of a Software for a Semi-Automated Segmentation of the Round Window Niche to Design a Patient Specific Implant to Treat Inner Ear Disorders==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36826970 J Imaging. 2023 Feb 20;9(2):51. PMID: 36826970] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9965310/pdf/jimaging-09-00051.pdf PDF]

'''Authors:''' Matin-Mann F, Gao Z, Wei C, Repp F, Artukarslan EN, John S, Alcacer Labrador D, Lenarz T, Scheper V.

'''Institution:''' Lower Saxony Center for Biomedical Engineering, Implant Research and Development (NIFE), Department of Otorhinolaryngology, Head and Neck Surgery, Hannover Medical School, Hannover, Germany.

'''Abstract:''' The aim of this study was to develop and validate a semi-automated segmentation approach that identifies the round window niche (RWN) and round window membrane (RWM) for use in the development of patient individualized round window niche implants (RNI) to treat inner ear disorders. Twenty cone beam computed tomography (CBCT) datasets of unilateral temporal bones of patients were included in the study. Defined anatomical landmarks such as the RWM were used to develop a customized [http://www.slicer.org '''3D Slicer'''] plugin for semi-automated segmentation of the RWN. Two otolaryngologists (User 1 and User 2) segmented the datasets manually and semi-automatically using the developed software. Both methods were compared in-silico regarding the resulting RWM area and RWN volume. Finally, the developed software was validated ex-vivo in N = 3 body donor implantation tests with additively manufactured RNI. The independently segmented temporal bones of the different Users showed a strong consistency in the volume of the RWN and the area of the RWM. The volume of the semi-automated RWN segmentations were 48 ± 11% smaller on average than the manual segmentations and the area of the RWM of the semi-automated segmentations was 21 ± 17% smaller on average than the manual segmentation. All additively manufactured implants, based on the semi-automated segmentation method could be implanted successfully in a pressure-tight fit into the RWN. The implants based on the manual segmentations failed to fit into the RWN and this suggests that the larger manual segmentations were over-segmentations. This study presents a semi-automated approach for segmenting the RWN and RWM in temporal bone CBCT scans that is efficient, fast, accurate, and not dependent on trained users. In addition, the manual segmentation, often positioned as the gold-standard, actually failed to pass the implantation validation.
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==Design and Analysis of HSC-BPPV Diagnostic Maneuver Based on Virtual Simulation==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36873445 Front Neurol. 2023 Feb 17;14:1132343. PMID: 36873445] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9981954/pdf/fneur-14-1132343.pdf PDF]

'''Authors:''' Li Y, Yang X.

'''Institution:''' Department of Research Center, Third Affiliated Hospital of Shanghai University, Wenzhou Third Clinical Institute Affiliated to Wenzhou Medical University, Wenzhou People's Hospital, Wenzhou, China.

'''Abstract:'''
'''Background:''' The preferred supine roll test for the diagnosis of horizontal semicircular canal BPPV has several disadvantages, including difficulty in locating the affected ear, inconsistent nystagmus performance on repeated testing, and lack of a typical latency period, resulting in insensitive diagnosis.

Objectives: To investigate novel diagnostic techniques with more scientific design, more accessible application, and better diagnostic sensitivity and specificity.

'''Materials and Methods:''' Based on clinical microscopic CT data, we created a virtual simulation model of BPPV using Unity software. The physical simulation of the traditional supine roll test was performed to observe and analyse the movement of the otoliths, whose initial position was the typical stable position. In addition, the normal vectors of the plane and crista ampullaris of the horizontal semicircular canal were measured using [http://www.slicer.org '''3D Slicer'''] software. Based on this, we analyzed the critical steps for designing diagnostic maneuvers for BPPV in the horizontal semicircular canal. For a more accurate diagnosis of horizontal semicircular canal BPPV, it is critical to rotate the horizontal semicircular canal to be parallel to gravity. It is also necessary to move the otolith by swinging the head. As a result, we developed two diagnostic maneuvers: the 60° roll test and the prone roll test. We also performed simulations to observe otolith movement and predict nystagmus performance.

'''Conclusions:''' The 60° roll test and the prone roll test can complement the supine roll test. Compared to the supine roll test, they not only effectively differentiate canalolithiasis from cupulolithiasis, but also make it easier to determine the position of the otoliths, and the characteristics of the nystagmus are more pronounced. Significant diagnostic features have significant potential benefits for home and telemedicine.
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==The Simplified Tailor-Made Workflows for a [http://www.slicer.org '''3D Slicer''']-Based Craniofacial Implant Design==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36801943 Sci Rep. 2023 Feb 17;13(1):2850. PMID: 36801943] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9938178/pdf/41598_2023_Article_30117.pdf PDF]

'''Authors:''' Tantisatirapong S, Khunakornpattanakarn S, Suesatsakul T, Boonpratatong A, Benjamin I, Tongmeesee S, Kangkorn T, Chanwimalueang

'''Institution:''' Department of Biomedical Engineering, Faculty of Engineering, Srinakharinwirot University, Nakhon Nayok, Thailand.

'''Abstract:''' A specific design of craniofacial implant model is vital and urgent for patients with traumatic head injury. The mirror technique is commonly used for modeling these implants, but it requires the presence of a healthy skull region opposite to the defect. To address this limitation, we propose three processing workflows for modeling craniofacial implants: the mirror method, the baffle planner, and the baffle-based mirror guideline. These workflows are based on extension modules on the [http://www.slicer.org '''3D Slicer'''] platform and were developed to simplify the modeling process for a variety of craniofacial scenarios. To evaluate the effectiveness of these proposed workflows, we investigated craniofacial CT datasets collected from four accidental cases. The designed implant models were created using the three proposed workflows and compared to reference models created by an experienced neurosurgeon. The spatial properties of the models were evaluated using performance metrics. Our results show that the mirror method is suitable for cases where a healthy skull region can be completely reflected to the defect region. The baffle planner module offers a flexible prototype model that can be fit independently to any defect location, but it requires customized refinement of contour and thickness to fill the missing region seamlessly and relies on the user's experience and expertise. The proposed baffle-based mirror guideline method strengthens the baffle planner method by tracing the mirrored surface. Overall, our study suggests that the three proposed workflows for craniofacial implant modeling simplify the process and can be practically applied to a variety of craniofacial scenarios. These findings have the potential to improve the care of patients with traumatic head injuries and could be used by neurosurgeons and other medical professionals.
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==Predicting Transient Ischemic Attack Risk in Patients With Mild Carotid Stenosis Using Machine Learning and CT Radiomics==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36846119 Front Neurol. 2023 Feb 8;14:1105616. PMID: 36846119] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9944715/pdf/fneur-14-1105616.pdf PDF]

'''Authors:''' Xia H, Yuan L, Zhao W, Zhang C, Zhao L, Hou J, Luan Y, Bi Y, Feng Y.

'''Institution:''' Department of Vascular Surgery, The First Affiliated Hospital of Kunming Medical University, Kunming, China.

'''Abstract:'''
'''Objective:''' This study aims to establish a radiomics-based machine learning model that predicts the risk of transient ischemic attack in patients with mild carotid stenosis (30-50% North American Symptomatic Carotid Endarterectomy Trial) using extracted computed tomography radiomics features and clinical information.

'''Methods:''' A total of 179 patients underwent carotid computed tomography angiography (CTA), and 219 carotid arteries with a plaque at the carotid bifurcation or proximal to the internal carotid artery were selected. The patients were divided into two groups; patients with symptoms of transient ischemic attack after CTA and patients without symptoms of transient ischemic attack after CTA. Then we performed random sampling methods stratified by the predictive outcome to obtain the training set (N = 165) and testing set (N = 66). [http://www.slicer.org '''3D Slicer'''] was employed to select the site of plaque on the computed tomography image as the volume of interest. An open-source package PyRadiomics in Python was used to extract radiomics features from the volume of interests. The random forest and logistic regression models were used to screen feature variables, and five classification algorithms were used, including random forest, eXtreme Gradient Boosting, logistic regression, support vector machine, and k-nearest neighbors. Data on radiomic feature information, clinical information, and the combination of these pieces of information were used to generate the model that predicts the risk of transient ischemic attack in patients with mild carotid artery stenosis (30-50% North American Symptomatic Carotid Endarterectomy Trial).

'''Results:''' The random forest model that was built based on the radiomics and clinical feature information had the highest accuracy (area under curve = 0.879; 95% confidence interval, 0.787-0.979). The combined model outperformed the clinical model, whereas the combined model showed no significant difference from the radiomics model.

'''Conclusion:''' The random forest model constructed with both radiomics and clinical information can accurately predict and improve discriminative power of computed tomography angiography in identifying ischemic symptoms in patients with carotid atherosclerosis. This model can aid in guiding the follow-up treatment of patients at high risk.
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==Deep Learning Enabled Multi-Organ Segmentation of Mouse Embryos==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36802342 Biol Open. 2023 Feb 15;12(2):bio059698. PMID: 36802342] | [https://cob.silverchair-cdn.com/cob/content_public/journal/bio/12/2/10.1242_bio.059698/2/bio059698.pdf PDF]

'''Authors:''' Rolfe SM, Whikehart SM, Maga AM.

'''Institution:''' Center for Developmental Biology and Regenerative Medicine, Seattle Children's Research Institute, Seattle, WA, USA.

'''Abstract:''' The International Mouse Phenotyping Consortium (IMPC) has generated a large repository of three-dimensional (3D) imaging data from mouse embryos, providing a rich resource for investigating phenotype/genotype interactions. While the data is freely available, the computing resources and human effort required to segment these images for analysis of individual structures can create a significant hurdle for research. In this paper, we present an open source, deep learning-enabled tool, Mouse Embryo Multi-Organ Segmentation (MEMOS), that estimates a segmentation of 50 anatomical structures with a support for manually reviewing, editing, and analyzing the estimated segmentation in a single application. MEMOS is implemented as an extension on the [http://www.slicer.org '''3D Slicer'''] platform and is designed to be accessible to researchers without coding experience. We validate the performance of MEMOS-generated segmentations through comparison to state-of-the-art atlas-based segmentation and quantification of previously reported anatomical abnormalities in a Cbx4 knockout strain. This article has an associated First Person interview with the first author of the paper.
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==Development and Validation of an 18FFDG-PET/CT Radiomic Model for Predicting Progression-Free Survival for Patients With Stage II - III Thoracic Esophageal Squamous Cell Carcinoma Who Are Treated With Definitive Chemoradiotherapy==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36794365 Acta Oncol. 2023 Feb;62(2):159-65. PMID: 36794365]

'''Authors:''' Takahashi N, Tanaka S, Umezawa R, Takanami K, Takeda K, Yamamoto T, Suzuki Y, Katsuta Y, Kadoya N, Jingu K.

'''Institution:''' Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Japan.

'''Abstract:'''
'''Background:''' Radiomics is a method for extracting a large amount of information from images and used to predict treatment outcomes, side effects and diagnosis. In this study, we developed and validated a radiomic model of [18F]FDG-PET/CT for predicting progression-free survival (PFS) of definitive chemoradiotherapy (dCRT) for patients with esophageal cancer.

'''Material and Methods:''' Patients with stage II - III esophageal cancer who underwent [18F]FDG-PET/CT within 45 days before dCRT between 2005 and 2017 were included. Patients were randomly assigned to a training set (85 patients) and a validation set (45 patients). Radiomic parameters inside the area of standard uptake value ≥ 3 were calculated. The open-source software [http://www.slicer.org '''3D Slicer'''] and Pyradiomics were used for segmentation and calculating radiomic parameters, respectively. Eight hundred sixty radiomic parameters and general information were investigated.In the training set, a radiomic model for PFS was made from the LASSO Cox regression model and Rad-score was calculated. In the validation set, the model was applied to Kaplan-Meier curves. The median value of Rad-score in the training set was used as a cutoff value in the validation set. JMP was used for statistical analysis. RStudio was used for the LASSO Cox regression model. p < 0.05 was defined as significant.

'''Results:''' The median follow-up periods were 21.9 months for all patients and 63.4 months for survivors. The 5-year PFS rate was 24.0%. In the training set, the LASSO Cox regression model selects 6 parameters and made a model. The low Rad-score group had significantly better PFS than that the high Rad-score group (p = 0.019). In the validation set, the low Rad-score group had significantly better PFS than that the high Rad-score group (p = 0.040).

'''Conclusions:''' The [18F]FDG-PET/CT radiomic model could predict PFS for patients with esophageal cancer who received dCRT.
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==Minimizing Magnetic Resonance Image Geometric Distortion at 7 Tesla for Frameless Presurgical Planning Using Skin-Adhered Fiducials==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36301228 Med Phys. 2023 Feb;50(2):694-701. PMID: 36301228]

'''Authors:''' Kirby KM, Koons EK, Welker KM, Fagan AJ.

'''Institution:''' Department of Radiology, Mayo Clinic, Rochester, MN, USA.

'''Abstract:'''
'''Background:''' 7T MRI offers significant benefits to spatial and contrast resolution compared to lower field strengths. This superior image quality can help better delineate targets in stereotactic neurosurgical procedures; however, the potential for increased geometric distortions at 7T has impaired its widespread use for these applications. Image geometric distortions can be due to distortions of B0 arising from tissue magnetic susceptibility effects or inherent field inhomogeneities, and nonlinearity of the magnetic field gradients.

'''Purpose:''' The purpose of this study was to investigate the use of 7T MRI for neurosurgical frameless stereotactic navigation procedures. Image geometric distortions at the skin surface in 7T images were minimized and compared to results from clinical 3T frameless imaging protocols.

'''Methods:''' A 3D-printed grid phantom filled with oil was designed to perform a fine calibration of the 7T imaging gradients, and an oil-filled head phantom with internal targets was used to determine ground truth (from computed tomography [CT]) positioning errors. Three volunteers and the head phantom were imaged consecutively at 3T and 7T. Ten skin-adhesive fiducial markers were placed on each subject's exposed skin surface at standard clinical placement locations for frameless procedures. Imaging sequences included MPRAGE (three bandwidths at 7T: 400, 690, and 1020 Hz/pixel, and one at 3T: 400 Hz/pixel), T2 SPACE, and T2 SPACE FLAIR acquisitions. An additional GRE field map was acquired on both scanners using a multi-echo GRE sequence. Custom Matlab code was used to perform additional distortion correction of the images using the unwrapped field maps. Fiducial localization was performed with [http://www.slicer.org '''3D Slicer'''], with absolute fiducial positioning errors determined in phantom experiments following rigid registration to the CT images. For human experiments, 3T and 7T images were registered and relative differences in fiducial locations were compared using two-tailed paired t-tests.

'''Results:''' Phantom measurements at 7T yielded gradient distance scaling errors of 1.1%, 2.2%, and 1.0% along the x-, y-, and z-axes, respectively. These system miscalibrations were traced back to phantom manufacturing deviations in the sphericity of the vendor's gradient calibration phantom. Correction factors along each gradient axis were applied, and afterward, geometric distortions of less than 1 mm were obtained in the 7T MR head phantom images for the 1020 Hz/pixel bandwidth MPRAGE sequence. For the human subjects, four fiducial locations were excluded from the analysis due to patient positioning differences. Differences between 3T and 7T MPRAGE with low/medium/high bandwidth were 2.2 /2.6/2.3 mm, respectively, before the correction, reducing to 1.6/1.3/1.0 mm after the correction (p < 0.001). T2 SPACE and T2 SPACE FLAIR yielded a similar pattern when the correction was applied, decreasing from 2.1 to 0.8 mm, and 2.6 to 1.0 mm, respectively.

'''Conclusions:''' 7T MRI can be used to perform frameless presurgical planning with skin-adhesive fiducials. Geometric distortions can be reduced to a clinically relevant level (errors < ∼1 mm) with no significant susceptibility-related distortions, by using high receiver bandwidth, ensuring gradients are properly calibrated, and placing skin fiducials in areas where distortions from patient positioning are minimal.
|}

==Acute Colonic Pseudo-Obstruction Secondary to Renal Calculus: A Case Report and Review of Pathophysiology==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36777972 Cureus. 2023 Feb 7;15(2):e34756. PMID: 36777972] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9905947/pdf/cureus-0015-00000034756.pdf PDF]

'''Authors:''' Gillies M, AlDujaili T.

'''Institution:''' General Surgery, Goulburn Valley Health, Shepparton, Australia

'''Abstract:''' Acute colonic pseudo-obstruction (ACPO) is obstruction of the large bowel without a mechanical cause. The exact mechanism remains incompletely understood but is thought to result from disruption to the autonomic regulation of the colon, typically in the context of hospitalized patients with medical illness, precipitating medications, or recent surgical intervention. This paper presents an unusual case of ACPO in an ambulatory patient with a recently passed renal calculus, explores the anatomy and physiology underlying the autonomic dysfunction theory of ACPO pathogenesis in the context of the case, and provides a 3D reconstruction of the patient's CT to illustrate the abrupt caliber change at the splenic flexure characteristic of ACPO.

'''Keywords:''' 3d reconstruction; acute colonic pseudo-obstruction; ogilvie's syndrome; renal calculi; [http://www.slicer.org '''3D Slicer'''] software.
|}

==A Novel Stereotactic Aspiration Technique for Intracerebral Hemorrhage==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36270590 World Neurosurg. 2023 Feb;170:e28-e36. PMID: 36270590]

'''Authors:''' Xu HZ, Guo J, Wang C, Liu X, Song ZQ, Chen RF, Qiu B, Wang Q, Huang Y.

'''Institution:''' Department of Neurosurgery, Civil Aviation General Hospital, Beijing, China.

'''Abstract:'''

'''Background:''' Minimally invasive surgery is effective and recommended for treatment of intracerebral hemorrhage; however, neurosurgeons in grass-root hospitals in underdeveloped countries lack effective and precise minimally invasive surgery techniques. The aim of this study was to present a technique of computed tomography angiography-based three-dimensional-printed navigation mold-guided stereotactic aspiration and demonstrate its clinical application using a hard needle in a series of patients.

'''Methods:''' The novel stereotactic aspiration technique was performed in 18 patients with spontaneous intracerebral hemorrhage at our center, and clinical outcomes were reported. We compared the volume of hematoma measured by 3 different methods: ABC/2 formula, manual segmentation with OsiriX, and manual segmentation with [http://www.slicer.org '''3D Slicer'''].

'''Results:''' The surgery was completed safely within an average operative time of 15.11 minutes, achieving the goal of <15 mL residual clot volume or >70% clot removal in all patients. No intracranial rebleeding or infection was observed postoperatively. At the end of the 6-month follow-up, 61.11% (11/18) of patients achieved a modified Rankin Scale score <3. There was overall better agreement of hematoma measurement using segmentation with [http://www.slicer.org '''3D Slicer'''] rather than ABC/2 measurement or hematoma measurement using segmentation with OsiriX.

'''Conclusions:''' Our novel method of stereotactic aspiration benefited patients in this study with good percent clot removal, few surgery-related complications, and a favorable prognosis. Manual segmentation with [http://www.slicer.org '''3D Slicer'''] could be used to provide the neurosurgeon with dependable information about hematoma volume. This cheap and convenient technique may be applied in grass-root hospitals in underdeveloped countries. Assessment in multicenter prospective clinical trials is needed.
|}

==Morphological Evaluation of the Normal and Hydrocephalic Third Ventricle on Cranial Magnetic Resonance Imaging in Children: A Retrospective Study==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35994062 Pediatr Radiol. 2023 Feb;53(2):282-96. PMID: 35994062]

'''Authors:''' Isıklar S, Turan Ozdemir S, Ozkaya G, Ozpar R, Parlak M.

'''Institution:''' Medical Imaging Techniques Program, Vocational School of Health Services, Bursa Uludag University, 16240, Bursa, Turkey.

'''Abstract:'''
'''Background:''' Third ventricle morphological changes reflect changes in the ventricular system in pediatric hydrocephalus, so visual inspection of the third ventricle shape is standard practice. However, normal pediatric reference data are not available.

'''Objective:''' To investigate both the normal development of the third ventricle in the 0-18-year age group and changes in its biometry due to hydrocephalus.

'''Materials and Methods:''' For this retrospective study, we selected individuals ages 0-18 years who had magnetic resonance imaging (MRI) from 2012 to 2020. We included 700 children (331 girls) who had three-dimensional (3-D) T1-weighted sequences without and 25 with hydrocephalus (11 girls). We measured the distances between the anatomical structures limiting the third ventricle by dividing the third ventricle into anterior and posterior regions. We made seven linear measurements and three index calculations using 3DSlicer and MRICloud pipeline, and we analyzed the results of 23 age groups in normal and hydrocephalic patients using SPSS (v. 23).

'''Results:''' Salient findings are: (1) The posterior part of the third ventricle is more affected by both developmental and hydrocephalus-related changes. (2) For third ventricle measurements, gender was insignificant while age was significant. (3) Normal third ventricular volumetric development showed a segmental increase in the 0-18 age range. The hydrocephalic third ventricle volume cut-off value in this age group was 3 cm3.

'''Conclusion:''' This study describes third ventricle morphometry using a linear measurement method. The ratios defined in the midsagittal plane were clinically useful for diagnosing the hydrocephalic third ventricle. The linear and volumetric reference data and ratios are expected to help increase diagnostic accuracy in distinguishing normal and hydrocephalic third ventricles.
|}

==Henri IV of France's Larynx 3D Reconstitution==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36149490 Eur Arch Otorhinolaryngol. 2023 Feb;280(2):919-24. PMID: 36149490]

'''Authors:''' Baudouin R, Amelot A, Laprie Y, Crevier-Buchman L, Maeda S, Huynh-Charlier I, Hans S, Charlier P.

'''Institution:''' Department of Otolaryngology-Head & Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Université Paris Saclay), Montigny-le-Bretonneux, France.

'''Abstract:''' Objectives: King Henri IV of France (reign from 1589 to 1610) was one of the most important kings of France. Embalmed and buried in Saint-Denis, his remains were beheaded in 1793. His head (including his larynx) survived in successive private collections until its definitive identification in 2010. The purpose of the study was to provide a morphologic study of the larynx with a 3D reconstitution.

'''Methods:''' A flexible endoscopy was performed via the mouth and via the trachea. Measures of the larynx (vocal folds lengths, thickness, width, larynx height) were collected from the CT-scan by a panel of experts blind each other. The segmentation of the laryngeal anatomical components (vocal folds, cartilages) was performed using [http://www.slicer.org '''3D Slicer''']. Mesh smoothing and 3D reconstitution were performed using Fusion 360®. Reconstitution was discussed between the experts. Decision was made by consensus after discussion.

'''Results:''' Cricoid, thyroid, arytenoid cartilages, vocal folds and hyoid bone were identified and a computed 3D reconstitution of the larynx was made. The laryngeal 3D model appeared morphologically similar to a living subject. Measures were similar but smaller than those of a modern subject.

'''Conclusions:''' The 3D reconstitution of the larynx of Henri IV of France was conducted from the CT-scan of his mummified head. This work constitutes a first valuable morphologic analysis of a larynx from an embalmed individual. This anatomical work is the first step towards the reconstruction of the voice of this historical character, which we hope to concretize with computer modeling tools in a second step.
|}

==Development and External Validation of a Novel Nomogram to Predict Prostate Cancer in Biopsy-Naïve Patients With PSA <10 Ng/Ml and PI-RADS v2.1 = 3 Lesions==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35920264 Cancer Med. 2023 Feb;12(3):2560-71. PMID: 35920264] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9939143/pdf/CAM4-12-2560.pdf PDF]

'''Authors:''' Hu C, Sun J, Xu Z, Zhang Z, Zhou Q, Xu J, Chen H, Wang C, Ouyang J.

'''Institution:''' Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.

'''Abstract:'''
'''Objective:''' To develop and externally validate a novel nomogram in biopsy-naïve patients with prostate-specific antigen (PSA) <10 ng/ml and PI-RADS v2.1 = 3 lesions.

'''Methods:''' We retrospectively collected 307 men that underwent initial biopsy from October 2015 to January 2022 in Cohort 1 (The First Affiliated Hospital of Soochow University). External cohort (Cohort 2, Kunshan Hospital) included 109 men that met our criteria from July 2016 to June 2021. By [http://www.slicer.org '''3D Slicer'''] Software, the volume of all lesions was divided into two subgroups (PI-RADS v2.1 = 3a and 3b). Logistic regression analysis was performed to screen for variables and construct nomogram by analyzing clinical data from Cohort 1. Receiver operating characteristics curve analysis, calibration plot and decision curve analysis (DCA) were plotted to validate the nomogram in external cohort.

'''Results:''' A total of 70 (22.8%) patients was diagnosed with prostate cancer in Institution 1. Among them, 34 (11.1%) had clinically significant prostate cancer (csPCa). Age, prostate-specific antigen density, digital rectal examination, PI-RADS v2.1 = 3 subgroups (3a and 3b) and apparent diffusion coefficient (ADC, <750 mm2 /s) were predictive factors for prostate cancer (PCa) and csPCa. High area under the curve of the nomogram was found in Cohort 1 and Cohort 2 for PCa (0.857 vs. 0.850) and for csPCa (0.896 vs. 0.893). Calibration curves showed excellent agreement between the predicted probability and actual risk for the models in internal and external validation. The DCA demonstrated net benefit of our nomogram.

'''Conclusion:''' Until now, this is the first nomogram that predicts PCa and csPCa in biopsy-naïve patients with PSA <10 ng/ml and PI-RADS v2.1 = 3 lesions. Furthermore, PI-RADS v2.1 = 3 subgroups were considered to be an independent risk factor in our model. Our nomogram may assist urologists in biopsy decision making for these so-called "double gray zone" patients.
|}

==A Three-Dimensionally Printed Otological Model for Cholesteatoma Mastoidectomy Training==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35789285 Eur Arch Otorhinolaryngol. 2023 Feb;280(2):671-80. PMID: 35789285]

'''Authors:''' de Souza MA, Bento RF, Lopes PT.

'''Institution:''' Otolaryngology Department, University of São Paulo School of Medicine, São Paulo, Brazil.

'''Abstract:'''
'''purpose:''' To relate the creation and expert validation (face and content validity) of an affordable three-dimensional (3D) printed model of temporal bones with chronic otitis media with cholesteatoma (COMC) as a simulator for mastoidectomy.

'''Methods:''' We performed computed tomography (CT) of the temporal bones of a patient with COMC followed at the University of São Paulo (USP) Hospital with [http://www.slicer.org '''3D Slicer'''] to create a 3-D model of the affected bone using light-curing resin and silicone (cholesteatoma). The final 3-D printed images were scored by 10 otologists using a customized version of the Michigan Standard Simulation Scale Experience (MiSSES). Internal consistency and inter-rater reliability were assessed using Cronbach's α and intraclass correlations.

'''Results:''' Otologists consistently scored the model positively for fidelity, educational value, reactions, and the overall model quality. Nine otologists agreed that the model was a good educational device for surgical training of COMC. All experts deemed the model ready-or nearly ready-for use. The final cost of the model, including raw materials and manufacturing, was 120 USD.

'''Conclusions:''' Using 3D printing technology, we created the first anatomically accurate, low-cost, disease-reproducing 3D model of temporal bones for mastoidectomy training for cholesteatoma.
|}

==Development of a Navigable 3D Virtual Model of Temporal Bone Anatomy==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36704866 J Vis Commun Med. 2023 Jan 26:1-5. PMID: 36704866] | [https://www.tandfonline.com/doi/full/10.1080/17453054.2023.2169110 PDF]

'''Authors:''' Sareen K.

'''Institution:''' Sant Parmanand Hospital, New Delhi, India.

'''Abstract:'''
'''Background:''' Computed Tomography (CT) scanning offers an accurate structural definition of bones, blood vessels, and soft tissues; however, mental integration of cross-sectional 2D CT images for a 3D understanding of complex anatomical structures becomes difficult when the field of view is confined to the temporal bone. This project tried to provide a feasible solution to this problem by creating a navigable 3D virtual model which may aid in better comprehension of the temporal bone anatomy.

'''Methods:''' A helical-CT scan was used to obtain high-resolution cross-sectional slices of a cadaveric human temporal bone. Using the volume-rendering capabilities of [http://www.slicer.org '''3D Slicer'''], which involves volume data management, cropping of the data set, and threshold painting, detailed anatomical structures were segmented based on the intensity captured from different regions. This volumetric data was converted to an interactive virtual model using Blender®.

'''Results:''' The final product is a web page that allows interaction and navigation with a 3D annotated model of the temporal bone, which can be accessed from any device with a web browser.

'''Conclusion:''' This model can function as a training tool for students, teachers, and practitioners to understand and review the complex anatomy of the temporal bone.
|}

==Maxillary Antral Pseudocyst Drift after Osteotome Sinus Floor Elevation with Simultaneous Implant Placement: A Case Report and Literature Review==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36769568 J Clin Med. 2023 Jan 24;12(3):920. PMID: 36769568] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9917374/pdf/jcm-12-00920.pdf PDF]

'''Authors:''' Wang P, Huang N, Ren J, Gong P, Long J, Huang B.

'''Institution:''' West China School of Stomatology, Sichuan University, Chengdu, China.

'''Abstract:''' This report describes maxillary antral pseudocyst drift after maxillary sinus floor augmentation through osteotome sinus floor elevation with simultaneous implant placement. [http://www.slicer.org '''3D Slicer'''] was used to measure the pseudocyst and maxilla for the placement of the implants; follow-up visits were scheduled at 6, 12, and 22 months. No adverse effects were observed during or after surgery, and all implants exhibited osseointegration without mobility. At 6 months after surgery, the pseudocyst had moved posterolaterally from the preoperative position near the anterior medial maxillary sinus, then returned to its original position at 12 months. However, it had remigrated to the posterolateral position at 22 months. The preoperative volume of the pseudocyst was 3.795 mm3; it was 2.370, 3.439, and 2.930 mm3 at 6, 12, and 22 months after surgery, respectively. The changes in pseudocyst drift and volume did not have a substantial negative influence on the implants, presumably because of cystic attachment and the recurrence of multiple pseudocysts at different locations. The risks associated with changes in a pseudocyst can be avoided, if an appropriate treatment plan is selected.
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==Radiomic Analysis Based on Magnetic Resonance Imaging for Predicting PD-L2 Expression in Hepatocellular Carcinoma==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36672315 Cancers (Basel). 2023 Jan 5;15(2):365. PMID: 36672315] | [http://www.ncbi.nlm.nih.gov/pmc/articles/pmc9856314/ PDF]

'''Authors:''' Tao YY, Shi Y, Gong XQ, Li L, Li ZM, Yang L, Zhang XM.

'''Institution:''' Medical Imaging Key Laboratory of Sichuan Province, Interventional Medical Center, Department of Radiology, Medical Research Center, Affiliated Hospital of North Sichuan Medical College, Nanchong, China.

'''Abstract:''' Hepatocellular carcinoma (HCC) is the sixth most common malignant tumour and the third leading cause of cancer death in the world. The emerging field of radiomics involves extracting many clinical image features that cannot be recognized by the human eye to provide information for precise treatment decision making. Radiomics has shown its importance in HCC identification, histological grading, microvascular invasion (MVI) status, treatment response, and prognosis, but there is no report on the preoperative prediction of programmed death ligand-2 (PD-L2) expression in HCC. The purpose of this study was to investigate the value of MRI radiomic features for the non-invasive prediction of immunotherapy target PD-L2 expression in hepatocellular carcinoma (HCC). A total of 108 patients with HCC confirmed by pathology were retrospectively analysed. Immunohistochemical analysis was used to evaluate the expression level of PD-L2. [http://www.slicer.org '''3D Slicer'''] software was used to manually delineate volumes of interest (VOIs) and extract radiomic features on preoperative T2-weighted, arterial-phase, and portal venous-phase MR images. Least absolute shrinkage and selection operator (LASSO) was performed to find the best radiomic features. Multivariable logistic regression models were constructed and validated using fivefold cross-validation. The area under the receiver characteristic curve (AUC) was used to evaluate the predictive performance of each model. The results show that among the 108 cases of HCC, 50 cases had high PD-L2 expression, and 58 cases had low PD-L2 expression. Radiomic features correlated with PD-L2 expression. The T2-weighted, arterial-phase, and portal venous-phase and combined MRI radiomics models showed AUCs of 0.789 (95% CI: 0.702-0.875), 0.727 (95% CI: 0.632-0.823), 0.770 (95% CI: 0.682-0.875), and 0.871 (95% CI: 0.803-0.939), respectively. The combined model showed the best performance. The results of this study suggest that prediction based on the radiomic characteristics of MRI could noninvasively predict the expression of PD-L2 in HCC before surgery and provide a reference for the selection of immune checkpoint blockade therapy.
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==Correlation Between Unilateral Internal Carotid Artery Stenosis and Asymmetric Distribution of Enlarged Perivascular Spaces in Patients With Acute Cerebral Infarction==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36649988 Zhonghua Yi Xue Za Zhi. 2023 Jan 17;103(3):178-185. PMID: 36649988]

'''Authors:''' Jian XL, Zhang M, Yun WW.

'''Abstract:'''
'''Objective:''' To explore the correlation between unilateral internal carotid artery (ICA) stenosis and asymmetrical distribution of enlarged perivascular spaces (EPVS) in patients with acute cerebral infarction.

'''Methods:''' Acute cerebral infarction patients with unilateral ICA stenosis hospitalized in Changzhou Second People's Hospital from October 2020 to December 2021 were collected. Routine cranial MRI and CT angiography were completed for each patient. The [http://www.slicer.org '''3D Slicer'''] software was used to quantitatively analyze the volume of patient's EPVS. Patients were divided into moderate stenosis group and severe stenosis/occlusion group according to the degree of ICA stenosis. Baseline data were compared between the two groups. Patients were further divided into three groups: moderate stenosis, severe stenosis and occlusion groups, and the ipsilateral and contralateral EPVS volume of ICA stenosis patients was compared. The asymmetry index (AI) was calculated for EPVS in the basal ganglia region (BG-EPVS) and EPVS in the centrum semiovale (CSO-EPVS). Patients with AI≥0.2 were included in the EPVS asymmetry group, while the rest were in the EPVS symmetry group, and the degree of unilateral ICA stenosis was compared between the two groups. Multivariate logistic regression model was used to analyze the relationship between ICA severe stenosis/occlusion and the asymmetric distribution of BG-EPVS.

'''Results:''' A total of 122 patients (96 males and 26 females) were enrolled, aged (70±10) years, with 81 cases in the unilateral ICA severe stenosis/occlusion group (46 cases of severe stenosis and 35 of occlusion) and 41 cases in the moderate stenosis group. Patients in the unilateral ICA severe stenosis/occlusion group had greater BG-EPVS volume [(4.08±0.76) mm3]and proportion of asymmetric distribution of BG-EPVS [75.3%(61/81)] than those of the moderate stenosis group [(3.12±0.85) mm3 and 39.0% (16/41)], with statistically significant differences (both P<0.001). The BG-EPVS volumes of the ipsilateral side of the stenosis in the severe stenosis group and the occlusion group [(3.34±0.86) mm3 and (3.93±0.60) mm3] were significantly greater than those of the contralateral side [(2.65±1.28) mm3 and (3.21±0.88) mm3], with statistically significant differences (both P<0.001). Correlation analysis indicated that the degree of unilateral ICA stenosis was positively correlated with the BG-EPVS volume on the stenosis side (r=0.62, P<0.001). Further comparison of the degree of unilateral ICA stenosis between the EPVS symmetric and asymmetric groups showed that the proportion of unilateral ICA severe stenosis/occlusion in the BG-EPVS asymmetry group was higher than that in the symmetric group [79.2%(61/77) vs 44.4%(20/45),P<0.001]. Multivariate logistic regression analysis showed that unilateral ICA severe stenosis/occlusion (OR=4.280, 95%CI: 1.743-10.508, P =0.002) and age (OR=1.055, 95%CI: 1.001-1.112, P=0.044) were risk factors for asymmetric distribution of BG-EPVS.

'''Conclusions:''' The severe stenosis/occlusion of the unilateral ICA and age are the risk factors for the asymmetric distribution of the BG-EPVS in patients with acute cerebral infarction. The ipsilateral EPVS volume of unilateral ICA stenosis is larger than that of the contralateral side, and the degree of ICA stenosis is positively correlated with the severity of BG-EPVS.
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==Radiomics to Predict the Mortality of Patients With Rheumatoid Arthritis-Associated Interstitial Lung Disease: A Proof-of-Concept Study==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36698825 Front Med (Lausanne). 2023 Jan 9;9:1069486. PMID: 36698825] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9870287/pdf/fmed-09-1069486.pdf PDF]

'''Authors:''' Venerito V, Manfredi A, Lopalco G, Lavista M, Cassone G, Scardapane A, Sebastiani M, Iannone F.

'''Institution:''' Rheumatology Unit, Department of Emergency and Organ Transplantation, University of Bari Aldo Moro, Bari, Italy.

'''Abstract:''' Objectives: Patients with rheumatoid arthritis (RA) and interstitial lung disease (ILD) have increased mortality compared to the general population and factors capable of predicting RA-ILD long-term clinical outcomes are lacking. In oncology, radiomics allows the quantification of tumour phenotype by analysing the characteristics of medical images. Using specific software, it is possible to segment organs on high-resolution computed tomography (HRCT) images and extract many features that may uncover disease characteristics that are not detected by the naked eye. We aimed to investigate whether features from whole lung radiomic analysis of HRCT may alone predict mortality in RA-ILD patients.

'''Methods:''' High-resolution computed tomographies of RA patients from January 2012 to March 2022 were analyzed. The time between the first available HRCT and the last follow-up visit or ILD-related death was recorded. We performed a volumetric analysis in [http://www.slicer.org '''3D Slicer'''], automatically segmenting the whole lungs and trachea via the Lung CT Analyzer. A LASSO-Cox model was carried out by considering ILD-related death as the outcome variable and extracting radiomic features as exposure variables.

'''Results:''' We retrieved the HRCTs of 30 RA-ILD patients. The median survival time (interquartile range) was 48 months (36-120 months). Thirteen out of 30 (43.33%) patients died during the observation period. Whole line segmentation was fast and reliable. The model included either the median grey level intensity within the whole lung segmentation [high-resolution (HR) 9.35, 95% CI 1.56-55.86] as a positive predictor of death and the 10th percentile of the number of included voxels (HR 0.20, 95% CI 0.05-0.84), the voxel-based pre-processing information (HR 0.23, 95% CI 0.06-0.82) and the flatness (HR 0.42, 95% CI 0.18-0.98), negatively correlating to mortality. The correlation of grey level values to their respective voxels (HR 1.52 95% CI 0.82-2.83) was also retained as a confounder.

'''Conclusion:''' Radiomic analysis may predict RA-ILD patients' mortality and may promote HRCT as a digital biomarker regardless of the clinical characteristics of the disease.
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==Evaluation of the Prognosis of Acute Subdural Hematoma According to the Density Differences Between Gray and White Matter==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36686517 Front Neurol. 2023 Jan 6;13:1024018. PMID: 36686517] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9853902/ PDF]

'''Authors:''' Li Z, Feng Y, Wang P, Han S, Zhang K, Zhang C, Lu S, Lv C, Zhu F, Bie L.

'''Institution:''' Department of Neurosurgery of the First Clinical Hospital, Jilin University, Changchun, China.

'''Abstract:'''
'''Objective:''' Acute subdural hematoma (ASDH) is a common neurological emergency, and its appearance on head-computed tomographic (CT) imaging helps guide clinical treatment. To provide a basis for clinical decision-making, we analyzed that the density difference between the gray and white matter of the CT image is associated with the prognosis of patients with ASDH.

'''Methods:''' We analyzed the data of 194 patients who had ASDH as a result of closed traumatic brain injury (TBI) between 2018 and 2021. The patients were subdivided into surgical and non-surgical groups, and the non-surgical group was further subdivided into "diffused [hematoma]" and "non-diffused" groups. The control group's CT scans were normal. The [http://www.slicer.org '''3D Slicer'''] software was used to quantitatively analyze the density of gray and white matter depicted in the CT images.

'''Results:''' Imaging evaluation showed that the median difference in density between the gray and white matter on the injured side was 4.12 HU (IQR, 3.91-4.22 HU; p < 0.001) and on the non-injured side was 4.07 HU (IQR, 3.90-4.19 HU; p < 0.001), and the hematoma needs to be surgically removed. The median density difference value of the gray and white matter on the injured side was 3.74 HU (IQR, 3.53-4.01 HU; p < 0.001) and on the non-injured side was 3.71 HU (IQR, 3.69-3.73 HU; p < 0.001), and the hematoma could diffuse in a short time.

'''Conclusion:''' Quantitative analysis of the density differences in the gray and white matter of the CT images can be used to evaluate the clinical prognosis of patients with ASDH.
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==The Knosp Criteria Revisited: 3-Dimensional Volumetric Analysis as a Predictive Tool for Extent of Resection in Complex Endoscopic Pituitary Surgery==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36170168 Front Oncol. Neurosurgery. 2023 Jan 1;92(1):179-85. PMID: 36170168]

'''Authors:''' DiRisio AC, Feng R, Shuman WH, Platt S, Price G, Dullea JT, Gilja S, D'Andrea MR, Delman BN, Bederson JB, Shrivastava RK.

'''Institution:''' Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.

'''Abstract:'''
'''Background:''' The Knosp criteria have been the historical standard for predicting cavernous sinus invasion, and therefore extent of surgical resection, of pituitary macroadenomas. Few studies have sought to reappraise the utility of this tool after recent advances in visualization and modeling of tumors in complex endoscopic surgery.

'''Objective:''' To evaluate our proposed alternative method, using 3-dimensional (3D) volumetric imaging, and whether it can better predict extent of resection in nonfunctional pituitary adenomas.

'''Methods:''' Patients who underwent endoscopic transsphenoidal resection of pituitary macroadenomas at our institution were reviewed. Information was collected on neurological, endocrine, and visual function. Volumetric segmentation was performed using [http://www.slicer.org '''3D Slicer'''] software. Relationship of tumor volume, clinical features, and Knosp grade on extent of resection was examined.

'''Results:''' One hundred forty patients were identified who had transsphenoidal resection of nonfunctional pituitary adenomas. Macroadenomas had a median volume of 6 cm3 (IQR 3.4-8.7), and 17% had a unilateral Knosp grade of at least 3B. On multiple logistic regression, only smaller log-transformed preoperative tumor volume was independently associated with increased odds of gross total resection (GTR; odds ratio: 0.27, 95% CI: 0.07-0.89, P < .05) when controlling for tumor proliferative status, age, and sex (area under the curve 0.67). The Knosp criteria did not independently predict GTR in this cohort (P > .05, area under the curve 0.46).

'''Conclusion:''' Increasing use of volumetric 3D imaging may better anticipate extent of resection compared with the Knosp grade metric and may have a greater positive predictive value for GTR. More research is needed to validate these findings and implement them using automated methods.
|}

==Differentiation of Lung Metastases Originated From Different Primary Tumors Using Radiomics Features Based on CT Imaging==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35577699 Acad Radiol. 2023 Jan;30(1):40-6. PMID: 35577699]

'''Authors:''' Shang H, Li J, Jiao T, Fang C, Li K, Yin D, Zeng Q.

'''Institution:''' Department of Radiology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, No. 16766 Jingshi Road, Jinan, Shandong, China.

'''Abstract:''' Rationale and objectives: To explore the feasibility of differentiating three predominant metastatic tumor types using lung computed tomography (CT) radiomics features based on supervised machine learning.

'''Materials and Methods:''' This retrospective analysis included 252 lung metastases (LM) (from 78 patients), which were divided into the training (n = 176) and test (n = 76) cohort randomly. The metastases originated from colorectal cancer (n = 97), breast cancer (n = 87), and renal carcinoma (n = 68). An additional 77 LM (from 35 patients) were used for external validation. All radiomics features were extracted from lung CT using an open-source software, [http://www.slicer.org '''3D Slicer''']. The least absolute shrinkage and selection operator (LASSO) method selected the optimal radiomics features to build the model. Random forest and support vector machine (SVM) were selected to build three-class and two-class models. The performance of the classification model was evaluated with the area under the receiver operating characteristic curve (AUC) by two strategies: one-versus-rest and one-versus-one.

'''Results:''' Eight hundred and fifty-one quantitative radiomics features were extracted from lung CT. By LASSO, 23 optimal features were extracted in three-class, and 25, 29, and 35 features in two-class for differentiating every two of three LM (colorectal cancer vs. renal carcinoma, colorectal cancer vs. breast cancer, and breast cancer vs. renal carcinoma, respectively). The AUCs of the three-class model were 0.83 for colorectal cancer, 0.79 for breast cancer, and 0.91 for renal carcinoma in the test cohort. In the external validation cohort, the AUCs were 0.77, 0.83, and 0.81, respectively. Swarmplot shows the distribution of radiomics features among three different LM types. In the two-class model, high accuracy and AUC were obtained by SVM. The AUC of discriminating colorectal cancer LM from renal carcinoma LM was 0.84, and breast cancer LM from colorectal cancer LM and renal carcinoma LM were 0.80 and 0.94, respectively. The AUCs were 0.77, 0.78, and 0.84 in the external validation cohort.

'''Conclusion:''' Quantitative radiomics features based on Lung CT exhibited good discriminative performance in LM of primary colorectal cancer, breast cancer, and renal carcinoma.
|}

==MRI Radiomic Features of Peritumoral Edema May Predict the Recurrence Sites of Glioblastoma Multiforme==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36686829 Front Oncol. 2023 Jan 4;12:1042498. PMID: 36686829] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9845721/pdf/fonc-12-1042498.pdf PDF]

'''Authors:''' Long H, Zhang P, Bi Y, Yang C, Wu M, He D, Huang S, Yang K, Qi S, Wang J.

'''Institution:''' Department of Neurosurgery, Nanfang Hospital, Southern Medical University, Guangzhou, China.

'''Abstract:'''

'''Background and Purpose:''' As one of the most aggressive malignant tumor in the central nervous system, the main cause of poor outcome of glioblastoma (GBM) is recurrence, a non-invasive method which can predict the area of recurrence pre-operation is necessary.To investigate whether there is radiological heterogeneity within peritumoral edema and identify the reproducible radiomic features predictive of the sites of recurrence of glioblastoma(GBM), which may be of value to optimize patients' management.

'''Materials and Methods:''' The clinical information and MR images (contrast-enhanced T1 weighted and FLAIR sequences) of 22 patients who have been histologically proven glioblastoma, were retrospectively evaluated. Kaplan-Meier methods was used for survival analysis. Oedematous regions were manually segmented by an expert into recurrence region, non-recurrence region. A set of 94 radiomic features were obtained from each region using the function of analyzing MR image of [http://www.slicer.org '''3D Slicer''']. Paired t test was performed to identify the features existing significant difference. Subsequently, the data of two patients from TCGA database was used to evaluate whether these features have clinical value.

'''Results:''' Ten features with significant differences between the recurrence and non-recurrence subregions were identified and verified on two individual patients from the TCGA database with pathologically confirmed diagnosis of GBM.

'''Conclusions:''' Our results suggested that heterogeneity does exist in peritumoral edema, indicating that the radiomic features of peritumoral edema from routine MR images can be utilized to predict the sites of GBM recurrence. Our findings may further guide the surgical treatment strategy for GBM.
|}

==Clinical Study on Application of 3D Slicer Software Assisted Domestic Frameless Stereotactic Robot in Biopsy of Intracranial Lesions==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36603886 Zhonghua Wai Ke Za Zhi. 2023 Jan 1;61(1):61-65. PMID: 36603886] | [http://www.ncbi.nlm.nih.gov/pmc/articles/pmc9849352/ PDF]

'''Authors:''' Chen H, Yan X, He F, Ding SC, Diao JF, Guo H, Cao SM, Yang CJ, Yin F.

'''Institution:''' Department of Neurosurgery, Aerospace Central Hospital, Beijing, China.

'''Abstract:'''
'''Objective:''' To examine the application value of [http://www.slicer.org '''3D Slicer'''] software assisted domestic frameless stereotactic robot in biopsy of intracranial lesions.

'''Methods:''' A retrospective analysis was performed on 80 patients who admitted consecutively and underwent intracerebral lesions biopsy with the domestic frameless stereotactic robot at Department of Neurosurgery, Aerospace Central Hospital from January 2019 to December 2021. There were 36 males and 44 females, with a mean age of (38.5±18.0) years (range: 6 to 71 years). Before surgery only enhanced T1-weighted three-dimensional magnetization prepared gradient echo sequences and diffusion tensor imaging scans were performed. Self-reconstruction of intracranial lesions, cerebral cortex and blood vessels was carried out using 3D Slicer software system after the DICOM format imaging data of 80 patients were collected. These imaging data were merged to the workstation of the domestic frameless stereotactic robot for preoperative surgical planning and the surgical puncture path was designed to avoid blood vessels in the brain functional area, cerebral cortex and sulcus.

'''Results:''' All frameless stereotactic biopsy were successfully performed. Postoperative pathological diagnosis included 50 cases of diffuse astrocytic and oligodendroglioma, 15 cases of lymphoma, 5 cases of metastatic tumors, 5 cases of inflammatory demyelinating disease, 2 cases of inflammatory granuloma, 1 case of hemangioma, 1 case of acute lymphoblastic leukemia intracranial invasion and 1 case of seminoma. The positive diagnosis rate was 100% (80/80). Postoperative imaging confirmed that the puncture path and target were accurately implemented according to the preoperative planning, and the target error was (1.32±0.44) mm (range: 0.55 to 1.99 mm). One case of puncture-related bleeding occurred at the target after surgery and improved after treatment.

'''Conclusion:''' The three-dimensional multimodal images reconstructed by the 3D Slicer software before operation could help the surgeons make the preoperative planning and reduce the risk of stereotactic brain biopsy.
|}

==Liver Cirrhosis and Tumor Location Can Affect the Range of Intrahepatic Microwave Ablation Zone==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36854449 Int J Hyperthermia. 2023;40(1):2181843. PMID: 36854449] | [https://www.tandfonline.com/doi/epdf/10.1080/02656736.2023.2181843?needAccess=true&role=button PDF]

'''Authors:''' Ding WZ, Wei H, Wu JP, Cheng ZG, Han ZY, Liu FY, Yu J, Liang P.

'''Institution:''' Fifth Medical Center of Chinese, PLA General Hospital, Beijing, China.

'''Abstract:'''
'''Background:''' The range of an ablation zone (AZ) plays a crucial role in the treatment effect of microwave ablation (MWA). The aim of this study was to analyze the factors influencing the AZ range.

'''Methods:''' Fourteen factors in four areas were included: patient-related factors (sex, age), disease-related factors (tumor location, liver cirrhosis), serological factors (ALT, AST, total protein, albumin, total bilirubin, direct bilirubin, and platelets), and MWA parameters (ablation time, power, and needle type). Multiple sequence MRI was used to delineate AZ by three radiologists using [http://www.slicer.org '''3D Slicer''']. MATLAB was used to calculate the AZ length, width, and area of the largest section. Linear regression analysis was used to analyze influencing factors. Moreover, a subgroup analysis was conducted for patients with viral hepatitis.

'''Result:''' 220 patients with 290 tumors were included between 2010-2021. In addition to MWA parameters, cirrhosis and tumor location were significant factors that influenced AZ (p < 0.001). The standardized coefficient (beta) of cirrhosis (cirrhosis vs. non-cirrhosis) was positive, which meant cirrhosis would lead to a decrease in AZ range. The beta of tumor location (near the hepatic hilar zone, intermediate zone, and periphery zone) was negative, indicating that AZ range decreased as the tumor location approached the hepatic hilum. For viral hepatitis patients, Fibrosis 4 (FIB4) score was a significant factor influencing AZ (p < 0.001), and the beta was negative, indicating that AZ range decreased as FIB4 increased.

'''Conclusion:''' Liver cirrhosis, tumor location, and FIB4 affect the AZ range and should be considered when planning MWA parameters.
|}

==A Magnetic Resonance Imaging Based Radiomics Model to Predict Mitosis Cycles in Intracranial Meningioma==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36653482 Sci Rep. 2023 Jan 18;13(1):969. PMID: 36653482] | [http://www.ncbi.nlm.nih.gov/pmc/articles/pmc9849352/ PDF]

'''Authors:'''Krähling H, Musigmann M, Akkurt BH, Sartoretti T, Sartoretti E, Henssen DJHA, Stummer W, Heindel W, Brokinkel B, Mannil M.

'''Institution:''' University Clinic for Radiology, University Hospital Muenster, Westfälische Wilhelms-University Muenster, Muenster, Germany.

'''Abstract:''' The aim of this study was to develop a magnetic resonance imaging (MRI) based radiomics model to predict mitosis cycles in intracranial meningioma grading prior to surgery. Preoperative contrast-enhanced T1-weighted (T1CE) cerebral MRI data of 167 meningioma patients between 2015 and 2020 were obtained, preprocessed and segmented using the [http://www.slicer.org '''3D Slicer'''] software and the PyRadiomics plugin. In total 145 radiomics features of the T1CE MRI images were computed. The criterion on the basis of which the feature selection was made is whether the number of mitoses per 10 high power field (HPF) is greater than or equal to zero. Our analyses show that machine learning algorithms can be used to make accurate predictions about whether the number of mitoses per 10 HPF is greater than or equal to zero. We obtained our best model using Ridge regression for feature pre-selection, followed by stepwise logistic regression for final model construction. Using independent test data, this model resulted in an AUC (Area under the Curve) of 0.8523, an accuracy of 0.7941, a sensitivity of 0.8182, a specificity of 0.7500 and a Cohen's Kappa of 0.5576. We analyzed the performance of this model as a function of the number of mitoses per 10 HPF. The model performs well for cases with zero mitoses as well as for cases with more than one mitosis per 10 HPF. The worst model performance (accuracy = 0.6250) is obtained for cases with one mitosis per 10 HPF. Our results show that MRI-based radiomics may be a promising approach to predict the mitosis cycles in intracranial meningioma prior to surgery. Specifically, our approach may offer a non-invasive means of detecting the early stages of a malignant process in meningiomas prior to the onset of clinical symptoms.
|}

==Advantages of a Training Course for Surgical Planning in Virtual Reality for Oral and Maxillofacial Surgery: Crossover Study==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36656632 JMIR Serious Games. 2023 Jan 19;11:e40541. PMID: 36656632] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9947820/?report=printable PDF]

'''Authors:''' Ulbrich M, Van den Bosch V, Bönsch A, Gruber LJ, Ooms M, Melchior C, Motmaen I, Wilpert C, Rashad A, Kuhlen TW, Hölzle F, Puladi B.

'''Institution:''' Department of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Aachen, Germany.

'''Abstract:'''
'''Background:''' As an integral part of computer-assisted surgery, virtual surgical planning (VSP) leads to significantly better surgery results, such as for oral and maxillofacial reconstruction with microvascular grafts of the fibula or iliac crest. It is performed on a 2D computer desktop screen (DS) based on preoperative medical imaging. However, in this environment, VSP is associated with shortcomings, such as a time-consuming planning process and the requirement of a learning process. Therefore, a virtual reality (VR)-based VSP application has great potential to reduce or even overcome these shortcomings due to the benefits of visuospatial vision, bimanual interaction, and full immersion. However, the efficacy of such a VR environment has not yet been investigated.

'''Objective:''' This study aimed to demonstrate the possible advantages of a VR environment through a substep of VSP, specifically the segmentation of the fibula (calf bone) and os coxae (hip bone), by conducting a training course in both DS and VR environments and comparing the results.

'''Methods:''' During the training course, 6 novices were taught how to use a software application in a DS environment, [http://www.slicer.org '''3D Slicer''']) and in a VR environment (Elucis) for the segmentation of the fibula and os coxae, and they were asked to carry out the maneuvers as accurately and quickly as possible. Overall, 13 fibula and 13 os coxae were segmented for each participant in both methods (VR and DS), resulting in 156 different models (78 fibula and 78 os coxae) per method (VR and DS) and 312 models in total. The individual learning processes in both environments were compared using objective criteria (time and segmentation performance) and self-reported questionnaires. The models resulting from the segmentation were compared mathematically (Hausdorff distance and Dice coefficient) and evaluated by 2 experienced radiologists in a blinded manner.

'''Results:''' A much faster learning curve was observed for the VR environment than the DS environment (β=.86 vs β=.25). This nearly doubled the segmentation speed (cm3/min) by the end of training, leading to a shorter time (P<.001) to reach a qualitative result. However, there was no qualitative difference between the models for VR and DS (P=.99). The VR environment was perceived by participants as more intuitive and less exhausting, and was favored over the DS environment.

'''Conclusions:''' The more rapid learning process and the ability to work faster in the VR environment could save time and reduce the VSP workload, providing certain advantages over the DS environment.
|}

==Lesion Size and Long-Term Cognitive Outcome After Pediatric Stroke: A Comparison Between Two Techniques to Assess Lesion Size==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36641854 Eur J Paediatr Neurol. 2023 Jan 7;42:126-32. PMID: 36641854]

'''Authors:''' Everts R, Bertato S, Steinlin M, Slavova N, Grunt S, Steiner L.

'''Institution:''' Division of Neuropediatrics, Development and Rehabilitation, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.

'''Abstract:'''
'''Background:''' There is little consensus on how lesion size impacts long-term cognitive outcome after pediatric arterial ischemic stroke (AIS). This study, therefore, compared two techniques to assessed lesion size in the chronic phase after AIS and determined their measurement agreement in relation to cognitive functions in patients after pediatric stroke.

'''Methods:''' Twenty-five patients after pediatric AIS were examined in the chronic phase (>2 years after stroke) in respect to intelligence, memory, executive functions, visuo-motor functions, motor abilities, and disease-specific outcome. Lesion size was measured using the ABC/2 formula and segmentation technique ([http://www.slicer.org '''3D Slicer''']). Correlation analysis determined the association between volumetry techniques and outcome measures in respect to long-term cognitive outcome.

'''Results:''' The measurements from the ABC/2 and segmentation technique were strongly correlated (r = 0.878, p < .001) and displayed agreement in particular for small lesions. Lesion size from both techniques was significantly correlated with disease-specific outcome (p < .001) and processing speed (p < .005) after controlling for age at stroke and multiple comparison.

'''Conclusion:''' The two techniques showed convergent validity and were both significantly correlated with long-term outcome after pediatric AIS. Compared to the time-consuming segmentation technique, ABC/2 facilitates clinical and research work as it requires relatively little time and is easy to apply.
|}

==Association Between Emphysema and Other Pulmonary Computed Tomography Patterns in COVID-19 Pneumonia==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36358023 J Med Virol. 2023 Jan;95(1):e28293. PMID: 36358023] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9828029/pdf/JMV-95-0.pdf PDF]

'''Authors:''' Han K, Wang J, Zou Y, Zhang Y, Zhou L, Yin Y.

'''Institution:''' Fetal-Neonatal Neuroimaging and Developmental Science Center, Division of Newborn Medicine, Boston Children's Hospital, Boston, USA.

'''Abstract:''' To evaluate the chest computed tomography (CT) findings of patients with Corona Virus Disease 2019 (COVID-19) on admission to hospital. And then correlate CT pulmonary infiltrates involvement with the findings of emphysema. We analyzed the different infiltrates of COVID-19 pneumonia using emphysema as the grade of pneumonia. We applied open-source assisted software, [http://www.slicer.org '''3D Slicer'''] to model the lungs and lesions of 66 patients with COVID-19, which were retrospectively included. we divided the 66 COVID-19 patients into the following two groups: (A) 12 patients with less than 10% emphysema in the low-attenuation area less than -950 Hounsfield units (%LAA-950), (B) 54 patients with greater than or equal to 10% emphysema in %LAA-950. Imaging findings were assessed retrospectively by two authors and then pulmonary infiltrates and emphysema volumes were measured on CT using [http://www.slicer.org '''3D Slicer'''] software. Differences between pulmonary infiltrates, emphysema, Collapsed, affected of patients with CT findings were assessed by Kruskal-Wallis and Wilcoxon test, respectively. Statistical significance was set at p < 0.05. The left lung (A) affected left lung 20.00/affected right lung 18.50, (B) affected left lung 13.00/affected right lung 11.50 was most frequently involved region in COVID-19. In addition, collapsed left lung, (A) collapsed left lung 4.95/collapsed right lung 4.65, (B) collapsed left lung 3.65/collapsed right lung 3.15 was also more severe than the right one. There were significant differences between the Group A and Group B in terms of the percentage of CT involvement in each lung region (p < 0.05), except for the inflated affected total lung (p = 0.152). The median percentage of collapsed left lung in the Group A was 20.00 (14.00-30.00), right lung was 18.50 (13.00-30.25) and the total was 19.00 (13.00-30.00), while the median percentage of collapsed left lung in the Group B was 13.00 (10.00-14.75), right lung was 11.50 (10.00-15.00) and the total was 12.50 (10.00-15.00). The percentage of affected left lung is an independent predictor of emphysema in COVID-19 patients. We need to focus on the left lung of the patient as it is more affected. The people with lower levels of emphysema may have more collapsed segments. The more collapsed segments may lead to more serious clinical feature.
|}

==A High-Resolution Pediatric Female Whole-Body Numerical Model With Comparison to a Male Model==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36595234 Phys Med Biol. 2023 Jan 13;68(2). PMID: 36595234]

'''Authors:''' Ntolkeras G, Jeong H, Zöllei L, Dmytriw AA, Purvaziri A, Lev MH, Grant PE, Bonmassar G.

'''Institution:''' Fetal-Neonatal Neuroimaging and Developmental Science Center, Division of Newborn Medicine, Boston Children's Hospital, Boston, USA.

'''Abstract:'''
'''Objective:''' Numerical models are central in designing and testing novel medical devices and in studying how different anatomical changes may affect physiology. Despite the numerous adult models available, there are only a few whole-body pediatric numerical models with significant limitations. In addition, there is a limited representation of both male and female biological sexes in the available pediatric models despite the fact that sex significantly affects body development, especially in a highly dynamic population. As a result, we developed Athena, a realistic female whole-body pediatric numerical model with high-resolution and anatomical detail.

'''Approach:''' We segmented different body tissues through Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) images of a healthy 3.5 year-old female child using 3D Slicer. We validated the high anatomical accuracy segmentation through two experienced sub-specialty-certified neuro-radiologists and the inter and intra-operator variability of the segmentation results comparing sex differences in organ metrics with physiologic values. Finally, we compared Athena with Martin, a similar male model, showing differences in anatomy, organ metrics, and MRI dosimetric exposure.

'''Main results:'''We segmented 267 tissue compartments, which included 50 brain tissue labels. The tissue metrics of Athena displayed no deviation from the literature value of healthy children. We show the variability of brain metrics in the male and female models. Finally, we offer an example of computing Specific Absorption Rate and Joule heating in a toddler/preschooler at 7T MRI.

'''Significance:''' This study introduces a female realistic high-resolution numerical model using MRI and CT scans of a 3.5 year-old female child, the use of which includes but is not limited to radiofrequency safety studies for medical devices (e.g. an implantable medical device safety in MRI), neurostimulation studies, and radiation dosimetry studies. This model will be open source and available on the Athinoula A. Martinos Center for Biomedical Imaging website.
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==Anatomical Morphology and Related Angles of Foramen Ovale: A Three-dimensional Computed Tomography Reconstruction==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36597246 J Coll Physicians Surg Pak. 2023 Jan;33(1):109-11. PMID: 36597246]

'''Authors:''' Cheng Z, Hu YL, Sun YX, Liang LZ, Pan DD, Wang DW.

'''Institution:''' Department of Neurosurgery, The Second Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, China.

'''Abstract:''' This study aimed to report the three-dimensional reconstruction of the foramen ovale (FO) based on computed tomography angiography and describe its shape and related angles. A retrospective analysis of 199 adult patients who were hospitalised at the Department of Neurosurgery, The Second Affiliated Hospital of Bengbu Medical College, Bengbu, China, from January to December 2020 was conducted. The original DICOM files of patients' computed tomography scans were processed by [http://www.slicer.org '''3D Slicer'''] software to reconstruct the three-dimensional skull. The morphological characteristics of the FO on both sides were analysed. Their size, related angles and volumes, and the differences between the two sides and gender were compared. A total of 398 FO from 199 patients were studied. The most frequent shape of the FO was oval, accounting for 54.27%. The mean lengths of the right and the left sides were 5.40±1.51 and 5.10±1.18mm, respectively. The mean width on the right and left sides was 3.23±1.16 and 3.33±1.19 mm, respectively. The FO is most commonly oval in shape. Clinicians may use the anatomical characteristics regarding the size and shape of the FO for diagnosis and treatment.
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Main Page/SlicerCommunity/2022

2023-07-25T16:59:25Z

Marianna: /* Three-Dimensional Assessment of Tongue Cancer Prognosis by Preoperative MRI */

{{:Main_Page/SlicerCommunity}}

__TOC__
=2022=
==Myosteatosis Is Not Associated with Complications or Survival in HCC Patients Undergoing Trans Arterial Embolization==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36615062 J Clin Med. 2022 Dec 29;12(1):262. PMID: 36615062] | [http://www.ncbi.nlm.nih.gov/pmc/articles/pmc9821378/ PDF]

'''Authors:''' Masetti C, Pugliese N, Lofino L, Colapietro F, Ceriani R, Lleo A, Poretti D, Pedicini V, De Nicola S, Torzilli G, Rimassa L, Aghemo A, Lanza E.

'''Institution:''' Division of Internal Medicine and Hepatology, Department of Gastroenterology, IRCCS Humanitas Research Hospital, Milan, Italy.

'''Abstract:''' Alterations in nutritional status, in particular sarcopenia, have been extensively associated with a poor prognosis in cirrhotic patients regardless of the etiology of liver disease. Less is known about the predictive value of myosteatosis, defined as pathological fat infiltration into the skeletal muscle. We retrospectively analyzed a cohort of 151 cirrhotic patients with unresectable hepatocellular carcinoma (HCC) who underwent their first trans-arterial embolization (TAE) between 1 March 2011 and 1 July 2019 at our Institution. Clinical and biochemical data were collected. Sarcopenia was assessed using the L3-SMI method while myosteatosis with a dedicated segmentation suite ([http://www.slicer.org '''3D Slicer''']), using a single slice at an axial plane located at L3 and calculating the IMAC (Intramuscular Adipose Tissue Content Index). The sex-specific cut-off values for defining myosteatosis were IMAC > -0.44 in males and >-0.31 in females. In our cohort, 115 (76%) patients were included in the myosteatosis group; 128 (85%) patients had a coexistent diagnosis of sarcopenia. Patients with myosteatosis were significantly older and showed higher BMI than patients without myosteatosis. In addition, male gender and alcoholic- or metabolic-related cirrhosis were most represented in the myosteatosis group. Myosteatosis was not associated with a different HCC burden, length of hospitalization, complication rate, and readmission in the first 30 days after discharge. Overall survival was not influenced by the presence of myosteatosis.
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==Open-Source Image Analysis Tool for the Identification and Quantification of Cortical Interruptions and Bone Erosions in High-Resolution Peripheral Quantitative Computed Tomography Images of Patients With Rheumatoid Arthritis==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36174928 Bone. 2022 Dec;165:116571. PMID: 36174928] | [https://www.sciencedirect.com/science/article/pii/S8756328222002484/pdfft?md5=f4b3663f25e7308114681619d46fffd7&pid=1-s2.0-S8756328222002484-main.pdf PDF]

'''Authors:''' Zhao M, Tse JJ, Kuczynski MT, Brunet SC, Yan R, Engelke K, Peters M, van den Bergh JP, van Rietbergen B, Stok KS, Barnabe C, Pauchard Y, Manske SL.

'''Institution:''' Department of Radiology, Cumming School of Medicine, University of Calgary, Calgary, Canada.

'''Abstract:''' Identification of bone erosions and quantification of erosion volume is important for rheumatoid arthritis diagnosis, and can add important information to evaluate disease progression and treatment effects. High-resolution peripheral quantitative computed tomography (HR-pQCT) is well suited for this purpose, however analysis methods are not widely available. The purpose of this study was to develop an open-source software tool for the identification and quantification of bone erosions using images acquired by HR-pQCT. The collection of modules, Bone Analysis Modules (BAM) - Erosion, implements previously published erosion analysis techniques as modules in [http://www.slicer.org '''3D Slicer'''], an open-source image processing and visualization tool. BAM includes a module to automatically identify cortical interruptions, from which erosions are manually selected, and a hybrid module that combines morphological and level set operations to quantify the volume of bone erosions. HR-pQCT images of the second and third metacarpophalangeal (MCP) joints were acquired in patients with RA (XtremeCT, n = 14, XtremeCTII, n = 22). The number of cortical interruptions detected by BAM-Erosion agreed strongly with the previously published cortical interruption detection algorithm for both XtremeCT (r2 = 0.85) and XtremeCTII (r2 = 0.87). Erosion volume assessment by BAM-Erosion agreed strongly (r2 = 0.95) with the Medical Image Analysis Framework. BAM-Erosion provides an open-source erosion analysis tool that produces comparable results to previously published algorithms, with improved options for visualization. The strength of the tool is that it implements multiple image processing algorithms for erosion analysis on a single, widely available, open-source platform that can accommodate future updates.
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==Evaluation of Scapula and Humerus Bone Change after Repair of Small- to Medium-Sized Rotator Cuff Tears: Comparison between Healing and Retear Groups Using Three-Dimensional Computed Tomography==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36518931 Clin Orthop Surg. 2022 Dec;14(4):564-75. PMID: 36518931] [http://www.ncbi.nlm.nih.gov/pmc/articles/pmc9715918/ PDF]

'''Authors:''' Kim JH, Min YK, Kim DY, Kim JW.

'''Institution:''' Department of Orthopedic Surgery, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea.

'''Abstract:''' Background: Rotator cuff tendon retears after rotator cuff repair cause glenohumeral joint instability, which results in changes in the glenoid and humerus head. However, limited data are available on the bone change after repair of small- to medium-sized rotator cuff tears. The aim of this study was to evaluate the difference of glenoid and humerus bone changes between healing and retear groups after repair of small- to medium-sized rotator cuff tears.

Methods: Among patients who had arthroscopic repair due to small- to medium-sized rotator cuff tears from January 2009 to January 2017, 49 patients who underwent both preoperative and postoperative (at least 3 years after surgery) shoulder computed tomography were enrolled. Using three-dimensional reconstruction program, [http://www.slicer.org '''3D Slicer'''] and shape analysis program (SlicerSALT), we compared the occurrence and degree of glenoid bone change, glenoid inclination change, retroversion change, and glenoid center, as well as the degree of humerus head change, between the healing and retear groups.

Results: The occurrence of glenoid bone change was significantly more common in the retear group than in the healing group (p = 0.026). The degree of bone change in the 11-1 o'clock axial plane and 10-8 o'clock, 11-7 o'clock, and 12-6 o'clock coronal plane and the degree of glenoid inclination change were significantly larger in the retear group than the healing group (p = 0.026, p = 0.026, p = 0.026, p = 0.026, and p = 0.014, respectively), but the average value of glenoid bone change in the retear group was within the range of 0.14 to 1.01 mm for each plane. The mean humeral head change was 5.69 ± 3.67 mm increase in the retear group and 1.27 ± 2.02 mm increase in the healing group. Compared with the healing group, the retear group showed statistically significantly increased humeral head change (p < 0.001).

Conclusions: There was difference in glenoid and humerus bone change between the healing and retear groups at midterm follow-up after repair of small- to medium-sized tears. However, considering the measurement bias, the difference between the two groups was within the measurement error range.
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==A Nomogram Based on CT Radiomics and Clinical Risk Factors for Prediction of Prognosis of Hypertensive Intracerebral Hemorrhage==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36531926 Comput Intell Neurosci. 2022 Dec 7;2022:9751988. PMID: 36531926] [http://www.ncbi.nlm.nih.gov/pmc/articles/pmc9750770/ PDF]

'''Authors:''' Fang C, An X, Li K, Zhang J, Shang H, Jiao T, Zeng Q.

'''Institution:''' Department of Radiology, The First Affiliated Hospital of Shandong First Medical University, Shandong Provincial Qianfoshan Hospital, Jinan, Shandong, China.

'''Abstract:''' Purpose: To develop and validate a clinical-radiomics nomogram based on clinical risk factors and CT radiomics feature to predict hypertensive intracerebral hemorrhage (HICH) prognosis.

Methods: A total of 195 patients with HICH treated in our hospital from January 2018 to January 2022 were retrospectively enrolled and randomly divided into two cohorts for training (n = 138) and validation (n = 57) according to the ratio of 7 : 3. All CT radiomics features were extracted from intrahematomal, perihematomal, and combined intra- and perihematomal regions by using free open-source software, [http://www.slicer.org '''3D Slicer''']. The least absolute shrinkage and selection operator method was used to select the optimal radiomics features, and the radiomics score (Rad-score) was calculated. The relationship between Rad-score, clinical risk factors, and the HICH prognosis was analyzed by univariate and multivariate logistic regression analyses, and the clinical-radiomics nomogram was built. The area under the receiver operating characteristic curve (AUC) and decision curve analysis (DCA) were used to evaluate the performance of the clinical-radiomics nomogram in predicting the prognosis of HICH.

Results: A total of 1702 radiomics features were extracted from the CT images of each patient for analysis. By univariate and stepwise multivariate logistic regression analyses, age, sex, RBC, serum glucose, D-dimer level, hematoma volume, and midline shift were clinical risk factors for the prognosis of HICH. Rad-score and clinical risk factors developed the clinical-radiomics nomogram. The nomogram showed the highest predictive efficiency in the training cohort (AUC = 0.95, 95% confidence interval (CI), 0.92 to 0.98) and the validation cohort (AUC = 0.90, 95% CI, 0.82 to 0.98). The calibration curve indicated that the clinical-radiomics nomogram had good calibration. DCA showed that the nomogram had high applicability in clinical practice.

Conclusions: The clinical-radiomics nomogram incorporated with the radiomics features and clinical risk factors has good potential in predicting the prognosis of HICH.
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==the Traction Force of the Pulled Limb in Hip Arthroscopic Surgery Is Determined by Stiffness Coefficient Which Is Significantly Related to Muscle Volume==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36477348 Knee Surg Sports Traumatol Arthrosc. 2022 Dec 7. PMID: 36477348]

'''Authors:''' Yin Y, Xue S, Zhang X, Yang G, Xu Y, Wang J, Huang H.

'''Institution:''' Department of Sports Medicine, Beijing Key Laboratory of Sports Injuries, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing, China.

'''Abstract:''' Purpose: To verify the relationship between muscle volume, lateral centre-edge angle (LCEA), alpha angle (AA), body mass index (BMI) and Beighton score with stiffness coefficient (SC). To analyse the difference of traction force at different physical states of hip joint capsule.

Methods: Thirty-six patients who underwent hip arthroscopy operation were included. The volumes of some related muscles were measured in MRI images by [http://www.slicer.org '''3D Slicer''']. We recorded and tested differences in traction force of five joint capsule physical states, including before (State 1) and after joint capsule puncture (State 2), after the establishment of anterolateral and mid-anterior approaches (State 3) and after incision of the joint capsule through these two approaches (States 4, 5). The correlation between muscle volume, BMI, LCEA, AA and SC was verified by Spearman test. Poisson regression was used to explain confounding variables.

Results: The average force at State 1 was 531.8 N. There were significant differences in traction force between these five states (p < 0.001). There was a significant positive correlation between muscle volumes and SC (p < 0.001). BMI had no correlation with SC (n.s.). The preoperative LCEA of the affected side was correlated with SC (p = 0.043). AA and SC were not correlated (n.s.).

Conclusion: The physical states of the hip joint capsule affected traction force. Muscle volume rather than BMI is an ideal index to estimate preoperative traction force. LCEA affected traction force, whilst AA and Beighton score did not. Measuring the muscle volume can help estimate the most suitable traction force for the patient.
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==3D Slicer-Based Calculation of Hematoma Irregularity Index for Predicting Hematoma Expansion in Intracerebral Hemorrhage==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36471307 BMC Neurol. 2022 Dec 5;22(1):452. PMID: 36471307] [http://www.ncbi.nlm.nih.gov/pmc/articles/pmc9720921/ PDF]

'''Authors:''' Cao L, Liu M, Wang M, Ding J, Mao K, Liu K, Li S.

'''Institution:''' Department of Sports Medicine, Beijing Key Laboratory of Sports Injuries, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing, China.

'''Abstract:''' Background: Irregular hematoma is considered as a risk sign of hematoma expansion. The aim of this study was to quantify hematoma irregularity with computed tomography based on [http://www.slicer.org '''3D Slicer'''].

Methods: Patients with spontaneous intracerebral hemorrhage who underwent an initial and subsequent non-contrast computed tomography (CT) at a single medical center between January 2019 to January 2020 were retrospectively identified. The Digital Imaging and Communication in Medicine (DICOM) standard images were loaded into the [http://www.slicer.org '''3D Slicer'''], and the surface area (S) and volume (V) of hematoma were calculated. The hematoma irregularity index (HII) was defined as [Formula: see text]. Logistic regression analyses and receiver operating characteristic (ROC) curve analysis were performed to assess predictive performance of HII.

Results: The enrolled patients were divided into those with hematoma enlargement (n = 36) and those without the enlargement (n = 57). HII in hematoma expansion group was 130.4 (125.1-140.0), and the index in non-enlarged hematoma group was 118.6 (113.5-122.3). There was significant difference in HII between the two groups (P < 0.01). Multivariate logistic regression analysis revealed that the HII was significantly associated with hematoma expansion before (odds ratio = 1.203, 95% confidence interval [CI], 1.115-1.298; P < 0.001) and after adjustment for age, hematoma volume, Glasgow Coma Scale score (odds ratio = 1.196, 95% CI, 1.102-1.298, P < 0.001). The area under the ROC curve was 0.86 (CI, 0.78-0.93, P < 0.01), and the best cutoff of HII for predicting hematoma growth was 123.8.

Conclusion: As a quantitative indicator of irregular hematoma, HII can be calculated using the [http://www.slicer.org '''3D Slicer''']. And the HII was independently correlated with hematoma expansion.
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==Interrelations Between the Too-Long Anterior Calcaneal Process, Hind and Mid-tarsal Bone Volumes, Angles and Osteochondral Lesion of the Dome of the Talus: Analysis by Software Slicer of 69 CT Scan of Feet==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36507201 Indian J Orthop. 2022 Nov 16;56(12):2228-36. PMID: 36507201]

'''Authors:''' Lucchesi G, Bonnel F, Mainard N, Orlando N, Sacco R, Dimeglio A, Boutry N, Canavese F.

'''Institution:''' Ortopediatria Center for Education, Research and Patient Care in Paediatric Orthopedics, Bologna, Italy.

'''Abstract:''' Introduction: Although the association between Too-Long Anterior Calcaneal Process (TLACP) and osteochondral lesion of the dome of the talus (OCL) has been hypothesized, no study has investigated the interrelations between TLACP, hind and mid-tarsal volumes and angles and the development of OCL. The main goals of this work are: (1) to measure the volume of the calcaneum, talus, navicular and cuboid in subjects with and without TLACP; (2) to evaluate the angular relationships between talus, calcaneum and navicular in subjects with and without TLACP; (3) to assess whether TLACP has an effect on the volume of OCL.

Methods: This is a retrospective study of 69 CT scans of 54 consecutive children aged 11-15 years who had undergone a CT scan due to symptomatology suggestive of TLACP. The [http://www.slicer.org '''3D Slicer'''] software allowed to calculate the volume of the talus, calcaneum, navicular, cuboid, TLACP and OCL (in cm3). The PACS system was used to perform the angular measurements (in degrees) between talus, calcaneum and navicular in the frontal, axial and sagittal plane.

Results: Amid the 69 CT scans, 49 were found to have pathologies related to TLACP (71%, TLACP Group) and 20/69 were normal (29%, Control Group). The mean hind and mid-tarsal bone volumes of the TLACP group were comparable to those of the control group. There were 40 (81.6%) OCLs detected exclusively in pathological feet (TLACP group); 32 lesions were medial (80%), and 8 lesions were lateral (20%). According to Ferkel and Sgaglione CT Staging System, there were 22 (55%) stage 1 lesions, 5 (12.5%) stage 2A, 3 (7.5%) stage 2B and 10 (25%) stage three lesions. Only the angle between the talus and calcaneum in the frontal plane was significantly lower in pathological feet with respect to the control group (p < 0.001). In pathological feet, the talus was supinated, and the calcaneus pronated.

Conclusions: TLACP tend to stiffen the foot, modifying its biomechanics and leading to supination of the talus and pronation of the calcaneum. This induces an overpressure at the medial side of the talus where we observed a greater frequency of medial OCL with larger volume than lateral OCL.
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==A Novel Three-Step Process for the Identification of Inner Ear Malformation Types==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36544941 Laryngoscope Investig Otolaryngol. 2022 Nov 24;7(6):2020-8. PMID: 36544941] [http://www.ncbi.nlm.nih.gov/pmc/articles/pmc9764783/ PDF]

'''Authors:''' Dhanasingh AE, Weiss NM, Erhard V, Altamimi F, Roland P, Hagr A, Van Rompaey V, Van de Heyning P.

'''Institution:''' Research and Development Department, MED-EL Innsbruck Austria.

'''Abstract:''' Objective: We hypothesize that visualizing inner-ear systematically in both cochlear view (oblique coronal plane) and in mid-modiolar section (axial plane) and following three sequential steps simplifies, identification of inner-ear malformation types.

Methods: Pre-operative computer-tomography (CT) scans of temporal bones of 112 ears with various inner ear malformation (IEM) types were taken for analysis. Images were analyzed using DICOM viewers, [http://www.slicer.org '''3D Slicer'''], and OTOPLAN®. The inner-ear was captured in the oblique-coronal plane for the measurement of length and width of cochlear basal turn which is also called as A-, and B-values respectively (Step 1). In the same plane, the angular-turns of lateral-wall (LW) of cochlear basal turn were measured (Step 2). As Step 3, the mid-modiolar section of inner ear was captured in the axial plane by following the A-value and perpendicular to cochlear view. From the mid-modiolar section, the outer-contour of inner ear was captured manually by following contrasting gray area between fluid filled and bony promontory and was compared to known resembling objects to identify IEM types (Step 3).

Results: Following reference values have emerged from our analysis: A-, and B-values (Step 1) on average are >8 mm and >5.5 mm respectively, in normal cochleae (NA), enlarged vestibular aqueduct syndrome (EVAS), incomplete partition (IP) type-I and -II, whereas it is <8 mm and <5.5 mm respectively, in IP type-III and cochlear hypoplasia (CH). Angular-turn of LW is consistently observed in cochlear basal turn (Step 2), is 540° in NA and EVAS, 450° in IP-II, and 360° in IP types I & III. In subjects with CH type, angular-turn of LW is either 360° or 450° or 540°. In true mid-modiolar section, outer-contour of inner-ear (Step-3), other than in CH and cystic inner-ear malformations, resembles recognizable shapes of known objects. Absence of EVA is an additional characteristic that confirms diagnosis of CH when the A-, B-values, and angular-turn of LW can be similar to other anatomical types. Drawing a straight line along posterior edge of internal auditory canal (IAC) in axial view can differentiate a true common cavity (CC) from cochlear aplasia-vestibular cavity (VC).
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==Chew on This: Oral Jaw Shape Is Not Correlated With Diet Type in Loricariid Catfishes==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36322589 PLoS One. 2022 Nov 2;17(11):e0277102. PMID: 36322589] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9629652/pdf/pone.0277102.pdf PDF]

'''Authors:''' Black CR, Armbruster JW.

'''Institution:''' Department Entomology National Museum of Natural History Smithsonian Institution, Washington, District of Columbia, USA.

'''Abstract:''' The correlation between form and function is influenced by biomechanical constraints, natural selection, and ecological interactions. In many species of suction-feeding fishes, jaw shape has shown to be closely associated with diet. However, these correlations have not been tested in fishes that have more complex jaw functions. For example, the neotropical loricariid catfishes possess a ventrally facing oral disk, which allows for the oral jaws to adhere to surfaces to conduct feeding. To determine if jaw shape is correlated to diet type, we assessed oral jaw shape across 36 species using CT scans. Shape was quantified with traditional and automated landmarking in [http://www.slicer.org '''3D Slicer'''], and diet type correlation was calculated using the phylogenetic generalized least squares (PGLS) method. We found that traditional and automated processes captured shape effectively when all jaw components were combined. PGLS found that diet type did not correlate to jaw shape; however, there was a correlation between clades with diverse diets and fast evolutionary rates of shape. These results suggest that shape is not constrained to diet type, and that similarly shaped jaws coupled with different types of teeth could allow the fishes to feed on a wide range of materials.
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==Can Quantitative Peritumoral CT Radiomics Features Predict the Prognosis of Patients With Non-Small Cell Lung Cancer? A Systematic Review==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36307554 Eur Radiol. 2022 Oct 29. PMID: 36307554]

'''Authors:''' Wu L, Lou X, Kong N, Xu M, Gao C.

'''Institution:''' Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, China.

'''Abstract:''' Objectives: To provide an overarching evaluation of the value of peritumoral CT radiomics features for predicting the prognosis of non-small cell lung cancer and to assess the quality of the available studies.

Methods: The PubMed, Embase, Web of Science, and Cochrane Library databases were searched for studies predicting the prognosis in patients with non-small cell lung cancer (NSCLC) using CT-based peritumoral radiomics features. Information about the patient, CT-scanner, and radiomics analyses were all extracted for the included studies. Study quality was assessed using the Radiomics Quality Score (RQS) and the Prediction Model Risk of Bias Assessment Tool (PROBAST).

Results: Thirteen studies were included with 2942 patients from 2017 to 2022. Only one study was prospective, and the others were all retrospectively designed. Manual segmentation and multicenter studies were performed by 69% and 46% of the included studies, respectively. [http://www.slicer.org '''3D Slicer'''] and MATLAB software were most commonly used for the segmentation of lesions and extraction of features. The peritumoral region was most frequently defined as dilated from the tumor boundary of 15 mm, 20 mm, or 30 mm. The median RQS of the studies was 13 (range 4-19), while all of included studies were assessed as having a high risk of bias (ROB) overall.

Conclusions: Peritumoral radiomics features based on CT images showed promise in predicting the prognosis of NSCLC, although well-designed studies and further biological validation are still needed.
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==A Custom-Made Removable Appliance for the Decompression of Odontogenic Cysts Fabricated Using a Digital Workflow==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36116543 J Dent. 2022 Nov;126:104295. PMID: 36116543] | [https://www.sciencedirect.com/science/article/pii/S0300571222003505/pdfft?md5=f819d603ef8dd5aa8ba2ab73a4d811b1&pid=1-s2.0-S0300571222003505-main.pdf PDF]

'''Authors:''' Kivovics M, Pénzes D, Moldvai J, Mijiritsky E, Németh O.

'''Institution:''' Department of Community Dentistry, Semmelweis University, Budapest, Hungary.

'''Abstract:''' This case series aimed to assess the feasibility of a custom-made decompression appliance fabricated using a digital workflow to decompress odontogenic cysts. Additionally, the treated cysts were assessed for volumetric changes.

Methods: A three-dimensional (3D) reconstruction software (CoDiagnostiX version 10.4) was used to obtain the master cast STL (Standard Tessellation Language) file by placing a customized virtual implant to create a recess for the tube of the decompression device. The decompression appliance was planned using Dental Wings Open Software (DWOS). Following rapid prototyping, the tube of the appliance was perforated using round burs. In cases where the appliances were designed to replace teeth, denture teeth were added using the conventional workflow. The appliances were delivered on the day of the cystostomy. Following decompression, cyst enucleation was performed. Cyst volume was assessed by manual segmentation of pre- and post-operative cone-beam computed tomography (CBCT) reconstructions using slice-by-slice boundary drawing with a scissors tool in the [http://www.slicer.org '''3D Slicer'''] v4.10.2 software. Percentage of volume reduction was calculated as follows: volume reduction/pre-operative volume × 100.

Results: Six odontogenic cysts in six patients (5 male, 1 female; age 40 years, range: 15-49 years) with a pre- and post-operative cyst volume of 5597 ± 3983 mm3 and 2330 ± 1860 mm3 respectively (p < 0.05) were treated. Percentage of volume reduction was 58.84 ± 13.22 % following a 6-month-long decompression period.

Conclusions: The digital workflow described in this case series enables the delivery of decompression appliances at the time of cystostomy, thus effectively reducing the volume of odontogenic cysts. The resulting bone formation established a safe zone around the anatomical landmarks; therefore, during enucleation surgery, complications to these landmarks can be avoided.
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==Associations of Depressive Symptoms With White Matter Abnormalities and Regional Cerebral Blood Flow in Patients With Amnestic Mild Cognitive Impairment==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36058887 Geriatr Gerontol Int. 2022 Oct;22(10):846-850. PMID: 36058887]

'''Authors:''' Hirao K, Yamashita F, Kato H, Kaneshiro K, Tsugawa A, Haime R, Fukasawa R, Sato T, Kanetaka H, Umahara T, Sakurai H, Hanyu H, Shimizu S.

'''Institution:''' Department of Geriatric Medicine, Tokyo Medical University, Tokyo, Japan.

'''Abstract:''' Aim: Depressive symptoms are one of the most common neuropsychiatric symptoms in patients with mild cognitive impairment (MCI) and Alzheimer's disease (AD), although the pathophysiologies of the depressive symptoms that occur in these diseases have not been elucidated to date. In this study, we therefore investigated the associations between depressive symptoms and cognitive performance, white matter abnormalities, and regional cerebral blood flow (rCBF) in amnestic MCI patients.

Methods: Thirty-eight patients with amnestic MCI were analyzed. The volumes of periventricular hyperintensities (PVH) and deep white matter hyperintensities (DWMH) were measured on T2-fluid-attenuated inversion recovery magnetic resonance imaging using the imaging software [http://www.slicer.org '''3D Slicer''']. Associations between the Geriatric Depression Scale (GDS) score and other neuropsychological test scores on the one hand and the PVH and DWMH volumes on the other were analyzed. Voxel-wise correlations of rCBF with GDS score, after controlling for the effects of age, were investigated using SPM8 software.

Results: Significant correlations were identified between GDS score, Trail Making Test B and apathy scale scores on the one hand and PVH volume on the other. A significant negative association between GDS score and rCBF was identified in the right dominant bilateral dorsolateral prefrontal cortex (DLPFC).

Conclusions: Depressive symptoms are significantly associated with PVH volume in MCI patients. The rCBF of the DLPFC was significantly associated with depressive symptoms, suggesting that this area might be closely involved in the pathogenesis of the depressive symptoms observed in MCI patients.
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==Preoperative MRI for Postoperative Seizure Prediction: A Radiomics Study of Dysembryoplastic Neuroepithelial Tumor and a Systematic Review==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36183180 Neurosurg Focus. 2022 Oct;53(4):E7. PMID: 36183180]

'''Authors:''' Wang J, Luo X, Chen C, Deng J, Long H, Yang K, Qi S.

'''Institution:''' Department of Neurosurgery, Nanfang Hospital, Southern Medical University, Guangzhou, China.

'''Abstract:''' Objective: In this systematic review the authors aimed to evaluate the effectiveness and superiority of radiomics in detecting tiny epilepsy lesions and to conduct original research in the use of radiomics for preliminary prediction of postoperative seizures in patients with dysembryoplastic neuroepithelial tumor (DNET).

Methods: The PubMed and Web of Science databases were searched from the earliest record, January 1, 2018, to December 29, 2021, for reports of the detection of epilepsy using radiomics, and the resulting articles were carefully checked according to the PRISMA 2020 guidelines. The authors then conducted original research by evaluating MR images in 18 patients, who were then separated into two groups, the epilepsy recurrence group (ERG) and the epilepsy nonrecurrence group. The tumor region and the edema region were segmented manually by [http://www.slicer.org '''3D Slicer''']. The radiomics data were extracted from MR images by using "Slicer Radiomics" running on Mac OS X. Tumor regions were observed with T1-weighted imaging, and edema with FLAIR imaging. Radiomics features with significant differences were selected through comparison according to epilepsy relapses performed with the Mann-Whitney U-test. The edema and tumor regions were also compared within groups to identify their distinctive features. Radiomics features were tested to verify their ability to predict recurrence epilepsy by receiver operating characteristic curve.

Results: This systematic review located 9 original articles related to epilepsy and radiomics published from 2018 to 2021. The reported studies demonstrated that radiomics is useful for detecting tiny epilepsy lesions. Among the radiomics features used, the predictive ability of the area under the curve was more than 0.8. The heterogeneity of the peritumoral edema region was found to be higher in the ERG.

Conclusions: Satellite lesions in the peritumoral edema region of DNET patients may cause epilepsy recurrence, and radiomics is an emerging method to detect and evaluate these epilepsy-associated lesions.
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==Three-Dimensional Changes in the Mandibular Proximal Segment After Using a Surgery-First Approach in Patients With Class III Malocclusion and Facial Asymmetry==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35175981 J Craniofac Surg. 2022 Oct 1;33(7):1956-1961. PMID: 35175981] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9378743/pdf/scs-33-1956.pdf PDF]

'''Authors:''' Kim M, Jha N, Choi JH, Kim YJ, Lee U, Cevidanes L, Choi JY, Baek SH.

'''Institution:''' University of Ulsan Department of Oral and Maxillofacial Surgery, Chungang University Hospital, Seoul, South Korea.

'''Abstract:''' This study was performed to evaluate condylar position and angulation after asymmetric mandibular setback between a conventional (CA) and surgery-first approach (SFA) using three-dimensional analysis. The condylar positions of 30 patients with skeletal Class III malocclusion and facial asymmetry who underwent 1-jaw (sagittal split ramus osteotomy) or 2-jaw orthognathic surgery (Le Fort I osteotomy and sagittal split ramus osteotomy) with CA (n = 18) or SFA (n = 12) from 2 university hospitals were studied. The three-dimensional assessment of condylar changes was performed using computed tomography images at the initial time point (T0) and at least 6 months after surgery (T1). Segmentation of condyles and cranial base assessment from cone-beam computed tomography images were performed using ITK-SNAP software (version 3.4.0). Condylar position and angulation changes were calculated using [http://www.slicer.org '''3D Slicer'''] v. 4.10.2 software, and statistical analysis was performed. No significant translational or rotational condylar changes were observed between the deviated and nondeviated sides in each group or between the CA and SFA groups except yaw (P = 0.014). Linear mixed-model analysis and multivariate analysis showed no significant difference between the CA and SFA groups. Surgery-first approach might not be associated with more harmful effects on the condylar position and angulation changes as compared with CA.
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==A Novel Stereotactic Aspiration Technique for Intracerebral Hemorrhage==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36270590 World Neurosurg. 2022 Oct 18:S1878-8750(22)01467-X. PMID: 36270590]

'''Authors:''' Xu HZ, Guo J, Wang C, Liu X, Song ZQ, Chen RF, Qiu B, Wang Q, Huang Y.

'''Institution:''' Departments of Neurosurgery, Civil Aviation General Hospital, Beijing, China.

'''Abstract:''' Background: Minimally invasive surgery (MIS) is effective and recommended for the treatment of intracerebral hemorrhage (ICH), whereas neurosurgeons in grass-root hospitals in undeveloped countries are lacking in effective and precise MIS techniques. Hereby, we present the technique of CTA-based 3D-printed navigation mold-guided stereotactic aspiration and demonstrate its clinical application using a hard needle for a series of patients.

Methods: We give a detailed description of the procedure and technique used in the novel stereotactic aspiration and report on its clinical outcome in our center. Moreover, we compared the volume of hematoma measured by three different methods: ABC/2 formula, manual segmentation with Osirix and manual segmentation with [http://www.slicer.org '''3D Slicer'''].

Results: The surgery was completed safely within an average operation time of 15.11 minutes, achieving the goal of < 15ml residual clot volume or >70% clot removal in all patients. No intracranial rebleeding or infection was observed postoperatively. 61.11% (11/18) of patients achieved mRS< 3 after 6 months' rehabilitation. There was overall better agreement of hematoma measurement using segmentation with [http://www.slicer.org '''3D Slicer'''] rather than the ABC/2 measurement, when compared with hematoma measurement using segmentation with Osirix.

Conclusions: We present a new method of stereotactic aspiration, which benefits patients in this study with good percent clot removal, few surgery-related complications, and a favorable prognosis. And manual segmentation with [http://www.slicer.org '''3D Slicer'''] could be used to provide neurosurgeon with solid information about hematoma volume. This cheap and convenient technique may provide a novel choice for grass-root hospitals in undeveloped countries, but it needs to be assessed in multicenter prospective clinical trials.
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==Characteristics of Cognitive Function in Patients With Cerebellar Infarction and Its Association With Lesion Location==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36268191 Front Aging Neurosci. 2022 Oct 4;14:965022. PMID: 36268191] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9577113/pdf/fnagi-14-965022.pdf PDF]

'''Authors:''' Liu Q, Liu C, Zhang Y.

'''Institution:''' Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.

'''Abstract:''' Objective: This study aimed to explore the characteristics of cognitive function in patients with cerebellar infarction and its association with lesion location. Methods: Forty-five patients with isolated cerebellar infarction were collected in the Department of Neurology, Beijing Tiantan Hospital. Thirty healthy controls were recruited matched by age and education. Global cognitive function was evaluated by using Addenbrooke's Cognitive Examination version III (ACE-III). An extensive neuropsychological assessment battery was also tested to evaluate the characteristics of each cognitive domain. [http://www.slicer.org '''3D Slicer'''] software was used to draw the lesion, and evaluate the lesions' volume, side, and location. Group analysis was used to compare the differences in cognitive performance between patients and healthy controls, and patients with left and right cerebellar hemisphere infarction. Spearman analysis was used to explore the correlation between cognitive function and lesion volume. We also subdivided each patient's lesions according to the cerebellar atlas to identify the specific cerebellar location related to cognitive decline. Results: Patients with cerebellar infarction had a lower ACE-III score compared with the healthy group (87.9 ± 6.2 vs. 93.7 ± 2.9, p < 0.001), and 22 (48.9%) patients were diagnosed with cognitive impairment. The z-transformed score of attention and executive function in the patients' group was -0.9 ± 1.4 and -0.8 ± 1.0 respectively, with 19 (43.2%) and 23 (56.4%) patients impaired. Compared with healthy controls, the relative risk ratio with 95% confidence interval (CI) for impairment in attention and executive function were 3.24 (1.22-8.57) and 3.39 (1.45-7.89). However, only 10 (22.1%) patients showed impairment in more than two cognitive domains. Compared with the left lesion group, patients with right cerebellar infarction showed significantly impaired executive function (-1.1 ± 0.3 vs. -0.5 ± 0.2, p = 0.01). And the cerebellar posterior lobe regions, especially lobules VI, VIII, and IX, were explored to have lower cognitive performance. Furthermore, lesion volume was identified to be associated with the ACE-III score (r = -0.37, p = 0.04). Conclusion: We identified that cerebellar involvement in cognition, especially in attention processing and executive function. Cerebellar right-sided lateralization of cognition and functional topography were also revealed in the current study.
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==The Reliability of the Measurement of Muscle Volume Using Magnetic Resonance Imaging in Typically Developing Infants by Two Raters==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36307532 Sci Rep. 2022 Oct 28;12(1):18191. PMID: 36307532] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9616850/pdf/41598_2022_Article_23087.pdf PDF]

'''Authors:''' Whitta G, Liang J, Stott NS, Mirjalili SA, Battin M, Williams SA.

'''Institution:''' Department of Anatomy and Medical Imaging, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.

'''Abstract:''' To assess intra-rater and inter-rater reliability of the manual segmentation of Magnetic Resonance Imaging (MRI) for the in vivo measurement of infant muscle volume of the knee extensor and flexor muscles by two raters. Muscles of the knee extensor and flexor muscle of ten typically developing infants (86 days ± 7 days) were scanned with MRI (Proton density sequence). Scans were then segmented using [http://www.slicer.org '''3D Slicer'''] software, and volumes rendered by two raters. Intra-rater and inter-rater reliability were assessed using intra-class correlation (ICC), with mean difference (MD), standard error of the mean (SEM), and minimal detectable change (MDC) for each muscle calculated. ICCs for Intra-rater reliability of the segmentation process for the muscle volume of the muscles of the knee extensors and flexor muscles were 0.901-0.972, and 0.776-0.945 respectively, with inter-rater reliabilities between 0.914-0.954 and 0.848-0.978, for the knee extensor and flexors muscles respectively. For intra-rater reliability, MD ≤ - 0.47 cm3, MDCs for were < 1.09 cm3 and for inter-rater MD ≤ - 1.40 cm3, MDCs for were < 1.63 cm3 for all muscles. MRI segmentation for muscle volumes showed good to excellent reliability, though given the small volumes of the muscles themselves, variations between raters are amplified. Care should be taken in the reporting and interpretation of infant muscle volume.
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==Minimizing MR Image Geometric Distortion at 7 Tesla for Frameless Presurgical Planning Using Skin-Adhered Fiducials==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36301228 Med Phys. 2022 Oct 27. PMID: 36301228]

'''Authors:''' Kirby KM, Koons EK, Welker KM, Fagan AJ.

'''Institution:''' Department of Radiology, Mayo Clinic, Rochester, MN, USA.

'''Abstract:''' Background: 7T MRI offers significant benefits to spatial and contrast resolution compared to lower field strengths. This superior image quality can help better delineate targets in stereotactic neurosurgical procedures; however, the potential for increased geometric distortions at 7T has impaired its widespread use for these applications. Image geometric distortions can be due to distortions of B0 arising from tissue magnetic susceptibility effects or inherent field inhomogeneities, and nonlinearity of the magnetic field gradients.

Purpose: The purpose of this study was to investigate the use of 7T MRI for neurosurgical frameless stereotactic navigation procedures. Image geometric distortions at the skin surface in 7T images were minimized and compared to results from clinical 3T frameless imaging protocols.

Methods: A 3D-printed grid phantom filled with oil was designed to perform a fine calibration of the 7T imaging gradients, and an oil-filled head phantom with internal targets was used to determine ground truth (from CT) positioning errors. Three volunteers and the head phantom were imaged consecutively at 3T and 7T. 10 skin-adhesive fiducial markers were placed on each subject's exposed skin surface at standard clinical placement locations for frameless procedures. Imaging sequences included MPRAGE (three bandwidths at 7T: 400, 690, and 1020 Hz/pixel, and one at 3T: 400 Hz/pixel), T2 SPACE, and T2 SPACE FLAIR acquisitions. An additional GRE fieldmap was acquired on both scanners using a multi-echo GRE sequence. Custom Matlab code was used to perform additional distortion correction of the images using the unwrapped field maps. Fiducial localization was performed with [http://www.slicer.org '''3D Slicer'''] , with absolute fiducial positioning errors determined in phantom experiments following rigid registration to the CT images. For human experiments, 3T and 7T images were registered and relative differences in fiducial locations were compared using two-tailed paired t-tests.

Results: Phantom measurements at 7T yielded gradient distance scaling errors of 1.1%, 2.2%, and 1.0% along the x-, y- and z-axes, respectively. These system miscalibrations were traced back to phantom manufacturing deviations in sphericity of the vendor's gradient calibration phantom. Correction factors along each gradient axis were applied, and afterward, geometric distortions of less than 1 mm were obtained in the 7T MR head phantom images for the 1020 Hz/pixel bandwidth MPRAGE sequence. For the human subjects, four fiducial locations were excluded from analysis due to patient positioning differences. Differences between 3T and 7T MPRAGE with low/medium/high bandwidth were 2.2mm / 2.6mm / 2.3mm, respectively, before the correction, reducing to 1.6mm / 1.3mm / 1.0mm after the correction (p<0.001). T2 SPACE and T2 SPACE FLAIR yielded a similar pattern when the correction was applied, decreasing from 2.1mm to 0.8mm, and 2.6mm to 1.0mm, respectively.

Conclusions: 7T MRI can be used to perform frameless presurgical planning with skin-adhesive fiducials. Geometric distortions can be reduced to a clinically relevant level (errors <∼1mm) with no significant susceptibility-related distortions, by using high receiver bandwidth, ensuring gradients are properly calibrated, and placing skin fiducials in areas where distortions from patient positioning are minimal.
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==Machine Learning for the Prediction of Osteopenia/Osteoporosis Using the CT Attenuation of Multiple Osseous Sites From Chest CT==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35988394 Eur J Radiol. 2022 Oct;155:110474. PMID: 35988394]

'''Authors:''' Sebro R, De la Garza-Ramos C.

'''Institution:''' Department of Radiology, Mayo Clinic, Jacksonville, FL, USA.

'''Abstract:''' To use machine learning and the CT attenuation of all bones visible on chest CT scans to predict osteopenia/osteoporosis.

Method: We retrospectively evaluated 364 patients with CT scans of the chest, and Dual-energy X-ray absorptiometry (DXA) scans within 6 months of each other. Studies were performed between 01/01/2015 and 08/01/2021. Volumetric segmentation of the ribs, thoracic vertebrae, sternum, and clavicle was performed using [http://www.slicer.org '''3D Slicer'''] to obtain the mean CT attenuation of each bone. The study sample was randomly split into training/validation (80 %, n = 291 patients) and test (20 %, n = 73 patients) datasets. Univariate analyses were used to identify the optimal CT attenuation thresholds to diagnose osteopenia/osteoporosis. We used penalized multivariable logistic regression models including Least Absolute Shrinkage and Selection Operator (LASSO), Elastic Net, and Ridge regression, and Support Vector Machines (SVM) with radial basis functions (RBF) to predict osteopenia/osteoporosis and compared these results to the CT attenuation threshold at T12.

Results: There were positive correlations between the CT attenuation between all bones (r > 0.6, P < 0.001 for all). There were positive correlations between CT attenuation of the bones and the L1-L4 BMD T-score, total hip T-score, and femoral neck T-scores (r > 0.4, P < 0.001 for all). A CT attenuation threshold of 170.2 Hounsfield units (HU) at T12 had an AUC of 0.702, while a threshold of 192.1 HU at T4 had an AUC of 0.757. The SVM with RBF had the highest AUC (AUC = 0.864) and was better than the LASSO (P = 0.011), Elastic Net (P = 0.011), Ridge regression (P = 0.011) but was not better than using the CT attenuation at T12 (P = 0.060).

Conclusions: The CT attenuation of the ribs, thoracic vertebra, sternum, and clavicle can be used individually and collectively to predict BMD and to predict osteopenia/osteoporosis.
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==Can Radiomic Feature Analysis Differentiate Adrenal Metastases From Lipid-Poor Adenomas on Single-Phase Contrast-Enhanced CT Abdomen?==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35948490 Clin Radiol. 2022 Oct;77(10):e711-e718. PMID: 35948490]

'''Authors:''' O'Shea A, Kilcoyne A, McDermott E, O'Grady M, McDermott S.

'''Institution:''' Department of Radiology, Massachusetts General Hospital, Boston, MA, USA.

'''Abstract:''' Aim: To assess if radiomic feature analysis could help to differentiate between the lipid-poor adenomas and metastases to the adrenal glands.

Materials and methods: Eighty-six patients (women:men 42:44; mean age 66 years) with biopsy-proven adrenal metastases and 55 patients (women:men 39:16; mean age 67 years) with lipid-poor adenomas who underwent contrast-enhanced, portal-venous phase CT of the abdomen. Radiomic features were extracted using the PyRadiomics extension for [http://www.slicer.org '''3D Slicer''']. Following elastic net regularisation, seven of 1,132 extracted radiomic features were selected to build a radiomic signature. This was combined with patient demographics to create a predictive nomogram. The calibration curves in both the training and validation cohorts were assessed using a Hosmer-Lemeshow test.

Results: The radiomic signature alone yielded an area under the curve of 91.7% in the training cohort (n=93) and 87.1% in the validation cohort (n=48). The predictive nomogram, which combined age, a previous history of malignancy, and the radiomic signature, had an AUC of 97.2% in the training cohort and 90.4% in the validation cohort.

Conclusion: The present nomogram has the potential to differentiate between a lipid-poor adrenal adenoma and adrenal metastasis on portal-venous CT.
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==Application of Machine Learning Model to Predict Osteoporosis Based on Abdominal Computed Tomography Images of the Psoas Muscle: A Retrospective Study==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36229793 BMC Geriatr. 2022 Oct 13;22(1):796. PMID: 36229793] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9563158/pdf/12877_2022_Article_3502.pdf PDF]

'''Authors:''' Huang CB, Hu JS, Tan K, Zhang W, Xu TH, Yang L.

'''Institution:''' Department of Orthopaedic Surgery, The Second Affiliated Hospital and Yuying Childrens Hospital of Wenzhou Medical University, Wenzhou, China.

'''Abstract:''' Background: With rapid economic development, the world's average life expectancy is increasing, leading to the increasing prevalence of osteoporosis worldwide. However, due to the complexity and high cost of dual-energy x-ray absorptiometry (DXA) examination, DXA has not been widely used to diagnose osteoporosis. In addition, studies have shown that the psoas index measured at the third lumbar spine (L3) level is closely related to bone mineral density (BMD) and has an excellent predictive effect on osteoporosis. Therefore, this study developed a variety of machine learning (ML) models based on psoas muscle tissue at the L3 level of unenhanced abdominal computed tomography (CT) to predict osteoporosis.

Methods: Medical professionals collected the CT images and the clinical characteristics data of patients over 40 years old who underwent DXA and abdominal CT examination in the Second Affiliated Hospital of Wenzhou Medical University database from January 2017 to January 2021. Using [http://www.slicer.org '''3D Slicer'''] software based on horizontal CT images of the L3, the specialist delineated three layers of the region of interest (ROI) along the bilateral psoas muscle edges. The PyRadiomics package in Python was used to extract the features of ROI. Then Mann-Whitney U test and the least absolute shrinkage and selection operator (LASSO) algorithm were used to reduce the dimension of the extracted features. Finally, six machine learning models, Gaussian naïve Bayes (GNB), random forest (RF), logistic regression (LR), support vector machines (SVM), Gradient boosting machine (GBM), and Extreme gradient boosting (XGBoost), were applied to train and validate these features to predict osteoporosis.

Results: A total of 172 participants met the inclusion and exclusion criteria for the study. 82 participants were enrolled in the osteoporosis group, and 90 were in the non-osteoporosis group. Moreover, the two groups had no significant differences in age, BMI, sex, smoking, drinking, hypertension, and diabetes. Besides, 826 radiomic features were obtained from unenhanced abdominal CT images of osteoporotic and non-osteoporotic patients. Five hundred fifty radiomic features were screened out of 826 by the Mann-Whitney U test. Finally, 16 significant radiomic features were obtained by the LASSO algorithm. These 16 radiomic features were incorporated into six traditional machine learning models (GBM, GNB, LR, RF, SVM, and XGB). All six machine learning models could predict osteoporosis well in the validation set, with the area under the receiver operating characteristic (AUROC) values greater than or equal to 0.8. GBM is more effective in predicting osteoporosis, whose AUROC was 0.86, sensitivity 0.70, specificity 0.92, and accuracy 0.81 in validation sets.

Conclusion: We developed six machine learning models to predict osteoporosis based on psoas muscle images of abdominal CT, and the GBM model had the best predictive performance. GBM model can better help clinicians to diagnose osteoporosis and provide timely anti-osteoporosis treatment for patients. In the future, the research team will strive to include participants from multiple institutions to conduct external validation of the ML model of this study.
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==Radiomics Combined With Clinical Features in Distinguishing Non-Calcifying Tuberculosis Granuloma and Lung Adenocarcinoma in Small Pulmonary Nodules==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36281359 PeerJ. 2022 Oct 19;10:e14127. PMID: 36281359] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9587713/pdf/peerj-10-14127.pdf PDF]

'''Authors:''' Dong Q, Wen Q, Li N, Tong J, Li Z, Bao X, Xu J, Li D.

'''Institution:''' Department of Thoracic Surgery at No. 4 Affiliated Hospital, Harbin Medical University, Harbin, China.

'''Abstract:''' Aim: To evaluate the performance of radiomics models with the combination of clinical features in distinguishing non-calcified tuberculosis granuloma (TBG) and lung adenocarcinoma (LAC) in small pulmonary nodules.

Methodology: We conducted a retrospective analysis of 280 patients with pulmonary nodules confirmed by surgical biopsy from January 2017 to December 2020. Samples were divided into LAC group (n = 143) and TBG group (n = 137). We assigned them to a training dataset (n = 196) and a testing dataset (n = 84). Clinical features including gender, age, smoking, CT appearance (size, location, spiculated sign, lobulated shape, vessel convergence, and pleural indentation) were extracted and included in the radiomics models. [http://www.slicer.org '''3D Slicer'''] and FAE software were used to delineate the Region of Interest (ROI) and extract clinical features. The performance of the model was evaluated by the Area Under the Receiver Operating Characteristic (ROC) Curve (AUC).

Results: Based on the model selection, clinical features gender, and age in the LAC group and TBG group showed a significant difference in both datasets (P < 0.05). CT appearance lobulated shape was also significantly different in the LAC group and TBG group (Training dataset, P = 0.034; Testing dataset, P = 0.030). AUC were 0.8344 (95% CI [0.7712-0.8872]) and 0.751 (95% CI [0.6382-0.8531]) in training and testing dataset, respectively.

Conclusion: With the capacity to detect differences between TBG and LAC based on their clinical features, radiomics models with a combined of clinical features may function as the potential non-invasive tool for distinguishing TBG and LAC in small pulmonary nodules.
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==Insights into Inner Ear Function and Disease Through Novel Visualization of the Ductus Reuniens, a Seminal Communication Between Hearing and Balance Mechanisms==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35804276 J Assoc Res Otolaryngol. 2022 Oct;23(5):633-645. PMID: 35804276]

'''Authors:''' Smith CM, Curthoys IS, Plontke SK, Menzel M, Mukherjee P, Wong C, Laitman JT.

'''Institution:''' Center for Anatomy and Functional Morphology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.

'''Abstract:''' The sensory end-organs responsible for hearing and balance in the mammalian inner ear are connected via a small membranous duct known as the ductus reuniens (also known as the reuniting duct (DR)). The DR serves as a vital nexus linking the hearing and balance systems by providing the only endolymphatic connection between the cochlea and vestibular labyrinth. Recent studies have hypothesized new roles of the DR in inner ear function and disease, but a lack of knowledge regarding its 3D morphology and spatial configuration precludes testing of such hypotheses. We reconstructed the 3D morphology of the DR and surrounding anatomy using osmium tetroxide micro-computed tomography and digital visualizations of three human inner ear specimens. This provides a detailed, quantitative description of the DR's morphology, spatial relationships to surrounding structures, and an estimation of its orientation relative to head position. Univariate measurements of the DR, inner ear, and cranial planes were taken using the software packages [http://www.slicer.org '''3D Slicer'''] and Zbrush. The DR forms a narrow, curved, flattened tube varying in lumen size, shape, and wall thickness, with its middle third being the narrowest. The DR runs in a shallow bony sulcus superior to the osseous spiral lamina and adjacent to a ridge of bone that we term the "crista reuniens" oriented posteromedially within the cranium. The DR's morphology and structural configuration relative to surrounding anatomy has important implications for understanding aspects of inner ear function and disease, particularly after surgical alteration of the labyrinth and potential causative factors for Ménière's disease.
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==Analysis of Cochlear Parameters in Paediatric Inner Ears with Enlarged Vestibular Aqueduct and Patent Cochlea==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36294805 J Pers Med. 2022 Oct 7;12(10):1666. PMID: 36294805] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9605104/pdf/jpm-12-01666.pdf PDF]

'''Authors:''' Li J, Kang S, Du H, Wang S, Wang D, Liu M, Yang S.

'''Institution:''' Department of Thoracic Surgery at No. 4 Affiliated Hospital, Harbin Medical University, Harbin, China.

'''Abstract:''' Is cochlear implant (CI) electrode selection for cochleae with an enlarged vestibular aqueduct (EVA) the same as that for patent cochleae with a normal inner ear structure? Preoperative high-resolution computed tomography (HRCT) images of 247 ears were assessed retrospectively. The A-value, B-value, and H-value were measured with OTOPLAN, and Bell curves were created to show the distribution. All ears with EVA were re-evaluated using a [http://www.slicer.org '''3D Slicer'''] to confirm whether incomplete partition type II (IP II) existed. The Mann-Whitney U-test was applied to determine a statistically significant difference. After adjustment with the Bonferroni correction method, a p-value ≤ 0.006 was considered significant. In total, 157 ears with patent cochlea and 90 ears with EVA were assessed. Seventy (82%) of the EVA ears had an IP II malformation, and 14 (19%) of these were not detected by CT scan but were later seen through the 3D reconstruction. A significant difference was found for the A value and B value between the patent cochleae and EVA-only and between the patent cochleae and EVA with IP II. Most EVA cases had an IP II malformation. The basal turn of the cochlea may be smaller in EVA cases than in the patent cochleae. Electrode selection should be adjusted accordingly.
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==Location Angle of Second Mesio-Buccal Canal in Maxillary Molars of an Indian Population: An in Vivo Retrospective CBCT Evaluation and Proposal of a New Classification==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36248703 PeerJ. 2022 Oct 10;10:e14234. PMID: 36248703] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9559056/pdf/peerj-10-14234.pdf PDF]

'''Authors:''' Vhorkate K, Banga K, Pawar AM, Mir S, Arora S, Wahjuningrum DA, Bhardwaj A, Luke AM.

'''Institution:''' Department of Conservative Dentistry and Endodontics, Nair Hospital Dental College, Mumbai, Maharashta, India.

'''Abstract:''' Background: The current investigation was designed for predicting the location angle of second mesio-buccal root canal in permanent maxillary (first and second) molars with the aid of proposed measuring points and line using cone beam computed tomography in an Indian population.

Methods: Three-hundred and twenty-four scans of permanent maxillary (first (n = 162) and second (n = 162)) molars with mesio-buccal 2 root canals and unassociated to the current evaluation were acquired. The maxillary molars were viewed with CSI imaging software. The images were captured and were further assessed using [http://www.slicer.org '''3D Slicer''']. The assessment included of measuring the distance between the main mesio-buccal and mesio-buccal 2 canal and the angle at which the MB2 it is located utilizing proposed lines joining the disto-buccal and palatal canals. The data was tabulated for the incidence of various angles where the MB2 is located and MB-MB2 distance was determined. The angles denoted were either positive; I (0.1° to 1.9°), II (2° to 4°), III (>4°) or negative I (-0.1° to -1.9°), II (-2° to -4°), III (>-4°). On the data tabulated a new Banga Vhorkate and Pawar's (BVP's) angular classification for maxillary molars was proposed.

Results: The existence of positive angle III was found in 41.35% of maxillary first molars (36 right and 31 left of 162), whereas positive angle II appeared in 41.98% of maxillary second molars (32 right and 36 left of 162). The MB1-MB2 in maxillary 1st molar is seen to be 3.12-3.31 mm and this distance in maxillary 2nd molar is 2.8-3.1 mm. The disto-buccal to palatal canal orifice mean distance was 5.06-5.22 mm in maxillary first molars and 4.9-5.8 mm in maxillary second molars.

Conclusion: Accurate diagnosis of the location of second mesio-buccal canal increases the success rate of endodontic treatment and a better prognosis. The new proposed classification may be considerably helpful in the urge to locate the mesio-buccal 2 canal.
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==Enhanced Visualisation of Normal Anatomy with Potential Use of Augmented Reality Superimposed on Three-Dimensional Printed Models==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36296054 Micromachines (Basel). 2022 Oct 10;13(10):1701. PMID: 36296054] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9608320/pdf/micromachines-13-01701.pdf PDF]

'''Authors:''' Geerlings-Batt J, Tillett C, Gupta A, Sun Z.

'''Institution:''' Discipline of Medical Radiation Science, Curtin Medical School, Curtin University, Perth, Australia.

'''Abstract:''' Anatomical knowledge underpins the practice of many healthcare professions. While cadaveric specimens are generally used to demonstrate realistic anatomy, high cost, ethical considerations and limited accessibility can often impede their suitability for use as teaching tools. This study aimed to develop an alternative to traditional teaching methods; a novel teaching tool using augmented reality (AR) and three-dimensional (3D) printed models to accurately demonstrate normal ankle and foot anatomy. An open-source software, [http://www.slicer.org '''3D Slicer'''] was used to segment a high-resolution magnetic resonance imaging (MRI) dataset of a healthy volunteer ankle and produce virtual bone and musculature objects. Bone and musculature were segmented using seed-planting and interpolation functions, respectively. Virtual models were imported into Unity 3D, which was used to develop user interface and achieve interactability prior to export to the Microsoft HoloLens 2. Three life-size models of bony anatomy were printed in yellow polylactic acid and thermoplastic polyurethane, with another model printed in white Visijet SL Flex with a supporting base attached to its plantar aspect. Interactive user interface with functional toggle switches was developed. Object recognition did not function as intended, with adequate tracking and AR superimposition not achieved. The models accurately demonstrate bony foot and ankle anatomy in relation to the associated musculature. Although segmentation outcomes were sufficient, the process was highly time consuming, with effective object recognition tools relatively inaccessible. This may limit the reproducibility of augmented reality learning tools on a larger scale. Research is required to determine the extent to which this tool accurately demonstrates anatomy and ascertain whether use of this tool improves learning outcomes and is effective for teaching anatomy.
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==Whole Tumor Radiomics Analysis for Risk Factors Associated with Rapid Growth of Vestibular Schwannoma in Contrast-Enhanced T1-Weighted Images==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35863640 2022 Oct;166:e572-e582. PMID: 35863640]

'''Authors:''' Itoyama T, Nakaura T, Hamasaki T, Takezaki T, Uentani H, Hirai T, Mukasa A.

'''Institution:''' Departments of Neurosurgery Kumamoto University Hospital, Kumamoto, Japan.

'''Abstract:''' Objective: To investigate the features associated with rapid growth of vestibular schwannoma using radiomics analysis on magnetic resonance imaging (MRI) together with clinical factors.

Methods: From August 2005 to February 2019, 67 patients with vestibular schwannoma underwent contrast-enhanced T1-weighted MRI at least twice as part of their diagnosis. After excluding three cases with an extremely short follow-up period of 15 days or less, 64 patients were finally enrolled in this study. Ninety-three texture features were extracted from the tumor image data using [http://www.slicer.org '''3D Slicer'''] software. We determined the texture features that significantly affected maximal tumor diameter growth of more than 2 mm/year using Random Forest and Bounty. We also analyzed age and tumor size as clinical factors. We calculated the areas under the curve (AUCs) using receiver-operating characteristic analysis for prediction models using texture, clinical, and mixed factors by Random Forest and 5-fold cross-validation.

Results: Two texture features, low minimum signal and high Idmn, were significantly associated with rapid growth of vestibular schwannoma. The mixed model of texture features and clinical factors offered the highest AUC (0.69), followed by the pure texture- (0.67), and pure clinical (0.63) models. The minimum signal was the most important variable followed by tumor size, Idmn, and age.

Conclusions: Our radiomics analysis found that texture features were significantly associated with the rapid growth of vestibular schwannoma in contrast-enhanced T1-weighted images. The mixed model offered a higher diagnostic performance than the pure texture or clinical models.
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==A Machine Learning-Based Predictive Model of Epidermal Growth Factor Mutations in Lung Adenocarcinomas==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36230590 Cancers (Basel). 2022 Sep 25;14(19):4664. PMID: 36230590] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9563411/pdf/cancers-14-04664.pdf PDF]

'''Authors:''' He R, Yang X, Li T, He Y, Xie X, Chen Q, Zhang Z, Cheng T.

'''Institution:''' School of Nuclear Science and Technology, University of South China, Hengyang, China.

'''Abstract:''' Data from 758 patients with lung adenocarcinoma were retrospectively collected. All patients had undergone computed tomography imaging and EGFR gene testing. Radiomic features were extracted using the medical imaging tool [http://www.slicer.org '''3D Slicer'''] and were combined with the clinical features to build a machine learning prediction model. The high-dimensional feature set was screened for optimal feature subsets using principal component analysis (PCA) and the least absolute shrinkage and selection operator (LASSO). Model prediction of EGFR mutation status in the validation group was evaluated using multiple classifiers. We showed that six clinical features and 622 radiomic features were initially collected. Thirty-one radiomic features with non-zero correlation coefficients were obtained by LASSO regression, and 24 features correlated with label values were obtained by PCA. The shared radiomic features determined by these two methods were selected and combined with the clinical features of the respective patient to form a subset of features related to EGFR mutations. The full dataset was partitioned into training and test sets at a ratio of 7:3 using 10-fold cross-validation. The area under the curve (AUC) of the four classifiers with cross-validations was: (1) K-nearest neighbor (AUCmean = 0.83, Acc = 81%); (2) random forest (AUCmean = 0.91, Acc = 83%); (3) LGBM (AUCmean = 0.94, Acc = 88%); and (4) support vector machine (AUCmean = 0.79, Acc = 83%). In summary, the subset of radiographic and clinical features selected by feature engineering effectively predicted the EGFR mutation status of this NSCLC patient cohort.
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==Clinical and Radiomic Factors for Predicting Invasiveness in Pulmonary Ground‑Glass Opacity==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36277144 Exp Ther Med. 2022 Sep 22;24(5):685. PMID: 36277144] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9533109/pdf/etm-24-05-11621.pdf PDF]

'''Authors:''' Dang Y, Wang R, Qian K, Lu J, Zhang Y.

'''Institution:''' Department of Thoracic Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China.

'''Abstract:''' Objectives: To provide an overarching evaluation of the value of peritumoral CT radiomics features for predicting the prognosis of non-small cell lung cancer and to assess the quality of the available studies.

Methods: The PubMed, Embase, Web of Science, and Cochrane Library databases were searched for studies predicting the prognosis in patients with non-small cell lung cancer (NSCLC) using CT-based peritumoral radiomics features. Information about the patient, CT-scanner, and radiomics analyses were all extracted for the included studies. Study quality was assessed using the Radiomics Quality Score (RQS) and the Prediction Model Risk of Bias Assessment Tool (PROBAST).

Results: Thirteen studies were included with 2942 patients from 2017 to 2022. Only one study was prospective, and the others were all retrospectively designed. Manual segmentation and multicenter studies were performed by 69% and 46% of the included studies, respectively. [http://www.slicer.org '''3D Slicer'''] and MATLAB software were most commonly used for the segmentation of lesions and extraction of features. The peritumoral region was most frequently defined as dilated from the tumor boundary of 15 mm, 20 mm, or 30 mm. The median RQS of the studies was 13 (range 4-19), while all of included studies were assessed as having a high risk of bias (ROB) overall.

Conclusions: Peritumoral radiomics features based on CT images showed promise in predicting the prognosis of NSCLC, although well-designed studies and further biological validation are still needed.
|}

==Myosteatosis Is Not Associated with Complications or Survival in HCC Patients Undergoing Trans Arterial Embolization==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36569106 OTA Int. 2022 Sep 21;5(4):e213. PMID: 36569106] | [http://www.ncbi.nlm.nih.gov/pmc/articles/pmc9782327/ PDF]

'''Authors:''' Chai Y, Simic R, Smith PN, Valter K, Limaye A, Li RW.

'''Institution:''' Trauma and Orthopaedic Research Laboratory, Department of Surgery, The Medical School, The Australian National University, Canberra, ACT, Australia.

'''Abstract:''' Objectives: Although 3-dimensional (3D) printing is becoming more widely adopted for clinical applications, it is yet to be accepted as part of standard practice. One of the key applications of this technology is orthopaedic surgical planning for urgent trauma cases. Anatomically accurate replicas of patients' fracture models can be produced to guide intervention. These high-quality models facilitate the design and printing of patient-specific implants and surgical devices. Therefore, a fast and accurate workflow will help orthopaedic surgeons to generate high-quality 3D printable models of complex fractures. Currently, there is a lack of access to an uncomplicated and inexpensive workflow.
Methods: Using patient DICOM data sets (n = 13), we devised a novel, simple, open-source, and rapid modeling process using Drishti software and compared its efficacy and data storage with the [http://www.slicer.org '''3D Slicer'''] image computing platform. We imported the computed tomography image directory acquired from patients into the software to isolate the model of bone surface from surrounding soft tissue using the minimum functions. One pelvic fracture case was further integrated into the customized implant design practice to demonstrate the compatibility of the 3D models generated from Drishti.
Results: The data sizes of the generated 3D models and the processing files that represent the original DICOM of Drishti are on average 27% and 12% smaller than that of [http://www.slicer.org '''3D Slicer'''], respectively (both P < 0.05). The time frame needed to reach the stage of viewing the 3D bone model and the exporting of the data of Drishti is 39% and 38% faster than that of [http://www.slicer.org '''3D Slicer'''], respectively (both P < 0.05). We also constructed a virtual model using third-party software to trial the implant design.
Conclusions: Drishti is more suitable for urgent trauma cases that require fast and efficient 3D bone reconstruction with less hardware requirement. 3D Slicer performs better at quantitative preoperative planning and multilayer segmentation. Both software platforms are compatible with third-party programs used to produce customized implants that could be useful for surgical training.
|}

==The Value of Whole-Lesion Histogram Analysis Based on Field‑of‑View Optimized and Constrained Undistorted Single Shot (FOCUS) DWI for Predicting Axillary Lymph Node Status in Early-Stage Breast Cancer==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36088299 BMC Med Imaging. 2022 Sep 10;22(1):163. PMID: 36088299] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9464403/pdf/12880_2022_Article_891.pdf PDF]

'''Authors:''' Fang S, Zhu J, Wang Y, Zhou J, Wang G, Xu W, Zhang W.

'''Institution:''' Department of Radiology, Changzhou Hospital of Traditional Chinese Medicine, Changzhou, Jiangsu Province, China.

'''Abstract:''' Background: This study aims to estimate the amount of axillary lymph node (ALN) involvement in early-stage breast cancer utilizing a field of view (FOV) optimized and constrained undistorted single-shot (FOCUS) diffusion-weighted imaging (DWI) approach, as well as a whole-lesion histogram analysis.

Methods: This retrospective analysis involved 81 individuals with invasive breast cancer. The patients were divided into three groups: N0 (negative ALN metastasis), N1-2 (low metastatic burden with 1-2 ALNs), and N≥3 (heavy metastatic burden with ≥ 3 ALNs) based on their sentinel lymph node biopsy (SLNB) or axillary lymph node dissection (ALND). Histogram parameters of apparent diffusion coefficient (ADC) depending basically on FOCUS DWI were performed using [http://www.slicer.org '''3D Slicer'''] software for whole lesions. The typical histogram characteristics for N0, N1-2, and N≥ 3 were compared to identify the significantly different parameters. To determine the diagnostic efficacy of significantly different factors, the area under their receiver operating characteristic (ROC) curves was examined.

Results: There were significant differences in the energy, maximum, 90 percentile, range, and lesion size among N0, N1-2, and N≥ 3 groups (P < 0.05). The energy differed significantly between N0 and N1-2 groups (P < 0.05), and some certain ADC histogram parameters and lesion sizes differed significantly between N0 and N≥3, or N1-2 and N≥3 groups. For ROC analysis, the energy yielded the best diagnostic performance in distinguishing N0 and N1-2 groups from N≥3 group with an AUC value of0.853. All parameters revealed excellent inter-observer agreement with inter-reader consistencies data ranging from0.919 to 0.982.

Conclusion: By employing FOCUS DWI method, the analysis of whole-lesion ADC histogram quantitatively provides a non-invasive way to evaluate the degree of ALN metastatic spread in early-stage breast cancer.
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==Radiomics-Based Infarct Features on CT Predict Hemorrhagic Transformation in Patients With Acute Ischemic Stroke==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36213752 Front Neurosci. 2022 Sep 21;16:1002717. PMID: 36213752] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9533555/pdf/fnins-16-1002717.pdf PDF]

'''Authors:''' Xie G, Li T, Ren Y, Wang D, Tang W, Li J, Li K.

'''Institution:''' North Sichuan Medical College, Nanchong, China.

'''Abstract:''' Objective: To develop and validate a model based on the radiomics features of the infarct areas on non-contrast-enhanced CT to predict hemorrhagic transformation (HT) in acute ischemic stroke.

Materials and methods: A total of 118 patients diagnosed with acute ischemic stroke in two centers from January 2019 to February 2022 were included. The radiomics features of infarcted areas on non-contrast-enhanced CT were extracted using [http://www.slicer.org '''3D Slicer''']. A univariate analysis and the least absolute shrinkage and selection operator (LASSO) were used to select features, and the radiomics score (Rad-score) was then constructed. The predictive model of HT was constructed by analyzing the Rad-score and clinical and imaging features in the training cohort, and it was verified in the validation cohort. The model was evaluated with the receiver operating characteristic curve, calibration curve and decision curve, and the prediction performance of the model in different scenarios was further discussed hierarchically.

Results: Of the 118 patients, 52 developed HT, including 21 cases of hemorrhagic infarct (HI) and 31 cases of parenchymal hematoma (PH). The Rad-score was constructed from five radiomics features and was the only independent predictor for HT. The predictive model was constructed from the Rad-score. The area under the curve (AUCs) of the model for predicting HT in the training and validation cohorts were 0.845 and 0.750, respectively. Calibration curve and decision curve analyses showed that the model performed well. Further analysis found that the model predicted HT for different infarct sizes or treatment methods in the training and validation cohorts with 78.3 and 71.4% accuracy, respectively. For all samples, the model predicted an AUC of 0.754 for HT in patients within 4.5 h since stroke onset, and predicted an AUC of 0.648 for PH.

Conclusion: This model, which was based on CT radiomics features, could help to predict HT in the setting of acute ischemic stroke for any infarct size and provide guiding suggestions for clinical treatment and prognosis evaluation.
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==Prediction of Changes in Tumor Regression during Radiotherapy for Nasopharyngeal Carcinoma by Using the Computed Tomography-Based Radiomics==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36226269 Contrast Media Mol Imaging. 2022 Sep 23;2022:3417480. PMID: 36226269] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9525792/pdf/CMMI2022-3417480.pdf PDF]

'''Authors:''' Yang Y, Wu J, Mai W, Li H.

'''Institution:''' Medical Imaging Center, The First Affliated Hospital of Jinan University, Guangzhou, China.

'''Abstract:''' This work aimed to explore the application value of computed tomography (CT)-based radiomics in predicting changes in tumor regression during radiotherapy for nasopharyngeal carcinoma. In this work, 144 patients with nasopharyngeal carcinoma who underwent concurrent chemoradiotherapy (CCRT) in our hospital from January 2015 to December 2021 were selected. The patients were divided into a radiosensitive group (79 cases) and an insensitive group (65 cases) according to the tumor volume shrinkage during radiotherapy. The [http://www.slicer.org '''3D Slicer'''] v.4.10.2 software was used to delineate the tumor region of interest (ROI), and a total of 1223 radiomics features were extracted using the radiomics module under the software. After between-group and within-group consistency tests, one-way ANOVA, and LASSO dimensionality reduction, three omics features were finally selected for the establishment of predictive models. At the same time, the age, gender, tumor T stage and N stage, hemoglobin, and albumin of the patients were collected to establish a clinical prediction model. The results showed that compared with logistic regression, decision tree, random forest, and AdaBoost models, the SVM model based on CT radiomics features had the best performance in predicting tumor regression changes during tumor radiotherapy (training group area under the receiver operating characteristic curve (AUC): 0.840 (95% confidence interval (CI): 0.764-0.916); validation group: AUC: 0.810 (95% CI: 0.676-0.944)). Compared with the supported vector machine (SVM) prediction model based on clinical features, the SVM model based on radiomics features had better performance in predicting the change of retraction during tumor radiotherapy (training group: omics feature SVM model AUC: 0.84, clinical feature SVM model: 0.78; validation group: omics feature SVM model AUC: 0.8, clinical feature SVM model: 0.58, P = 0.044). Based on the radiomics characteristics and clinical characteristics of patients, a nomo prediction map was established, and the calibration curve shows good consistency, which can be visualized to assist clinical judgment. In this work, the prediction model composed of CT-based radiomic features combined with clinical features can accurately predict withdrawal changes during tumor radiotherapy, ensuring the accuracy of treatment planning, and minimizing the number of CT scans during radiotherapy.
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==3D Printed Model to Assist Endovascular Prostate Artery Embolization for Benign Prostatic Hyperplasia==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36105833 Radiol Case Rep. 2022 Sep 6;17(11):4161-4164. PMID: 36105833] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9464764/pdf/main.pdf PDF]

'''Authors:''' Dalla S, Richards L, Alli A, Custer B, Rohr A.

'''Institution:''' University of Kansas School of Medicine, Kansas City, KS, USA.

'''Abstract:''' With the growth and ease of 3D printing accessibility, the medical community has begun to adopt it in various ways. Modeling of prostatic arteries for embolization is an application that has yet to be fully explored. We present a case where a patient specific 3D-printed model was used as a reference during prostate artery embolization for a 70-year-old male with obstructive benign prostatic hyperplasia refractory to medical treatment. The prostate arteries were segmented from preoperative contrast enhanced computed tomography using [http://www.slicer.org '''3D Slicer'''] software and printed on a FormLabs Form2 resin printer. The models were then used for operative planning for the embolization of both right and left prostate arteries. The procedure was a success without complications and the patient returned 1 month later with significantly improved symptoms. Additionally, interventionists found the model to be helpful in selecting approach for arterial embolization.
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==Gastroenteropancreatic Neuroendocrine Neoplasms (GEP-NENs): A Radiomic Model to Predict Tumor Grade==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35917099 Radiol Med. 2022 Sep;127(9):928-938. PMID: 35917099]

'''Authors:''' Chiti G, Grazzini G, Flammia F, Matteuzzi B, Tortoli P, Bettarini S, Pasqualini E, Granata V, Busoni S, Messserini L, Pradella S, Massi D, Miele V.

'''Institution:''' Department of Emergency Radiology, University Hospital Careggi, Florence, Italy.

'''Abstract:''' Purpose: The aim of this single-center retrospective study is to assess whether contrast-enhanced computed tomography (CECT) radiomics analysis is predictive of gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) grade based on the 2019 World Health Organization (WHO) classification and to establish a tumor grade (G) prediction model.

Material and methods: Preoperative CECT images of 78 patients with GEP-NENs were retrospectively reviewed and divided in two groups (G1-G2 in class 0, G3-NEC in class 1). A total of 107 radiomics features were extracted from each neoplasm ROI in CT arterial and venous phases acquisitions with [http://www.slicer.org '''3D Slicer''']. Mann-Whitney test and LASSO regression method were performed in R for feature selection and feature reduction, in order to build the radiomic-based predictive model. The model was developed for a training cohort (75% of the total) and validated on the independent validation cohort (25%). ROC curves and AUC values were generated on training and validation cohorts.

Results: 40 and 24 features, for arterial phase and venous phase, respectively, were found to be significant in class distinction. From the LASSO regression 3 and 2 features, for arterial phase and venous phase, respectively, were identified as suitable for groups classification and used to build the tumor grade radiomic-based prediction model. The prediction of the arterial model resulted in AUC values of 0.84 (95% CI 0.72-0.97) and 0.82 (95% CI 0.62-1) for the training cohort and validation cohort, respectively, while the prediction of the venous model yielded AUC values of 0.7877 (95% CI 0.6416-0.9338) and 0.6813 (95% CI 0.3933-0.9693) for the training cohort and validation cohort, respectively.

Conclusions: CT-radiomics analysis may aid in differentiating the histological grade for GEP-NENs.
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==Planning System for the Optimization of Electric Field Delivery Using Implanted Electrodes for Brain Tumor Control==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35754362 Med Phys. 2022 Sep;49(9):6055-6067. PMID: 35754362]

'''Authors:''' Iredale E, Voigt B, Rankin A, Kim KW, Chen JZ, Schmid S, Hebb MO, Peters TM, Wong E.

'''Institution:''' Department of Medical Biophysics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.

'''Abstract:''' Background: The use of non-ionizing electric fields from low-intensity voltage sources (< 10 V) to control malignant tumor growth is showing increasing potential as a cancer treatment modality. A method of applying these low-intensity electric fields using multiple implanted electrodes within or adjacent to tumor volumes has been termed as intratumoral modulation therapy (IMT).

Purpose: This study explores advancements in the previously established IMT optimization algorithm, and the development of a custom treatment planning system for patient-specific IMT. The practicality of the treatment planning system is demonstrated by implementing the full optimization pipeline on a brain phantom with robotic electrode implantation, postoperative imaging, and treatment stimulation.

Methods: The integrated planning pipeline in [http://www.slicer.org '''3D Slicer'''] begins with importing and segmenting patient magnetic resonance images (MRI) or computed tomography (CT) images. The segmentation process is manual, followed by a semi-automatic smoothing step that allows the segmented brain and tumor mesh volumes to be smoothed and simplified by applying selected filters. Electrode trajectories are planned manually on the patient MRI or CT by selecting insertion and tip coordinates for a chosen number of electrodes. The electrode tip positions and stimulation parameters (phase shift and voltage) can then be optimized with the custom semi-automatic IMT optimization algorithm where users can select the prescription electric field, voltage amplitude limit, tissue electrical properties, nearby organs at risk, optimization parameters (electrode tip location, individual contact phase shift and voltage), desired field coverage percent, and field conformity optimization. Tables of optimization results are displayed, and the resulting electric field is visualized as a field-map superimposed on the MR or CT image, with 3D renderings of the brain, tumor, and electrodes. Optimized electrode coordinates are transferred to robotic electrode implantation software to enable planning and subsequent implantation of the electrodes at the desired trajectories.

Results: An IMT treatment planning system was developed that incorporates patient-specific MRI or CT, segmentation, volume smoothing, electrode trajectory planning, electrode tip location and stimulation parameter optimization, and results visualization. All previous manual pipeline steps operating on diverse software platforms were coalesced into a single semi-automated [http://www.slicer.org '''3D Slicer''']-based user interface. Brain phantom validation of the full system implementation was successful in preoperative planning, robotic electrode implantation, and postoperative treatment planning to adjust stimulation parameters based on actual implant locations. Voltage measurements were obtained in the brain phantom to determine the electrical parameters of the phantom and validate the simulated electric field distribution.

Conclusions: A custom treatment planning and implantation system for IMT has been developed in this study and validated on a phantom brain model, providing an essential step in advancing IMT technology toward future clinical safety and efficacy investigations.
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==Diagnostic Value of 18F-FDG PET/CT-Based Radiomics Nomogram in Bone Marrow Involvement of Pediatric Neuroblastoma==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36117128 Acad Radiol. 2022 Sep 15:S1076-6332(22)00476-7. PMID: 36117128]

'''Authors:''' Feng L, Yang X, Lu X, Kan Y, Wang C, Zhang H, Wang W, Yang J.

'''Institution:''' Department of Nuclear Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing, China.

'''Abstract:''' Objectives: To develop and validate an 18F-FDG PET/CT-based radiomics nomogram and evaluate the value of the 18F-FDG PET/CT-based radiomics nomogram for the diagnosis of bone marrow involvement (BMI) in pediatric neuroblastoma.

Materials and methods: A total of 144 patients with neuroblastoma (100 in the training cohort and 44 in the validation cohort) were retrospectively included. The PET/CT images of patients were visually assessed. The results of bone marrow aspirates or biopsies were used as the gold standard for BMI. Radiomics features and conventional PET parameters were extracted using the [http://www.slicer.org '''3D Slicer''']. Features were selected by the least absolute shrinkage and selection operator regression, and radiomics signature was constructed. Univariate and multivariate logistic regression analyses were applied to identify the independent clinical risk factors and construct the clinical model. Other different models, including the conventional PET model, combined PET-clinical model and combined radiomics model, were built using logistic regression. The combined radiomics model was based on clinical factors, conventional PET parameters and radiomics signature, which was presented as a radiomics nomogram. The diagnostic performance of the different models was evaluated by receiver operating characteristic (ROC) curves and decision curve analysis (DCA).

Results: By visual assessment, BMI was observed in 80 patients. Four conventional PET parameters (SUVmax, SUVmean, metabolic tumor volume, and total lesion glycolysis) were extracted. And 15 radiomics features were selected to build the radiomics signature. The 11q aberration, neuron-specific enolase and vanillylmandelic acid were identified as the independent clinical risk factors to establish the clinical model. The radiomics nomogram incorporating the radiomics signature, the independent clinical risk factors and SUVmean demonstrated the best diagnostic value for identifying BMI, with an area under the curve (AUC) of 0.963 and 0.931 in the training and validation cohorts, respectively. And the DCA demonstrated that the radiomics nomogram was clinically useful.

Conclusion: The 18F-FDG PET/CT-based radiomics nomogram which incorporates radiomics signature, independent clinical risk factors and conventional PET parameters could improve the diagnostic performance for BMI of pediatric neuroblastoma without additional medical costs and radiation exposure.
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==Radiomics Nomogram: Prediction of 2-Year Disease-Free Survival in Young Age Breast Cancer==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36139620 Cancers (Basel). 2022 Sep 14;14(18):4461. PMID: 36139620] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9497155/pdf/cancers-14-04461.pdf PDF]

'''Authors:''' Lee J, Kim SH, Kim Y, Park J, Park GE, Kang BJ.

'''Institution:''' Department of Radiology, College of Medicine, Seoul Saint Mary's Hospital, The Catholic University of Korea, Seoul, Korea.

'''Abstract:''' This study aimed to predict early breast cancer recurrence in women under 40 years of age using radiomics signature and clinicopathological information. We retrospectively investigated 155 patients under 40 years of age with invasive breast cancer who underwent MRI and surgery. Through stratified random sampling, 111 patients were assigned as the training set, and 44 were assigned as the validation set. Recurrence-associated factors were investigated based on recurrence within 5 years during the total follow-up period. A Rad-score was generated through texture analysis [http://www.slicer.org '''3D Slicer'''], v.4.8.0) of breast MRI using the least absolute shrinkage and selection operator Cox regression model. The Rad-score showed a significant association with disease-free survival (DFS) in the training set (p = 0.003) and validation set (p = 0.020) in the Kaplan-Meier analysis. The nomogram was generated through Cox proportional hazards models, and its predictive ability was validated. The nomogram included the Rad-score and estrogen receptor negativity as predictive factors and showed fair DFS predictive ability in both the training and validation sets (C-index 0.63, 95% CI 0.45-0.79). In conclusion, the Rad-score can predict the disease recurrence of invasive breast cancer in women under 40 years of age, and the Rad-score-based nomogram showed reasonably high DFS predictive ability, especially within 2 years of surgery.
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==Clinical-Radiomics Nomogram for Identifying HER2 Status in Patients With Breast Cancer: A Multicenter Study==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36158700 Front Oncol. 2022 Sep 7;12:922185. PMID: 36158700] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9490879/pdf/fonc-12-922185.pdf PDF]

'''Authors:''' Fang C, Zhang J, Li J, Shang H, Li K, Jiao T, Yin D, Li F, Cui Y, Zeng Q.

'''Institution:''' Department of Radiology, Shandong Provincial Qianfoshan Hospital, The First Hospital Affiliated Hospital of Shandong First Medical University, Jinan, China.

'''Abstract:''' Purpose: To develop and validate a clinical-radiomics nomogram based on radiomics features and clinical risk factors for identification of human epidermal growth factor receptor 2 (HER2) status in patients with breast cancer (BC).

Methods: Two hundred and thirty-five female patients with BC were enrolled from July 2018 to February 2022 and divided into a training group (from center I, 115 patients), internal validation group (from center I, 49 patients), and external validation group (from centers II and III, 71 patients). The preoperative MRI of all patients was obtained, and radiomics features were extracted by a free open-source software called [http://www.slicer.org '''3D Slicer''']. The Least Absolute Shrinkage and Selection Operator regression model was used to identify the most useful features. The radiomics score (Rad-score) was calculated by using the radiomics signature-based formula. A clinical-radiomics nomogram combining clinical factors and Rad-score was developed through multivariate logistic regression analysis. The performance of the nomogram was evaluated using receiver operating characteristic (ROC) curve and decision curve analysis (DCA).

Results: A total of 2,553 radiomics features were extracted, and 21 radiomics features were selected as the most useful radiomics features. Multivariate logistic regression analysis indicated that Rad-score, progesterone receptor (PR), and Ki-67 were independent parameters to distinguish HER2 status. The clinical-radiomics nomogram, which comprised Rad-score, PR, and Ki-67, showed a favorable classification capability, with AUC of 0.87 [95% confidence internal (CI), 0.80 to 0.93] in the training group, 0.81 (95% CI, 0.69 to 0.94) in the internal validation group, and 0.84 (95% CI, 0.75 to 0.93) in the external validation group. DCA illustrated that the nomogram was useful in clinical practice.

Conclusions: The nomogram combined with Rad-score, PR, and Ki-67 can identify the HER2 status of BC.
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==Volumetric Pancreas Segmentation on Computed Tomography: Accuracy and Efficiency of a Convolutional Neural Network Versus Manual Segmentation in [http://www.slicer.org '''3D Slicer'''] in the Context of Interreader Variability of Expert Radiologists==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36055122 J Comput Assist Tomogr. 2022 Sep 1. PMID: 36055122]

'''Authors:''' Khasawneh H, Patra A, Rajamohan N, Suman G, Klug J, Majumder S, Chari ST, Korfiatis P, Goenka AH.

'''Institution:''' From the Department of Radiology, Mayo Clinic, Rochester, MN, USA.

'''Abstract:''' Purpose: This study aimed to compare accuracy and efficiency of a convolutional neural network (CNN)-enhanced workflow for pancreas segmentation versus radiologists in the context of interreader reliability.

Methods: Volumetric pancreas segmentations on a data set of 294 portal venous computed tomographies were performed by 3 radiologists (R1, R2, and R3) and by a CNN. Convolutional neural network segmentations were reviewed and, if needed, corrected ("corrected CNN [c-CNN]" segmentations) by radiologists. Ground truth was obtained from radiologists' manual segmentations using simultaneous truth and performance level estimation algorithm. Interreader reliability and model's accuracy were evaluated with Dice-Sorenson coefficient (DSC) and Jaccard coefficient (JC). Equivalence was determined using a two 1-sided test. Convolutional neural network segmentations below the 25th percentile DSC were reviewed to evaluate segmentation errors. Time for manual segmentation and c-CNN was compared.

Results: Pancreas volumes from 3 sets of segmentations (manual, CNN, and c-CNN) were noninferior to simultaneous truth and performance level estimation-derived volumes [76.6 cm3 (20.2 cm3), P < 0.05]. Interreader reliability was high (mean [SD] DSC between R2-R1, 0.87 [0.04]; R3-R1, 0.90 [0.05]; R2-R3, 0.87 [0.04]). Convolutional neural network segmentations were highly accurate (DSC, 0.88 [0.05]; JC, 0.79 [0.07]) and required minimal-to-no corrections (c-CNN: DSC, 0.89 [0.04]; JC, 0.81 [0.06]; equivalence, P < 0.05). Undersegmentation (n = 47 [64%]) was common in the 73 CNN segmentations below 25th percentile DSC, but there were no major errors. Total inference time (minutes) for CNN was 1.2 (0.3). Average time (minutes) taken by radiologists for c-CNN (0.6 [0.97]) was substantially lower compared with manual segmentation (3.37 [1.47]; savings of 77.9%-87% [P < 0.0001]).

Conclusions: Convolutional neural network-enhanced workflow provides high accuracy and efficiency for volumetric pancreas segmentation on computed tomography.
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==Stereotactic Navigation Using Registration Based on Intra-Abdominal Landmarks in Robotic-Assisted Lateral Pelvic Lymph Node Dissection==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35676544 Tech Coloproctol. 2022 Sep;26(9):735-43. PMID: 35676544]

'''Authors:''' Ochiai K, Kobayashi E, Sasaki K, Nozawa H, Kawai K, Murono K, Sakuma I, Ishihara S.

'''Institution:''' Department of Surgical Oncology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan.

'''Abstract:''' Background: We carried out robot-assisted lateral pelvic lymph node dissection (LPLND) for rectal cancer with a stereotactic navigation system. The purpose of this study was to evaluate the accuracy and feasibility of the system.

Methods: We constructed a navigation system based on the Polaris Spectra optical tracking device (Northern Digital Inc., Canada) and the open-source software [http://www.slicer.org '''3D Slicer'''] v.3.8.1. We used the landmark-based registration method for patient-to-image registration. Body surface landmarks and intra-abdominal landmarks were used. We evaluated the time required for registration and target registration error (TRE; the distance between corresponding points after registration) for the root of the superior gluteal artery the root of the obturator or superior vesical artery, and the obturator foramen during minimally invasive LPLND for rectal cancer. Five patients who had LPLND for rectal cancer at the University of Tokyo Hospital between September 2020 and May 2021 were enrolled.

Results: The mean time required for registration was 49 s with the body surface landmarks and 88 s with the intra-abdominal landmarks. The mean TRE improved markedly when the registration was performed using intra-abdominal landmarks. The mean TRE of the root of the superior gluteal artery, the root of the obturator or superior vesical artery, and the obturator foramen were 55.8 mm, 53.4 mm, and 55.2 mm with the body surface landmarks and 11.8 mm, 10.0 mm, and 12.6 mm with the intra-abdominal landmarks, respectively. There were no adverse events related to the registration process.

Conclusions: When stereotactic navigation systems are used for minimally invasive LPLND, the use of intra-abdominal landmarks for registration is feasible and may allow simpler and more accurate navigation than the use of body surface landmarks.
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==Utilizing 3D Slicer to Incorporate Tomographic Images Into GATE Monte Carlo Simulation for Personalized Dosimetry in Yttrium-90 Radioembolization==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36098271 Med Phys. 2022 Sep 13. PMID: 36098271]

'''Authors:''' Abdul Hadi MFR, Abdullah AN, Hashikin NAA, Ying CK, Yeong CH, Yoon TL, Ng KH.

'''Institution:''' School of Physics, Universiti Sains Malaysia, USM, Penang, Malaysia.

'''Abstract:''' Purpose: Monte Carlo (MC) simulation is an important technique that can help design advanced and challenging experimental setups. GATE (Geant4 application for tomographic emission) is a useful simulation toolkit for applications in nuclear medicine. Transarterial radioembolization is a treatment for liver cancer, where microspheres embedded with yttrium-90 (90 Y) are administered intra-arterially to the tumor. Personalized dosimetry for this treatment may provide higher dosimetry accuracy compared to the conventional partition model (PM) calculation. However, incorporation of three-dimensional tomographic input data into MC simulation is an intricate process. In this article, [http://www.slicer.org '''3D Slicer'''], free and open-source software, was utilized for the incorporation of patient tomographic images into GATE to demonstrate the feasibility of personalized dosimetry in hepatic radioembolization with 90 Y.

Methods: In this article, the steps involved in importing, segmenting, and registering tomographic images using [http://www.slicer.org '''3D Slicer'''] were thoroughly described, before importing them into GATE for MC simulation. The absorbed doses estimated using GATE were then compared with that of PM. SlicerRT, a [http://www.slicer.org '''3D Slicer'''] extension, was then used to visualize the isodose from the MC simulation.

Results: A workflow diagram consisting of all the steps taken in the utilization of [http://www.slicer.org '''3D Slicer'''] for personalized dosimetry in 90 Y radioembolization has been presented in this article. In comparison to the MC simulation, the absorbed doses to the tumor and normal liver were overestimated by PM by 105.55% and 20.23%, respectively, whereas for lungs, the absorbed dose estimated by PM was underestimated by 25.32%. These values were supported by the isodose distribution obtained via SlicerRT, suggesting the presence of beta particles outside the volumes of interest. These findings demonstrate the importance of personalized dosimetry for a more accurate absorbed dose estimation compared to PM.

Conclusion: The methodology provided in this study can assist users (especially students or researchers who are new to MC simulation) in navigating intricate steps required in the importation of tomographic data for MC simulation. These steps can also be utilized for other radiation therapy related applications, not necessarily limited to internal dosimetry.
|}

==Three-Dimensional Printer Use in the Australian and New Zealand Radiation Therapy Setting==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36097141 J Med Radiat Sci. 2022 Sep 12. PMID: 36097141]

'''Authors:''' Albantow CE, Brown SJ.

'''Institution:''' Crown Princess Mary Cancer Centre, Westmead Hospital, Westmead, New South Wales, Australia.

'''Abstract:''' Introduction: This cross-sectional survey aimed to collect data from radiation therapy departments around Australia and New Zealand to establish a baseline of 3D printer and product use.

Methods: Each department in Australia and New Zealand was contacted to determine the most appropriate person to answer the survey. A Microsoft Forms link to the survey was sent to the individual. The survey contained 47 questions in relation to what 3D printing device departments had (if any), how it was being utilised, and what 3D printed products were in use.

Results: A total of 112 departments completed the survey (100% response rate), with 22.3% reporting 3D printer ownership, and thirty-four departments (30.4%) outsourcing 3D printed products. The primary use of 3D printers was bolus production (60.9%). Public departments represented 84% of printer ownership, while private departments were the greatest users of outsourced 3D printed products (91.4%). 3D Slicer was the most common software used for Digital Imaging and Communications in Medicine (DICOM) file conversion (42.3%), while polylactic acid (PLA) and acrylonitrile butadiene styrene (ABS) were the most common filaments in use, 46% and 14%, respectively.

Conclusion: This research established a baseline for 3D printer and product use within the Australian and New Zealand radiotherapy setting.
|}

==Development of a Novel Combined Nomogram Model Integrating Rad-Score, Age and ECOG to Predict the Survival of Patients With Hepatocellular Carcinoma Treated by Transcatheter Arterial Chemoembolization==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36092317 J Gastrointest Oncol. 2022 Aug;13(4):1889-1897. PMID: 36092317] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9464403/pdf/12880_2022_Article_891.pdf PDF]

'''Authors:''' Liu A, Liu B, Duan X, Yang B, Wang Y, Dong P, Zhou P.

'''Institution:''' Department of Radiology, The Affiliated Hospital of Southwest Medical University, Luzhou, China.

'''Abstract:''' Background: Liver cancer is affecting more and more people's health. Transcatheter arterial chemoembolization (TACE) has become a routine treatment option, but the prognosis of patients is not optimistic. Effectively prediction of prognosis can provide clinicians with an objective basis for patient prognosis and timely adjustment of treatment strategies, thus improving the quality of patient survival. However, the current prediction methods have some limitations. Therefore, this study aims to develop a radiomics nomogram for predicting survival after TACE in patients with advanced hepatocellular carcinoma (HCC).

Methods: Seventy advanced HCC patients treated with TACE were enrolled from January 2013 to July 2019. Clinical information included age, sex, and Eastern Cooperative Oncology Group (ECOG) score. Overall survival (OS) was confirmed by postoperative follow-up. Radiomics features were extracted using [http://www.slicer.org '''3D Slicer'''] v. 4.11. software, then obtain radiomics signature and calculate radiomics score (Rad-score) for each patient. Univariate and multivariate Cox regression were used to analyze the baseline clinical data of patients and establish clinical models. The obtained radiomics signature was incorporated into the clinical model to establish the radiomics nomogram. The predictive performance and calibration ability of the model were assessed by the area under the receiver operating characteristic (ROC) curve (AUC), C-index, and calibration curve.

Results: Three significant features were selected from 851 radiomics features by the least absolute shrinkage and selection operator (LASSO) Cox regression model to construct the radiomics signature, and were significantly correlated with overall survival (P<0.001). Rad-score, age, and ECOG score were combined to construct a radiomics nomogram. The AUC, sensitivity, and specificity of the radiomics nomogram were 0.801 (95% CI: 0.693-0.909), 0.822 (95% CI: 0.674-0.915), and 0.720 (95% CI: 0.674-0.915), respectively. The C-index of the radiomics nomogram was 0.700 (95% CI: 0.547-0.853). Calibration curves showed better agreement between the predicted and actual probabilities in the radiomics nomogram among the 3 features.

Conclusions: The Rad-score was a strong risk predictor of survival after TACE for HCC patients. The radiomics nomogram might be improved the predictive efficacy of survival after TACE and it may also provide assistance to physicians in making treatment decisions.
|}

==Testing the Applicability and Performance of Auto ML for Potential Applications in Diagnostic Neuroradiology==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35953588 Sci Rep. 2022 Aug 11;12(1):13648. PMID: 35953588] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9366823/pdf/41598_2022_Article_18028.pdf PDF]

'''Authors:''' Musigmann M, Akkurt BH, Krähling H, Nacul NG, Remonda L, Sartoretti T, Henssen D, Brokinkel B, Stummer W, Heindel W, Mannil M.

'''Institution:''' University Clinic for Radiology, Westfälische Wilhelms-University Muenster and University Hospital Münster, Muenster, Germany.

'''Abstract:''' To investigate the applicability and performance of automated machine learning (AutoML) for potential applications in diagnostic neuroradiology. In the medical sector, there is a rapidly growing demand for machine learning methods, but only a limited number of corresponding experts. The comparatively simple handling of AutoML should enable even non-experts to develop adequate machine learning models with manageable effort. We aim to investigate the feasibility as well as the advantages and disadvantages of developing AutoML models compared to developing conventional machine learning models. We discuss the results in relation to a concrete example of a medical prediction application. In this retrospective IRB-approved study, a cohort of 107 patients who underwent gross total meningioma resection and a second cohort of 31 patients who underwent subtotal resection were included. Image segmentation of the contrast enhancing parts of the tumor was performed semi-automatically using the open-source software platform [http://www.slicer.org '''3D Slicer'''] A total of 107 radiomic features were extracted by hand-delineated regions of interest from the pre-treatment MRI images of each patient. Within the AutoML approach, 20 different machine learning algorithms were trained and tested simultaneously. For comparison, a neural network and different conventional machine learning algorithms were trained and tested. With respect to the exemplary medical prediction application used in this study to evaluate the performance of Auto ML, namely the pre-treatment prediction of the achievable resection status of meningioma, AutoML achieved remarkable performance nearly equivalent to that of a feed-forward neural network with a single hidden layer. However, in the clinical case study considered here, logistic regression outperformed the AutoML algorithm. Using independent test data, we observed the following classification results (AutoML/neural network/logistic regression): mean area under the curve = 0.849/0.879/0.900, mean accuracy = 0.821/0.839/0.881, mean kappa = 0.465/0.491/0.644, mean sensitivity = 0.578/0.577/0.692 and mean specificity = 0.891/0.914/0.936. The results obtained with AutoML are therefore very promising. However, the AutoML models in our study did not yet show the corresponding performance of the best models obtained with conventional machine learning methods. While AutoML may facilitate and simplify the task of training and testing machine learning algorithms as applied in the field of neuroradiology and medical imaging, a considerable amount of expert knowledge may still be needed to develop models with the highest possible discriminatory power for diagnostic neuroradiology.
|}

==Radiomics for Pseudoprogression Prediction in High Grade Gliomas: Added Value of MR Contrast Agent==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35965975 Heliyon. 2022 Aug 2;8(8):e10023. PMID: 35965975] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9364026/pdf/main.pdf PDF]

'''Authors:''' Mammadov O, Akkurt BH, Musigmann M, Ari AP, Blömer DA, Kasap DNG, Henssen DJHA, Nacul NG, Sartoretti E, Sartoretti T, Backhaus P, Thomas C, Stummer W, Heindel W, Mannil M.

'''Institution:''' University Clinic for Radiology, Westfälische Wilhelms-University Muenster and University Hospital Münster, Muenster, Germany.

'''Abstract:''' Objective: Our aim is to define the capabilities of radiomics in predicting pseudoprogression from pre-treatment MR images in patients diagnosed with high-grade gliomas using T1 non-contrast-enhanced and contrast-enhanced images.

Material & methods: In this retrospective IRB-approved study, image segmentation of high-grade gliomas was semi-automatically performed using [http://www.slicer.org '''3D Slicer''']. Non-contrast-enhanced T1-weighted images and contrast-enhanced T1-weighted images were used prior to surgical therapy or radio-chemotherapy. Imaging data was split into a training sample and an independent test sample at random. We extracted 107 radiomic features by use of PyRadiomics. Feature selection and model construction were performed using Generalized Boosted Regression Models (GBM).

Results: Our cohort included 124 patients (female: n = 53), diagnosed with progressive (n = 61) and pseudoprogressive disease (n = 63) of primary high-grade gliomas. Based on non-contrast-enhanced T1-weighted images of the independent test sample, the mean area under the curve (AUC), mean sensitivity, mean specificity and mean accuracy of our model were 0.651 [0.576, 0.761], 0.616 [0.417, 0.833], 0.578 [0.417, 0.750] and 0.597 [0.500, 0.708] to predict the development of pseudoprogression. In comparison, the independent test data of contrast-enhanced T1-weighted images yielded significantly higher values of AUC = 0.819 [0.760, 0.872], sensitivity = 0.817 [0.750, 0.833], specificity = 0.723 [0.583, 0.833] and accuracy = 0.770 [0.687, 0.833].

Conclusion: Our findings show that it is possible to predict pseudoprogression of high-grade gliomas with a Radiomics model using contrast-enhanced T1-weighted images with comparatively good discriminatory power. The use of a contrast agent results in a clear added value.
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==Morphological Evaluation of the Normal and Hydrocephalic Third Ventricle on Cranial Magnetic Resonance Imaging in Children: A Retrospective Study==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35994062 Pediatr Radiol. 2022 Aug 22. PMID: 35994062]

'''Authors:''' Isıklar S, Turan Ozdemir S, Ozkaya G, Ozpar R, Parlak M.

'''Institution:''' Medical Imaging Techniques Program, Vocational School of Health Services, Bursa Uludag University, Bursa, Turkey.

'''Abstract:''' Background: Third ventricle morphological changes reflect changes in the ventricular system in pediatric hydrocephalus, so visual inspection of the third ventricle shape is standard practice. However, normal pediatric reference data are not available.

Objective: To investigate both the normal development of the third ventricle in the 0-18-year age group and changes in its biometry due to hydrocephalus.

Materials and methods: For this retrospective study, we selected individuals ages 0-18 years who had magnetic resonance imaging (MRI) from 2012 to 2020. We included 700 children (331 girls) who had three-dimensional (3-D) T1-weighted sequences without and 25 with hydrocephalus (11 girls). We measured the distances between the anatomical structures limiting the third ventricle by dividing the third ventricle into anterior and posterior regions. We made seven linear measurements and three index calculations using [http://www.slicer.org '''3D Slicer'''] and MRICloud pipeline, and we analyzed the results of 23 age groups in normal and hydrocephalic patients using SPSS (v. 23).

Results: Salient findings are: (1) The posterior part of the third ventricle is more affected by both developmental and hydrocephalus-related changes. (2) For third ventricle measurements, gender was insignificant while age was significant. (3) Normal third ventricular volumetric development showed a segmental increase in the 0-18 age range. The hydrocephalic third ventricle volume cut-off value in this age group was 3 cm3.

Conclusion: This study describes third ventricle morphometry using a linear measurement method. The ratios defined in the midsagittal plane were clinically useful for diagnosing the hydrocephalic third ventricle. The linear and volumetric reference data and ratios are expected to help increase diagnostic accuracy in distinguishing normal and hydrocephalic third ventricles.
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==Assessing Preoperative Risk of STR in Skull Meningiomas Using MR Radiomics and Machine Learning==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35982218 Sci Rep. 2022 Aug 18;12(1):14043. PMID: 35982218] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9388514/pdf/41598_2022_Article_18458.pdf PDF]

'''Authors:''' Musigmann M, Akkurt BH, Krähling H, Brokinkel B, Henssen DJHA, Sartoretti T, Nacul NG, Stummer W, Heindel W, Mannil M.

'''Institution:''' University Clinic for Radiology, Westfälische Wilhelms-University Muenster and University Hospital Muenster, Muenster, Germany.

'''Abstract:''' Our aim is to predict possible gross total and subtotal resections of skull meningiomas from pre-treatment T1 post contrast MR-images using radiomics and machine learning in a representative patient cohort. We analyse the accuracy of our model predictions depending on the tumor location within the skull and the postoperative tumor volume. In this retrospective, IRB-approved study, image segmentation of the contrast enhancing parts of the tumor was semi-automatically performed using the [http://www.slicer.org '''3D Slicer'''] open-source software platform. Imaging data were split into training data and independent test data at random. We extracted a total of 107 radiomic features by hand-delineated regions of interest on T1 post contrast MR images. Feature preselection and model construction were performed with eight different machine learning algorithms. Each model was estimated 100 times on new training data and then tested on a previously unknown, independent test data set to avoid possible overfitting. Our cohort included 138 patients. A gross total resection of the meningioma was performed in 107 cases and a subtotal resection in the remaining 31 cases. Using the training data, the mean area under the curve (AUC), mean accuracy, mean kappa, mean sensitivity and mean specificity were 0.901, 0.875, 0.629, 0.675 and 0.933 respectively. We obtained very similar results with the independent test data: mean AUC = 0.900, mean accuracy = 0.881, mean kappa = 0.644, mean sensitivity = 0.692 and mean specificity = 0.936. Thus, our model exposes good and stable predictive performance with both training and test data. Our radiomics approach shows that with machine learning algorithms and comparatively few explanatory factors such as the location of the tumor within the skull as well as its shape, it is possible to make accurate predictions about whether a meningioma can be completely resected by surgery. Complete resections and resections with larger postoperative tumor volumes can be predicted with very high accuracy. However, cases with very small postoperative tumor volumes are comparatively difficult to predict correctly.
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==Long-Term Three-Dimensional Condylar Remodeling During Presurgical Orthodontics and After Orthognathic Surgery of Mandibular Retrognathia With High Mandibular Plane Angle==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35978222 Clin Oral Investig. 2022 Aug 17. PMID: 35978222]

'''Authors:''' Al-Rezami KF, Abotaleb BM, Alkebsi K, Wang R, Al-Nasri A, Sakran K, Aladimi M, Yang P.

'''Institution:''' State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China.

'''Abstract:''' Objectives: Patients with high mandibular plane facial morphology are the most dominant facial type who experience TMJ abnormalities with resultant condylar resorption, affecting the orthodontic and orthognathic treatment outcomes. The study aimed to quantitatively assess the three-dimensional condylar remodeling during the presurgical orthodontics and after orthognathic surgery of the retrognathic mandible with a high mandibular plane angle. The study also investigated the correlation between the resultant remodeling based on the hypothesis that condylar resorption following orthognathic surgery is a part of a progressive presurgical resorption process.

Materials and methods: The study included adults with mandibular retrognathism and high mandibular plane angle who have computed tomography scans (CT) obtained before any treatment (T0), after completion of presurgical treatment before surgery (T1), and at long-term follow-up after surgery (T2). DICOM of CT scan was gathered and processed using ITK-SNAP and [http://www.slicer.org '''3D Slicer'''] software. The interval between T0 and T1 was represented as a presurgical phase, while between T1 and T2 was defined as a postsurgical phase (T1-T2).

Results: Twenty-five patients (50 condyles) were included with a mean age of 23 ± 3.2 years. The mean of the follow-up during the presurgical phase was 19.8 ± 7.1 months and 15.5 ± 5.5 months during the postsurgical phase. The condylar volume during the presurgical phase (T0-T1) was relatively stable (- 3.3 ± 37.2mm3). However, during the postsurgical phase (T1-T2), the volume was significantly reduced - 113.8 ± 98.3mm3 (P < 0.001). Localized condylar surface resorption during the postsurgical phase was significantly higher than during the presurgical phase (P < 0.05). No correlation was found between the localized condylar surface remodeling during the presurgical and postsurgical phases. However, a negative statistically significant correlation existed between the overall condylar volume changes during the presurgical and postsurgical phases (r = 0.502, P < 0.001).

Conclusion: Significant condylar resorption following orthognathic surgery of the retrognathic mandible with a high mandibular plane angle might occur regardless of the presurgical status of the condyle.

Clinical relevance: The study provided an evidence to be discussed with the patients and considered throughout the treatment of mandibular retrognathia with high mandibular plane angle.
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==Development and External Validation of a Novel Nomogram to Predict Prostate Cancer in Biopsy-Naïve Patients With PSA <10 Ng/Ml and PI-RADS v2.1 = 3 Lesions==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35920264 Med. 2022 Aug 3. PMID: 35920264]

'''Authors:''' Hu C, Sun J, Xu Z, Zhang Z, Zhou Q, Xu J, Chen H, Wang C, Ouyang J.

'''Institution:''' Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.

'''Abstract:''' Objective: To develop and externally validate a novel nomogram in biopsy-naïve patients with prostate-specific antigen (PSA) <10 ng/ml and PI-RADS v2.1 = 3 lesions.

Methods: We retrospectively collected 307 men that underwent initial biopsy from October 2015 to January 2022 in Cohort 1 (The First Affiliated Hospital of Soochow University). External cohort (Cohort 2, Kunshan Hospital) included 109 men that met our criteria from July 2016 to June 2021. By [http://www.slicer.org '''3D Slicer'''] Software, the volume of all lesions was divided into two subgroups (PI-RADS v2.1 = 3a and 3b). Logistic regression analysis was performed to screen for variables and construct nomogram by analyzing clinical data from Cohort 1. Receiver operating characteristics curve analysis, calibration plot and decision curve analysis (DCA) were plotted to validate the nomogram in external cohort.

Results: A total of 70 (22.8%) patients was diagnosed with prostate cancer in Institution 1. Among them, 34 (11.1%) had clinically significant prostate cancer (csPCa). Age, prostate-specific antigen density, digital rectal examination, PI-RADS v2.1 = 3 subgroups (3a and 3b) and apparent diffusion coefficient (ADC, <750 mm2 /s) were predictive factors for prostate cancer (PCa) and csPCa. High area under the curve of the nomogram was found in Cohort 1 and Cohort 2 for PCa (0.857 vs. 0.850) and for csPCa (0.896 vs. 0.893). Calibration curves showed excellent agreement between the predicted probability and actual risk for the models in internal and external validation. The DCA demonstrated net benefit of our nomogram.

Conclusion: Until now, this is the first nomogram that predicts PCa and csPCa in biopsy-naïve patients with PSA <10 ng/ml and PI-RADS v2.1 = 3 lesions. Furthermore, PI-RADS v2.1 = 3 subgroups were considered to be an independent risk factor in our model. Our nomogram may assist urologists in biopsy decision making for these so-called "double gray zone" patients.
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==Masotid Growth and the Configuration of Cochlear Implant Electrode Lead==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35861389 Ear Nose Throat J. 2022 Jul 21:1455613221106221. PMID: 35861389]

'''Authors:''' Alhabib SF, Almuhawas F, Hagr A, Alzhrani F, Hamed N, Alenzi S, Abdelsamad Y, Dhanasingh A.

'''Institution:''' King Abdullah Ear Specialist Center (KAESC), College of Medicine, ORL Department, King Saud University, Riyadh, Saudi Arabia.

'''Abstract:''' To study the changes in the coiled configuration of electrode excess lead in the mastoid cavity in the cochlear implant recipients over time.

Methods: Post-operative CT scans at two different appointments of fourteen patients with cochlear implants (CI) were retrospectively analyzed using a DICOM viewer software, [http://www.slicer.org '''3D Slicer''']. Mastoid thickness (MT) was measured in the oblique coronal plane from the round window (RW) entrance to the mastoid edge and inter-cochlear distance (ICD) was measured in the axial plane at the fundus level between two ears. 3D segmentation of the entire inner ear of both sides and coiled electrode excess lead was performed to visually compare the changes in coiled configuration between the two CT scan time points.

Result: MT and ICD increased logarithmically with the patient's age, as has been measured from both the 1st and the 2nd CT scans and a weak linear correlation between MT and ICD was observed. Growth in MT and ICT measured between the time of 1st and 2nd CT scans showed a strong linear correlation. In eight cases, changes in the electrode excess lead have been observed in the 2nd CT scan, either a change in the coiling configuration of electrode excess lead or shifted laterally toward the mastoid edge. The ICD growth between the 1st and the 2nd CT scans was >2 mm in only seven cases and all of them were children. All other six cases had no observed changes in the coiled electrode lead. In addition, the mastoid growth between the 1st and the 2nd CT scan was >2.5 mm in only 4 cases.

Conclusion: Coiled configuration of electrode excess lead could change when the MT and ICD increased over time.
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==Bridging 3D Slicer and ROS2 for Image-Guided Robotic Interventions==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35891016 Sensors (Basel). 2022 Jul 17;22(14):5336. PMID: 35891016] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9324680/pdf/sensors-22-05336.pdf PDF]

'''Authors:''' Connolly L, Deguet A, Leonard S, Tokuda J, Ungi T, Krieger A, Kazanzides P, Mousavi P, Fichtinger G, Taylor RH.

'''Institution:''' Whiting School of Engineering, Johns Hopkins University, Baltimore, MD, USA.

'''Abstract:''' Developing image-guided robotic systems requires access to flexible, open-source software. For image guidance, the open-source medical imaging platform [http://www.slicer.org '''3D Slicer'''] is one of the most adopted tools that can be used for research and prototyping. Similarly, for robotics, the open-source middleware suite robot operating system (ROS) is the standard development framework. In the past, there have been several "ad hoc" attempts made to bridge both tools; however, they are all reliant on middleware and custom interfaces. Additionally, none of these attempts have been successful in bridging access to the full suite of tools provided by ROS or [http://www.slicer.org '''3D Slicer''']. Therefore, in this paper, we present the SlicerROS2 module, which was designed for the direct use of ROS2 packages and libraries within [http://www.slicer.org '''3D Slicer''']. The module was developed to enable real-time visualization of robots, accommodate different robot configurations, and facilitate data transfer in both directions (between ROS and Slicer). We demonstrate the system on multiple robots with different configurations, evaluate the system performance and discuss an image-guided robotic intervention that can be prototyped with this module. This module can serve as a starting point for clinical system development that reduces the need for custom interfaces and time-intensive platform setup.
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==Radiomic Cancer Hallmarks to Identify High-Risk Patients in Non-Metastatic Colon Cancer==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35884499 Cancers (Basel). 2022 Jul 15;14(14):3438. PMID: 35884499] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9319440/pdf/cancers-14-03438.pdf PDF]

'''Authors:''' Caruso D, Polici M, Zerunian M, Del Gaudio A, Parri E, Giallorenzi MA, De Santis D, Tarantino G, Tarallo M, Dentice di Accadia FM, Iannicelli E, Garbarino GM, Canali G, Mercantini P, Fiori E, Laghi A.

'''Institution:''' Radiology Unit, Department of Medical Surgical Sciences and Translational Medicine, Sapienza University of Rome-Sant'Andrea University Hospital, Rome, Italy.

'''Abstract:''' The study was aimed to develop a radiomic model able to identify high-risk colon cancer by analyzing pre-operative CT scans. The study population comprised 148 patients: 108 with non-metastatic colon cancer were retrospectively enrolled from January 2015 to June 2020, and 40 patients were used as the external validation cohort. The population was divided into two groups-High-risk and No-risk-following the presence of at least one high-risk clinical factor. All patients had baseline CT scans, and 3D cancer segmentation was performed on the portal phase by two expert radiologists using open-source software [http://www.slicer.org '''3D Slicer'''] v4.10.2. Among the 107 radiomic features extracted, stable features were selected to evaluate the inter-class correlation (ICC) (cut-off ICC > 0.8). Stable features were compared between the two groups (T-test or Mann-Whitney), and the significant features were selected for univariate and multivariate logistic regression to build a predictive radiomic model. The radiomic model was then validated with an external cohort. In total, 58/108 were classified as High-risk and 50/108 as No-risk. A total of 35 radiomic features were stable (0.81 ≤ ICC < 0.92). Among these, 28 features were significantly different between the two groups (p < 0.05), and only 9 features were selected to build the radiomic model. The radiomic model yielded an AUC of 0.73 in the internal cohort and 0.75 in the external cohort. In conclusion, the radiomic model could be seen as a performant, non-invasive imaging tool to properly stratify colon cancers with high-risk disease.
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==Comparison of Three 3D Segmentation Software Tools for Hip Surgical Planning==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35890923 Sensors (Basel). 2022 Jul 13;22(14):5242. PMID: 35890923] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9323631/pdf/sensors-22-05242.pdf PDF]

'''Authors:''' Mandolini M, Brunzini A, Facco G, Mazzoli A, Forcellese A, Gigante A.

'''Institution:''' Department of Industrial Engineering and Mathematical Sciences, Università Politecnica delle Marche, Ancona, Italy.

'''Abstract:''' In hip arthroplasty, preoperative planning is fundamental to reaching a successful surgery. Nowadays, several software tools for computed tomography (CT) image processing are available. However, research studies comparing segmentation tools for hip surgery planning for patients affected by osteoarthritic diseases or osteoporotic fractures are still lacking. The present work compares three different software from the geometric, dimensional, and usability perspectives to identify the best three-dimensional (3D) modelling tool for the reconstruction of pathological femoral heads. Syngo.via Frontier (by Siemens Healthcare) is a medical image reading and post-processing software that allows low-skilled operators to produce prototypes. Materialise (by Mimics) is a commercial medical modelling software. [http://www.slicer.org '''3D Slicer'''] is an open-source development platform used in medical and biomedical fields. The 3D models reconstructed starting from the in vivo CT images of the pathological femoral head are compared with the geometries obtained from the laser scan of the in vitro bony specimens. The results show that Mimics and [http://www.slicer.org '''3D Slicer'''] are better for dimensional and geometric accuracy in the 3D reconstruction, while syngo.via Frontier is the easiest to use in the hospital setting.
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==The Prognostic Value of 18 F-FDG PET/CT Intra-Tumoural Metabolic Heterogeneity in Pretreatment Neuroblastoma Patients==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35791003 Cancer Imaging. 2022 Jul 5;22(1):32. PMID: 35791003] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9254530/pdf/40644_2022_Article_472.pdf PDF]

'''Authors:''' Liu J, Si Y, Zhou Z, Yang X, Li C, Qian L, Feng LJ, Zhang M, Zhang SX, Liu J, Kan Y, Gong J, Yang J.

'''Institution:''' Department of Nuclear Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing, China.

'''Abstract:''' Background: Neuroblastoma (NB) is the most common tumour in children younger than 5 years old and notable for highly heterogeneous. Our aim was to quantify the intra-tumoural metabolic heterogeneity of primary tumour lesions by using 18F-FDG PET/CT and evaluate the prognostic value of intra-tumoural metabolic heterogeneity in NB patients.

Methods: We retrospectively enrolled 38 pretreatment NB patients in our study. 18F-FDG PET/CT images were reviewed and analyzed using [http://www.slicer.org '''3D Slicer'''] software. The semi-quantitative metabolic parameters of primary tumour were measured, including the maximum standard uptake value (SUVmax), metabolic tumour volume (MTV), and total lesion glycolysis (TLG). The areas under the curve of cumulative SUV-volume histogram index (AUC-CSH index) was used to quantify intra-tumoural metabolic heterogeneity. The median follow-up was 21.3 months (range 3.6 - 33.4 months). The outcome endpoint was event-free survival (EFS), including progression-free survival and overall survival. Survival analysis was performed using Cox regression models and Kaplan Meier survival plots.

Results: In all 38 newly diagnosed NB patients, 2 patients died, and 17 patients experienced a relapse. The AUC-CSHtotal (r=0.630, P<0.001) showed moderate correlation with the AUC-CSH40%. In univariate analysis, chromosome 11q deletion (P=0.033), Children's Oncology Group (COG) risk grouping (P=0.009), bone marrow involvement (BMI, P=0.015), and AUC-CSHtotal (P=0.007) were associated with EFS. The AUC-CSHtotal (P=0.036) and BMI (P=0.045) remained significant in multivariate analysis. The Kaplan Meier survival analyses demonstrated that patients with higher intra-tumoural metabolic heterogeneity and BMI had worse outcomes (log-rank P=0.002).

Conclusion: The intra-tumoural metabolic heterogeneity of primary lesions in NB was an independent prognostic factor for EFS. The combined predictive effect of intra-tumoural metabolic heterogeneity and BMI provided prognostic survival information in NB patients.
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==Practical Methods for Segmentation and Calculation of Brain Volume and Intracranial Volume: A Guide and Comparison==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35782251 Quant Imaging Med Surg. 2022 Jul;12(7):3748-61. PMID: 35782251] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9246750/pdf/qims-12-07-3748.pdf PDF]

'''Authors:''' Harkey T, Baker D, Hagen J, Scott H, Palys V.

'''Institution:''' Department of Neurosurgery, University of Arkansas for Medical Sciences, Little Rock, AR, USA.

'''Abstract:''' Hypothesis: Automated image registration techniques can successfully determine anatomical variation in human temporal bones with statistical shape modeling.

Background: Background: Accurate segmentation and calculation of total brain volume (BV) and intracranial volume (ICV) (further-volumetry) may serve various clinical tasks and research studies in neuroscience. Manual segmentation is extremely time consuming. There is a relative lack of published broad recommendations and comparisons of tools for automated volumetry, especially for users without expertise in computer science, for settings with limited resources, and when neuroimaging quality is suboptimal due to clinical circumstances. Our objective is to decrease the barrier to entry for research and clinical groups to perform volumetric cranial imaging analysis using free and reliable software tools.

Methods: Automated volumetry from computed tomography (CT)/magnetic resonance imaging (MRI) scans was accomplished using [http://www.slicer.org '''3D Slicer'''] v. 4.11.0, FreeSurfer (v. 7.1.1), and volBrain (v. 1.0) in a cohort of 39 patients with ischemic middle cerebral artery territory brain infarcts in the acute stage. Visual inspection for accuracy was also performed. Statistical analysis included coefficient of determination (R2) and Bland-Altman (B-A) plots. A multifaceted comparison between [http://www.slicer.org '''3D Slicer'''], FreeSurfer, and volBrain from practical user perspective was performed to compile a list of distinguishing features.

Results: BV: FreeSurfer, [http://www.slicer.org '''3D Slicer'''], and volBrain provide similar estimations when high quality T1-MRI scans with 1 mm slices (3D scans) are available, whereas 3 mm and thicker slices (2D scans) introduce a dispersion in results. ICV: the most accurate volumetry is provided by [http://www.slicer.org '''3D Slicer'''] using CT scans. volBrain uses T1-MRIs and also provides good results which agree with 3[http://www.slicer.org '''3D Slicer''']. Both of these methods may be more trustworthy than T1 MRI-derived FreeSurfer calculations.

Conclusions: All three studied tools of automated intracranial and brain volumetry - [http://www.slicer.org '''3D Slicer'''], FreeSurfer, and volBrain-are free, reliable, require no complex programming, but still have certain limitations and significant differences. Based on our investigation findings, the readers should be able to select the right volumetry tool and neuroimaging study, and then follow provided step-by-step instructions to accomplish specific volumetry tasks.
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==Statistical Shape Model of the Temporal Bone Using Segmentation Propagation==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35761465 Otol Neurotol. 2022 Jul 1;43(6):e679-e687. PMID: 35761465]

'''Authors:''' Ding AS, Lu A, Li Z, Galaiya D, Ishii M, Siewerdsen JH, Taylor RH, Creighton FX.

'''Institution:''' Department of Computer Science, Johns Hopkins University Whiting School of Engineering, Baltimore, MD, USA.

'''Abstract:''' Hypothesis: Automated image registration techniques can successfully determine anatomical variation in human temporal bones with statistical shape modeling.

Background: There is a lack of knowledge about inter-patient anatomical variation in the temporal bone. Statistical shape models (SSMs) provide a powerful method for quantifying variation of anatomical structures in medical images but are time-intensive to manually develop. This study presents SSMs of temporal bone anatomy using automated image-registration techniques.

Methods: Fifty-three cone-beam temporal bone CTs were included for SSM generation. The malleus, incus, stapes, bony labyrinth, and facial nerve were automatically segmented using [http://www.slicer.org '''3D Slicer'''] and a template-based segmentation propagation technique. Segmentations were then used to construct SSMs using MATLAB. The first three principal components of each SSM were analyzed to describe shape variation.

Results: Principal component analysis of middle and inner ear structures revealed novel modes of anatomical variation. The first three principal components for the malleus represented variability in manubrium length (mean: 4.47 mm; ±2-SDs: 4.03-5.03 mm) and rotation about its long axis (±2-SDs: -1.6° to 1.8° posteriorly). The facial nerve exhibits variability in first and second genu angles. The bony labyrinth varies in the angle between the posterior and superior canals (mean: 88.9°; ±2-SDs: 83.7°-95.7°) and cochlear orientation (±2-SDs: -4.0° to 3.0° anterolaterally).

Conclusions: SSMs of temporal bone anatomy can inform surgeons on clinically relevant inter-patient variability. Anatomical variation elucidated by these models can provide novel insight into function and pathophysiology. These models also allow further investigation of anatomical variation based on age, BMI, sex, and geographical location.
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==CT-Based Radiomics for Prediction of Therapeutic Response to Everolimus in Metastatic Neuroendocrine Tumors==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35717429 Radiol Med. 2022 Jul;127(7):691-701. PMID: 35717429] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9308597/pdf/11547_2022_Article_1506.pdf PDF]

'''Authors:''' Caruso D, Polici M, Rinzivillo M, Zerunian M, Nacci I, Marasco M, Magi L, Tarallo M, Gargiulo S, Iannicelli E, Annibale B, Laghi A, Panzuto F.

'''Institution:''' Department of Medical Surgical Sciences and Translational Medicine, "Sapienza"-University of Rome, Sant'Andrea University Hospital, Rome, Italy.

'''Abstract:''' To test radiomic approach in patients with metastatic neuroendocrine tumors (NETs) treated with Everolimus, with the aim to predict progression-free survival (PFS) and death.

Materials and methods: Twenty-five patients with metastatic neuroendocrine tumors, 15/25 pancreatic (60%), 9/25 ileal (36%), 1/25 lung (4%), were retrospectively enrolled between August 2013 and December 2020. All patients underwent contrast-enhanced CT before starting Everolimus, histological diagnosis, tumor grading, PFS, overall survival (OS), death, and clinical data collected. Population was divided into two groups: responders (PFS ≤ 11 months) and non-responders (PFS > 11 months). 3D segmentation was performed on whole liver of naïve CT scans in arterial and venous phases, using a dedicated software, [http://www.slicer.org '''3D Slicer'''] v4.10.2. A total of 107 radiomic features were extracted and compared between two groups (T test or Mann-Whitney), radiomics performance assessed with receiver operating characteristic curve, Kaplan-Meyer curves used for survival analysis, univariate and multivariate logistic regression performed to predict death, and interobserver variability assessed. All significant radiomic comparisons were validated by using a synthetic external cohort. P < 0.05 is considered significant.

Results: 15/25 patients were classified as responders (median PFS 25 months and OS 29 months) and 10/25 as non-responders (median PFS 4.5 months and OS 23 months). Among radiomic parameters, Correlation and Imc1 showed significant differences between two groups (P < 0.05) with the best performance (internal cohort AUC 0.86-0.84, P < 0.0001; external cohort AUC 0.84-0.90; P < 0.0001). Correlation < 0.21 resulted correlated with death at Kaplan-Meyer analysis (P = 0.02). Univariate analysis showed three radiomic features independently correlated with death, and in multivariate analysis radiomic model showed good performance with AUC 0.87, sensitivity 100%, and specificity 66.7%. Three features achieved 0.77 ≤ ICC < 0.83 and one ICC = 0.92.

Conclusions: In patients affected by metastatic NETs eligible for Everolimus treatment, radiomics could be used as imaging biomarker able to predict PFS and death.
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==Smartphone Navigated Endoscopic Port Surgery of Hypertensive Basal Ganglia Hemorrhage==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35609413 J Clin Neurosci. 2022 Jul;101:193-7. PMID: 35609413]

'''Authors:''' Li F, Gan Z, Xu X, Zhao Y, Wang Q, Chen C, Liu H, Xiong R, Qi Z, Sun G, Zhang J, Xu B, Chen X.

'''Institution:''' Department of Neurosurgery, Chinese PLA General Hospital, Beijing, China.

'''Abstract:''' Objective: Endoscopic port surgery is a promising alternative for the surgical treatment of intracerebral hypertensive basal ganglia hemorrhage (HBGH). The precise location of hematoma is a crucial step for surgery. The authors developed a simple, low-cost navigation method using an Android smartphone for the localization of HBGH.

Methods: All patients' CT DICOM data were processed with an open-source software, [http://www.slicer.org '''3D Slicer''']. The volume of hematoma, angle, and length of trajectory were calculated automatically. A smartphone running the Android system and the Compass APP was used to help insert the inner introducer. An endoscopic port system was applied to create a working channel for neuro-endoscopic hematoma evacuation.

Results: There were 27 patients enrolled in this study (mean age 56). All patients underwent successful surgical evacuation of HBGH with neuroendoscopic evacuation. The mean time taken for the surgical plan was 4 min. The total operation time from skin incision to final suture was 82.6 min. Compared with standard neuronavigation, mean error of trajectory was 5.1 mm. The mean preoperative hematoma volume was 44.8 ml. The optimal trajectory angle averaged 39.5°and the length was 71 mm. Intraoperative blood loss was about 45 ml. Post-operative hematoma volume was 2.9 ml, and the average evacuation rate was 93.6%. One week after surgery, the mean GCS score was improved from 8.2 to 13.8 (p < 0.01).

Conclusions: This simple, low-cost navigation method using [http://www.slicer.org '''3D Slicer'''], an Android smartphone with the Compass APP, helps precisely insert the endoscopic working channel to the desired point, which is crucial for satisfactory evacuation of HBGH.
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==A Predictive Nomogram for Atypical Meningioma Based On Preoperative Magnetic Resonance Imaging and Routine Blood Tests==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35430397 World Neurosurg. 2022 Jul;163:e610-e616. PMID: 35430397]

'''Authors:''' Lin Y, Dai P, Lin Q, Chen J.

'''Institution:''' Dongshan County Hospital of Fujian Province, Zhangzhou, Fujian, China.

'''Abstract:''' Objective: The objective of the study was to establish a 5-year progression-free survival prediction nomogram using preoperative routine blood tests and magnetic resonance imaging to guide postoperative treatment.

Methods: Our study was a retrospective analysis of patients with atypical meningioma admitted into our facility from January 31, 2010, to January 31, 2016. We used single-factor logistic analysis to extract valuable indicators from preoperative blood test results and [http://www.slicer.org '''3D Slicer'''] software to extract radiomic features from magnetic resonance imaging. The radiomics score was calculated by least absolute shrinkage and selection operator logistic regression analysis. We then combined blood indicators and radiomic signatures to construct a radiomic nomogram image. The performance of the model was evaluated comprehensively using the following three aspects: recognition ability, accuracy, and clinical value.

Results: Six significant radiological features were selected through least absolute shrinkage and selection operator logistic regression analysis. The radiometric label established by these six features has satisfactory predictive performance. The area under the curve in the training group was 0.885 (95% confidence interval, 0.8037-0.9659), and the area under the curve in the validation set was 0.789 (95% confidence interval, 0.6092-0.9686). We used the combined image tags and preoperative leukocyte and neutrophil count to construct a 5-year progression-free survival prediction nomogram.

Conclusions: The analysis results of the calibration curve and the decision curve show that the nomogram constructed by combining radiomics and preoperative blood tests has a good predictive value for 5-year progression-free survival in atypical meningioma and can provide a reference for selecting postoperative treatment options.
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==A Hybrid Registration Method Using the Mandibular Bone Surface for Electromagnetic Navigation in Mandibular Surgery==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35441961 Int J Comput Assist Radiol Surg. 2022 Jul;17(7):1343-53. PMID: 35441961]

'''Authors:'''de Geer AF, van Alphen MJA, Zuur CL, Loeve AJ, van Veen RLP, Karakullukcu MB.

'''Institution:''' Verwelius 3D Lab, Department of Head and Neck Surgery and Oncology, Netherlands Cancer Institute, Antoni van Leeuwenhoek, Amsterdam, The Netherlands.

'''Abstract:''' Purpose: To utilize navigated mandibular (reconstructive) surgery, accurate registration of the preoperative CT scan with the actual patient in the operating room (OR) is required. In this phantom study, the feasibility of a noninvasive hybrid registration method is assessed. This method consists of a point registration with anatomic landmarks for initialization and a surface registration using the bare mandibular bone surface for optimization.

Methods: Three mandible phantoms with reference notches on two osteotomy planes were 3D printed. An electromagnetic tracking system in combination with [http://www.slicer.org '''3D Slicer'''] software was used for navigation. Different configurations, i.e., different surface point areas and number and configuration of surface points, were tested with a dentate phantom (A) in a metal-free environment. To simulate the intraoperative environment and different anatomies, the registration procedure was also performed with an OR bed using the dentate phantom and two (partially) edentulous phantoms with atypical anatomy (B and C). The accuracy of the registration was calculated using the notches on the osteotomy planes and was expressed as the target registration error (TRE). TRE values of less than 2.0 mm were considered as clinically acceptable.

Results: In all experiments, the mean TRE was less than 2.0 mm. No differences were found using different surface point areas or number or configurations of surface points. Registration accuracy in the simulated intraoperative setting was-mean (SD)-0.96 (0.22), 0.93 (0.26), and 1.50 (0.28) mm for phantom A, phantom B, and phantom C.

Conclusion: Hybrid registration is a noninvasive method that requires only a small area of the bare mandibular bone surface to obtain high accuracy in phantom setting. Future studies should test this method in clinical setting during actual surgery.
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==Generating Patient-Matched 3D-Printed Pedicle Screw and Laminectomy Drill Guides From Cone Beam CT Images: Studies in Ovine and Porcine Cadavers==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35445429 Med Phys. 2022 Jul;49(7):4642-52. PMID: 35445429] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9544846/pdf/MP-49-4642.pdf PDF]

'''Authors:''' Kanawati A, Constantinidis A, Williams Z, O'Brien R, Reynolds T.

'''Institution:''' Westmead Hospital, Sydney, NSW, Australia.

'''Abstract:''' Background: The emergence of robotic Cone Beam Computed Tomography (CBCT) imaging systems in trauma departments has enabled 3D anatomical assessment of musculoskeletal injuries, supplementing conventional 2D fluoroscopic imaging for examination, diagnosis, and treatment planning. To date, the primary focus has been on trauma sites in the extremities.

Purpose: To determine if CBCT images can be used during the treatment planning process in spinal instrumentation and laminectomy procedures, allowing accurate 3D-printed pedicle screw and laminectomy drill guides to be generated for the cervical and thoracic spine.

Methods: The accuracy of drill guides generated from CBCT images was assessed using animal cadavers (ovine and porcine). Preoperative scans were acquired using a robotic CBCT C-arm system, the Siemens ARTIS pheno (Siemens Healthcare, GmbH, Germany). The CBCT images were imported into [http://www.slicer.org '''3D Slicer'''] v.4.10.2 where vertebral models and specific guides were developed and subsequently 3D-printed. In the ovine cadaver, 11 pedicle screw guides from the T1-T5 and T7-T12 vertebra and six laminectomy guides from the C2-C7 vertebra were planned and printed. In the porcine cadaver, nine pedicle screw guides from the C3-T4 vertebra were planned and printed. For the pedicle screw guides, accuracy was assessed by three observers according to pedicle breach via the Gertzbein-Robbins grading system as well as measured mean axial and sagittal screw error via postoperative CBCT and CT scans. For the laminectomies, the guides were designed to leave 1 mm of lamina. The average thickness of the lamina at the midpoint was used to assess the accuracy of the guides, measured via postoperative CBCT and CT scans from three observers. For all measurements, the intraclass correlation coefficient (ICC) was calculated to determine observer reliability.

Results: Compared with the planned screw angles for both the ovine and porcine procedures (n = 32), the mean axial and sagittal screw error measured on the postoperative CBCT scans from three observers were 3.9 ± 1.9° and 1.8 ± 0.8°, respectively. The ICC among the observes was 0.855 and 0.849 for the axial and sagittal measurements, respectively, indicating good reliability. In the ovine cadaver, directly comparing the measured axial and sagittal screw angle of the visible screws (n = 14) in the postoperative CBCT and conventional CT scans from three observers revealed an average difference 1.9 ± 1.0° in axial angle and 1.8 ± 1.0° in the sagittal angle. The average thickness of the lamina at the middle of each vertebra, as measured on-screen in the postoperative CBCT scans by three observes was 1.6 ± 0.2 mm. The ICC among observers was 0.693, indicating moderate reliability. No lamina breaches were observed in the postoperative images.

Conclusion: Here, CBCT images have been used to generate accurate 3D-printed pedicle screw and laminectomy drill guides for use in the cervical and thoracic spine. The results demonstrate sufficient precision compared with those previously reported, generated from standard preoperative CT and MRI scans, potentially expanding the treatment planning capabilities of robotic CBCT imaging systems in trauma departments and operating rooms.
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==Investigating Metacarpi of Hamdani Sheep via Different Measurement and Modelling Methods: A Methodological Study==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35608253 Anat Histol Embryol. 2022 Jul;51(4):484-91. PMID: 35608253]

'''Authors:''' Güzel BC, Koçyiğit A, Demircioğlu İ, Demiraslan Y.

'''Institution:''' Department of Anatomy, Faculty of Veterinary Medicine, Fırat University, Elazig, Turkey.

'''Abstract:''' The aim of the study was to perform the morphometric analyses on metacarpi of Hamdani sheep via different measurement methods and to compare the methods. Thus, metacarpal bones of 15 females and 15 males were used in the study. Measurements were taken from the measurement points determined on metacarpus via four methods, and their statistical analyses were performed. When both male and female metacarpal bones were examined in the De parameter in the comparison with the methods, it was observed that the four measurement methods were different from one another (p < 0.01). When DEM and DEL measurement parameters were examined in male metacarpus, the highest value was measured in ImageJ and the smallest value was measured in [http://www.slicer.org '''3D Slicer'''] software; however, it was found that the statistical difference was not significant when compared numerically (p > 0.05). As a result, while it was observed that the measurements made by using digital calliper measurements, photometric analysis, and 3D software were similar in some of the parameters but there was no statistically significant difference; whereas, Statistical difference was detected in some parameters.
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==Continuous Subcortical Monitoring of Motor Pathways During Glioma Surgery With Ultrasonic Surgical Aspirator: Technical Description in a Single Institute Experience==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35766211 J Neurosurg Sci. 2022 Jun 28. PMID: 35766211]

'''Authors:''' D'Elia A, Lavalle L, Bua A, Schiano DI Cola M, Ciavarro M, Esposito V.

'''Institution:''' Neurosurgery Department, IRCCS Neuromed, Pozzilli, Isernia, Italy.

'''Abstract:''' Background: Actual challenge in surgical treatment of intra-axial gliomas involving eloquent areas is maximal safe resection. Mapping and monitoring of cortical and subcortical motor functions are important tools to avoid postoperative deficits. In the present study, we present our experience with a continuous dynamic motor mapping technique pairing a traditional monopolar stimulator with a Cavitron Ultrasonic Surgical Aspirator (CUSA) to perform a continuous stimulation of the white matter avoiding removal interruption.

Methods: We describe a single center retrospective analysis of 1-year consecutive patients with intraxial tumors located adjacent to corticospinal tract and treated with surgical resection adopting "continuous dynamic mapping technique". With the support of a reconstruction software, [http://www.slicer.org '''3D Slicer'''], we classified the Extent Of Resection (EOR) as Gross Total Resection (GTR) (>98%), Sub-Total Resection (STR) (from 90% to 97%), and Partial Resection (<90%). Medical Research Council (MRC) grading was adopted to evaluate neurological outcomes (from 0 to 5), assessed on 1st postoperative day, at 1 week, 1 month and 3 months.

Results: From July 2017 to July 2018, 29 patients underwent to surgical removal of intraxial tumor adjacent to motor areas, using continuous dynamic subcortical mapping. Median age was 54 years old (range 12-75 years). At preoperative MRI tractography reconstruction, mean distance between tumor and corticospinal tract was 4,4 mm (range At 1 week post-operative assessment, motor deficits were still present in 12 patients (41%). At 1 month, 10 patients (35%) had persisting deficits, which required admission to rehabilitation department. At 3 months, 4 patients (14%) had persistent motor impairment and overall 28 patients (98%) were able to walk by themselves.

Conclusions: Our early experience showed that a combination of dynamic subcortical mapping with transcranial and cortical strip MEP (Motor Evoked Potentials) monitoring is useful in tumors close to motor eloquent areas to extend surgical resection avoiding permanent consequences. However, we need for further experience to consolidate and improve this technique.
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==A New Method of Preoperative Assessment of Correct Electrode Array Alignment Based on Post-Operative Measurements in a Cochlear Implanted Cohort==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35727414 Eur Arch Otorhinolaryngol. 2022 Jun 21. PMID: 35727414]

'''Authors:''' Horvath B, Perenyi A, Molnar FA, Nagy R, Csanady M, Kiss JG, Rovo L.

'''Institution:''' Doctoral School of Clinical Medicine, University of Szeged, Szeged, Hungary.

'''Abstract:''' Purpose: During cochlear implantation surgery, a range of complications may occur such as tip fold-over. We recently developed a method to estimate the insertion orientation of the electrode array. The aim of the study was to determine the optimal angle of orientation in a cohort of cochlear implanted patients.

Methods: On eighty-five CT scans (80 uncomplicated insertions and 5 cases with tip fold-over), location of the electrode array's Insertion Guide (IG), Orientation marker (OM) and two easily identifiable landmarks (the round window (RW) and the incus short process (ISP)) were manually marked. The angle enclosed by ISP-RW line and the Cochlear™ Slim Modiolar electrode array's OM line determined the electrode array insertion angle.

Results: The average insertion angle was 45.0-47.2° ± 10.4-12° SD and was validated with 98% confidence interval. Based on the measurements obtained, patients' sex and age had no impact on the size of this angle. Although the angles of the tip fold-over cases (44.9°, 46.9°, 34.2°, 54.3°, 55.9°) fell within this average range, the further it diverted from the average it increased the likelihood for tip fold-over.

Conclusion: Electrode array insertion in the individually calculated angle relative to the visible incus short process provides a useful guide for the surgeon when aiming for the optimal angle, and potentially enhances good surgical outcomes. Our results show that factors other than the orientation angle may additionally contribute to failures in implantation when the Slim Modiolar electrode is used.

Keywords: [http://www.slicer.org '''3D Slicer''']; Cochlear implant; Medical image processing; Neuro-otology surgery; Slim Modiolar.
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==Role of Personalized 3D Printing in Brain Protection After Decompressive Craniectomy==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35705481 Zhonghua Yi Xue Za Zhi. 2022 Jun 21;102(23):1766-70. PMID: 35705481] |

'''Authors:''' Shi ZJ, Zhang H, Jiang DH, Chen SF, Zhou LW, Tan GW, Wang ZX.

'''Institution:''' Department of Neurosurgery, the First Affiliated Hospital of Xiamen University, Xiamen, China.

'''Abstract:''' Objective: To explore the application value of personalized three-dimensional (3D) printed protective cap in brain protection after decompressive craniectomy (DC). Methods: Fourty-five patients who underwent DC from January 2021 to October 2021 were selected, including 26 males and 19 females, aged 5-73 (50±13) years old. The brain CT data were imported into [http://www.slicer.org '''3D Slicer'''] software to rebuild the protective cap through 3D printing. The cap was worn on the head of the patient, thereby preventing secondary braindamage. The follow-up results were compared with 53 patients without protective capduring the same period. Results: There were no statistically significant differences in age, skull defect location and follow-up time between the two groups (all P>0.05).Among 45 patients, 47 brain protective caps (2 cases with bilateral skull defects) were successfully designed. The time for image post-processingand 3D printing was (21.2±6.0) min and (62.4±8.3) min, respectively. There were 6 cases of low compliance, 9 cases of moderate compliance, 32 cases of high compliance, respectively. Six cases with low conformity were redesigned and printed, 2 of 9 cases with moderate conformity were redesigned and printed, and the remaining 7 cases reached high compliance after grinding and packaging. In the current study, 45 patients with brain protective caps were followed up for 3 months, and no secondary brain injury occurred. However, among 53 patients without brain protective caps during the same period, 4 patients had secondary accidental brain compression. The incidence of injury was 7.5 %, and the difference was statistically significant (P<0.001). Conclusion: Brain protective cap designed based on cranial CT and 3D printing can be used in patients with skull defects to protect the brain tissue from secondary crush damage and has certain clinical value.
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==Different Lung Parenchyma Quantification Using Dissimilar Segmentation Software: A Multi-Center Study for COVID-19 Patients==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35741310 Diagnostics (Basel). 2022 Jun 20;12(6):1501. PMID: 35741310] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9222070/pdf/diagnostics-12-01501.pdf PDF]

'''Authors:''' Risoli C, Nicolò M, Colombi D, Moia M, Rapacioli F, Anselmi P, Michieletti E, Ambrosini R, Di Terlizzi M, Grazioli L, Colmo C, Di Naro A, Natale MP, Tombolesi A, Adraman A, Tuttolomondo D, Costantino C, Vetti E, Martini C.

'''Institution:''' Department of Radiological Function, "Guglielmo da Saliceto" Hospital, Piacenza, Italy.

'''Abstract:''' Background: Chest Computed Tomography (CT) imaging has played a central role in the diagnosis of interstitial pneumonia in patients affected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and can be used to obtain the extent of lung involvement in COVID-19 pneumonia patients either qualitatively, via visual inspection, or quantitatively, via AI-based software. This study aims to compare the qualitative/quantitative pathological lung extension data on COVID-19 patients. Secondly, the quantitative data obtained were compared to verify their concordance since they were derived from three different lung segmentation software.

Methods: This double-center study includes a total of 120 COVID-19 patients (60 from each center) with positive reverse-transcription polymerase chain reaction (RT-PCR) who underwent a chest CT scan from November 2020 to February 2021. CT scans were analyzed retrospectively and independently in each center. Specifically, CT images were examined manually by two different and experienced radiologists for each center, providing the qualitative extent score of lung involvement, whereas the quantitative analysis was performed by one trained radiographer for each center using three different software: [http://www.slicer.org '''3D Slicer'''], CT Lung Density Analysis, and CT Pulmo 3D.

Results: The agreement between radiologists for visual estimation of pneumonia at CT can be defined as good (ICC 0.79, 95% CI 0.73-0.84). The statistical tests show that [http://www.slicer.org '''3D Slicer'''] overestimates the measures assessed; however, ICC index returns a value of 0.92 (CI 0.90-0.94), indicating excellent reliability within the three software employed. ICC was also performed between each single software and the median of the visual score provided by the radiologists. This statistical analysis underlines that the best agreement is between [http://www.slicer.org '''3D Slicer'''] "LungCTAnalyzer" and the median of the visual score (0.75 with a CI 0.67-82 and with a median value of 22% of disease extension for the software and 25% for the visual values).

Conclusions: This study provides for the first time a direct comparison between the actual gold standard, which is represented by the qualitative information described by radiologists, and novel quantitative AI-based techniques, here represented by three different commonly used lung segmentation software, underlying the importance of these specific values that in the future could be implemented as consistent prognostic and clinical course parameters.
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==Assessment of the Accuracy of Imaging Software for 3D Rendering of the Upper Airway, Usable in Orthodontic and Craniofacial Clinical Settings==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35691961 Prog Orthod. 2022 Jun 13;23(1):22. PMID: 35691961] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9189077/pdf/40510_2022_Article_413.pdf PDF]

'''Authors:''' Lo Giudice A, Ronsivalle V, Gastaldi G, Leonardi R.

'''Institution:''' Department of General Surgery and Medical-Surgical Specialties, School of Dentistry, Unit of Orthodontics, University of Catania, Policlinico Universitario "Gaspare Rodolico - San Marco", Catania, Italy.

'''Abstract:''' Background: Several semi-automatic software are available for the three-dimensional reconstruction of the airway from DICOM files. The aim of this study was to evaluate the accuracy of the segmentation of the upper airway testing four free source and one commercially available semi-automatic software. A total of 20 cone-beam computed tomography (CBCT) were selected to perform semi-automatic segmentation of the upper airway. The software tested were Invesalius, ITK-Snap, Dolphin 3D, [http://www.slicer.org '''3D Slicer'''] and Seg3D. The same upper airway models were manually segmented (Mimics software) and set as the gold standard (GS) reference of the investigation. A specific 3D imaging technology was used to perform the superimposition between the upper airway model obtained with semi-automatic software and the GS model, and to perform the surface-to-surface matching analysis. The accuracy of semi-automatic segmentation was evaluated calculating the volumetric mean differences (mean bias and limits of agreement) and the percentage of matching of the upper airway models compared to the manual segmentation (GS). Qualitative assessments were performed using color-coded maps. All data were statistically analyzed for software comparisons.

Results: Statistically significant differences were found in the volumetric dimensions of the upper airway models and in the matching percentage among the tested software (p < 0.001). Invesalius was the most accurate software for 3D rendering of the upper airway (mean bias = 1.54 cm3; matching = 90.05%) followed by ITK-Snap (mean bias = - 2.52 cm3; matching = 84.44%), Seg 3D (mean bias = 3.21 cm3, matching = 87.36%), [http://www.slicer.org '''3D Slicer'''] (mean bias = - 4.77 cm3; matching = 82.08%) and Dolphin 3D (difference mean = - 6.06 cm3; matching = 78.26%). According to the color-coded map, the dis-matched area was mainly located at the most anterior nasal region of the airway. Volumetric data showed excellent inter-software reliability (GS vs semi-automatic software), with coefficient values ranging from 0.904 to 0.993, confirming proportional equivalence with manual segmentation.

Conclusion: Despite the excellent inter-software reliability, different semi-automatic segmentation algorithms could generate different patterns of inaccuracy error (underestimation/overestimation) of the upper airway models. Thus, is unreasonable to expect volumetric agreement among different software packages for the 3D rendering of the upper airway anatomy.
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==3D Printing of Subclavian Artery: Utility for Preprocedural Planning and Correlation With Subclavian Artery Percutaneous Vascular Interventions==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35652708 J Invasive Cardiol. 2022 Jun;34(6):E455-E461. PMID: 35652708]

'''Authors:''' Memon S, Janzer S, Friend E, Kalra S, George JC.

'''Institution:''' Pennsylvania Hospital, University of Pennsylvania Health System, Philadelphia, PA, USA.

'''Abstract:''' Background: Three-dimensional (3D) printing for subclavian artery (SA) percutaneous vascular interventions (PVI) may allow superior understanding of patient specific complex anatomy and aid with preprocedural planning.

Methods: Five patients with computed tomography angiography (CTA) of the neck who underwent SA PVI were queried retrospectively. 3D printing of aortic arch and great vessels was accomplished with [http://www.slicer.org '''3D Slicer'''] software and painted with acrylic paint to highlight anatomic features. The aortic arch type and implications for preprocedural planning for SA interventions including complex chronic total occlusion (CTO) lesions were determined. Comparisons were made with SA angiograms and 3D-CTA.

Results: Of the 5 patients, type I (n = 2), type II (n = 1), and type III (n = 2) aortic arches were identified. Proximal and distal reference vessel size and total lesion length were determined using a digital millimeter caliper and correlated with intraprocedural balloons and stents. In 3D-printed models (3D-PMs) of patients with SA-CTO (n = 2), cap morphology (tapered vs blunt) and distal vessel filling were visualized, permitting optimal arterial access site selection for successful cap crossing. The vertebral arteries (VAs) were also 3D printed which further allowed the ability to delineate optimal stent deployment site (proximal or distal to VA), a common dilemma that is faced intraprocedurally. The 3D-PMs also allowed preprocedural precision in stent and balloon size and length, potentially leading to procedural efficiency and cost-effectiveness.

Conclusion: 3D printing of aortic arch and great vessel anatomy for SA-PVI allows multiple procedure-related factors to be predicted in advance, translating to decrease in contrast volume, radiation time, procedure and fluoroscopic time, thereby improving procedure and cost efficiency.
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==The Use of Augmented Reality Navigation Technology in Combination With Endoscopic Surgery for the Treatment of an Odontogenic Cyst of the Upper Jaw: A Technical Report==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35799962 Imaging Sci Dent. 2022 Jun;52(2):225-30. PMID: 35799962] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9226234/pdf/isd-52-225.pdf PDF]

'''Authors:''' Lysenko A, Razumova A, Yaremenko A, Ivanov V, Strelkov S, Krivtsov A.

'''Institution:''' Department of Dental Surgery and Maxillofacial Surgery, First Pavlov State Medical University, Saint-Petersburg, Russia.

'''Abstract:''' Purpose: This report presents the first known use of a rigid endoscope with augmented reality technology for the removal of an odontogenic cyst that penetrated the maxillary sinus and illustrates its practical use in a patient.

Materials and methods: In the preoperative period, cone-beam computed tomography was performed in a specially designed marker holder frame, and the contours of the cyst and the nearest anatomical formations were segmented in the [http://www.slicer.org '''3D Slicer'''] program. During the operation, a marker was installed on the patient's head, as well as on the tip of the endoscope, which made it possible to visualize the mass and the movement of the endoscope. The surgical intervention was performed with the support of augmented reality in HoloLens glasses (Microsoft Corporation, Redmond, WA, USA).

Results: The use of this technology improved the accuracy of surgical manipulations, reduced operational risks, and shortened the time of surgery and the rehabilitation period.

Conclusion: With the help of modern technologies, a navigation system was created that helped to track the position of the endoscope in mixed reality in real time, as well as to fully visualize anatomical formations.
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==Comparison of Response Assessment in Veterinary Neuro-Oncology and Two Volumetric Neuroimaging Methods to Assess Therapeutic Brain Tumour Responses in Veterinary Patients==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/34792828 Vet Comp Oncol. 2022 Jun;20(2):404-15. PMID: 34792828]

'''Authors:''' Coppola G, Morris J, Gutierrez-Quintana R, Burnside S, José-López R.

'''Institution:''' School of Veterinary Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK.

'''Abstract:''' Standardized veterinary neuroimaging response assessment methods for brain tumours are lacking. Consequently, a response assessment in veterinary neuro-oncology (RAVNO) system which uses the sum product of orthogonal lesion diameters on 1-image section with the largest tumour area, has recently been proposed. In this retrospective study, 22 pre-treatment magnetic resonance imaging (MRI) studies from 18 dogs and four cats with suspected intracranial neoplasia were compared by a single observer to 32 post-treatment MRIs using the RAVNO system and two volumetric methods based on tumour margin or area delineation with HOROS and [http://www.slicer.org '''3D Slicer'''] software, respectively. Intra-observer variability was low, with no statistically significant differences in agreement index between methods (mean AI ± SD, 0.91 ± 0.06 for RAVNO; 0.86 ± 0.08 for HOROS; and 0.91 ± 0.05 for [http://www.slicer.org '''3D Slicer''']), indicating good reproducibility. Response assessments consisting of complete or partial responses, and stable or progressive disease, agreed in 23 out of 32 (72%) MRI evaluations using the three methods. The RAVNO system failed to identify changes in mass burden detected with volumetric methods in six cases. [http://www.slicer.org '''3D Slicer'''] differed from the other two methods in three cases involving cysts or necrotic tissue as it allowed for more accurate exclusion of these structures. The volumetric response assessment methods were more precise in determining changes in absolute tumour burden than RAVNO but were more time-consuming to use. Based on observed agreement between methods, low intra-observer variability and decreased time constraint, RAVNO might be a suitable response assessment method for the clinical setting.
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==Intracardiac MR Imaging (ICMRI) Guiding-Sheath With Amplified Expandable-Tip Imaging and MR-Tracking for Navigation and Arrhythmia Ablation Monitoring: Swine Testing at 1.5 and 3T==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35142398 Magn Reson Med. 2022 Jun;87(6):2885-900. PMID: 35142398]

'''Authors:''' Schmidt EJ, Olson G, Tokuda J, Alipour A, Watkins RD, Meyer EM, Elahi H, Stevenson WG, Schweitzer J, Dumoulin CL, Johnson T, Kolandaivelu A, Loew W, Halperin HR.

'''Institution:''' Medicine (Cardiology), Johns Hopkins University, Baltimore, MD, USA.

'''Abstract:''' Purpose: Develop a deflectable intracardiac MR imaging (ICMRI) guiding-sheath to accelerate imaging during MR-guided electrophysiological (EP) interventions for radiofrequency (500 kHz) ablation (RFA) of arrhythmia. Requirements include imaging at three to five times surface-coil SNR in cardiac chambers, vascular insertion, steerable-active-navigation into cardiac chambers, operation with ablation catheters, and safe levels of MR-induced heating.

Methods: ICMRI's 6 mm outer-diameter (OD) metallic-braided shaft had a 2.6 mm OD internal lumen for ablation-catheter insertion. Miniature-Baluns (MBaluns) on ICMRI's 1 m shaft reduced body-coil-induced heating. Distal section was a folded "star"-shaped imaging-coil mounted on an expandable frame, with an integrated miniature low-noise-amplifier overcoming cable losses. A handle-activated movable-shaft expanded imaging-coil to 35 mm OD for imaging within cardiac-chambers. Four MR-tracking micro-coils enabled navigation and motion-compensation, assuming a tetrahedron-shape when expanded. A second handle-lever enabled distal-tip deflection. ICMRI with a protruding deflectable EP catheter were used for MR-tracked navigation and RFA using a dedicated [http://www.slicer.org '''3D Slicer'''] user-interface. ICMRI was tested at 3T and 1.5T in swine to evaluate (a) heating, (b) cardiac-chamber access, (c) imaging field-of-view and SNR, and (d) intraprocedural RFA lesion monitoring.

Results: The 3T and 1.5T imaging SNR demonstrated >400% SNR boost over a 4 × 4 × 4 cm3 FOV in the heart, relative to body and spine arrays. ICMRI with MBaluns met ASTM/IEC heating limits during navigation. Tip-deflection allowed navigating ICMRI and EP catheter into atria and ventricles. Acute-lesion long-inversion-time-T1-weighted 3D-imaging (TWILITE) ablation-monitoring using ICMRI required 5:30 min, half the time needed with surface arrays alone.

Conclusion: ICMRI assisted EP-catheter navigation to difficult targets and accelerated RFA monitoring.
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==Three-Dimensional Condylar Displacement and Remodelling Following Correction of Asymmetric Mandibular Prognathism With Maxillary Canting==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/34924271 Int J Oral Maxillofac Surg. 2022 Jun;51(6):813-22. PMID: 34924271]

'''Authors:''' Abotaleb BM, Bi R, Jiang N, Ye B, Bai Y, Al-Watary MQ, Zhu S.

'''Institution:''' Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, China.

'''Abstract:''' The aim of this study was to investigate the three-dimensional condylar displacement and long-term remodelling following the correction of asymmetric mandibular prognathism with maxillary canting. Thirty consecutive patients (60 condyles) with asymmetric mandibular prognathism >4 mm and occlusal canting >3 mm, treated by Le Fort I osteotomy and bilateral sagittal split ramus osteotomy, were included. Spiral computed tomography scans obtained at different periods during long-term follow-up (mean 17 ± 7.2 months) were gathered and processed using ITK-SNAP and 3D Slicer. The condyles were subjected to translational and rotational displacements immediately after the surgery (T2), which had not fully returned to the original preoperative positions at the last follow-up (T3). Condylar remodelling was observed at the last follow-up (T3), with the shorter side condyles subjected to higher surface resorption and overall condylar volume loss. The overall condylar volume on the shorter side was significantly reduced compared to the volume on the elongated side (-11.9 ± 90.6 vs -131.7 ± 138.2 mm3; P = 0.001). About 73%, 87%, 53%, and 54% of the shorter side condyles experienced resorption on the posterior, superior, medial, and lateral surfaces, respectively; in contrast, only 50% of the elongated side condyles showed resorption on the superior surface. Higher preoperative asymmetry was significantly correlated with increased postoperative condylar displacement (P < 0.05). The vertical asymmetry and the vector of condylar displacement were associated with the resultant remodelling process. It is concluded that condylar resorption of the shorter side condyle, which may affect the long-term surgical stability, has to be considered.
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==New Ultra-Fast Algorithm for Cochlear Implant Misalignment Detection==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35390602 Eur J Radiol. 2022 Jun;151:110283. PMID: 35390602]

'''Authors:''' Waldeck S, Helal R, Al-Dhamari I, Schmidt S, von Falck C, Chapot R, Brockmann M, Overhoff D.

'''Institution:''' Department of Diagnostic and Interventional Radiology and Neuroradiology, Bundeswehr Central Hospital Koblenz, Germany.

'''Abstract:''' Purpose: Postoperative imaging following cochlear implant (CI) placement is currently the only means of diagnosing proper electrode position. Manual multiplanar reconstruction (MPR) analysis of CT and CBCT is time-consuming and requires extensive training. This study aims to evaluate the rate of CI misalignment and to determine the amount of time necessary to reach a diagnosis of correct versus incorrect CI placement for readers of different experience levels, using a novel algorithm for image analysis (ACIR) compared to MPR analysis.

Method: The retrospective single centre study included 333 patients with cochlear implant surgery between May 2002 and May 2021. Postoperative CT and CBCT images were evaluated in three subgroups and the time to diagnosis was documented. Group 1: image evaluation using conventional MPR analysis; group 2: image evaluation by an experienced neuroradiologist via a novel ultra-fast algorithm; group 3: image evaluation by a young specialist via novel ultra-fast algorithm. T-test and Pearson's chi-squared test were used for inter-group comparisons.

Results: 333 patients (63.3 ± 15.9 years; 188 men) with 335 CIs were evaluated. The rate of CI misalignment diagnosed from 3D imaging was 14.3% (n = 48). MPR analysis required 255.7 ± 70.4 s per temporal bone, whereas [http://www.slicer.org '''3D Slicer'''] plugin reduced analysis time to 83.3 ± 7.7 s (p < 0.001) for the experienced reader and 89.6 ± 8.7 s for the young specialist (p < 0.001).

Conclusion: 3D postoperative imaging reveals high incidences of CI misalignment. Application of a novel ultra-fast algorithm significantly reduces the time for diagnosis compared to MPR analysis for readers of varying experience levels.
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==COVID-19 CT Scan Lung Segmentation: How We Do It==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35091874 J Digit Imaging. 2022 Jun;35(3):424-31. PMID: 35091874] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8796745/pdf/10278_2022_Article_593.pdf PDF]

'''Authors:''' Negroni D, Zagaria D, Paladini A, Falaschi Z, Arcoraci A, Barini M, Carriero A.

'''Institution:''' Department of Radiology, "Maggiore Della Carità" Hospital, AOU Maggiore Della Carità, Corso Mazzini 18, Novara, Italy.

'''Abstract:''' The National Health Systems have been severely stressed out by the COVID-19 pandemic because 14% of patients require hospitalization and oxygen support, and 5% require admission to an Intensive Care Unit (ICU). Relationship between COVID-19 prognosis and the extent of alterations on chest CT obtained by both visual and software-based quantification that expresses objective evaluations of the percentage of ventilated lung parenchyma compared to the affected one has been proven. While commercial applications for automatic medical image computing and visualization are expensive and limited in their spread, the open-source systems are characterized by not enough standardization and time-consuming troubles. We analyzed chest CT exams on 246 patients suspected of COVID-19 performed in the Emergency Department CT room. The lung parenchyma segmentation was obtained by a threshold-based method using the open-source [http://www.slicer.org '''3D Slicer'''] software and software tools called "Segment Editor" and "Segment Quantification." For the three main characteristics analyzed on lungs affected by COVID-19 pneumonia, a specifical densitometry value range was defined: from - 950 to - 700 HU for well-aerated parenchyma; from - 700 to - 250 HU for interstitial lung disease; from - 250 to 250 HU for parenchymal consolidation. For the well-aerated parenchyma and the interstitial alterations, the procedure was semi-automatic with low time consumption, whereas consolidations' analysis needed manual interventions by the operator. After the chest CT, 13% of the sample was admitted to intensive care, while 34% of them to the sub-intensive care. In patients moved to intensive care, the parenchyma analysis reported a higher crazy paving presentation. The quantitative analysis of the alterations affecting the lung parenchyma of patients with COVID-19 pneumonia can be performed by threshold method segmentation on [http://www.slicer.org '''3D Slicer''']. The segmentation could have an important role in the quantification in different COVID-19 pneumonia presentations, allowing to help the clinician in the correct management of patients.
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==A Novel Method for Observing Tumor Margin in Hepatoblastoma Based on Microstructure 3D Reconstruction==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/32969743 Fetal Pediatr Pathol. 2022 Jun;41(3):371-380. PMID: 32969743]

'''Authors:''' Liu J, Wu X, Xu C, Ma M, Zhao J, Li M, Yu Q, Hao X, Wang G, Wei B, Xia N, Dong Q.

'''Institution:''' Department of Pediatric Surgery, Affiliated Hospital of Qingdao University, Qingdao University, Qingdao, China.

'''Abstract:''' Objective: We investigated three-dimensional (3 D) reconstruction for the assessment of the tumor margin microstructure of hepatoblastoma (HB). Methods: Eleven surgical resections of childhood hepatoblastomas obtained between September 2018 and December 2019 were formalin-fixed, paraffin-embedded, serially sectioned at 4 μm, stained with hematoxylin and eosin (every 19th and 20th section stained with alpha-fetoprotein and glypican 3), and the digital images of all sections were acquired at 100× followed by image registration using the B-spline based method with modified residual complexity. Reconstruction was performed using [http://www.slicer.org '''3D Slicer'''] software. Results: The reconstructed orthogonal 3 D images clearly presented the internal microstructure of the tumor margin. The rendered 3 D image could be rotated at any angle. Conclusions: Microstructure 3 D reconstruction is feasible for observing the pathological structure of the HB tumor margin.
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==The Preoperative Evaluation Value of 3D-Slicer Program Before Microsurgical Vascular Decompression in Patients With Hemifacial Spasm==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35429853 Clin Neurol Neurosurg. 2022 Jun;217:107241. PMID: 35429853]

'''Authors:''' Shi H, Li Y, Wang Y, Guo W, Zhang K, Du Y, Shi H, Qian T.

'''Institution:''' Department of Neurosurgery, Hebei General Hospital, Shijiazhuang, China.

'''Abstract:''' Background: To compare the diagnostic accuracy of 3D fast imaging employing steady-state acquisition (FIESTA) combined with 3D-time-of-flight (TOF) MR angiography (MRA) sequences (FTMS) and 3D-reconstuction synthesized by [http://www.slicer.org '''3D Slicer'''] program in evaluation the neurovascular relationships and offending vessels preoperatively in patients with hemifacial spasm (HFS).

Methods: Clinical data of HFS patients who underwent microsurgical vascular decompression (MVD) were analyzed. All patients underwent MRA scans with FTMS and 3D-reconstruction before surgery. The neurovascular relationship and offending vessels were evaluated and compared with intraoperative findings.

Results: Forty patients were included in this study, 18 (45%) of them were male. The mean age was 49.6 years. The Kappa identity tests identified the agreement between the FTMS and intraoperative findings in evaluating the neurovascular relationship and offending vessel was 0.263 and 0.643, respectively. The agreement between the 3D-reconstruction and intraoperative findings was 0.633 and 0.921 respectively. There was borderline significant difference between the two methods in predicting neurovascular relationship (χ2 = 9.363, P = 0.053), and there were significant differences between the two methods in predicting offending vessels (χ2 = 188.408, P < 0.001). The sensitivity and specificity of FTMS in evaluating the neurovascular relationship were 89.7% and 100%, respectively, while those with 3D-reconstruction were both 100%. Moreover, the correct 3D- reconstruction examinations in predicting vessel and nerve relationships (r = 0.634, P = 0.034) and offending vessels (r = 0.652, P = 0.028) were significantly correlated with completely symptoms remission.

Conclusions: The 3D-reconstuction synthesized by [http://www.slicer.org '''3D Slicer'''] program was more accurate than FTMS in preoperative evaluation of neurovascular relationship and offending vessel. The technique is expected to be helpful in preoperative evaluation.

Availability of data and material: The dataset used and/or analyzed during the current study are available from the corresponding author on reasonable request.
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==Treatment of Pediatric Vaginal Rhabdomyosarcoma With the Use of a Real-Time Tracked Custom Applicator==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35623721 Brachytherapy. May-Jun 2022;21(3):291-9. PMID: 35623721] | [https://www.brachyjournal.com/article/S1538-4721(21)00102-1/fulltext PDF]

'''Authors:''' Morcos M, Vogel J, Garcia JR, Gomez-Lobo V, Bartolac S.

'''Institution:''' Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins Medicine, Baltimore, MD, USA.

'''Abstract:''' Purpose: To describe the development, design, and implementation of a 3D printed MR-compatible pediatric vaginal multichannel brachytherapy cylinder. Safety and quality measures to ensure consistent treatment required innovative identification on MR and CT, and real-time tracking.

Methods and materials: A 4-year-old with vaginal botryoides rhabdomyosarcoma underwent MR-simulation with a custom 3D printed biocompatible resin cylinder with four channels to ensure dose optimization capability. A total of four identifier regions were designed into the applicator in order to utilize these for MR-visualization and real-time tracking. A biocompatible 3D printed cylinder was designed to meet dose objectives using an MR and CT compatible material. [http://www.slicer.org '''3D Slicer'''] was required for real-time tracking during treatment.

Results: Based on MR simulation, a treatment plan was created with dose differentials in the area of prior surgery versus normal vaginal tissue. Creation of a low dose CT scan on a mobile CT allowed CT visualization of the applicator for verification. Treatment was administered under the use of a real-time optical tracking with rotational and depth adjustments monitored.

Conclusions: This advanced integration of 3D printed MR and CT biocompatible material, with unique design features consistent with a multi-channel vaginal cylinder, and incorporation of real-time optical tracking ensured that no positional changes were required, allowed successful treatment with differential dosing for a post-operative pediatric vaginal rhabdomyosarcoma patient.
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==The Prognostic Impact of Preoperative Body Composition in Perihilar and Intrahepatic Cholangiocarcinoma==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35616275 Hepatol Commun. 2022 May 26. PMID: 35616275] | [https://aasldpubs.onlinelibrary.wiley.com/doi/10.1002/hep4.2004 PDF]

'''Authors:''' Lurje I, Czigany Z, Eischet S, Bednarsch J, Ulmer TF, Isfort P, Strnad P, Trautwein C, Tacke F, Neumann UP, Lurje G.

'''Institution:''' Department of Hepatology and Gastroenterology, Campus Charité Mitte, Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin, Berlin, Germany.

'''Abstract:''' Cholangiocarcinoma (CCA) is a rare but highly aggressive malignancy of the biliary system. Although it is amenable to surgical resection in early disease, outcomes are frequently dismal. Here, we investigated the prevalence of body composition (BC) alterations and their prognostic role for surgical patients with intrahepatic (iCCA) and perihilar (pCCA) disease. Patients undergoing curative-intent surgery for iCCA or pCCA between 2010 and 2019 at University Hospital Aachen were included. Axial computed tomography images were retrospectively assessed with a segmentation tool, [http://www.slicer.org '''3D Slicer'''] at the level of the third lumbar vertebra to determine lumbar skeletal muscle (SM) index, mean SM radiation attenuation, and visceral fat area. The related BC pathologies sarcopenia, myosteatosis, visceral obesity, and sarcopenic obesity were determined using previously described cutoffs. A total of 189 patients (86 with iCCA, 103 with pCCA) were included. Alterations of BC were highly prevalent in iCCA and pCCA, respectively: sarcopenia, 33% (28/86) and 39% (40/103); myosteatosis, 66% (57/86) and 66% (68/103); visceral obesity, 56% (48/86) and 67% (69/103); sarcopenic obesity, 11% (9/86) and 17% (17/103). Sarcopenia and myosteatosis did not have a significant prognostic role for disease-free survival (DFS) and overall survival (OS). Patients with iCCA with sarcopenic obesity (n = 9) had significantly shorter OS than patients without sarcopenic obesity (n = 7; log-rank p = 0.002; median OS, 11 months and 31 months; 1-year mortality, 55.6% [5/9] and 22% [17/77]; 5-year mortality, 88.9% [8/9] and 61% [47/77], respectively). In multivariable analysis, only tumor-related risk factors remained prognostic for DFS and OS. Sarcopenic obesity may affect clinical outcomes after curative-intent surgery for iCCA, indicating that imaging-based analysis of BC may hold prognostic value for long-term survival and could aid preoperative patient selection.
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==HEARTBEAT4D: An Open-source Toolbox for Turning 4D Cardiac CT into VR/AR==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35614275 J Digit Imaging. 2022 May 25. PMID: 35614275]

'''Authors:''' Bindschadler M, Buddhe S, Ferguson MR, Jones T, Friedman SD, Otto RK.

'''Institution:''' Department of Pediatrics, Seattle Children's Heart Center and the University of Washington, Seattle, WA, USA.

'''Abstract:''' Four-dimensional data sets are increasingly common in MRI and CT. While clinical visualization often focuses on individual temporal phases capturing the tissue(s) of interest, it may be possible to gain additional insight through exploring animated 3D reconstructions of physiological motion made possible by augmented or virtual reality representations of 4D patient imaging. Cardiac CT acquisitions can provide sufficient spatial resolution and temporal data to support advanced visualization, however, there are no open-source tools readily available to facilitate the transformation from raw medical images to dynamic and interactive augmented or virtual reality representations. To address this gap, we developed a workflow using free and open-source tools to process 4D cardiac CT imaging starting from raw DICOM data and ending with dynamic AR representations viewable on a phone, tablet, or computer. In addition to assembling the workflow using existing platforms ([http://www.slicer.org '''3D Slicer'''] and Unity), we also contribute two new features: 1. custom software which can propagate a segmentation created for one cardiac phase to all others and export to surface files in a fully automated fashion, and 2. a user interface and linked code for the animation and interactive review of the surfaces in augmented reality. Validation of the surface-based areas demonstrated excellent correlation with radiologists' image-based areas (R > 0.99). While our tools were developed specifically for 4D cardiac CT, the open framework will allow it to serve as a blueprint for similar applications applied to 4D imaging of other tissues and using other modalities. We anticipate this and related workflows will be useful both clinically and for educational purposes.
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==Three-Dimensional Evaluation of Maxillary Second Molar Position in Untreated Patients With Normal Occlusion: Implications for Preadjusted Appliance Prescriptions==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/33783560 J Orofac Orthop. 2022 May;83(3):172-180. PMID: 33783560]

'''Authors:''' Goracci C, Ruellas AC, Nieri M, Crouch S, McNamara JA Jr, Franchi L.

'''Institution:''' Department of Medical Biotechnologies, University of Siena, Policlinico Le Scotte, Siena, Italy.

'''Abstract:''' A sample of 41 subjects (16 females, 25 males) was selected from the University of Michigan Growth Study (UMGS). Digital dental casts with fully erupted second molars in occlusion were chosen (mean age 14.9 ± 1.3 years). Digital measurements were recorded with the open source software [http://www.slicer.org '''3D Slicer''']. The digital measurements of the UMGS sample were compared with the manual measurements collected by Andrews from his sample of untreated class I subjects with normal overbite and overjet. Two mixed effect models (sagittal and transversal inclinations) were performed. The "random effect" was represented by the subjects, while the "fixed effects" were the two compared groups, the side of the arch (right and left), and the group × side interaction. Outcome variables were sagittal and transversal inclinations of the upper second molars.
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==Evidence of Linear Bone Flap Resorption in Patients Undergoing Autologous Cranioplasty Following Decompressive Craniectomy: A [http://www.slicer.org '''3D Slicer'''] Segmented Analysis of Serial CT Images==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35597539 World Neurosurg. 2022 May 18:S1878-8750(22)00677-5. PMID: 35597539]

'''Authors:''' Spake CS, Goli R, Beqiri D, Crozier JW, Cielo DJ, Klinge PM, Svokos K, Woo AS.

'''Institution:''' Division of Plastic Surgery, The Warren Alpert Medical School of Brown University, Providence, RI, USA.

'''Abstract:''' Objectives: Autologous cranioplasty (CP) following decompressive craniectomy (DC) carries risk of bone flap resorption (BFR). The current literature offers limited information regarding the natural progression of BFR, and the rate at which it occurs. We aim to characterize the progression of BFR over time and elucidate risk factors for accelerated BFR.

Methods: A retrospective analysis was conducted on patients who underwent DC and autologous CP. Serial computed tomography (CT) images were used to quantify degree of BFR over time. Risk factors included age, diabetes, smoking status, flap fragmentation, defect size, and DC-CP time interval. Chi-square analyses and Student's t-tests were performed to examine differences between patients who experienced BFR and those who did not.

Results: Overall, 82% of patients demonstrated evidence of clinically relevant resorption on CT. On average, the bone flap decreased in volume by 36.7% within the first year, with a linear loss in volume after multiple years of follow-up. Individuals who developed greater BFR were significantly younger (43 ± 17 vs. 56 ± 12, p=0.022), had a lower incidence of diabetes (5.9% vs. 43%, p=0.037), and had more bone flap fragments (1.4 ± 0.67 vs. 1.00 ± 0, p <0.001) than those who did not.

Conclusion: Resorption following CP with cryopreserved bone appears to progress in a fairly linear and continuous fashion over time. Using serial CT images, we found a resorption rate of 82% at our institution. We identified several possible risk factors for resorption, including flap fragmentation, younger age, and absence of diabetes.
|}

==Custom Massive Allograft in a Case of Pelvic Bone Tumour: Simulation of Processing with Computerised Numerical Control vs. Robotic Machining==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35628908 J Clin Med. 2022 May 15;11(10):2781. PMID: 35628908] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9143408/pdf/jcm-11-02781.pdf PDF]

'''Authors:''' Vivarelli L, Govoni M, Attala D, Zoccali C, Biagini R, Dallari D.

'''Institution:''' Reconstructive Orthopaedic Surgery and Innovative Techniques-Musculoskeletal Tissue Bank, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.

'''Abstract:''' The use of massive bone allografts after the resection of bone tumours is still a challenging process. However, to overcome some issues related to the processing procedures and guarantee the best three-dimensional matching between donor and recipient, some tissue banks have developed a virtual tissue database based on the scanning of the available allografts for using their 3D shape during virtual surgical planning (VSP) procedures. To promote the use of future VSP bone-shaping protocols useful for machining applications within a cleanroom environment, in our work, we simulate a massive bone allograft machining with two different machines: a four-axes (computer numerical control, CNC) vs. a five-axes (robot) milling machine. The allograft design was based on a real case of allograft reconstruction after pelvic tumour resection and obtained with [http://www.slicer.org '''3D Slicer'''] and Rhinoceros software. Machining simulations were performed with RhinoCAM and graphically and mathematically analysed with CloudCompare and R, respectively. In this case, the geometrical differences of the allograft design are not clinically relevant; however, the mathematical analysis showed that the robot performed better than the four-axes machine. The proof-of-concept presented here paves the way towards massive bone allograft cleanroom machining. Nevertheless, further studies, such as the simulation of different types of allografts and real machining on massive bone allografts, are needed.
|}

==Combination of Preoperative Multimodal Image Fusion and Intraoperative Dyna CT in Percutaneous Balloon Compression of Trigeminal Ganglion for Primary Trigeminal Neuralgia: Experience in 24 Patients==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35615652 Front Surg. 2022 May 9;9:895394. PMID: 35615652] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9124886/pdf/fsurg-09-895394.pdf PDF]

'''Authors:''' Liao CC, Li JY, Wu KH, Jian ZH, Yi XF, Weng ZJ, Chen G.

'''Institution:''' Department of Neurosurgery, Zhuhai People's Hospital (Zhuhai Hospital Affifiliated With Jinan University, China), Zhuhai, China.

'''Abstract:''' Objective: We retrospectively assessed the surgical results of PBC with preoperative multimodal image fusion and intraoperative Dyna Computed Tomography (CT) in 24 patients with primary trigeminal neuralgia (PTN) to explore a valuable aid for Percutaneous balloon compression (PBC).

Methods: We studied the data of 24 patients with PTN. All patients underwent PBC and were assessed with preoperative multimodal image fusion [computed tomography (CT) and magnetic resonance imaging (MRI)] and intraoperative Dyna CT in the Department of Neurosurgery of Zhuhai People's Hospital between October 2020 and September 2021. Multimodal image fusion-three-dimensional (3D) reconstruction of CT and MRI data-was performed using [http://www.slicer.org '''3D Slicer'''] software, and preoperative evaluation was performed according to the results of image fusion. Dyna CT was used to dynamically observe the position and shape of the metallic hollow introducer and Fogarty catheter and balloon during the operation to guide the operation in real time. We performed follow-up assessments each month and summarized the clinical characteristics, surgical effects, and complications in all patients.

Results: Surgery was successful for all patients; the patients reported immediate pain relief. Surgical complications included facial numbness in 24 patients (100%), mild masseter weakness in three (12.5%), herpes zoster in three (12.5%), and balloon rupture in one (4.2%). None of the patients had serious surgical complications. The mean follow-up time was 9.6 ± 2.7 months. During the follow-up period, 22 patients (91.7%) experienced no recurrence of pain, and two patients (8.3%) experienced recurrence of pain, of which one underwent secondary PBC surgery.

Conclusions: Preoperative multimodal image reconstruction can help fully evaluate PBC surgery, clarify the etiology, and predict the volume of contrast medium required during the operation. It provided important assistance for PBC treatment of trigeminal neuralgia patients when preoperative multimodal image fusion is combined with intraoperative Dyna CT.
|}

==TITAN: An End-to-End Data Analysis Environment for the Hyperion™ Imaging System==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35060322 Cytometry A. 2022 May;101(5):423-33. PMID: 35060322]

'''Authors:''' Thirumal S, Jamzad A, Cotechini T, Hindmarch CT, Graham CH, Siemens DR, Mousavi P.

'''Institution:''' School of Computing, Queen's University, Kingston, Canada.

'''Abstract:''' Imaging Mass Cytometry (IMC) is a powerful high-throughput technique enabling resolution of up to 37 markers in a single fixed tissue section while also preserving in situ spatial relationships. Currently, IMC processing and analysis necessitates the use of multiple different software, labour-intensive pipeline development, different operating systems and knowledge of bioinformatics, all of which are a barrier to many potential users. Here we present TITAN - an open-source, single environment, end-to-end pipeline that can be utilized for image visualization, segmentation, analysis and export of IMC data. TITAN is implemented as an extension within the publicly available [http://www.slicer.org '''3D Slicer'''] software. We demonstrate the utility, application, reliability and comparability of TITAN using publicly available IMC data from recently-published breast cancer and COVID-19 lung injury studies. Compared with current IMC analysis methods, TITAN provides a user-friendly, efficient single environment to accurately visualize, segment, and analyze IMC data for all users.
|}

==Kidney Hypertrophy in Living Kidney Donors and Their Corresponding Recipients==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35248353 Transplant Proc. 2022 Apr;54(3):627-31. PMID: 35248353]

'''Authors:''' Steden K, Figiel J, Hoyer J, Kamalanabhaiah SR.

'''Institution:''' Department of Nephrology, University Hospital of Marburg, UKGM GmbH, Marburg, Germany.

'''Abstract:''' Background: In this long-term study we compared kidney volume changes and function between living kidney donors and their corresponding recipients via magnetic resonance imaging after 3 to 8 years post transplantation.

Methods: For measurement of the kidney volume in magnetic resonance imaging images we used [http://www.slicer.org '''3D Slicer''']. Statistical analysis was performed via t test and correlation.

Results: A profound volume increase was observed in both transplanted and orthotopic kidney. The volume increase of the orthotopic kidneys was with 58 cm³ ± 23.8 cm³ SD (41%) greater than in the corresponding transplanted kidneys with 43 cm³ ± 36.9 cm³ SD (30%).

Conclusions: This study detected a persistent volume increase in both orthotopic and transplanted kidneys after donation. Neither significant increases of hypertension or proteinuria were observable or could be correlated to renal hypertrophy.
|}

==Hematoma Segmentation of Spontaneous Intracerebral Hemorrhage Based on Watershed and Region-Growing Algorithm==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35642163 Sichuan Da Xue Xue Bao Yi Xue Ban. 2022 May;53(3):511-6. PMID: 35642163]

'''Authors:''' Zhao JY, Zhou ZS, Wang XY, Zhang HY, Duan ZH, Wang SM, Wan HL, Zhang T.

'''Institution:''' Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China.

'''Abstract:''' Objective: To establish a brain hematoma CT image segmentation method based on watershed and region-growing algorithm so as to measure hematoma volume quickly and accurately, to explore the consistency between the results of this segmentation method and those of manual segmentation, the clinical gold standard, and to compare the results of this method with the calculation of the two Tada formulas commonly used in clinical practice.

Methods: The preoperative CT images of 152 patients who were treated for spontaneous cerebral hemorrhage at the Department of Neurosurgery, West China Hospital, Sichuan University between January 2018 and June 2019 were retrospectively collected. The CT images were randomly assigned, by using a random number table, to the training set, the test set and the validation set, which contained 100 patients, 22 patients and 30 patients, respectively. The labeling results of the training set and the test set were used in algorithm training and testing. Four methods, namely, manual segmentation, algorithm segmentation, i.e., segmentation calculation based on watershed and regional growth algorithm, Tada formula, i.e., the traditional Tada formula calculation, and accurate Tada formula, i.e., accurate Tada formula calculation based on [http://www.slicer.org '''3D Slicer'''], were applied on the validation set to measure the hematoma volume. The Digital Imaging and Communications in Medicine (DICOM) data of subjects meeting the selection criteria of the study were manually segmented by two experienced neurosurgeons. The hematoma segmentation model was built based on watershed algorithm and regional growth algorithm. Seed point selected by neurosurgeons was taken as the starting point of growth. Regional grayscale difference criterion combined with manual segmentation validation were adopted to determine the regional growth threshold that met the segmentation precision requirements for intracranial hematoma. Using manual segmentation as the gold standard, Bland-Altman consistency analysis was used to verify the consistency of the three other methods for measuring hematoma volume.

Results: With manual segmentation as the gold standard, among the three methods of measuring hematoma volume, algorithm segmentation had the smallest percentage error, the narrowest range of difference, the highest intra-group correlation coefficient (0.987), good consistency, and the narrowest 95% limits of agreement ( LoA). The percentage error of its segmentation was not statistically significant for hematomas of different volumes.

Conclusion: The segmentation method of spontaneous intracerebral hemorrhage based on watershed and regional growth algorithm shows stable measurement performance and good consistency with the clinical gold standard, which has considerable clinical significance, but it still needs further validation with more clinical samples.
|}

==Virtual Planning and Rapid 3D Prototyping Surgical Guide for Anterior Crown Lengthening Surgery: A Clinical Case Report==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/34932246 J Prosthodont. 2022 Apr;31(4):275-81. PMID: 34932246]

'''Authors:''' Kim J, Lin YC, Danielak M, Van M, Lee DH, Kim H, Arany PR.

'''Institution:''' Department of Oral Biology, School of Dental Medicine, University at Buffalo, NY, USA.

'''Abstract:''' Progress with additive 3D printing is revolutionizing biomaterial manufacturing, including clinical dentistry and prosthodontics. Among the several 3D additive printing technologies, stereolithography is very popular as it utilizes light-activated resin for precise resolution. A simplified digital technique was used to fabricate two designs of a surgical guide for crown lengthening. Two cases are presented that utilized digital DICOM files obtained with computed tomography (CT) imaging and processed using four CAD software (Blue Sky Plan, Exocad, Meshmixer and [http://www.slicer.org '''3D Slicer''']). The final models were converted to standard tesselation (STL) files and the guides were 3D printed with an additive sterelithography (SLA) printer. The first case was fabricated with a bone model from CBCT data, and the second case was generated with intraoral and wax-up scans alone. Both methods appear to be equally effective compared to using a conventional method of guide fabrication. However, proximal bone reduction was a concern with both designs. Digitally fabricated 3D printed surgical guide for crown lengthening has merit and a practical design is needed for future clinical validation. This article is protected by copyright. All rights reserved.
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==A New Simple, Cost-Effective Navigation System (EASY Navigator) for Neurosurgical Interventions==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35490891 World Neurosurg. 2022 Apr 29;164:143-7. PMID: 35490891]

'''Authors:''' Faraj MK, Kailan SL, Al-Neami AQH.

'''Institution:''' Department of Surgery, Consultant Neurosurgeon, College of Medicine, University of Baghdad, Baghdad, Iraq.

'''Abstract:''' Navigation technique facilitates reaching deeply seated masses more precisely with the least sacrifice of normal tissues. There are 2 primary navigation systems: electromagnetic and infrared (optical). The technique is based on recording the head position intraoperatively and merging this image with preoperative magnetic resonance imaging.

Methods: We tried to replace these conventional navigating systems with a simple technique using free software, [http://www.slicer.org '''3D Slicer'''] and a computer air mouse. The study was designed into 3 stages. In stage 1, we used this method on 3-dimensional printed models of patients' magnetic resonance images with deeply seated brain tumors. In stage 2, we performed the surgeries on patients. In the last stage, we used both the conventional navigation system with our method simultaneously on the same patients and compared the accuracy of both methods.

Results: This new system was as accurate as conventional navigating systems, ranging from ±2 mm.

Conclusions: This new technique, if done properly, can replace conventional methods with less time of preparation, and its cost is almost free.
|}

==3D Visualization of Perianal Fistulas Using Parametric Models==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35094202 Tech Coloproctol. 2022 Apr;26(4):291-300. PMID: 35094202]

'''Authors:''' Navkar NV, Balakrishnan S, Kharbech S, Sabawi M, Abinahed J, Ahmed A, Al-Ansari A, Omar A, Khanna M, Darweesh A.

'''Institution:''' Department of Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.

'''Abstract:''' Background: Magnetic resonance imaging (MRI) is used as a standard for assessment of complex perianal fistulas. Apart from textual description of the case, 3D reconstructed models from MRI further aid in understanding the entire anatomy of the fistula tract and its relation to the pelvic floor. This information is crucial as it helps surgeons to understand the extent and complexity of the disease before surgical treatment. However, 3D model generation from MRI is a time-consuming step for a radiologist as it requires tedious manual delineations to be performed on every slice of the images. The aim of this study was to develop a method that could enable radiologists to present enhanced information to surgeons for treatment of complex perianal fistulas while simultaneously reducing the manual efforts and time required to generate the information.

Methods: A method was proposed to depict relevant anatomies of complex perianal fistula as parametric models in three-dimensional (3D) space. A plugin inside [http://www.slicer.org '''3D Slicer'''] software was developed for the generation of the parametric models from MRI. The levator ani muscle, internal sphincter, and external sphincter are represented as tubular structures, whereas fistula tracks and abscess are presented as splines.

Results: Parametric models were generated to depict three cases of complex perianal fistulas and similarity measures were computed for ten cases. Visual comparison of the parametric models was made with the 3D models generated by the standard approach. The parametric models took less time to create and were able to visually present enriched information as compared to the 3D models generated by the standard approach.

Conclusions: The proposed method, using parametric models, shows potential for faster generation and better visualization of the 3D information required for the treatment of complex perianal fistula cases.
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==Optimized Tractography Mapping and Quantitative Evaluation of Pyramidal Tracts for Surgical Resection of Insular Gliomas: a Correlative Study with Diffusion Tensor Imaging-Derived Metrics and Patient Motor Strength==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35064370 J Digit Imaging. 2022 Apr;35(2):356-64. PMID: 35064370]

'''Authors:''' Li Y, Hou Y, Li Q, Tang J, Lu J.

'''Institution:''' Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.

'''Abstract:''' We investigate the correlation between diffusion tensor imaging (DTI)-derived metric statistics and motor strength grade of insular glioma patients after optimizing the pyramidal tract (PT) delineation. Motor strength grades of 45 insular glioma patients were assessed. All the patients underwent structural and diffusion MRI examination before and after surgery. We co-registered pre- and post-op datasets, and a two-tensor unscented Kalman filter (UKF) algorithm was employed to delineate bilateral PTs after DWI pre-processing. The tractography results were voxelized, and their labelmaps were cropped according to the location of frontal and insular parts of the lesion. Both the whole and cropped labelmaps were used as regions of interest to analyze fractional anisotropy (FA) and Trace statistics; hence, their ratios were calculated (lesional side tract/contralateral normal tract). The combination of DWI pre-processing and two-tensor UKF algorithm successfully delineated bilateral PTs of all the patients. It effectively accomplished both full fiber delineation within the edema and an extensive lateral fanning that had a favorable correspondence to the bilateral motor cortices. Before surgery, correlations were found between patients' motor strength grades and ratios of PT volume and FA standard deviation (SD). Nearly 3 months after surgery, correlations were found between motor strength grades and the ratios of metric statistics as follows: whole PT volume, whole mean FA, and FA SD. We substantiated the correlation between DTI-derived metric statistics and motor strength grades of insular glioma patients. Moreover, we posed a workflow for comprehensive pre- and post-op DTI quantitative research of glioma patients.

Keywords: [http://www.slicer.org '''3D Slicer''']; Diffusion tensor imaging; Insular glioma; Pyramidal tracts.
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==The Significance of Nanoparticles in Brain Cancer Diagnosis and Treatment: Modeling and Simulation==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35405668 Biomed Phys Eng Express. 2022 Apr 22;8(3). PMID: 35405668]

'''Authors:''' Badawi MI, Hafez KS.

'''Institution:''' Biomedical Equipment Technology Department, Faculty of Applied Health Sciences Technology, Pharos University, Alexandria, Egypt.

'''Abstract:''' A numerical analysis of specific absorption rate (SAR) and temperature distributions in a realistic human head model is presented in this study. The key challenge is to rise cancer temperature to an optimal temperature without heating nearby healthy tissues. The model's uniqueness is that it captures the effect of nanoparticles on both brain cancer diagnosis and treatment. A realistic human head model with a cancerous brain segmented from 2D magnetic resonance imaging (MRI) gained from an actual patient using [http://www.slicer.org '''3D Slicer'''], modeled, and simulated using CST-Microwave Studio, and illuminated by Archimedes spiral antenna. At frequencies of 2450 MHz and 915 MHz, the model simulated the absence and presence of various nanoparticles. The obtained results suggest that when using nanoparticles, it is possible to achieve sufficient energy deposition and temperature rise to therapeutic values (greater than 42 °C) in brain cancers using the proposed noninvasive hyperthermia system at 915 MHz frequency, especially for gold nanoparticles, without harming surrounding healthy tissue. Our research might pave the way for a clinical applicator prototype that can heat brain cancer.
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==Surgically Assisted Maxillary Expansion With or Without Pterygoid Disjunction Alters Maxillomandibular Positioning==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35426586 Oral Maxillofac Surg. 2022 Apr 15. PMID: 35426586]

'''Authors:''' Carvalho FSR, Soares ECS, de Medeiros JR, Júnior JMM, Hyppolito JOP, de Barros Silva PG, Ribeiro TR, Costa FWG.

'''Institution:''' Department of Oral and Maxillofacial Surgery, Federal University of Ceará Campus Sobral, Sobral, Ceará, Brazil.

'''Abstract:''' Purpose: This study aimed to analyze alterations in mandibular positioning after surgically assisted maxillary expansion (SARME) with and without pterygoid disjunction (PD).

Methods: Cone-beam computed tomography scans of 24 healthy individuals (18-45 years old) with transverse deficiency, superior to 5 mm, underwent SARME with or without PD. The aspects prospectively assessed were (1) alignment and position of the head (ITK-Snap and [http://www.slicer.org '''3D Slicer'''] software); (2) McNamara's and Steiner-Tweed-Wits' cephalometric analysis (Dolphin Imaging®); and (3) colorimetric evaluation based on 3D correspondence analysis ([http://www.slicer.org '''3D Slicer'''] software).

Results: A decrease in 1-NA and 1-SN angles as well as an increased occlusal plane in both groups was observed. Superior-inferior and anteroposterior spatial displacements of the chin were statistically significant in the PD group. Altered colorimetric patterns were also observed in the PD group.

Conclusions: This study found more evident tooth inclination in the group without PD; mandibular alterations were more evident in the PD group. Further studies with 3D analysis are strongly recommended for more comprehensive results.
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==Reproducibility for Hepatocellular Carcinoma CT Radiomic Features: Influence of Delineation Variability Based on 3D-CT, 4D-CT and Multiple-Parameter MR Images==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35494061 Front Oncol. 2022 Apr 14;12:881931. PMID: 35494061] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9047864/pdf/fonc-12-881931.pdf PDF]

'''Authors:''' Duan J, Qiu Q, Zhu J, Shang D, Dou X, Sun T, Yin Y, Meng X.

'''Institution:''' School of Precision Instrument and Opto-electronics Engineering, Tianjin University, Tianjin, China.

'''Abstract:''' Purpose: Accurate lesion segmentation is a prerequisite for radiomic feature extraction. It helps to reduce the features variability so as to improve the reporting quality of radiomics study. In this research, we aimed to conduct a radiomic feature reproducibility test of inter-/intra-observer delineation variability in hepatocellular carcinoma using 3D-CT images, 4D-CT images and multiple-parameter MR images.

Materials and methods: For this retrospective study, 19 HCC patients undergoing 3D-CT, 4D-CT and multiple-parameter MR scans were included in this study. The gross tumor volume (GTV) was independently delineated twice by two observers based on contrast-enhanced computed tomography (CECT), maximum intensity projection (MIP), LAVA-Flex, T2W FRFSE and DWI-EPI images. We also delineated the peritumoral region, which was defined as 0 to 5 mm radius surrounding the GTV. 107 radiomic features were automatically extracted from CECT images using [http://www.slicer.org '''3D Slicer'''] software. Quartile coefficient of dispersion (QCD) and intraclass correlation coefficient (ICC) were applied to assess the variability of each radiomic feature. QCD<10% and ICC≥0.75 were considered small variations and excellent reliability. Finally, the principal component analysis (PCA) was used to test the feasibility of dimensionality reduction.

Results: For tumor tissues, the numbers of radiomic features with QCD<10% indicated no obvious inter-/intra-observer differences or discrepancies in 3D-CT, 4D-CT and multiple-parameter MR delineation. However, the number of radiomic features (mean 89) with ICC≥0.75 was the highest in the multiple-parameter MR group, followed by the 3DCT group (mean 77) and the MIP group (mean 73). The peritumor tissues also showed similar results. A total of 15 and 7 radiomic features presented excellent reproducibility and small variation in tumor and peritumoral tissues, respectively. Two robust features showed excellent reproducibility and small variation in tumor and peritumoral tissues. In addition, the values of the two features both represented statistically significant differences among tumor and peritumoral tissues (P<0.05). The PCA results indicated that the first seven principal components could preserve at least 90% of the variance of the original set of features.

Conclusion: Delineation on multiple-parameter MR images could help to improve the reproducibility of the HCC CT radiomic features and weaken the inter-/intra-observer influence.
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==Pseudoprogression Prediction in High Grade Primary CNS Tumors by Use of Radiomics==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35396525 Sci Rep. 2022 Apr 8;12(1):5915. PMID: 35396525] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8993885/pdf/41598_2022_Article_9945.pdf PDF]

'''Authors:''' Ari AP, Akkurt BH, Musigmann M, Mammadov O, Blömer DA, Kasap DNG, Henssen DJHA, Nacul NG, Sartoretti E, Sartoretti T, Backhaus P, Thomas C, Stummer W, Heindel W, Mannil M.

'''Institution:''' University Clinic for Radiology, Westfälische Wilhelms-University Muenster and University Hospital Muenster, Albert-Schweitzer-Campus 1, Muenster, Germany.

'''Abstract:''' Our aim is to define the capabilities of radiomics and machine learning in predicting pseudoprogression development from pre-treatment MR images in a patient cohort diagnosed with high grade gliomas. In this retrospective analysis, we analysed 131 patients with high grade gliomas. Segmentation of the contrast enhancing parts of the tumor before administration of radio-chemotherapy was semi-automatically performed using the [http://www.slicer.org '''3D Slicer'''] open-source software platform (version 4.10) on T1 post contrast MR images. Imaging data was split into training data, test data and an independent validation sample at random. We extracted a total of 107 radiomic features by hand-delineated regions of interest (ROI). Feature selection and model construction were performed using Generalized Boosted Regression Models (GBM). 131 patients were included, of which 64 patients had a histopathologically proven progressive disease and 67 were diagnosed with mixed or pure pseudoprogression after initial treatment. Our Radiomics approach is able to predict the occurrence of pseudoprogression with an AUC, mean sensitivity, mean specificity and mean accuracy of 91.49% [86.27%, 95.89%], 79.92% [73.08%, 87.55%], 88.61% [85.19%, 94.44%] and 84.35% [80.19%, 90.57%] in the full development group, 78.51% [75.27%, 82.46%], 66.26% [57.95%, 73.02%], 78.31% [70.48%, 84.19%] and 72.40% [68.06%, 76.85%] in the testing group and finally 72.87% [70.18%, 76.28%], 71.75% [62.29%, 75.00%], 80.00% [69.23%, 84.62%] and 76.04% [69.90%, 80.00%] in the independent validation sample, respectively. Our results indicate that radiomics is a promising tool to predict pseudo-progression, thus potentially allowing to reduce the use of biopsies and invasive histopathology.
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==Radiomics Analysis Based on Lumbar Spine CT to Detect Osteoporosis==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35499565 Eur Radiol. 2022 Apr 30:1-8. PMID: 35499565] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9059457/pdf/330_2022_Article_8805.pdf PDF]

'''Authors:''' Jiang YW, Xu XJ, Wang R, Chen CM.

'''Institution:''' Department of Neurosurgery, Fujian Medical University Union Hospital, No. 29, Xin Quan Road, Fuzhou City, Fujian Province, China.

'''Abstract:''' Objectives: Undiagnosed osteoporosis may lead to severe complications after spinal surgery. This study aimed to construct and validate a radiomic signature based on CT scans to screen for lumbar spine osteoporosis.

Methods: Using a stratified random sample method, 386 vertebral bodies were randomly divided into a training set (n = 270) and a test set (n = 116). A total of 1040 radiomics features were automatically retracted from lumbar spine CT scans using the [http://www.slicer.org '''3D Slicer'''] pyradiomics module, and a radiomic signature was created. The sensitivity, specificity, accuracy, and area under the receiver operating characteristic curve (AUC) of the Hounsfield and radiomics signature models were calculated. The AUCs of the two models were compared using the DeLong test. Their clinical usefulness was assessed using a decision curve analysis.

Results: Twelve features were chosen to establish the radiomic signature. The AUCs of the radiomics signature and Hounsfield models were 0.96 and 0.88 in the training set and 0.92 and 0.84 in the test set, respectively. According to the DeLong test, the AUCs of the two models were significantly different (p < 0.05). The radiomics signature model indicated a higher overall net benefit than the Hounsfield model, as determined by decision curve analysis.

Conclusions: The CT-based radiomic signature can differentiate patients with/without osteoporosis prior to lumbar spinal surgery. Without additional medical cost and radiation exposure, the radiomics method may provide valuable information facilitating surgical decision-making.

Key points: • The goal of the study was to evaluate the efficacy of a radiomics signature model based on routine preoperative lumbar spine CT scans in screening osteoporosis. • The radiomics signature model demonstrated excellent prediction performance in both the training and test sets. • This radiomics method may provide valuable information and facilitate surgical decision-making without additional medical costs and radiation exposure.
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==Characterization of Volumetric Growth of Intracranial Meningiomas in Māori and Pasifika Populations in New Zealand==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35239240 ANZ J Surg. 2022 Apr;92(4):848-55. PMID: 35239240]

'''Authors:''' Davis B, Beldishevski-Shotadze O, Ibrahim Z, McHugh F, Turner C, Olson S, Faull R, Dragunow M, Law AJJ, Correia JA.

'''Institution:''' Department of Neurosurgery, Auckland City Hospital, Grafton, Auckland, New Zealand.

'''Abstract:''' Background: Māori and Pasifika populations in New Zealand have a higher incidence and prevalence of intracranial meningioma (IM). We sought to evaluate the volumetric growth rate of meningiomas under surveillance in these populations.

Methods: From July 2002 to October 2020, 336 patients with a total of 408 IM underwent conservative management with serial radiological surveillance at Auckland City Hospital and met the criteria for the study. Inclusion criteria included: age >16 at diagnosis, ≥2 appropriate scans one or more years apart. Exclusion criteria included previous cranial irradiation, a diagnosis of Neurofibromatosis and prior treatment of meningioma. Demographic and clinical data were obtained from the electronic medical records. Imaging data were recorded from the first and last scans. We utilized open-source image processing software, [http://www.slicer.org '''3D Slicer'''] for semi-automated segmentation and volume calculation. Consistent with previous literature, we calculated the relative growth rate (RGR, %/year) and annual volume change (AVC, cm3 /year) over time.

Results: Four hundred and eight meningiomas were volumetrically characterized for a mean duration of 6.2 years. The Māori and Pasifika populations (n = 134/393) demonstrated a higher RGR (31.41 versus 14.33%/year) (P = 0.026) and AVC (2.05 versus 0.95 cm3 ) (P = 0.025) compared to the control population. They also presented at a younger age and had a higher rate of tumour multiplicity. Males represented only 17.6% of the cohort but exhibited a higher growth rate (AVC = 2.52 cm3 /year) than females (AVC = 0.99 cm3 /year) (P = 0034).

Conclusions: Māori and Pasifika populations in New Zealand have a higher incidence and volumetric growth rate of IM compared to a control population. This warrants further clinical, histopathological and genomic analysis.
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==Poly(L-Co-D,L Lactic Acid-Co-Trimethylene Carbonate) 3D Printed Scaffold Cultivated With Mesenchymal Stem Cells Directed to Bone Reconstruction: In Vitro and in Vivo Studies==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35130780 J Biomater Appl. 2022 Apr;36(9):1550-66. PMID: 35130780]

'''Authors:''' Asami J, Hausen MA, Komatsu D, Ferreira LM, Silva GBG, da Silva LCSC, Baldo DA, Oliveira Junior JM, Motta AC, Duek EAR.

'''Institution:''' Federal University of Sao Carlos (UFSCar), Sorocaba, SP, Brazil.

'''Abstract:''' A recent and quite promising technique for bone tissue engineering is the 3D printing, peculiarly regarding the production of high-quality scaffolds. The 3D printed scaffold strictly provides suitable characteristics for living cells, in order to induce treatment, reconstruction and substitution of injured tissue. The purpose of this work was to evaluate the behavior of the 3D scaffold based on Poly(L-co-D,L lactic acid-co-Trimethylene Carbonate) (PLDLA-TMC), which was designed in Solidworks™ software, projected in [http://www.slicer.org '''3D Slicer''']™, 3D printed in filament extrusion, cultured with mesenchymal stem cells (MSCs) and tested in vitro and in vivo models. For in vitro study, the MSCs were seeded in a PLDLA-TMC 3D scaffold with 600 μm pore size and submitted to proliferation and osteogenic differentiation. The in vivo assays implanted the PLDLA-TMC scaffolds with or without MSCs in the calvaria of Wistar rats submitted to 8 mm cranial bone defect, in periods of 8-12 weeks. The results showed that PLDLA-TMC 3D scaffolds favored adherence and cell growth, and suggests an osteoinductive activity, which means that the material itself augmented cellular differentiation. The implanted PLDLA-TMC containing MSCs, showed better results after 12 weeks prior grafting, due the absence of inflammatory processes, enlarged regeneration of bone tissue and facilitated angiogenesis. Notwithstanding, the 3D PLDLA-TMC itself implanted enriched tissue repair; the addition of cells known to upregulate tissue healing reinforce the perspectives for the PLDLA-TMC applications in the field of bone tissue engineering in clinical trials.
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==Comparing Three-Dimensional Models of Placenta Accreta Spectrum With Surgical Findings==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/33998689 Int J Gynaecol Obstet. 2022 Apr;157(1):188-97. PMID: 33998689]

'''Authors:''' Mulligan KM, Bartels HC, Armstrong F, Immel E, Corcoran S, Walsh JM, McAuliffe F, McParland P, Carroll S, Higgins S, Mahony R, Donnelly J, Geoghegan T, Colleran G, O'Cearbhaill E, Downey P, Brennan DJ.

'''Institution:''' UCD School of Medicine, National Maternity Hospital, Dublin, Ireland.

'''Abstract:''' Objective: Placenta accreta spectrum (PAS) is associated with significant maternal morbidity mainly related to blood loss. Pre-operative planning is aided by antenatal ultrasound and magnetic resonance imaging. We sought to assess whether three-dimensional (3D) models from MR images were accurate when compared with surgical and pathological findings.

Methods: Digital Imaging and Communications in Medicine files containing MR images with varying severity of PAS (n = 4) were modeled using [http://www.slicer.org '''3D Slicer''']. Placenta, bladder, and myometrial defects were modeled. Myometrial defects at three different uterine locations were included-anterior, lateral and inferior. 3D models were used to identify the relationship between the myometrial defect and the internal cervical os. Findings were validated in a larger series of PAS cases (n = 14) where patterns of invasion were compared with estimated blood loss and distance from defect to the internal os.

Results: The defect illustrated in the four 3D models correlates to both surgical and pathological findings in terms of depth and pattern of invasion, location of defect, bladder involvement. Blood loss and topography of the defect from 3D modeling were examined in 14 further cases. Inferior defects were associated with increased blood loss compared with anterior defects. Increased distance from cervix was associated with reduced blood loss (R2 = 0.352, P = 0.01).

Conclusion: Three-dimensional models of PAS provide an accurate preoperative description of placental invasion and should be investigated as a tool for selecting patients for uterine-conserving surgery. Accurate 3D models of placenta accreta spectrum are achievable and may provide additional information, such as distance of the defect from the internal os.
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==Giant Pediatric Supratentorial Tumor: Clinical Feature and Surgical Strategy==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35558365 Front Pediatr. 2022 Apr 26;10:870951. PMID: 35558365] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9086618/pdf/fped-10-870951.pdf PDF]

'''Authors:''' Zhang ZD, Fang HY, Pang C, Yang Y, Li SZ, Zhou LL, Bai GH, Sheng HS.

'''Institution:''' Department of Neurosurgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.

'''Abstract:''' To analyze the clinical character of giant pediatric supratentorial tumor (GPST) and explore prognostic factors.

Materials and methods: We analyzed the clinical data comprising of 35 cases of GPST from a single center between January 2015 and December 2020. The tumor volume was measured by [http://www.slicer.org '''3D Slicer'''] software based on preoperative magnetic resonance imaging (MRI). Glasgow Outcome Scale (GOS) was used to evaluate the short-term prognosis.

Result: The tumor volume varied from 27.3 to 632.8 ml (mean volume 129.8 ml/ median volume 82.8 ml). Postoperative histopathological types include ependymoma, pilocytic astrocytoma, choroid plexus papilloma (CPP), craniopharyngioma, primitive neuroectodermal tumor (PNET), choroid plexus carcinoma (CPC), immature teratoma, atypical teratoid rhabdoid tumor (AT/RT), anaplastic astrocytoma, and gangliocytoma. Tumors in children younger than 3 years and tumors located at the hemispheres appeared to be larger than their respective counterparts, though no statistical significance was found. A patient with giant immature teratoma died during the operation because of excessive bleeding. Postoperative complications include cerebrospinal fluid subgaleal collection/effusion, infection, neurological deficits, and seizures. The mean GOS score of patients with GPST in 6 months is 3.43 ± 1.12, and 83% of patients (29/35) showed improvement. Favorable GPST characteristics to indicated better GOS included small tumor (≤100 ml) (p = 0.029), low-grade (WHO I-II) (p = 0.001), and gross total resection (GTR) (p = 0.015). WHO grade was highly correlated with GOS score (correlation coefficient = -0.625, p < 0.001). GTR and tumor volume were also correlated (correlation coefficient = -0.428, p = 0.010).

Conclusion: The prognosis of GPST is highly correlated with the histopathological type. Smaller tumors are more likely to achieve GTR and might lead to a higher GOS score. Early diagnosis and GTR of the tumor are important for GPST management.
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==Volumetric Assessment of Changes in the Alveolar Ridge Dimension Following GBR Using a Combination FDBA With Collagen Membrane or Novel Resorbable Scaffold: A Prospective Two-Center Clinical Trial==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/34245016 J Periodontol. 2022 Mar;93(3):343-53. PMID: 34245016]

'''Authors:''' Dowlatshahi S, Chen CY, Zigdon-Giladi H, Horwitz J, Ahn C, Kim DM, Machtei EE.

'''Institution:''' Division of Periodontology, Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA, USA.

'''Abstract:''' Background: The aim of this study was to examine osseous changes following lateral bone augmentation using a novel Ossix Volumax (OV) scaffold alone and compare it to combination therapy using freeze-dried bone allograft (FDBA) and resorbable collagen membrane (FDBA/CM).

Methods: Thirty patients completed this 9-months prospective two-center cohort clinical trial. Before surgery and 9-months re-entry, linear measurements were performed, and impressions taken. Cone-beam computed tomography (CBCT) were done at baseline and 9 months. DICOM slice data were converted into volumetric images using [http://www.slicer.org '''3D Slicer''']. Following 3D volumetric image construction, pre- and post-op Standard Triangle Language files were superimposed and volumetric data were extracted for a 10-mm region of interest. Linear measurements were compared similarly.

Results: Baseline clinical parameters were similar in both groups (4.22 and 4.53 mm for OV and FDBA/CM at -2 mm, respectively). Following treatment, vertical distance from the stent had changed minimally (-0.36 and -0.12 mm, respectively). Similarly, lateral bone gain ranged from 0 to 0.4 mm, for both groups. To the contrary, the CBCT measurements showed a significantly greater increase in horizontal width in the control at -2 mm (0.95 ± 0.2 mm) compared with -0.62 mm for the OV (P = 0.000). Similar changes were observed at -5 mm (0.63 and -0.41 mm, respectively, P = 0.01). Sites volume had increased from 266 ± 149 mm3 to 360 ± 138 mm3 (P = 0.001) for FDBA/CM with negligible changes for OV (from 334 to 335 mm3 , P = 0.952). these between-group changes being statistically significant (P = 0.023).

Conclusion: FDBA/CM yielded better albeit moderate increase in the volume of the edentulous ridge, while OV scaffolds failed to produce similar results.
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==Choroidal Macrovessel: Systematic Review and Analysis of Anatomic Origin==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/34332961 Surv Ophthalmol. 2022 Mar-Apr;67(2):570-8. PMID: 34332961]

'''Authors:''' Bowen RC, Raval V, Soto H, Singh AD.

'''Institution:''' Cole Eye Institute, Cleveland Clinic, Cleveland, OH, USA; Department of Ophthalmology and Visual Sciences, University of Iowa, Iowa City, IA, USA.

'''Abstract:''' There are various hypotheses for the anatomic origin of a choroidal macrovessel. We assess whether a choroidal macrovessel is a dilated posterior ciliary artery. A systematic review of published literature on choroidal macrovessels was performed with two additional cases from our institution. We compared the visible entry and vascular course of the macrovessel in the published literature. We performed a comparative analysis using indocyanine green angiography, swept source optical computed tomography, and 3D reconstruction of two choroidal macrovessels using [http://www.slicer.org '''3D Slicer'''] (Harvard, Boston, USA). From the 14 studies found, 18 cases met inclusion criteria. The reported literature and our two cases showed a radiating course along a sectoral distribution pattern of either short or long posterior ciliary arteries. Our review of literature and 3D reconstruction analysis support the hypothesis that choroidal macrovessels are dilated posterior ciliary arteries.
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==Using Three-Dimensional Visualization as an Optimal Tool to Plan and Validate an Aortopexy in a Congenital Heart Disease Patient With Severe Tracheal Stenosis==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/34738096 Interact Cardiovasc Thorac Surg. 2022 Mar 31;34(4):708-10. PMID: 34738096]

'''Authors:''' Kehl T, van Rüth V, Weinrich JM, Hübler M.

'''Institution:''' Clinic for Children's Heart Medicine, University Heart & Vascular Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany.

'''Abstract:''' We present a patient with severe tracheal stenosis resulting from a compression by the innominate artery 6 months after an arterial switch operation in a dextro-transposition of the great arteries. Segmentation and three-dimensional (3D) visualization were derived from a contrast-enhanced dual-source computed tomography and post-processing was performed using a dedicated open-source platform, [http://www.slicer.org '''3D Slicer''']. Post-processing allowed a comprehensible visualization of the relationship of the innominate artery to the trachea when compared to standard computer tomography reformations. Finally, the surgical approach to move the innominate artery anteriorly in order to relieve the tracheal obstruction was emphasized based on the improved 3D visualization of the actual pathology. An effective aortopexy could be performed and the postoperative result was confirmed by a second 3D visualization. About 3 months of follow-up, the patient is completely asymptomatic. Three-dimensional visualization offers excellent opportunities for diagnosis, treatment planning and follow-up in patients with a vascular-related tracheal stenosis in the context of congenital heart disease.
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==Bladder Urothelial Carcinoma: Machine Learning-based Computed Tomography Radiomics for Prediction of Histological Variant==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35351362 Acad Radiol. 2022 Mar 26:S1076-6332(22)00116-7. PMID: 35351362]

'''Authors:''' Evrimler S, Ali Gedik M, Ahmet Serel T, Ertunc O, Alperen Ozturk S, Soyupek S.

'''Institution:''' Department of Radiology, Suleyman Demirel University School of Medicine, Isparta, Turkey.

'''Abstract:''' Rationale and objectives: Histological variant (HV) of bladder urothelial carcinoma (UC) is a significant factor for therapy management. We aim to assess the predictive performance of machine learning (ML)-based Computed Tomography radiomics of UC for HV.

Materials and methods: Volume of interest of 37 bladder UC tumors, of which 21 were pure and 16 were HV, were manually segmented. The extracted first- and second-order texture features (n = 117) using [http://www.slicer.org '''3D Slicer'''] radiomics were compared to the radical cystectomy histopathological results. ML algorithms were performed to determine the significant models using Python 2.3, Pycaret library. The sample size was increased to 74 by synthetic data generation, and three outliers from the training set were removed (training dataset; n = 52, test dataset; n = 19). The predictive performances of 15 ML algorithms were compared. Then, the best two models were evaluated on the test set and ensembled by Voting Classifier.

Results: The ML algorithms demonstrated area under curve (AUC) and accuracy ranging 0.79-0.97 and 50%-90%, respectively on the train set. The best models were Gradient Boosting Classifier (AUC: 0.95, accuracy: 90%) and CatBoost Classifier (AUC: 0.97, accuracy: 85%). On the test set; the Voting Classifier of these two models demonstrated AUC, accuracy, recall, precision, and F1 scores as follows; 0.93, 79%, 86%, 67%, and 75%, respectively.

Conclusion: ML-based Computed Tomography radiomics of UC can predict HV, a prognostic factor that is indeterminable by qualitative radiological evaluation and can be missed in the preoperative histopathological specimens.
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==Semi-Automatic Segmentation of Cone Beam Computed Tomography Datasets for Volume Measurements of Equine Cheek Teeth==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/34866465 J Vet Dent. 2022 Mar;39(1):41-48. PMID: 34866465]

'''Authors:''' Herren FL, Gerber V, Meier R, Schweizer-Gorgas D, Klopfenstein Bregger MD.

'''Institution:''' University of Bern, Switzerland.

'''Abstract:''' The volumes of equine teeth may change considerably over time for several reasons including domestication, routine dental floating, and the hypsodont and anelodont nature of the teeth. Cone beam computed tomography (CBCT) of the head is routinely performed in standing horses and, in this proof of concept study, the feasibility of measuring tooth volume from CBCT datasets was determined. The CBCT images of 5 equine cadaver cheek teeth were segmented with a [http://www.slicer.org '''3D Slicer'''] software using a predefined protocol, corrected manually, and re-assembled into a 3D model. Individual tooth volume (VS) was calculated from the model. After extraction, the volumes were also measured using the "gold-standard" water displacement method (VW) for comparison. The VS of 77 teeth ranged from 7114 to 42,300 mm3 which strongly correlated with VW (r = 0.99), and on average VS was 6.1% less than VW. There was no significant difference in VS between the right and left arcades in individual animals. Maxillary cheek tooth volume was on average 40% larger than it was for mandibular counterparts. Semi-automatic image segmentation of equine cheek teeth from CBCT data is feasible and accurate but requires some manual intervention. This preliminary study provides initial data on the volume of equine cheek teeth and creates new possibilities for future in vivo studies.
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==Radiomics-Based Artificial Intelligence Differentiation of Neurodegenerative Diseases with Reference to the Volumetry==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35455005 Life (Basel). 2022 Mar 31;12(4):514. PMID: 35455005] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9024778/pdf/life-12-00514.pdf PDF]

'''Authors:''' Cheung EYW, Chau ACM, Tang FH, On Behalf Of The Alzheimer's Disease Neuroimaging Initiative.

'''Institution:''' School of Medical Health and Sciences, Tung Wah College, Ho Man Tin, Hong Kong, China.

'''Abstract:''' This study aimed to build automated detection models-one by brain regional volume (V-model), and the other by radiomics features of the whole brain (R-model)-to differentiate mild cognitive impairment (MCI) from cognitive normal (CN), and Alzheimer's Disease (AD) from mild cognitive impairment (MCI). The objectives are to compare the models and identify whether radiomics or volumetry can provide a better prediction for differentiating different types of dementia.

Method: 582 MRI T1-weighted images were retrieved from the Alzheimer's Disease Neuroimaging Initiative (ADNI) database, which is a multicenter operating open source database for AD. In total, 97 images of AD, 293 images of MCI patient and 192 images of cognitive normal were divided into a training, a validation and a test group at a ratio of 70:15:15. For each T1-weighted image, volumetric segmentation was performed with the image analysis software FreeSurfer, and radiomics features were retrieved by imaging research software [http://www.slicer.org '''3D Slicer''']. Brain regional volume and radiomics features were used to build the V-model and R-model, respectively, using the random forest algorithm by R. The receiver operating characteristics (ROC) curve of both models were used to evaluate their diagnostic accuracy and reliability to differentiate AD, MCI and CN.

Results: To differentiate MCI and CN, both V-model and R-model achieved excellent performance, with an AUC of 0.9992 ± 0.0022 and 0.9850 ± 0.0032, respectively. No significant difference was found between the two AUCs, indicating both models obtained similar good performance. In MCI and AD differentiation, the V-model and R-model yielded AUC of 0.9986 ± 0.0013 and 0.9714 ± 0.0175, respectively. The best performance was to differentiate AD from CN, where the V-model and R-model yielded AUC of 0.9994 ± 0.0019 and 0.9830 ± 0.009, respectively. The results suggested that both volumetry and radiomics approaches could be used in differentiating AD, MCI and CN, based on T1 weighted MR images using random forest algorithm successfully.

Conclusion: This study showed that the radiomics features from T1-weighted MR images achieved excellence performance in differentiating AD, MCI and CN. Compared to the volumetry method, the accuracy, sensitivity and specificity are slightly lower in using radiomics, but still attained very good and reliable classification of the three stages of neurodegeneration. In view of the convenience and operator independence in feature extraction, radiomics can be a quantitative biomarker to differentiate the disease groups.
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==Optimized Fitting of a Midface Implant to Anchor a Magnetic Nasal Prosthesis Using 3D Printing==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/34463790 HNO. 2022 Mar;70(3):200-5. PMID: 34463790]

'''Authors:''' Wrobel C, Keppeler D, Meyer AC.

'''Institution:''' Klinik für Hals-Nasen-Ohrenheilkunde, Universitätsmedizin Göttingen, Georg-August-Universität Göttingen, Göttingen, Deutschland.

'''Abstract:''' Background: Plate-based anchorage systems for craniofacial prostheses offer advantages over extraoral solitary titanium implants in terms of the flexible choice of mounting points and higher stability. Disadvantages become apparent in the complex individual intraoperative adaptation of the plate-based systems to the usually poorly accessible bone. The current article presents a method to overcome these disadvantages and make greater use of the advantages of plate-based systems.

Materials and methods: The bony midface of a patient who had undergone rhinectomy for cancer of the nasal entrance was reconstructed as a virtual 3D model based on preoperative CT. The open-source software, [http://www.slicer.org '''3D Slicer'''] allowed easy and fast reconstruction as well as adaptation for 3D printing using transparent plastic (MED610; stratasys Ltd., MN, USA).

Results: A titanium mini-plate (MEDICON) for anchoring the nasal prosthesis could be fitted extremely precisely on the midface 3D print. Important anatomical structures were spared, and screw placement was selected according to the individual bone thickness. Implantation of the in-advance fitted titanium plate was performed without complications and without further adjustments.

Conclusion: In-advance fitting of plate-based systems for anchorage of craniofacial prostheses using 3D printing of the midface overcomes their disadvantages of time-consuming and possibly imprecise individual adaptation. This method further exploits the advantages of higher stability through more possible mounting points, even in thinner bone, to prevent loosening. In addition, in-advance fitting of titanium plates on the 3D model enables better identification and protection of important anatomical structures and shortens operative time.
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==Automatic Intra-Subject Registration and Fusion of Multimodal Cochlea 3D Clinical Images==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35235600 PLoS One. 2022 Mar 2;17(3):e0264449. PMID: 35235600] | [https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/35235600/ PDF]

'''Authors:''' Al-Dhamari I, Helal R, Morozova O, Abdelaziz T, Jacob R, Paulus D, Waldeck S.

'''Institution:''' Computer Vision Department, Koblenz University, Koblenz, Germany.

'''Abstract:''' Background: The postoperative imaging assessment of Cochlear Implant (CI) patients is imperative. The main obstacle is that Magnetic Resonance imaging (MR) is contraindicated or hindered by significant artefacts in most cases with CIs. This study describes an automatic cochlear image registration and fusion method that aims to help radiologists and surgeons to process pre-and postoperative 3D multimodal imaging studies in cochlear implant (CI) patients.

Methods and findings: We propose a new registration method, Automatic Cochlea Image Registration (ACIR-v3), which uses a stochastic quasi-Newton optimiser with a mutual information metric to find 3D rigid transform parameters for registration of preoperative and postoperative CI imaging. The method was tested against a clinical cochlear imaging dataset that contains 131 multimodal 3D imaging studies of 41 CI patients with preoperative and postoperative images. The preoperative images were MR, Multidetector Computed Tomography (MDCT) or Cone Beam Computed Tomography (CBCT) while the postoperative were CBCT. The average root mean squared error of ACIR-v3 method was 0.41 mm with a standard deviation of 0.39 mm. The results were evaluated quantitatively using the mean squared error of two 3D landmarks located manually by two neuroradiology experts in each image and compared to other previously known registration methods, e.g. Fast Preconditioner Stochastic Gradient Descent, in terms of accuracy and speed.

Conclusions: Our method, ACIR-v3, produces high resolution images in the postoperative stage and allows for visualisation of the accurate anatomical details of the MRI with the absence of significant metallic artefacts. The method is implemented as an open-source plugin for [http://www.slicer.org '''3D Slicer'''] tool.
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==Accuracy of Patient Setup Positioning Using Surface-Guided Radiotherapy With Deformable Registration in Cases of Surface Deformation==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35077004 J Appl Clin Med Phys. 2022 Mar;23(3):e13493. PMID: 35077004]

'''Authors:''' Kadman B, Takemura A, Ito T, Okada N, Kojima H, Ueda S.

'''Institution:''' Division of Health Sciences, Graduate School of Medical Sciences, Pharmaceutical and Health Sciences, Kanazawa University, Japan.

'''Abstract:''' The Catalyst™ HD (C-RAD Positioning AB, Uppsala, Sweden) is surface-guided radiotherapy (SGRT) equipment that adopts a deformable model. The challenge in applying the SGRT system is accurately correcting the setup error using a deformable model when the body of the patient is deformed. This study evaluated the effect of breast deformation on the accuracy of the setup correction of the SGRT system. Physical breast phantoms were used to investigate the relationship between the mean deviation setup error obtained from the SGRT system and the breast deformation. Physical breast phantoms were used to simulate extension and shrinkage deformation (-30 to 30 mm) by changing breast pieces. [http://www.slicer.org '''3D Slicer'''] software was used to evaluate the deformation. The maximum deformations in X, Y, and Z directions were obtained as the differences between the original and deformed breasts. We collected the mean deviation setup error from the SGRT system by replacing the original breast part with the deformed breast part. The mean absolute difference of lateral, longitudinal, vertical, pitch, roll, and yaw, between the rigid and deformable registrations was 2.4 ± 1.7 mm, 1.3 ± 1.2 mm, 6.4 ± 5.2 mm, 2.5° ± 2.5°, 2.2° ± 2.4°, and 1.0° ± 1.0°, respectively. Deformation in the Y direction had the best correlation with the mean deviation translation error (R = 0.949) and rotation error (R = 0.832). As the magnitude of breast deformation increased, both mean deviation setup errors increased, and there was greater error in translation than in rotation. Large deformation of the breast surface affects the setup correction. Deformation in the Y direction most affects translation and rotation errors.
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==Quantitative Measurements of Esophageal Varices Using Computed Tomography for Prediction of Severe Varices and the Risk of Bleeding: A Preliminary Study==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35286491 Insights Imaging. 2022 Mar 14;13(1):47. PMID: 35286491] | [https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/35286491/ PDF]

'''Authors:''' Wan S, He Y, Zhang X, Wei Y, Song B.

'''Institution:''' Department of Radiology, West China Hospital, Sichuan University, Chengdu, China.

'''Abstract:''' Background: We aimed to assess whether the quantitative parameters of esophageal varices (EV) based on computed tomography (CT) can noninvasively predict severe EV and the risk of esophageal variceal bleeding (EVB).

Methods: A total of 136 endoscopically confirmed EV patients were included in this retrospective study and were divided into a non-conspicuous (mild-to-moderate EV, n = 30) and a conspicuous EV group (severe EV, n = 106), a bleeding (n = 89) and a non-bleeding group (n = 47). EV grade (EVG), EV diameter (EVD), cross-sectional surface area (CSA), EV volume (EVV), spleen volume (SV), splenic vein (SNV), portal vein (PV), diameter of left gastric vein (DLGV), and the opening type of LGV were measured independently using [http://www.slicer.org '''3D Slicer''']. Univariate and multivariate logistic analysis were used to determine the independent factors and the receiver operating characteristic (ROC) curves were performed to evaluate the diagnostic performance.

Results: The difference of EVG, EVD, CSA, EVV, DLGV, SNV between the conspicuous and non-conspicuous EV group were statistically significant (p < 0.05), area under the curves (AUCs) of them for predicting severe EV were 0.72, 0.772, 0.704, 0.768, 0.707, 0.65, with corresponding sensitivities of 70.3%, 63.5%, 50%, 74.3%, 52.7%, 48.6%, specificities of 71.4%, 85.7%, 100%, 71.4%, 81%, 81%, respectively. EVG, CSA (odds ratio 3.258, 95% CI 1.597-6.647; 1.029, 95% CI 1.008-1.050) were found to be independent predictive factors. However, there was no significant difference of the included indices between the bleeding and non-bleeding group (p > 0.05).

Conclusions: CT can be used as a noninvasive method to predict the severity of EV, which may reduce the invasive screening of endoscopy.
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==An Automatic Measurement System of Distal Femur Morphological Parameters Using '''3D Slicer''' Software==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/34958998 Bone. 2022 Mar;156:116300. PMID: 34958998] | [https://www.sciencedirect.com/science/article/pii/S875632822100466X/pdfft?md5=526e3a6d1d4dad79ff85bbfd6d3ef156&pid=1-s2.0-S875632822100466X-main.pdf PDF]

'''Authors:''' Chen Z, Wang Y, Li X, Wang K, Li Z, Yang P.

'''Institution:''' College of Computer Science, Xi'an University of Posts and Telecommunications, Shaanxi, China.

'''Abstract:''' In the field of joint surgery, the computer-aided design of knee prostheses suitable for the Chinese population requires a large quantity of anatomical knee data. In this study, we propose a new method that uses [http://www.slicer.org '''3D Slicer'''] software to automatically measure the morphological parameters of the distal femur. First, 141 femur samples were segmented from CT data to establish the femoral shape library. Next, balanced iterative reducing and clustering using hierarchies (BIRCH) combined with iterative closest point (ICP) and generalised procrustes analysis (GPA) were used to achieve fast registration of the femur samples. The statistical model was automatically calculated from the registered femur samples, and an orthopaedic surgeon marked the points on the statistical model. Finally, we developed an automatic measurement system using [http://www.slicer.org '''3D Slicer'''] software, and a deformable model matching method was applied to establish the point correspondence between the statistical model and the other samples. By matching points on the statistical model to corresponding points in other samples, we measured all other samples. We marked six points and measured eight parameters. We evaluated the performance of automatic matching by comparing the points marked manually with those matched automatically and verified the accuracy of the system by comparing the manual and automatic measurement results. The results indicated that the average error of the automatic matching points was 1.03 mm, and the average length error and average angle error measured automatically by the system were 0.37 mm and 0.63°, respectively. These errors were smaller than the intra-rater and inter-rater errors measured manually by two different surgeons, which showed that the accuracy of our automatic method was high. Taken together, this study established an accurate and automatic measurement system for the distal femur based on the secondary development of [http://www.slicer.org '''3D Slicer'''] software to assist orthopaedic surgeons in completing the measurements of big data and further promote the improved design of Chinese-specific knee prostheses.
|}

==Repeatability, Robustness, and Reproducibility of Texture Features on 3 Tesla Liver MRI==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35092926 Clin Imaging. 2022 Mar;83:177-83. PMID: 35092926]

'''Authors:''' Prabhu V, Gillingham N, Babb JS, Mali RD, Rusinek H, Bruno MT, Chandarana H.

'''Institution:''' Department of Radiology, NYU Langone Health, New York, NY, USA.

'''Abstract:''' Objective: Texture features are proposed for classification and prognostication, with lacking information about variability. We assessed 3 T liver MRI feature variability.

Methods: Five volunteers underwent standard 3 T MRI, and repeated with identical and altered parameters. Two readers placed regions of interest using [http://www.slicer.org '''3D Slicer''']. Repeatability (between standard and repeat scan), robustness (between standard and parameter changed scan), and reproducibility (two reader variation) were computed using coefficient of variation (CV).

Results: 67%, 49%, and 61% of features had good-to-excellent (CV ≤ 10%) repeatability on ADC, T1, and T2, respectively, least frequently for first order (19-35%). 22%, 19%, and 21% of features had good-to-excellent robustness on ADC, T1, and T2, respectively. 52%, 35%, and 25% of feature measurements had good-to-excellent inter-reader reproducibility on ADC, T1, and T2, respectively, with highest good-to-excellent reproducibility for first order features on ADC/T1.

Conclusion: We demonstrated large variations in texture features on 3T liver MRI. Further study should evaluate methods to reduce variability.
|}

==Total Intracranial Volume as a Covariate for Predicting Prognosis in Patients With Primary Intracerebral Hemorrhage==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35121234 Clin Neurol Neurosurg. 2022 Mar;214:107135. PMID: 35121234]

'''Authors:''' Wang L, Liu C, Lu E, Zhang D, Zhang H, Xu X, Liu R, Yuan C, Sun J, Zhou Q, Chen X, Wang L, Yang G.

'''Institution:''' Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Harbin, China.

'''Abstract:''' Objectives: The initial hematoma volume is reliable and stable imaging predictor for the outcome of patients with intracerebral hemorrhage, and the total intracranial volume varies between patients. However, the role of total intracranial volume in predicting the prognosis of spontaneous intracerebral hemorrhage has not been previously addressed.

Methods: 782 patients with spontaneous intracerebral hemorrhage were selected in this retrospective cohort at the Neurosurgery Emergency Unit of The First Affiliated Hospital of Harbin Medical University. Due to missing CT images, initial CT exceeding 24 h, traumatic cerebral hemorrhage, and aneurysm, 145 patients were excluded and the remaining 637 patients were included in our analysis. Functional outcome was assessed using the modified Rankin Scale(mRS) and mortality at 3-months after spontaneous intracerebral hemorrhage. CT image datasets were calculated by [http://www.slicer.org '''3D Slicer''']. The initial hematoma volume was normalized to the total intracranial volume to evaluate poor functional outcomes (mRS, 4-6) and mortality.

Results: The results demonstrated that normalized initial hematoma volume can be used as an indicator of poor functional outcome (mRS, 4-6) (AUCNrIHV=0.753, 95%-CI:0.710-0.795, p < 0.001), mortality (AUCNrIHV=0.808, 95%-CI:0.754-0.862, p < 0.001) and hematoma expansion (AUCNrIHV=0.690, 95%-CI:0.613-0.767, p < 0.001). Meanwhile, the initial hematoma volume in predicting poor functional outcome (AUCIHV=0.749, 95%-CI:0.707-0.792, p < 0.001), mortality (AUCIHV=0.816, 95%-CI: 0.763-0.870, p < 0.001) and hematoma expansion (AUCIHV=0.704, 95%-CI: 0.626-0.782, p < 0.001) was similar to the normalized initial hematoma volume.

Conclusions: The normalized initial hematoma volume has no apparent benefit in predicting the prognosis of patients with cerebral hemorrhage compared with initial hematoma volume.
|}

==3D-Slicer Software-Assisted Neuroendoscopic Surgery in the Treatment of Hypertensive Cerebral Hemorrhage==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35222690 Comput Math Methods Med. 2022 Feb 18;2022:7156598. PMID: 35222690] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8881139/pdf/CMMM2022-7156598.pdf PDF]

'''Authors:''' Liao R, Liu L, Song B, Wan X, Wang S, Xu J.

'''Institution:''' University of Ulsan Department of Oral and Maxillofacial Surgery, Chungang University Hospital, Seoul, South Korea.

'''Abstract:''' To explore the [http://www.slicer.org '''3D Slicer'''] software-assisted endoscopic treatment for patients with hypertensive cerebral hemorrhage.

Methods: A total of 120 patients with hypertensive cerebral hemorrhage were selected and randomly divided into control group and [http://www.slicer.org '''3D Slicer'''] group with 60 cases each. Patients in the control group underwent traditional imaging positioning craniotomy, and patients in the [http://www.slicer.org '''3D Slicer'''] group underwent [http://www.slicer.org '''3D Slicer'''] followed by precision puncture treatment. In this paper, we evaluate the hematoma clearance rate, nerve function, ability of daily living, complication rate, and prognosis.

Results: The [http://www.slicer.org '''3D Slicer'''] group is better than the control group in various indicators. Compared with the control group, the [http://www.slicer.org '''3D Slicer'''] group has lower complications, slightly higher hematoma clearance rate, and better recovery of nerve function and daily living ability before and after surgery. The incidence of poor prognosis is low.

Conclusion: The [http://www.slicer.org '''3D Slicer'''] software-assisted endoscopic treatment for patients with hypertensive intracerebral hemorrhage has a better hematoma clearance effect, which is beneficial to the patient's early recovery and reduces the damage to the brain nerve of the patient.
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==FreeSurfer and 3D Slicer-Assisted SEEG Implantation for Drug-Resistant Epilepsy==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35295674 Front Neurorobot. 2022 Feb 28;16:848746. PMID: 35295674] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8918516/pdf/fnbot-16-848746.pdf PDF]

'''Authors:''' Liu Q, Wang J, Wang C, Wei F, Zhang C, Wei H, Ye X, Xu J.

'''Institution:''' Department of Neurosurgery, Clinical Neuroscience Center Comprehensive Epilepsy Unit, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

'''Abstract:''' Objective: Our study aimed to develop an approach to improve the speed and resolution of cerebral-hemisphere and lesion modeling and evaluate the advantages and disadvantages of robot-assisted surgical planning software.

Methods: We applied both conventional robot planning software (method 1) and open-source auxiliary software (FreeSurfer and [http://www.slicer.org '''3D Slicer''']; method 2) to model the brain and lesions in 19 patients with drug-resistant epilepsy. The patients' mean age at implantation was 21.4 years (range, 6-52 years). Each patient received an average of 12 electrodes (range, 9-16) between May and November 2021. The electrode-implantation plan was designed based on the models established using the two methods. We statistically analyzed and compared the duration of designing the models and planning the implantation using these two methods and performed the surgeries with the implantation plan designed using the auxiliary software.

Results: A significantly longer time was needed to reconstruct a cerebral-hemisphere model using method 1 (mean, 206 s) than using method 2 (mean, 20 s) (p < 0.05). Both methods identified a mean of 1.4 lesions (range, 1-5) in each patient. Overall, using method 1 required longer (mean, 130 s; range, 48-436) than using method 2 (mean, 68.1 s; range, 50-104; p < 0.05). In addition, the clarity of the model based on method 1 was lower than that based on method 2. To devise an electrode-implantation plan, it took 9.1-25.5 min (mean, 16) and 6.6-14.8 min (mean, 10.2) based on methods 1 and 2, respectively (p < 0.05). The average target point error of 231 electrodes amounted to 1.90 mm ± 0.37 mm (range, 0.33-3.61 mm). The average entry point error was 0.89 ± 0.26 mm (range, 0.17-1.67 mm). None of the patients presented with intracranial hemorrhage or infection, and no other serious complications were observed.

Conclusions: FreeSurfer and [http://www.slicer.org '''3D Slicer''']-assisted SEEG implantation is an excellent approach to enhance modeling speed and resolution, shorten the electrode-implantation planning time, and boost the efficiency of clinical work. These well-known, trusted open-source programs do not have explicitly restricted licenses. These tools, therefore, seem well suited for clinical-research applications under the premise of approval by an ethics committee, informed consent of the patient, and clinical judgment of the surgeon.
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==SegmentGeometry: A Tool for Measuring Second Moment of Area in 3D Slicer==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35291672 Integr Org Biol. 2022 Feb 28;4(1):obac009. PMID: 35291672] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8919404/pdf/obac009.pdf PDF]

'''Authors:''' Huie JM, Summers AP, Kawano SM.

'''Institution:''' Department of Biological Sciences, George Washington University, Washington, DC, USA.

'''Abstract:''' Second moment of area is a measure of how well the cross-section of a beam will resist bending because of its shape. Many have used second moment of area to investigate the mechanical adaptations of biological structures from stingray jaws to animal limb bones. In this context it is important to acknowledge the assumptions of beam theory, in which second moment of area plays a key role, if reasonable results are desired. For example, to minimize shear the structure should be at least 10 times longer than it is wide and deflection should be minimal. Analyzing the internal geometry of biological structures has never been easier or more accessible given the wide, and growing availability of micro-CT scans. Here, we offer a guide on the care that needs to be taken when interpreting second moment of area, and present open-access, open-source software that can process hundreds if not thousands of structures in a short time frame. SegmentGeometry, an extension for the open-source imaging platform [http://www.slicer.org '''3D Slicer'''], iterates slice-by-slice through 3D structures to calculate second moment of area and other cross-sectional properties. We analyzed 2 case studies to demonstrate the power of this tool and to highlight interpretations that can be gleaned from second moment of area. Second moment of area is just one part of the Euler-Bernoulli beam theory and considering the full equation would greatly increase the number and diversity of questions that can be answered.
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==Decreased Functional Connectivities of Low-Degree Level Rich Club Organization and Caudate in Post-stroke Cognitive Impairment Based on Resting-State fMRI and Radiomics Features==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35250435 Front Neurosci. 2022 Feb 16;15:796530. PMID: 35250435] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8890030/pdf/fnins-15-796530.pdf PDF]

'''Authors:''' Miao G, Rao B, Wang S, Fang P, Chen Z, Chen L, Zhang X, Zheng J, Xu H, Liao W.

'''Institution:''' Department of Rehabilitation Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China.

'''Abstract:''' Background: Stroke is an important cause of cognitive impairment. Rich club organization, a highly interconnected network brain core region, is closely related to cognition. We hypothesized that the disturbance of rich club organization exists in patients with post-stroke cognitive impairment (PSCI).

Methods: We collected data on resting-state functional magnetic resonance imaging (rs-fMRI) with 21 healthy controls (HC), 16 hemorrhagic stroke (hPSCI), and 21 infarct stroke (iPSCI). 3D shape features and first-order statistics of stroke lesions were extracted using [http://www.slicer.org '''3D Slicer'''] software. Additionally, we assessed cognitive function using the Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE).

Results: Normalized rich club coefficients were higher in hPSCI and iPSCI than HC at low-degree k-levels (k = 1-8 in iPSCI, k = 2-8 in hPSCI). Feeder and local connections were significantly decreased in PSCI patients versus HC, mainly distributed in salience network (SN), default-mode network (DMN), cerebellum network (CN), and orbitofrontal cortex (ORB), especially involving the right and left caudate with changed nodal efficiency. The feeder and local connections of significantly between-group difference were positively related to MMSE and MoCA scores, primarily distributed in the sensorimotor network (SMN) and visual network (VN) in hPSCI, SN, and DMN in iPSCI. Additionally, decreased local connections and low-degree ϕnorm(k) were correlated to 3D shape features and first-order statistics of stroke lesions.

Conclusion: This study reveals the disrupted low-degree level rich club organization and relatively preserved functional core network in PSCI patients. Decreased feeder and local connections in cognition-related networks (DMN, SN, CN, and ORB), particularly involving the caudate nucleus, may offer insight into pathological mechanism of PSCI patients. The shape and signal features of stroke lesions may provide an essential clue for the damage of functional connectivity and the whole brain networks.
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==Morphological Changes of the Root Apex in Anterior Teeth With Periapical Periodontitis: An In-Vivo Study==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35120518 BMC Oral Health. 2022 Feb 5;22(1):31. PMID: 35120518] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8817522/pdf/12903_2022_Article_2062.pdf PDF]

'''Authors:''' Zhang CC, Liu YJ, Yang WD, Zhang QN, Zha MZ, Wen SH, Wang Q.

'''Institution:''' Department of Endodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing City, China.

'''Abstract:''' Introduction: The aim was to analyze the morphological changes of root apex in anterior teeth with periapical periodontitis.

Methods: 32 untreated anterior teeth with periapical periodontitis were enrolled, compared with the healthy contralateral teeth. Two-dimensional measurement of Cone-beam computed tomography was used to determine the location and measure diameter of the apical constriction according to Schell's methods. An open-source software, [http://www.slicer.org '''3D Slicer'''] was used to reconstruct the teeth. The apical constriction form was analysis according to Schell's topography. The distances of apical constriction to apical foramen and anatomical apex were measured respectively.

Results: The difference value between buccolingual and mesiodistal diameter was (0.06 ± 0.09) mm and (0.04 ± 0.04) mm in periapical periodontitis and controls (p < 0.05). The mean distance between apical constriction and anatomical apex was significantly shorter in periapical periodontitis than controls, so was the mean distance of apical constriction to apical foramen. The most common form of apical constriction was flaring (65.6%) in periapical periodontitis.

Conclusions: The anterior teeth with periapical periodontitis had shorter distances of apical constriction to anatomical apex and apical foramen, bigger disparities between the diameters of buccolingual and mesiodistal, and higher proportion of flaring apical constriction.
|}

==Volumetric White Matter Hyperintensity Ranges Correspond to Fazekas Scores on Brain MRI==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35158149 J Stroke Cerebrovasc Dis. 2022 Feb 11;31(4):106333. PMID: 35158149]

'''Authors:''' Andere A, Jindal G, Molino J, Collins S, Merck D, Burton T, Stretz C, Yaghi S, Sacchetti DC, Jamal SE, Reznik ME, Furie K, Cutting S.

'''Institution:''' Department of Neurology, Brown University, Providence, RI, USA.

'''Abstract:''' Introduction: White matter hyperintensity (WMH) is an abnormal T2 signal in the deep and subcortical white matter visualized on MRI associated with hypertension, cerebrovascular disease, and aging. The Fazekas (Fz) scoring system is a commonly used qualitative tool to assess the severity of WMH. While studies have compared Fazekas scores to other scoring methods, the comparison of Fazekas scores and volume of WMH using current semiautomated volumetric techniques has not been studied.

Methods: We reviewed MRI studies acquired at our institution between 2015 and 2017. Relative WMH was scored by one author trained in Fazekas scoring. A board certified neuroradiologist scored them independently for confirmation. Manual segmentations of WMH were completed using [http://www.slicer.org '''3D Slicer'''] v.4.9. A 3D model was formed to quantify WMH in milliliters (mL). ANOVA tests were performed to determine the association of Fazekas scores with corresponding WMH volumes.

Results: Among the 198 patients in our study, WMH were visualized in 163 (Fz1: n=66; Fz2: n=49; Fz3: n=48). WMH volumes significantly differed according to Fazekas score (F = 141.1, p<0.001), with increasing WMHV associated with higher Fazekas scores: Fz1, range 0.1-8.3 mL (mean 3.7, SD 2.3); Fz2, range 6.0-17.7 mL (mean 10.8, SD 3.1); Fz3, range 14.2-77.2 mL (mean 35.2, SD 17.9); and Fz3 (excluding 11 outliers above 50 mL), 14.2-47.0 mL (mean 27.1, SD 8.9).

Conclusion: Fazekas scores correspond with distinct ranges of WMH volume with relatively little overlap, but scores based on volumes are more efficacious. A modified Fazekas from 0-4 should be considered.
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==A Radiomics Model Based on DCE-MRI and DWI May Improve the Prediction of Estimating IDH1 Mutation and Angiogenesis in Gliomas==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/34995947 Eur J Radiol. 2022 Feb;147:110141. PMID: 34995947]

'''Authors:''' Wang J, Hu Y, Zhou X, Bao S, Chen Y, Ge M, Jia Z.

'''Institution:''' Department of Medical Imaging, Affiliated Hospital of Nantong University, Nantong, China.

'''Abstract:''' Purpose: To investigate the value of a radiomics model based on dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and diffusion weighted imaging (DWI) in estimating isocitrate dehydrogenase 1 (IDH1) mutation and angiogenesis in gliomas.

Method: One hundred glioma patients with DCE-MRI and DWI were enrolled in this study (training and validation groups with a ratio of 7:3). The IDH1 genotypes and expression of vascular endothelial growth factor (VEGF) in gliomas were assessed by immunohistochemistry. Radiomics features were extracted by an open source software [http://www.slicer.org '''3D Slicer'''] and reduced using Least absolute shrinkage and selection operator (Lasso). The support vector machine (SVM) model was developed based on the most useful predictive radiomics features. The conventional model was built by the selected clinical and morphological features. Finally, a combined model including radiomics signature, age and enhancement degree was established. Receiver operator characteristic (ROC) curve was implemented to assess the diagnostic performance of the three models.

Results: For IDH1 mutation, the combined model achieved the highest area under curve (AUC) in comparison with the SVM and conventional models (training group, AUC = 0.967, 0.939 and 0.906; validation group, AUC = 0.909, 0.880 and 0.842). Furthermore, the SVM model showed good diagnostic performance in estimating gliomas VEGF expression (validation group, AUC = 0.919).

Conclusions: The radiomics model based on DCE-MRI and DWI can have a considerable effect on the evaluation of IDH1 mutation and angiogenesis in gliomas.
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==The Role of Pre-therapeutic 18F-FDG PET/CT in Pediatric Hemophagocytic Lymphohistiocytosis With Epstein-Barr Virus Infection==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35127776 Front Med (Lausanne). 2022 Jan 21;8:836438. PMID: 35127776] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8813965/pdf/fmed-08-836438.pdf PDF]

'''Authors:''' Lu X, Wei A, Yang X, Liu J, Li S, Kan Y, Wang W, Wang T, Zhang R, Yang J.

'''Institution:''' Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.

'''Abstract:''' Objective: To evaluate the role of pre-therapeutic 18F-FDG PET/CT in pediatric hemophagocytic lymphohistiocytosis (HLH) with Epstein-Barr virus (EBV) infection.

Methods: This retrospective study included 29 HLH children (1-16 years) with EBV infection, who underwent pre-therapeutic 18F-FDG PET/CT from July 2018 to November 2020. Pathology results were considered as the reference standard. These patients were divided into two groups: EBV-induced malignancy-associated HLH (M-HLH, N = 9) and EBV-induced non-malignancy-associated HLH (NM-HLH, N = 20). The regions of interest (ROIs) of the liver, spleen (Sp), bone marrow (BM), lymph nodes (LN), hypermetabolic lesions, liver background (LiBG), and mediastinum (M) were drawn with software [http://www.slicer.org '''3D Slicer''']. The volumetric and metabolic parameters, including maximum standard uptake value (SUVmax), metabolic tumor volume, and total lesion glycolysis of these ROIs, clinical parameters, and laboratory parameters were compared between the two groups. The efficiency of the above parameters in predicting the treatment response and overall survival (OS) was analyzed.

Results: Receiver operating characteristic curve analysis indicated that SUVmax-lesions and SUVmax-LN/M (AUC = 0.822, 0.819, cut-off = 6.04, 5.74, respectively) performed better in differentiating M-HLH from NM-HLH. It had the best diagnostic performance when age was added with the SUVmax-LN/M (AUC = 0.933, sensitivity = 100%, specificity = 85.0%). The presence of extranodal hypermetabolic lesions in multiple organs indicated the M-HLH (P = 0.022). Older age, higher SUVmax-LN and SUVmax-lesions, and the presence of serous effusion were associated with poorer treatment response at the 2nd and 4th week (not reaching partial remission). Multivariate analysis showed that SUVmax-lesions > 7.66 and SUVmax-Sp/LiBG > 2.01 were independent prognostic factors for overall survival (P = 0.025, 0.036, respectively).

Conclusions: 18F-FDG PET/CT could be a valuable technique for identifying the underlying malignancy and predicting prognosis in pediatric HLH with EBV infection. M-HLH could be considered when SUVmax-lesions > 6.04, SUVmax-LN/M > 5.74, and the presence of extranodal hypermetabolic lesions in multiple organs on 18F-FDG PET/CT. SUVmax-lesions and SUVmax-Sp/LiBG might be independent prognostic factors for OS.
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==A Preoperative MRI-Based Radiomics-Clinicopathological Classifier to Predict the Recurrence of Pituitary Macroadenoma Within 5 Years==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35069413 Front Neurol. 2022 Jan 5;12:780628. PMID: 35069413] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8767054/pdf/fneur-12-780628.pdf PDF]

'''Authors:''' Zhang Y, Luo Y, Kong X, Wan T, Long Y, Ma J.

'''Institution:''' Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.

'''Abstract:''' To investigate the ability of a MRI-based radiomics-clinicopathological model to predict pituitary macroadenoma (PMA) recurrence within 5 years. Materials and Methods: We recruited 74 recurrent and 94 non-recurrent subjects, following first surgery with 5-year follow-up data. Univariate and multivariate analyses were conducted to identify independent clinicopathological risk factors. Two independent and blinded neuroradiologists used [http://www.slicer.org '''3D Slicer'''] software to manually delineate whole tumors using preoperative axial contrast-enhanced T1WI (CE-T1WI) images. [http://www.slicer.org '''3D Slicer'''] was then used to extract radiomics features from segmented tumors. Dimensionality reduction was carried out by the least absolute shrinkage and selection operator (LASSO). Two multilayer perceptron (MLP) models were established, including independent clinicopathological risk factors (Model 1) and a combination of screened radiomics features and independent clinicopathological markers (Model 2). The predictive performance of these models was evaluated by receiver operator characteristic (ROC) curve analysis. Results: In total, 1,130 features were identified, and 4 of these were selected by LASSO. In the test set, the area under the curve (AUC) of Model 2 was superior to Model 1 {0.783, [95% confidence interval (CI): 0.718-.860] vs. 0.739, (95% CI: 0.665-0.818)}. Model 2 also yielded the higher accuracy (0.808 vs. 0.692), sensitivity (0.826 vs. 0.652), and specificity (0.793 vs. 0.724) than Model 1. Conclusions: The integrated classifier was superior to a clinical classifier and may facilitate the prediction of individualized prognosis and therapy.
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==Spatial Omics: Navigating to the Golden Era of Cancer Research==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35040595 Clin Transl Med. 2022 Jan;12(1):e696. PMID: 35040595] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8764875/pdf/CTM2-12-e696.pdf PDF]

'''Authors:''' Wu Y, Cheng Y, Wang X, Fan J, Gao Q.

'''Institution:''' Center for Tumor Diagnosis & Therapy and Department of Cancer Center, Zhongshan Hospital, Fudan University, Shanghai, China.

'''Abstract:''' The idea that tumour microenvironment (TME) is organised in a spatial manner will not surprise many cancer biologists; however, systematically capturing spatial architecture of TME is still not possible until recent decade. The past five years have witnessed a boom in the research of high-throughput spatial techniques and algorithms to delineate TME at an unprecedented level. Here, we review the technological progress of spatial omics and how advanced computation methods boost multi-modal spatial data analysis. Then, we discussed the potential clinical translations of spatial omics research in precision oncology, and proposed a transfer of spatial ecological principles to cancer biology in spatial data interpretation. So far, spatial omics is placing us in the golden age of spatial cancer research. Further development and application of spatial omics may lead to a comprehensive decoding of the TME ecosystem and bring the current spatiotemporal molecular medical research into an entirely new paradigm.

"Computational strategies originally designed for radiomics, such as [http://www.slicer.org '''3D Slicer'''], are expected to reconstruct the spatial molecular organization."
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==WHO Grade Loses Its Prognostic Value in Molecularly Defined Diffuse Lower-Grade Gliomas==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35083156 Front Oncol. 2022 Jan 10;11:803975. PMID: 35083156] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8785215/pdf/fonc-11-803975.pdf PDF]

'''Authors:''' Carstam L, Corell A, Smits A, Dénes A, Barchéus H, Modin K, Sjögren H, Ferreyra Vega S, Bontell TO, Carén H, Jakola AS.

'''Institution:''' Department of Neurosurgery, Sahlgrenska University Hospital, Gothenburg, Sweden.

'''Abstract:''' Background: While molecular insights to diffuse lower-grade glioma (dLGG) have improved the basis for prognostication, most established clinical prognostic factors come from the pre-molecular era. For instance, WHO grade as a predictor for survival in dLGG with isocitrate dehydrogenase (IDH) mutation has recently been questioned. We studied the prognostic role of WHO grade in molecularly defined subgroups and evaluated earlier used prognostic factors in the current molecular setting.

Material and methods: A total of 253 adults with morphological dLGG, consecutively included between 2007 and 2018, were assessed. IDH mutations, codeletion of chromosomal arms 1p/19q, and cyclin-dependent kinase inhibitor 2A/B (CDKN2A/B) deletions were analyzed.

Results: There was no survival benefit for patients with WHO grade 2 over grade 3 IDH-mut dLGG after exclusion of tumors with known CDKN2A/B homozygous deletion (n=157) (log-rank p=0.97). This was true also after stratification for oncological postoperative treatment and when astrocytomas and oligodendrogliomas were analyzed separately. In IDH-mut astrocytomas, residual tumor volume after surgery was an independent prognostic factor for survival (HR 1.02; 95% CI 1.01-1.03; p=0.003), but not in oligodendrogliomas (HR 1.02; 95% CI 1.00-1.03; p=0.15). Preoperative tumor size was an independent predictor in both astrocytomas (HR 1.03; 95% CI 1.00-1.05; p=0.02) and oligodendrogliomas (HR 1.05; 95% CI 1.01-1.09; p=0.01). Age was not a significant prognostic factor in multivariable analyses (astrocytomas p=0.64, oligodendrogliomas p=0.08).

Conclusion: Our findings suggest that WHO grade is not a robust prognostic factor in molecularly well-defined dLGG. Preoperative tumor size remained a prognostic factor in both IDH-mut astrocytomas and oligodendrogliomas in our cohort, whereas residual tumor volume predicted prognosis in IDH-mut astrocytomas only. The age cutoffs for determining high risk in patients with IDH-mut dLGG from the pre-molecular era are not supported by our results.

Keywords: CDKN2A/B deletion; IDH-mut; WHO grade; astrocytoma; extent of resection; lower-grade glioma; oligodendroglioma; prognostic factors.

"The volume of residual tumor after surgery was determined by tumor volume segmentation. The tumor volume was evaluated by semi-automatic segmentation performed with the open-source software [http://www.slicer.org '''3D Slicer'''], v.4.6.2 or newer."
|}

==A Baboon Brain Atlas for Magnetic Resonance Imaging and Positron Emission Tomography Image Analysis==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35095430 Front Neuroanat. 2022 Jan 14;15:778769. PMID: 35095430] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8795914/pdf/fnana-15-778769.pdf PDF]

'''Authors:''' Agaronyan A, Syed R, Kim R, Hsu CH, Love SA, Hooker JM, Reid AE, Wang PC,
Ishibashi N, Kang Y, Tu TW.

'''Institution:''' Center for Neuroscience Research, Children's National Hospital, Washington D.C., USA.

'''Abstract:''' The olive baboon (Papio anubis) is phylogenetically proximal to humans. Investigation into the baboon brain has shed light on the function and organization of the human brain, as well as on the mechanistic insights of neurological disorders such as Alzheimer's and Parkinson's. Non-invasive brain imaging, including positron emission tomography (PET) and magnetic resonance imaging (MRI), are the primary outcome measures frequently used in baboon studies. PET functional imaging has long been used to study cerebral metabolic processes, though it lacks clear and reliable anatomical information. In contrast, MRI provides a clear definition of soft tissue with high resolution and contrast to distinguish brain pathology and anatomy, but lacks specific markers of neuroreceptors and/or neurometabolites. There is a need to create a brain atlas that combines the anatomical and functional/neurochemical data independently available from MRI and PET. For this purpose, a three-dimensional atlas of the olive baboon brain was developed to enable multimodal imaging analysis. The atlas was created on a population-representative template encompassing 89 baboon brains. The atlas defines 24 brain regions, including the thalamus, cerebral cortex, putamen, corpus callosum, and insula. The atlas was evaluated with four MRI images and 20 PET images employing the radiotracers for [11C]benzamide, [11C]metergoline, [18F]FAHA, and [11C]rolipram, with and without structural aids like [18F]fluorodeoxyglucose images. The atlas-based analysis pipeline includes automated segmentation, registration, quantification of region volume, the volume of distribution, and standardized uptake value. Results showed that, in comparison to PET analysis utilizing the "gold standard" manual quantification by neuroscientists, the performance of the atlas-based analysis was at >80 and >70% agreement for MRI and PET, respectively. The atlas can serve as a foundation for further refinement, and incorporation into a high-throughput workflow of baboon PET and MRI data. The new atlas is freely available on the Figshare online repository (https://doi.org/10.6084/m9.figshare.16663339), and the template images are available from neuroImaging tools & resources collaboratory (NITRC) (https://www.nitrc.org/projects/haiko89/).

"Each PET image was registered to the atlas by [http://www.slicer.org '''3D Slicer''']’s landmark registration tool "
|}

==SPHARM-PDM Based Image Preprocessing Pipeline for Quantitative Morphometric Analysis (QMA) for in Situ Joint Assessment in Rabbit and Rat Models==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35064147 Sci Rep. 2022 Jan 21;12(1):1113. PMID: 35064147] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8782854/pdf/41598_2021_Article_4542.pdf PDF]

'''Authors:''' Durongbhan P, Davey CE, Stok KS.

'''Institution:''' Department of Biomedical Engineering, The University of Melbourne, Australia.

'''Abstract:''' The accessibility of quantitative measurements of joint morphometry depends on appropriate tibial alignment and volume of interest (VOI) selection of joint compartments; often a challenging and time-consuming manual task. In this work, we developed a novel automatic, efficient, and model-invariant image preprocessing pipeline that allows for highly reproducible 3D quantitative morphometric analysis (QMA) of the joint. The pipeline addresses the problem by deploying two modules: an alignment module and a subdivision module. Alignment is achieved by representing the tibia in its basic form using lower degree spherical harmonic basis functions and aligning using principal component analysis. The second module subdivides the joint into lateral and medial VOIs via a water shedding approach based on persistence homology. Multiple repeated micro-computed tomography scans of small (rat) and medium (rabbit) animal knees were processed using the pipeline to demonstrate model invariance. Existing QMA was performed to evaluate the pipeline's ability to generate reproducible measurements. Intraclass correlation coefficient and mean-normalised root-mean-squared error of more than 0.75 and lower than 9.5%, respectively, were achieved for joint centre of mass, joint contact area under virtual loading, joint space width, and joint space volume. Processing time and technical requirements were reduced compared to manual processing in previous studies.

"SPHARM processing, statistical shape analysis module in [http://www.slicer.org '''3D Slicer'''])"
|}

==Clinical Evaluation of 3D Printed Nano-Porous Hydroxyapatite Bone Graft for Alveolar Ridge Preservation: A Randomized Controlled Trial==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/35028038/ J Dent Sci. 2022 Jan;17(1):194-203. PMID: 35028038] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8739241/pdf/main.pdf PDF]

'''Authors:''' Kijartorn P, Wongpairojpanich J, Thammarakcharoen F, Suwanprateeb J,
Buranawat B.

'''Institution:''' Department of Periodontology and Implantology, Faculty of Dentistry, Thammasat University, Pathum Thani, Thailand.

'''Abstract:''' Background/purpose: Ridge resorption after tooth extraction may result in inadequate bone volume and unfavorable ridge architecture for ideal implant placement. The use of bone substitutes has been advocated to fill extraction sites and to enhance primary implant stability. This study was made to evaluate the clinical efficacy of novel 3D printed nano-porous hydroxyapatite (3DP HA, test group) in comparison to nano-crystalline bone graft (NanoBone®, control group) in alveolar ridge preservation prior to implant placement.

Materials and methods: Thirty patients were randomized into two groups following tooth extraction. All extracted sockets were filled with 3DP HA or NanoBone® and covered with a non-resorbable membrane. After four months, cone-beam computed tomography (CBCT) and intraoral scanner were used to measure dimensional changes of bone and soft tissue surface. Bone core specimens were harvested for histological analysis during implant osteotomy. Implant stability was assessed using a modified damping capacity analysis.

Results: At four months postoperatively, dimensional changes in soft tissue surface resorption were less in the test group than in the control group; however, alveolar bone resorption was the same in both groups. Histological analysis revealed new bone formation, residual graft and fibrous connective tissue in both groups. The average primary implant stability (IST) value for both groups was approximately 70. There was no statistically significant difference in all parameters between two groups (p > 0.05).

Conclusion: 3DP HA could potentially be used as an alternative bone graft material for alveolar ridge preservation.

"To measure the alveolar bone changes, two DICOM files acquired from CBCT from two time points were segmented and reconstructed into 3D STL image files by using [http://www.slicer.org '''3D Slicer'''] software v.4.10.1."
|}

==High-Resolution MRI of the Human Palatine Tonsil and Its Schematic Anatomic 3D Reconstruction==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/34342906 J Anat. 2022 Jan;240(1):166-71. PMID: 34342906] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8655163/pdf/JOA-240-166.pdf PDF]

'''Authors:''' Herrmann KH, Hoffmann F, Ernst G, Pertzborn D, Pelzel D, Geißler K, Guntinas-Lichius O, Reichenbach JR, von Eggeling F.

'''Institution:''' Medical Physics Group, Institute for Diagnostic and Interventional Radiology, Jena University Hospital, Jena, Germany.

'''Abstract:''' The palatine tonsils form an important part of the human immune system. Together with the other lymphoid tonsils of Waldeyer's tonsillar ring, they act as the first line of defense against ingested or inhaled pathogens. Although histologically stained sections of the palatine tonsil are widely available, they represent the tissue only in two dimensions and do not provide reference to three-dimensional space. Such a representation of a tonsillar specimen based on imaging data as a 3D anatomical reconstruction is lacking both in scientific publications and especially in textbooks. As a first step in this direction, the objective of the present work was to image a resected tonsil specimen with high spatial resolution in a 9.4 T small-bore preclinical MRI and to combine these data with data from the completely sectioned and H&E stained same palatine tonsil. Based on the information from both image modalities, a 3D anatomical sketch was drawn by a scientific graphic artist. In perspective, such studies could help to overcome the difficulty of capturing the spatial extent and arrangement of anatomical structures from 2D images and to establish a link between three-dimensional anatomical preparations and two-dimensional sections or illustrations, as they have been found so far in common textbooks and anatomical atlases.

"3D model was assembled using the free software tool, [http://www.slicer.org '''3D Slicer''']"
|}

==The Effects of Cranial Orientation on Forensic Frontal Sinus Identification as Assessed by Outline Analyses==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35053060 Clin Transl Med. 2022 Jan;12(1):e696. PMID: 35053060] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8773378/pdf/biology-11-00062.pdf PDF]

'''Authors:''' Butaric LN, Richman A, Garvin HM.

'''Institution:''' Department of Anatomy, Des Moines University, 3200 Grand Avenue, Des Moines, IA, USA.

'''Abstract:''' The utility of frontal sinuses for personal identification is widely recognized, but potential factors affecting its reliability remain uncertain. Deviations in cranial position between antemortem and postmortem radiographs may affect sinus appearance. This study investigates how slight deviations in orientations affect sinus size and outline shape and potentially impact identification. Frontal sinus models were created from CT scans of 21 individuals and digitally oriented to represent three clinically relevant radiographic views. From each standard view, model orientations were deviated at 5° intervals in horizontal, vertical, and diagonal (e.g., left-up) directions (27 orientations per individual). For each orientation, sinus dimensions were obtained, and outline shape was assessed by elliptical Fourier analyses and principal component (PC) analyses. Wilcoxon sign rank tests indicated that sinus breadth remained relatively stable (p > 0.05), while sinus height was significantly affected with vertical deviations (p < 0.006). Mann-Whitney U tests on Euclidean distances from the PC scores indicated consistently lower intra- versus inter-individual distances (p < 0.05). Two of the three orientations maintained perfect (100%) outline identification matches, while the third had a 98% match rate. Smaller and/or discontinuous sinuses were most problematic, and although match rates are high, practitioners should be aware of possible alterations in sinus variables when conducting frontal sinus identifications.

"The associated frontal sinus and cranial models for each individual were imported into the program [http://www.slicer.org '''3D Slicer''']."
|}

==Phenotyping Type 2 Diabetes in Terms of Myocardial Insulin Resistance and Its Potential Cardiovascular Consequences: A New Strategy Based on 18 F-FDG PET/CT==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35055345 J Pers Med. 2022 Jan 2;12(1):30. PMID: 35055345] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8778238/pdf/jpm-12-00030.pdf PDF]

'''Authors:''' Herance JR, Simó R, Velasquez MA, Paun B, García-Leon D, Aparicio C, Marés R, Simó-Servat O, Castell-Conesa J, Hernández C, Aguadé-Bruix S.

'''Institution:''' Medical Molecular Imaging Research Group, Nuclear Medicine Department, Vall d'Hebron Research Institute (VHIR), Vall d'Hebron University Hospital, Autonomous University Barcelona, Barcelona, Spain.

'''Abstract:''' Background: Systemic insulin resistance is generally postulated as an independent risk factor of cardiovascular events in type 2 diabetes (T2D). However, the role of myocardial insulin resistance (mIR) remains to be clarified.

Methods: Two 18F-FDG PET/CT scans were performed on forty-three T2D patients at baseline and after hyperinsulinemic-euglycemic clamp (HEC). Myocardial insulin sensitivity (mIS) was determined by measuring the increment in myocardial 18F-FDG uptake after HEC. Coronary artery calcium scoring (CACs) and myocardial radiodensity (mRD) were assessed by CT.

Results: After HEC, seventeen patients exhibited a strikingly enhancement of myocardial 18F-FDG uptake and twenty-six a marginal increase, thus revealing mIS and mIR, respectively. Patients with mIR showed higher mRD (HU: 38.95 [33.81-44.06] vs. 30.82 [21.48-38.02]; p = 0.03) and CACs > 400 (AU: 52% vs. 29%; p = 0.002) than patients with mIS. In addition, HOMA-IR and mIS only showed a correlation in those patients with mIR.

Conclusions: 18F-FDG PET combined with HEC is a reliable method for identifying patients with mIR. This subgroup of patients was found to be specifically at high risk of developing cardiovascular events and showed myocardial structural changes. Moreover, the gold-standard HOMA-IR index was only associated with mIR in this subgroup of patients. Our results open up a new avenue for stratifying patients with cardiovascular risk in T2D.

"All acquired 18F-FDG PET images in DICOM format were first SUVbw normalized using the PET DICOM Extension available in [http://www.slicer.org '''3D Slicer''']."
|}

==Developing Virtual Reality Head Mounted Display (HMD) Set-Up for Thoracoscopic Surgery of Complex Congenital Lung MalFormations in Children==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35053675 Children (Basel). 2022 Jan 3;9(1):50. PMID: 35053675] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8774663/pdf/children-09-00050.pdf PDF]

'''Authors:''' Pelizzo G, Costanzo S, Roveri M, Lanfranchi G, Vertemati M, Milani P,
Zuccotti G, Cassin S, Panfili S, Rizzetto F, Campari A, Camporesi A, Calcaterra V.

'''Institution:''' Pediatric Surgery Department, "Vittore Buzzi" Children's Hospital, Milan, Italy.

'''Abstract:''' Video assisted thoracoscopic surgery (VATS) has been adopted in pediatric age for the treatment of congenital lung malformations (CLM). The success of VATS in pediatrics largely depends on the surgeon's skill ability to understand the airways, vascular system and lung parenchyma anatomy in CLM. In the last years, virtual reality (VR) and 3-dimensional (3D) printing of organ models and VR head mounted display (HMD) technologies have been introduced for completion of preoperative planning in adult patients. To date no reports about the use of VR HMD technologies in a pediatric setting are available. The aim of this report is to introduce a VR HMD model in VATS procedure to improve the quality of care in children with CLM. VR HMD set-up for planning thoracoscopic surgery was performed in a series of pediatric patients with diagnosis of CLM. The preoperative VR HMD evaluation allowed a navigation into the malformation with the aim to explore, interact, and make the surgeon more confident and skilled to answer to the traps. A development of surgical simulations models and teaching program dedicated to education and training in pediatric VATS is suitable among the pediatric surgery community. Further studies should demonstrate all the benefits of such technology in pediatric patients submitted to VATS procedure.

"CT images were then exported into DICOM files and loaded into [http://www.slicer.org '''3D Slicer''']."
|}

==Dynamic Contrast-Enhanced Magnetic Resonance Imaging for the Prediction of Monoclonal Antibody Tumor Disposition==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35054865 Int J Mol Sci. 2022 Jan 8;23(2):679. PMID: 35054865] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8775965/pdf/ijms-23-00679.pdf PDF]

'''Authors:''' Bordeau BM, Polli JR, Schweser F, Grimm HP, Richter WF, Balthasar JP.

'''Institution:''' Department of Pharmaceutical Sciences, University at Buffalo, Buffalo, NY, USA.

'''Abstract:''' The prediction of monoclonal antibody (mAb) disposition within solid tumors for individual patients is difficult due to inter-patient variability in tumor physiology. Improved a priori prediction of mAb pharmacokinetics in tumors may facilitate the development of patient-specific dosing protocols and facilitate improved selection of patients for treatment with anti-cancer mAb. Here, we report the use of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), with tumor penetration of the contrast agent gadobutrol used as a surrogate, to improve physiologically based pharmacokinetic model (PBPK) predictions of cetuximab pharmacokinetics in epidermal growth factor receptor (EGFR) positive xenografts. In the initial investigations, mice bearing Panc-1, NCI-N87, and LS174T xenografts underwent DCE-MRI imaging with the contrast agent gadobutrol, followed by intravenous dosing of an 125Iodine-labeled, non-binding mAb (8C2). Tumor concentrations of 8C2 were determined following the euthanasia of mice (3 h-6 days after 8C2 dosing). Potential predictor relationships between DCE-MRI kinetic parameters and 8C2 PBPK parameters were evaluated through covariate modeling. The addition of the DCE-MRI parameter Ktrans alone or Ktrans in combination with the DCE-MRI parameter Vp on the PBPK parameters for tumor blood flow (QTU) and tumor vasculature permeability (σTUV) led to the most significant improvement in the characterization of 8C2 pharmacokinetics in individual tumors. To test the utility of the DCE-MRI covariates on a priori prediction of the disposition of mAb with high-affinity tumor binding, a second group of tumor-bearing mice underwent DCE-MRI imaging with gadobutrol, followed by the administration of 125 Iodine-labeled cetuximab (a high-affinity anti-EGFR mAb). The MRI-PBPK covariate relationships, which were established with the untargeted antibody 8C2, were implemented into the PBPK model with considerations for EGFR expression and cetuximab-EGFR interaction to predict the disposition of cetuximab in individual tumors (a priori). The incorporation of the Ktrans MRI parameter as a covariate on the PBPK parameters QTU and σTUV decreased the PBPK model prediction error for cetuximab tumor pharmacokinetics from 223.71 to 65.02%. DCE-MRI may be a useful clinical tool in improving the prediction of antibody pharmacokinetics in solid tumors. Further studies are warranted to evaluate the utility of the DCE-MRI approach to additional mAbs and additional drug modalities.

"Dynamic contrast-enhanced scans were opened in [http://www.slicer.org '''3D Slicer'''], and tumor regions were defined using the segmentation editor."
|}

==Distribution of Electric Field in Patients With Obsessive Compulsive Disorder Treated With Deep Brain Stimulation of the Bed Nucleus of Stria Terminalis==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/34652518 Acta Neurochir (Wien). 2022 Jan;164(1):193-202. PMID: 34652518] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8761125/pdf/701_2021_Article_4991.pdf PDF]

'''Authors:''' Naesström M, Johansson J, Hariz M, Bodlund O, Wårdell K, Blomstedt P.

'''Institution:''' Division of Psychiatry, Department of Clinical Sciences, Umea University, Umea, Sweden

'''Abstract:''' Background: Deep brain stimulation (DBS) is being investigated as a treatment for therapy-refractory obsessive compulsive disorder (OCD). Many different brain targets are being trialled. Several of these targets such as the ventral striatum (including the nucleus accumbens (NAc)), the ventral capsule, the inferior thalamic peduncle, and the bed nucleus of stria terminalis (BNST)) belong to the same network, are anatomically very close to one another, or even overlap. Data is still missing on how various stimulation parameters in a given target will affect surrounding anatomical areas and impact the clinical outcome of DBS.

Methods: In a pilot study of eleven participants with DBS of the BNST, we investigate through patient-specific simulation of electric field, which anatomical areas are affected by the electric field, and if this can be related to the clinical results. Our study combined individual patient's stimulation parameters at 12- and 24-month follow-up with image data from the preoperative MRI and postoperative CT. These data were used to calculate the distribution of electric field and create individual anatomical models of the field of stimulation.

Results: The individual electric stimulation fields by stimulation in the BNST were similar at both the 12- and 24-month follow-up, involving mainly anterior limb of the internal capsule (ALIC), genu of the internal capsule (IC), BNST, fornix, anteromedial globus pallidus externa (GPe), and the anterior commissure. A statistical significant correlation (p < 0.05) between clinical effect measured by the Yale-Brown Obsessive Compulsive Scale and stimulation was found at the 12-month follow-up in the ventral ALIC and anteromedial GPe.

Conclusions: Many of the targets under investigation for OCD are in anatomical proximity. As seen in our study, off-target effects are overlapping. Therefore, DBS in the region of ALIC, NAc, and BNST may perhaps be considered to be stimulation of the same target.

"The results were visualized in [http://www.slicer.org '''3D Slicer'''] v.4.6.2"
|}

==Finite Element Analysis in Clinical Patients With Atherosclerosis==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/34740008 J Mech Behav Biomed Mater. 2022 Jan;125:104927. PMID: 34740008]

'''Authors:''' Noble C, Carlson KD, Neumann E, Lewis B, Dragomir-Daescu D, Lerman A, Erdemir A, Young MD.

'''Institution:''' Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA.

'''Abstract:''' Endovascular plaque composition is strongly related to stent strut stress and is responsible for strut fatigue, stent failure, and possible in-stent restenosis. To evaluate the effect of plaque on artery wall resistance to expansion we performed in silico analysis of atherosclerotic vessels. We generated finite element models from in vivo intravascular ultrasound virtual histology images to determine local artery surface stiffness and determined which plaque structures have the greatest influence. We validated the predictive capacity of our modeling approach by testing an atherosclerotic peripheral artery ex vivo with pressure-inflation testing at physiological pressures ranging from 10 to 200 mmHg. For this purpose, the in silico deformation of the arterial wall was compared to that observed ex vivo. We found that calcification had a positive effect on surface stiffness with fibrous plaque and necrotic core having negative effects. Additionally, larger plaque structures demonstrated significantly higher average surface stiffness and calcification located nearer the lumen was also shown to increase surface stiffness. Therefore, more developed plaques will have greater resistance to expansion and higher stent strut stress, with calcification located near the lumen further increasing stress in localized areas. Thus, it may be expected that such plaque structures may increase the likelihood of localized stent strut fracture.

"Using the segment editor module in [http://www.slicer.org '''3D Slicer'''], the high intensity pixels (representing primarily the artery wall) were segmented using the “threshold” effect."
|}

==Predictive Value of Thrombus Susceptibility for Cardioembolic Stroke by Quantitative Susceptibility Mapping==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/34993100 Quant Imaging Med Surg. 2022 Jan;12(1):550-7. PMID: 34993100] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8666785/pdf/qims-12-01-550.pdf PDF]

'''Authors:''' Chen J, Zhang Z, Nie X, Xu Y, Liu C, Zhao X, Wang Y.

'''Institution:''' Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.

'''Abstract:''' Background: The hypointense blooming signal of thrombi on susceptibility-weighted imaging (SWI), known as the susceptibility vessel sign (SVS), is predictive of cardioembolic stroke. The SVS originates from the local magnetic susceptibility effect; thus, the susceptibility value of thrombi may provide useful information in discriminating stroke etiology. We aim to utilize quantitative susceptibility mapping (QSM) to assess thrombus's susceptibility value in acute ischemic stroke patients and explore the relationship of thrombus susceptibility with cardioembolic stroke.

Methods: From 2018 to 2020, 132 consecutive acute ischemic stroke patients with middle cerebral artery occlusion were recruited within 48 hours of onset. All patients underwent a three-dimensional multi-echo SWI scan using a 3 Tesla magnetic resonance imaging scanner. The SVS presence and the diameter of the SVS-related hypointense signal were assessed on SWI. QSM was applied to compute the susceptibility value of the thrombus. The receiver operating characteristic (ROC) methodology was used to define the optimal cutoff value of the susceptibility in QSM and the diameter on SWI for predicting cardioembolic stroke.

Results: The SVS was identified in 93 (70.5%) patients with symptomatic middle cerebral artery occlusion and was significantly associated with cardioembolism. The hyperintense signal on QSM in the corresponding middle cerebral artery occlusion was present in 116 (87.9%) patients. ROC analysis indicated that thrombus susceptibility had a greater area under the curve than that of the SVS diameter (0.88 vs. 0.70, P<0.001) and that the optimal cutoff value of thrombus susceptibility for cardioembolism was 0.35 ppm. Multivariate analysis demonstrated that thrombus susceptibility (≥0.35 ppm) was an independent predictor of cardioembolic stroke (odds ratio =20.75; 95% CI, 7.19-59.87; P<0.001), with sensitivity, specificity, a positive predictive value, and a negative predictive value of 85.2%, 80.8%, 75.4%, and 88.7%, respectively, while the SVS presence showed sensitivity, specificity, a positive predictive value, and a negative predictive value of 90.7%, 43.6%, 87.2%, and 52.7%, respectively.

Conclusions: Thrombus susceptibility provides superior diagnostic performance over the SVS for discriminating between cardioembolism and other stroke subtypes. Quantitative susceptibility measurements of thrombi may help predict cardioembolic stroke in patients with acute middle cerebral artery occlusion.

"The thrombus susceptibility value [in units of parts per million (ppm)] and thrombus volume of the ROIs were extracted using the [http://www.slicer.org '''3D Slicer'''] quantification module."
|}

==Knee Joint Unloading and Daily Physical Activity Associate With Cartilage T2 Relaxation Times 1 Month After ACL Injury==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/33783030 J Orthop Res. 2022 Jan;40(1):138-49. PMID: 33783030] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8751300/pdf/13014_2021_Article_1978.pdf PDF]

'''Authors:''' Wellsandt E, Kallman T, Golightly Y, Podsiadlo D, Dudley A, Vas S, Michaud K,
Tao M, Sajja B, Manzer M.

'''Institution:''' Division of Physical Therapy Education, University of Nebraska Medical Center, Omaha, NE, USA.

'''Abstract:''' Osteoarthritis (OA) is prevalent after anterior cruciate ligament (ACL) injury, but mechanisms underlying its development are poorly understood. The purpose of this study was to determine if gait biomechanics and daily physical activity (PA) associate with cartilage T2 relaxation times, a marker of collagen organization and water content, 1 month after ACL injury. Twenty-seven participants (15-35 years old) without chondral lesions completed magnetic resonance imaging, three-dimensional gait analysis, and 1 week of PA accelerometry. Interlimb differences and ratios were calculated for gait biomechanics and T2 relaxation times, respectively. Multiple linear regression models adjusted for age, sex, and concomitant meniscus injury were used to determine the association between gait biomechanics and PA with T2 relaxation times, respectively. Altered knee adduction moment (KAM) impulse, less knee flexion excursion (kEXC) and higher daily step counts accounted for 35.8%-65.8% of T2 relaxation time variation in the weightbearing and posterior cartilage of the medial and lateral compartment (all p ≤ .011). KAM impulse was the strongest factor for T2 relaxation times in all models (all p ≤ .001). Lower KAM impulse associated with longer T2 relaxation times in the injured medial compartment (β = -.720 to -.901) and shorter T2 relaxation in the lateral compartment (β = .713 to .956). At 1 month after ACL injury, altered KAM impulse, less kEXC, and higher PA associated with longer T2 relaxation times, which may indicate poorer cartilage health. Statement of Clinical Significance: Gait biomechanics and daily PA are modifiable targets that may improve cartilage health acutely after ACL injury and slow progression to OA.

"Before uninjured segmentation, a manual and affine registration technique was used to register the injured reference images to the uninjured knee using [http://www.slicer.org '''3D Slicer'''] software."
|}

==Low-Dose Lung Radiation Therapy for COVID-19 Lung Disease: A Preclinical Efficacy Study in a Bleomycin Model of Pneumonitis==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/34478832 Int J Radiat Oncol Biol Phys. 2022 Jan 1;112(1):197-211. PMID: 34478832] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8406661/pdf/main.pdf PDF]

'''Authors:''' Jackson MR, Stevenson K, Chahal SK, Curley E, Finney GE, Gutierrez-Quintana
R, Onwubiko E, Rupp A, Strathdee K, Williams K, MacLeod MKL, McSharry C,
Chalmers AJ.

'''Institution:''' Institute of Cancer Sciences, University of Glasgow, UK.

'''Abstract:''' Purpose: Low-dose whole lung radiation therapy (LDLR) has been proposed as a treatment for patients with acute respiratory distress syndrome associated with SARS-CoV-2 infection, and clinical trials are underway. There is an urgent need for preclinical evidence to justify this approach and inform dose, scheduling, and mechanisms of action.

Methods and materials: Female C57BL/6 mice were treated with intranasal bleomycin sulfate (7.5 or 11.25 units/kg, day 0) and then exposed to whole lung radiation therapy (0.5, 1.0, or 1.5 Gy, or sham; day 3). Bodyweight was measured daily, and lung tissue was harvested for histology and flow cytometry on day 10. Computed tomography lung imaging was performed before radiation (day 3) and pre-endpoint (day 10).

Results: Bleomycin caused pneumonitis of variable severity, which correlated with weight loss. LDLR at 1.0 Gy was associated with a significant increase in the proportion of mice recovering to 98% of initial bodyweight, and a proportion of these mice exhibited less severe histopathologic lung changes. Mice experiencing moderate initial weight loss were more likely to respond to LDLR than those experiencing severe initial weight loss. In addition, LDLR (1.0 Gy) significantly reduced bleomycin-induced increases in interstitial macrophages, CD103+ dendritic cells (DCs), and neutrophil-DC hybrids. Overall, bleomycin-treated mice exhibited significantly higher percentages of non aerated lung in left than right lungs, and LDLR (1.0 Gy) limited further reductions in aerated lung volume in right but not left lungs. LDLR at 0.5 and 1.5 Gy did not improve bodyweight, flow cytometric, or radiologic readouts of bleomycin-induced pneumonitis.

Conclusions: Our data support the concept that LDLR can ameliorate acute inflammatory lung injury, identify 1.0 Gy as the most effective dose, and provide evidence that it is more effective in the context of moderate than severe pneumonitis. Mechanistically, LDLR at 1.0 Gy significantly suppressed bleomycin-induced accumulation of pulmonary interstitial macrophages, CD103+ DCs, and neutrophil-DC hybrids.

"Images were analyzed using the Lung CT analyzer module from the [http://www.slicer.org '''3D Slicer'''] software extension SlicerCIP."
|}

==Knee Cartilage T2 Relaxation Times 3 Months After ACL Reconstruction Are Associated With Knee Gait Variables Linked to Knee Osteoarthritis==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/33783867 J Orthop Res. 2022 Jan;40(1):252-9. PMID: 33783867]

'''Authors:''' Williams JR, Neal K, Alfayyadh A, Lennon K, Capin JJ, Khandha A, Manal K,
Potter HG, Snyder-Mackler L, Buchanan TS.

'''Institution:''' Department of Mechanical Engineering, University of Delaware, Newark, DE, USA.

'''Abstract:''' Osteoarthritis development after ACL reconstruction (ACLR) is not well understood. Investigators have examined associations between knee biomechanical alterations and quantitative MRI (qMRI) variables, reflective of cartilage health, 12-60 months following ACLR; however, none have done so early after surgery. As part of an exploratory study, 45 individuals (age, 23 ± 7 years) underwent motion analysis during walking and qMRI 3 months after ACLR. For each limb, peak knee adduction moment (pKAM) and peak knee flexion moment (pKFM) were determined using inverse dynamics and peak medial compartment force was calculated using a neuromusculoskeletal model. T2 relaxation times in the medial compartment and linear regressions were used to determine the associations between gait variables and deep and superficial cartilage T2 relaxation times in six regions. pKAM was positively associated with deep layer T2 relaxation times within the femoral central and posterior regions when examined in the involved limb and from an interlimb difference perspective (involved limb - uninvolved limb). After adjusting for age, the association between interlimb difference of pKAM and interlimb difference of deep layer T2 relaxation times in the tibial central region became significant (p = .043). Interlimb difference of pKFM was negatively associated with interlimb difference of deep layer T2 relaxation times within the femoral central and posterior regions. These associations suggest that degenerative pathways leading to osteoarthritis may be detectable as early as 3 months after reconstruction. Preventative therapeutic techniques may need to be employed early in the rehabilitation process to prevent cartilage degradation.

"All images were analyzed using the [http://www.slicer.org '''3D Slicer'''] software."
|}

==Prognostic Value of Tumor Measurement Parameters and SCC-Ag Changes in Patients With Locally-Advanced Cervical Cancer==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35012582 Radiat Oncol. 2022 Jan 10;17(1):6. PMID: 35012582] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8751300/pdf/13014_2021_Article_1978.pdf PDF]

'''Authors:''' Chen W, Xiu S, Xie X, Guo H, Xu Y, Bai P, Xia X.

'''Institution:''' Department of Radiation Oncology, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fujian, China.

'''Abstract:''' Objective: To investigate the prognostic relevance of specific measurement parameters such as tumor diameter, tumor volume, tumor volume reduction rate (TVRR), and changes in the squamous cell carcinoma antigen (SCC-Ag) level in patients with locally-advanced cervical cancer (LACC) undergoing concurrent radiotherapy and chemotherapy.

Methods: This was a retrospective study of 203 patients with stage IIA-IVA cervical squamous cell carcinoma who were newly diagnosed at our hospital between January 2011 and March 2015. Clinical data and pre-and post-treatment imaging information were collected and each parameter was calculated using [http://www.slicer.org '''3D Slicer'''] software. The pre/post-treatment tumor diameter (TDpre/post), tumor volume (TVpre/post), SCC-Ag (SCCpre/post), and TVRR, SCC-Ag reduction rate (SCCRR) were analyzed and their prognostic relevance evaluated.

Results: The median follow-up was 69 months. The 5-year overall survival (OS) and disease progression-free survival (PFS) rates were 69.5% and 64.5%, respectively. On univariate analysis, TDpre/post, TVpre/post, TVRR, SCCpre/post and SCCRR showed significant association with OS and PFS (P < 0.05). On multivariate analysis, TDpre [Hazard ratio (HR) = 0.373, P = 0.028], TDpost (HR = 0.376, P = 0.003) and SCCpost (HR = 0.374, P = 0.001) were independent predictors of OS. TVRR (HR = 2.998, P < 0.001), SCCpre (HR = 0.563, P = 0.041), and SCCpost (HR = 0.253, P < 0.001) were independent predictors of PFS. Tumor measurement parameters showed a positive correlation with SCC-Ag (P < 0.05).

Conclusion: TDpre/post, TVpre/post, TVRR, SCCpre/post, and SCCRR were prognostic factors in LACC. TDpre/post and SCCpost showed the most significant prognostic value. TVRR and SCCpre/post were closely related to disease progression. Further studies should investigate the correlation between measurement parameters of tumor and SCC-Ag.
|}

==MRI Radiomic Features-Based Machine Learning Approach to Classify Ischemic Stroke Onset Time==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/34218292 J Neurol. 2022 Jan;269(1):350-60. PMID: 34218292]

'''Authors:''' Zhang YQ, Liu AF, Man FY, Zhang YY, Li C, Liu YE, Zhou J, Zhang AP, Zhang YD, Lv J, Jiang WJ.

'''Institution:''' Department of Vascular Neurosurgery, New Era Stroke Care and Research Institute, The PLA Rocket Force Characteristic Medical Center, Beijing, China.

'''Abstract:''' Purpose: We aimed to investigate the ability of MRI radiomics features-based machine learning (ML) models to classify the time since stroke onset (TSS), which could aid in stroke assessment and treatment options.

Methods: This study involved 84 patients with acute ischemic stroke due to anterior circulation artery occlusion (51 in the training cohort and 33 in the independent test cohort). Region of infarct segmentation was manually outlined by [http://www.slicer.org '''3D Slicer'''] software. Image processing including registration, normalization and radiomics features calculation were done in R (version 3.6.1). A total of 4312 radiomic features from each image sequence were captured and used in six ML models to estimate stroke onset time for binary classification (≤ 4.5 h). Receiver-operating characteristic curve (ROC) and other parameters were calculated to evaluate the performance of the models in both training and test cohorts.

Results: Twelve radiomics and six clinic features were selected to construct the ML models for TSS classification. The deep learning model-based DWI/ADC radiomic features performed the best for binary TSS classification in the independent test cohort, with an AUC of 0.754, accuracy of 0.788, sensitivity of 0.952, specificity of 0.500, positive predictive value of 0.769, and negative predictive value of 0.857, respectively. Furthermore, adding clinical information did not improve the performance of the DWI/ADC-based deep learning model. The TSS prediction models can be visited at: http://123.57.65.199:3838/deeptss/ .

Conclusions: A unique deep learning model based on DWI/ADC radiomic features was constructed for TSS classification, which could aid in decision making for thrombolysis in patients with unknown stroke onset.
|}

==Translation and Rotation Analysis Based on Stress MRI for the Diagnosis of Anterior Cruciate Ligament Tears==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/34993076/ Quant Imaging Med Surg. 2022 Jan; 12(1): 257–68. PMID: 34993076] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8666731/pdf/qims-12-01-257.pdf PDF]

'''Authors:''' Klon W, Domżalski M, Malinowski K,Sadlik B

'''Institution:''' St Luke’s Hospital, Bielsko-Biała, Poland.

'''Abstract:''' Due to the increasing need for a detailed biomechanical analysis of anterior cruciate ligament (ACL) lesions, the aim of the study was to develop a method of direct measurement of the three-dimensional tibial translation and rotation based on stress MRI.

Methods
For the purpose of the study, thirty patients with acute ACL rupture and 17 healthy control subjects were selected. Based on clinical examination, they were qualified for MRI examination using the Arthroholder Device prototype to perform anterior tibial translation. Each examination was performed at 30° of knee flexion, initially without tibia translation and then using the force applied to the calf of 80 N. The femur and tibia were separately registered using rigid local SimpleITK landmark refinement; translation and rotation parameters were then calculated using the 3D transformation algorithms. The significance level was set at 0.05.

Results
Initially, the device and method for obtaining the parameters of the 3D translation and rotation were validated. The pooled Standard Deviation for translation parameters was 0.81 mm and for rotation parameters 0.87°. Compared to the control group, statistically significant differences were found in parameters such as Anterior Shift [(median ± interquartile range) 3.89 mm ±6.55 vs. 0.90 mm ±2.78, P=0.002238] and External Rotation (−0.55° ±3.88 vs. −2.87° ±2.40, P=0.005074). Statistically significant correlations were observed in combined groups between Anterior Shift and parameters such as External Rotation (P=0.001611), PCL Tibial Attachment Point (pPCL) Anterior Shift (<0.000001), Rolimeter Measurement (P=0.000016), and Side-to-Side Difference (SSD) (P=0.000383). A significant statistical correlation was also observed between External Rotation and parameters such as Rolimeter (P=0.02261) and SSD (P=0.03458).

Conclusions
The analysis of the anterior tibia translation using stress MRI and the proposed three-dimensional calculation method allows for a detailed analysis of the tibial translation and rotation parameters. The correlations showed the importance of external rotation during anterior tibial translation.
|}

==The Relationship of LDH and Hematological Parameters with Ischemic Volume and Prognosis in Cerebrovascular Disease==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/34983146 J Coll Physicians Surg Pak. 2022 Jan;32(1):42-5. PMID: 34983146]

'''Authors:''' Alatlı T, Kocaoglu S, Akay E.

'''Institution:''' Department of Emergency, Faculty of Medicine, Balikesir University, Balikesir, Turkey.

'''Abstract:''' Objective: To determine whether lactate dehydrogenase (LDH), platelet-lymphocyte ratio (PLR), neutrophil-lymphocyte ratio (NLR), and lymphocyte-monocyte ratio (LMR) values can be used as a prediction for their relationship with stroke volume (SV) and for in-hospital mortality in stroke patients in Emergency Department (ED).

Study design: Analytical study.

Place and duration of study: Balikesir University, Turkey from 24/03/2021 to 30/06/2021.

Methodology: Patients aged 18 years or older, diagnosed with stroke in ED, were included in the study. Stroke volumes were calculated from diffusion-weighted images (DWi) with [http://www.slicer.org '''3D Slicer'''] software using image-based semi-automatic and manual segmentation methods.

Results: Of the 265 patients, 128 (48.3%) were males. SV was significantly higher in the non-survivor group than in the survivor group (p=0.007). NLR was significantly higher in the non-survivor group than in the survivor group (p=0.018).

Conclusion: The ratios of NLR and SV stand out as practical parameters for the estimation of mortality, prognosis, and management of patients diagnosed with acute stroke. Taking into account, these parameters in the diagnosis process and prognosis management in EDs will provide convenience.
|}

Main Page/SlicerCommunity/2023

2023-07-25T16:56:14Z

Marianna: /* Magnetic Resonance Imaging in Naso-Oropharyngeal Carcinoma: Role of Texture Analysis in the Assessment of Response to Radiochemotherapy, a Preliminary Study */

{{:Main_Page/SlicerCommunity}}

__TOC__

=2023=
==Dosimetric Assessment of Gadolinium-159 for Hepatic Radioembolization: Tomographic Images and Monte Carlo Simulation==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37393764 Appl Radiat Isot. 2023 Sep;199:110916. PMID: 37393764]

'''Authors:''' Musa AS, Abdul Hadi MFR, Hashikin NAA, Ashour NI, Ying CK.

'''Institution:''' School of Physics, Universiti Sains Malaysia, Penang, Malaysia.

'''Abstract:'''
A common therapeutic radionuclide used in hepatic radioembolization is yttrium-90 (90Y). However, the absence of gamma emissions makes it difficult to verify the post-treatment distribution of 90Y microspheres. Gadolinium-159 (159Gd) has physical properties that are suitable for therapy and post-treatment imaging in hepatic radioembolization procedures. The current study is innovative for conducting a dosimetric investigation of the use of 159Gd in hepatic radioembolization by simulating tomographic images using the Geant4 application for tomographic emission (GATE) Monte Carlo (MC) simulation. For registration and segmentation, tomographic images of five patients with hepatocellular carcinoma (HCC) who had undergone transarterial radioembolization (TARE) therapy were processed using a [http://www.slicer.org '''3D Slicer''']. The tomographic images with 159Gd and 90Y separately were simulated using the GATE MC Package. The output of simulation (dose image) was uploaded to [http://www.slicer.org '''3D Slicer'''] to compute the absorbed dose for each organ of interests. 159Gd were able to provide a recommended dose of 120 Gy to the tumour, with normal liver and lungs absorbed doses close to that of 90Y and less than the respective maximum permitted doses of 70 Gy and 30 Gy, respectively. Compared to 90Y, 159Gd requires higher administered activity approximately 4.92 times to achieve a tumour dose of 120 Gy. Thus; this research gives new insights into the use of 159Gd as a theranostic radioisotope, with the potential to be used as a90Y alternative for liver radioembolization.
|}

==Augmented Reality Presentation of the Extracranial Facial Nerve: An Innovation in Parotid Surgery==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37328316 Br J Oral Maxillofac Surg. 2023 Jul;61(6):428-36. PMID: 37328316]

'''Authors:''' Saadya A, Chegini S, Morley S, McGurk M.

'''Institution:''' University College London Hospital, UK.

'''Abstract:'''
Surgeons used to be unaware of the facial nerve's position during parotid surgery. Now, with special magnetic resonance imaging (MRI) sequences, it can be located and converted into a 3D model displayed on an augmented reality (AR) device for surgeons to study and manipulate. This study explores the accuracy and usefulness of the technique for the treatment of benign and malignant parotid tumours. A total of 20 patients with parotid tumours had 3-Tesla MRI scans, and their anatomical structures were segmented using [http://www.slicer.org '''3D Slicer'''] software. The structures were imported into a Microsoft HoloLens 2® device, displayed in 3D, and shown to the patient for consent. Intraoperative video recording was used to record the position of the facial nerve in relation to the tumour. The predicted path of the nerve taken from the 3D model was combined with surgical observation and video recording in all cases. The imaging proved to have application in both benign and malignant disease. It also improved the process of informed patient consent. Three-dimensional MRI imaging of the facial nerve within the parotid gland and its display in a 3D model is an innovative technique for parotid surgery. Surgeons can now see the nerve's position and tailor their approach to each patient's tumour, providing personalised care. The technique eliminates the surgeon's blind spot and is a significant advantage in parotid surgery.
|}

==Magnetic Resonance Imaging in Naso-Oropharyngeal Carcinoma: Role of Texture Analysis in the Assessment of Response to Radiochemotherapy, a Preliminary Study==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37336860/ Radiol Med. 2023 Jul;128(7):839-52. PMID: 37336860] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10317900/pdf/11547_2023_Article_1653.pdf PDF]

'''Authors:''' Bicci E, Nardi C, Calamandrei L, Barcali E, Pietragalla M, Calistri L, Desideri I, Mungai F, Bonasera L, Miele V.

'''Institution:''' Department of Experimental and Clinical Biomedical Sciences, Radiodiagnostic Unit #2, University of Florence, Florence, Italy.

'''Abstract:'''
Objective: Identifying MRI texture parameters able to distinguish inflammation, fibrosis, and residual cancer in patients with naso-oropharynx carcinoma after radiochemotherapy (RT-CHT).

Material and methods: In this single-centre, observational, retrospective study, texture analysis was performed on ADC maps and post-gadolinium T1 images of patients with histological diagnosis of naso-oropharyngeal carcinoma treated with RT-CHT. An initial cohort of 99 patients was selected; 57 of them were later excluded. The final cohort of 42 patients was divided into 3 groups (inflammation, fibrosis, and residual cancer) according to MRI, 18F-FDG-PET/CT performed 3-4 months after RT-CHT, and biopsy. Pre-RT-CHT lesions and the corresponding anatomic area post-RT-CHT were segmented with [http://www.slicer.org '''3D Slicer'''] software from which 107 textural features were derived. T-Student and Wilcoxon signed-rank tests were performed, and features with p-value < 0.01 were considered statistically significant. Cut-off values-obtained by ROC curves-to discriminate post-RT-CHT non-tumoural changes from residual cancer were calculated for the parameters statistically associated to the diseased status at follow-up.

Results: Two features-Energy and Grey Level Non-Uniformity-were statistically significant on T1 images in the comparison between 'positive' (residual cancer) and 'negative' patients (inflammation and fibrosis). Energy was also found to be statistically significant in both patients with fibrosis and residual cancer. Grey Level Non-Uniformity was significant in the differentiation between residual cancer and inflammation. Five features were statistically significant on ADC maps in the differentiation between 'positive' and 'negative' patients. The reduction in values of such features between pre- and post-RT-CHT was correlated with a good response to therapy.

Conclusions: Texture analysis on post-gadolinium T1 images and ADC maps can differentiate residual cancer from fibrosis and inflammation in early follow-up of naso-oropharyngeal carcinoma treated with RT-CHT.
|}

==BabelBrain: An Open-Source Application for Prospective Modeling of Transcranial Focused Ultrasound for Neuromodulation Applications==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37155375/ IEEE Trans Ultrason Ferroelectr Freq Control. 2023 Jul;70(7):587-99. PMID: 37155375]

'''Authors:''' Pichardo S.

'''Institution:''' Department of Radiology, University of Calgary, Calgary, Canada.

'''Abstract:'''
BabelBrain is an open-source standalone graphic-user-interface application designed for studies of neuromodulation using transcranial-focused ultrasound (FUS). It calculates the transmitted acoustic field in the brain tissue, taking into account the distortion effects caused by the skull barrier. The simulation is prepared using scans from magnetic resonance imaging (MRI) and, if available, computed tomography (CT) and zero-echo time MRI scans. It also calculates the thermal effects based on a given ultrasound regime, such as the total duration of exposure, the duty cycle, and acoustic intensity. The tool is designed to work in tandem with neuronavigation and visualization software, such as [http://www.slicer.org '''3D Slicer''']. It uses image processing to prepare domains for ultrasound simulation and uses the BabelViscoFDTD library for transcranial modeling calculations. BabelBrain supports multiple GPU backends, including Metal, OpenCL, and CUDA, and works on all major operating systems including Linux, macOS, and Windows. This tool is particularly optimized for Apple ARM64 systems, which are common in brain imaging research. The article presents the modeling pipeline used in BabelBrain and a numerical study where different methods of acoustic properties mapping were tested to select the best method that can reproduce the transcranial pressure transmission efficiency reported in the literature.
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==Volumetric Analysis of the Sinus and Orbit in Silent Sinus Syndrome After Endoscopic Sinus Surgery==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/36939460/ Otolaryngol Head Neck Surg. 2023 Jul;169(1):151-156. PMID: 36939460]

'''Authors:'''
Amin D, Chitguppi C, Xu V, Haghshenas C, Gorniak R, Rabinowitz M, Toskala E, Rosen M, Nyquist G.

'''Institution:''' Department of Otolaryngology-Head & Neck Surgery, Thomas Jefferson University, Philadelphia, PA, USA.

'''Abstract:'''
Objective: The term "silent sinus syndrome" (SSS) describes spontaneous enophthalmos secondary to subclinical maxillary sinus atelectasis. Debate remains on whether treatment with endoscopic maxillary antrostomy alone is adequate in reversing atelectasis and globe displacement. This study aims to determine the degree of volume change of the diseased sinus and orbit as well as the change in orbital height in patients treated with endoscopic antrostomy without orbital floor augmentation.

Study design: Retrospective review with image analysis.

Setting: Single tertiary care institution.

Methods: Three-dimensional (3D) analysis of computed tomographic imaging data was performed using [http://www.slicer.org '''3D Slicer''']. 3D models of the maxillary sinus and orbit of the diseased and normal sides were created, and volume measurements were calculated using the segmentation program.

Results: Thirteen patients with SSS who underwent endoscopic sinus surgery (ESS) and had follow-up computed tomographic imaging were analyzed. After endoscopic antrostomy, the mean volume of the diseased maxillary sinus significantly increased by 9.82%, from 6.37 to 7.00 cm3 (p = .0302). There was no significant change in mean orbital volume; however, the mean orbital height decreased by 5.67%, from 38.09 to 35.93 mm from pretreatment to posttreatment samples (p = .0101). All patients had resolution of clinical or radiographic enophthalmos and orbital displacement with ESS alone.

Conclusion: Endoscopic maxillary antrostomy alone in the treatment of SSS significantly increased maxillary sinus volume and decreased diseased orbital height. These changes were associated with clinical and radiographic improvement in globe displacement. These findings support performing ESS alone, reserving orbital augmentation for patients who do not exhibit adequate clinical improvement.
|}

==Safety and Efficacy of Thoracic Endovascular Aortic Repair for Acute Stanford Type B Aortic Dissection With Retrograde Type a Intramural Hematoma==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/36921645/ J Vasc Surg. 2023 Jul;78(1):61-69.e4. PMID: 36921645] | [https://www.jvascsurg.org/action/showPdf?pii=S0741-5214%2823%2900438-X PDF]

'''Authors:''' Wang J, Li M, Li J, He H, Zhou Y, Li X, Li Q, Gu F, Ye Z, Dardik A, Shu C.

'''Institution:''' Department of Vascular Surgery, Second Xiangya Hospital, Central South University, Changsha, China; Institute of Vascular Diseases, Central South University, Changsha, China.

'''Abstract:'''
Objective: The aim of this study was to evaluate safety and efficacy of thoracic endovascular aortic repair (TEVAR) for acute Stanford type B aortic dissection (TBAD) with retrograde type A intramural hematoma (TAIMH).

Methods: Patients with acute TBAD with retrograde TAIMH treated with TEVAR between January 1, 2014, to March 31, 2022, were retrospectively reviewed. Aortic diameter and distance were measured using the [http://www.slicer.org '''3D Slicer'''] image computing platform. Patients' characteristics, procedural, in-hospital and follow-up data, and aortic remodeling were analyzed.

Results: Fifty-two patients (average age, 52.6 years; 42 males [80.8%]) were included. The median interval from symptom onset to TEVAR was 11 days (interquartile range, 7.0-16.8 days). The maximal diameter of the ascending aorta (AA) was <50 mm, and the hematoma thickness in the AA was ≤10 mm in all patients. Both the in-hospital and 30-day mortality rates were 0%. The 30-day complication rate was 11.5%. The overall cumulative survival rates were 100% at 1 year, 97.1% at 3 years, and 92.6% at 5 years. Four of 52 patients (7.7%) developed retrograde type A aortic dissection at 10 days to 4 months postoperatively, and one of 52 patients (1.9%) developed an isolated AA dissection 4 months postoperatively; these five patients were treated and alive at late follow-up in March 2022. The rates of cumulative freedom from thoracic aortic re-intervention were 93.7% at 1 year and 90.7% at 5 years. Positive AA remodeling was observed in 92.3% (48/52) of patients during follow-up. The maximal diameter of AA (mean ± standard error of mean) at admission was 42.7 ± 0.8 mm, which decreased to 39.5 ± 0.9 mm at last follow-up. The maximal AA hematoma thickness at admission was 7.6 ± 0.3 mm, which reduced to 2.2 ± 0.9 mm at last follow-up.

Conclusions: For selected patients of acute Stanford TBAD with retrograde TAIMH, endovascular repair may be a safe, effective, and durable alternative treatment, if the maximum diameter of the AA is <50 mm and the intramural hematoma thickness in the AA is ≤10 mm.
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==The Traction Force of the Pulled Limb in Hip Arthroscopic Surgery Is Determined by Stiffness Coefficient Which Is Significantly Related to Muscle Volume==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/36477348/ Knee Surg Sports Traumatol Arthrosc. 2023 Jul;31(7):2708-2715. PMID: 36477348]

'''Authors:''' Yin Y, Xue S, Zhang X, Yang G, Xu Y, Wang J, Huang H.

'''Institution:''' Department of Sports Medicine, Beijing Key Laboratory of Sports Injuries, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing, People's Republic of China.

'''Abstract:'''
Purpose: To verify the relationship between muscle volume, lateral centre-edge angle (LCEA), alpha angle (AA), body mass index (BMI) and Beighton score with stiffness coefficient (SC). To analyse the difference of traction force at different physical states of hip joint capsule.

Methods: Thirty-six patients who underwent hip arthroscopy operation were included. The volumes of some related muscles were measured in MRI images by [http://www.slicer.org '''3D Slicer''']. We recorded and tested differences in traction force of five joint capsule physical states, including before (State 1) and after joint capsule puncture (State 2), after the establishment of anterolateral and mid-anterior approaches (State 3) and after incision of the joint capsule through these two approaches (States 4, 5). The correlation between muscle volume, BMI, LCEA, AA and SC was verified by Spearman test. Poisson regression was used to explain confounding variables.

Results: The average force at State 1 was 531.8 N. There were significant differences in traction force between these five states (p < 0.001). There was a significant positive correlation between muscle volumes and SC (p < 0.001). BMI had no correlation with SC (n.s.). The preoperative LCEA of the affected side was correlated with SC (p = 0.043). AA and SC were not correlated (n.s.).

Conclusion: The physical states of the hip joint capsule affected traction force. Muscle volume rather than BMI is an ideal index to estimate preoperative traction force. LCEA affected traction force, whilst AA and Beighton score did not. Measuring the muscle volume can help estimate the most suitable traction force for the patient.
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==Three-Dimensional Assessment of Tongue Cancer Prognosis by Preoperative MRI==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/35426211/ Oral Dis. 2023 Jul;29(5):2006-2011. PMID: 35426211]

'''Authors:''' Li C, Zhu L, Guo Y, Ji T, Ren Z.

'''Institution:''' Department of Oral and Maxillofacial Head and Neck Oncology, The Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

'''Abstract:'''
Purpose: To obtain the relative volume by measuring the tongue volume and the lesion volume, and further explore its relationship with the prognosis of patients, hoping to supplement the TNM staging with a new index.

Methods: ITK-SANP software was used to outline the patients' MRI. After MRI reconstruction and measurement, [http://www.slicer.org '''3D Slicer'''] software was used to estimate tumor volume.

Results: A total of 64 patients with tongue cancer who met the inclusion criteria were included in the study. The estimated tumor volume after MRI reconstruction revealed a significant and robust correlation with tumor stage (p < 0.05, Rs = 0.6207) and a substantial and medium correlation with early lymph node metastasis (p < 0.05, Rs = 0.4873).

Conclusions: We classified tongue cancer into three grades based on tumor volume (Stage I, tumors smaller than 1500 mm³; Stage II, tumors 1500-9000 mm³; and Stage III, tumors larger than 9000 mm³), and such grading could be used as a reference for tumor staging, lymph node metastasis, and patient prognosis to a certain extent.
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==Multimodal Measurements of Levator Bowl Volume in Nulligravid Asymptomatic Women: Endovaginal Ultrasound Versus MRI==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36656345 Int Urogynecol J. 2023 Jul;34(7):1627-33. PMID: 36656345]

'''Authors:''' Chill HH, Martin LC, Abramowitch SD, Rostaminia G.

'''Institution:''' Female Pelvic Medicine and Reconstructive Surgery (FPMRS), Division of Urogynecology, University of Chicago, Northshore University HealthSystem, Skokie, IL, USA.

'''Abstract:''' Introduction and hypothesis: Measurements of levator bowl volume using advanced imaging, may be predictive of pelvic floor muscle function. The aim of this study was to compare the volume of the levator bowl using both magnetic resonance imaging (MRI) and endovaginal ultrasound (EVU) of healthy asymptomatic women.

'''Methods:''' All participants underwent a comprehensive interview including completion of the Pelvic Floor Distress Inventory Questionnaire-20 questionnaire, pelvic examination with a pelvic organ prolapse quantification evaluation, MRI, and EVU. The pelvic floor was segmented using [http://www.slicer.org '''3D Slicer'''] and the MRI segmentations were trimmed using two methods: soft-tissue landmarks and the field of view (FOV) of the ultrasound volume. The levator bowl volume of the 3D segmented shapes was measured using Blender's 3D printing toolkit. Normality was tested using the Shapiro-Wilks test and comparisons were made using self-paired t tests.

'''Results:''' The final analysis included 19 patients. Levator bowl volume measured via MRI was larger than that measured in EVU (46.1 ± 7.9 cm3 vs 27.4 ± 5.9 cm3, p<0.001). Reducing the FOV of the MRI to that of EVU caused the MRI volume to be much closer to the EVU volume (35.5 ± 3.3 cm3 vs 27.4 ± 5.9 cm3, p<0.001); however, it remained significantly larger.

'''Conclusion:''' Levator bowl volume measured using MRI was larger than that measured using EVU no matter the method of delineation of the levator muscles. Although EVU is safe, cheap, and easy to perform, it captures a smaller volume of levator bowel than MRI.
|}

==Pectoralis Muscle Area Measured at T4 Level Is Closely Associated With Adverse COVID-19 Outcomes in Hospitalized Patients==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37259659 J Musculoskelet Neuronal Interact. 2023 Jun 1;23(2):196-204. PMID: 37259659] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10233225/pdf/JMNI-23-196.pdf PDF]

'''Authors:''' Tekin ZN, Dogruoz Karatekin B, Dogan MB, Bilgi Z.

'''Institution:''' Istanbul Medeniyet University, Goztepe Prof Dr Suleyman Yalcin City Hospital, Radiology, Istanbul, Turkey.

'''Abstract:'''
Objectives: Skeletal muscle area (SMA) at T4 level on chest computed tomography (CT) is a newly available method that can be used as a surrogate sarcopenia marker. The objective of this study is to evaluate association of SMA with adverse COVID-19 outcomes in hospitalized patients.

Methods: Hospitalized COVID-19 patients were prospectively recorded in a database containing age, gender, date of admission, date of outcome (discharge, mortality, presence of intensive care unit (ICU) stay, additional coding information (comorbidities, superimposed conditions). Admission CT-scans were retrospectively evaluated for segmentation (bilateral pectoralis major/minor, erector spinae, levator scapulae, rhomboideus minor and major and transversospinalis muscles) and SMA calculation using [http://www.slicer.org '''3D Slicer'''] software.

Results: 167 cases were evaluated (68 male, 72 female, 140 survived, 27 dead). Muscle area was lower in patients with ICU stay (p=0.023, p=0.018, p=0.008) and mortality outcome (p=0.004, p=0.007, p=0.002) for pectoralis, back and SMA. In multivariate Cox-regression analysis, hazard ratio (HR) value for the pectoralis muscle area value below 2800 mm2 was found to be 3.138(95% CI: 1.171-8.413) for mortality and 2.361(95% CI: 1.012-5.505) for ICU.

Conclusions: Pectoralis muscle area measured at T4 level with 3-D slicer was closely associated with adverse outcomes (mortality, ICU stay) in hospitalized COVID-19 patients. Since early treatment methods for COVID-19 are being evaluated, this method may be a useful adjunct to clinical decision making in regard to prioritization.
|}

==Precise Location of the Ventricular Catheter Tip in Ventriculoperitoneal Shunt Placement Guided by 3D Printed Individualized Guide==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37086587/ Clin Neurol Neurosurg. 2023 Jun;229:107730. PMID: 37086587]

'''Authors:''' Tian Q, Yi J, Wu Y, Wang S, Qu Y, Cai Q.

'''Institution:''' Department of Neurosurgery, Tangdu hospital, Air Force Medical University, Shaanxi, China.

'''Abstract:'''
Objective: Improper placement of the ventricular catheter tip is the most common cause of shunting disorders after ventriculoperitoneal shunt (VPS) placement surgery. Here, through two illustrative cases, we described a novel method of precise ventricular catheter tip location.

Methods: [http://www.slicer.org '''3D Slicer'''] software was used to define the ventricle puncture path and determine the ventricle catheter tip location preoperatively, and the 3D individualized guide model was printed.

Results: The ventricular puncture was performed under the guidance of the 3D guide to achieve precise ventricle catheter tip location intraoperatively.

Conclusions: This technique is safe, simple, efficient and cost-effective, which facilitates its clinical implementation and promotion.
|}

==PIRET-A Platform for Treatment Planning in Electroporation-Based Therapies==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37015676/ IEEE Trans Biomed Eng. 2023 Jun;70(6):1902-10. PMID: 37015676]

'''Authors:''' Perera-Bel E, Aycock KN, Salameh ZS, Gomez-Barea M, Davalos RV, Ivorra A, Ballester MAG.

'''Institution:''' BCN MedTech, Department of Information and Communication Technologies, Universitat Pompeu Fabra, Barcelona, Spain.

'''Abstract:'''
Tissue electroporation is the basis of several therapies. Electroporation is performed by briefly exposing tissues to high electric fields. It is generally accepted that electroporation is effective where an electric field magnitude threshold is overreached. However, it is difficult to preoperatively estimate the field distribution because it is highly dependent on anatomy and treatment parameters.

Objective: We developed PIRET, a platform to predict the treatment volume in electroporation-based therapies.

Methods: The platform seamlessly integrates tools to build patient-specific models where the electric field is simulated to predict the treatment volume. Patient anatomy is segmented from medical images and 3D reconstruction aids in placing the electrodes and setting up treatment parameters.

Results: Four canine patients that had been treated with high-frequency irreversible electroporation were retrospectively planned with PIRET and with a workflow commonly used in previous studies, which uses different general-purpose segmentation, [http://www.slicer.org '''3D Slicer'''] and modeling software (3Matic and COMSOL Multiphysics). PIRET outperformed the other workflow by 65 minutes (× 1.7 faster), thanks to the improved user experience during treatment setup and model building. Both approaches computed similarly accurate electric field distributions, with average Dice scores higher than 0.93.

Conclusion: A platform which integrates all the required tools for electroporation treatment planning is presented. Treatment plan can be performed rapidly with minimal user interaction in a stand-alone platform.

Significance: This platform is, to the best of our knowledge, the most complete software for treatment planning of irreversible electroporation. It can potentially be used for other electroporation applications.
|}

==Surgically Assisted Maxillary Expansion With or Without Pterygoid Disjunction Alters Maxillomandibular Positioning==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/35426586/ Oral Maxillofac Surg. 2023 Jun;27(2):269-281. PMID: 35426586]

'''Authors:''' Carvalho FSR, Soares ECS, de Medeiros JR, Júnior JMM, Hyppolito JOP, de Barros Silva PG, Ribeiro TR, Costa FWG.

'''Institution:''' Department of Oral and Maxillofacial Surgery, Federal University of Ceará Campus Sobral, Brazil.

'''Abstract:'''
Purpose: This study aimed to analyze alterations in mandibular positioning after surgically assisted maxillary expansion (SARME) with and without pterygoid disjunction (PD).

Methods: Cone-beam computed tomography scans of 24 healthy individuals (18-45 years old) with transverse deficiency, superior to 5 mm, underwent SARME with or without PD. The aspects prospectively assessed were (1) alignment and position of the head (ITK-Snap and [http://www.slicer.org '''3D Slicer'''] software); (2) McNamara's and Steiner-Tweed-Wits' cephalometric analysis (Dolphin Imaging®); and (3) colorimetric evaluation based on 3D correspondence analysis ([http://www.slicer.org '''3D Slicer'''] software).

Results: A decrease in 1-NA and 1-SN angles as well as an increased occlusal plane in both groups was observed. Superior-inferior and anteroposterior spatial displacements of the chin were statistically significant in the PD group. Altered colorimetric patterns were also observed in the PD group.

Conclusions: This study found more evident tooth inclination in the group without PD; mandibular alterations were more evident in the PD group. Further studies with 3D analysis are strongly recommended for more comprehensive results.
|}

==ERCP 2.0: Biliary 3D-Reconstruction in Patients With Malignant Hilar Stricture==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37379653 Clin Res Hepatol Gastroenterol. 2023 Jun 26;47(7):102172. PMID: 37379653]

'''Authors:''' Becq A, Szewczyk J, Salin G, Chartier M, Chaput U, Leenhardt R, Dray X, Arrive L, Camus M.

'''Institution:''' Department of Gastroenterology, Henri-Mondor University Hospital, AP-HP, EA 7375, Université Paris Est Créteil, France.

'''Abstract:'''
Background: Endoscopic retrograde cholangiopancreatography (ERCP) for malignant hilar strictures is challenging. The correlation between Magnetic resonance cholangiopancreatography (MRCP) and per ERCP 2D fluoroscopic images is not obvious. The aim of this study was to evaluate the feasibility and potential usefulness of MRCP-based handmade biliary 3D reconstruction in this setting.

Methods: Methods Patients who underwent MRCP followed by ERCP for biliary drainage of a malignant hilar stricture at our institution between 2018 and 2020 were reviewed. A handmade 3D segmentation using [http://www.slicer.org '''3D Slicer'''] (Kitware, France) was fashioned and reviewed with an expert radiologist. The primary outcome was the feasibility of biliary segmentation.

Results: A total of 16 patients were included. The mean age was 70.1 (+/- 8.6) years-old and 68.8% had hilar cholangiocarcinoma. Handmade segmentation was successful in all cases. The agreement between the MRCP interpretation and the 3D reconstruction was 37.5%, as per the Bismuth classification. 3D reconstruction available prior to ERCP could have helped guide for better stent placement in 11 cases (68.8%).

Conclusions: MRCP-based biliary 3D segmentation-reconstruction, in patients with malignant hilar stricture is feasible and seems to provide a better anatomical understanding compared to MRCP and could help improve endoscopic management.
|}

==3D Printing Personalized Guide Plate in the Management of Recurrent Intramuscular Venous Malformations: A Single Center Experience==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/36967547/ Phlebology. 2023 Jun;38(5):307-314. PMID: 36967547]

'''Authors:''' Han T, Jiang S, Xiong J, Cui J, Shen W.

'''Institution:''' Department of Burns and Plastic Surgery, Children's Hospital of Nanjing Medical University, Nanjing, China.

'''Abstract:'''
Objective: This study aimed to investigate the feasibility and effectiveness of 3D printing personalized guide plate in the management of recurrent intramuscular venous malformations (IVM).

Methods: Fifteen patients with recurrent IVM were retrospectively assessed. [http://www.slicer.org '''3D Slicer'''] software was used to extract and reconstruct the imaging data from CT and/or MRI to highlight the morphology, size, and puncture depth of the lesion. With the guidance of personalized plate, complete excision of the IVM was adopted along the pre-marked (methylene blue, MB) margin.

Results: Personalized guide plate matched involved extremity well, and MB-puncture approach was consistent with preoperative design. All IVMs were removed radically in one single session. Complete pain relief was obtained in all cases postoperatively.

Conclusion: The application of 3D printing guide plate can be safe, effective, and reliable to confirming the precise margin of IVM, renders a promising technique with a high practical value in resection of recurrent lesion.
|}

==White Matter Hyperintensities: A Possible Link Between Sarcopenia and Cognitive Impairment in Patients With Mild to Moderate Alzheimer's Disease==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37330930 Eur Geriatr Med. 2023 Jun 18. PMID: 37330930]

'''Authors:''' Weng X, Liu S, Li M, Zhang Y, Zhu J, Liu C, Hu H.

'''Institution:''' Department of Neurology, The Second Affiliated Hospital of Soochow University, Jiangsu, China.

'''Abstract:'''
Purpose: Alzheimer's disease (AD) has been reported to be associated with sarcopenia. White matter hyperintensities (WMH) are common in AD patients. However, the effect of WMH on sarcopenia in AD remains unclear. We hence aimed to investigate the possible association between regional WMH volumes and sarcopenic parameters in AD.

Methods: 57 mild to moderate AD patients and 22 normal controls (NC) were enrolled. Sarcopenic parameters were assessed, including appendicular skeletal mass index (ASMI), grip strength, 5-times sit-to-stand (5-STS) time, and gait speed. The volumes of periventricular hyperintensities (PVH) and deep white matter hyperintensities (DWMH) were quantified using [http://www.slicer.org '''3D Slicer'''] software.

Results: AD subjects exhibited a lower ASMI, a slower gait speed, an increased 5-STS time, and larger volumes of PVH and DWMH than those in the NC group. In AD subjects, total WMH and PVH volumes were related to cognitive impairment, particularly executive function decline. Moreover, total WMH volume and PVH volume were negatively correlated with gait speed across various clinical stages of AD. Multiple linear regression analysis showed that PVH volume was independently associated with 5-STS time and gait speed, whereas DWMH volume was only independently associated with gait speed.

Conclusion: WMH volume was associated with cognitive decline and various sarcopenic parameters. It thereby suggested that WMH may serve as the connection between sarcopenia and cognitive dysfunction in AD. Further studies are needed to confirm these findings and to determine whether sarcopenia interventions reduce WMH volume and improve cognitive function in AD.
|}

==CT Angiography Radiomics Combining Traditional Risk Factors to Predict Brain Arteriovenous Malformation Rupture: a Machine Learning, Multicenter Study==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37311939 Transl Stroke Res. 2023 Jun 13. PMID: 37311939]

'''Authors:''' Zhang S, Wang J, Sun S, Zhang Q, Zhai Y, Wang X, Ge P, Shi Z, Zhang D.

'''Institution:''' Department of Neurosurgery, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.

'''Abstract:'''
This study aimed to develop a machine learning model for predicting brain arteriovenous malformation (bAVM) rupture using a combination of traditional risk factors and radiomics features. This multicenter retrospective study enrolled 586 patients with unruptured bAVMs from 2010 to 2020. All patients were grouped into the hemorrhage (n = 368) and non-hemorrhage (n = 218) groups. The bAVM nidus were segmented on CT angiography images using [http://www.slicer.org '''3D Slicer'''] software, and radiomic features were extracted using Pyradiomics. The dataset included a training set and an independent testing set. The machine learning model was developed on the training set and validated on the testing set by merging numerous base estimators and a final estimator based on the stacking method. The area under the receiver operating characteristic (ROC) curve, precision, and the f1 score were evaluated to determine the performance of the model. A total of 1790 radiomics features and 8 traditional risk factors were contained in the original dataset, and 241 features remained for model training after L1 regularization filtering. The base estimator of the ensemble model was Logistic Regression, whereas the final estimator was Random Forest. In the training set, the area under the ROC curve of the model was 0.982 (0.967-0.996) and 0.893 (0.826-0.960) in the testing set. This study indicated that radiomics features are a valuable addition to traditional risk factors for predicting bAVM rupture. In the meantime, ensemble learning can effectively improve the performance of a prediction model.
|}

==Real-Time Integration Between Microsoft HoloLens 2 and 3D Slicer With Demonstration in Pedicle Screw Placement Planning==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37310561 Int J Comput Assist Radiol Surg. 2023 Jun 13. PMID: 37310561]

'''Authors:''' Pose-Díez-de-la-Lastra A, Ungi T, Morton D, Fichtinger G, Pascau J.

'''Institution:''' Departamento de Bioingeniería, Universidad Carlos III de Madrid, Spain.

'''Abstract:'''
Purpose: Up to date, there has been a lack of software infrastructure to connect [http://www.slicer.org '''3D Slicer'''] to any augmented reality (AR) device. This work describes a novel connection approach using Microsoft HoloLens 2 and OpenIGTLink, with a demonstration in pedicle screw placement planning.

Methods: We developed an AR application in Unity that is wirelessly rendered onto Microsoft HoloLens 2 using Holographic Remoting. Simultaneously, Unity connects to [http://www.slicer.org '''3D Slicer'''] using the OpenIGTLink communication protocol. Geometrical transform and image messages are transferred between both platforms in real time. Through the AR glasses, a user visualizes a patient's computed tomography overlaid onto virtual 3D models showing anatomical structures. We technically evaluated the system by measuring message transference latency between the platforms. Its functionality was assessed in pedicle screw placement planning. Six volunteers planned pedicle screws' position and orientation with the AR system and on a 2D desktop planner. We compared the placement accuracy of each screw with both methods. Finally, we administered a questionnaire to all participants to assess their experience with the AR system.

Results: The latency in message exchange is sufficiently low to enable real-time communication between the platforms. The AR method was non-inferior to the 2D desktop planner, with a mean error of 2.1 ± 1.4 mm. Moreover, 98% of the screw placements performed with the AR system were successful, according to the Gertzbein-Robbins scale. The average questionnaire outcomes were 4.5/5.

Conclusions: Real-time communication between Microsoft HoloLens 2 and 3D Slicer is feasible and supports accurate planning for pedicle screw placement.
|}

==Delirium After Traumatic Brain Injury: Prediction by Location and Size of Brain Lesion==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37317796 Ann Rehabil Med. 2023 Jun 7. PMID: 37317796] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10326395/pdf/arm-23008.pdf PDF]

'''Authors:''' Han SJ, Suh JH, Lee JY, Kim SJ.

'''Institution:''' Department of Rehabilitation Medicine, College of Medicine, Ewha Womans University, Seoul, Korea.

'''Abstract:'''
Objective: To examine (1) the location of brain lesion that would predict post-traumatic delirium and (2) the association between volume of brain lesion and occurrence of delirium in patients with traumatic brain injury (TBI).

Methods: A retrospective study was conducted by reviewing medical records of 68 TBI patients, categorized into two groups: the delirious group (n=38) and non-delirious group (n=30). The location and volume of TBI were investigated with the [http://www.slicer.org '''3D Slicer'''] software.

Results: The TBI region in the delirious group mainly involved the frontal or temporal lobe (p=0.038). All 36 delirious patients had brain injury on the right side (p=0.046). The volume of hemorrhage in the delirious group was larger by about 95 mL compared to the non-delirious group, but this difference was not statistically significant (p=0.382).

Conclusion: Patients with delirium after TBI had significantly different injury site and side, but not lesion size compared to patients without delirium.
|}

==Mitral Paravalvular Leak 3D Printing from 3D-Transesophageal Echocardiography==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37288866 Anatol J Cardiol. 2023 Jun 7. PMID: 37288866] | [https://doi.org/10.14744/AnatolJCardiol.2023.3008 PDF]

'''Authors:''' Jedrzejek M, Kozlowski M, Peszek-Przybyla E, Jadczyk T, Pysz P, Wojakowski W, Smolka G.

'''Institution:''' Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland.

'''Abstract:'''
Background: Paravalvular leaks can be detected in almost 15% of patients after mitral valve prosthesis implantation. This complication can result in congestive heart failure and hemolysis. Despite advancements in non-invasive imaging, percutaneous closure of paravalvular leaks is not always successful. Therefore, efforts are made to improve treatment outcomes by using 3D-printed models of defects as pre-procedural support for interventional cardiologists.

Methods: Retrospectively, 3D-transesophageal echocardiography recordings of 8 patients with clinically significant mitral paravalvular leaks were analyzed. Qlab Software was used to export DICOM images of each paravalvular leak channel, including surrounding tissue. Image segmentation was performed in [http://www.slicer.org '''3D Slicer'''], a free, open-source software package used for imaging research. Models were printed to actual size with the poly jet Stratasys Objet 30 printer with a transparent, rigid material.

Results: Duration of model preparation and printing, as well as the total cost, was calculated. Mean total time of model preparation was 430.5 ± 196 minutes.

Conclusion: 3D-printing from 3D-transesophageal echocardiography is technically feasible. Both shape and location of paravalvular leaks are preserved during model preparation and printing. It remains to be tested if 3D-printing would improve outcomes of percutaneous paravalvular leaks closure.
|}

==Prediction of Ki-67 Expression in Gastrointestinal Stromal Tumors Using Radiomics of Plain and Multiphase Contrast-Enhanced CT==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37266658 Eur Radiol. 2023 Jun 2. PMID: 37266658]

'''Authors:''' Liu Y, He C, Fang W, Peng L, Shi F 4, Xia Y, Zhou Q, Zhang R 5, Li C.

'''Institution:''' Medical Imaging Department, Chongqing University Central Hospital, Chongqing Emergency Medical Center, Chongqing, China.

'''Abstract:'''
Objective: To study the value of radiomics models based on plain and multiphase contrast-enhanced CT to predict Ki-67 expression in gastrointestinal stromal tumors (GISTs).

Methods: A total of 215 patients with GISTs were retrospectively analyzed, including 150 patients in one hospital as the training set and 65 patients in another hospital as the external verification set. The tumor at the largest level of CT images was delineated as the region of interest (ROI). The maximum diameter of the ROI was defined as the tumor size. A total of 851 radiomics features were extracted from each ROI by [http://www.slicer.org '''3D Slicer'''] Radiomics. After dimensionality reduction, three machine learning classification algorithms including logistic regression (LR), random forest (RF), and support vector machine (SVM) were used for Ki-67 expression prediction. Using a multivariable logistic model, a nomogram was established to predict the expression of Ki-67 individually.

Results: Delong tests showed that the SVM models had the highest accuracy in the arterial phase (Z value 0.217-1.139) and venous phase (Z value 0.022-1.396). For the plain phase, LR and SVM models had the highest accuracy (Z value 0.874-1.824, 1.139-1.763). For the delayed phase, LR models had the highest accuracy (Z value 0.056-1.824). For the combined phase, RF models had the highest accuracy (Z value 0.232-1.978). There was no significant difference among the above models for KI-67 expression prediction (Z value 0.022-1.978). A nomogram was developed with a C-index of 0.913 (95% CI, 0.878 to 0.956).

Conclusions: Radiomics of both plain and enhanced CT images could accurately predict the expression of Ki-67 in GIST. For patients who were not suitable to use contrast agents, plain scan could be used as an alternative.
|}

==Accuracy of Imaging Software for 3d Rendering of Tooth Structures, Usable in Clinical Settings==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37272346 Int J Comput Dent. 2023 Jun 5;0(0):0. PMID: 37272346]

'''Authors:''' Ronsivalle V, Venezia P, Migliorati M, Grippaudo C, Barbato E, Nucci L, Isola G, Leonardi RM, Lo Giudice A.

'''Institution:''' Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Policlinico Universitario "Vittorio Emanuele-G. Rodolico", Catania, Italy.

'''Abstract:'''
Aim: The aim of this study was to evaluate the segmentation accuracy of dentition testing four free-source semi-automatic software.

Materials and methods: A total of 20 cone-beam computed tomography (CBCT) were selected to perform semi-automatic segmentation of maxillary and mandibular dentition. The software tested were Invesalius, ITK-Snap, [http://www.slicer.org '''3D Slicer'''] and Seg3D. Each tooth model was also manually segmented (Mimics software) and set as the gold standard (GS) reference of the investigation. A specific 3D imaging technology was used to perform the superimposition between the teeth models obtained with semi-automatic software and the GS model, and to perform the surface-to-surface matching analysis. The accuracy of semi-automatic segmentation was evaluated calculating the volumetric mean differences (mean bias and limits of agreement) and the percentage of matching of the tooth models compared to the manual segmentation (GS). Qualitative assessments were performed using color-coded maps. All data were statistically analysed to perform software comparisons.

Result: Statistically significant differences were found in the volumetric and matching percentage data (p < 0,05). Invesalius was the most accurate software for 3D rendering of the dentition with a volumetric bias (Mimics) ranging from 4,59 mm3 to 85,79 mm3; instead, ITK-SNAP showed the higher volumetric bias, ranging from 30,22 mm3 to 319,83 mm3. The dis-matched area was mainly located at the radicular region of the teeth. Volumetric data showed excellent inter-software reliability with coefficient values ranging from 0,951 to 0,997.

Conclusion: Different semi-automatic software algorithms could generate different patterns of inaccuracy error in the segmentation of teeth.
|}

==A Retrospective Three-Dimensional Study of the Mandibular Growth During Preoperative Orthodontics in Late Adolescent Patients With Skeletal Class III Malocclusion==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37271262 J Stomatol Oral Maxillofac Surg. 2023 Jun 2:101526. PMID: 37271262]

'''Authors:''' Yuan M, Zheng Z, Li H, Wang P, Liu Y, Bi R.

'''Institution:''' State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthognathic and TMJ Surgery, West China Hospital of Stomatology, Sichuan University, China.

'''Abstract:'''
Introduction: The mandible's ongoing development presents a contraindication for combined orthodontic-orthognathic treatment. The aim of this study was to evaluate the mandibular stability before and after preoperative orthodontic treatment in late adolescent patients with skeletal Class III malocclusion and to investigate the most appropriate time to start preoperative orthodontic treatment.

Material and methods: The study population consisted of 58 adolescents, aged between 15 and 21 years, with skeletal Class III malocclusion; the adolescents underwent CT scans at the beginning (T1) and the end (T2) of preoperative orthodontic treatment. The CT data were analyzed using ITK-SNAP and [http://www.slicer.org '''3D Slicer'''] software, and the effects of age and gender on mandibular development were investigated.

Results: In these 58 patients, there were no significant local bone alterations in the condyle and anterior chin point between T1 and T2 and no significant changes in the mandibular branch height, mandibular body length, condylar distance, and mandibular angle distance (p>0.05). The mandibular growth at the angel of mandible was statistically significant (p<0.05), but it was not clinically significant because the mean value of the growth was small (right: 0.416±0.986 mm, left: 0.328±0.886 mm). No effect of age and gender on mandibular development was observed.

Conclusion: The mandibular morphology was stable during preoperative orthodontic treatment in patients at the late adolescent stage. This study provides evidence for the possibility of early implementation of preoperative orthodontics.
|}

==Assessment of Variabilities in Lung-Contouring Methods on CBCT Preclinical Radiomics Outputs==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37345013 Cancers (Basel). 2023 May 9;15(10):2677. PMID: 37345013] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10216427/pdf/cancers-15-02677.pdf PDF]

'''Authors:''' Brown KH, Illyuk J, Ghita M, Walls GM, McGarry CK, Butterworth KT.

'''Institution:''' Patrick G. Johnston Centre for Cancer Research, Queen's University Belfast, UK.

'''Abstract:'''
Radiomics image analysis has the potential to uncover disease characteristics for the development of predictive signatures and personalised radiotherapy treatment. Inter-observer and inter-software delineation variabilities are known to have downstream effects on radiomics features, reducing the reliability of the analysis. The purpose of this study was to investigate the impact of these variabilities on radiomics outputs from preclinical cone-beam computed tomography (CBCT) scans. Inter-observer variabilities were assessed using manual and semi-automated contours of mouse lungs (n = 16). Inter-software variabilities were determined between two tools ([http://www.slicer.org '''3D Slicer'''] and ITK-SNAP). The contours were compared using Dice similarity coefficient (DSC) scores and the 95th percentile of the Hausdorff distance (HD95p) metrics. The good reliability of the radiomics outputs was defined using intraclass correlation coefficients (ICC) and their 95% confidence intervals. The median DSC scores were high (0.82-0.94), and the HD95p metrics were within the submillimetre range for all comparisons. the shape and NGTDM features were impacted the most. Manual contours had the most reliable features (73%), followed by semi-automated (66%) and inter-software (51%) variabilities. From a total of 842 features, 314 robust features overlapped across all contouring methodologies. In addition, our results have a 70% overlap with features identified from clinical inter-observer studies.
|}

==A Training Tool for Clinicians in Segmenting Medical Images to Make 3D Models==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37342255 Ann Surg Open. 2023 May 23;4(2):e275. PMID: 37342255] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7614675/pdf/EMS170894.pdf PDF]

'''Authors:''' Chegini S, Tahim A, Liu M, Chooi Y, Edwards E, Clarkson M, Schilling C.

'''Institution:''' Department of Head and Neck Surgery, University College London Hospital, London, UK.

'''Abstract:'''
Introduction: 3D models produced from medical imaging can be used to plan treatment, design prosthesis, teach and for communication. Despite the clinical benefit, few clinicians have experience of how 3D models are produced.This is the first study evaluating a training tool to teach clinicians to produce 3D models and reporting the perceived impact on their clinical practice.

Method: Following ethical approval, 10 clinicians completed a bespoke training tool, comprising written and video material alongside online support. Each clinician and 2 technicians (included as control) were sent 3 CT scans and asked to produce 6 fibula 3D models using an open-source software, [http://www.slicer.org '''3D Slicer''']. The produced models were compared to those produced by the technicians using Hausdorff distance calculation. Thematic analysis was used to study the post-intervention questionnaire.

Results: The mean Hausdorff distance between the final model produced by the clinicians and technicians was 0.65mm SD0.54mm. The first model made by clinicians took a mean time of 1hr 25mins and the final model took 16:04mins (5:00-46:00mins). 100% of learners reported finding the training tool useful and will employ it in future practice.

Discussion: The training tool described in this paper is able to successfully train clinicians to produce fibula models from CT scans. Learners were able to produce comparable models to technicians within an acceptable timeframe. This does not replace technicians. However, the learners perceived this training will allow them to use this technology in more cases, with appropriate case selection and they appreciate the limits of this technology.
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==3D Slicer Combined With Neuroendoscope in Treatment of a Distal Segment Aneurysm of the Anterior Choroidal Artery Complicated Intraventricular Hemorrhage: A Case Report and Literature Review==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37251467 Heliyon. 2023 May 18;9(6):e16193. PMID: 37251467] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10220353/pdf/main.pdf PDF]

'''Authors:''' Zhou L, Ren Y, Li Z, Zhang H, Wei H, Song P, Cheng L, Wang W, Gao L, Lei P, Hua Q, Chen Q, Zhou J, Li G, Cai Q.

'''Institution:''' Department of Neurosurgery, Renmin Hospital of Wuhan University, Wuhan, China.

'''Abstract:'''
Introduction: Pure ventricular hemorrhage is often secondary to Moyamoya disease, rarely caused by rupture of ventricular aneurysm. The surgical treatment of the latter is very challenging. [http://www.slicer.org '''3D Slicer'''] reconstruction technology can accurately locate small intracranial lesions and combined with minimally invasive surgery with transcranial neuroendoscope is a new attempt to treat the above diseases.

Case presentation: We report a case of pure intraventricular hemorrhage secondary to rupture of a distal segment aneurysm of the anterior choroidal artery. Brain computed tomography (CT) before admission showed pure ventricular hemorrhage, and brain CT angiography (CTA) before operation showed a distal segment aneurysm of the anterior choroidal artery. We used [http://www.slicer.org '''3D Slicer'''] reconstruction and precise location of the focus before the operation and used the minimally invasive surgery technique with transcranial neuroendoscope to completely remove the hematoma in the ventricle, and found the responsible aneurysm located in the ventricle.

Conclusion: Pure intraventricular hemorrhage requires vigilance against the distal segment aneurysm of the anterior choroidal artery. At present, conventional microscopic craniotomy and intravascular interventional therapy have limitations, and [http://www.slicer.org '''3D Slicer'''] reconstruction and precise positioning technology combined with transcranial neuroendoscope minimally invasive surgery may be a good choice.
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==Application of Preoperative Multimodal Image Fusion Technique in Microvascular Decompression Surgery via Suboccipital Retrosigmoid Approach==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36716853 World Neurosurg. 2023 May;173:e37-e47. PMID: 36716853] | [https://pdf.sciencedirectassets.com/280061/AIP/1-s2.0-S1878875023001031/main.pdf PDF]

'''Authors:''' Liao CC, Wu KH, Chen G.

'''Institution:''' Department of Neurosurgery, Zhuhai People's Hospital (Zhuhai Hospital Affiliated with Jinan University,China), Zhuhai, China.

'''Abstract:'''
'''Objective:''' To explore the application value of preoperative multimodal image fusion technique in microvascular decompression (MVD) surgery via the suboccipital retrosigmoid approach.

'''Methods:''' Comprehensive data of 13 patients with primary trigeminal neuralgia (TN) and 13 patients with hemifacial spasm (HFS) treated by MVD surgery via the suboccipital retrosigmoid approach at the Department of Neurosurgery in Zhuhai People's Hospital from January 2021 to December 2021 were retrospectively analyzed. Preoperatively, all patients underwent cranial thin-section computed tomography and magnetic resonance examinations. Three-dimensional (3D) digital images of the skull, brainstem, nerves, and blood vessels were constructed by the [http://www.slicer.org '''3D Slicer'''] software or RadiAnt DICOM Viewer, which were then applied to design the surgical approach and surgical plan. The multimodal image fusion results, clinical characteristics, intraoperative data, surgical outcomes, and complications of all patients were summarized.

'''Results:''' The 3D digital images after fusion reconstruction can vividly show the anatomical relationship between the skull, brainstem, nerves, and blood vessels and was helpful to tailor the surgical strategy. All 26 patients underwent a smooth surgery. During the surgery, the key points were accurately located, the corners of the transverse sinus and sigmoid sinus were completely exposed, and no venous sinus injury occurred in all 26 patients. The key point was approximately located at the top point of the digastric groove, 12.3 ± 0.46 mm vertically above and 6.3 ± 0.6 mm laterally to the Frankfurt horizontal plane. The average cranial opening time was 30.4 (±3.6) min, and the mean operating time was 104.7 (±12.1) min. The diameter of the bone window was about 2.0 cm-3.0 cm, and the bone flap was restored. Among the 13 patients with primary TN, 12 (92.3%) exhibited complete relief of pain and 1 had significant relief. Complications of surgery included facial sensory numbness in 1 case, vertigo in 2 cases, and herpes at the corners of the mouth in 1 case. Of the 13 patients with HFS, 12 (92.3%) had complete relief of facial twitching symptoms and 1 had significant relief, and the complications included mild facial palsy in 2 (15.4%) cases and facial sensory numbness in another 2 (15.4%) cases. The mean follow-up time after surgery ranged from 6-16 months, and 1 of 26 patients experienced recurrence of HFS during the follow-up period.

'''Conclusions:''' Preoperative multimodal image fusion technology can provide adequate preoperative assessment for patients and assistance in designing surgical approaches, which is an important guideline for MVD surgery via the suboccipital retrosigmoid approach for primary TN and facial muscle spasm.
|}

==An Interactive App with Multi-parametric MRI - Whole-Mount Histology Correlation for Enhanced Prostate MRI Training of Radiology Residents==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37137744 Acad Radiol. 2023 May 1:S1076-6332(23)00183-6. PMID: 37137744]

'''Authors:''' Chatterjee A, Szasz T, Munakami M, Karademir I, Yusufishaq MS, Martens S, Wheeler C, Antic T, Thomas S, Karczmar GS, Oto A.

'''Institution:''' Department of Radiology, University of Chicago, Chicago, IL, USA.

'''Abstract:'''
Rationale and objectives: To validate the educational value of a newly created learning application in enhancing prostate MRI training of radiologists for detecting prostate cancer using an observer study.

Materials and methods: An interactive learning app, LearnRadiology, was developed using a web-based framework to display multi-parametric prostate MRI images with whole-mount histology for 20 cases curated for unique pathology and teaching points. Twenty new prostate MRI cases, different from the ones used in the web app, were uploaded on [http://www.slicer.org '''3D Slicer''']. Three radiologists (R1: radiologist; R2, R3: residents) blinded to pathology results were asked to mark areas suspected of cancer and provide a confidence score (1-5, with 5 being high confidence level). Then after a minimum memory washout period of 1 month, the same radiologists used the learning app and then repeated the same observer study. The diagnostic performance for detecting cancers before and after accessing the learning app was measured by correlating MRI with whole-mount pathology by an independent reviewer.

Results: The 20 subjects included in the observer study had 39 cancer lesions (13 Gleason 3 + 3, 17 Gleason 3 + 4, 7 Gleason 4 + 3, and 2 Gleason 4 + 5 lesions). The sensitivity (R1: 54% → 64%, P = 0.08; R2: 44% → 59%, P = 0.03; R3: 62% → 72%, P = 0.04) and positive predictive value (R1: 68% → 76%, P = 0.23; R2: 52% → 79%, P = 0.01; R3: 48% → 65%, P = 0.04) for all 3 radiologists improved after using the teaching app. The confidence score for true positive cancer lesion also improved significantly (R1: 4.0 ± 1.0 → 4.3 ± 0.8; R2: 3.1 ± 0.8 → 4.0 ± 1.1; R3: 2.8 ± 1.2 → 4.1 ± 1.1; P < 0.05).

Conclusion: The web-based and interactive LearnRadiology app learning resource can support medical student and postgraduate education by improving diagnostic performance of trainees for detecting prostate cancer.
|}

==3D Printed Guide Tube System for Acute Neuropixels Probe Recordings in Non-Human Primates==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37105161 J Neural Eng. 2023 May 11;20(3):036009. PMID: 37105161] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10172811/pdf/jne_20_3_036009.pdf PDF]

'''Authors:''' Bauer DL, Pobiel B, Hilber K, Verma AK, Wang J, Vitek J, Johnson M, Johnson L.

'''Institution:''' Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, USA.

'''Abstract:'''
Objective.
Neuropixels (NP) probes are a significant advance in electrophysiological recording technology that enable monitoring of hundreds of neurons in the brain simultaneously at different depths. Application of this technology has been predominately in rodents, however widespread use in non-human primates (NHPs) such as rhesus macaques has been limited. In this study we sought to overcome two overarching challenges that impede acute NP implantation in NHPs: (1) traditional microdrive systems that mount to cephalic chambers are commonly used to access cortical areas for microelectrode recordings but are not designed to accommodate NP probes, and (2) NHPs have thick dura mater and tissue growth within the cephalic chambers which poses a challenge for insertion of the extremely fragile NP probe.
Approach.
In this study we present a novel NP guide tube system that can be adapted to commercial microdrive systems and demonstrate an implant method using the NP guide tube system. This system was developed using a combination of CAD design, 3D printing, and small part machining. Software programs, [http://www.slicer.org '''3D Slicer'''] and SolidWorks were used to target cortical areas, approximate recording depths and locations, and for in-silico implant testing.
Main results.
We performedin vivotesting to validate our methodology, successfully implanting, explanting, and reimplanting NP probes. We collected stable neurophysiological recordings in the premotor cortex of a rhesus macaque at rest and during performance of a reaching task.Significance.In this study we demonstrate a robust Neuropixels implant system that allows multiple penetrations with the same NP probe and share design files that will facilitate the adoption of this powerful recording technology for NHP studies.
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==Diagnostic Value of 18F-FDG PET/CT-Based Radiomics Nomogram in Bone Marrow Involvement of Pediatric Neuroblastoma==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/36117128 Acad Radiol. 2023 May;30(5):940-51. PMID: 36117128]

'''Authors:''' Feng L, Yang X, Lu X, Kan Y, Wang C, Zhang H, Wang W, Yang J.

'''Institution:''' Department of Nuclear Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing, China.

'''Abstract:'''
Objectives: To develop and validate an 18F-FDG PET/CT-based radiomics nomogram and evaluate the value of the 18F-FDG PET/CT-based radiomics nomogram for the diagnosis of bone marrow involvement (BMI) in pediatric neuroblastoma.

Materials and methods: A total of 144 patients with neuroblastoma (100 in the training cohort and 44 in the validation cohort) were retrospectively included. The PET/CT images of patients were visually assessed. The results of bone marrow aspirates or biopsies were used as the gold standard for BMI. Radiomics features and conventional PET parameters were extracted using [http://www.slicer.org '''3D Slicer''']. Features were selected by the least absolute shrinkage and selection operator regression, and radiomics signature was constructed. Univariate and multivariate logistic regression analyses were applied to identify the independent clinical risk factors and construct the clinical model. Other different models, including the conventional PET model, combined PET-clinical model and combined radiomics model, were built using logistic regression. The combined radiomics model was based on clinical factors, conventional PET parameters and radiomics signature, which was presented as a radiomics nomogram. The diagnostic performance of the different models was evaluated by receiver operating characteristic (ROC) curves and decision curve analysis (DCA).

Results: By visual assessment, BMI was observed in 80 patients. Four conventional PET parameters (SUVmax, SUVmean, metabolic tumor volume, and total lesion glycolysis) were extracted. And 15 radiomics features were selected to build the radiomics signature. The 11q aberration, neuron-specific enolase and vanillylmandelic acid were identified as the independent clinical risk factors to establish the clinical model. The radiomics nomogram incorporating the radiomics signature, the independent clinical risk factors and SUVmean demonstrated the best diagnostic value for identifying BMI, with an area under the curve (AUC) of 0.963 and 0.931 in the training and validation cohorts, respectively. And the DCA demonstrated that the radiomics nomogram was clinically useful.

Conclusion: The 18F-FDG PET/CT-based radiomics nomogram which incorporates radiomics signature, independent clinical risk factors and conventional PET parameters could improve the diagnostic performance for BMI of pediatric neuroblastoma without additional medical costs and radiation exposure.
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==Opportunistic Screening for Osteoporosis Using CT Scans of the Knee: A Pilot Study==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37203533 Stud Health Technol Inform. 2023 May 18;302:909-910. PMID: 37203533]

'''Authors:''' Elmahdy M, Sebro R.

'''Institution:''' Department of Radiology, Mayo Clinic, Jacksonville, FL, USA.

'''Abstract:'''
Knee CT scans are used for planning for total knee arthroplasties in patients who are often simultaneously at risk for frailty fractures due to low bone mineral density. We retrospectively identified 200 patients (85.5% female) with concurrent CT scans of the knee and Dual energy x-ray absorptiometry (DXA). The mean CT attenuation of the distal femur, proximal tibia and fibula, and patella, were calculated using volumetric 3-dimensional segmentation using [http://www.slicer.org '''3D Slicer''']. Data were split randomly into training 80% and test 20% datasets. The optimal CT attenuation threshold for the proximal fibula was obtained in the training dataset and evaluated in the test dataset. A support vector machine (SVM) with radial basis function (RBF) using C-classification was trained and tuned using 5-fold cross-validation in the training dataset and then evaluated in the test dataset. The SVM had a higher area-under-the curve (AUC) of 0.937 and better performance to detect osteoporosis/osteopenia than the CT attenuation of the fibula (AUC of 0.717) (P=0.015). Opportunistic screening for osteoporosis/osteopenia could be accomplished using CT scans of the knee.
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==Sustainable 3D Printing of Oral Films With Tunable Characteristics Using CMC-Based Inks From Durian Rind Wastes==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/36933810 Eur J Pharm Biopharm. 2023 May;186:30-42. PMID: 36933810]

'''Authors:''' Panraksa P, Rachtanapun P, Thipchai P, Lesniewska E, Brachais CH, Debeaufort F, Chambin O, Jantrawut P.

'''Institution:''' Department of Pharmaceutical Sciences, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, Thailand.

'''Abstract:'''
With the growing interest in environmentally friendly and personalized medicines, new concept for combining three-dimensional printing (3DP) with natural-based biomaterials derived from agro-food wastes has emerged. This approach provides sustainable solutions for agricultural waste management and potential for developing of novel pharmaceutical products with tunable characteristics. This work demonstrated the feasibility of fabricating personalized theophylline films with four different structures (Full, Grid, Star, and Hilbert) using syringe extrusion 3DP and carboxymethyl cellulose (CMC) derived from durian rind wastes. Our findings suggested that all the CMC-based inks with shear thinning properties capable of being extruded smoothly through a small nozzle could potentially be used to fabricate the films with various complex printing patterns and high structural fidelity. The results also demonstrated that the film characteristics and release profiles could be easily modified by simply changing the slicing parameters (e.g., infill density and printing pattern). Amongst all formulations, Grid film, which was 3D-printed with 40 % infill and a grid pattern, demonstrated a highly porous structure with high total pore volume. The voids between printing layers in Grid film increased theophylline release (up to 90 % in 45 min) through improved wetting and water penetration. All findings in this study provide significant insight into how to modify film characteristics simply by digitally changing the printing pattern in [http://www.slicer.org '''3D Slicer'''] software without creating a new CAD model. This approach could help to simplify the 3DP process so that non-specialist users can easily implement it in community pharmacies or hospital on demand.
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==An Automated Landmark Method to Describe Geometric Changes in the Human Mandible During Growth==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/36893681 Arch Oral Biol. 2023 May;149:105663. PMID: 36893681]

'''Authors:''' Fournier G, Maret D, Telmon N, Savall F.

'''Institution:''' Faculté de Chirurgie Dentaire, Université Paul Sabatier, Centre Hospitalier Universitaire, Toulouse, France.

'''Abstract:'''
Objective: The principal aim of this study was to assess an automatic landmarking approach to human mandibles based on the atlas method. The secondary aim was to identify the areas of greatest variation in the mandibles of middle-aged to older adults.

Design: Our sample consisted of 160 mandibles from computed tomography scans of 80 men and 80 women aged between 40 and 79 years. Eleven anatomical landmarks were placed manually on mandibles. The automated landmarking through point cloud alignment and correspondence (ALPACA) method implemented in [http://www.slicer.org '''3D Slicer'''] was used to automatically place landmarks to all meshes. Euclidean distances, normalized centroid size, and Procrustes ANOVA were calculated for both methods. A pseudo-landmarks approach was followed using ALPACA to identify areas of changes among our sample.

Results: The ALPACA method showed significant differences in Euclidean distances for all landmarks compared to the manual method. A mean Euclidean distance of 1.7 mm was found for the ALPACA method and 0.99 mm for the manual method. Both methods found that sex, age, and size had a significant effect on mandibular shape. The greatest variations were observed in the condyle, ramus, and symphysis regions.

Conclusion: The results obtained using the ALPACA method are acceptable and promising. This approach can automatically place landmarks with an average accuracy of less than 2 mm, which may be sufficient in most anthropometric analyses. In the light of our results, however, odontological application such as occlusal analysis is not recommended.
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==Clinical Study of Puncture Technique in Single Division of the Trigeminal Ganglion Intumescentia==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37183316 Pain Pract. 2023 May 14. PMID: 37183316] | [https://onlinelibrary.wiley.com/doi/epdf/10.1111/papr.13239 PDF]

'''Authors:''' Zhang L, Guo Y, Xu J, He Y, Qi Z, Chen H, Zhang H.

'''Institution:''' Department of Neurosurgery, Jianhu Hospital Affiliated to Nantong University, Yancheng, China.

'''Abstract:'''
Objective: We explored the feasibility of single-division puncture in the ophthalmic division, maxillary division, and mandibular division of the trigeminal ganglion intumescentia (TGI) and the feasibility of radiofrequency treatment of trigeminal neuralgia.

Methods: According to the previous anatomical image studies, [http://www.slicer.org '''3D Slicer'''] software was used to analyze the CT images of the patients. The trigeminal ganglion fossa (TGF) was used as the imaging sign. TGI was identified in the sagittal plane along the fiber. The puncture path starts from the TGI center-foramen ovale line, extending outward to the epidermis as the needle insertion point, and extending inward to the division boundary. For lateral puncture, which is blocked by the mandible, the positions of closed mouth, open mouth, and over-open mouth were used. Multiple targets were generated using straight electrodes and curved electrodes to achieve full coverage of TGI. According to the preoperative design, general anesthesia surgery was performed. Xper CT was used for imaging, and the puncture was guided by Xper Guide. Radiofrequency treatment of TGI was conducted.

Results: In total, 45 patients with trigeminal neuralgia underwent 50 single-division TGI punctures. The procedure was smooth and the compliance with the design was good. Continuous radiofrequency (CRF) was performed, the VAS scores were 25 times at 70°C, 19 times at 65°C, two times at 60°C, and two times at 50°C (both in the ophthalmic division). Pulsed radiofrequency (PRF) was conducted two times. Within 24 h after the procedure, the VAS scores were all 0. From 1 to 7 days after the procedure, pain recurrence was found in three cases, of whom two cases received pulsed radiofrequency treatment. Patients were followed up for 1-24 months and there were no recurrence. After continuous radiofrequency at 65-70°C, the moderate tactile loss was observed, and nearly half of the patients had food residues on the surgical side after 6 months. After continuous radiofrequency at 60°C, there was mild tactile loss and no food residue. The tactile sensation was slightly decreased after continuous radiofrequency at 50°C, and the tactile sensation was normal the next day.

Conclusion: Trigeminal ganglion intumescentia single-division radiofrequency is effective and feasible for the treatment of trigeminal neuralgia.
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==Three-Dimensional Volume Rendering of Pelvic Floor Anatomy with Focus on Fibroids in Relation to the Lower Urogenital Tract Based on Cross-Sectional MRI Images==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37171621 J Med Syst. 2023 May 12;47(1):62. PMID: 37171621] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10181971/pdf/10916_2023_Article_1947.pdf PDF]

'''Authors:''' Fan KS, Durnea C, Nygaard CC, Khalil M, Doumouchtsis SK.

'''Institution:''' Institute for Medical and Biomedical Education, St. George's University of London, London, UK.

'''Abstract:'''
We aimed to assess the feasibility of developing three-dimensional (3D) models of pelvic organs using cross-sectional MRI images of patients with uterine fibroids and urinary symptoms and of obtaining anatomical information unavailable in 2D imaging modalities. We also aimed to compare two image processing applications. We performed a feasibility study analysing MRI scans from three women, aged 30 to 58 years old, with fibroids and urinary symptoms. Cross-sectional images were used to render 3D models of pelvic anatomy, including bladder, uterus and fibroids, using [http://www.slicer.org '''3D Slicer'''] and OsiriX. Dimensions, volumes and anatomical relationships of the pelvic organs were evaluated. Comparisons between anatomical landmarks and measurements obtained from the two image processing applications were undertaken. Rendered 3D pelvic models yielded detailed anatomical information and data on spatial relationships that were unobtainable from cross-sectional images. Models were rendered in sufficient resolution to aid understanding of spatial relationships between urinary bladder, uterus and fibroid(s). Measurements of fibroid volumes ranged from 5,336 to 418,012 mm3 and distances between the fibroid and urinary bladder ranged from 0.10 to 83.60 mm. Statistical analysis of measurements showed no significant differences in measurements between the two image processing applications. To date, limited data exist on the use of 3D volume reconstructions of routine MRI scans, to investigate pelvic pathologies such as fibroids in women with urinary symptoms. This study suggests that post-MRI image processing can provide additional information over standard MRI. Further studies are required to assess the role of these data in clinical practice, surgical planning and training. Three-dimensional reconstruction of routine two-dimensional magnetic resonance imaging provides additional anatomical information and may improve our understanding of anatomical relationships, their role in clinical presentations and possibly guide clinical and surgical management.
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==The First Endovascular Rat Glioma Model for Pre-Clinical Evaluation of Intra-Arterial Therapeutics==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37157800 Interv Neuroradiol. 2023 May 8:15910199231169597. PMID: 37157800]

'''Authors:''' Lim J, Baig AA, Donnelly BM, Chaves LD, Pol SU, Koenigsknecht C, Pionessa D, Levy BR, Gutierrez L, Tutino VM, Levy EI, Siddiqui AH.

'''Institution:''' Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA.

'''Abstract:'''
Background: Several translational animal models have been described assessing intra-arterial (IA) treatments for malignant gliomas. We describe the first endovascular animal model that allows testing of IA drug delivery as a first-line treatment, which is difficult to do in actual patients. We report a unique protocol for vascular access and IA delivery in the rat model that, unlike prior reports, does not require direct puncture and opening of proximal cerebrovasculature which carries risk of ischemia in the animal brain post-delivery.

Methods: Wistar rats underwent left femoral artery catherization with a Balt Magic 1.2F catheter or Marathon Flow directed 1.5F Microcatheter with an Asahi Chikai 0.008 micro-guidewire which was navigated to the left internal carotid artery under x-ray. 25% mannitol was administered to test blood brain barrier breakdown (BBBB). Additional rats were implanted with C6 glioma cells in the left frontal lobe. C6 Glioma-Implanted Rats (C6GRs) were monitored for overall survival and tumor growth. Tumor volumes from MRI images were calculated utilizing [http://www.slicer.org '''3D Slicer''']. Additional rats underwent femoral artery catheterization with Bevacizumab, carboplatin, or irinotecan injected into the left internal carotid artery to test feasibility and safety.

Results: A successful endovascular access and BBBB protocol was established. BBBB was confirmed with positive Evans blue staining. 10 rats were successfully implanted with C6 gliomas with confirmed growths on MRI. Overall survival was 19.75 ± 2.21 days. 5 rats were utilized for the development of our femoral catheterization protocol and BBBB testing. With regards to IA chemotherapy dosage testing, control rats tolerated targeted 10 mg/kg of bevascizumab, 2.4 mg/kg of carboplatin, and 15 mg/kg of irinotecan IA ICA injections without any complications.

Conclusions: We present the first endovascular IA rat glioma model that allows selective catheterization of the intracranial vasculature and assessment of IA therapies for gliomas without need for access and sacrifice of proximal cerebrovasculature.
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==Muscle Magnetic Resonance Characterization of STIM1 Tubular Aggregate Myopathy Using Unsupervised Learning==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37155641 PLoS One. 2023 May 8;18(5):e0285422. PMID: 37155641] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10166478/pdf/pone.0285422.pd PDF]

'''Authors:''' Lupi A, Spolaor S, Favero A, Bello L, Stramare R, Pegoraro E, Nobile MS.

'''Institution:''' Institute of Radiology, Department of Medicine-DIMED, University of Padua, Padua, Italy.

'''Abstract:'''
Purpose: Congenital myopathies are a heterogeneous group of diseases affecting the skeletal muscles and characterized by high clinical, genetic, and histological variability. Magnetic Resonance (MR) is a valuable tool for the assessment of involved muscles (i.e., fatty replacement and oedema) and disease progression. Machine Learning is becoming increasingly applied for diagnostic purposes, but to our knowledge, Self-Organizing Maps (SOMs) have never been used for the identification of the patterns in these diseases. The aim of this study is to evaluate if SOMs may discriminate between muscles with fatty replacement (S), oedema (E) or neither (N).

Methods: MR studies of a family affected by tubular aggregates myopathy (TAM) with the histologically proven autosomal dominant mutation of the STIM1 gene, were examined: for each patient, in two MR assessments (i.e., t0 and t1, the latter after 5 years), fifty-three muscles were evaluated for muscular fatty replacement on the T1w images, and for oedema on the STIR images, for reference. Sixty radiomic features were collected from each muscle at t0 and t1 MR assessment using [http://www.slicer.org '''3D Slicer'''] software, in order to obtain data from images. A SOM was created to analyze all datasets using three clusters (i.e., 0, 1 and 2) and results were compared with radiological evaluation.

Results: Six patients with TAM STIM1-mutation were included. At t0 MR assessments, all patients showed widespread fatty replacement that intensifies at t1, while oedema mainly affected the muscles of the legs and appears stable at follow-up. All muscles with oedema showed fatty replacement, too. At t0 SOM grid clustering shows almost all N muscles in Cluster 0 and most of the E muscles in Cluster 1; at t1 almost all E muscles appear in Cluster 1.

Conclusion: Our unsupervised learning model appears to be able to recognize muscles altered by the presence of edema and fatty replacement.
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==Quantifying the Effect of an Endo-Vaginal Probe on Position of the Pelvic Floor Viscera and Muscles==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37145123 Int Urogynecol J. 2023 May 5. PMID: 37145123]

'''Authors:''' Chill HH, Martin LC, Abramowitch SD, Rostaminia G.

'''Institution:''' Female Pelvic Medicine and Reconstructive Surgery (FPMRS) Division, University of Chicago Pritzker School of Medicine, Northshore University HealthSystem, Skokie, IL, USA.

'''Abstract:'''
Introduction and hypothesis: Endovaginal ultrasound has long been hypothesized to have a significant effect on locations of what it visualizes. However, little work has directly quantified its effect. This study aimed to quantify it.

Methods: This cross-sectional study consisted of 20 healthy asymptomatic volunteers who underwent both endovaginal ultrasound and MRI. The urethra, vagina, rectum, pelvic floor, and pubic bone were segmented in both ultrasound and MRI using [http://www.slicer.org '''3D Slicer''']. Then, using [http://www.slicer.org '''3D Slicer''']'s transform tool the volumes were rigidly aligned based on the posterior curvature of the pubic bone. The organs were then split into thirds along their long axis to compare their distal, middle, and proximal sections. Using Houdini, we compared the location of the centroid of each of the urethra, vagina, and rectum and the surface-to-surface difference of the urethra and rectum. The anterior curvature of the pelvic floor was also compared. Normality of all variables was assessed by Shapiro-Wilk test.

Results: The largest amount of surface-to-surface distance was observed in the proximal region for the urethra and rectum. Across all three organs, the majority of the deviation was in the anterior direction for geometries obtained from ultrasound versus those from MRI. For each subject, the trace defining the midline of the levator plate was more anterior for ultrasound compared to MRI.

Conclusions: While it has often been assumed that placing a probe in the vagina probably distorts the anatomy, this study quantified the distortion and displacement of the pelvic viscera. This allows for better interpretation of clinical and research findings based on this modality.
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==Laser Interstitial Thermal Therapy in the Treatment of Brain Metastases: The Relationship Between Changes in Postoperative Magnetic Resonance Imaging Characteristics and Tumor Recurrence==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36823478 Acta Neurochir (Wien). 2023 May;165(5):1379-1387. PMID: 36823478]

'''Authors:''' Xue Z, Guan X, Yuan L, Kang P, Zhang C, Li D, Jia G, Jia W.

'''Institution:''' Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, China.

'''Abstract:'''
'''Background:''' Laser interstitial thermal therapy (LITT) has been used to treat brain metastases (BMs) in several countries, and its safety and effectiveness have been confirmed. In most cases, magnetic resonance imaging (MRI) reveals an increase in tumor volume with an enhanced margin after LITT. However, little is known about the relationship between this MRI change and tumor recurrence.

'''Objective:''' We report the first case series of BMs treated by LITT in China to evaluate the clinical characteristics and predictive factors of tumor recurrence.

'''Material and Methods:''' Patients with less than four brain metastatic lesions and a Karnofsky performance status (KPS) > 70 were eligible for study inclusion. Standard LITT procedures were performed, and a follow-up MRI was performed to analyze the radiographic changes, especially the volume ratio of the enhanced margin and the whole lesion on MRI at 30 days postoperatively. All the volume-related data were delineated and calculated using [http://www.slicer.org '''3D Slicer'''] software. Related predictors were also collected to evaluate the correlation with local tumor control.

'''Results:''' Eighteen patients with nineteen lesions were enrolled for treatment and follow-up. Primary tumor histology included pulmonary carcinoma (n = 11) and breast cancer (n = 4). On average, the tumor size measured 3.01 cm3 (range, 0.40-7.40 cm3), the total ablation time was 13.58 min (range, 2.88-37.15 min), and the complete ablation rate was 92.4% (range, 29.2-100%). Comparing 3s0-day follow-up MRI results with preoperative MRI findings, 18 lesions showed a 2.28-fold (range, 1.21-4.88) volume increase; all the lesions displayed an enhanced component with a volume ratio of 42.35% (range, 10.14-100%). Five patients experienced tumor recurrence, and the local tumor control rates at 90 days and 180 days of follow-up were 68.4% and 66.7%, respectively. Univariate analysis indicated that the primary tumor, ablation rate, and enhanced volume ratio (EVR) > 40% in the 30-day MRI were associated with tumor recurrence, whereas multivariate analysis showed that only EVR > 40% was a predictive factor of local control.

'''Conclusion:''' LITT is a minimally invasive method used to ablate brain metastases which can be used as the first-line treatment for BM patients under certain indications. After LITT, most tumors showed volume enlargement on the 30-day MRI scan, and EVR > 40% on the 30-day MRI may indicate late tumor recurrence.
|}

==Image Data and Computational Grids for Computing Brain Shift and Solving the Electrocorticography Forward Problem==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37128587/ Data Brief. 2023 Apr 7;48:109122. PMID: 37128587] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10147975/pdf/main.pdf PDF]

'''Authors:''' Zwick BF, Safdar S, Bourantas GC, Joldes GR, Hyde DE, Warfield SK, Wittek A, Miller K.

'''Institution:''' Intelligent Systems for Medicine Laboratory, The University of Western Australia, 35 Stirling Highway, Perth, WA, Australia.

'''Abstract:'''
This article describes the dataset applied in the research reported in NeuroImage article "Patient-specific solution of the electrocorticography forward problem in deforming brain" [1] that is available for download from the Zenodo data repository (https://zenodo.org/record/7687631) [2]. Preoperative structural and diffusion-weighted magnetic resonance (MR) and postoperative computed tomography (CT) images of a 12-year-old female epilepsy patient under evaluation for surgical intervention were obtained retrospectively from Boston Children's Hospital. We used these images to conduct the analysis at The University of Western Australia's Intelligent Systems for Medicine Laboratory using SlicerCBM [3], our open-source software extension for the [http://www.slicer.org '''3D Slicer'''] medical imaging platform. As part of the analysis, we processed the images to extract the patient-specific brain geometry; created computational grids, including a tetrahedral grid for the meshless solution of the biomechanical model and a regular hexahedral grid for the finite element solution of the electrocorticography forward problem; predicted the postoperative MRI and DTI that correspond to the brain configuration deformed by the placement of subdural electrodes using biomechanics-based image warping; and solved the patient-specific electrocorticography forward problem to compute the electric potential distribution within the patient's head using the original preoperative and predicted postoperative image data. The well-established and open-source file formats used in this dataset, including Nearly Raw Raster Data (NRRD) files for images, STL files for surface geometry, and Visualization Toolkit (VTK) files for computational grids, allow other research groups to easily reuse the data presented herein to solve the electrocorticography forward problem accounting for the brain shift caused by implantation of subdural grid electrodes.
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==ImFinite Element Analysis of a Healthy Knee Joint at Deep Squatting for the Study of Tibiofemoral and Patellofemoral Contact==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37143926 J Orthop. 2023 Apr 21;40:7-16. PMID: 37143926]

'''Authors:''' Kothurkar R, Lekurwale R, Gad M, Rathod CM.

'''Institution:''' Department of Mechanical Engineering, K. J. Somaiya College of Engineering, Mumbai, India.

'''Abstract:'''
Background: In non-western countries, deep squatting is a daily activity, and prolonged deep squatting is common among occupational squatters. Household tasks, taking a bath, socializing, using toilets, and performing religious acts are among the activities frequently carried out while squatting by the Asian population. High knee loading is responsible for a knee injury and osteoarthritis. Finite element analysis is an effective tool to determine stresses on the knee joint.

Methods: Magnetic Resonance Imaging (MRI) and Computed Tomographic (CT) images were acquired of one adult without knee injuries. The CT images were acquired at the fully extended knee and one more set of images was acquired with the knee at a deeply flexed knee position. The MRI was acquired with the fully extended knee. 3 Dimensional models of bones were created using CT and soft tissue using MRI with the help of [http://www.slicer.org '''3D Slicer'''] software. Kinematics and finite element analysis of the knee was performed for standing and deep squatting posture using Ansys Workbench 2022.

Results: High peak stresses were observed at deep squatting compared to standing along with the reduction in the contact area. Peak von Mises stresses on femoral cartilage, tibial cartilage, patellar cartilage, and meniscus were increased from 3.3 MPa to 19.9 MPa, 2.9 MPa to 12.4 MPa, 1.5 MPa to 16.7 MPa and 15.8 MPa to 32.8 MPa respectively during deep squatting. Posterior translation of 7.01 mm, and 12.58 mm was observed for medial and lateral femoral condyle respectively from full extension to 153° knee flexion.

Conclusions: Increased stresses in the knee joint at deep squat posture may cause cartilage damage. A sustained deep squat posture should be avoided for healthy knee joints. More posterior translations of the medial femoral condyle at higher knee flexion angle warrant further investigation.
|}

==A Comparison of Machine Learning Models for Survival Prediction of Patients with Glioma Using Radiomic Features from MRI Scans==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37362372/ Indian J Radiol Imaging. 2023 Apr 28;33(3):338-343. PMID: 37362372] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10289839/pdf/10-1055-s-0043-1767786.pdf PDF]

'''Authors:''' Manjunath M, Saravanakumar S, Kiran S, Chatterjee J.

'''Institution:''' Department of Biotechnology, People's Education Society University, Bangalore, Karnataka, India.

'''Abstract:'''
Background Glioma is a primary, malignant, highly aggressive brain tumor, with patients having an average life expectancy of 14 to 16 months after diagnosis. Magnetic resonance imaging (MRI) scans of these patients can be used to extract and analyze quantifiable features with potential clinical significance. We hypothesize that there is a correlation between radiomic features extracted from MRI scans and survival. Along with clinical data, the radiomic features could be used in survival prediction of patients, providing beneficial information for clinicians to design personalized treatment plans. Methods In our study, we have utilized [http://www.slicer.org '''3D Slicer'''] for tumor segmentation and feature extraction and performed survival prediction of patients with glioma using four different machine learning models. Results and Conclusion Among the models compared, we have achieved a maximum prediction accuracy of 64.4% using the k-nearest neighbors model, which was trained and tested on a combination of clinical data and radiomic features extracted from MRI images provided in the BraTS 2020 dataset.
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==Circular RNA hsa_circ_0000690 as a Potential Biomarker for Diagnosis and Prognosis of Intracranial Aneurysm: Closely Relating to the Volume of Hemorrhage==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36879365 Brain Behav. Apr;13(4):e2929. PMID: 36879365] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10097068/pdf/BRB3-13-e2929.pdf PDF]

'''Authors:'''Huang Y, Cao H, Qi X, Guan C, Que S.

'''Institution:''' Department of Neurosurgery, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, Fujian, China.

'''Abstract:'''

'''Purpose:''' This study aimed to explore circular RNA (circRNA) hsa_circ_0000690 as a potential biomarker for diagnosis and prognosis of intracranial aneurysm (IA) and its relationship with clinical factors and complications of IA.

'''Material/Methods:''' 216 IA patients admitted to the neurosurgery department of our hospital from January 2019 to December 2020 were selected as the experimental group, and 186 healthy volunteers were selected as the control group. The expression of hsa_circ_0000690 in peripheral blood was detected by quantitative real-time PCR, and its diagnostic value was assessed by receiver operating characteristic curve. Relationship between hsa_circ_0000690 and clinical factors of IA was assessed by chi-square test. Nonparametric test was used in univariate analysis, and regression analysis was used in multivariate analysis. Multivariate Cox proportional hazards regression analysis was used to analyze the survival time.

'''Results:''' CircRNA hsa_circ_0000690 of IA patients was relatively lower than that in the control group (p < .001). The AUC of hsa_circ_0000690 was 0.752, the specificity was 0.780, and sensitivity was 0.620, with diagnostic threshold of 0.0449. In addition, hsa_circ_0000690 expression was correlated with Glasgow Coma Scale, the volume of subarachnoid hemorrhage, modified Fisher scale, Hunt-Hess levels and surgical type. For hydrocephalus and delayed cerebral ischemia, hsa_circ_0000690 was significant in univariate analysis, but nonsignificant in multivariate analysis. For prognosis, hsa_circ_0000690 was significantly associated with modified Rankin Scales after surgery for 3 months, but not associated with survival time.

'''Conclusions:''' The expression of hsa_circ_0000690 can act as a diagnostic marker for IA and predict the prognosis of 3 months after operation and is closely related to the volume of hemorrhage.

'''Keywords:''' [http://www.slicer.org '''3D Slicer''']; biomarker; circRNA; diagnosis; intracranial aneurysm; prognosis; subarachnoid hemorrhage
|}

==Can Quantitative Peritumoral CT Radiomics Features Predict the Prognosis of Patients With Non-Small Cell Lung Cancer? A Systematic Review==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36307554 Eur Radiol. 2023 Mar;33(3):2105-17. PMID: 36307554] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9935659/pdf/330_2022_Article_9174.pdf PDF]

'''Authors:''' Wu L, Lou X, Kong N, Xu M, Gao C.

'''Institution:''' Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China.

'''Abstract:''' Objectives: To provide an overarching evaluation of the value of peritumoral CT radiomics features for predicting the prognosis of non-small cell lung cancer and to assess the quality of the available studies.

'''Methods:''' The PubMed, Embase, Web of Science, and Cochrane Library databases were searched for studies predicting the prognosis in patients with non-small cell lung cancer (NSCLC) using CT-based peritumoral radiomics features. Information about the patient, CT-scanner, and radiomics analyses were all extracted for the included studies. Study quality was assessed using the Radiomics Quality Score (RQS) and the Prediction Model Risk of Bias Assessment Tool (PROBAST).

'''Results:''' Thirteen studies were included with 2942 patients from 2017 to 2022. Only one study was prospective, and the others were all retrospectively designed. Manual segmentation and multicenter studies were performed by 69% and 46% of the included studies, respectively. [http://www.slicer.org '''3D Slicer'''] and MATLAB software were most commonly used for the segmentation of lesions and extraction of features. The peritumoral region was most frequently defined as dilated from the tumor boundary of 15 mm, 20 mm, or 30 mm. The median RQS of the studies was 13 (range 4-19), while all of included studies were assessed as having a high risk of bias (ROB) overall.

'''Conclusions:''' Peritumoral radiomics features based on CT images showed promise in predicting the prognosis of NSCLC, although well-designed studies and further biological validation are still needed.

'''Key points:''' Peritumoral radiomics features based on CT images are promising and encouraging for predicting the prognosis of non-small cell lung cancer. The peritumoral region was often dilated from the tumor boundary of 15 mm or 20 mm because these were considered safe margins. The median Radiomics Quality Score of the included studies was 13 (range 4-19), and all of studies were considered to have a high risk of bias overall.
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==Three Dimensional Assessment of Radiographic Changes after Indirect Pulp Capping using Silver Diamine Fluoride with or without Potassium Iodide in Young Permanent Teeth (12-month RCT)==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36878216 Caries Res. 2023;57(2):177-188. PMID: 36878216]

'''Authors:''' Baraka MMAL, Cevidanes L, Tekeya M, Bakry N, Ruellas A, Botero T, Benavides E, Fontana M.

'''Institution:''' Department of Experimental Oncology, European Institute of Oncology, IRCCS, 20139 Milan, Italy.

'''Abstract:''' The aim was to have a three-dimensional evaluation of radiographic changes after indirect pulp capping (IPC) with silver diamine fluoride (SDF) with or without potassium iodide (KI) and resin modified glass ionomer cement (RMGIC) in deep carious young permanent molars using cone beam computed tomography (CBCT). 108 first permanent molars with deep occlusal cavitated caries lesions, in forty-nine 6-9-year-old children, were randomly allocated to one of 3 groups (n=36) and treated with SDF+KI, SDF and RMGIC as IPC materials. CBCT scans were taken at 0 and at 12-months to assess tertiary dentin formation (volume and grey level intensity), increase in root length, and pathological changes as secondary caries, periapical radiolucency, internal resorption and obliteration of the pulp. The three-dimensional image analysis procedures were performed using ITK-SNAP and [http://www.slicer.org '''3D Slicer'''] CMF. Comparisons were made using analysis of variance with a fixed effect for treatment and random effects for patient, and patient-by-treatment to account for within-patient correlations. A two-sided 5% significance level was used. There were no significant differences among the three groups regarding tertiary dentin volume (p=0.712) and grey level intensity (p=0.660), increase in root length (p=0.365), prevention of secondary caries (p=0.63) and periapical radiolucency (p=0.80) in the analysed 69 CBCT scans. The study did not find differences among the groups regarding quality and quantity of tertiary dentin formed, increase in root length, absence of secondary caries and other signs of failure as shown by CBCT.

'''Clinical Significance:''' The results show no significant differences in radiographic outcomes (quality and quantity of tertiary dentin formed, increase in root length, absence of secondary caries and other signs of failure) when using SDF+KI, SDF and RMGIC in IPC. The results of this study can help guide treatment decision making regarding use of SDF and SDF+KI as IPC materials in deep cavitated lesions.
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==Cross-Sectional Reliability and Concurrent Validity of a Quantitative 2-Dimensional Ultrasound Image Analysis of Effusion and Synovial Hypertrophy in Knee Osteoarthritis==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37008822/ Osteoarthr Cartil Open. 2023 Mar 16;5(2):100356. PMID: 37008822] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10060736/pdf/main.pdf PDF]

'''Authors:''' Dima R, Birmingham TB, Philpott HT, Bryant D, Fenster A, Appleton CT.

'''Institution:''' Faculty of Health Sciences, University of Western Ontario, London, ON, Canada.

'''Abstract:'''
Objective: Effusion-synovitis is related to pain and progression in knee osteoarthritis (OA), but current gold standard ultrasound (US) measures are limited to semi-quantitative grading of joint distension or 1-dimensional thickness measures. A novel quantitative 2-dimensional image analysis methodology is applied to US images of effusion-synovitis; reliability and concurrent validity was assessed in patients with knee OA.

Methods: Cross sectional analysis of US images collected from 51 patients with symptomatic knee OA were processed in ImageJ and segmented in [http://www.slicer.org '''3D Slicer'''] to produce a binary mask of the supra-patellar synovitis region of interest (ROI). Area measures (mm2) of total synovitis, effusion and hypertrophy components were exported. Intra-rater reliability and test-retest reliability (1-14 days washout) were estimated with intra-class correlation coefficients (ICCs). Concurrent validity was measured by Spearman correlations between quantitative measures and gold standard OMERACT and caliper measurements of synovitis.

Results: Intra-rater reliability for hypertrophy area was estimated at 0.98, 0.99 for effusion area, and 0.99 for total synovitis area. The test-retest reliability for total synovitis area was 0.63 (SEM 87.8 mm2), 0.59 for hypertrophy area (SEM 21.0 mm2), and 0.64 for effusion area (SEM 73.8 mm2). Correlation between total synovitis area and OMERACT grade was 0.84, 0.81 between total synovitis area and effusion-synovitis calipers, and 0.81 between total effusion area and effusion calipers.

Conclusion: This new research tool for image analysis demonstrated excellent intra-rater reliability, good concurrent validity, and moderate test-retest reliability. Quantitative 2D US measures of effusion-synovitis and its individual components may enhance the study and management of knee OA.
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==Patient-Specific Needle Guidance Templates Drilled Intraprocedurally for Image Guided Intervention: Feasibility Study in Swine==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36173542 Int J Comput Assist Radiol Surg. 2023 Mar;18(3):537-44. PMID: 36173542]

'''Authors:''' Glossop N, Bale R, Xu S, Pritchard WF, Karanian JW, Wood BJ.

'''Institution:''' Queen's University, Kingston, ON, Canada.

'''Abstract:'''
'''purpose:''' Thermal ablation of large tumors may benefit from simultaneous placement of multiple needles, but accurate placement becomes challenging as the number of needles increases. The aim of this work was to evaluate use of personalized needle guidance grid templates based on intraprocedural CT and fabricated at the point of care to implement ablation treatment plans with multiple needles in vivo.

'''Methods:''' A plastic frame was designed to hold two parallel plastic guide plates in a rigid relationship, fixed over the abdomen by a mounting arm. Steel ball targets (1.5 mm) were implanted under ultrasound in the livers of two domestic swine under general anesthesia. Following breath-hold CT of the subject and frame, the targets and frame were identified using customized [http://www.slicer.org '''3D Slicer''']-based planning software. Multiple needle trajectories targeting the balls were planned, including complex off-plane trajectories. A machining program for drilling the hole pattern corresponding to the planned needle trajectories was generated. The pattern was drilled in the two plates with a numerical-controlled milling machine in the suite. The plates were attached to the frame and needles passed through the paired holes to the calculated depth. Placement accuracy was defined as needle tip-to-target distance on post-placement CT.

'''Results:''' The planning process and manufacturing required approximately 6 and 15 min, respectively. Needles were rapidly inserted (n = 11) to the target points without complications or traversing nontarget anatomy. The mean needle tip-to-target distance error was 3.4 ± 2.2, range 0-7 mm.

'''Conclusion:''' Rapid and accurate needle placement was feasible using a subject-specific, custom-drilled, needle guidance grid template fabricated intraprocedurally. Targeting accuracy and performance were similar to more complex and expensive tracking systems which may enable accurate intraprocedural implementation of treatment plans in the liver or other organs. This may be of value in complex ablation cases or in areas where more advanced guidance systems are not available.
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==Automatic Landmark Identification in Cone-Beam Computed Tomography==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36811276 Orthod Craniofac Res. 2023 Feb 21. PMID: 36811276]

'''Authors:''' Gillot M, Miranda F, Baquero B, Ruellas A, Gurgel M, Al Turkestani N, Anchling L, Hutin N, Biggs E, Yatabe M, Paniagua B, Fillion-Robin JC, Allemang D, Bianchi J, Cevidanes L, Prieto JC.

'''Institution:''' Department of Orthodontics and Pediatric Dentistry, School of Dental Medicine, University of Michigan, Ann Arbor, MI, USA.

'''Abstract:'''
'''Objective:''' To present and validate an open-source fully automated landmark placement (ALICBCT) tool for cone-beam computed tomography scans.

'''Material and Methods:''' One hundred and forty-three large and medium field of view cone-beam computed tomography (CBCT) were used to train and test a novel approach, called ALICBCT that reformulates landmark detection as a classification problem through a virtual agent placed inside volumetric images. The landmark agents were trained to navigate in a multi-scale volumetric space to reach the estimated landmark position. The agent movements decision relies on a combination of DenseNet feature network and fully connected layers. For each CBCT, 32 ground truth landmark positions were identified by 2 clinician experts. After validation of the 32 landmarks, new models were trained to identify a total of 119 landmarks that are commonly used in clinical studies for the quantification of changes in bone morphology and tooth position.

'''Results:''' Our method achieved a high accuracy with an average of 1.54±0.87 mm error for the 32 landmark positions with rare failures, taking an average of 4.2s computation time to identify each landmark in one large 3D-CBCT scan using a conventional GPU.

'''Conclusion:''' The ALICBCT algorithm is a robust automatic identification tool that has been deployed for clinical and research use as an extension in the 3D Slicer platform allowing continuous updates for increased precision.
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==Development and In-Silico and Ex-Vivo Validation of a Software for a Semi-Automated Segmentation of the Round Window Niche to Design a Patient Specific Implant to Treat Inner Ear Disorders==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36826970 J Imaging. 2023 Feb 20;9(2):51. PMID: 36826970] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9965310/pdf/jimaging-09-00051.pdf PDF]

'''Authors:''' Matin-Mann F, Gao Z, Wei C, Repp F, Artukarslan EN, John S, Alcacer Labrador D, Lenarz T, Scheper V.

'''Institution:''' Lower Saxony Center for Biomedical Engineering, Implant Research and Development (NIFE), Department of Otorhinolaryngology, Head and Neck Surgery, Hannover Medical School, Hannover, Germany.

'''Abstract:''' The aim of this study was to develop and validate a semi-automated segmentation approach that identifies the round window niche (RWN) and round window membrane (RWM) for use in the development of patient individualized round window niche implants (RNI) to treat inner ear disorders. Twenty cone beam computed tomography (CBCT) datasets of unilateral temporal bones of patients were included in the study. Defined anatomical landmarks such as the RWM were used to develop a customized [http://www.slicer.org '''3D Slicer'''] plugin for semi-automated segmentation of the RWN. Two otolaryngologists (User 1 and User 2) segmented the datasets manually and semi-automatically using the developed software. Both methods were compared in-silico regarding the resulting RWM area and RWN volume. Finally, the developed software was validated ex-vivo in N = 3 body donor implantation tests with additively manufactured RNI. The independently segmented temporal bones of the different Users showed a strong consistency in the volume of the RWN and the area of the RWM. The volume of the semi-automated RWN segmentations were 48 ± 11% smaller on average than the manual segmentations and the area of the RWM of the semi-automated segmentations was 21 ± 17% smaller on average than the manual segmentation. All additively manufactured implants, based on the semi-automated segmentation method could be implanted successfully in a pressure-tight fit into the RWN. The implants based on the manual segmentations failed to fit into the RWN and this suggests that the larger manual segmentations were over-segmentations. This study presents a semi-automated approach for segmenting the RWN and RWM in temporal bone CBCT scans that is efficient, fast, accurate, and not dependent on trained users. In addition, the manual segmentation, often positioned as the gold-standard, actually failed to pass the implantation validation.
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==Design and Analysis of HSC-BPPV Diagnostic Maneuver Based on Virtual Simulation==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36873445 Front Neurol. 2023 Feb 17;14:1132343. PMID: 36873445] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9981954/pdf/fneur-14-1132343.pdf PDF]

'''Authors:''' Li Y, Yang X.

'''Institution:''' Department of Research Center, Third Affiliated Hospital of Shanghai University, Wenzhou Third Clinical Institute Affiliated to Wenzhou Medical University, Wenzhou People's Hospital, Wenzhou, China.

'''Abstract:'''
'''Background:''' The preferred supine roll test for the diagnosis of horizontal semicircular canal BPPV has several disadvantages, including difficulty in locating the affected ear, inconsistent nystagmus performance on repeated testing, and lack of a typical latency period, resulting in insensitive diagnosis.

Objectives: To investigate novel diagnostic techniques with more scientific design, more accessible application, and better diagnostic sensitivity and specificity.

'''Materials and Methods:''' Based on clinical microscopic CT data, we created a virtual simulation model of BPPV using Unity software. The physical simulation of the traditional supine roll test was performed to observe and analyse the movement of the otoliths, whose initial position was the typical stable position. In addition, the normal vectors of the plane and crista ampullaris of the horizontal semicircular canal were measured using [http://www.slicer.org '''3D Slicer'''] software. Based on this, we analyzed the critical steps for designing diagnostic maneuvers for BPPV in the horizontal semicircular canal. For a more accurate diagnosis of horizontal semicircular canal BPPV, it is critical to rotate the horizontal semicircular canal to be parallel to gravity. It is also necessary to move the otolith by swinging the head. As a result, we developed two diagnostic maneuvers: the 60° roll test and the prone roll test. We also performed simulations to observe otolith movement and predict nystagmus performance.

'''Conclusions:''' The 60° roll test and the prone roll test can complement the supine roll test. Compared to the supine roll test, they not only effectively differentiate canalolithiasis from cupulolithiasis, but also make it easier to determine the position of the otoliths, and the characteristics of the nystagmus are more pronounced. Significant diagnostic features have significant potential benefits for home and telemedicine.
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==The Simplified Tailor-Made Workflows for a [http://www.slicer.org '''3D Slicer''']-Based Craniofacial Implant Design==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36801943 Sci Rep. 2023 Feb 17;13(1):2850. PMID: 36801943] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9938178/pdf/41598_2023_Article_30117.pdf PDF]

'''Authors:''' Tantisatirapong S, Khunakornpattanakarn S, Suesatsakul T, Boonpratatong A, Benjamin I, Tongmeesee S, Kangkorn T, Chanwimalueang

'''Institution:''' Department of Biomedical Engineering, Faculty of Engineering, Srinakharinwirot University, Nakhon Nayok, Thailand.

'''Abstract:''' A specific design of craniofacial implant model is vital and urgent for patients with traumatic head injury. The mirror technique is commonly used for modeling these implants, but it requires the presence of a healthy skull region opposite to the defect. To address this limitation, we propose three processing workflows for modeling craniofacial implants: the mirror method, the baffle planner, and the baffle-based mirror guideline. These workflows are based on extension modules on the [http://www.slicer.org '''3D Slicer'''] platform and were developed to simplify the modeling process for a variety of craniofacial scenarios. To evaluate the effectiveness of these proposed workflows, we investigated craniofacial CT datasets collected from four accidental cases. The designed implant models were created using the three proposed workflows and compared to reference models created by an experienced neurosurgeon. The spatial properties of the models were evaluated using performance metrics. Our results show that the mirror method is suitable for cases where a healthy skull region can be completely reflected to the defect region. The baffle planner module offers a flexible prototype model that can be fit independently to any defect location, but it requires customized refinement of contour and thickness to fill the missing region seamlessly and relies on the user's experience and expertise. The proposed baffle-based mirror guideline method strengthens the baffle planner method by tracing the mirrored surface. Overall, our study suggests that the three proposed workflows for craniofacial implant modeling simplify the process and can be practically applied to a variety of craniofacial scenarios. These findings have the potential to improve the care of patients with traumatic head injuries and could be used by neurosurgeons and other medical professionals.
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==Predicting Transient Ischemic Attack Risk in Patients With Mild Carotid Stenosis Using Machine Learning and CT Radiomics==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36846119 Front Neurol. 2023 Feb 8;14:1105616. PMID: 36846119] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9944715/pdf/fneur-14-1105616.pdf PDF]

'''Authors:''' Xia H, Yuan L, Zhao W, Zhang C, Zhao L, Hou J, Luan Y, Bi Y, Feng Y.

'''Institution:''' Department of Vascular Surgery, The First Affiliated Hospital of Kunming Medical University, Kunming, China.

'''Abstract:'''
'''Objective:''' This study aims to establish a radiomics-based machine learning model that predicts the risk of transient ischemic attack in patients with mild carotid stenosis (30-50% North American Symptomatic Carotid Endarterectomy Trial) using extracted computed tomography radiomics features and clinical information.

'''Methods:''' A total of 179 patients underwent carotid computed tomography angiography (CTA), and 219 carotid arteries with a plaque at the carotid bifurcation or proximal to the internal carotid artery were selected. The patients were divided into two groups; patients with symptoms of transient ischemic attack after CTA and patients without symptoms of transient ischemic attack after CTA. Then we performed random sampling methods stratified by the predictive outcome to obtain the training set (N = 165) and testing set (N = 66). [http://www.slicer.org '''3D Slicer'''] was employed to select the site of plaque on the computed tomography image as the volume of interest. An open-source package PyRadiomics in Python was used to extract radiomics features from the volume of interests. The random forest and logistic regression models were used to screen feature variables, and five classification algorithms were used, including random forest, eXtreme Gradient Boosting, logistic regression, support vector machine, and k-nearest neighbors. Data on radiomic feature information, clinical information, and the combination of these pieces of information were used to generate the model that predicts the risk of transient ischemic attack in patients with mild carotid artery stenosis (30-50% North American Symptomatic Carotid Endarterectomy Trial).

'''Results:''' The random forest model that was built based on the radiomics and clinical feature information had the highest accuracy (area under curve = 0.879; 95% confidence interval, 0.787-0.979). The combined model outperformed the clinical model, whereas the combined model showed no significant difference from the radiomics model.

'''Conclusion:''' The random forest model constructed with both radiomics and clinical information can accurately predict and improve discriminative power of computed tomography angiography in identifying ischemic symptoms in patients with carotid atherosclerosis. This model can aid in guiding the follow-up treatment of patients at high risk.
|}

==Deep Learning Enabled Multi-Organ Segmentation of Mouse Embryos==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36802342 Biol Open. 2023 Feb 15;12(2):bio059698. PMID: 36802342] | [https://cob.silverchair-cdn.com/cob/content_public/journal/bio/12/2/10.1242_bio.059698/2/bio059698.pdf PDF]

'''Authors:''' Rolfe SM, Whikehart SM, Maga AM.

'''Institution:''' Center for Developmental Biology and Regenerative Medicine, Seattle Children's Research Institute, Seattle, WA, USA.

'''Abstract:''' The International Mouse Phenotyping Consortium (IMPC) has generated a large repository of three-dimensional (3D) imaging data from mouse embryos, providing a rich resource for investigating phenotype/genotype interactions. While the data is freely available, the computing resources and human effort required to segment these images for analysis of individual structures can create a significant hurdle for research. In this paper, we present an open source, deep learning-enabled tool, Mouse Embryo Multi-Organ Segmentation (MEMOS), that estimates a segmentation of 50 anatomical structures with a support for manually reviewing, editing, and analyzing the estimated segmentation in a single application. MEMOS is implemented as an extension on the [http://www.slicer.org '''3D Slicer'''] platform and is designed to be accessible to researchers without coding experience. We validate the performance of MEMOS-generated segmentations through comparison to state-of-the-art atlas-based segmentation and quantification of previously reported anatomical abnormalities in a Cbx4 knockout strain. This article has an associated First Person interview with the first author of the paper.
|}

==Development and Validation of an 18FFDG-PET/CT Radiomic Model for Predicting Progression-Free Survival for Patients With Stage II - III Thoracic Esophageal Squamous Cell Carcinoma Who Are Treated With Definitive Chemoradiotherapy==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36794365 Acta Oncol. 2023 Feb;62(2):159-65. PMID: 36794365]

'''Authors:''' Takahashi N, Tanaka S, Umezawa R, Takanami K, Takeda K, Yamamoto T, Suzuki Y, Katsuta Y, Kadoya N, Jingu K.

'''Institution:''' Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Japan.

'''Abstract:'''
'''Background:''' Radiomics is a method for extracting a large amount of information from images and used to predict treatment outcomes, side effects and diagnosis. In this study, we developed and validated a radiomic model of [18F]FDG-PET/CT for predicting progression-free survival (PFS) of definitive chemoradiotherapy (dCRT) for patients with esophageal cancer.

'''Material and Methods:''' Patients with stage II - III esophageal cancer who underwent [18F]FDG-PET/CT within 45 days before dCRT between 2005 and 2017 were included. Patients were randomly assigned to a training set (85 patients) and a validation set (45 patients). Radiomic parameters inside the area of standard uptake value ≥ 3 were calculated. The open-source software [http://www.slicer.org '''3D Slicer'''] and Pyradiomics were used for segmentation and calculating radiomic parameters, respectively. Eight hundred sixty radiomic parameters and general information were investigated.In the training set, a radiomic model for PFS was made from the LASSO Cox regression model and Rad-score was calculated. In the validation set, the model was applied to Kaplan-Meier curves. The median value of Rad-score in the training set was used as a cutoff value in the validation set. JMP was used for statistical analysis. RStudio was used for the LASSO Cox regression model. p < 0.05 was defined as significant.

'''Results:''' The median follow-up periods were 21.9 months for all patients and 63.4 months for survivors. The 5-year PFS rate was 24.0%. In the training set, the LASSO Cox regression model selects 6 parameters and made a model. The low Rad-score group had significantly better PFS than that the high Rad-score group (p = 0.019). In the validation set, the low Rad-score group had significantly better PFS than that the high Rad-score group (p = 0.040).

'''Conclusions:''' The [18F]FDG-PET/CT radiomic model could predict PFS for patients with esophageal cancer who received dCRT.
|}

==Minimizing Magnetic Resonance Image Geometric Distortion at 7 Tesla for Frameless Presurgical Planning Using Skin-Adhered Fiducials==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36301228 Med Phys. 2023 Feb;50(2):694-701. PMID: 36301228]

'''Authors:''' Kirby KM, Koons EK, Welker KM, Fagan AJ.

'''Institution:''' Department of Radiology, Mayo Clinic, Rochester, MN, USA.

'''Abstract:'''
'''Background:''' 7T MRI offers significant benefits to spatial and contrast resolution compared to lower field strengths. This superior image quality can help better delineate targets in stereotactic neurosurgical procedures; however, the potential for increased geometric distortions at 7T has impaired its widespread use for these applications. Image geometric distortions can be due to distortions of B0 arising from tissue magnetic susceptibility effects or inherent field inhomogeneities, and nonlinearity of the magnetic field gradients.

'''Purpose:''' The purpose of this study was to investigate the use of 7T MRI for neurosurgical frameless stereotactic navigation procedures. Image geometric distortions at the skin surface in 7T images were minimized and compared to results from clinical 3T frameless imaging protocols.

'''Methods:''' A 3D-printed grid phantom filled with oil was designed to perform a fine calibration of the 7T imaging gradients, and an oil-filled head phantom with internal targets was used to determine ground truth (from computed tomography [CT]) positioning errors. Three volunteers and the head phantom were imaged consecutively at 3T and 7T. Ten skin-adhesive fiducial markers were placed on each subject's exposed skin surface at standard clinical placement locations for frameless procedures. Imaging sequences included MPRAGE (three bandwidths at 7T: 400, 690, and 1020 Hz/pixel, and one at 3T: 400 Hz/pixel), T2 SPACE, and T2 SPACE FLAIR acquisitions. An additional GRE field map was acquired on both scanners using a multi-echo GRE sequence. Custom Matlab code was used to perform additional distortion correction of the images using the unwrapped field maps. Fiducial localization was performed with [http://www.slicer.org '''3D Slicer'''], with absolute fiducial positioning errors determined in phantom experiments following rigid registration to the CT images. For human experiments, 3T and 7T images were registered and relative differences in fiducial locations were compared using two-tailed paired t-tests.

'''Results:''' Phantom measurements at 7T yielded gradient distance scaling errors of 1.1%, 2.2%, and 1.0% along the x-, y-, and z-axes, respectively. These system miscalibrations were traced back to phantom manufacturing deviations in the sphericity of the vendor's gradient calibration phantom. Correction factors along each gradient axis were applied, and afterward, geometric distortions of less than 1 mm were obtained in the 7T MR head phantom images for the 1020 Hz/pixel bandwidth MPRAGE sequence. For the human subjects, four fiducial locations were excluded from the analysis due to patient positioning differences. Differences between 3T and 7T MPRAGE with low/medium/high bandwidth were 2.2 /2.6/2.3 mm, respectively, before the correction, reducing to 1.6/1.3/1.0 mm after the correction (p < 0.001). T2 SPACE and T2 SPACE FLAIR yielded a similar pattern when the correction was applied, decreasing from 2.1 to 0.8 mm, and 2.6 to 1.0 mm, respectively.

'''Conclusions:''' 7T MRI can be used to perform frameless presurgical planning with skin-adhesive fiducials. Geometric distortions can be reduced to a clinically relevant level (errors < ∼1 mm) with no significant susceptibility-related distortions, by using high receiver bandwidth, ensuring gradients are properly calibrated, and placing skin fiducials in areas where distortions from patient positioning are minimal.
|}

==Acute Colonic Pseudo-Obstruction Secondary to Renal Calculus: A Case Report and Review of Pathophysiology==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36777972 Cureus. 2023 Feb 7;15(2):e34756. PMID: 36777972] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9905947/pdf/cureus-0015-00000034756.pdf PDF]

'''Authors:''' Gillies M, AlDujaili T.

'''Institution:''' General Surgery, Goulburn Valley Health, Shepparton, Australia

'''Abstract:''' Acute colonic pseudo-obstruction (ACPO) is obstruction of the large bowel without a mechanical cause. The exact mechanism remains incompletely understood but is thought to result from disruption to the autonomic regulation of the colon, typically in the context of hospitalized patients with medical illness, precipitating medications, or recent surgical intervention. This paper presents an unusual case of ACPO in an ambulatory patient with a recently passed renal calculus, explores the anatomy and physiology underlying the autonomic dysfunction theory of ACPO pathogenesis in the context of the case, and provides a 3D reconstruction of the patient's CT to illustrate the abrupt caliber change at the splenic flexure characteristic of ACPO.

'''Keywords:''' 3d reconstruction; acute colonic pseudo-obstruction; ogilvie's syndrome; renal calculi; [http://www.slicer.org '''3D Slicer'''] software.
|}

==A Novel Stereotactic Aspiration Technique for Intracerebral Hemorrhage==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36270590 World Neurosurg. 2023 Feb;170:e28-e36. PMID: 36270590]

'''Authors:''' Xu HZ, Guo J, Wang C, Liu X, Song ZQ, Chen RF, Qiu B, Wang Q, Huang Y.

'''Institution:''' Department of Neurosurgery, Civil Aviation General Hospital, Beijing, China.

'''Abstract:'''

'''Background:''' Minimally invasive surgery is effective and recommended for treatment of intracerebral hemorrhage; however, neurosurgeons in grass-root hospitals in underdeveloped countries lack effective and precise minimally invasive surgery techniques. The aim of this study was to present a technique of computed tomography angiography-based three-dimensional-printed navigation mold-guided stereotactic aspiration and demonstrate its clinical application using a hard needle in a series of patients.

'''Methods:''' The novel stereotactic aspiration technique was performed in 18 patients with spontaneous intracerebral hemorrhage at our center, and clinical outcomes were reported. We compared the volume of hematoma measured by 3 different methods: ABC/2 formula, manual segmentation with OsiriX, and manual segmentation with [http://www.slicer.org '''3D Slicer'''].

'''Results:''' The surgery was completed safely within an average operative time of 15.11 minutes, achieving the goal of <15 mL residual clot volume or >70% clot removal in all patients. No intracranial rebleeding or infection was observed postoperatively. At the end of the 6-month follow-up, 61.11% (11/18) of patients achieved a modified Rankin Scale score <3. There was overall better agreement of hematoma measurement using segmentation with [http://www.slicer.org '''3D Slicer'''] rather than ABC/2 measurement or hematoma measurement using segmentation with OsiriX.

'''Conclusions:''' Our novel method of stereotactic aspiration benefited patients in this study with good percent clot removal, few surgery-related complications, and a favorable prognosis. Manual segmentation with [http://www.slicer.org '''3D Slicer'''] could be used to provide the neurosurgeon with dependable information about hematoma volume. This cheap and convenient technique may be applied in grass-root hospitals in underdeveloped countries. Assessment in multicenter prospective clinical trials is needed.
|}

==Morphological Evaluation of the Normal and Hydrocephalic Third Ventricle on Cranial Magnetic Resonance Imaging in Children: A Retrospective Study==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35994062 Pediatr Radiol. 2023 Feb;53(2):282-96. PMID: 35994062]

'''Authors:''' Isıklar S, Turan Ozdemir S, Ozkaya G, Ozpar R, Parlak M.

'''Institution:''' Medical Imaging Techniques Program, Vocational School of Health Services, Bursa Uludag University, 16240, Bursa, Turkey.

'''Abstract:'''
'''Background:''' Third ventricle morphological changes reflect changes in the ventricular system in pediatric hydrocephalus, so visual inspection of the third ventricle shape is standard practice. However, normal pediatric reference data are not available.

'''Objective:''' To investigate both the normal development of the third ventricle in the 0-18-year age group and changes in its biometry due to hydrocephalus.

'''Materials and Methods:''' For this retrospective study, we selected individuals ages 0-18 years who had magnetic resonance imaging (MRI) from 2012 to 2020. We included 700 children (331 girls) who had three-dimensional (3-D) T1-weighted sequences without and 25 with hydrocephalus (11 girls). We measured the distances between the anatomical structures limiting the third ventricle by dividing the third ventricle into anterior and posterior regions. We made seven linear measurements and three index calculations using 3DSlicer and MRICloud pipeline, and we analyzed the results of 23 age groups in normal and hydrocephalic patients using SPSS (v. 23).

'''Results:''' Salient findings are: (1) The posterior part of the third ventricle is more affected by both developmental and hydrocephalus-related changes. (2) For third ventricle measurements, gender was insignificant while age was significant. (3) Normal third ventricular volumetric development showed a segmental increase in the 0-18 age range. The hydrocephalic third ventricle volume cut-off value in this age group was 3 cm3.

'''Conclusion:''' This study describes third ventricle morphometry using a linear measurement method. The ratios defined in the midsagittal plane were clinically useful for diagnosing the hydrocephalic third ventricle. The linear and volumetric reference data and ratios are expected to help increase diagnostic accuracy in distinguishing normal and hydrocephalic third ventricles.
|}

==Henri IV of France's Larynx 3D Reconstitution==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36149490 Eur Arch Otorhinolaryngol. 2023 Feb;280(2):919-24. PMID: 36149490]

'''Authors:''' Baudouin R, Amelot A, Laprie Y, Crevier-Buchman L, Maeda S, Huynh-Charlier I, Hans S, Charlier P.

'''Institution:''' Department of Otolaryngology-Head & Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Université Paris Saclay), Montigny-le-Bretonneux, France.

'''Abstract:''' Objectives: King Henri IV of France (reign from 1589 to 1610) was one of the most important kings of France. Embalmed and buried in Saint-Denis, his remains were beheaded in 1793. His head (including his larynx) survived in successive private collections until its definitive identification in 2010. The purpose of the study was to provide a morphologic study of the larynx with a 3D reconstitution.

'''Methods:''' A flexible endoscopy was performed via the mouth and via the trachea. Measures of the larynx (vocal folds lengths, thickness, width, larynx height) were collected from the CT-scan by a panel of experts blind each other. The segmentation of the laryngeal anatomical components (vocal folds, cartilages) was performed using [http://www.slicer.org '''3D Slicer''']. Mesh smoothing and 3D reconstitution were performed using Fusion 360®. Reconstitution was discussed between the experts. Decision was made by consensus after discussion.

'''Results:''' Cricoid, thyroid, arytenoid cartilages, vocal folds and hyoid bone were identified and a computed 3D reconstitution of the larynx was made. The laryngeal 3D model appeared morphologically similar to a living subject. Measures were similar but smaller than those of a modern subject.

'''Conclusions:''' The 3D reconstitution of the larynx of Henri IV of France was conducted from the CT-scan of his mummified head. This work constitutes a first valuable morphologic analysis of a larynx from an embalmed individual. This anatomical work is the first step towards the reconstruction of the voice of this historical character, which we hope to concretize with computer modeling tools in a second step.
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==Development and External Validation of a Novel Nomogram to Predict Prostate Cancer in Biopsy-Naïve Patients With PSA <10 Ng/Ml and PI-RADS v2.1 = 3 Lesions==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35920264 Cancer Med. 2023 Feb;12(3):2560-71. PMID: 35920264] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9939143/pdf/CAM4-12-2560.pdf PDF]

'''Authors:''' Hu C, Sun J, Xu Z, Zhang Z, Zhou Q, Xu J, Chen H, Wang C, Ouyang J.

'''Institution:''' Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.

'''Abstract:'''
'''Objective:''' To develop and externally validate a novel nomogram in biopsy-naïve patients with prostate-specific antigen (PSA) <10 ng/ml and PI-RADS v2.1 = 3 lesions.

'''Methods:''' We retrospectively collected 307 men that underwent initial biopsy from October 2015 to January 2022 in Cohort 1 (The First Affiliated Hospital of Soochow University). External cohort (Cohort 2, Kunshan Hospital) included 109 men that met our criteria from July 2016 to June 2021. By [http://www.slicer.org '''3D Slicer'''] Software, the volume of all lesions was divided into two subgroups (PI-RADS v2.1 = 3a and 3b). Logistic regression analysis was performed to screen for variables and construct nomogram by analyzing clinical data from Cohort 1. Receiver operating characteristics curve analysis, calibration plot and decision curve analysis (DCA) were plotted to validate the nomogram in external cohort.

'''Results:''' A total of 70 (22.8%) patients was diagnosed with prostate cancer in Institution 1. Among them, 34 (11.1%) had clinically significant prostate cancer (csPCa). Age, prostate-specific antigen density, digital rectal examination, PI-RADS v2.1 = 3 subgroups (3a and 3b) and apparent diffusion coefficient (ADC, <750 mm2 /s) were predictive factors for prostate cancer (PCa) and csPCa. High area under the curve of the nomogram was found in Cohort 1 and Cohort 2 for PCa (0.857 vs. 0.850) and for csPCa (0.896 vs. 0.893). Calibration curves showed excellent agreement between the predicted probability and actual risk for the models in internal and external validation. The DCA demonstrated net benefit of our nomogram.

'''Conclusion:''' Until now, this is the first nomogram that predicts PCa and csPCa in biopsy-naïve patients with PSA <10 ng/ml and PI-RADS v2.1 = 3 lesions. Furthermore, PI-RADS v2.1 = 3 subgroups were considered to be an independent risk factor in our model. Our nomogram may assist urologists in biopsy decision making for these so-called "double gray zone" patients.
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==A Three-Dimensionally Printed Otological Model for Cholesteatoma Mastoidectomy Training==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35789285 Eur Arch Otorhinolaryngol. 2023 Feb;280(2):671-80. PMID: 35789285]

'''Authors:''' de Souza MA, Bento RF, Lopes PT.

'''Institution:''' Otolaryngology Department, University of São Paulo School of Medicine, São Paulo, Brazil.

'''Abstract:'''
'''purpose:''' To relate the creation and expert validation (face and content validity) of an affordable three-dimensional (3D) printed model of temporal bones with chronic otitis media with cholesteatoma (COMC) as a simulator for mastoidectomy.

'''Methods:''' We performed computed tomography (CT) of the temporal bones of a patient with COMC followed at the University of São Paulo (USP) Hospital with [http://www.slicer.org '''3D Slicer'''] to create a 3-D model of the affected bone using light-curing resin and silicone (cholesteatoma). The final 3-D printed images were scored by 10 otologists using a customized version of the Michigan Standard Simulation Scale Experience (MiSSES). Internal consistency and inter-rater reliability were assessed using Cronbach's α and intraclass correlations.

'''Results:''' Otologists consistently scored the model positively for fidelity, educational value, reactions, and the overall model quality. Nine otologists agreed that the model was a good educational device for surgical training of COMC. All experts deemed the model ready-or nearly ready-for use. The final cost of the model, including raw materials and manufacturing, was 120 USD.

'''Conclusions:''' Using 3D printing technology, we created the first anatomically accurate, low-cost, disease-reproducing 3D model of temporal bones for mastoidectomy training for cholesteatoma.
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==Development of a Navigable 3D Virtual Model of Temporal Bone Anatomy==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36704866 J Vis Commun Med. 2023 Jan 26:1-5. PMID: 36704866] | [https://www.tandfonline.com/doi/full/10.1080/17453054.2023.2169110 PDF]

'''Authors:''' Sareen K.

'''Institution:''' Sant Parmanand Hospital, New Delhi, India.

'''Abstract:'''
'''Background:''' Computed Tomography (CT) scanning offers an accurate structural definition of bones, blood vessels, and soft tissues; however, mental integration of cross-sectional 2D CT images for a 3D understanding of complex anatomical structures becomes difficult when the field of view is confined to the temporal bone. This project tried to provide a feasible solution to this problem by creating a navigable 3D virtual model which may aid in better comprehension of the temporal bone anatomy.

'''Methods:''' A helical-CT scan was used to obtain high-resolution cross-sectional slices of a cadaveric human temporal bone. Using the volume-rendering capabilities of [http://www.slicer.org '''3D Slicer'''], which involves volume data management, cropping of the data set, and threshold painting, detailed anatomical structures were segmented based on the intensity captured from different regions. This volumetric data was converted to an interactive virtual model using Blender®.

'''Results:''' The final product is a web page that allows interaction and navigation with a 3D annotated model of the temporal bone, which can be accessed from any device with a web browser.

'''Conclusion:''' This model can function as a training tool for students, teachers, and practitioners to understand and review the complex anatomy of the temporal bone.
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==Maxillary Antral Pseudocyst Drift after Osteotome Sinus Floor Elevation with Simultaneous Implant Placement: A Case Report and Literature Review==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36769568 J Clin Med. 2023 Jan 24;12(3):920. PMID: 36769568] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9917374/pdf/jcm-12-00920.pdf PDF]

'''Authors:''' Wang P, Huang N, Ren J, Gong P, Long J, Huang B.

'''Institution:''' West China School of Stomatology, Sichuan University, Chengdu, China.

'''Abstract:''' This report describes maxillary antral pseudocyst drift after maxillary sinus floor augmentation through osteotome sinus floor elevation with simultaneous implant placement. [http://www.slicer.org '''3D Slicer'''] was used to measure the pseudocyst and maxilla for the placement of the implants; follow-up visits were scheduled at 6, 12, and 22 months. No adverse effects were observed during or after surgery, and all implants exhibited osseointegration without mobility. At 6 months after surgery, the pseudocyst had moved posterolaterally from the preoperative position near the anterior medial maxillary sinus, then returned to its original position at 12 months. However, it had remigrated to the posterolateral position at 22 months. The preoperative volume of the pseudocyst was 3.795 mm3; it was 2.370, 3.439, and 2.930 mm3 at 6, 12, and 22 months after surgery, respectively. The changes in pseudocyst drift and volume did not have a substantial negative influence on the implants, presumably because of cystic attachment and the recurrence of multiple pseudocysts at different locations. The risks associated with changes in a pseudocyst can be avoided, if an appropriate treatment plan is selected.
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==Radiomic Analysis Based on Magnetic Resonance Imaging for Predicting PD-L2 Expression in Hepatocellular Carcinoma==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36672315 Cancers (Basel). 2023 Jan 5;15(2):365. PMID: 36672315] | [http://www.ncbi.nlm.nih.gov/pmc/articles/pmc9856314/ PDF]

'''Authors:''' Tao YY, Shi Y, Gong XQ, Li L, Li ZM, Yang L, Zhang XM.

'''Institution:''' Medical Imaging Key Laboratory of Sichuan Province, Interventional Medical Center, Department of Radiology, Medical Research Center, Affiliated Hospital of North Sichuan Medical College, Nanchong, China.

'''Abstract:''' Hepatocellular carcinoma (HCC) is the sixth most common malignant tumour and the third leading cause of cancer death in the world. The emerging field of radiomics involves extracting many clinical image features that cannot be recognized by the human eye to provide information for precise treatment decision making. Radiomics has shown its importance in HCC identification, histological grading, microvascular invasion (MVI) status, treatment response, and prognosis, but there is no report on the preoperative prediction of programmed death ligand-2 (PD-L2) expression in HCC. The purpose of this study was to investigate the value of MRI radiomic features for the non-invasive prediction of immunotherapy target PD-L2 expression in hepatocellular carcinoma (HCC). A total of 108 patients with HCC confirmed by pathology were retrospectively analysed. Immunohistochemical analysis was used to evaluate the expression level of PD-L2. [http://www.slicer.org '''3D Slicer'''] software was used to manually delineate volumes of interest (VOIs) and extract radiomic features on preoperative T2-weighted, arterial-phase, and portal venous-phase MR images. Least absolute shrinkage and selection operator (LASSO) was performed to find the best radiomic features. Multivariable logistic regression models were constructed and validated using fivefold cross-validation. The area under the receiver characteristic curve (AUC) was used to evaluate the predictive performance of each model. The results show that among the 108 cases of HCC, 50 cases had high PD-L2 expression, and 58 cases had low PD-L2 expression. Radiomic features correlated with PD-L2 expression. The T2-weighted, arterial-phase, and portal venous-phase and combined MRI radiomics models showed AUCs of 0.789 (95% CI: 0.702-0.875), 0.727 (95% CI: 0.632-0.823), 0.770 (95% CI: 0.682-0.875), and 0.871 (95% CI: 0.803-0.939), respectively. The combined model showed the best performance. The results of this study suggest that prediction based on the radiomic characteristics of MRI could noninvasively predict the expression of PD-L2 in HCC before surgery and provide a reference for the selection of immune checkpoint blockade therapy.
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==Correlation Between Unilateral Internal Carotid Artery Stenosis and Asymmetric Distribution of Enlarged Perivascular Spaces in Patients With Acute Cerebral Infarction==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36649988 Zhonghua Yi Xue Za Zhi. 2023 Jan 17;103(3):178-185. PMID: 36649988]

'''Authors:''' Jian XL, Zhang M, Yun WW.

'''Abstract:'''
'''Objective:''' To explore the correlation between unilateral internal carotid artery (ICA) stenosis and asymmetrical distribution of enlarged perivascular spaces (EPVS) in patients with acute cerebral infarction.

'''Methods:''' Acute cerebral infarction patients with unilateral ICA stenosis hospitalized in Changzhou Second People's Hospital from October 2020 to December 2021 were collected. Routine cranial MRI and CT angiography were completed for each patient. The [http://www.slicer.org '''3D Slicer'''] software was used to quantitatively analyze the volume of patient's EPVS. Patients were divided into moderate stenosis group and severe stenosis/occlusion group according to the degree of ICA stenosis. Baseline data were compared between the two groups. Patients were further divided into three groups: moderate stenosis, severe stenosis and occlusion groups, and the ipsilateral and contralateral EPVS volume of ICA stenosis patients was compared. The asymmetry index (AI) was calculated for EPVS in the basal ganglia region (BG-EPVS) and EPVS in the centrum semiovale (CSO-EPVS). Patients with AI≥0.2 were included in the EPVS asymmetry group, while the rest were in the EPVS symmetry group, and the degree of unilateral ICA stenosis was compared between the two groups. Multivariate logistic regression model was used to analyze the relationship between ICA severe stenosis/occlusion and the asymmetric distribution of BG-EPVS.

'''Results:''' A total of 122 patients (96 males and 26 females) were enrolled, aged (70±10) years, with 81 cases in the unilateral ICA severe stenosis/occlusion group (46 cases of severe stenosis and 35 of occlusion) and 41 cases in the moderate stenosis group. Patients in the unilateral ICA severe stenosis/occlusion group had greater BG-EPVS volume [(4.08±0.76) mm3]and proportion of asymmetric distribution of BG-EPVS [75.3%(61/81)] than those of the moderate stenosis group [(3.12±0.85) mm3 and 39.0% (16/41)], with statistically significant differences (both P<0.001). The BG-EPVS volumes of the ipsilateral side of the stenosis in the severe stenosis group and the occlusion group [(3.34±0.86) mm3 and (3.93±0.60) mm3] were significantly greater than those of the contralateral side [(2.65±1.28) mm3 and (3.21±0.88) mm3], with statistically significant differences (both P<0.001). Correlation analysis indicated that the degree of unilateral ICA stenosis was positively correlated with the BG-EPVS volume on the stenosis side (r=0.62, P<0.001). Further comparison of the degree of unilateral ICA stenosis between the EPVS symmetric and asymmetric groups showed that the proportion of unilateral ICA severe stenosis/occlusion in the BG-EPVS asymmetry group was higher than that in the symmetric group [79.2%(61/77) vs 44.4%(20/45),P<0.001]. Multivariate logistic regression analysis showed that unilateral ICA severe stenosis/occlusion (OR=4.280, 95%CI: 1.743-10.508, P =0.002) and age (OR=1.055, 95%CI: 1.001-1.112, P=0.044) were risk factors for asymmetric distribution of BG-EPVS.

'''Conclusions:''' The severe stenosis/occlusion of the unilateral ICA and age are the risk factors for the asymmetric distribution of the BG-EPVS in patients with acute cerebral infarction. The ipsilateral EPVS volume of unilateral ICA stenosis is larger than that of the contralateral side, and the degree of ICA stenosis is positively correlated with the severity of BG-EPVS.
|}

==Radiomics to Predict the Mortality of Patients With Rheumatoid Arthritis-Associated Interstitial Lung Disease: A Proof-of-Concept Study==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36698825 Front Med (Lausanne). 2023 Jan 9;9:1069486. PMID: 36698825] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9870287/pdf/fmed-09-1069486.pdf PDF]

'''Authors:''' Venerito V, Manfredi A, Lopalco G, Lavista M, Cassone G, Scardapane A, Sebastiani M, Iannone F.

'''Institution:''' Rheumatology Unit, Department of Emergency and Organ Transplantation, University of Bari Aldo Moro, Bari, Italy.

'''Abstract:''' Objectives: Patients with rheumatoid arthritis (RA) and interstitial lung disease (ILD) have increased mortality compared to the general population and factors capable of predicting RA-ILD long-term clinical outcomes are lacking. In oncology, radiomics allows the quantification of tumour phenotype by analysing the characteristics of medical images. Using specific software, it is possible to segment organs on high-resolution computed tomography (HRCT) images and extract many features that may uncover disease characteristics that are not detected by the naked eye. We aimed to investigate whether features from whole lung radiomic analysis of HRCT may alone predict mortality in RA-ILD patients.

'''Methods:''' High-resolution computed tomographies of RA patients from January 2012 to March 2022 were analyzed. The time between the first available HRCT and the last follow-up visit or ILD-related death was recorded. We performed a volumetric analysis in [http://www.slicer.org '''3D Slicer'''], automatically segmenting the whole lungs and trachea via the Lung CT Analyzer. A LASSO-Cox model was carried out by considering ILD-related death as the outcome variable and extracting radiomic features as exposure variables.

'''Results:''' We retrieved the HRCTs of 30 RA-ILD patients. The median survival time (interquartile range) was 48 months (36-120 months). Thirteen out of 30 (43.33%) patients died during the observation period. Whole line segmentation was fast and reliable. The model included either the median grey level intensity within the whole lung segmentation [high-resolution (HR) 9.35, 95% CI 1.56-55.86] as a positive predictor of death and the 10th percentile of the number of included voxels (HR 0.20, 95% CI 0.05-0.84), the voxel-based pre-processing information (HR 0.23, 95% CI 0.06-0.82) and the flatness (HR 0.42, 95% CI 0.18-0.98), negatively correlating to mortality. The correlation of grey level values to their respective voxels (HR 1.52 95% CI 0.82-2.83) was also retained as a confounder.

'''Conclusion:''' Radiomic analysis may predict RA-ILD patients' mortality and may promote HRCT as a digital biomarker regardless of the clinical characteristics of the disease.
|}

==Evaluation of the Prognosis of Acute Subdural Hematoma According to the Density Differences Between Gray and White Matter==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36686517 Front Neurol. 2023 Jan 6;13:1024018. PMID: 36686517] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9853902/ PDF]

'''Authors:''' Li Z, Feng Y, Wang P, Han S, Zhang K, Zhang C, Lu S, Lv C, Zhu F, Bie L.

'''Institution:''' Department of Neurosurgery of the First Clinical Hospital, Jilin University, Changchun, China.

'''Abstract:'''
'''Objective:''' Acute subdural hematoma (ASDH) is a common neurological emergency, and its appearance on head-computed tomographic (CT) imaging helps guide clinical treatment. To provide a basis for clinical decision-making, we analyzed that the density difference between the gray and white matter of the CT image is associated with the prognosis of patients with ASDH.

'''Methods:''' We analyzed the data of 194 patients who had ASDH as a result of closed traumatic brain injury (TBI) between 2018 and 2021. The patients were subdivided into surgical and non-surgical groups, and the non-surgical group was further subdivided into "diffused [hematoma]" and "non-diffused" groups. The control group's CT scans were normal. The [http://www.slicer.org '''3D Slicer'''] software was used to quantitatively analyze the density of gray and white matter depicted in the CT images.

'''Results:''' Imaging evaluation showed that the median difference in density between the gray and white matter on the injured side was 4.12 HU (IQR, 3.91-4.22 HU; p < 0.001) and on the non-injured side was 4.07 HU (IQR, 3.90-4.19 HU; p < 0.001), and the hematoma needs to be surgically removed. The median density difference value of the gray and white matter on the injured side was 3.74 HU (IQR, 3.53-4.01 HU; p < 0.001) and on the non-injured side was 3.71 HU (IQR, 3.69-3.73 HU; p < 0.001), and the hematoma could diffuse in a short time.

'''Conclusion:''' Quantitative analysis of the density differences in the gray and white matter of the CT images can be used to evaluate the clinical prognosis of patients with ASDH.
|}

==The Knosp Criteria Revisited: 3-Dimensional Volumetric Analysis as a Predictive Tool for Extent of Resection in Complex Endoscopic Pituitary Surgery==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36170168 Front Oncol. Neurosurgery. 2023 Jan 1;92(1):179-85. PMID: 36170168]

'''Authors:''' DiRisio AC, Feng R, Shuman WH, Platt S, Price G, Dullea JT, Gilja S, D'Andrea MR, Delman BN, Bederson JB, Shrivastava RK.

'''Institution:''' Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.

'''Abstract:'''
'''Background:''' The Knosp criteria have been the historical standard for predicting cavernous sinus invasion, and therefore extent of surgical resection, of pituitary macroadenomas. Few studies have sought to reappraise the utility of this tool after recent advances in visualization and modeling of tumors in complex endoscopic surgery.

'''Objective:''' To evaluate our proposed alternative method, using 3-dimensional (3D) volumetric imaging, and whether it can better predict extent of resection in nonfunctional pituitary adenomas.

'''Methods:''' Patients who underwent endoscopic transsphenoidal resection of pituitary macroadenomas at our institution were reviewed. Information was collected on neurological, endocrine, and visual function. Volumetric segmentation was performed using [http://www.slicer.org '''3D Slicer'''] software. Relationship of tumor volume, clinical features, and Knosp grade on extent of resection was examined.

'''Results:''' One hundred forty patients were identified who had transsphenoidal resection of nonfunctional pituitary adenomas. Macroadenomas had a median volume of 6 cm3 (IQR 3.4-8.7), and 17% had a unilateral Knosp grade of at least 3B. On multiple logistic regression, only smaller log-transformed preoperative tumor volume was independently associated with increased odds of gross total resection (GTR; odds ratio: 0.27, 95% CI: 0.07-0.89, P < .05) when controlling for tumor proliferative status, age, and sex (area under the curve 0.67). The Knosp criteria did not independently predict GTR in this cohort (P > .05, area under the curve 0.46).

'''Conclusion:''' Increasing use of volumetric 3D imaging may better anticipate extent of resection compared with the Knosp grade metric and may have a greater positive predictive value for GTR. More research is needed to validate these findings and implement them using automated methods.
|}

==Differentiation of Lung Metastases Originated From Different Primary Tumors Using Radiomics Features Based on CT Imaging==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35577699 Acad Radiol. 2023 Jan;30(1):40-6. PMID: 35577699]

'''Authors:''' Shang H, Li J, Jiao T, Fang C, Li K, Yin D, Zeng Q.

'''Institution:''' Department of Radiology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, No. 16766 Jingshi Road, Jinan, Shandong, China.

'''Abstract:''' Rationale and objectives: To explore the feasibility of differentiating three predominant metastatic tumor types using lung computed tomography (CT) radiomics features based on supervised machine learning.

'''Materials and Methods:''' This retrospective analysis included 252 lung metastases (LM) (from 78 patients), which were divided into the training (n = 176) and test (n = 76) cohort randomly. The metastases originated from colorectal cancer (n = 97), breast cancer (n = 87), and renal carcinoma (n = 68). An additional 77 LM (from 35 patients) were used for external validation. All radiomics features were extracted from lung CT using an open-source software, [http://www.slicer.org '''3D Slicer''']. The least absolute shrinkage and selection operator (LASSO) method selected the optimal radiomics features to build the model. Random forest and support vector machine (SVM) were selected to build three-class and two-class models. The performance of the classification model was evaluated with the area under the receiver operating characteristic curve (AUC) by two strategies: one-versus-rest and one-versus-one.

'''Results:''' Eight hundred and fifty-one quantitative radiomics features were extracted from lung CT. By LASSO, 23 optimal features were extracted in three-class, and 25, 29, and 35 features in two-class for differentiating every two of three LM (colorectal cancer vs. renal carcinoma, colorectal cancer vs. breast cancer, and breast cancer vs. renal carcinoma, respectively). The AUCs of the three-class model were 0.83 for colorectal cancer, 0.79 for breast cancer, and 0.91 for renal carcinoma in the test cohort. In the external validation cohort, the AUCs were 0.77, 0.83, and 0.81, respectively. Swarmplot shows the distribution of radiomics features among three different LM types. In the two-class model, high accuracy and AUC were obtained by SVM. The AUC of discriminating colorectal cancer LM from renal carcinoma LM was 0.84, and breast cancer LM from colorectal cancer LM and renal carcinoma LM were 0.80 and 0.94, respectively. The AUCs were 0.77, 0.78, and 0.84 in the external validation cohort.

'''Conclusion:''' Quantitative radiomics features based on Lung CT exhibited good discriminative performance in LM of primary colorectal cancer, breast cancer, and renal carcinoma.
|}

==MRI Radiomic Features of Peritumoral Edema May Predict the Recurrence Sites of Glioblastoma Multiforme==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36686829 Front Oncol. 2023 Jan 4;12:1042498. PMID: 36686829] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9845721/pdf/fonc-12-1042498.pdf PDF]

'''Authors:''' Long H, Zhang P, Bi Y, Yang C, Wu M, He D, Huang S, Yang K, Qi S, Wang J.

'''Institution:''' Department of Neurosurgery, Nanfang Hospital, Southern Medical University, Guangzhou, China.

'''Abstract:'''

'''Background and Purpose:''' As one of the most aggressive malignant tumor in the central nervous system, the main cause of poor outcome of glioblastoma (GBM) is recurrence, a non-invasive method which can predict the area of recurrence pre-operation is necessary.To investigate whether there is radiological heterogeneity within peritumoral edema and identify the reproducible radiomic features predictive of the sites of recurrence of glioblastoma(GBM), which may be of value to optimize patients' management.

'''Materials and Methods:''' The clinical information and MR images (contrast-enhanced T1 weighted and FLAIR sequences) of 22 patients who have been histologically proven glioblastoma, were retrospectively evaluated. Kaplan-Meier methods was used for survival analysis. Oedematous regions were manually segmented by an expert into recurrence region, non-recurrence region. A set of 94 radiomic features were obtained from each region using the function of analyzing MR image of [http://www.slicer.org '''3D Slicer''']. Paired t test was performed to identify the features existing significant difference. Subsequently, the data of two patients from TCGA database was used to evaluate whether these features have clinical value.

'''Results:''' Ten features with significant differences between the recurrence and non-recurrence subregions were identified and verified on two individual patients from the TCGA database with pathologically confirmed diagnosis of GBM.

'''Conclusions:''' Our results suggested that heterogeneity does exist in peritumoral edema, indicating that the radiomic features of peritumoral edema from routine MR images can be utilized to predict the sites of GBM recurrence. Our findings may further guide the surgical treatment strategy for GBM.
|}

==Clinical Study on Application of 3D Slicer Software Assisted Domestic Frameless Stereotactic Robot in Biopsy of Intracranial Lesions==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36603886 Zhonghua Wai Ke Za Zhi. 2023 Jan 1;61(1):61-65. PMID: 36603886] | [http://www.ncbi.nlm.nih.gov/pmc/articles/pmc9849352/ PDF]

'''Authors:''' Chen H, Yan X, He F, Ding SC, Diao JF, Guo H, Cao SM, Yang CJ, Yin F.

'''Institution:''' Department of Neurosurgery, Aerospace Central Hospital, Beijing, China.

'''Abstract:'''
'''Objective:''' To examine the application value of [http://www.slicer.org '''3D Slicer'''] software assisted domestic frameless stereotactic robot in biopsy of intracranial lesions.

'''Methods:''' A retrospective analysis was performed on 80 patients who admitted consecutively and underwent intracerebral lesions biopsy with the domestic frameless stereotactic robot at Department of Neurosurgery, Aerospace Central Hospital from January 2019 to December 2021. There were 36 males and 44 females, with a mean age of (38.5±18.0) years (range: 6 to 71 years). Before surgery only enhanced T1-weighted three-dimensional magnetization prepared gradient echo sequences and diffusion tensor imaging scans were performed. Self-reconstruction of intracranial lesions, cerebral cortex and blood vessels was carried out using 3D Slicer software system after the DICOM format imaging data of 80 patients were collected. These imaging data were merged to the workstation of the domestic frameless stereotactic robot for preoperative surgical planning and the surgical puncture path was designed to avoid blood vessels in the brain functional area, cerebral cortex and sulcus.

'''Results:''' All frameless stereotactic biopsy were successfully performed. Postoperative pathological diagnosis included 50 cases of diffuse astrocytic and oligodendroglioma, 15 cases of lymphoma, 5 cases of metastatic tumors, 5 cases of inflammatory demyelinating disease, 2 cases of inflammatory granuloma, 1 case of hemangioma, 1 case of acute lymphoblastic leukemia intracranial invasion and 1 case of seminoma. The positive diagnosis rate was 100% (80/80). Postoperative imaging confirmed that the puncture path and target were accurately implemented according to the preoperative planning, and the target error was (1.32±0.44) mm (range: 0.55 to 1.99 mm). One case of puncture-related bleeding occurred at the target after surgery and improved after treatment.

'''Conclusion:''' The three-dimensional multimodal images reconstructed by the 3D Slicer software before operation could help the surgeons make the preoperative planning and reduce the risk of stereotactic brain biopsy.
|}

==Liver Cirrhosis and Tumor Location Can Affect the Range of Intrahepatic Microwave Ablation Zone==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36854449 Int J Hyperthermia. 2023;40(1):2181843. PMID: 36854449] | [https://www.tandfonline.com/doi/epdf/10.1080/02656736.2023.2181843?needAccess=true&role=button PDF]

'''Authors:''' Ding WZ, Wei H, Wu JP, Cheng ZG, Han ZY, Liu FY, Yu J, Liang P.

'''Institution:''' Fifth Medical Center of Chinese, PLA General Hospital, Beijing, China.

'''Abstract:'''
'''Background:''' The range of an ablation zone (AZ) plays a crucial role in the treatment effect of microwave ablation (MWA). The aim of this study was to analyze the factors influencing the AZ range.

'''Methods:''' Fourteen factors in four areas were included: patient-related factors (sex, age), disease-related factors (tumor location, liver cirrhosis), serological factors (ALT, AST, total protein, albumin, total bilirubin, direct bilirubin, and platelets), and MWA parameters (ablation time, power, and needle type). Multiple sequence MRI was used to delineate AZ by three radiologists using [http://www.slicer.org '''3D Slicer''']. MATLAB was used to calculate the AZ length, width, and area of the largest section. Linear regression analysis was used to analyze influencing factors. Moreover, a subgroup analysis was conducted for patients with viral hepatitis.

'''Result:''' 220 patients with 290 tumors were included between 2010-2021. In addition to MWA parameters, cirrhosis and tumor location were significant factors that influenced AZ (p < 0.001). The standardized coefficient (beta) of cirrhosis (cirrhosis vs. non-cirrhosis) was positive, which meant cirrhosis would lead to a decrease in AZ range. The beta of tumor location (near the hepatic hilar zone, intermediate zone, and periphery zone) was negative, indicating that AZ range decreased as the tumor location approached the hepatic hilum. For viral hepatitis patients, Fibrosis 4 (FIB4) score was a significant factor influencing AZ (p < 0.001), and the beta was negative, indicating that AZ range decreased as FIB4 increased.

'''Conclusion:''' Liver cirrhosis, tumor location, and FIB4 affect the AZ range and should be considered when planning MWA parameters.
|}

==A Magnetic Resonance Imaging Based Radiomics Model to Predict Mitosis Cycles in Intracranial Meningioma==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36653482 Sci Rep. 2023 Jan 18;13(1):969. PMID: 36653482] | [http://www.ncbi.nlm.nih.gov/pmc/articles/pmc9849352/ PDF]

'''Authors:'''Krähling H, Musigmann M, Akkurt BH, Sartoretti T, Sartoretti E, Henssen DJHA, Stummer W, Heindel W, Brokinkel B, Mannil M.

'''Institution:''' University Clinic for Radiology, University Hospital Muenster, Westfälische Wilhelms-University Muenster, Muenster, Germany.

'''Abstract:''' The aim of this study was to develop a magnetic resonance imaging (MRI) based radiomics model to predict mitosis cycles in intracranial meningioma grading prior to surgery. Preoperative contrast-enhanced T1-weighted (T1CE) cerebral MRI data of 167 meningioma patients between 2015 and 2020 were obtained, preprocessed and segmented using the [http://www.slicer.org '''3D Slicer'''] software and the PyRadiomics plugin. In total 145 radiomics features of the T1CE MRI images were computed. The criterion on the basis of which the feature selection was made is whether the number of mitoses per 10 high power field (HPF) is greater than or equal to zero. Our analyses show that machine learning algorithms can be used to make accurate predictions about whether the number of mitoses per 10 HPF is greater than or equal to zero. We obtained our best model using Ridge regression for feature pre-selection, followed by stepwise logistic regression for final model construction. Using independent test data, this model resulted in an AUC (Area under the Curve) of 0.8523, an accuracy of 0.7941, a sensitivity of 0.8182, a specificity of 0.7500 and a Cohen's Kappa of 0.5576. We analyzed the performance of this model as a function of the number of mitoses per 10 HPF. The model performs well for cases with zero mitoses as well as for cases with more than one mitosis per 10 HPF. The worst model performance (accuracy = 0.6250) is obtained for cases with one mitosis per 10 HPF. Our results show that MRI-based radiomics may be a promising approach to predict the mitosis cycles in intracranial meningioma prior to surgery. Specifically, our approach may offer a non-invasive means of detecting the early stages of a malignant process in meningiomas prior to the onset of clinical symptoms.
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==Advantages of a Training Course for Surgical Planning in Virtual Reality for Oral and Maxillofacial Surgery: Crossover Study==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36656632 JMIR Serious Games. 2023 Jan 19;11:e40541. PMID: 36656632] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9947820/?report=printable PDF]

'''Authors:''' Ulbrich M, Van den Bosch V, Bönsch A, Gruber LJ, Ooms M, Melchior C, Motmaen I, Wilpert C, Rashad A, Kuhlen TW, Hölzle F, Puladi B.

'''Institution:''' Department of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Aachen, Germany.

'''Abstract:'''
'''Background:''' As an integral part of computer-assisted surgery, virtual surgical planning (VSP) leads to significantly better surgery results, such as for oral and maxillofacial reconstruction with microvascular grafts of the fibula or iliac crest. It is performed on a 2D computer desktop screen (DS) based on preoperative medical imaging. However, in this environment, VSP is associated with shortcomings, such as a time-consuming planning process and the requirement of a learning process. Therefore, a virtual reality (VR)-based VSP application has great potential to reduce or even overcome these shortcomings due to the benefits of visuospatial vision, bimanual interaction, and full immersion. However, the efficacy of such a VR environment has not yet been investigated.

'''Objective:''' This study aimed to demonstrate the possible advantages of a VR environment through a substep of VSP, specifically the segmentation of the fibula (calf bone) and os coxae (hip bone), by conducting a training course in both DS and VR environments and comparing the results.

'''Methods:''' During the training course, 6 novices were taught how to use a software application in a DS environment, [http://www.slicer.org '''3D Slicer''']) and in a VR environment (Elucis) for the segmentation of the fibula and os coxae, and they were asked to carry out the maneuvers as accurately and quickly as possible. Overall, 13 fibula and 13 os coxae were segmented for each participant in both methods (VR and DS), resulting in 156 different models (78 fibula and 78 os coxae) per method (VR and DS) and 312 models in total. The individual learning processes in both environments were compared using objective criteria (time and segmentation performance) and self-reported questionnaires. The models resulting from the segmentation were compared mathematically (Hausdorff distance and Dice coefficient) and evaluated by 2 experienced radiologists in a blinded manner.

'''Results:''' A much faster learning curve was observed for the VR environment than the DS environment (β=.86 vs β=.25). This nearly doubled the segmentation speed (cm3/min) by the end of training, leading to a shorter time (P<.001) to reach a qualitative result. However, there was no qualitative difference between the models for VR and DS (P=.99). The VR environment was perceived by participants as more intuitive and less exhausting, and was favored over the DS environment.

'''Conclusions:''' The more rapid learning process and the ability to work faster in the VR environment could save time and reduce the VSP workload, providing certain advantages over the DS environment.
|}

==Lesion Size and Long-Term Cognitive Outcome After Pediatric Stroke: A Comparison Between Two Techniques to Assess Lesion Size==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36641854 Eur J Paediatr Neurol. 2023 Jan 7;42:126-32. PMID: 36641854]

'''Authors:''' Everts R, Bertato S, Steinlin M, Slavova N, Grunt S, Steiner L.

'''Institution:''' Division of Neuropediatrics, Development and Rehabilitation, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.

'''Abstract:'''
'''Background:''' There is little consensus on how lesion size impacts long-term cognitive outcome after pediatric arterial ischemic stroke (AIS). This study, therefore, compared two techniques to assessed lesion size in the chronic phase after AIS and determined their measurement agreement in relation to cognitive functions in patients after pediatric stroke.

'''Methods:''' Twenty-five patients after pediatric AIS were examined in the chronic phase (>2 years after stroke) in respect to intelligence, memory, executive functions, visuo-motor functions, motor abilities, and disease-specific outcome. Lesion size was measured using the ABC/2 formula and segmentation technique ([http://www.slicer.org '''3D Slicer''']). Correlation analysis determined the association between volumetry techniques and outcome measures in respect to long-term cognitive outcome.

'''Results:''' The measurements from the ABC/2 and segmentation technique were strongly correlated (r = 0.878, p < .001) and displayed agreement in particular for small lesions. Lesion size from both techniques was significantly correlated with disease-specific outcome (p < .001) and processing speed (p < .005) after controlling for age at stroke and multiple comparison.

'''Conclusion:''' The two techniques showed convergent validity and were both significantly correlated with long-term outcome after pediatric AIS. Compared to the time-consuming segmentation technique, ABC/2 facilitates clinical and research work as it requires relatively little time and is easy to apply.
|}

==Association Between Emphysema and Other Pulmonary Computed Tomography Patterns in COVID-19 Pneumonia==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36358023 J Med Virol. 2023 Jan;95(1):e28293. PMID: 36358023] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9828029/pdf/JMV-95-0.pdf PDF]

'''Authors:''' Han K, Wang J, Zou Y, Zhang Y, Zhou L, Yin Y.

'''Institution:''' Fetal-Neonatal Neuroimaging and Developmental Science Center, Division of Newborn Medicine, Boston Children's Hospital, Boston, USA.

'''Abstract:''' To evaluate the chest computed tomography (CT) findings of patients with Corona Virus Disease 2019 (COVID-19) on admission to hospital. And then correlate CT pulmonary infiltrates involvement with the findings of emphysema. We analyzed the different infiltrates of COVID-19 pneumonia using emphysema as the grade of pneumonia. We applied open-source assisted software, [http://www.slicer.org '''3D Slicer'''] to model the lungs and lesions of 66 patients with COVID-19, which were retrospectively included. we divided the 66 COVID-19 patients into the following two groups: (A) 12 patients with less than 10% emphysema in the low-attenuation area less than -950 Hounsfield units (%LAA-950), (B) 54 patients with greater than or equal to 10% emphysema in %LAA-950. Imaging findings were assessed retrospectively by two authors and then pulmonary infiltrates and emphysema volumes were measured on CT using [http://www.slicer.org '''3D Slicer'''] software. Differences between pulmonary infiltrates, emphysema, Collapsed, affected of patients with CT findings were assessed by Kruskal-Wallis and Wilcoxon test, respectively. Statistical significance was set at p < 0.05. The left lung (A) affected left lung 20.00/affected right lung 18.50, (B) affected left lung 13.00/affected right lung 11.50 was most frequently involved region in COVID-19. In addition, collapsed left lung, (A) collapsed left lung 4.95/collapsed right lung 4.65, (B) collapsed left lung 3.65/collapsed right lung 3.15 was also more severe than the right one. There were significant differences between the Group A and Group B in terms of the percentage of CT involvement in each lung region (p < 0.05), except for the inflated affected total lung (p = 0.152). The median percentage of collapsed left lung in the Group A was 20.00 (14.00-30.00), right lung was 18.50 (13.00-30.25) and the total was 19.00 (13.00-30.00), while the median percentage of collapsed left lung in the Group B was 13.00 (10.00-14.75), right lung was 11.50 (10.00-15.00) and the total was 12.50 (10.00-15.00). The percentage of affected left lung is an independent predictor of emphysema in COVID-19 patients. We need to focus on the left lung of the patient as it is more affected. The people with lower levels of emphysema may have more collapsed segments. The more collapsed segments may lead to more serious clinical feature.
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==A High-Resolution Pediatric Female Whole-Body Numerical Model With Comparison to a Male Model==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36595234 Phys Med Biol. 2023 Jan 13;68(2). PMID: 36595234]

'''Authors:''' Ntolkeras G, Jeong H, Zöllei L, Dmytriw AA, Purvaziri A, Lev MH, Grant PE, Bonmassar G.

'''Institution:''' Fetal-Neonatal Neuroimaging and Developmental Science Center, Division of Newborn Medicine, Boston Children's Hospital, Boston, USA.

'''Abstract:'''
'''Objective:''' Numerical models are central in designing and testing novel medical devices and in studying how different anatomical changes may affect physiology. Despite the numerous adult models available, there are only a few whole-body pediatric numerical models with significant limitations. In addition, there is a limited representation of both male and female biological sexes in the available pediatric models despite the fact that sex significantly affects body development, especially in a highly dynamic population. As a result, we developed Athena, a realistic female whole-body pediatric numerical model with high-resolution and anatomical detail.

'''Approach:''' We segmented different body tissues through Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) images of a healthy 3.5 year-old female child using 3D Slicer. We validated the high anatomical accuracy segmentation through two experienced sub-specialty-certified neuro-radiologists and the inter and intra-operator variability of the segmentation results comparing sex differences in organ metrics with physiologic values. Finally, we compared Athena with Martin, a similar male model, showing differences in anatomy, organ metrics, and MRI dosimetric exposure.

'''Main results:'''We segmented 267 tissue compartments, which included 50 brain tissue labels. The tissue metrics of Athena displayed no deviation from the literature value of healthy children. We show the variability of brain metrics in the male and female models. Finally, we offer an example of computing Specific Absorption Rate and Joule heating in a toddler/preschooler at 7T MRI.

'''Significance:''' This study introduces a female realistic high-resolution numerical model using MRI and CT scans of a 3.5 year-old female child, the use of which includes but is not limited to radiofrequency safety studies for medical devices (e.g. an implantable medical device safety in MRI), neurostimulation studies, and radiation dosimetry studies. This model will be open source and available on the Athinoula A. Martinos Center for Biomedical Imaging website.
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==Anatomical Morphology and Related Angles of Foramen Ovale: A Three-dimensional Computed Tomography Reconstruction==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36597246 J Coll Physicians Surg Pak. 2023 Jan;33(1):109-11. PMID: 36597246]

'''Authors:''' Cheng Z, Hu YL, Sun YX, Liang LZ, Pan DD, Wang DW.

'''Institution:''' Department of Neurosurgery, The Second Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, China.

'''Abstract:''' This study aimed to report the three-dimensional reconstruction of the foramen ovale (FO) based on computed tomography angiography and describe its shape and related angles. A retrospective analysis of 199 adult patients who were hospitalised at the Department of Neurosurgery, The Second Affiliated Hospital of Bengbu Medical College, Bengbu, China, from January to December 2020 was conducted. The original DICOM files of patients' computed tomography scans were processed by [http://www.slicer.org '''3D Slicer'''] software to reconstruct the three-dimensional skull. The morphological characteristics of the FO on both sides were analysed. Their size, related angles and volumes, and the differences between the two sides and gender were compared. A total of 398 FO from 199 patients were studied. The most frequent shape of the FO was oval, accounting for 54.27%. The mean lengths of the right and the left sides were 5.40±1.51 and 5.10±1.18mm, respectively. The mean width on the right and left sides was 3.23±1.16 and 3.33±1.19 mm, respectively. The FO is most commonly oval in shape. Clinicians may use the anatomical characteristics regarding the size and shape of the FO for diagnosis and treatment.
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Main Page/SlicerCommunity/2023

2023-07-25T16:52:11Z

Marianna: /* Augmented Reality Presentation of the Extracranial Facial Nerve: An Innovation in Parotid Surgery */

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=2023=
==Dosimetric Assessment of Gadolinium-159 for Hepatic Radioembolization: Tomographic Images and Monte Carlo Simulation==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37393764 Appl Radiat Isot. 2023 Sep;199:110916. PMID: 37393764]

'''Authors:''' Musa AS, Abdul Hadi MFR, Hashikin NAA, Ashour NI, Ying CK.

'''Institution:''' School of Physics, Universiti Sains Malaysia, Penang, Malaysia.

'''Abstract:'''
A common therapeutic radionuclide used in hepatic radioembolization is yttrium-90 (90Y). However, the absence of gamma emissions makes it difficult to verify the post-treatment distribution of 90Y microspheres. Gadolinium-159 (159Gd) has physical properties that are suitable for therapy and post-treatment imaging in hepatic radioembolization procedures. The current study is innovative for conducting a dosimetric investigation of the use of 159Gd in hepatic radioembolization by simulating tomographic images using the Geant4 application for tomographic emission (GATE) Monte Carlo (MC) simulation. For registration and segmentation, tomographic images of five patients with hepatocellular carcinoma (HCC) who had undergone transarterial radioembolization (TARE) therapy were processed using a [http://www.slicer.org '''3D Slicer''']. The tomographic images with 159Gd and 90Y separately were simulated using the GATE MC Package. The output of simulation (dose image) was uploaded to [http://www.slicer.org '''3D Slicer'''] to compute the absorbed dose for each organ of interests. 159Gd were able to provide a recommended dose of 120 Gy to the tumour, with normal liver and lungs absorbed doses close to that of 90Y and less than the respective maximum permitted doses of 70 Gy and 30 Gy, respectively. Compared to 90Y, 159Gd requires higher administered activity approximately 4.92 times to achieve a tumour dose of 120 Gy. Thus; this research gives new insights into the use of 159Gd as a theranostic radioisotope, with the potential to be used as a90Y alternative for liver radioembolization.
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==Augmented Reality Presentation of the Extracranial Facial Nerve: An Innovation in Parotid Surgery==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37328316 Br J Oral Maxillofac Surg. 2023 Jul;61(6):428-36. PMID: 37328316]

'''Authors:''' Saadya A, Chegini S, Morley S, McGurk M.

'''Institution:''' University College London Hospital, UK.

'''Abstract:'''
Surgeons used to be unaware of the facial nerve's position during parotid surgery. Now, with special magnetic resonance imaging (MRI) sequences, it can be located and converted into a 3D model displayed on an augmented reality (AR) device for surgeons to study and manipulate. This study explores the accuracy and usefulness of the technique for the treatment of benign and malignant parotid tumours. A total of 20 patients with parotid tumours had 3-Tesla MRI scans, and their anatomical structures were segmented using [http://www.slicer.org '''3D Slicer'''] software. The structures were imported into a Microsoft HoloLens 2® device, displayed in 3D, and shown to the patient for consent. Intraoperative video recording was used to record the position of the facial nerve in relation to the tumour. The predicted path of the nerve taken from the 3D model was combined with surgical observation and video recording in all cases. The imaging proved to have application in both benign and malignant disease. It also improved the process of informed patient consent. Three-dimensional MRI imaging of the facial nerve within the parotid gland and its display in a 3D model is an innovative technique for parotid surgery. Surgeons can now see the nerve's position and tailor their approach to each patient's tumour, providing personalised care. The technique eliminates the surgeon's blind spot and is a significant advantage in parotid surgery.
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==Magnetic Resonance Imaging in Naso-Oropharyngeal Carcinoma: Role of Texture Analysis in the Assessment of Response to Radiochemotherapy, a Preliminary Study==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37336860/ Radiol Med. 2023 Jul;128(7):839-52. PMID: 37336860]

'''Authors:''' Bicci E, Nardi C, Calamandrei L, Barcali E, Pietragalla M, Calistri L, Desideri I, Mungai F, Bonasera L, Miele V.

'''Institution:''' Department of Experimental and Clinical Biomedical Sciences, Radiodiagnostic Unit #2, University of Florence, Florence, Italy.

'''Abstract:'''
Objective: Identifying MRI texture parameters able to distinguish inflammation, fibrosis, and residual cancer in patients with naso-oropharynx carcinoma after radiochemotherapy (RT-CHT).

Material and methods: In this single-centre, observational, retrospective study, texture analysis was performed on ADC maps and post-gadolinium T1 images of patients with histological diagnosis of naso-oropharyngeal carcinoma treated with RT-CHT. An initial cohort of 99 patients was selected; 57 of them were later excluded. The final cohort of 42 patients was divided into 3 groups (inflammation, fibrosis, and residual cancer) according to MRI, 18F-FDG-PET/CT performed 3-4 months after RT-CHT, and biopsy. Pre-RT-CHT lesions and the corresponding anatomic area post-RT-CHT were segmented with [http://www.slicer.org '''3D Slicer'''] software from which 107 textural features were derived. T-Student and Wilcoxon signed-rank tests were performed, and features with p-value < 0.01 were considered statistically significant. Cut-off values-obtained by ROC curves-to discriminate post-RT-CHT non-tumoural changes from residual cancer were calculated for the parameters statistically associated to the diseased status at follow-up.

Results: Two features-Energy and Grey Level Non-Uniformity-were statistically significant on T1 images in the comparison between 'positive' (residual cancer) and 'negative' patients (inflammation and fibrosis). Energy was also found to be statistically significant in both patients with fibrosis and residual cancer. Grey Level Non-Uniformity was significant in the differentiation between residual cancer and inflammation. Five features were statistically significant on ADC maps in the differentiation between 'positive' and 'negative' patients. The reduction in values of such features between pre- and post-RT-CHT was correlated with a good response to therapy.

Conclusions: Texture analysis on post-gadolinium T1 images and ADC maps can differentiate residual cancer from fibrosis and inflammation in early follow-up of naso-oropharyngeal carcinoma treated with RT-CHT.
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==BabelBrain: An Open-Source Application for Prospective Modeling of Transcranial Focused Ultrasound for Neuromodulation Applications==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37155375/ IEEE Trans Ultrason Ferroelectr Freq Control. 2023 Jul;70(7):587-99. PMID: 37155375]

'''Authors:''' Pichardo S.

'''Institution:''' Department of Radiology, University of Calgary, Calgary, Canada.

'''Abstract:'''
BabelBrain is an open-source standalone graphic-user-interface application designed for studies of neuromodulation using transcranial-focused ultrasound (FUS). It calculates the transmitted acoustic field in the brain tissue, taking into account the distortion effects caused by the skull barrier. The simulation is prepared using scans from magnetic resonance imaging (MRI) and, if available, computed tomography (CT) and zero-echo time MRI scans. It also calculates the thermal effects based on a given ultrasound regime, such as the total duration of exposure, the duty cycle, and acoustic intensity. The tool is designed to work in tandem with neuronavigation and visualization software, such as [http://www.slicer.org '''3D Slicer''']. It uses image processing to prepare domains for ultrasound simulation and uses the BabelViscoFDTD library for transcranial modeling calculations. BabelBrain supports multiple GPU backends, including Metal, OpenCL, and CUDA, and works on all major operating systems including Linux, macOS, and Windows. This tool is particularly optimized for Apple ARM64 systems, which are common in brain imaging research. The article presents the modeling pipeline used in BabelBrain and a numerical study where different methods of acoustic properties mapping were tested to select the best method that can reproduce the transcranial pressure transmission efficiency reported in the literature.
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==Volumetric Analysis of the Sinus and Orbit in Silent Sinus Syndrome After Endoscopic Sinus Surgery==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/36939460/ Otolaryngol Head Neck Surg. 2023 Jul;169(1):151-156. PMID: 36939460]

'''Authors:'''
Amin D, Chitguppi C, Xu V, Haghshenas C, Gorniak R, Rabinowitz M, Toskala E, Rosen M, Nyquist G.

'''Institution:''' Department of Otolaryngology-Head & Neck Surgery, Thomas Jefferson University, Philadelphia, PA, USA.

'''Abstract:'''
Objective: The term "silent sinus syndrome" (SSS) describes spontaneous enophthalmos secondary to subclinical maxillary sinus atelectasis. Debate remains on whether treatment with endoscopic maxillary antrostomy alone is adequate in reversing atelectasis and globe displacement. This study aims to determine the degree of volume change of the diseased sinus and orbit as well as the change in orbital height in patients treated with endoscopic antrostomy without orbital floor augmentation.

Study design: Retrospective review with image analysis.

Setting: Single tertiary care institution.

Methods: Three-dimensional (3D) analysis of computed tomographic imaging data was performed using [http://www.slicer.org '''3D Slicer''']. 3D models of the maxillary sinus and orbit of the diseased and normal sides were created, and volume measurements were calculated using the segmentation program.

Results: Thirteen patients with SSS who underwent endoscopic sinus surgery (ESS) and had follow-up computed tomographic imaging were analyzed. After endoscopic antrostomy, the mean volume of the diseased maxillary sinus significantly increased by 9.82%, from 6.37 to 7.00 cm3 (p = .0302). There was no significant change in mean orbital volume; however, the mean orbital height decreased by 5.67%, from 38.09 to 35.93 mm from pretreatment to posttreatment samples (p = .0101). All patients had resolution of clinical or radiographic enophthalmos and orbital displacement with ESS alone.

Conclusion: Endoscopic maxillary antrostomy alone in the treatment of SSS significantly increased maxillary sinus volume and decreased diseased orbital height. These changes were associated with clinical and radiographic improvement in globe displacement. These findings support performing ESS alone, reserving orbital augmentation for patients who do not exhibit adequate clinical improvement.
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==Safety and Efficacy of Thoracic Endovascular Aortic Repair for Acute Stanford Type B Aortic Dissection With Retrograde Type a Intramural Hematoma==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/36921645/ J Vasc Surg. 2023 Jul;78(1):61-69.e4. PMID: 36921645] | [https://www.jvascsurg.org/action/showPdf?pii=S0741-5214%2823%2900438-X PDF]

'''Authors:''' Wang J, Li M, Li J, He H, Zhou Y, Li X, Li Q, Gu F, Ye Z, Dardik A, Shu C.

'''Institution:''' Department of Vascular Surgery, Second Xiangya Hospital, Central South University, Changsha, China; Institute of Vascular Diseases, Central South University, Changsha, China.

'''Abstract:'''
Objective: The aim of this study was to evaluate safety and efficacy of thoracic endovascular aortic repair (TEVAR) for acute Stanford type B aortic dissection (TBAD) with retrograde type A intramural hematoma (TAIMH).

Methods: Patients with acute TBAD with retrograde TAIMH treated with TEVAR between January 1, 2014, to March 31, 2022, were retrospectively reviewed. Aortic diameter and distance were measured using the [http://www.slicer.org '''3D Slicer'''] image computing platform. Patients' characteristics, procedural, in-hospital and follow-up data, and aortic remodeling were analyzed.

Results: Fifty-two patients (average age, 52.6 years; 42 males [80.8%]) were included. The median interval from symptom onset to TEVAR was 11 days (interquartile range, 7.0-16.8 days). The maximal diameter of the ascending aorta (AA) was <50 mm, and the hematoma thickness in the AA was ≤10 mm in all patients. Both the in-hospital and 30-day mortality rates were 0%. The 30-day complication rate was 11.5%. The overall cumulative survival rates were 100% at 1 year, 97.1% at 3 years, and 92.6% at 5 years. Four of 52 patients (7.7%) developed retrograde type A aortic dissection at 10 days to 4 months postoperatively, and one of 52 patients (1.9%) developed an isolated AA dissection 4 months postoperatively; these five patients were treated and alive at late follow-up in March 2022. The rates of cumulative freedom from thoracic aortic re-intervention were 93.7% at 1 year and 90.7% at 5 years. Positive AA remodeling was observed in 92.3% (48/52) of patients during follow-up. The maximal diameter of AA (mean ± standard error of mean) at admission was 42.7 ± 0.8 mm, which decreased to 39.5 ± 0.9 mm at last follow-up. The maximal AA hematoma thickness at admission was 7.6 ± 0.3 mm, which reduced to 2.2 ± 0.9 mm at last follow-up.

Conclusions: For selected patients of acute Stanford TBAD with retrograde TAIMH, endovascular repair may be a safe, effective, and durable alternative treatment, if the maximum diameter of the AA is <50 mm and the intramural hematoma thickness in the AA is ≤10 mm.
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==The Traction Force of the Pulled Limb in Hip Arthroscopic Surgery Is Determined by Stiffness Coefficient Which Is Significantly Related to Muscle Volume==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/36477348/ Knee Surg Sports Traumatol Arthrosc. 2023 Jul;31(7):2708-2715. PMID: 36477348]

'''Authors:''' Yin Y, Xue S, Zhang X, Yang G, Xu Y, Wang J, Huang H.

'''Institution:''' Department of Sports Medicine, Beijing Key Laboratory of Sports Injuries, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing, People's Republic of China.

'''Abstract:'''
Purpose: To verify the relationship between muscle volume, lateral centre-edge angle (LCEA), alpha angle (AA), body mass index (BMI) and Beighton score with stiffness coefficient (SC). To analyse the difference of traction force at different physical states of hip joint capsule.

Methods: Thirty-six patients who underwent hip arthroscopy operation were included. The volumes of some related muscles were measured in MRI images by [http://www.slicer.org '''3D Slicer''']. We recorded and tested differences in traction force of five joint capsule physical states, including before (State 1) and after joint capsule puncture (State 2), after the establishment of anterolateral and mid-anterior approaches (State 3) and after incision of the joint capsule through these two approaches (States 4, 5). The correlation between muscle volume, BMI, LCEA, AA and SC was verified by Spearman test. Poisson regression was used to explain confounding variables.

Results: The average force at State 1 was 531.8 N. There were significant differences in traction force between these five states (p < 0.001). There was a significant positive correlation between muscle volumes and SC (p < 0.001). BMI had no correlation with SC (n.s.). The preoperative LCEA of the affected side was correlated with SC (p = 0.043). AA and SC were not correlated (n.s.).

Conclusion: The physical states of the hip joint capsule affected traction force. Muscle volume rather than BMI is an ideal index to estimate preoperative traction force. LCEA affected traction force, whilst AA and Beighton score did not. Measuring the muscle volume can help estimate the most suitable traction force for the patient.
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==Three-Dimensional Assessment of Tongue Cancer Prognosis by Preoperative MRI==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/35426211/ Oral Dis. 2023 Jul;29(5):2006-2011. PMID: 35426211]

'''Authors:''' Li C, Zhu L, Guo Y, Ji T, Ren Z.

'''Institution:''' Department of Oral and Maxillofacial Head and Neck Oncology, The Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

'''Abstract:'''
Purpose: To obtain the relative volume by measuring the tongue volume and the lesion volume, and further explore its relationship with the prognosis of patients, hoping to supplement the TNM staging with a new index.

Methods: ITK-SANP software was used to outline the patients' MRI. After MRI reconstruction and measurement, [http://www.slicer.org '''3D Slicer'''] software was used to estimate tumor volume.

Results: A total of 64 patients with tongue cancer who met the inclusion criteria were included in the study. The estimated tumor volume after MRI reconstruction revealed a significant and robust correlation with tumor stage (p < 0.05, Rs = 0.6207) and a substantial and medium correlation with early lymph node metastasis (p < 0.05, Rs = 0.4873).

Conclusions: We classified tongue cancer into three grades based on tumor volume (Stage I, tumors smaller than 1500 mm³; Stage II, tumors 1500-9000 mm³; and Stage III, tumors larger than 9000 mm³), and such grading could be used as a reference for tumor staging, lymph node metastasis, and patient prognosis to a certain extent.
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==Multimodal Measurements of Levator Bowl Volume in Nulligravid Asymptomatic Women: Endovaginal Ultrasound Versus MRI==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36656345 Int Urogynecol J. 2023 Jul;34(7):1627-33. PMID: 36656345]

'''Authors:''' Chill HH, Martin LC, Abramowitch SD, Rostaminia G.

'''Institution:''' Female Pelvic Medicine and Reconstructive Surgery (FPMRS), Division of Urogynecology, University of Chicago, Northshore University HealthSystem, Skokie, IL, USA.

'''Abstract:''' Introduction and hypothesis: Measurements of levator bowl volume using advanced imaging, may be predictive of pelvic floor muscle function. The aim of this study was to compare the volume of the levator bowl using both magnetic resonance imaging (MRI) and endovaginal ultrasound (EVU) of healthy asymptomatic women.

'''Methods:''' All participants underwent a comprehensive interview including completion of the Pelvic Floor Distress Inventory Questionnaire-20 questionnaire, pelvic examination with a pelvic organ prolapse quantification evaluation, MRI, and EVU. The pelvic floor was segmented using [http://www.slicer.org '''3D Slicer'''] and the MRI segmentations were trimmed using two methods: soft-tissue landmarks and the field of view (FOV) of the ultrasound volume. The levator bowl volume of the 3D segmented shapes was measured using Blender's 3D printing toolkit. Normality was tested using the Shapiro-Wilks test and comparisons were made using self-paired t tests.

'''Results:''' The final analysis included 19 patients. Levator bowl volume measured via MRI was larger than that measured in EVU (46.1 ± 7.9 cm3 vs 27.4 ± 5.9 cm3, p<0.001). Reducing the FOV of the MRI to that of EVU caused the MRI volume to be much closer to the EVU volume (35.5 ± 3.3 cm3 vs 27.4 ± 5.9 cm3, p<0.001); however, it remained significantly larger.

'''Conclusion:''' Levator bowl volume measured using MRI was larger than that measured using EVU no matter the method of delineation of the levator muscles. Although EVU is safe, cheap, and easy to perform, it captures a smaller volume of levator bowel than MRI.
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==Pectoralis Muscle Area Measured at T4 Level Is Closely Associated With Adverse COVID-19 Outcomes in Hospitalized Patients==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37259659 J Musculoskelet Neuronal Interact. 2023 Jun 1;23(2):196-204. PMID: 37259659] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10233225/pdf/JMNI-23-196.pdf PDF]

'''Authors:''' Tekin ZN, Dogruoz Karatekin B, Dogan MB, Bilgi Z.

'''Institution:''' Istanbul Medeniyet University, Goztepe Prof Dr Suleyman Yalcin City Hospital, Radiology, Istanbul, Turkey.

'''Abstract:'''
Objectives: Skeletal muscle area (SMA) at T4 level on chest computed tomography (CT) is a newly available method that can be used as a surrogate sarcopenia marker. The objective of this study is to evaluate association of SMA with adverse COVID-19 outcomes in hospitalized patients.

Methods: Hospitalized COVID-19 patients were prospectively recorded in a database containing age, gender, date of admission, date of outcome (discharge, mortality, presence of intensive care unit (ICU) stay, additional coding information (comorbidities, superimposed conditions). Admission CT-scans were retrospectively evaluated for segmentation (bilateral pectoralis major/minor, erector spinae, levator scapulae, rhomboideus minor and major and transversospinalis muscles) and SMA calculation using [http://www.slicer.org '''3D Slicer'''] software.

Results: 167 cases were evaluated (68 male, 72 female, 140 survived, 27 dead). Muscle area was lower in patients with ICU stay (p=0.023, p=0.018, p=0.008) and mortality outcome (p=0.004, p=0.007, p=0.002) for pectoralis, back and SMA. In multivariate Cox-regression analysis, hazard ratio (HR) value for the pectoralis muscle area value below 2800 mm2 was found to be 3.138(95% CI: 1.171-8.413) for mortality and 2.361(95% CI: 1.012-5.505) for ICU.

Conclusions: Pectoralis muscle area measured at T4 level with 3-D slicer was closely associated with adverse outcomes (mortality, ICU stay) in hospitalized COVID-19 patients. Since early treatment methods for COVID-19 are being evaluated, this method may be a useful adjunct to clinical decision making in regard to prioritization.
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==Precise Location of the Ventricular Catheter Tip in Ventriculoperitoneal Shunt Placement Guided by 3D Printed Individualized Guide==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37086587/ Clin Neurol Neurosurg. 2023 Jun;229:107730. PMID: 37086587]

'''Authors:''' Tian Q, Yi J, Wu Y, Wang S, Qu Y, Cai Q.

'''Institution:''' Department of Neurosurgery, Tangdu hospital, Air Force Medical University, Shaanxi, China.

'''Abstract:'''
Objective: Improper placement of the ventricular catheter tip is the most common cause of shunting disorders after ventriculoperitoneal shunt (VPS) placement surgery. Here, through two illustrative cases, we described a novel method of precise ventricular catheter tip location.

Methods: [http://www.slicer.org '''3D Slicer'''] software was used to define the ventricle puncture path and determine the ventricle catheter tip location preoperatively, and the 3D individualized guide model was printed.

Results: The ventricular puncture was performed under the guidance of the 3D guide to achieve precise ventricle catheter tip location intraoperatively.

Conclusions: This technique is safe, simple, efficient and cost-effective, which facilitates its clinical implementation and promotion.
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==PIRET-A Platform for Treatment Planning in Electroporation-Based Therapies==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37015676/ IEEE Trans Biomed Eng. 2023 Jun;70(6):1902-10. PMID: 37015676]

'''Authors:''' Perera-Bel E, Aycock KN, Salameh ZS, Gomez-Barea M, Davalos RV, Ivorra A, Ballester MAG.

'''Institution:''' BCN MedTech, Department of Information and Communication Technologies, Universitat Pompeu Fabra, Barcelona, Spain.

'''Abstract:'''
Tissue electroporation is the basis of several therapies. Electroporation is performed by briefly exposing tissues to high electric fields. It is generally accepted that electroporation is effective where an electric field magnitude threshold is overreached. However, it is difficult to preoperatively estimate the field distribution because it is highly dependent on anatomy and treatment parameters.

Objective: We developed PIRET, a platform to predict the treatment volume in electroporation-based therapies.

Methods: The platform seamlessly integrates tools to build patient-specific models where the electric field is simulated to predict the treatment volume. Patient anatomy is segmented from medical images and 3D reconstruction aids in placing the electrodes and setting up treatment parameters.

Results: Four canine patients that had been treated with high-frequency irreversible electroporation were retrospectively planned with PIRET and with a workflow commonly used in previous studies, which uses different general-purpose segmentation, [http://www.slicer.org '''3D Slicer'''] and modeling software (3Matic and COMSOL Multiphysics). PIRET outperformed the other workflow by 65 minutes (× 1.7 faster), thanks to the improved user experience during treatment setup and model building. Both approaches computed similarly accurate electric field distributions, with average Dice scores higher than 0.93.

Conclusion: A platform which integrates all the required tools for electroporation treatment planning is presented. Treatment plan can be performed rapidly with minimal user interaction in a stand-alone platform.

Significance: This platform is, to the best of our knowledge, the most complete software for treatment planning of irreversible electroporation. It can potentially be used for other electroporation applications.
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==Surgically Assisted Maxillary Expansion With or Without Pterygoid Disjunction Alters Maxillomandibular Positioning==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/35426586/ Oral Maxillofac Surg. 2023 Jun;27(2):269-281. PMID: 35426586]

'''Authors:''' Carvalho FSR, Soares ECS, de Medeiros JR, Júnior JMM, Hyppolito JOP, de Barros Silva PG, Ribeiro TR, Costa FWG.

'''Institution:''' Department of Oral and Maxillofacial Surgery, Federal University of Ceará Campus Sobral, Brazil.

'''Abstract:'''
Purpose: This study aimed to analyze alterations in mandibular positioning after surgically assisted maxillary expansion (SARME) with and without pterygoid disjunction (PD).

Methods: Cone-beam computed tomography scans of 24 healthy individuals (18-45 years old) with transverse deficiency, superior to 5 mm, underwent SARME with or without PD. The aspects prospectively assessed were (1) alignment and position of the head (ITK-Snap and [http://www.slicer.org '''3D Slicer'''] software); (2) McNamara's and Steiner-Tweed-Wits' cephalometric analysis (Dolphin Imaging®); and (3) colorimetric evaluation based on 3D correspondence analysis ([http://www.slicer.org '''3D Slicer'''] software).

Results: A decrease in 1-NA and 1-SN angles as well as an increased occlusal plane in both groups was observed. Superior-inferior and anteroposterior spatial displacements of the chin were statistically significant in the PD group. Altered colorimetric patterns were also observed in the PD group.

Conclusions: This study found more evident tooth inclination in the group without PD; mandibular alterations were more evident in the PD group. Further studies with 3D analysis are strongly recommended for more comprehensive results.
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==ERCP 2.0: Biliary 3D-Reconstruction in Patients With Malignant Hilar Stricture==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37379653 Clin Res Hepatol Gastroenterol. 2023 Jun 26;47(7):102172. PMID: 37379653]

'''Authors:''' Becq A, Szewczyk J, Salin G, Chartier M, Chaput U, Leenhardt R, Dray X, Arrive L, Camus M.

'''Institution:''' Department of Gastroenterology, Henri-Mondor University Hospital, AP-HP, EA 7375, Université Paris Est Créteil, France.

'''Abstract:'''
Background: Endoscopic retrograde cholangiopancreatography (ERCP) for malignant hilar strictures is challenging. The correlation between Magnetic resonance cholangiopancreatography (MRCP) and per ERCP 2D fluoroscopic images is not obvious. The aim of this study was to evaluate the feasibility and potential usefulness of MRCP-based handmade biliary 3D reconstruction in this setting.

Methods: Methods Patients who underwent MRCP followed by ERCP for biliary drainage of a malignant hilar stricture at our institution between 2018 and 2020 were reviewed. A handmade 3D segmentation using [http://www.slicer.org '''3D Slicer'''] (Kitware, France) was fashioned and reviewed with an expert radiologist. The primary outcome was the feasibility of biliary segmentation.

Results: A total of 16 patients were included. The mean age was 70.1 (+/- 8.6) years-old and 68.8% had hilar cholangiocarcinoma. Handmade segmentation was successful in all cases. The agreement between the MRCP interpretation and the 3D reconstruction was 37.5%, as per the Bismuth classification. 3D reconstruction available prior to ERCP could have helped guide for better stent placement in 11 cases (68.8%).

Conclusions: MRCP-based biliary 3D segmentation-reconstruction, in patients with malignant hilar stricture is feasible and seems to provide a better anatomical understanding compared to MRCP and could help improve endoscopic management.
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==3D Printing Personalized Guide Plate in the Management of Recurrent Intramuscular Venous Malformations: A Single Center Experience==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/36967547/ Phlebology. 2023 Jun;38(5):307-314. PMID: 36967547]

'''Authors:''' Han T, Jiang S, Xiong J, Cui J, Shen W.

'''Institution:''' Department of Burns and Plastic Surgery, Children's Hospital of Nanjing Medical University, Nanjing, China.

'''Abstract:'''
Objective: This study aimed to investigate the feasibility and effectiveness of 3D printing personalized guide plate in the management of recurrent intramuscular venous malformations (IVM).

Methods: Fifteen patients with recurrent IVM were retrospectively assessed. [http://www.slicer.org '''3D Slicer'''] software was used to extract and reconstruct the imaging data from CT and/or MRI to highlight the morphology, size, and puncture depth of the lesion. With the guidance of personalized plate, complete excision of the IVM was adopted along the pre-marked (methylene blue, MB) margin.

Results: Personalized guide plate matched involved extremity well, and MB-puncture approach was consistent with preoperative design. All IVMs were removed radically in one single session. Complete pain relief was obtained in all cases postoperatively.

Conclusion: The application of 3D printing guide plate can be safe, effective, and reliable to confirming the precise margin of IVM, renders a promising technique with a high practical value in resection of recurrent lesion.
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==White Matter Hyperintensities: A Possible Link Between Sarcopenia and Cognitive Impairment in Patients With Mild to Moderate Alzheimer's Disease==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37330930 Eur Geriatr Med. 2023 Jun 18. PMID: 37330930]

'''Authors:''' Weng X, Liu S, Li M, Zhang Y, Zhu J, Liu C, Hu H.

'''Institution:''' Department of Neurology, The Second Affiliated Hospital of Soochow University, Jiangsu, China.

'''Abstract:'''
Purpose: Alzheimer's disease (AD) has been reported to be associated with sarcopenia. White matter hyperintensities (WMH) are common in AD patients. However, the effect of WMH on sarcopenia in AD remains unclear. We hence aimed to investigate the possible association between regional WMH volumes and sarcopenic parameters in AD.

Methods: 57 mild to moderate AD patients and 22 normal controls (NC) were enrolled. Sarcopenic parameters were assessed, including appendicular skeletal mass index (ASMI), grip strength, 5-times sit-to-stand (5-STS) time, and gait speed. The volumes of periventricular hyperintensities (PVH) and deep white matter hyperintensities (DWMH) were quantified using [http://www.slicer.org '''3D Slicer'''] software.

Results: AD subjects exhibited a lower ASMI, a slower gait speed, an increased 5-STS time, and larger volumes of PVH and DWMH than those in the NC group. In AD subjects, total WMH and PVH volumes were related to cognitive impairment, particularly executive function decline. Moreover, total WMH volume and PVH volume were negatively correlated with gait speed across various clinical stages of AD. Multiple linear regression analysis showed that PVH volume was independently associated with 5-STS time and gait speed, whereas DWMH volume was only independently associated with gait speed.

Conclusion: WMH volume was associated with cognitive decline and various sarcopenic parameters. It thereby suggested that WMH may serve as the connection between sarcopenia and cognitive dysfunction in AD. Further studies are needed to confirm these findings and to determine whether sarcopenia interventions reduce WMH volume and improve cognitive function in AD.
|}

==CT Angiography Radiomics Combining Traditional Risk Factors to Predict Brain Arteriovenous Malformation Rupture: a Machine Learning, Multicenter Study==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37311939 Transl Stroke Res. 2023 Jun 13. PMID: 37311939]

'''Authors:''' Zhang S, Wang J, Sun S, Zhang Q, Zhai Y, Wang X, Ge P, Shi Z, Zhang D.

'''Institution:''' Department of Neurosurgery, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.

'''Abstract:'''
This study aimed to develop a machine learning model for predicting brain arteriovenous malformation (bAVM) rupture using a combination of traditional risk factors and radiomics features. This multicenter retrospective study enrolled 586 patients with unruptured bAVMs from 2010 to 2020. All patients were grouped into the hemorrhage (n = 368) and non-hemorrhage (n = 218) groups. The bAVM nidus were segmented on CT angiography images using [http://www.slicer.org '''3D Slicer'''] software, and radiomic features were extracted using Pyradiomics. The dataset included a training set and an independent testing set. The machine learning model was developed on the training set and validated on the testing set by merging numerous base estimators and a final estimator based on the stacking method. The area under the receiver operating characteristic (ROC) curve, precision, and the f1 score were evaluated to determine the performance of the model. A total of 1790 radiomics features and 8 traditional risk factors were contained in the original dataset, and 241 features remained for model training after L1 regularization filtering. The base estimator of the ensemble model was Logistic Regression, whereas the final estimator was Random Forest. In the training set, the area under the ROC curve of the model was 0.982 (0.967-0.996) and 0.893 (0.826-0.960) in the testing set. This study indicated that radiomics features are a valuable addition to traditional risk factors for predicting bAVM rupture. In the meantime, ensemble learning can effectively improve the performance of a prediction model.
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==Real-Time Integration Between Microsoft HoloLens 2 and 3D Slicer With Demonstration in Pedicle Screw Placement Planning==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37310561 Int J Comput Assist Radiol Surg. 2023 Jun 13. PMID: 37310561]

'''Authors:''' Pose-Díez-de-la-Lastra A, Ungi T, Morton D, Fichtinger G, Pascau J.

'''Institution:''' Departamento de Bioingeniería, Universidad Carlos III de Madrid, Spain.

'''Abstract:'''
Purpose: Up to date, there has been a lack of software infrastructure to connect [http://www.slicer.org '''3D Slicer'''] to any augmented reality (AR) device. This work describes a novel connection approach using Microsoft HoloLens 2 and OpenIGTLink, with a demonstration in pedicle screw placement planning.

Methods: We developed an AR application in Unity that is wirelessly rendered onto Microsoft HoloLens 2 using Holographic Remoting. Simultaneously, Unity connects to [http://www.slicer.org '''3D Slicer'''] using the OpenIGTLink communication protocol. Geometrical transform and image messages are transferred between both platforms in real time. Through the AR glasses, a user visualizes a patient's computed tomography overlaid onto virtual 3D models showing anatomical structures. We technically evaluated the system by measuring message transference latency between the platforms. Its functionality was assessed in pedicle screw placement planning. Six volunteers planned pedicle screws' position and orientation with the AR system and on a 2D desktop planner. We compared the placement accuracy of each screw with both methods. Finally, we administered a questionnaire to all participants to assess their experience with the AR system.

Results: The latency in message exchange is sufficiently low to enable real-time communication between the platforms. The AR method was non-inferior to the 2D desktop planner, with a mean error of 2.1 ± 1.4 mm. Moreover, 98% of the screw placements performed with the AR system were successful, according to the Gertzbein-Robbins scale. The average questionnaire outcomes were 4.5/5.

Conclusions: Real-time communication between Microsoft HoloLens 2 and 3D Slicer is feasible and supports accurate planning for pedicle screw placement.
|}

==Delirium After Traumatic Brain Injury: Prediction by Location and Size of Brain Lesion==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37317796 Ann Rehabil Med. 2023 Jun 7. PMID: 37317796] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10326395/pdf/arm-23008.pdf PDF]

'''Authors:''' Han SJ, Suh JH, Lee JY, Kim SJ.

'''Institution:''' Department of Rehabilitation Medicine, College of Medicine, Ewha Womans University, Seoul, Korea.

'''Abstract:'''
Objective: To examine (1) the location of brain lesion that would predict post-traumatic delirium and (2) the association between volume of brain lesion and occurrence of delirium in patients with traumatic brain injury (TBI).

Methods: A retrospective study was conducted by reviewing medical records of 68 TBI patients, categorized into two groups: the delirious group (n=38) and non-delirious group (n=30). The location and volume of TBI were investigated with the [http://www.slicer.org '''3D Slicer'''] software.

Results: The TBI region in the delirious group mainly involved the frontal or temporal lobe (p=0.038). All 36 delirious patients had brain injury on the right side (p=0.046). The volume of hemorrhage in the delirious group was larger by about 95 mL compared to the non-delirious group, but this difference was not statistically significant (p=0.382).

Conclusion: Patients with delirium after TBI had significantly different injury site and side, but not lesion size compared to patients without delirium.
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==Mitral Paravalvular Leak 3D Printing from 3D-Transesophageal Echocardiography==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37288866 Anatol J Cardiol. 2023 Jun 7. PMID: 37288866] | [https://doi.org/10.14744/AnatolJCardiol.2023.3008 PDF]

'''Authors:''' Jedrzejek M, Kozlowski M, Peszek-Przybyla E, Jadczyk T, Pysz P, Wojakowski W, Smolka G.

'''Institution:''' Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland.

'''Abstract:'''
Background: Paravalvular leaks can be detected in almost 15% of patients after mitral valve prosthesis implantation. This complication can result in congestive heart failure and hemolysis. Despite advancements in non-invasive imaging, percutaneous closure of paravalvular leaks is not always successful. Therefore, efforts are made to improve treatment outcomes by using 3D-printed models of defects as pre-procedural support for interventional cardiologists.

Methods: Retrospectively, 3D-transesophageal echocardiography recordings of 8 patients with clinically significant mitral paravalvular leaks were analyzed. Qlab Software was used to export DICOM images of each paravalvular leak channel, including surrounding tissue. Image segmentation was performed in [http://www.slicer.org '''3D Slicer'''], a free, open-source software package used for imaging research. Models were printed to actual size with the poly jet Stratasys Objet 30 printer with a transparent, rigid material.

Results: Duration of model preparation and printing, as well as the total cost, was calculated. Mean total time of model preparation was 430.5 ± 196 minutes.

Conclusion: 3D-printing from 3D-transesophageal echocardiography is technically feasible. Both shape and location of paravalvular leaks are preserved during model preparation and printing. It remains to be tested if 3D-printing would improve outcomes of percutaneous paravalvular leaks closure.
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==Prediction of Ki-67 Expression in Gastrointestinal Stromal Tumors Using Radiomics of Plain and Multiphase Contrast-Enhanced CT==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37266658 Eur Radiol. 2023 Jun 2. PMID: 37266658]

'''Authors:''' Liu Y, He C, Fang W, Peng L, Shi F 4, Xia Y, Zhou Q, Zhang R 5, Li C.

'''Institution:''' Medical Imaging Department, Chongqing University Central Hospital, Chongqing Emergency Medical Center, Chongqing, China.

'''Abstract:'''
Objective: To study the value of radiomics models based on plain and multiphase contrast-enhanced CT to predict Ki-67 expression in gastrointestinal stromal tumors (GISTs).

Methods: A total of 215 patients with GISTs were retrospectively analyzed, including 150 patients in one hospital as the training set and 65 patients in another hospital as the external verification set. The tumor at the largest level of CT images was delineated as the region of interest (ROI). The maximum diameter of the ROI was defined as the tumor size. A total of 851 radiomics features were extracted from each ROI by [http://www.slicer.org '''3D Slicer'''] Radiomics. After dimensionality reduction, three machine learning classification algorithms including logistic regression (LR), random forest (RF), and support vector machine (SVM) were used for Ki-67 expression prediction. Using a multivariable logistic model, a nomogram was established to predict the expression of Ki-67 individually.

Results: Delong tests showed that the SVM models had the highest accuracy in the arterial phase (Z value 0.217-1.139) and venous phase (Z value 0.022-1.396). For the plain phase, LR and SVM models had the highest accuracy (Z value 0.874-1.824, 1.139-1.763). For the delayed phase, LR models had the highest accuracy (Z value 0.056-1.824). For the combined phase, RF models had the highest accuracy (Z value 0.232-1.978). There was no significant difference among the above models for KI-67 expression prediction (Z value 0.022-1.978). A nomogram was developed with a C-index of 0.913 (95% CI, 0.878 to 0.956).

Conclusions: Radiomics of both plain and enhanced CT images could accurately predict the expression of Ki-67 in GIST. For patients who were not suitable to use contrast agents, plain scan could be used as an alternative.
|}

==Accuracy of Imaging Software for 3d Rendering of Tooth Structures, Usable in Clinical Settings==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37272346 Int J Comput Dent. 2023 Jun 5;0(0):0. PMID: 37272346]

'''Authors:''' Ronsivalle V, Venezia P, Migliorati M, Grippaudo C, Barbato E, Nucci L, Isola G, Leonardi RM, Lo Giudice A.

'''Institution:''' Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Policlinico Universitario "Vittorio Emanuele-G. Rodolico", Catania, Italy.

'''Abstract:'''
Aim: The aim of this study was to evaluate the segmentation accuracy of dentition testing four free-source semi-automatic software.

Materials and methods: A total of 20 cone-beam computed tomography (CBCT) were selected to perform semi-automatic segmentation of maxillary and mandibular dentition. The software tested were Invesalius, ITK-Snap, [http://www.slicer.org '''3D Slicer'''] and Seg3D. Each tooth model was also manually segmented (Mimics software) and set as the gold standard (GS) reference of the investigation. A specific 3D imaging technology was used to perform the superimposition between the teeth models obtained with semi-automatic software and the GS model, and to perform the surface-to-surface matching analysis. The accuracy of semi-automatic segmentation was evaluated calculating the volumetric mean differences (mean bias and limits of agreement) and the percentage of matching of the tooth models compared to the manual segmentation (GS). Qualitative assessments were performed using color-coded maps. All data were statistically analysed to perform software comparisons.

Result: Statistically significant differences were found in the volumetric and matching percentage data (p < 0,05). Invesalius was the most accurate software for 3D rendering of the dentition with a volumetric bias (Mimics) ranging from 4,59 mm3 to 85,79 mm3; instead, ITK-SNAP showed the higher volumetric bias, ranging from 30,22 mm3 to 319,83 mm3. The dis-matched area was mainly located at the radicular region of the teeth. Volumetric data showed excellent inter-software reliability with coefficient values ranging from 0,951 to 0,997.

Conclusion: Different semi-automatic software algorithms could generate different patterns of inaccuracy error in the segmentation of teeth.
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==A Retrospective Three-Dimensional Study of the Mandibular Growth During Preoperative Orthodontics in Late Adolescent Patients With Skeletal Class III Malocclusion==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37271262 J Stomatol Oral Maxillofac Surg. 2023 Jun 2:101526. PMID: 37271262]

'''Authors:''' Yuan M, Zheng Z, Li H, Wang P, Liu Y, Bi R.

'''Institution:''' State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthognathic and TMJ Surgery, West China Hospital of Stomatology, Sichuan University, China.

'''Abstract:'''
Introduction: The mandible's ongoing development presents a contraindication for combined orthodontic-orthognathic treatment. The aim of this study was to evaluate the mandibular stability before and after preoperative orthodontic treatment in late adolescent patients with skeletal Class III malocclusion and to investigate the most appropriate time to start preoperative orthodontic treatment.

Material and methods: The study population consisted of 58 adolescents, aged between 15 and 21 years, with skeletal Class III malocclusion; the adolescents underwent CT scans at the beginning (T1) and the end (T2) of preoperative orthodontic treatment. The CT data were analyzed using ITK-SNAP and [http://www.slicer.org '''3D Slicer'''] software, and the effects of age and gender on mandibular development were investigated.

Results: In these 58 patients, there were no significant local bone alterations in the condyle and anterior chin point between T1 and T2 and no significant changes in the mandibular branch height, mandibular body length, condylar distance, and mandibular angle distance (p>0.05). The mandibular growth at the angel of mandible was statistically significant (p<0.05), but it was not clinically significant because the mean value of the growth was small (right: 0.416±0.986 mm, left: 0.328±0.886 mm). No effect of age and gender on mandibular development was observed.

Conclusion: The mandibular morphology was stable during preoperative orthodontic treatment in patients at the late adolescent stage. This study provides evidence for the possibility of early implementation of preoperative orthodontics.
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==Assessment of Variabilities in Lung-Contouring Methods on CBCT Preclinical Radiomics Outputs==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37345013 Cancers (Basel). 2023 May 9;15(10):2677. PMID: 37345013] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10216427/pdf/cancers-15-02677.pdf PDF]

'''Authors:''' Brown KH, Illyuk J, Ghita M, Walls GM, McGarry CK, Butterworth KT.

'''Institution:''' Patrick G. Johnston Centre for Cancer Research, Queen's University Belfast, UK.

'''Abstract:'''
Radiomics image analysis has the potential to uncover disease characteristics for the development of predictive signatures and personalised radiotherapy treatment. Inter-observer and inter-software delineation variabilities are known to have downstream effects on radiomics features, reducing the reliability of the analysis. The purpose of this study was to investigate the impact of these variabilities on radiomics outputs from preclinical cone-beam computed tomography (CBCT) scans. Inter-observer variabilities were assessed using manual and semi-automated contours of mouse lungs (n = 16). Inter-software variabilities were determined between two tools ([http://www.slicer.org '''3D Slicer'''] and ITK-SNAP). The contours were compared using Dice similarity coefficient (DSC) scores and the 95th percentile of the Hausdorff distance (HD95p) metrics. The good reliability of the radiomics outputs was defined using intraclass correlation coefficients (ICC) and their 95% confidence intervals. The median DSC scores were high (0.82-0.94), and the HD95p metrics were within the submillimetre range for all comparisons. the shape and NGTDM features were impacted the most. Manual contours had the most reliable features (73%), followed by semi-automated (66%) and inter-software (51%) variabilities. From a total of 842 features, 314 robust features overlapped across all contouring methodologies. In addition, our results have a 70% overlap with features identified from clinical inter-observer studies.
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==A Training Tool for Clinicians in Segmenting Medical Images to Make 3D Models==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37342255 Ann Surg Open. 2023 May 23;4(2):e275. PMID: 37342255] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7614675/pdf/EMS170894.pdf PDF]

'''Authors:''' Chegini S, Tahim A, Liu M, Chooi Y, Edwards E, Clarkson M, Schilling C.

'''Institution:''' Department of Head and Neck Surgery, University College London Hospital, London, UK.

'''Abstract:'''
Introduction: 3D models produced from medical imaging can be used to plan treatment, design prosthesis, teach and for communication. Despite the clinical benefit, few clinicians have experience of how 3D models are produced.This is the first study evaluating a training tool to teach clinicians to produce 3D models and reporting the perceived impact on their clinical practice.

Method: Following ethical approval, 10 clinicians completed a bespoke training tool, comprising written and video material alongside online support. Each clinician and 2 technicians (included as control) were sent 3 CT scans and asked to produce 6 fibula 3D models using an open-source software, [http://www.slicer.org '''3D Slicer''']. The produced models were compared to those produced by the technicians using Hausdorff distance calculation. Thematic analysis was used to study the post-intervention questionnaire.

Results: The mean Hausdorff distance between the final model produced by the clinicians and technicians was 0.65mm SD0.54mm. The first model made by clinicians took a mean time of 1hr 25mins and the final model took 16:04mins (5:00-46:00mins). 100% of learners reported finding the training tool useful and will employ it in future practice.

Discussion: The training tool described in this paper is able to successfully train clinicians to produce fibula models from CT scans. Learners were able to produce comparable models to technicians within an acceptable timeframe. This does not replace technicians. However, the learners perceived this training will allow them to use this technology in more cases, with appropriate case selection and they appreciate the limits of this technology.
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==3D Slicer Combined With Neuroendoscope in Treatment of a Distal Segment Aneurysm of the Anterior Choroidal Artery Complicated Intraventricular Hemorrhage: A Case Report and Literature Review==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37251467 Heliyon. 2023 May 18;9(6):e16193. PMID: 37251467] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10220353/pdf/main.pdf PDF]

'''Authors:''' Zhou L, Ren Y, Li Z, Zhang H, Wei H, Song P, Cheng L, Wang W, Gao L, Lei P, Hua Q, Chen Q, Zhou J, Li G, Cai Q.

'''Institution:''' Department of Neurosurgery, Renmin Hospital of Wuhan University, Wuhan, China.

'''Abstract:'''
Introduction: Pure ventricular hemorrhage is often secondary to Moyamoya disease, rarely caused by rupture of ventricular aneurysm. The surgical treatment of the latter is very challenging. [http://www.slicer.org '''3D Slicer'''] reconstruction technology can accurately locate small intracranial lesions and combined with minimally invasive surgery with transcranial neuroendoscope is a new attempt to treat the above diseases.

Case presentation: We report a case of pure intraventricular hemorrhage secondary to rupture of a distal segment aneurysm of the anterior choroidal artery. Brain computed tomography (CT) before admission showed pure ventricular hemorrhage, and brain CT angiography (CTA) before operation showed a distal segment aneurysm of the anterior choroidal artery. We used [http://www.slicer.org '''3D Slicer'''] reconstruction and precise location of the focus before the operation and used the minimally invasive surgery technique with transcranial neuroendoscope to completely remove the hematoma in the ventricle, and found the responsible aneurysm located in the ventricle.

Conclusion: Pure intraventricular hemorrhage requires vigilance against the distal segment aneurysm of the anterior choroidal artery. At present, conventional microscopic craniotomy and intravascular interventional therapy have limitations, and [http://www.slicer.org '''3D Slicer'''] reconstruction and precise positioning technology combined with transcranial neuroendoscope minimally invasive surgery may be a good choice.
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==Application of Preoperative Multimodal Image Fusion Technique in Microvascular Decompression Surgery via Suboccipital Retrosigmoid Approach==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36716853 World Neurosurg. 2023 May;173:e37-e47. PMID: 36716853] | [https://pdf.sciencedirectassets.com/280061/AIP/1-s2.0-S1878875023001031/main.pdf PDF]

'''Authors:''' Liao CC, Wu KH, Chen G.

'''Institution:''' Department of Neurosurgery, Zhuhai People's Hospital (Zhuhai Hospital Affiliated with Jinan University,China), Zhuhai, China.

'''Abstract:'''
'''Objective:''' To explore the application value of preoperative multimodal image fusion technique in microvascular decompression (MVD) surgery via the suboccipital retrosigmoid approach.

'''Methods:''' Comprehensive data of 13 patients with primary trigeminal neuralgia (TN) and 13 patients with hemifacial spasm (HFS) treated by MVD surgery via the suboccipital retrosigmoid approach at the Department of Neurosurgery in Zhuhai People's Hospital from January 2021 to December 2021 were retrospectively analyzed. Preoperatively, all patients underwent cranial thin-section computed tomography and magnetic resonance examinations. Three-dimensional (3D) digital images of the skull, brainstem, nerves, and blood vessels were constructed by the [http://www.slicer.org '''3D Slicer'''] software or RadiAnt DICOM Viewer, which were then applied to design the surgical approach and surgical plan. The multimodal image fusion results, clinical characteristics, intraoperative data, surgical outcomes, and complications of all patients were summarized.

'''Results:''' The 3D digital images after fusion reconstruction can vividly show the anatomical relationship between the skull, brainstem, nerves, and blood vessels and was helpful to tailor the surgical strategy. All 26 patients underwent a smooth surgery. During the surgery, the key points were accurately located, the corners of the transverse sinus and sigmoid sinus were completely exposed, and no venous sinus injury occurred in all 26 patients. The key point was approximately located at the top point of the digastric groove, 12.3 ± 0.46 mm vertically above and 6.3 ± 0.6 mm laterally to the Frankfurt horizontal plane. The average cranial opening time was 30.4 (±3.6) min, and the mean operating time was 104.7 (±12.1) min. The diameter of the bone window was about 2.0 cm-3.0 cm, and the bone flap was restored. Among the 13 patients with primary TN, 12 (92.3%) exhibited complete relief of pain and 1 had significant relief. Complications of surgery included facial sensory numbness in 1 case, vertigo in 2 cases, and herpes at the corners of the mouth in 1 case. Of the 13 patients with HFS, 12 (92.3%) had complete relief of facial twitching symptoms and 1 had significant relief, and the complications included mild facial palsy in 2 (15.4%) cases and facial sensory numbness in another 2 (15.4%) cases. The mean follow-up time after surgery ranged from 6-16 months, and 1 of 26 patients experienced recurrence of HFS during the follow-up period.

'''Conclusions:''' Preoperative multimodal image fusion technology can provide adequate preoperative assessment for patients and assistance in designing surgical approaches, which is an important guideline for MVD surgery via the suboccipital retrosigmoid approach for primary TN and facial muscle spasm.
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==An Interactive App with Multi-parametric MRI - Whole-Mount Histology Correlation for Enhanced Prostate MRI Training of Radiology Residents==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37137744 Acad Radiol. 2023 May 1:S1076-6332(23)00183-6. PMID: 37137744]

'''Authors:''' Chatterjee A, Szasz T, Munakami M, Karademir I, Yusufishaq MS, Martens S, Wheeler C, Antic T, Thomas S, Karczmar GS, Oto A.

'''Institution:''' Department of Radiology, University of Chicago, Chicago, IL, USA.

'''Abstract:'''
Rationale and objectives: To validate the educational value of a newly created learning application in enhancing prostate MRI training of radiologists for detecting prostate cancer using an observer study.

Materials and methods: An interactive learning app, LearnRadiology, was developed using a web-based framework to display multi-parametric prostate MRI images with whole-mount histology for 20 cases curated for unique pathology and teaching points. Twenty new prostate MRI cases, different from the ones used in the web app, were uploaded on [http://www.slicer.org '''3D Slicer''']. Three radiologists (R1: radiologist; R2, R3: residents) blinded to pathology results were asked to mark areas suspected of cancer and provide a confidence score (1-5, with 5 being high confidence level). Then after a minimum memory washout period of 1 month, the same radiologists used the learning app and then repeated the same observer study. The diagnostic performance for detecting cancers before and after accessing the learning app was measured by correlating MRI with whole-mount pathology by an independent reviewer.

Results: The 20 subjects included in the observer study had 39 cancer lesions (13 Gleason 3 + 3, 17 Gleason 3 + 4, 7 Gleason 4 + 3, and 2 Gleason 4 + 5 lesions). The sensitivity (R1: 54% → 64%, P = 0.08; R2: 44% → 59%, P = 0.03; R3: 62% → 72%, P = 0.04) and positive predictive value (R1: 68% → 76%, P = 0.23; R2: 52% → 79%, P = 0.01; R3: 48% → 65%, P = 0.04) for all 3 radiologists improved after using the teaching app. The confidence score for true positive cancer lesion also improved significantly (R1: 4.0 ± 1.0 → 4.3 ± 0.8; R2: 3.1 ± 0.8 → 4.0 ± 1.1; R3: 2.8 ± 1.2 → 4.1 ± 1.1; P < 0.05).

Conclusion: The web-based and interactive LearnRadiology app learning resource can support medical student and postgraduate education by improving diagnostic performance of trainees for detecting prostate cancer.
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==3D Printed Guide Tube System for Acute Neuropixels Probe Recordings in Non-Human Primates==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37105161 J Neural Eng. 2023 May 11;20(3):036009. PMID: 37105161] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10172811/pdf/jne_20_3_036009.pdf PDF]

'''Authors:''' Bauer DL, Pobiel B, Hilber K, Verma AK, Wang J, Vitek J, Johnson M, Johnson L.

'''Institution:''' Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, USA.

'''Abstract:'''
Objective.
Neuropixels (NP) probes are a significant advance in electrophysiological recording technology that enable monitoring of hundreds of neurons in the brain simultaneously at different depths. Application of this technology has been predominately in rodents, however widespread use in non-human primates (NHPs) such as rhesus macaques has been limited. In this study we sought to overcome two overarching challenges that impede acute NP implantation in NHPs: (1) traditional microdrive systems that mount to cephalic chambers are commonly used to access cortical areas for microelectrode recordings but are not designed to accommodate NP probes, and (2) NHPs have thick dura mater and tissue growth within the cephalic chambers which poses a challenge for insertion of the extremely fragile NP probe.
Approach.
In this study we present a novel NP guide tube system that can be adapted to commercial microdrive systems and demonstrate an implant method using the NP guide tube system. This system was developed using a combination of CAD design, 3D printing, and small part machining. Software programs, [http://www.slicer.org '''3D Slicer'''] and SolidWorks were used to target cortical areas, approximate recording depths and locations, and for in-silico implant testing.
Main results.
We performedin vivotesting to validate our methodology, successfully implanting, explanting, and reimplanting NP probes. We collected stable neurophysiological recordings in the premotor cortex of a rhesus macaque at rest and during performance of a reaching task.Significance.In this study we demonstrate a robust Neuropixels implant system that allows multiple penetrations with the same NP probe and share design files that will facilitate the adoption of this powerful recording technology for NHP studies.
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==Diagnostic Value of 18F-FDG PET/CT-Based Radiomics Nomogram in Bone Marrow Involvement of Pediatric Neuroblastoma==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/36117128 Acad Radiol. 2023 May;30(5):940-51. PMID: 36117128]

'''Authors:''' Feng L, Yang X, Lu X, Kan Y, Wang C, Zhang H, Wang W, Yang J.

'''Institution:''' Department of Nuclear Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing, China.

'''Abstract:'''
Objectives: To develop and validate an 18F-FDG PET/CT-based radiomics nomogram and evaluate the value of the 18F-FDG PET/CT-based radiomics nomogram for the diagnosis of bone marrow involvement (BMI) in pediatric neuroblastoma.

Materials and methods: A total of 144 patients with neuroblastoma (100 in the training cohort and 44 in the validation cohort) were retrospectively included. The PET/CT images of patients were visually assessed. The results of bone marrow aspirates or biopsies were used as the gold standard for BMI. Radiomics features and conventional PET parameters were extracted using [http://www.slicer.org '''3D Slicer''']. Features were selected by the least absolute shrinkage and selection operator regression, and radiomics signature was constructed. Univariate and multivariate logistic regression analyses were applied to identify the independent clinical risk factors and construct the clinical model. Other different models, including the conventional PET model, combined PET-clinical model and combined radiomics model, were built using logistic regression. The combined radiomics model was based on clinical factors, conventional PET parameters and radiomics signature, which was presented as a radiomics nomogram. The diagnostic performance of the different models was evaluated by receiver operating characteristic (ROC) curves and decision curve analysis (DCA).

Results: By visual assessment, BMI was observed in 80 patients. Four conventional PET parameters (SUVmax, SUVmean, metabolic tumor volume, and total lesion glycolysis) were extracted. And 15 radiomics features were selected to build the radiomics signature. The 11q aberration, neuron-specific enolase and vanillylmandelic acid were identified as the independent clinical risk factors to establish the clinical model. The radiomics nomogram incorporating the radiomics signature, the independent clinical risk factors and SUVmean demonstrated the best diagnostic value for identifying BMI, with an area under the curve (AUC) of 0.963 and 0.931 in the training and validation cohorts, respectively. And the DCA demonstrated that the radiomics nomogram was clinically useful.

Conclusion: The 18F-FDG PET/CT-based radiomics nomogram which incorporates radiomics signature, independent clinical risk factors and conventional PET parameters could improve the diagnostic performance for BMI of pediatric neuroblastoma without additional medical costs and radiation exposure.
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==Opportunistic Screening for Osteoporosis Using CT Scans of the Knee: A Pilot Study==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37203533 Stud Health Technol Inform. 2023 May 18;302:909-910. PMID: 37203533]

'''Authors:''' Elmahdy M, Sebro R.

'''Institution:''' Department of Radiology, Mayo Clinic, Jacksonville, FL, USA.

'''Abstract:'''
Knee CT scans are used for planning for total knee arthroplasties in patients who are often simultaneously at risk for frailty fractures due to low bone mineral density. We retrospectively identified 200 patients (85.5% female) with concurrent CT scans of the knee and Dual energy x-ray absorptiometry (DXA). The mean CT attenuation of the distal femur, proximal tibia and fibula, and patella, were calculated using volumetric 3-dimensional segmentation using [http://www.slicer.org '''3D Slicer''']. Data were split randomly into training 80% and test 20% datasets. The optimal CT attenuation threshold for the proximal fibula was obtained in the training dataset and evaluated in the test dataset. A support vector machine (SVM) with radial basis function (RBF) using C-classification was trained and tuned using 5-fold cross-validation in the training dataset and then evaluated in the test dataset. The SVM had a higher area-under-the curve (AUC) of 0.937 and better performance to detect osteoporosis/osteopenia than the CT attenuation of the fibula (AUC of 0.717) (P=0.015). Opportunistic screening for osteoporosis/osteopenia could be accomplished using CT scans of the knee.
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==Sustainable 3D Printing of Oral Films With Tunable Characteristics Using CMC-Based Inks From Durian Rind Wastes==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/36933810 Eur J Pharm Biopharm. 2023 May;186:30-42. PMID: 36933810]

'''Authors:''' Panraksa P, Rachtanapun P, Thipchai P, Lesniewska E, Brachais CH, Debeaufort F, Chambin O, Jantrawut P.

'''Institution:''' Department of Pharmaceutical Sciences, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, Thailand.

'''Abstract:'''
With the growing interest in environmentally friendly and personalized medicines, new concept for combining three-dimensional printing (3DP) with natural-based biomaterials derived from agro-food wastes has emerged. This approach provides sustainable solutions for agricultural waste management and potential for developing of novel pharmaceutical products with tunable characteristics. This work demonstrated the feasibility of fabricating personalized theophylline films with four different structures (Full, Grid, Star, and Hilbert) using syringe extrusion 3DP and carboxymethyl cellulose (CMC) derived from durian rind wastes. Our findings suggested that all the CMC-based inks with shear thinning properties capable of being extruded smoothly through a small nozzle could potentially be used to fabricate the films with various complex printing patterns and high structural fidelity. The results also demonstrated that the film characteristics and release profiles could be easily modified by simply changing the slicing parameters (e.g., infill density and printing pattern). Amongst all formulations, Grid film, which was 3D-printed with 40 % infill and a grid pattern, demonstrated a highly porous structure with high total pore volume. The voids between printing layers in Grid film increased theophylline release (up to 90 % in 45 min) through improved wetting and water penetration. All findings in this study provide significant insight into how to modify film characteristics simply by digitally changing the printing pattern in [http://www.slicer.org '''3D Slicer'''] software without creating a new CAD model. This approach could help to simplify the 3DP process so that non-specialist users can easily implement it in community pharmacies or hospital on demand.
|}

==An Automated Landmark Method to Describe Geometric Changes in the Human Mandible During Growth==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/36893681 Arch Oral Biol. 2023 May;149:105663. PMID: 36893681]

'''Authors:''' Fournier G, Maret D, Telmon N, Savall F.

'''Institution:''' Faculté de Chirurgie Dentaire, Université Paul Sabatier, Centre Hospitalier Universitaire, Toulouse, France.

'''Abstract:'''
Objective: The principal aim of this study was to assess an automatic landmarking approach to human mandibles based on the atlas method. The secondary aim was to identify the areas of greatest variation in the mandibles of middle-aged to older adults.

Design: Our sample consisted of 160 mandibles from computed tomography scans of 80 men and 80 women aged between 40 and 79 years. Eleven anatomical landmarks were placed manually on mandibles. The automated landmarking through point cloud alignment and correspondence (ALPACA) method implemented in [http://www.slicer.org '''3D Slicer'''] was used to automatically place landmarks to all meshes. Euclidean distances, normalized centroid size, and Procrustes ANOVA were calculated for both methods. A pseudo-landmarks approach was followed using ALPACA to identify areas of changes among our sample.

Results: The ALPACA method showed significant differences in Euclidean distances for all landmarks compared to the manual method. A mean Euclidean distance of 1.7 mm was found for the ALPACA method and 0.99 mm for the manual method. Both methods found that sex, age, and size had a significant effect on mandibular shape. The greatest variations were observed in the condyle, ramus, and symphysis regions.

Conclusion: The results obtained using the ALPACA method are acceptable and promising. This approach can automatically place landmarks with an average accuracy of less than 2 mm, which may be sufficient in most anthropometric analyses. In the light of our results, however, odontological application such as occlusal analysis is not recommended.
|}

==Clinical Study of Puncture Technique in Single Division of the Trigeminal Ganglion Intumescentia==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37183316 Pain Pract. 2023 May 14. PMID: 37183316] | [https://onlinelibrary.wiley.com/doi/epdf/10.1111/papr.13239 PDF]

'''Authors:''' Zhang L, Guo Y, Xu J, He Y, Qi Z, Chen H, Zhang H.

'''Institution:''' Department of Neurosurgery, Jianhu Hospital Affiliated to Nantong University, Yancheng, China.

'''Abstract:'''
Objective: We explored the feasibility of single-division puncture in the ophthalmic division, maxillary division, and mandibular division of the trigeminal ganglion intumescentia (TGI) and the feasibility of radiofrequency treatment of trigeminal neuralgia.

Methods: According to the previous anatomical image studies, [http://www.slicer.org '''3D Slicer'''] software was used to analyze the CT images of the patients. The trigeminal ganglion fossa (TGF) was used as the imaging sign. TGI was identified in the sagittal plane along the fiber. The puncture path starts from the TGI center-foramen ovale line, extending outward to the epidermis as the needle insertion point, and extending inward to the division boundary. For lateral puncture, which is blocked by the mandible, the positions of closed mouth, open mouth, and over-open mouth were used. Multiple targets were generated using straight electrodes and curved electrodes to achieve full coverage of TGI. According to the preoperative design, general anesthesia surgery was performed. Xper CT was used for imaging, and the puncture was guided by Xper Guide. Radiofrequency treatment of TGI was conducted.

Results: In total, 45 patients with trigeminal neuralgia underwent 50 single-division TGI punctures. The procedure was smooth and the compliance with the design was good. Continuous radiofrequency (CRF) was performed, the VAS scores were 25 times at 70°C, 19 times at 65°C, two times at 60°C, and two times at 50°C (both in the ophthalmic division). Pulsed radiofrequency (PRF) was conducted two times. Within 24 h after the procedure, the VAS scores were all 0. From 1 to 7 days after the procedure, pain recurrence was found in three cases, of whom two cases received pulsed radiofrequency treatment. Patients were followed up for 1-24 months and there were no recurrence. After continuous radiofrequency at 65-70°C, the moderate tactile loss was observed, and nearly half of the patients had food residues on the surgical side after 6 months. After continuous radiofrequency at 60°C, there was mild tactile loss and no food residue. The tactile sensation was slightly decreased after continuous radiofrequency at 50°C, and the tactile sensation was normal the next day.

Conclusion: Trigeminal ganglion intumescentia single-division radiofrequency is effective and feasible for the treatment of trigeminal neuralgia.
|}

==Three-Dimensional Volume Rendering of Pelvic Floor Anatomy with Focus on Fibroids in Relation to the Lower Urogenital Tract Based on Cross-Sectional MRI Images==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37171621 J Med Syst. 2023 May 12;47(1):62. PMID: 37171621] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10181971/pdf/10916_2023_Article_1947.pdf PDF]

'''Authors:''' Fan KS, Durnea C, Nygaard CC, Khalil M, Doumouchtsis SK.

'''Institution:''' Institute for Medical and Biomedical Education, St. George's University of London, London, UK.

'''Abstract:'''
We aimed to assess the feasibility of developing three-dimensional (3D) models of pelvic organs using cross-sectional MRI images of patients with uterine fibroids and urinary symptoms and of obtaining anatomical information unavailable in 2D imaging modalities. We also aimed to compare two image processing applications. We performed a feasibility study analysing MRI scans from three women, aged 30 to 58 years old, with fibroids and urinary symptoms. Cross-sectional images were used to render 3D models of pelvic anatomy, including bladder, uterus and fibroids, using [http://www.slicer.org '''3D Slicer'''] and OsiriX. Dimensions, volumes and anatomical relationships of the pelvic organs were evaluated. Comparisons between anatomical landmarks and measurements obtained from the two image processing applications were undertaken. Rendered 3D pelvic models yielded detailed anatomical information and data on spatial relationships that were unobtainable from cross-sectional images. Models were rendered in sufficient resolution to aid understanding of spatial relationships between urinary bladder, uterus and fibroid(s). Measurements of fibroid volumes ranged from 5,336 to 418,012 mm3 and distances between the fibroid and urinary bladder ranged from 0.10 to 83.60 mm. Statistical analysis of measurements showed no significant differences in measurements between the two image processing applications. To date, limited data exist on the use of 3D volume reconstructions of routine MRI scans, to investigate pelvic pathologies such as fibroids in women with urinary symptoms. This study suggests that post-MRI image processing can provide additional information over standard MRI. Further studies are required to assess the role of these data in clinical practice, surgical planning and training. Three-dimensional reconstruction of routine two-dimensional magnetic resonance imaging provides additional anatomical information and may improve our understanding of anatomical relationships, their role in clinical presentations and possibly guide clinical and surgical management.
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==The First Endovascular Rat Glioma Model for Pre-Clinical Evaluation of Intra-Arterial Therapeutics==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37157800 Interv Neuroradiol. 2023 May 8:15910199231169597. PMID: 37157800]

'''Authors:''' Lim J, Baig AA, Donnelly BM, Chaves LD, Pol SU, Koenigsknecht C, Pionessa D, Levy BR, Gutierrez L, Tutino VM, Levy EI, Siddiqui AH.

'''Institution:''' Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA.

'''Abstract:'''
Background: Several translational animal models have been described assessing intra-arterial (IA) treatments for malignant gliomas. We describe the first endovascular animal model that allows testing of IA drug delivery as a first-line treatment, which is difficult to do in actual patients. We report a unique protocol for vascular access and IA delivery in the rat model that, unlike prior reports, does not require direct puncture and opening of proximal cerebrovasculature which carries risk of ischemia in the animal brain post-delivery.

Methods: Wistar rats underwent left femoral artery catherization with a Balt Magic 1.2F catheter or Marathon Flow directed 1.5F Microcatheter with an Asahi Chikai 0.008 micro-guidewire which was navigated to the left internal carotid artery under x-ray. 25% mannitol was administered to test blood brain barrier breakdown (BBBB). Additional rats were implanted with C6 glioma cells in the left frontal lobe. C6 Glioma-Implanted Rats (C6GRs) were monitored for overall survival and tumor growth. Tumor volumes from MRI images were calculated utilizing [http://www.slicer.org '''3D Slicer''']. Additional rats underwent femoral artery catheterization with Bevacizumab, carboplatin, or irinotecan injected into the left internal carotid artery to test feasibility and safety.

Results: A successful endovascular access and BBBB protocol was established. BBBB was confirmed with positive Evans blue staining. 10 rats were successfully implanted with C6 gliomas with confirmed growths on MRI. Overall survival was 19.75 ± 2.21 days. 5 rats were utilized for the development of our femoral catheterization protocol and BBBB testing. With regards to IA chemotherapy dosage testing, control rats tolerated targeted 10 mg/kg of bevascizumab, 2.4 mg/kg of carboplatin, and 15 mg/kg of irinotecan IA ICA injections without any complications.

Conclusions: We present the first endovascular IA rat glioma model that allows selective catheterization of the intracranial vasculature and assessment of IA therapies for gliomas without need for access and sacrifice of proximal cerebrovasculature.
|}

==Muscle Magnetic Resonance Characterization of STIM1 Tubular Aggregate Myopathy Using Unsupervised Learning==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37155641 PLoS One. 2023 May 8;18(5):e0285422. PMID: 37155641] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10166478/pdf/pone.0285422.pd PDF]

'''Authors:''' Lupi A, Spolaor S, Favero A, Bello L, Stramare R, Pegoraro E, Nobile MS.

'''Institution:''' Institute of Radiology, Department of Medicine-DIMED, University of Padua, Padua, Italy.

'''Abstract:'''
Purpose: Congenital myopathies are a heterogeneous group of diseases affecting the skeletal muscles and characterized by high clinical, genetic, and histological variability. Magnetic Resonance (MR) is a valuable tool for the assessment of involved muscles (i.e., fatty replacement and oedema) and disease progression. Machine Learning is becoming increasingly applied for diagnostic purposes, but to our knowledge, Self-Organizing Maps (SOMs) have never been used for the identification of the patterns in these diseases. The aim of this study is to evaluate if SOMs may discriminate between muscles with fatty replacement (S), oedema (E) or neither (N).

Methods: MR studies of a family affected by tubular aggregates myopathy (TAM) with the histologically proven autosomal dominant mutation of the STIM1 gene, were examined: for each patient, in two MR assessments (i.e., t0 and t1, the latter after 5 years), fifty-three muscles were evaluated for muscular fatty replacement on the T1w images, and for oedema on the STIR images, for reference. Sixty radiomic features were collected from each muscle at t0 and t1 MR assessment using [http://www.slicer.org '''3D Slicer'''] software, in order to obtain data from images. A SOM was created to analyze all datasets using three clusters (i.e., 0, 1 and 2) and results were compared with radiological evaluation.

Results: Six patients with TAM STIM1-mutation were included. At t0 MR assessments, all patients showed widespread fatty replacement that intensifies at t1, while oedema mainly affected the muscles of the legs and appears stable at follow-up. All muscles with oedema showed fatty replacement, too. At t0 SOM grid clustering shows almost all N muscles in Cluster 0 and most of the E muscles in Cluster 1; at t1 almost all E muscles appear in Cluster 1.

Conclusion: Our unsupervised learning model appears to be able to recognize muscles altered by the presence of edema and fatty replacement.
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==Quantifying the Effect of an Endo-Vaginal Probe on Position of the Pelvic Floor Viscera and Muscles==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37145123 Int Urogynecol J. 2023 May 5. PMID: 37145123]

'''Authors:''' Chill HH, Martin LC, Abramowitch SD, Rostaminia G.

'''Institution:''' Female Pelvic Medicine and Reconstructive Surgery (FPMRS) Division, University of Chicago Pritzker School of Medicine, Northshore University HealthSystem, Skokie, IL, USA.

'''Abstract:'''
Introduction and hypothesis: Endovaginal ultrasound has long been hypothesized to have a significant effect on locations of what it visualizes. However, little work has directly quantified its effect. This study aimed to quantify it.

Methods: This cross-sectional study consisted of 20 healthy asymptomatic volunteers who underwent both endovaginal ultrasound and MRI. The urethra, vagina, rectum, pelvic floor, and pubic bone were segmented in both ultrasound and MRI using [http://www.slicer.org '''3D Slicer''']. Then, using [http://www.slicer.org '''3D Slicer''']'s transform tool the volumes were rigidly aligned based on the posterior curvature of the pubic bone. The organs were then split into thirds along their long axis to compare their distal, middle, and proximal sections. Using Houdini, we compared the location of the centroid of each of the urethra, vagina, and rectum and the surface-to-surface difference of the urethra and rectum. The anterior curvature of the pelvic floor was also compared. Normality of all variables was assessed by Shapiro-Wilk test.

Results: The largest amount of surface-to-surface distance was observed in the proximal region for the urethra and rectum. Across all three organs, the majority of the deviation was in the anterior direction for geometries obtained from ultrasound versus those from MRI. For each subject, the trace defining the midline of the levator plate was more anterior for ultrasound compared to MRI.

Conclusions: While it has often been assumed that placing a probe in the vagina probably distorts the anatomy, this study quantified the distortion and displacement of the pelvic viscera. This allows for better interpretation of clinical and research findings based on this modality.
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==Laser Interstitial Thermal Therapy in the Treatment of Brain Metastases: The Relationship Between Changes in Postoperative Magnetic Resonance Imaging Characteristics and Tumor Recurrence==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36823478 Acta Neurochir (Wien). 2023 May;165(5):1379-1387. PMID: 36823478]

'''Authors:''' Xue Z, Guan X, Yuan L, Kang P, Zhang C, Li D, Jia G, Jia W.

'''Institution:''' Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, China.

'''Abstract:'''
'''Background:''' Laser interstitial thermal therapy (LITT) has been used to treat brain metastases (BMs) in several countries, and its safety and effectiveness have been confirmed. In most cases, magnetic resonance imaging (MRI) reveals an increase in tumor volume with an enhanced margin after LITT. However, little is known about the relationship between this MRI change and tumor recurrence.

'''Objective:''' We report the first case series of BMs treated by LITT in China to evaluate the clinical characteristics and predictive factors of tumor recurrence.

'''Material and Methods:''' Patients with less than four brain metastatic lesions and a Karnofsky performance status (KPS) > 70 were eligible for study inclusion. Standard LITT procedures were performed, and a follow-up MRI was performed to analyze the radiographic changes, especially the volume ratio of the enhanced margin and the whole lesion on MRI at 30 days postoperatively. All the volume-related data were delineated and calculated using [http://www.slicer.org '''3D Slicer'''] software. Related predictors were also collected to evaluate the correlation with local tumor control.

'''Results:''' Eighteen patients with nineteen lesions were enrolled for treatment and follow-up. Primary tumor histology included pulmonary carcinoma (n = 11) and breast cancer (n = 4). On average, the tumor size measured 3.01 cm3 (range, 0.40-7.40 cm3), the total ablation time was 13.58 min (range, 2.88-37.15 min), and the complete ablation rate was 92.4% (range, 29.2-100%). Comparing 3s0-day follow-up MRI results with preoperative MRI findings, 18 lesions showed a 2.28-fold (range, 1.21-4.88) volume increase; all the lesions displayed an enhanced component with a volume ratio of 42.35% (range, 10.14-100%). Five patients experienced tumor recurrence, and the local tumor control rates at 90 days and 180 days of follow-up were 68.4% and 66.7%, respectively. Univariate analysis indicated that the primary tumor, ablation rate, and enhanced volume ratio (EVR) > 40% in the 30-day MRI were associated with tumor recurrence, whereas multivariate analysis showed that only EVR > 40% was a predictive factor of local control.

'''Conclusion:''' LITT is a minimally invasive method used to ablate brain metastases which can be used as the first-line treatment for BM patients under certain indications. After LITT, most tumors showed volume enlargement on the 30-day MRI scan, and EVR > 40% on the 30-day MRI may indicate late tumor recurrence.
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==Image Data and Computational Grids for Computing Brain Shift and Solving the Electrocorticography Forward Problem==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37128587/ Data Brief. 2023 Apr 7;48:109122. PMID: 37128587] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10147975/pdf/main.pdf PDF]

'''Authors:''' Zwick BF, Safdar S, Bourantas GC, Joldes GR, Hyde DE, Warfield SK, Wittek A, Miller K.

'''Institution:''' Intelligent Systems for Medicine Laboratory, The University of Western Australia, 35 Stirling Highway, Perth, WA, Australia.

'''Abstract:'''
This article describes the dataset applied in the research reported in NeuroImage article "Patient-specific solution of the electrocorticography forward problem in deforming brain" [1] that is available for download from the Zenodo data repository (https://zenodo.org/record/7687631) [2]. Preoperative structural and diffusion-weighted magnetic resonance (MR) and postoperative computed tomography (CT) images of a 12-year-old female epilepsy patient under evaluation for surgical intervention were obtained retrospectively from Boston Children's Hospital. We used these images to conduct the analysis at The University of Western Australia's Intelligent Systems for Medicine Laboratory using SlicerCBM [3], our open-source software extension for the [http://www.slicer.org '''3D Slicer'''] medical imaging platform. As part of the analysis, we processed the images to extract the patient-specific brain geometry; created computational grids, including a tetrahedral grid for the meshless solution of the biomechanical model and a regular hexahedral grid for the finite element solution of the electrocorticography forward problem; predicted the postoperative MRI and DTI that correspond to the brain configuration deformed by the placement of subdural electrodes using biomechanics-based image warping; and solved the patient-specific electrocorticography forward problem to compute the electric potential distribution within the patient's head using the original preoperative and predicted postoperative image data. The well-established and open-source file formats used in this dataset, including Nearly Raw Raster Data (NRRD) files for images, STL files for surface geometry, and Visualization Toolkit (VTK) files for computational grids, allow other research groups to easily reuse the data presented herein to solve the electrocorticography forward problem accounting for the brain shift caused by implantation of subdural grid electrodes.
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==ImFinite Element Analysis of a Healthy Knee Joint at Deep Squatting for the Study of Tibiofemoral and Patellofemoral Contact==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37143926 J Orthop. 2023 Apr 21;40:7-16. PMID: 37143926]

'''Authors:''' Kothurkar R, Lekurwale R, Gad M, Rathod CM.

'''Institution:''' Department of Mechanical Engineering, K. J. Somaiya College of Engineering, Mumbai, India.

'''Abstract:'''
Background: In non-western countries, deep squatting is a daily activity, and prolonged deep squatting is common among occupational squatters. Household tasks, taking a bath, socializing, using toilets, and performing religious acts are among the activities frequently carried out while squatting by the Asian population. High knee loading is responsible for a knee injury and osteoarthritis. Finite element analysis is an effective tool to determine stresses on the knee joint.

Methods: Magnetic Resonance Imaging (MRI) and Computed Tomographic (CT) images were acquired of one adult without knee injuries. The CT images were acquired at the fully extended knee and one more set of images was acquired with the knee at a deeply flexed knee position. The MRI was acquired with the fully extended knee. 3 Dimensional models of bones were created using CT and soft tissue using MRI with the help of [http://www.slicer.org '''3D Slicer'''] software. Kinematics and finite element analysis of the knee was performed for standing and deep squatting posture using Ansys Workbench 2022.

Results: High peak stresses were observed at deep squatting compared to standing along with the reduction in the contact area. Peak von Mises stresses on femoral cartilage, tibial cartilage, patellar cartilage, and meniscus were increased from 3.3 MPa to 19.9 MPa, 2.9 MPa to 12.4 MPa, 1.5 MPa to 16.7 MPa and 15.8 MPa to 32.8 MPa respectively during deep squatting. Posterior translation of 7.01 mm, and 12.58 mm was observed for medial and lateral femoral condyle respectively from full extension to 153° knee flexion.

Conclusions: Increased stresses in the knee joint at deep squat posture may cause cartilage damage. A sustained deep squat posture should be avoided for healthy knee joints. More posterior translations of the medial femoral condyle at higher knee flexion angle warrant further investigation.
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==A Comparison of Machine Learning Models for Survival Prediction of Patients with Glioma Using Radiomic Features from MRI Scans==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37362372/ Indian J Radiol Imaging. 2023 Apr 28;33(3):338-343. PMID: 37362372] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10289839/pdf/10-1055-s-0043-1767786.pdf PDF]

'''Authors:''' Manjunath M, Saravanakumar S, Kiran S, Chatterjee J.

'''Institution:''' Department of Biotechnology, People's Education Society University, Bangalore, Karnataka, India.

'''Abstract:'''
Background Glioma is a primary, malignant, highly aggressive brain tumor, with patients having an average life expectancy of 14 to 16 months after diagnosis. Magnetic resonance imaging (MRI) scans of these patients can be used to extract and analyze quantifiable features with potential clinical significance. We hypothesize that there is a correlation between radiomic features extracted from MRI scans and survival. Along with clinical data, the radiomic features could be used in survival prediction of patients, providing beneficial information for clinicians to design personalized treatment plans. Methods In our study, we have utilized [http://www.slicer.org '''3D Slicer'''] for tumor segmentation and feature extraction and performed survival prediction of patients with glioma using four different machine learning models. Results and Conclusion Among the models compared, we have achieved a maximum prediction accuracy of 64.4% using the k-nearest neighbors model, which was trained and tested on a combination of clinical data and radiomic features extracted from MRI images provided in the BraTS 2020 dataset.
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==Circular RNA hsa_circ_0000690 as a Potential Biomarker for Diagnosis and Prognosis of Intracranial Aneurysm: Closely Relating to the Volume of Hemorrhage==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36879365 Brain Behav. Apr;13(4):e2929. PMID: 36879365] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10097068/pdf/BRB3-13-e2929.pdf PDF]

'''Authors:'''Huang Y, Cao H, Qi X, Guan C, Que S.

'''Institution:''' Department of Neurosurgery, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, Fujian, China.

'''Abstract:'''

'''Purpose:''' This study aimed to explore circular RNA (circRNA) hsa_circ_0000690 as a potential biomarker for diagnosis and prognosis of intracranial aneurysm (IA) and its relationship with clinical factors and complications of IA.

'''Material/Methods:''' 216 IA patients admitted to the neurosurgery department of our hospital from January 2019 to December 2020 were selected as the experimental group, and 186 healthy volunteers were selected as the control group. The expression of hsa_circ_0000690 in peripheral blood was detected by quantitative real-time PCR, and its diagnostic value was assessed by receiver operating characteristic curve. Relationship between hsa_circ_0000690 and clinical factors of IA was assessed by chi-square test. Nonparametric test was used in univariate analysis, and regression analysis was used in multivariate analysis. Multivariate Cox proportional hazards regression analysis was used to analyze the survival time.

'''Results:''' CircRNA hsa_circ_0000690 of IA patients was relatively lower than that in the control group (p < .001). The AUC of hsa_circ_0000690 was 0.752, the specificity was 0.780, and sensitivity was 0.620, with diagnostic threshold of 0.0449. In addition, hsa_circ_0000690 expression was correlated with Glasgow Coma Scale, the volume of subarachnoid hemorrhage, modified Fisher scale, Hunt-Hess levels and surgical type. For hydrocephalus and delayed cerebral ischemia, hsa_circ_0000690 was significant in univariate analysis, but nonsignificant in multivariate analysis. For prognosis, hsa_circ_0000690 was significantly associated with modified Rankin Scales after surgery for 3 months, but not associated with survival time.

'''Conclusions:''' The expression of hsa_circ_0000690 can act as a diagnostic marker for IA and predict the prognosis of 3 months after operation and is closely related to the volume of hemorrhage.

'''Keywords:''' [http://www.slicer.org '''3D Slicer''']; biomarker; circRNA; diagnosis; intracranial aneurysm; prognosis; subarachnoid hemorrhage
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==Can Quantitative Peritumoral CT Radiomics Features Predict the Prognosis of Patients With Non-Small Cell Lung Cancer? A Systematic Review==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36307554 Eur Radiol. 2023 Mar;33(3):2105-17. PMID: 36307554] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9935659/pdf/330_2022_Article_9174.pdf PDF]

'''Authors:''' Wu L, Lou X, Kong N, Xu M, Gao C.

'''Institution:''' Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China.

'''Abstract:''' Objectives: To provide an overarching evaluation of the value of peritumoral CT radiomics features for predicting the prognosis of non-small cell lung cancer and to assess the quality of the available studies.

'''Methods:''' The PubMed, Embase, Web of Science, and Cochrane Library databases were searched for studies predicting the prognosis in patients with non-small cell lung cancer (NSCLC) using CT-based peritumoral radiomics features. Information about the patient, CT-scanner, and radiomics analyses were all extracted for the included studies. Study quality was assessed using the Radiomics Quality Score (RQS) and the Prediction Model Risk of Bias Assessment Tool (PROBAST).

'''Results:''' Thirteen studies were included with 2942 patients from 2017 to 2022. Only one study was prospective, and the others were all retrospectively designed. Manual segmentation and multicenter studies were performed by 69% and 46% of the included studies, respectively. [http://www.slicer.org '''3D Slicer'''] and MATLAB software were most commonly used for the segmentation of lesions and extraction of features. The peritumoral region was most frequently defined as dilated from the tumor boundary of 15 mm, 20 mm, or 30 mm. The median RQS of the studies was 13 (range 4-19), while all of included studies were assessed as having a high risk of bias (ROB) overall.

'''Conclusions:''' Peritumoral radiomics features based on CT images showed promise in predicting the prognosis of NSCLC, although well-designed studies and further biological validation are still needed.

'''Key points:''' Peritumoral radiomics features based on CT images are promising and encouraging for predicting the prognosis of non-small cell lung cancer. The peritumoral region was often dilated from the tumor boundary of 15 mm or 20 mm because these were considered safe margins. The median Radiomics Quality Score of the included studies was 13 (range 4-19), and all of studies were considered to have a high risk of bias overall.
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==Three Dimensional Assessment of Radiographic Changes after Indirect Pulp Capping using Silver Diamine Fluoride with or without Potassium Iodide in Young Permanent Teeth (12-month RCT)==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36878216 Caries Res. 2023;57(2):177-188. PMID: 36878216]

'''Authors:''' Baraka MMAL, Cevidanes L, Tekeya M, Bakry N, Ruellas A, Botero T, Benavides E, Fontana M.

'''Institution:''' Department of Experimental Oncology, European Institute of Oncology, IRCCS, 20139 Milan, Italy.

'''Abstract:''' The aim was to have a three-dimensional evaluation of radiographic changes after indirect pulp capping (IPC) with silver diamine fluoride (SDF) with or without potassium iodide (KI) and resin modified glass ionomer cement (RMGIC) in deep carious young permanent molars using cone beam computed tomography (CBCT). 108 first permanent molars with deep occlusal cavitated caries lesions, in forty-nine 6-9-year-old children, were randomly allocated to one of 3 groups (n=36) and treated with SDF+KI, SDF and RMGIC as IPC materials. CBCT scans were taken at 0 and at 12-months to assess tertiary dentin formation (volume and grey level intensity), increase in root length, and pathological changes as secondary caries, periapical radiolucency, internal resorption and obliteration of the pulp. The three-dimensional image analysis procedures were performed using ITK-SNAP and [http://www.slicer.org '''3D Slicer'''] CMF. Comparisons were made using analysis of variance with a fixed effect for treatment and random effects for patient, and patient-by-treatment to account for within-patient correlations. A two-sided 5% significance level was used. There were no significant differences among the three groups regarding tertiary dentin volume (p=0.712) and grey level intensity (p=0.660), increase in root length (p=0.365), prevention of secondary caries (p=0.63) and periapical radiolucency (p=0.80) in the analysed 69 CBCT scans. The study did not find differences among the groups regarding quality and quantity of tertiary dentin formed, increase in root length, absence of secondary caries and other signs of failure as shown by CBCT.

'''Clinical Significance:''' The results show no significant differences in radiographic outcomes (quality and quantity of tertiary dentin formed, increase in root length, absence of secondary caries and other signs of failure) when using SDF+KI, SDF and RMGIC in IPC. The results of this study can help guide treatment decision making regarding use of SDF and SDF+KI as IPC materials in deep cavitated lesions.
|}

==Cross-Sectional Reliability and Concurrent Validity of a Quantitative 2-Dimensional Ultrasound Image Analysis of Effusion and Synovial Hypertrophy in Knee Osteoarthritis==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37008822/ Osteoarthr Cartil Open. 2023 Mar 16;5(2):100356. PMID: 37008822] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10060736/pdf/main.pdf PDF]

'''Authors:''' Dima R, Birmingham TB, Philpott HT, Bryant D, Fenster A, Appleton CT.

'''Institution:''' Faculty of Health Sciences, University of Western Ontario, London, ON, Canada.

'''Abstract:'''
Objective: Effusion-synovitis is related to pain and progression in knee osteoarthritis (OA), but current gold standard ultrasound (US) measures are limited to semi-quantitative grading of joint distension or 1-dimensional thickness measures. A novel quantitative 2-dimensional image analysis methodology is applied to US images of effusion-synovitis; reliability and concurrent validity was assessed in patients with knee OA.

Methods: Cross sectional analysis of US images collected from 51 patients with symptomatic knee OA were processed in ImageJ and segmented in [http://www.slicer.org '''3D Slicer'''] to produce a binary mask of the supra-patellar synovitis region of interest (ROI). Area measures (mm2) of total synovitis, effusion and hypertrophy components were exported. Intra-rater reliability and test-retest reliability (1-14 days washout) were estimated with intra-class correlation coefficients (ICCs). Concurrent validity was measured by Spearman correlations between quantitative measures and gold standard OMERACT and caliper measurements of synovitis.

Results: Intra-rater reliability for hypertrophy area was estimated at 0.98, 0.99 for effusion area, and 0.99 for total synovitis area. The test-retest reliability for total synovitis area was 0.63 (SEM 87.8 mm2), 0.59 for hypertrophy area (SEM 21.0 mm2), and 0.64 for effusion area (SEM 73.8 mm2). Correlation between total synovitis area and OMERACT grade was 0.84, 0.81 between total synovitis area and effusion-synovitis calipers, and 0.81 between total effusion area and effusion calipers.

Conclusion: This new research tool for image analysis demonstrated excellent intra-rater reliability, good concurrent validity, and moderate test-retest reliability. Quantitative 2D US measures of effusion-synovitis and its individual components may enhance the study and management of knee OA.
|}

==Patient-Specific Needle Guidance Templates Drilled Intraprocedurally for Image Guided Intervention: Feasibility Study in Swine==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36173542 Int J Comput Assist Radiol Surg. 2023 Mar;18(3):537-44. PMID: 36173542]

'''Authors:''' Glossop N, Bale R, Xu S, Pritchard WF, Karanian JW, Wood BJ.

'''Institution:''' Queen's University, Kingston, ON, Canada.

'''Abstract:'''
'''purpose:''' Thermal ablation of large tumors may benefit from simultaneous placement of multiple needles, but accurate placement becomes challenging as the number of needles increases. The aim of this work was to evaluate use of personalized needle guidance grid templates based on intraprocedural CT and fabricated at the point of care to implement ablation treatment plans with multiple needles in vivo.

'''Methods:''' A plastic frame was designed to hold two parallel plastic guide plates in a rigid relationship, fixed over the abdomen by a mounting arm. Steel ball targets (1.5 mm) were implanted under ultrasound in the livers of two domestic swine under general anesthesia. Following breath-hold CT of the subject and frame, the targets and frame were identified using customized [http://www.slicer.org '''3D Slicer''']-based planning software. Multiple needle trajectories targeting the balls were planned, including complex off-plane trajectories. A machining program for drilling the hole pattern corresponding to the planned needle trajectories was generated. The pattern was drilled in the two plates with a numerical-controlled milling machine in the suite. The plates were attached to the frame and needles passed through the paired holes to the calculated depth. Placement accuracy was defined as needle tip-to-target distance on post-placement CT.

'''Results:''' The planning process and manufacturing required approximately 6 and 15 min, respectively. Needles were rapidly inserted (n = 11) to the target points without complications or traversing nontarget anatomy. The mean needle tip-to-target distance error was 3.4 ± 2.2, range 0-7 mm.

'''Conclusion:''' Rapid and accurate needle placement was feasible using a subject-specific, custom-drilled, needle guidance grid template fabricated intraprocedurally. Targeting accuracy and performance were similar to more complex and expensive tracking systems which may enable accurate intraprocedural implementation of treatment plans in the liver or other organs. This may be of value in complex ablation cases or in areas where more advanced guidance systems are not available.
|}

==Automatic Landmark Identification in Cone-Beam Computed Tomography==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36811276 Orthod Craniofac Res. 2023 Feb 21. PMID: 36811276]

'''Authors:''' Gillot M, Miranda F, Baquero B, Ruellas A, Gurgel M, Al Turkestani N, Anchling L, Hutin N, Biggs E, Yatabe M, Paniagua B, Fillion-Robin JC, Allemang D, Bianchi J, Cevidanes L, Prieto JC.

'''Institution:''' Department of Orthodontics and Pediatric Dentistry, School of Dental Medicine, University of Michigan, Ann Arbor, MI, USA.

'''Abstract:'''
'''Objective:''' To present and validate an open-source fully automated landmark placement (ALICBCT) tool for cone-beam computed tomography scans.

'''Material and Methods:''' One hundred and forty-three large and medium field of view cone-beam computed tomography (CBCT) were used to train and test a novel approach, called ALICBCT that reformulates landmark detection as a classification problem through a virtual agent placed inside volumetric images. The landmark agents were trained to navigate in a multi-scale volumetric space to reach the estimated landmark position. The agent movements decision relies on a combination of DenseNet feature network and fully connected layers. For each CBCT, 32 ground truth landmark positions were identified by 2 clinician experts. After validation of the 32 landmarks, new models were trained to identify a total of 119 landmarks that are commonly used in clinical studies for the quantification of changes in bone morphology and tooth position.

'''Results:''' Our method achieved a high accuracy with an average of 1.54±0.87 mm error for the 32 landmark positions with rare failures, taking an average of 4.2s computation time to identify each landmark in one large 3D-CBCT scan using a conventional GPU.

'''Conclusion:''' The ALICBCT algorithm is a robust automatic identification tool that has been deployed for clinical and research use as an extension in the 3D Slicer platform allowing continuous updates for increased precision.
|}

==Development and In-Silico and Ex-Vivo Validation of a Software for a Semi-Automated Segmentation of the Round Window Niche to Design a Patient Specific Implant to Treat Inner Ear Disorders==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36826970 J Imaging. 2023 Feb 20;9(2):51. PMID: 36826970] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9965310/pdf/jimaging-09-00051.pdf PDF]

'''Authors:''' Matin-Mann F, Gao Z, Wei C, Repp F, Artukarslan EN, John S, Alcacer Labrador D, Lenarz T, Scheper V.

'''Institution:''' Lower Saxony Center for Biomedical Engineering, Implant Research and Development (NIFE), Department of Otorhinolaryngology, Head and Neck Surgery, Hannover Medical School, Hannover, Germany.

'''Abstract:''' The aim of this study was to develop and validate a semi-automated segmentation approach that identifies the round window niche (RWN) and round window membrane (RWM) for use in the development of patient individualized round window niche implants (RNI) to treat inner ear disorders. Twenty cone beam computed tomography (CBCT) datasets of unilateral temporal bones of patients were included in the study. Defined anatomical landmarks such as the RWM were used to develop a customized [http://www.slicer.org '''3D Slicer'''] plugin for semi-automated segmentation of the RWN. Two otolaryngologists (User 1 and User 2) segmented the datasets manually and semi-automatically using the developed software. Both methods were compared in-silico regarding the resulting RWM area and RWN volume. Finally, the developed software was validated ex-vivo in N = 3 body donor implantation tests with additively manufactured RNI. The independently segmented temporal bones of the different Users showed a strong consistency in the volume of the RWN and the area of the RWM. The volume of the semi-automated RWN segmentations were 48 ± 11% smaller on average than the manual segmentations and the area of the RWM of the semi-automated segmentations was 21 ± 17% smaller on average than the manual segmentation. All additively manufactured implants, based on the semi-automated segmentation method could be implanted successfully in a pressure-tight fit into the RWN. The implants based on the manual segmentations failed to fit into the RWN and this suggests that the larger manual segmentations were over-segmentations. This study presents a semi-automated approach for segmenting the RWN and RWM in temporal bone CBCT scans that is efficient, fast, accurate, and not dependent on trained users. In addition, the manual segmentation, often positioned as the gold-standard, actually failed to pass the implantation validation.
|}

==Design and Analysis of HSC-BPPV Diagnostic Maneuver Based on Virtual Simulation==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36873445 Front Neurol. 2023 Feb 17;14:1132343. PMID: 36873445] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9981954/pdf/fneur-14-1132343.pdf PDF]

'''Authors:''' Li Y, Yang X.

'''Institution:''' Department of Research Center, Third Affiliated Hospital of Shanghai University, Wenzhou Third Clinical Institute Affiliated to Wenzhou Medical University, Wenzhou People's Hospital, Wenzhou, China.

'''Abstract:'''
'''Background:''' The preferred supine roll test for the diagnosis of horizontal semicircular canal BPPV has several disadvantages, including difficulty in locating the affected ear, inconsistent nystagmus performance on repeated testing, and lack of a typical latency period, resulting in insensitive diagnosis.

Objectives: To investigate novel diagnostic techniques with more scientific design, more accessible application, and better diagnostic sensitivity and specificity.

'''Materials and Methods:''' Based on clinical microscopic CT data, we created a virtual simulation model of BPPV using Unity software. The physical simulation of the traditional supine roll test was performed to observe and analyse the movement of the otoliths, whose initial position was the typical stable position. In addition, the normal vectors of the plane and crista ampullaris of the horizontal semicircular canal were measured using [http://www.slicer.org '''3D Slicer'''] software. Based on this, we analyzed the critical steps for designing diagnostic maneuvers for BPPV in the horizontal semicircular canal. For a more accurate diagnosis of horizontal semicircular canal BPPV, it is critical to rotate the horizontal semicircular canal to be parallel to gravity. It is also necessary to move the otolith by swinging the head. As a result, we developed two diagnostic maneuvers: the 60° roll test and the prone roll test. We also performed simulations to observe otolith movement and predict nystagmus performance.

'''Conclusions:''' The 60° roll test and the prone roll test can complement the supine roll test. Compared to the supine roll test, they not only effectively differentiate canalolithiasis from cupulolithiasis, but also make it easier to determine the position of the otoliths, and the characteristics of the nystagmus are more pronounced. Significant diagnostic features have significant potential benefits for home and telemedicine.
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==The Simplified Tailor-Made Workflows for a [http://www.slicer.org '''3D Slicer''']-Based Craniofacial Implant Design==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36801943 Sci Rep. 2023 Feb 17;13(1):2850. PMID: 36801943] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9938178/pdf/41598_2023_Article_30117.pdf PDF]

'''Authors:''' Tantisatirapong S, Khunakornpattanakarn S, Suesatsakul T, Boonpratatong A, Benjamin I, Tongmeesee S, Kangkorn T, Chanwimalueang

'''Institution:''' Department of Biomedical Engineering, Faculty of Engineering, Srinakharinwirot University, Nakhon Nayok, Thailand.

'''Abstract:''' A specific design of craniofacial implant model is vital and urgent for patients with traumatic head injury. The mirror technique is commonly used for modeling these implants, but it requires the presence of a healthy skull region opposite to the defect. To address this limitation, we propose three processing workflows for modeling craniofacial implants: the mirror method, the baffle planner, and the baffle-based mirror guideline. These workflows are based on extension modules on the [http://www.slicer.org '''3D Slicer'''] platform and were developed to simplify the modeling process for a variety of craniofacial scenarios. To evaluate the effectiveness of these proposed workflows, we investigated craniofacial CT datasets collected from four accidental cases. The designed implant models were created using the three proposed workflows and compared to reference models created by an experienced neurosurgeon. The spatial properties of the models were evaluated using performance metrics. Our results show that the mirror method is suitable for cases where a healthy skull region can be completely reflected to the defect region. The baffle planner module offers a flexible prototype model that can be fit independently to any defect location, but it requires customized refinement of contour and thickness to fill the missing region seamlessly and relies on the user's experience and expertise. The proposed baffle-based mirror guideline method strengthens the baffle planner method by tracing the mirrored surface. Overall, our study suggests that the three proposed workflows for craniofacial implant modeling simplify the process and can be practically applied to a variety of craniofacial scenarios. These findings have the potential to improve the care of patients with traumatic head injuries and could be used by neurosurgeons and other medical professionals.
|}

==Predicting Transient Ischemic Attack Risk in Patients With Mild Carotid Stenosis Using Machine Learning and CT Radiomics==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36846119 Front Neurol. 2023 Feb 8;14:1105616. PMID: 36846119] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9944715/pdf/fneur-14-1105616.pdf PDF]

'''Authors:''' Xia H, Yuan L, Zhao W, Zhang C, Zhao L, Hou J, Luan Y, Bi Y, Feng Y.

'''Institution:''' Department of Vascular Surgery, The First Affiliated Hospital of Kunming Medical University, Kunming, China.

'''Abstract:'''
'''Objective:''' This study aims to establish a radiomics-based machine learning model that predicts the risk of transient ischemic attack in patients with mild carotid stenosis (30-50% North American Symptomatic Carotid Endarterectomy Trial) using extracted computed tomography radiomics features and clinical information.

'''Methods:''' A total of 179 patients underwent carotid computed tomography angiography (CTA), and 219 carotid arteries with a plaque at the carotid bifurcation or proximal to the internal carotid artery were selected. The patients were divided into two groups; patients with symptoms of transient ischemic attack after CTA and patients without symptoms of transient ischemic attack after CTA. Then we performed random sampling methods stratified by the predictive outcome to obtain the training set (N = 165) and testing set (N = 66). [http://www.slicer.org '''3D Slicer'''] was employed to select the site of plaque on the computed tomography image as the volume of interest. An open-source package PyRadiomics in Python was used to extract radiomics features from the volume of interests. The random forest and logistic regression models were used to screen feature variables, and five classification algorithms were used, including random forest, eXtreme Gradient Boosting, logistic regression, support vector machine, and k-nearest neighbors. Data on radiomic feature information, clinical information, and the combination of these pieces of information were used to generate the model that predicts the risk of transient ischemic attack in patients with mild carotid artery stenosis (30-50% North American Symptomatic Carotid Endarterectomy Trial).

'''Results:''' The random forest model that was built based on the radiomics and clinical feature information had the highest accuracy (area under curve = 0.879; 95% confidence interval, 0.787-0.979). The combined model outperformed the clinical model, whereas the combined model showed no significant difference from the radiomics model.

'''Conclusion:''' The random forest model constructed with both radiomics and clinical information can accurately predict and improve discriminative power of computed tomography angiography in identifying ischemic symptoms in patients with carotid atherosclerosis. This model can aid in guiding the follow-up treatment of patients at high risk.
|}

==Deep Learning Enabled Multi-Organ Segmentation of Mouse Embryos==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36802342 Biol Open. 2023 Feb 15;12(2):bio059698. PMID: 36802342] | [https://cob.silverchair-cdn.com/cob/content_public/journal/bio/12/2/10.1242_bio.059698/2/bio059698.pdf PDF]

'''Authors:''' Rolfe SM, Whikehart SM, Maga AM.

'''Institution:''' Center for Developmental Biology and Regenerative Medicine, Seattle Children's Research Institute, Seattle, WA, USA.

'''Abstract:''' The International Mouse Phenotyping Consortium (IMPC) has generated a large repository of three-dimensional (3D) imaging data from mouse embryos, providing a rich resource for investigating phenotype/genotype interactions. While the data is freely available, the computing resources and human effort required to segment these images for analysis of individual structures can create a significant hurdle for research. In this paper, we present an open source, deep learning-enabled tool, Mouse Embryo Multi-Organ Segmentation (MEMOS), that estimates a segmentation of 50 anatomical structures with a support for manually reviewing, editing, and analyzing the estimated segmentation in a single application. MEMOS is implemented as an extension on the [http://www.slicer.org '''3D Slicer'''] platform and is designed to be accessible to researchers without coding experience. We validate the performance of MEMOS-generated segmentations through comparison to state-of-the-art atlas-based segmentation and quantification of previously reported anatomical abnormalities in a Cbx4 knockout strain. This article has an associated First Person interview with the first author of the paper.
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==Development and Validation of an 18FFDG-PET/CT Radiomic Model for Predicting Progression-Free Survival for Patients With Stage II - III Thoracic Esophageal Squamous Cell Carcinoma Who Are Treated With Definitive Chemoradiotherapy==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36794365 Acta Oncol. 2023 Feb;62(2):159-65. PMID: 36794365]

'''Authors:''' Takahashi N, Tanaka S, Umezawa R, Takanami K, Takeda K, Yamamoto T, Suzuki Y, Katsuta Y, Kadoya N, Jingu K.

'''Institution:''' Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Japan.

'''Abstract:'''
'''Background:''' Radiomics is a method for extracting a large amount of information from images and used to predict treatment outcomes, side effects and diagnosis. In this study, we developed and validated a radiomic model of [18F]FDG-PET/CT for predicting progression-free survival (PFS) of definitive chemoradiotherapy (dCRT) for patients with esophageal cancer.

'''Material and Methods:''' Patients with stage II - III esophageal cancer who underwent [18F]FDG-PET/CT within 45 days before dCRT between 2005 and 2017 were included. Patients were randomly assigned to a training set (85 patients) and a validation set (45 patients). Radiomic parameters inside the area of standard uptake value ≥ 3 were calculated. The open-source software [http://www.slicer.org '''3D Slicer'''] and Pyradiomics were used for segmentation and calculating radiomic parameters, respectively. Eight hundred sixty radiomic parameters and general information were investigated.In the training set, a radiomic model for PFS was made from the LASSO Cox regression model and Rad-score was calculated. In the validation set, the model was applied to Kaplan-Meier curves. The median value of Rad-score in the training set was used as a cutoff value in the validation set. JMP was used for statistical analysis. RStudio was used for the LASSO Cox regression model. p < 0.05 was defined as significant.

'''Results:''' The median follow-up periods were 21.9 months for all patients and 63.4 months for survivors. The 5-year PFS rate was 24.0%. In the training set, the LASSO Cox regression model selects 6 parameters and made a model. The low Rad-score group had significantly better PFS than that the high Rad-score group (p = 0.019). In the validation set, the low Rad-score group had significantly better PFS than that the high Rad-score group (p = 0.040).

'''Conclusions:''' The [18F]FDG-PET/CT radiomic model could predict PFS for patients with esophageal cancer who received dCRT.
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==Minimizing Magnetic Resonance Image Geometric Distortion at 7 Tesla for Frameless Presurgical Planning Using Skin-Adhered Fiducials==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36301228 Med Phys. 2023 Feb;50(2):694-701. PMID: 36301228]

'''Authors:''' Kirby KM, Koons EK, Welker KM, Fagan AJ.

'''Institution:''' Department of Radiology, Mayo Clinic, Rochester, MN, USA.

'''Abstract:'''
'''Background:''' 7T MRI offers significant benefits to spatial and contrast resolution compared to lower field strengths. This superior image quality can help better delineate targets in stereotactic neurosurgical procedures; however, the potential for increased geometric distortions at 7T has impaired its widespread use for these applications. Image geometric distortions can be due to distortions of B0 arising from tissue magnetic susceptibility effects or inherent field inhomogeneities, and nonlinearity of the magnetic field gradients.

'''Purpose:''' The purpose of this study was to investigate the use of 7T MRI for neurosurgical frameless stereotactic navigation procedures. Image geometric distortions at the skin surface in 7T images were minimized and compared to results from clinical 3T frameless imaging protocols.

'''Methods:''' A 3D-printed grid phantom filled with oil was designed to perform a fine calibration of the 7T imaging gradients, and an oil-filled head phantom with internal targets was used to determine ground truth (from computed tomography [CT]) positioning errors. Three volunteers and the head phantom were imaged consecutively at 3T and 7T. Ten skin-adhesive fiducial markers were placed on each subject's exposed skin surface at standard clinical placement locations for frameless procedures. Imaging sequences included MPRAGE (three bandwidths at 7T: 400, 690, and 1020 Hz/pixel, and one at 3T: 400 Hz/pixel), T2 SPACE, and T2 SPACE FLAIR acquisitions. An additional GRE field map was acquired on both scanners using a multi-echo GRE sequence. Custom Matlab code was used to perform additional distortion correction of the images using the unwrapped field maps. Fiducial localization was performed with [http://www.slicer.org '''3D Slicer'''], with absolute fiducial positioning errors determined in phantom experiments following rigid registration to the CT images. For human experiments, 3T and 7T images were registered and relative differences in fiducial locations were compared using two-tailed paired t-tests.

'''Results:''' Phantom measurements at 7T yielded gradient distance scaling errors of 1.1%, 2.2%, and 1.0% along the x-, y-, and z-axes, respectively. These system miscalibrations were traced back to phantom manufacturing deviations in the sphericity of the vendor's gradient calibration phantom. Correction factors along each gradient axis were applied, and afterward, geometric distortions of less than 1 mm were obtained in the 7T MR head phantom images for the 1020 Hz/pixel bandwidth MPRAGE sequence. For the human subjects, four fiducial locations were excluded from the analysis due to patient positioning differences. Differences between 3T and 7T MPRAGE with low/medium/high bandwidth were 2.2 /2.6/2.3 mm, respectively, before the correction, reducing to 1.6/1.3/1.0 mm after the correction (p < 0.001). T2 SPACE and T2 SPACE FLAIR yielded a similar pattern when the correction was applied, decreasing from 2.1 to 0.8 mm, and 2.6 to 1.0 mm, respectively.

'''Conclusions:''' 7T MRI can be used to perform frameless presurgical planning with skin-adhesive fiducials. Geometric distortions can be reduced to a clinically relevant level (errors < ∼1 mm) with no significant susceptibility-related distortions, by using high receiver bandwidth, ensuring gradients are properly calibrated, and placing skin fiducials in areas where distortions from patient positioning are minimal.
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==Acute Colonic Pseudo-Obstruction Secondary to Renal Calculus: A Case Report and Review of Pathophysiology==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36777972 Cureus. 2023 Feb 7;15(2):e34756. PMID: 36777972] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9905947/pdf/cureus-0015-00000034756.pdf PDF]

'''Authors:''' Gillies M, AlDujaili T.

'''Institution:''' General Surgery, Goulburn Valley Health, Shepparton, Australia

'''Abstract:''' Acute colonic pseudo-obstruction (ACPO) is obstruction of the large bowel without a mechanical cause. The exact mechanism remains incompletely understood but is thought to result from disruption to the autonomic regulation of the colon, typically in the context of hospitalized patients with medical illness, precipitating medications, or recent surgical intervention. This paper presents an unusual case of ACPO in an ambulatory patient with a recently passed renal calculus, explores the anatomy and physiology underlying the autonomic dysfunction theory of ACPO pathogenesis in the context of the case, and provides a 3D reconstruction of the patient's CT to illustrate the abrupt caliber change at the splenic flexure characteristic of ACPO.

'''Keywords:''' 3d reconstruction; acute colonic pseudo-obstruction; ogilvie's syndrome; renal calculi; [http://www.slicer.org '''3D Slicer'''] software.
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==A Novel Stereotactic Aspiration Technique for Intracerebral Hemorrhage==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36270590 World Neurosurg. 2023 Feb;170:e28-e36. PMID: 36270590]

'''Authors:''' Xu HZ, Guo J, Wang C, Liu X, Song ZQ, Chen RF, Qiu B, Wang Q, Huang Y.

'''Institution:''' Department of Neurosurgery, Civil Aviation General Hospital, Beijing, China.

'''Abstract:'''

'''Background:''' Minimally invasive surgery is effective and recommended for treatment of intracerebral hemorrhage; however, neurosurgeons in grass-root hospitals in underdeveloped countries lack effective and precise minimally invasive surgery techniques. The aim of this study was to present a technique of computed tomography angiography-based three-dimensional-printed navigation mold-guided stereotactic aspiration and demonstrate its clinical application using a hard needle in a series of patients.

'''Methods:''' The novel stereotactic aspiration technique was performed in 18 patients with spontaneous intracerebral hemorrhage at our center, and clinical outcomes were reported. We compared the volume of hematoma measured by 3 different methods: ABC/2 formula, manual segmentation with OsiriX, and manual segmentation with [http://www.slicer.org '''3D Slicer'''].

'''Results:''' The surgery was completed safely within an average operative time of 15.11 minutes, achieving the goal of <15 mL residual clot volume or >70% clot removal in all patients. No intracranial rebleeding or infection was observed postoperatively. At the end of the 6-month follow-up, 61.11% (11/18) of patients achieved a modified Rankin Scale score <3. There was overall better agreement of hematoma measurement using segmentation with [http://www.slicer.org '''3D Slicer'''] rather than ABC/2 measurement or hematoma measurement using segmentation with OsiriX.

'''Conclusions:''' Our novel method of stereotactic aspiration benefited patients in this study with good percent clot removal, few surgery-related complications, and a favorable prognosis. Manual segmentation with [http://www.slicer.org '''3D Slicer'''] could be used to provide the neurosurgeon with dependable information about hematoma volume. This cheap and convenient technique may be applied in grass-root hospitals in underdeveloped countries. Assessment in multicenter prospective clinical trials is needed.
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==Morphological Evaluation of the Normal and Hydrocephalic Third Ventricle on Cranial Magnetic Resonance Imaging in Children: A Retrospective Study==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35994062 Pediatr Radiol. 2023 Feb;53(2):282-96. PMID: 35994062]

'''Authors:''' Isıklar S, Turan Ozdemir S, Ozkaya G, Ozpar R, Parlak M.

'''Institution:''' Medical Imaging Techniques Program, Vocational School of Health Services, Bursa Uludag University, 16240, Bursa, Turkey.

'''Abstract:'''
'''Background:''' Third ventricle morphological changes reflect changes in the ventricular system in pediatric hydrocephalus, so visual inspection of the third ventricle shape is standard practice. However, normal pediatric reference data are not available.

'''Objective:''' To investigate both the normal development of the third ventricle in the 0-18-year age group and changes in its biometry due to hydrocephalus.

'''Materials and Methods:''' For this retrospective study, we selected individuals ages 0-18 years who had magnetic resonance imaging (MRI) from 2012 to 2020. We included 700 children (331 girls) who had three-dimensional (3-D) T1-weighted sequences without and 25 with hydrocephalus (11 girls). We measured the distances between the anatomical structures limiting the third ventricle by dividing the third ventricle into anterior and posterior regions. We made seven linear measurements and three index calculations using 3DSlicer and MRICloud pipeline, and we analyzed the results of 23 age groups in normal and hydrocephalic patients using SPSS (v. 23).

'''Results:''' Salient findings are: (1) The posterior part of the third ventricle is more affected by both developmental and hydrocephalus-related changes. (2) For third ventricle measurements, gender was insignificant while age was significant. (3) Normal third ventricular volumetric development showed a segmental increase in the 0-18 age range. The hydrocephalic third ventricle volume cut-off value in this age group was 3 cm3.

'''Conclusion:''' This study describes third ventricle morphometry using a linear measurement method. The ratios defined in the midsagittal plane were clinically useful for diagnosing the hydrocephalic third ventricle. The linear and volumetric reference data and ratios are expected to help increase diagnostic accuracy in distinguishing normal and hydrocephalic third ventricles.
|}

==Henri IV of France's Larynx 3D Reconstitution==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36149490 Eur Arch Otorhinolaryngol. 2023 Feb;280(2):919-24. PMID: 36149490]

'''Authors:''' Baudouin R, Amelot A, Laprie Y, Crevier-Buchman L, Maeda S, Huynh-Charlier I, Hans S, Charlier P.

'''Institution:''' Department of Otolaryngology-Head & Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Université Paris Saclay), Montigny-le-Bretonneux, France.

'''Abstract:''' Objectives: King Henri IV of France (reign from 1589 to 1610) was one of the most important kings of France. Embalmed and buried in Saint-Denis, his remains were beheaded in 1793. His head (including his larynx) survived in successive private collections until its definitive identification in 2010. The purpose of the study was to provide a morphologic study of the larynx with a 3D reconstitution.

'''Methods:''' A flexible endoscopy was performed via the mouth and via the trachea. Measures of the larynx (vocal folds lengths, thickness, width, larynx height) were collected from the CT-scan by a panel of experts blind each other. The segmentation of the laryngeal anatomical components (vocal folds, cartilages) was performed using [http://www.slicer.org '''3D Slicer''']. Mesh smoothing and 3D reconstitution were performed using Fusion 360®. Reconstitution was discussed between the experts. Decision was made by consensus after discussion.

'''Results:''' Cricoid, thyroid, arytenoid cartilages, vocal folds and hyoid bone were identified and a computed 3D reconstitution of the larynx was made. The laryngeal 3D model appeared morphologically similar to a living subject. Measures were similar but smaller than those of a modern subject.

'''Conclusions:''' The 3D reconstitution of the larynx of Henri IV of France was conducted from the CT-scan of his mummified head. This work constitutes a first valuable morphologic analysis of a larynx from an embalmed individual. This anatomical work is the first step towards the reconstruction of the voice of this historical character, which we hope to concretize with computer modeling tools in a second step.
|}

==Development and External Validation of a Novel Nomogram to Predict Prostate Cancer in Biopsy-Naïve Patients With PSA <10 Ng/Ml and PI-RADS v2.1 = 3 Lesions==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35920264 Cancer Med. 2023 Feb;12(3):2560-71. PMID: 35920264] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9939143/pdf/CAM4-12-2560.pdf PDF]

'''Authors:''' Hu C, Sun J, Xu Z, Zhang Z, Zhou Q, Xu J, Chen H, Wang C, Ouyang J.

'''Institution:''' Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.

'''Abstract:'''
'''Objective:''' To develop and externally validate a novel nomogram in biopsy-naïve patients with prostate-specific antigen (PSA) <10 ng/ml and PI-RADS v2.1 = 3 lesions.

'''Methods:''' We retrospectively collected 307 men that underwent initial biopsy from October 2015 to January 2022 in Cohort 1 (The First Affiliated Hospital of Soochow University). External cohort (Cohort 2, Kunshan Hospital) included 109 men that met our criteria from July 2016 to June 2021. By [http://www.slicer.org '''3D Slicer'''] Software, the volume of all lesions was divided into two subgroups (PI-RADS v2.1 = 3a and 3b). Logistic regression analysis was performed to screen for variables and construct nomogram by analyzing clinical data from Cohort 1. Receiver operating characteristics curve analysis, calibration plot and decision curve analysis (DCA) were plotted to validate the nomogram in external cohort.

'''Results:''' A total of 70 (22.8%) patients was diagnosed with prostate cancer in Institution 1. Among them, 34 (11.1%) had clinically significant prostate cancer (csPCa). Age, prostate-specific antigen density, digital rectal examination, PI-RADS v2.1 = 3 subgroups (3a and 3b) and apparent diffusion coefficient (ADC, <750 mm2 /s) were predictive factors for prostate cancer (PCa) and csPCa. High area under the curve of the nomogram was found in Cohort 1 and Cohort 2 for PCa (0.857 vs. 0.850) and for csPCa (0.896 vs. 0.893). Calibration curves showed excellent agreement between the predicted probability and actual risk for the models in internal and external validation. The DCA demonstrated net benefit of our nomogram.

'''Conclusion:''' Until now, this is the first nomogram that predicts PCa and csPCa in biopsy-naïve patients with PSA <10 ng/ml and PI-RADS v2.1 = 3 lesions. Furthermore, PI-RADS v2.1 = 3 subgroups were considered to be an independent risk factor in our model. Our nomogram may assist urologists in biopsy decision making for these so-called "double gray zone" patients.
|}

==A Three-Dimensionally Printed Otological Model for Cholesteatoma Mastoidectomy Training==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35789285 Eur Arch Otorhinolaryngol. 2023 Feb;280(2):671-80. PMID: 35789285]

'''Authors:''' de Souza MA, Bento RF, Lopes PT.

'''Institution:''' Otolaryngology Department, University of São Paulo School of Medicine, São Paulo, Brazil.

'''Abstract:'''
'''purpose:''' To relate the creation and expert validation (face and content validity) of an affordable three-dimensional (3D) printed model of temporal bones with chronic otitis media with cholesteatoma (COMC) as a simulator for mastoidectomy.

'''Methods:''' We performed computed tomography (CT) of the temporal bones of a patient with COMC followed at the University of São Paulo (USP) Hospital with [http://www.slicer.org '''3D Slicer'''] to create a 3-D model of the affected bone using light-curing resin and silicone (cholesteatoma). The final 3-D printed images were scored by 10 otologists using a customized version of the Michigan Standard Simulation Scale Experience (MiSSES). Internal consistency and inter-rater reliability were assessed using Cronbach's α and intraclass correlations.

'''Results:''' Otologists consistently scored the model positively for fidelity, educational value, reactions, and the overall model quality. Nine otologists agreed that the model was a good educational device for surgical training of COMC. All experts deemed the model ready-or nearly ready-for use. The final cost of the model, including raw materials and manufacturing, was 120 USD.

'''Conclusions:''' Using 3D printing technology, we created the first anatomically accurate, low-cost, disease-reproducing 3D model of temporal bones for mastoidectomy training for cholesteatoma.
|}

==Development of a Navigable 3D Virtual Model of Temporal Bone Anatomy==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36704866 J Vis Commun Med. 2023 Jan 26:1-5. PMID: 36704866] | [https://www.tandfonline.com/doi/full/10.1080/17453054.2023.2169110 PDF]

'''Authors:''' Sareen K.

'''Institution:''' Sant Parmanand Hospital, New Delhi, India.

'''Abstract:'''
'''Background:''' Computed Tomography (CT) scanning offers an accurate structural definition of bones, blood vessels, and soft tissues; however, mental integration of cross-sectional 2D CT images for a 3D understanding of complex anatomical structures becomes difficult when the field of view is confined to the temporal bone. This project tried to provide a feasible solution to this problem by creating a navigable 3D virtual model which may aid in better comprehension of the temporal bone anatomy.

'''Methods:''' A helical-CT scan was used to obtain high-resolution cross-sectional slices of a cadaveric human temporal bone. Using the volume-rendering capabilities of [http://www.slicer.org '''3D Slicer'''], which involves volume data management, cropping of the data set, and threshold painting, detailed anatomical structures were segmented based on the intensity captured from different regions. This volumetric data was converted to an interactive virtual model using Blender®.

'''Results:''' The final product is a web page that allows interaction and navigation with a 3D annotated model of the temporal bone, which can be accessed from any device with a web browser.

'''Conclusion:''' This model can function as a training tool for students, teachers, and practitioners to understand and review the complex anatomy of the temporal bone.
|}

==Maxillary Antral Pseudocyst Drift after Osteotome Sinus Floor Elevation with Simultaneous Implant Placement: A Case Report and Literature Review==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36769568 J Clin Med. 2023 Jan 24;12(3):920. PMID: 36769568] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9917374/pdf/jcm-12-00920.pdf PDF]

'''Authors:''' Wang P, Huang N, Ren J, Gong P, Long J, Huang B.

'''Institution:''' West China School of Stomatology, Sichuan University, Chengdu, China.

'''Abstract:''' This report describes maxillary antral pseudocyst drift after maxillary sinus floor augmentation through osteotome sinus floor elevation with simultaneous implant placement. [http://www.slicer.org '''3D Slicer'''] was used to measure the pseudocyst and maxilla for the placement of the implants; follow-up visits were scheduled at 6, 12, and 22 months. No adverse effects were observed during or after surgery, and all implants exhibited osseointegration without mobility. At 6 months after surgery, the pseudocyst had moved posterolaterally from the preoperative position near the anterior medial maxillary sinus, then returned to its original position at 12 months. However, it had remigrated to the posterolateral position at 22 months. The preoperative volume of the pseudocyst was 3.795 mm3; it was 2.370, 3.439, and 2.930 mm3 at 6, 12, and 22 months after surgery, respectively. The changes in pseudocyst drift and volume did not have a substantial negative influence on the implants, presumably because of cystic attachment and the recurrence of multiple pseudocysts at different locations. The risks associated with changes in a pseudocyst can be avoided, if an appropriate treatment plan is selected.
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==Radiomic Analysis Based on Magnetic Resonance Imaging for Predicting PD-L2 Expression in Hepatocellular Carcinoma==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36672315 Cancers (Basel). 2023 Jan 5;15(2):365. PMID: 36672315] | [http://www.ncbi.nlm.nih.gov/pmc/articles/pmc9856314/ PDF]

'''Authors:''' Tao YY, Shi Y, Gong XQ, Li L, Li ZM, Yang L, Zhang XM.

'''Institution:''' Medical Imaging Key Laboratory of Sichuan Province, Interventional Medical Center, Department of Radiology, Medical Research Center, Affiliated Hospital of North Sichuan Medical College, Nanchong, China.

'''Abstract:''' Hepatocellular carcinoma (HCC) is the sixth most common malignant tumour and the third leading cause of cancer death in the world. The emerging field of radiomics involves extracting many clinical image features that cannot be recognized by the human eye to provide information for precise treatment decision making. Radiomics has shown its importance in HCC identification, histological grading, microvascular invasion (MVI) status, treatment response, and prognosis, but there is no report on the preoperative prediction of programmed death ligand-2 (PD-L2) expression in HCC. The purpose of this study was to investigate the value of MRI radiomic features for the non-invasive prediction of immunotherapy target PD-L2 expression in hepatocellular carcinoma (HCC). A total of 108 patients with HCC confirmed by pathology were retrospectively analysed. Immunohistochemical analysis was used to evaluate the expression level of PD-L2. [http://www.slicer.org '''3D Slicer'''] software was used to manually delineate volumes of interest (VOIs) and extract radiomic features on preoperative T2-weighted, arterial-phase, and portal venous-phase MR images. Least absolute shrinkage and selection operator (LASSO) was performed to find the best radiomic features. Multivariable logistic regression models were constructed and validated using fivefold cross-validation. The area under the receiver characteristic curve (AUC) was used to evaluate the predictive performance of each model. The results show that among the 108 cases of HCC, 50 cases had high PD-L2 expression, and 58 cases had low PD-L2 expression. Radiomic features correlated with PD-L2 expression. The T2-weighted, arterial-phase, and portal venous-phase and combined MRI radiomics models showed AUCs of 0.789 (95% CI: 0.702-0.875), 0.727 (95% CI: 0.632-0.823), 0.770 (95% CI: 0.682-0.875), and 0.871 (95% CI: 0.803-0.939), respectively. The combined model showed the best performance. The results of this study suggest that prediction based on the radiomic characteristics of MRI could noninvasively predict the expression of PD-L2 in HCC before surgery and provide a reference for the selection of immune checkpoint blockade therapy.
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==Correlation Between Unilateral Internal Carotid Artery Stenosis and Asymmetric Distribution of Enlarged Perivascular Spaces in Patients With Acute Cerebral Infarction==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36649988 Zhonghua Yi Xue Za Zhi. 2023 Jan 17;103(3):178-185. PMID: 36649988]

'''Authors:''' Jian XL, Zhang M, Yun WW.

'''Abstract:'''
'''Objective:''' To explore the correlation between unilateral internal carotid artery (ICA) stenosis and asymmetrical distribution of enlarged perivascular spaces (EPVS) in patients with acute cerebral infarction.

'''Methods:''' Acute cerebral infarction patients with unilateral ICA stenosis hospitalized in Changzhou Second People's Hospital from October 2020 to December 2021 were collected. Routine cranial MRI and CT angiography were completed for each patient. The [http://www.slicer.org '''3D Slicer'''] software was used to quantitatively analyze the volume of patient's EPVS. Patients were divided into moderate stenosis group and severe stenosis/occlusion group according to the degree of ICA stenosis. Baseline data were compared between the two groups. Patients were further divided into three groups: moderate stenosis, severe stenosis and occlusion groups, and the ipsilateral and contralateral EPVS volume of ICA stenosis patients was compared. The asymmetry index (AI) was calculated for EPVS in the basal ganglia region (BG-EPVS) and EPVS in the centrum semiovale (CSO-EPVS). Patients with AI≥0.2 were included in the EPVS asymmetry group, while the rest were in the EPVS symmetry group, and the degree of unilateral ICA stenosis was compared between the two groups. Multivariate logistic regression model was used to analyze the relationship between ICA severe stenosis/occlusion and the asymmetric distribution of BG-EPVS.

'''Results:''' A total of 122 patients (96 males and 26 females) were enrolled, aged (70±10) years, with 81 cases in the unilateral ICA severe stenosis/occlusion group (46 cases of severe stenosis and 35 of occlusion) and 41 cases in the moderate stenosis group. Patients in the unilateral ICA severe stenosis/occlusion group had greater BG-EPVS volume [(4.08±0.76) mm3]and proportion of asymmetric distribution of BG-EPVS [75.3%(61/81)] than those of the moderate stenosis group [(3.12±0.85) mm3 and 39.0% (16/41)], with statistically significant differences (both P<0.001). The BG-EPVS volumes of the ipsilateral side of the stenosis in the severe stenosis group and the occlusion group [(3.34±0.86) mm3 and (3.93±0.60) mm3] were significantly greater than those of the contralateral side [(2.65±1.28) mm3 and (3.21±0.88) mm3], with statistically significant differences (both P<0.001). Correlation analysis indicated that the degree of unilateral ICA stenosis was positively correlated with the BG-EPVS volume on the stenosis side (r=0.62, P<0.001). Further comparison of the degree of unilateral ICA stenosis between the EPVS symmetric and asymmetric groups showed that the proportion of unilateral ICA severe stenosis/occlusion in the BG-EPVS asymmetry group was higher than that in the symmetric group [79.2%(61/77) vs 44.4%(20/45),P<0.001]. Multivariate logistic regression analysis showed that unilateral ICA severe stenosis/occlusion (OR=4.280, 95%CI: 1.743-10.508, P =0.002) and age (OR=1.055, 95%CI: 1.001-1.112, P=0.044) were risk factors for asymmetric distribution of BG-EPVS.

'''Conclusions:''' The severe stenosis/occlusion of the unilateral ICA and age are the risk factors for the asymmetric distribution of the BG-EPVS in patients with acute cerebral infarction. The ipsilateral EPVS volume of unilateral ICA stenosis is larger than that of the contralateral side, and the degree of ICA stenosis is positively correlated with the severity of BG-EPVS.
|}

==Radiomics to Predict the Mortality of Patients With Rheumatoid Arthritis-Associated Interstitial Lung Disease: A Proof-of-Concept Study==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36698825 Front Med (Lausanne). 2023 Jan 9;9:1069486. PMID: 36698825] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9870287/pdf/fmed-09-1069486.pdf PDF]

'''Authors:''' Venerito V, Manfredi A, Lopalco G, Lavista M, Cassone G, Scardapane A, Sebastiani M, Iannone F.

'''Institution:''' Rheumatology Unit, Department of Emergency and Organ Transplantation, University of Bari Aldo Moro, Bari, Italy.

'''Abstract:''' Objectives: Patients with rheumatoid arthritis (RA) and interstitial lung disease (ILD) have increased mortality compared to the general population and factors capable of predicting RA-ILD long-term clinical outcomes are lacking. In oncology, radiomics allows the quantification of tumour phenotype by analysing the characteristics of medical images. Using specific software, it is possible to segment organs on high-resolution computed tomography (HRCT) images and extract many features that may uncover disease characteristics that are not detected by the naked eye. We aimed to investigate whether features from whole lung radiomic analysis of HRCT may alone predict mortality in RA-ILD patients.

'''Methods:''' High-resolution computed tomographies of RA patients from January 2012 to March 2022 were analyzed. The time between the first available HRCT and the last follow-up visit or ILD-related death was recorded. We performed a volumetric analysis in [http://www.slicer.org '''3D Slicer'''], automatically segmenting the whole lungs and trachea via the Lung CT Analyzer. A LASSO-Cox model was carried out by considering ILD-related death as the outcome variable and extracting radiomic features as exposure variables.

'''Results:''' We retrieved the HRCTs of 30 RA-ILD patients. The median survival time (interquartile range) was 48 months (36-120 months). Thirteen out of 30 (43.33%) patients died during the observation period. Whole line segmentation was fast and reliable. The model included either the median grey level intensity within the whole lung segmentation [high-resolution (HR) 9.35, 95% CI 1.56-55.86] as a positive predictor of death and the 10th percentile of the number of included voxels (HR 0.20, 95% CI 0.05-0.84), the voxel-based pre-processing information (HR 0.23, 95% CI 0.06-0.82) and the flatness (HR 0.42, 95% CI 0.18-0.98), negatively correlating to mortality. The correlation of grey level values to their respective voxels (HR 1.52 95% CI 0.82-2.83) was also retained as a confounder.

'''Conclusion:''' Radiomic analysis may predict RA-ILD patients' mortality and may promote HRCT as a digital biomarker regardless of the clinical characteristics of the disease.
|}

==Evaluation of the Prognosis of Acute Subdural Hematoma According to the Density Differences Between Gray and White Matter==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36686517 Front Neurol. 2023 Jan 6;13:1024018. PMID: 36686517] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9853902/ PDF]

'''Authors:''' Li Z, Feng Y, Wang P, Han S, Zhang K, Zhang C, Lu S, Lv C, Zhu F, Bie L.

'''Institution:''' Department of Neurosurgery of the First Clinical Hospital, Jilin University, Changchun, China.

'''Abstract:'''
'''Objective:''' Acute subdural hematoma (ASDH) is a common neurological emergency, and its appearance on head-computed tomographic (CT) imaging helps guide clinical treatment. To provide a basis for clinical decision-making, we analyzed that the density difference between the gray and white matter of the CT image is associated with the prognosis of patients with ASDH.

'''Methods:''' We analyzed the data of 194 patients who had ASDH as a result of closed traumatic brain injury (TBI) between 2018 and 2021. The patients were subdivided into surgical and non-surgical groups, and the non-surgical group was further subdivided into "diffused [hematoma]" and "non-diffused" groups. The control group's CT scans were normal. The [http://www.slicer.org '''3D Slicer'''] software was used to quantitatively analyze the density of gray and white matter depicted in the CT images.

'''Results:''' Imaging evaluation showed that the median difference in density between the gray and white matter on the injured side was 4.12 HU (IQR, 3.91-4.22 HU; p < 0.001) and on the non-injured side was 4.07 HU (IQR, 3.90-4.19 HU; p < 0.001), and the hematoma needs to be surgically removed. The median density difference value of the gray and white matter on the injured side was 3.74 HU (IQR, 3.53-4.01 HU; p < 0.001) and on the non-injured side was 3.71 HU (IQR, 3.69-3.73 HU; p < 0.001), and the hematoma could diffuse in a short time.

'''Conclusion:''' Quantitative analysis of the density differences in the gray and white matter of the CT images can be used to evaluate the clinical prognosis of patients with ASDH.
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==The Knosp Criteria Revisited: 3-Dimensional Volumetric Analysis as a Predictive Tool for Extent of Resection in Complex Endoscopic Pituitary Surgery==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36170168 Front Oncol. Neurosurgery. 2023 Jan 1;92(1):179-85. PMID: 36170168]

'''Authors:''' DiRisio AC, Feng R, Shuman WH, Platt S, Price G, Dullea JT, Gilja S, D'Andrea MR, Delman BN, Bederson JB, Shrivastava RK.

'''Institution:''' Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.

'''Abstract:'''
'''Background:''' The Knosp criteria have been the historical standard for predicting cavernous sinus invasion, and therefore extent of surgical resection, of pituitary macroadenomas. Few studies have sought to reappraise the utility of this tool after recent advances in visualization and modeling of tumors in complex endoscopic surgery.

'''Objective:''' To evaluate our proposed alternative method, using 3-dimensional (3D) volumetric imaging, and whether it can better predict extent of resection in nonfunctional pituitary adenomas.

'''Methods:''' Patients who underwent endoscopic transsphenoidal resection of pituitary macroadenomas at our institution were reviewed. Information was collected on neurological, endocrine, and visual function. Volumetric segmentation was performed using [http://www.slicer.org '''3D Slicer'''] software. Relationship of tumor volume, clinical features, and Knosp grade on extent of resection was examined.

'''Results:''' One hundred forty patients were identified who had transsphenoidal resection of nonfunctional pituitary adenomas. Macroadenomas had a median volume of 6 cm3 (IQR 3.4-8.7), and 17% had a unilateral Knosp grade of at least 3B. On multiple logistic regression, only smaller log-transformed preoperative tumor volume was independently associated with increased odds of gross total resection (GTR; odds ratio: 0.27, 95% CI: 0.07-0.89, P < .05) when controlling for tumor proliferative status, age, and sex (area under the curve 0.67). The Knosp criteria did not independently predict GTR in this cohort (P > .05, area under the curve 0.46).

'''Conclusion:''' Increasing use of volumetric 3D imaging may better anticipate extent of resection compared with the Knosp grade metric and may have a greater positive predictive value for GTR. More research is needed to validate these findings and implement them using automated methods.
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==Differentiation of Lung Metastases Originated From Different Primary Tumors Using Radiomics Features Based on CT Imaging==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35577699 Acad Radiol. 2023 Jan;30(1):40-6. PMID: 35577699]

'''Authors:''' Shang H, Li J, Jiao T, Fang C, Li K, Yin D, Zeng Q.

'''Institution:''' Department of Radiology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, No. 16766 Jingshi Road, Jinan, Shandong, China.

'''Abstract:''' Rationale and objectives: To explore the feasibility of differentiating three predominant metastatic tumor types using lung computed tomography (CT) radiomics features based on supervised machine learning.

'''Materials and Methods:''' This retrospective analysis included 252 lung metastases (LM) (from 78 patients), which were divided into the training (n = 176) and test (n = 76) cohort randomly. The metastases originated from colorectal cancer (n = 97), breast cancer (n = 87), and renal carcinoma (n = 68). An additional 77 LM (from 35 patients) were used for external validation. All radiomics features were extracted from lung CT using an open-source software, [http://www.slicer.org '''3D Slicer''']. The least absolute shrinkage and selection operator (LASSO) method selected the optimal radiomics features to build the model. Random forest and support vector machine (SVM) were selected to build three-class and two-class models. The performance of the classification model was evaluated with the area under the receiver operating characteristic curve (AUC) by two strategies: one-versus-rest and one-versus-one.

'''Results:''' Eight hundred and fifty-one quantitative radiomics features were extracted from lung CT. By LASSO, 23 optimal features were extracted in three-class, and 25, 29, and 35 features in two-class for differentiating every two of three LM (colorectal cancer vs. renal carcinoma, colorectal cancer vs. breast cancer, and breast cancer vs. renal carcinoma, respectively). The AUCs of the three-class model were 0.83 for colorectal cancer, 0.79 for breast cancer, and 0.91 for renal carcinoma in the test cohort. In the external validation cohort, the AUCs were 0.77, 0.83, and 0.81, respectively. Swarmplot shows the distribution of radiomics features among three different LM types. In the two-class model, high accuracy and AUC were obtained by SVM. The AUC of discriminating colorectal cancer LM from renal carcinoma LM was 0.84, and breast cancer LM from colorectal cancer LM and renal carcinoma LM were 0.80 and 0.94, respectively. The AUCs were 0.77, 0.78, and 0.84 in the external validation cohort.

'''Conclusion:''' Quantitative radiomics features based on Lung CT exhibited good discriminative performance in LM of primary colorectal cancer, breast cancer, and renal carcinoma.
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==MRI Radiomic Features of Peritumoral Edema May Predict the Recurrence Sites of Glioblastoma Multiforme==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36686829 Front Oncol. 2023 Jan 4;12:1042498. PMID: 36686829] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9845721/pdf/fonc-12-1042498.pdf PDF]

'''Authors:''' Long H, Zhang P, Bi Y, Yang C, Wu M, He D, Huang S, Yang K, Qi S, Wang J.

'''Institution:''' Department of Neurosurgery, Nanfang Hospital, Southern Medical University, Guangzhou, China.

'''Abstract:'''

'''Background and Purpose:''' As one of the most aggressive malignant tumor in the central nervous system, the main cause of poor outcome of glioblastoma (GBM) is recurrence, a non-invasive method which can predict the area of recurrence pre-operation is necessary.To investigate whether there is radiological heterogeneity within peritumoral edema and identify the reproducible radiomic features predictive of the sites of recurrence of glioblastoma(GBM), which may be of value to optimize patients' management.

'''Materials and Methods:''' The clinical information and MR images (contrast-enhanced T1 weighted and FLAIR sequences) of 22 patients who have been histologically proven glioblastoma, were retrospectively evaluated. Kaplan-Meier methods was used for survival analysis. Oedematous regions were manually segmented by an expert into recurrence region, non-recurrence region. A set of 94 radiomic features were obtained from each region using the function of analyzing MR image of [http://www.slicer.org '''3D Slicer''']. Paired t test was performed to identify the features existing significant difference. Subsequently, the data of two patients from TCGA database was used to evaluate whether these features have clinical value.

'''Results:''' Ten features with significant differences between the recurrence and non-recurrence subregions were identified and verified on two individual patients from the TCGA database with pathologically confirmed diagnosis of GBM.

'''Conclusions:''' Our results suggested that heterogeneity does exist in peritumoral edema, indicating that the radiomic features of peritumoral edema from routine MR images can be utilized to predict the sites of GBM recurrence. Our findings may further guide the surgical treatment strategy for GBM.
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==Clinical Study on Application of 3D Slicer Software Assisted Domestic Frameless Stereotactic Robot in Biopsy of Intracranial Lesions==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36603886 Zhonghua Wai Ke Za Zhi. 2023 Jan 1;61(1):61-65. PMID: 36603886] | [http://www.ncbi.nlm.nih.gov/pmc/articles/pmc9849352/ PDF]

'''Authors:''' Chen H, Yan X, He F, Ding SC, Diao JF, Guo H, Cao SM, Yang CJ, Yin F.

'''Institution:''' Department of Neurosurgery, Aerospace Central Hospital, Beijing, China.

'''Abstract:'''
'''Objective:''' To examine the application value of [http://www.slicer.org '''3D Slicer'''] software assisted domestic frameless stereotactic robot in biopsy of intracranial lesions.

'''Methods:''' A retrospective analysis was performed on 80 patients who admitted consecutively and underwent intracerebral lesions biopsy with the domestic frameless stereotactic robot at Department of Neurosurgery, Aerospace Central Hospital from January 2019 to December 2021. There were 36 males and 44 females, with a mean age of (38.5±18.0) years (range: 6 to 71 years). Before surgery only enhanced T1-weighted three-dimensional magnetization prepared gradient echo sequences and diffusion tensor imaging scans were performed. Self-reconstruction of intracranial lesions, cerebral cortex and blood vessels was carried out using 3D Slicer software system after the DICOM format imaging data of 80 patients were collected. These imaging data were merged to the workstation of the domestic frameless stereotactic robot for preoperative surgical planning and the surgical puncture path was designed to avoid blood vessels in the brain functional area, cerebral cortex and sulcus.

'''Results:''' All frameless stereotactic biopsy were successfully performed. Postoperative pathological diagnosis included 50 cases of diffuse astrocytic and oligodendroglioma, 15 cases of lymphoma, 5 cases of metastatic tumors, 5 cases of inflammatory demyelinating disease, 2 cases of inflammatory granuloma, 1 case of hemangioma, 1 case of acute lymphoblastic leukemia intracranial invasion and 1 case of seminoma. The positive diagnosis rate was 100% (80/80). Postoperative imaging confirmed that the puncture path and target were accurately implemented according to the preoperative planning, and the target error was (1.32±0.44) mm (range: 0.55 to 1.99 mm). One case of puncture-related bleeding occurred at the target after surgery and improved after treatment.

'''Conclusion:''' The three-dimensional multimodal images reconstructed by the 3D Slicer software before operation could help the surgeons make the preoperative planning and reduce the risk of stereotactic brain biopsy.
|}

==Liver Cirrhosis and Tumor Location Can Affect the Range of Intrahepatic Microwave Ablation Zone==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36854449 Int J Hyperthermia. 2023;40(1):2181843. PMID: 36854449] | [https://www.tandfonline.com/doi/epdf/10.1080/02656736.2023.2181843?needAccess=true&role=button PDF]

'''Authors:''' Ding WZ, Wei H, Wu JP, Cheng ZG, Han ZY, Liu FY, Yu J, Liang P.

'''Institution:''' Fifth Medical Center of Chinese, PLA General Hospital, Beijing, China.

'''Abstract:'''
'''Background:''' The range of an ablation zone (AZ) plays a crucial role in the treatment effect of microwave ablation (MWA). The aim of this study was to analyze the factors influencing the AZ range.

'''Methods:''' Fourteen factors in four areas were included: patient-related factors (sex, age), disease-related factors (tumor location, liver cirrhosis), serological factors (ALT, AST, total protein, albumin, total bilirubin, direct bilirubin, and platelets), and MWA parameters (ablation time, power, and needle type). Multiple sequence MRI was used to delineate AZ by three radiologists using [http://www.slicer.org '''3D Slicer''']. MATLAB was used to calculate the AZ length, width, and area of the largest section. Linear regression analysis was used to analyze influencing factors. Moreover, a subgroup analysis was conducted for patients with viral hepatitis.

'''Result:''' 220 patients with 290 tumors were included between 2010-2021. In addition to MWA parameters, cirrhosis and tumor location were significant factors that influenced AZ (p < 0.001). The standardized coefficient (beta) of cirrhosis (cirrhosis vs. non-cirrhosis) was positive, which meant cirrhosis would lead to a decrease in AZ range. The beta of tumor location (near the hepatic hilar zone, intermediate zone, and periphery zone) was negative, indicating that AZ range decreased as the tumor location approached the hepatic hilum. For viral hepatitis patients, Fibrosis 4 (FIB4) score was a significant factor influencing AZ (p < 0.001), and the beta was negative, indicating that AZ range decreased as FIB4 increased.

'''Conclusion:''' Liver cirrhosis, tumor location, and FIB4 affect the AZ range and should be considered when planning MWA parameters.
|}

==A Magnetic Resonance Imaging Based Radiomics Model to Predict Mitosis Cycles in Intracranial Meningioma==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36653482 Sci Rep. 2023 Jan 18;13(1):969. PMID: 36653482] | [http://www.ncbi.nlm.nih.gov/pmc/articles/pmc9849352/ PDF]

'''Authors:'''Krähling H, Musigmann M, Akkurt BH, Sartoretti T, Sartoretti E, Henssen DJHA, Stummer W, Heindel W, Brokinkel B, Mannil M.

'''Institution:''' University Clinic for Radiology, University Hospital Muenster, Westfälische Wilhelms-University Muenster, Muenster, Germany.

'''Abstract:''' The aim of this study was to develop a magnetic resonance imaging (MRI) based radiomics model to predict mitosis cycles in intracranial meningioma grading prior to surgery. Preoperative contrast-enhanced T1-weighted (T1CE) cerebral MRI data of 167 meningioma patients between 2015 and 2020 were obtained, preprocessed and segmented using the [http://www.slicer.org '''3D Slicer'''] software and the PyRadiomics plugin. In total 145 radiomics features of the T1CE MRI images were computed. The criterion on the basis of which the feature selection was made is whether the number of mitoses per 10 high power field (HPF) is greater than or equal to zero. Our analyses show that machine learning algorithms can be used to make accurate predictions about whether the number of mitoses per 10 HPF is greater than or equal to zero. We obtained our best model using Ridge regression for feature pre-selection, followed by stepwise logistic regression for final model construction. Using independent test data, this model resulted in an AUC (Area under the Curve) of 0.8523, an accuracy of 0.7941, a sensitivity of 0.8182, a specificity of 0.7500 and a Cohen's Kappa of 0.5576. We analyzed the performance of this model as a function of the number of mitoses per 10 HPF. The model performs well for cases with zero mitoses as well as for cases with more than one mitosis per 10 HPF. The worst model performance (accuracy = 0.6250) is obtained for cases with one mitosis per 10 HPF. Our results show that MRI-based radiomics may be a promising approach to predict the mitosis cycles in intracranial meningioma prior to surgery. Specifically, our approach may offer a non-invasive means of detecting the early stages of a malignant process in meningiomas prior to the onset of clinical symptoms.
|}

==Advantages of a Training Course for Surgical Planning in Virtual Reality for Oral and Maxillofacial Surgery: Crossover Study==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36656632 JMIR Serious Games. 2023 Jan 19;11:e40541. PMID: 36656632] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9947820/?report=printable PDF]

'''Authors:''' Ulbrich M, Van den Bosch V, Bönsch A, Gruber LJ, Ooms M, Melchior C, Motmaen I, Wilpert C, Rashad A, Kuhlen TW, Hölzle F, Puladi B.

'''Institution:''' Department of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Aachen, Germany.

'''Abstract:'''
'''Background:''' As an integral part of computer-assisted surgery, virtual surgical planning (VSP) leads to significantly better surgery results, such as for oral and maxillofacial reconstruction with microvascular grafts of the fibula or iliac crest. It is performed on a 2D computer desktop screen (DS) based on preoperative medical imaging. However, in this environment, VSP is associated with shortcomings, such as a time-consuming planning process and the requirement of a learning process. Therefore, a virtual reality (VR)-based VSP application has great potential to reduce or even overcome these shortcomings due to the benefits of visuospatial vision, bimanual interaction, and full immersion. However, the efficacy of such a VR environment has not yet been investigated.

'''Objective:''' This study aimed to demonstrate the possible advantages of a VR environment through a substep of VSP, specifically the segmentation of the fibula (calf bone) and os coxae (hip bone), by conducting a training course in both DS and VR environments and comparing the results.

'''Methods:''' During the training course, 6 novices were taught how to use a software application in a DS environment, [http://www.slicer.org '''3D Slicer''']) and in a VR environment (Elucis) for the segmentation of the fibula and os coxae, and they were asked to carry out the maneuvers as accurately and quickly as possible. Overall, 13 fibula and 13 os coxae were segmented for each participant in both methods (VR and DS), resulting in 156 different models (78 fibula and 78 os coxae) per method (VR and DS) and 312 models in total. The individual learning processes in both environments were compared using objective criteria (time and segmentation performance) and self-reported questionnaires. The models resulting from the segmentation were compared mathematically (Hausdorff distance and Dice coefficient) and evaluated by 2 experienced radiologists in a blinded manner.

'''Results:''' A much faster learning curve was observed for the VR environment than the DS environment (β=.86 vs β=.25). This nearly doubled the segmentation speed (cm3/min) by the end of training, leading to a shorter time (P<.001) to reach a qualitative result. However, there was no qualitative difference between the models for VR and DS (P=.99). The VR environment was perceived by participants as more intuitive and less exhausting, and was favored over the DS environment.

'''Conclusions:''' The more rapid learning process and the ability to work faster in the VR environment could save time and reduce the VSP workload, providing certain advantages over the DS environment.
|}

==Lesion Size and Long-Term Cognitive Outcome After Pediatric Stroke: A Comparison Between Two Techniques to Assess Lesion Size==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36641854 Eur J Paediatr Neurol. 2023 Jan 7;42:126-32. PMID: 36641854]

'''Authors:''' Everts R, Bertato S, Steinlin M, Slavova N, Grunt S, Steiner L.

'''Institution:''' Division of Neuropediatrics, Development and Rehabilitation, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.

'''Abstract:'''
'''Background:''' There is little consensus on how lesion size impacts long-term cognitive outcome after pediatric arterial ischemic stroke (AIS). This study, therefore, compared two techniques to assessed lesion size in the chronic phase after AIS and determined their measurement agreement in relation to cognitive functions in patients after pediatric stroke.

'''Methods:''' Twenty-five patients after pediatric AIS were examined in the chronic phase (>2 years after stroke) in respect to intelligence, memory, executive functions, visuo-motor functions, motor abilities, and disease-specific outcome. Lesion size was measured using the ABC/2 formula and segmentation technique ([http://www.slicer.org '''3D Slicer''']). Correlation analysis determined the association between volumetry techniques and outcome measures in respect to long-term cognitive outcome.

'''Results:''' The measurements from the ABC/2 and segmentation technique were strongly correlated (r = 0.878, p < .001) and displayed agreement in particular for small lesions. Lesion size from both techniques was significantly correlated with disease-specific outcome (p < .001) and processing speed (p < .005) after controlling for age at stroke and multiple comparison.

'''Conclusion:''' The two techniques showed convergent validity and were both significantly correlated with long-term outcome after pediatric AIS. Compared to the time-consuming segmentation technique, ABC/2 facilitates clinical and research work as it requires relatively little time and is easy to apply.
|}

==Association Between Emphysema and Other Pulmonary Computed Tomography Patterns in COVID-19 Pneumonia==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36358023 J Med Virol. 2023 Jan;95(1):e28293. PMID: 36358023] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9828029/pdf/JMV-95-0.pdf PDF]

'''Authors:''' Han K, Wang J, Zou Y, Zhang Y, Zhou L, Yin Y.

'''Institution:''' Fetal-Neonatal Neuroimaging and Developmental Science Center, Division of Newborn Medicine, Boston Children's Hospital, Boston, USA.

'''Abstract:''' To evaluate the chest computed tomography (CT) findings of patients with Corona Virus Disease 2019 (COVID-19) on admission to hospital. And then correlate CT pulmonary infiltrates involvement with the findings of emphysema. We analyzed the different infiltrates of COVID-19 pneumonia using emphysema as the grade of pneumonia. We applied open-source assisted software, [http://www.slicer.org '''3D Slicer'''] to model the lungs and lesions of 66 patients with COVID-19, which were retrospectively included. we divided the 66 COVID-19 patients into the following two groups: (A) 12 patients with less than 10% emphysema in the low-attenuation area less than -950 Hounsfield units (%LAA-950), (B) 54 patients with greater than or equal to 10% emphysema in %LAA-950. Imaging findings were assessed retrospectively by two authors and then pulmonary infiltrates and emphysema volumes were measured on CT using [http://www.slicer.org '''3D Slicer'''] software. Differences between pulmonary infiltrates, emphysema, Collapsed, affected of patients with CT findings were assessed by Kruskal-Wallis and Wilcoxon test, respectively. Statistical significance was set at p < 0.05. The left lung (A) affected left lung 20.00/affected right lung 18.50, (B) affected left lung 13.00/affected right lung 11.50 was most frequently involved region in COVID-19. In addition, collapsed left lung, (A) collapsed left lung 4.95/collapsed right lung 4.65, (B) collapsed left lung 3.65/collapsed right lung 3.15 was also more severe than the right one. There were significant differences between the Group A and Group B in terms of the percentage of CT involvement in each lung region (p < 0.05), except for the inflated affected total lung (p = 0.152). The median percentage of collapsed left lung in the Group A was 20.00 (14.00-30.00), right lung was 18.50 (13.00-30.25) and the total was 19.00 (13.00-30.00), while the median percentage of collapsed left lung in the Group B was 13.00 (10.00-14.75), right lung was 11.50 (10.00-15.00) and the total was 12.50 (10.00-15.00). The percentage of affected left lung is an independent predictor of emphysema in COVID-19 patients. We need to focus on the left lung of the patient as it is more affected. The people with lower levels of emphysema may have more collapsed segments. The more collapsed segments may lead to more serious clinical feature.
|}

==A High-Resolution Pediatric Female Whole-Body Numerical Model With Comparison to a Male Model==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36595234 Phys Med Biol. 2023 Jan 13;68(2). PMID: 36595234]

'''Authors:''' Ntolkeras G, Jeong H, Zöllei L, Dmytriw AA, Purvaziri A, Lev MH, Grant PE, Bonmassar G.

'''Institution:''' Fetal-Neonatal Neuroimaging and Developmental Science Center, Division of Newborn Medicine, Boston Children's Hospital, Boston, USA.

'''Abstract:'''
'''Objective:''' Numerical models are central in designing and testing novel medical devices and in studying how different anatomical changes may affect physiology. Despite the numerous adult models available, there are only a few whole-body pediatric numerical models with significant limitations. In addition, there is a limited representation of both male and female biological sexes in the available pediatric models despite the fact that sex significantly affects body development, especially in a highly dynamic population. As a result, we developed Athena, a realistic female whole-body pediatric numerical model with high-resolution and anatomical detail.

'''Approach:''' We segmented different body tissues through Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) images of a healthy 3.5 year-old female child using 3D Slicer. We validated the high anatomical accuracy segmentation through two experienced sub-specialty-certified neuro-radiologists and the inter and intra-operator variability of the segmentation results comparing sex differences in organ metrics with physiologic values. Finally, we compared Athena with Martin, a similar male model, showing differences in anatomy, organ metrics, and MRI dosimetric exposure.

'''Main results:'''We segmented 267 tissue compartments, which included 50 brain tissue labels. The tissue metrics of Athena displayed no deviation from the literature value of healthy children. We show the variability of brain metrics in the male and female models. Finally, we offer an example of computing Specific Absorption Rate and Joule heating in a toddler/preschooler at 7T MRI.

'''Significance:''' This study introduces a female realistic high-resolution numerical model using MRI and CT scans of a 3.5 year-old female child, the use of which includes but is not limited to radiofrequency safety studies for medical devices (e.g. an implantable medical device safety in MRI), neurostimulation studies, and radiation dosimetry studies. This model will be open source and available on the Athinoula A. Martinos Center for Biomedical Imaging website.
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==Anatomical Morphology and Related Angles of Foramen Ovale: A Three-dimensional Computed Tomography Reconstruction==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36597246 J Coll Physicians Surg Pak. 2023 Jan;33(1):109-11. PMID: 36597246]

'''Authors:''' Cheng Z, Hu YL, Sun YX, Liang LZ, Pan DD, Wang DW.

'''Institution:''' Department of Neurosurgery, The Second Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, China.

'''Abstract:''' This study aimed to report the three-dimensional reconstruction of the foramen ovale (FO) based on computed tomography angiography and describe its shape and related angles. A retrospective analysis of 199 adult patients who were hospitalised at the Department of Neurosurgery, The Second Affiliated Hospital of Bengbu Medical College, Bengbu, China, from January to December 2020 was conducted. The original DICOM files of patients' computed tomography scans were processed by [http://www.slicer.org '''3D Slicer'''] software to reconstruct the three-dimensional skull. The morphological characteristics of the FO on both sides were analysed. Their size, related angles and volumes, and the differences between the two sides and gender were compared. A total of 398 FO from 199 patients were studied. The most frequent shape of the FO was oval, accounting for 54.27%. The mean lengths of the right and the left sides were 5.40±1.51 and 5.10±1.18mm, respectively. The mean width on the right and left sides was 3.23±1.16 and 3.33±1.19 mm, respectively. The FO is most commonly oval in shape. Clinicians may use the anatomical characteristics regarding the size and shape of the FO for diagnosis and treatment.
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Main Page/SlicerCommunity/2023

2023-07-25T16:51:40Z

Marianna: /* Dosimetric Assessment of Gadolinium-159 for Hepatic Radioembolization: Tomographic Images and Monte Carlo Simulation */

{{:Main_Page/SlicerCommunity}}

__TOC__

=2023=
==Augmented Reality Presentation of the Extracranial Facial Nerve: An Innovation in Parotid Surgery==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37328316 Br J Oral Maxillofac Surg. 2023 Jul;61(6):428-36. PMID: 37328316]

'''Authors:''' Saadya A, Chegini S, Morley S, McGurk M.

'''Institution:''' University College London Hospital, UK.

'''Abstract:'''
Surgeons used to be unaware of the facial nerve's position during parotid surgery. Now, with special magnetic resonance imaging (MRI) sequences, it can be located and converted into a 3D model displayed on an augmented reality (AR) device for surgeons to study and manipulate. This study explores the accuracy and usefulness of the technique for the treatment of benign and malignant parotid tumours. A total of 20 patients with parotid tumours had 3-Tesla MRI scans, and their anatomical structures were segmented using [http://www.slicer.org '''3D Slicer'''] software. The structures were imported into a Microsoft HoloLens 2® device, displayed in 3D, and shown to the patient for consent. Intraoperative video recording was used to record the position of the facial nerve in relation to the tumour. The predicted path of the nerve taken from the 3D model was combined with surgical observation and video recording in all cases. The imaging proved to have application in both benign and malignant disease. It also improved the process of informed patient consent. Three-dimensional MRI imaging of the facial nerve within the parotid gland and its display in a 3D model is an innovative technique for parotid surgery. Surgeons can now see the nerve's position and tailor their approach to each patient's tumour, providing personalised care. The technique eliminates the surgeon's blind spot and is a significant advantage in parotid surgery.
|}

==Magnetic Resonance Imaging in Naso-Oropharyngeal Carcinoma: Role of Texture Analysis in the Assessment of Response to Radiochemotherapy, a Preliminary Study==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37336860/ Radiol Med. 2023 Jul;128(7):839-52. PMID: 37336860]

'''Authors:''' Bicci E, Nardi C, Calamandrei L, Barcali E, Pietragalla M, Calistri L, Desideri I, Mungai F, Bonasera L, Miele V.

'''Institution:''' Department of Experimental and Clinical Biomedical Sciences, Radiodiagnostic Unit #2, University of Florence, Florence, Italy.

'''Abstract:'''
Objective: Identifying MRI texture parameters able to distinguish inflammation, fibrosis, and residual cancer in patients with naso-oropharynx carcinoma after radiochemotherapy (RT-CHT).

Material and methods: In this single-centre, observational, retrospective study, texture analysis was performed on ADC maps and post-gadolinium T1 images of patients with histological diagnosis of naso-oropharyngeal carcinoma treated with RT-CHT. An initial cohort of 99 patients was selected; 57 of them were later excluded. The final cohort of 42 patients was divided into 3 groups (inflammation, fibrosis, and residual cancer) according to MRI, 18F-FDG-PET/CT performed 3-4 months after RT-CHT, and biopsy. Pre-RT-CHT lesions and the corresponding anatomic area post-RT-CHT were segmented with [http://www.slicer.org '''3D Slicer'''] software from which 107 textural features were derived. T-Student and Wilcoxon signed-rank tests were performed, and features with p-value < 0.01 were considered statistically significant. Cut-off values-obtained by ROC curves-to discriminate post-RT-CHT non-tumoural changes from residual cancer were calculated for the parameters statistically associated to the diseased status at follow-up.

Results: Two features-Energy and Grey Level Non-Uniformity-were statistically significant on T1 images in the comparison between 'positive' (residual cancer) and 'negative' patients (inflammation and fibrosis). Energy was also found to be statistically significant in both patients with fibrosis and residual cancer. Grey Level Non-Uniformity was significant in the differentiation between residual cancer and inflammation. Five features were statistically significant on ADC maps in the differentiation between 'positive' and 'negative' patients. The reduction in values of such features between pre- and post-RT-CHT was correlated with a good response to therapy.

Conclusions: Texture analysis on post-gadolinium T1 images and ADC maps can differentiate residual cancer from fibrosis and inflammation in early follow-up of naso-oropharyngeal carcinoma treated with RT-CHT.
|}

==BabelBrain: An Open-Source Application for Prospective Modeling of Transcranial Focused Ultrasound for Neuromodulation Applications==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37155375/ IEEE Trans Ultrason Ferroelectr Freq Control. 2023 Jul;70(7):587-99. PMID: 37155375]

'''Authors:''' Pichardo S.

'''Institution:''' Department of Radiology, University of Calgary, Calgary, Canada.

'''Abstract:'''
BabelBrain is an open-source standalone graphic-user-interface application designed for studies of neuromodulation using transcranial-focused ultrasound (FUS). It calculates the transmitted acoustic field in the brain tissue, taking into account the distortion effects caused by the skull barrier. The simulation is prepared using scans from magnetic resonance imaging (MRI) and, if available, computed tomography (CT) and zero-echo time MRI scans. It also calculates the thermal effects based on a given ultrasound regime, such as the total duration of exposure, the duty cycle, and acoustic intensity. The tool is designed to work in tandem with neuronavigation and visualization software, such as [http://www.slicer.org '''3D Slicer''']. It uses image processing to prepare domains for ultrasound simulation and uses the BabelViscoFDTD library for transcranial modeling calculations. BabelBrain supports multiple GPU backends, including Metal, OpenCL, and CUDA, and works on all major operating systems including Linux, macOS, and Windows. This tool is particularly optimized for Apple ARM64 systems, which are common in brain imaging research. The article presents the modeling pipeline used in BabelBrain and a numerical study where different methods of acoustic properties mapping were tested to select the best method that can reproduce the transcranial pressure transmission efficiency reported in the literature.
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==Volumetric Analysis of the Sinus and Orbit in Silent Sinus Syndrome After Endoscopic Sinus Surgery==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/36939460/ Otolaryngol Head Neck Surg. 2023 Jul;169(1):151-156. PMID: 36939460]

'''Authors:'''
Amin D, Chitguppi C, Xu V, Haghshenas C, Gorniak R, Rabinowitz M, Toskala E, Rosen M, Nyquist G.

'''Institution:''' Department of Otolaryngology-Head & Neck Surgery, Thomas Jefferson University, Philadelphia, PA, USA.

'''Abstract:'''
Objective: The term "silent sinus syndrome" (SSS) describes spontaneous enophthalmos secondary to subclinical maxillary sinus atelectasis. Debate remains on whether treatment with endoscopic maxillary antrostomy alone is adequate in reversing atelectasis and globe displacement. This study aims to determine the degree of volume change of the diseased sinus and orbit as well as the change in orbital height in patients treated with endoscopic antrostomy without orbital floor augmentation.

Study design: Retrospective review with image analysis.

Setting: Single tertiary care institution.

Methods: Three-dimensional (3D) analysis of computed tomographic imaging data was performed using [http://www.slicer.org '''3D Slicer''']. 3D models of the maxillary sinus and orbit of the diseased and normal sides were created, and volume measurements were calculated using the segmentation program.

Results: Thirteen patients with SSS who underwent endoscopic sinus surgery (ESS) and had follow-up computed tomographic imaging were analyzed. After endoscopic antrostomy, the mean volume of the diseased maxillary sinus significantly increased by 9.82%, from 6.37 to 7.00 cm3 (p = .0302). There was no significant change in mean orbital volume; however, the mean orbital height decreased by 5.67%, from 38.09 to 35.93 mm from pretreatment to posttreatment samples (p = .0101). All patients had resolution of clinical or radiographic enophthalmos and orbital displacement with ESS alone.

Conclusion: Endoscopic maxillary antrostomy alone in the treatment of SSS significantly increased maxillary sinus volume and decreased diseased orbital height. These changes were associated with clinical and radiographic improvement in globe displacement. These findings support performing ESS alone, reserving orbital augmentation for patients who do not exhibit adequate clinical improvement.
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==Safety and Efficacy of Thoracic Endovascular Aortic Repair for Acute Stanford Type B Aortic Dissection With Retrograde Type a Intramural Hematoma==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/36921645/ J Vasc Surg. 2023 Jul;78(1):61-69.e4. PMID: 36921645] | [https://www.jvascsurg.org/action/showPdf?pii=S0741-5214%2823%2900438-X PDF]

'''Authors:''' Wang J, Li M, Li J, He H, Zhou Y, Li X, Li Q, Gu F, Ye Z, Dardik A, Shu C.

'''Institution:''' Department of Vascular Surgery, Second Xiangya Hospital, Central South University, Changsha, China; Institute of Vascular Diseases, Central South University, Changsha, China.

'''Abstract:'''
Objective: The aim of this study was to evaluate safety and efficacy of thoracic endovascular aortic repair (TEVAR) for acute Stanford type B aortic dissection (TBAD) with retrograde type A intramural hematoma (TAIMH).

Methods: Patients with acute TBAD with retrograde TAIMH treated with TEVAR between January 1, 2014, to March 31, 2022, were retrospectively reviewed. Aortic diameter and distance were measured using the [http://www.slicer.org '''3D Slicer'''] image computing platform. Patients' characteristics, procedural, in-hospital and follow-up data, and aortic remodeling were analyzed.

Results: Fifty-two patients (average age, 52.6 years; 42 males [80.8%]) were included. The median interval from symptom onset to TEVAR was 11 days (interquartile range, 7.0-16.8 days). The maximal diameter of the ascending aorta (AA) was <50 mm, and the hematoma thickness in the AA was ≤10 mm in all patients. Both the in-hospital and 30-day mortality rates were 0%. The 30-day complication rate was 11.5%. The overall cumulative survival rates were 100% at 1 year, 97.1% at 3 years, and 92.6% at 5 years. Four of 52 patients (7.7%) developed retrograde type A aortic dissection at 10 days to 4 months postoperatively, and one of 52 patients (1.9%) developed an isolated AA dissection 4 months postoperatively; these five patients were treated and alive at late follow-up in March 2022. The rates of cumulative freedom from thoracic aortic re-intervention were 93.7% at 1 year and 90.7% at 5 years. Positive AA remodeling was observed in 92.3% (48/52) of patients during follow-up. The maximal diameter of AA (mean ± standard error of mean) at admission was 42.7 ± 0.8 mm, which decreased to 39.5 ± 0.9 mm at last follow-up. The maximal AA hematoma thickness at admission was 7.6 ± 0.3 mm, which reduced to 2.2 ± 0.9 mm at last follow-up.

Conclusions: For selected patients of acute Stanford TBAD with retrograde TAIMH, endovascular repair may be a safe, effective, and durable alternative treatment, if the maximum diameter of the AA is <50 mm and the intramural hematoma thickness in the AA is ≤10 mm.
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==The Traction Force of the Pulled Limb in Hip Arthroscopic Surgery Is Determined by Stiffness Coefficient Which Is Significantly Related to Muscle Volume==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/36477348/ Knee Surg Sports Traumatol Arthrosc. 2023 Jul;31(7):2708-2715. PMID: 36477348]

'''Authors:''' Yin Y, Xue S, Zhang X, Yang G, Xu Y, Wang J, Huang H.

'''Institution:''' Department of Sports Medicine, Beijing Key Laboratory of Sports Injuries, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing, People's Republic of China.

'''Abstract:'''
Purpose: To verify the relationship between muscle volume, lateral centre-edge angle (LCEA), alpha angle (AA), body mass index (BMI) and Beighton score with stiffness coefficient (SC). To analyse the difference of traction force at different physical states of hip joint capsule.

Methods: Thirty-six patients who underwent hip arthroscopy operation were included. The volumes of some related muscles were measured in MRI images by [http://www.slicer.org '''3D Slicer''']. We recorded and tested differences in traction force of five joint capsule physical states, including before (State 1) and after joint capsule puncture (State 2), after the establishment of anterolateral and mid-anterior approaches (State 3) and after incision of the joint capsule through these two approaches (States 4, 5). The correlation between muscle volume, BMI, LCEA, AA and SC was verified by Spearman test. Poisson regression was used to explain confounding variables.

Results: The average force at State 1 was 531.8 N. There were significant differences in traction force between these five states (p < 0.001). There was a significant positive correlation between muscle volumes and SC (p < 0.001). BMI had no correlation with SC (n.s.). The preoperative LCEA of the affected side was correlated with SC (p = 0.043). AA and SC were not correlated (n.s.).

Conclusion: The physical states of the hip joint capsule affected traction force. Muscle volume rather than BMI is an ideal index to estimate preoperative traction force. LCEA affected traction force, whilst AA and Beighton score did not. Measuring the muscle volume can help estimate the most suitable traction force for the patient.
|}

==Three-Dimensional Assessment of Tongue Cancer Prognosis by Preoperative MRI==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/35426211/ Oral Dis. 2023 Jul;29(5):2006-2011. PMID: 35426211]

'''Authors:''' Li C, Zhu L, Guo Y, Ji T, Ren Z.

'''Institution:''' Department of Oral and Maxillofacial Head and Neck Oncology, The Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

'''Abstract:'''
Purpose: To obtain the relative volume by measuring the tongue volume and the lesion volume, and further explore its relationship with the prognosis of patients, hoping to supplement the TNM staging with a new index.

Methods: ITK-SANP software was used to outline the patients' MRI. After MRI reconstruction and measurement, [http://www.slicer.org '''3D Slicer'''] software was used to estimate tumor volume.

Results: A total of 64 patients with tongue cancer who met the inclusion criteria were included in the study. The estimated tumor volume after MRI reconstruction revealed a significant and robust correlation with tumor stage (p < 0.05, Rs = 0.6207) and a substantial and medium correlation with early lymph node metastasis (p < 0.05, Rs = 0.4873).

Conclusions: We classified tongue cancer into three grades based on tumor volume (Stage I, tumors smaller than 1500 mm³; Stage II, tumors 1500-9000 mm³; and Stage III, tumors larger than 9000 mm³), and such grading could be used as a reference for tumor staging, lymph node metastasis, and patient prognosis to a certain extent.
|}

==Multimodal Measurements of Levator Bowl Volume in Nulligravid Asymptomatic Women: Endovaginal Ultrasound Versus MRI==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36656345 Int Urogynecol J. 2023 Jul;34(7):1627-33. PMID: 36656345]

'''Authors:''' Chill HH, Martin LC, Abramowitch SD, Rostaminia G.

'''Institution:''' Female Pelvic Medicine and Reconstructive Surgery (FPMRS), Division of Urogynecology, University of Chicago, Northshore University HealthSystem, Skokie, IL, USA.

'''Abstract:''' Introduction and hypothesis: Measurements of levator bowl volume using advanced imaging, may be predictive of pelvic floor muscle function. The aim of this study was to compare the volume of the levator bowl using both magnetic resonance imaging (MRI) and endovaginal ultrasound (EVU) of healthy asymptomatic women.

'''Methods:''' All participants underwent a comprehensive interview including completion of the Pelvic Floor Distress Inventory Questionnaire-20 questionnaire, pelvic examination with a pelvic organ prolapse quantification evaluation, MRI, and EVU. The pelvic floor was segmented using [http://www.slicer.org '''3D Slicer'''] and the MRI segmentations were trimmed using two methods: soft-tissue landmarks and the field of view (FOV) of the ultrasound volume. The levator bowl volume of the 3D segmented shapes was measured using Blender's 3D printing toolkit. Normality was tested using the Shapiro-Wilks test and comparisons were made using self-paired t tests.

'''Results:''' The final analysis included 19 patients. Levator bowl volume measured via MRI was larger than that measured in EVU (46.1 ± 7.9 cm3 vs 27.4 ± 5.9 cm3, p<0.001). Reducing the FOV of the MRI to that of EVU caused the MRI volume to be much closer to the EVU volume (35.5 ± 3.3 cm3 vs 27.4 ± 5.9 cm3, p<0.001); however, it remained significantly larger.

'''Conclusion:''' Levator bowl volume measured using MRI was larger than that measured using EVU no matter the method of delineation of the levator muscles. Although EVU is safe, cheap, and easy to perform, it captures a smaller volume of levator bowel than MRI.
|}

==Pectoralis Muscle Area Measured at T4 Level Is Closely Associated With Adverse COVID-19 Outcomes in Hospitalized Patients==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37259659 J Musculoskelet Neuronal Interact. 2023 Jun 1;23(2):196-204. PMID: 37259659] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10233225/pdf/JMNI-23-196.pdf PDF]

'''Authors:''' Tekin ZN, Dogruoz Karatekin B, Dogan MB, Bilgi Z.

'''Institution:''' Istanbul Medeniyet University, Goztepe Prof Dr Suleyman Yalcin City Hospital, Radiology, Istanbul, Turkey.

'''Abstract:'''
Objectives: Skeletal muscle area (SMA) at T4 level on chest computed tomography (CT) is a newly available method that can be used as a surrogate sarcopenia marker. The objective of this study is to evaluate association of SMA with adverse COVID-19 outcomes in hospitalized patients.

Methods: Hospitalized COVID-19 patients were prospectively recorded in a database containing age, gender, date of admission, date of outcome (discharge, mortality, presence of intensive care unit (ICU) stay, additional coding information (comorbidities, superimposed conditions). Admission CT-scans were retrospectively evaluated for segmentation (bilateral pectoralis major/minor, erector spinae, levator scapulae, rhomboideus minor and major and transversospinalis muscles) and SMA calculation using [http://www.slicer.org '''3D Slicer'''] software.

Results: 167 cases were evaluated (68 male, 72 female, 140 survived, 27 dead). Muscle area was lower in patients with ICU stay (p=0.023, p=0.018, p=0.008) and mortality outcome (p=0.004, p=0.007, p=0.002) for pectoralis, back and SMA. In multivariate Cox-regression analysis, hazard ratio (HR) value for the pectoralis muscle area value below 2800 mm2 was found to be 3.138(95% CI: 1.171-8.413) for mortality and 2.361(95% CI: 1.012-5.505) for ICU.

Conclusions: Pectoralis muscle area measured at T4 level with 3-D slicer was closely associated with adverse outcomes (mortality, ICU stay) in hospitalized COVID-19 patients. Since early treatment methods for COVID-19 are being evaluated, this method may be a useful adjunct to clinical decision making in regard to prioritization.
|}

==Precise Location of the Ventricular Catheter Tip in Ventriculoperitoneal Shunt Placement Guided by 3D Printed Individualized Guide==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37086587/ Clin Neurol Neurosurg. 2023 Jun;229:107730. PMID: 37086587]

'''Authors:''' Tian Q, Yi J, Wu Y, Wang S, Qu Y, Cai Q.

'''Institution:''' Department of Neurosurgery, Tangdu hospital, Air Force Medical University, Shaanxi, China.

'''Abstract:'''
Objective: Improper placement of the ventricular catheter tip is the most common cause of shunting disorders after ventriculoperitoneal shunt (VPS) placement surgery. Here, through two illustrative cases, we described a novel method of precise ventricular catheter tip location.

Methods: [http://www.slicer.org '''3D Slicer'''] software was used to define the ventricle puncture path and determine the ventricle catheter tip location preoperatively, and the 3D individualized guide model was printed.

Results: The ventricular puncture was performed under the guidance of the 3D guide to achieve precise ventricle catheter tip location intraoperatively.

Conclusions: This technique is safe, simple, efficient and cost-effective, which facilitates its clinical implementation and promotion.
|}

==PIRET-A Platform for Treatment Planning in Electroporation-Based Therapies==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37015676/ IEEE Trans Biomed Eng. 2023 Jun;70(6):1902-10. PMID: 37015676]

'''Authors:''' Perera-Bel E, Aycock KN, Salameh ZS, Gomez-Barea M, Davalos RV, Ivorra A, Ballester MAG.

'''Institution:''' BCN MedTech, Department of Information and Communication Technologies, Universitat Pompeu Fabra, Barcelona, Spain.

'''Abstract:'''
Tissue electroporation is the basis of several therapies. Electroporation is performed by briefly exposing tissues to high electric fields. It is generally accepted that electroporation is effective where an electric field magnitude threshold is overreached. However, it is difficult to preoperatively estimate the field distribution because it is highly dependent on anatomy and treatment parameters.

Objective: We developed PIRET, a platform to predict the treatment volume in electroporation-based therapies.

Methods: The platform seamlessly integrates tools to build patient-specific models where the electric field is simulated to predict the treatment volume. Patient anatomy is segmented from medical images and 3D reconstruction aids in placing the electrodes and setting up treatment parameters.

Results: Four canine patients that had been treated with high-frequency irreversible electroporation were retrospectively planned with PIRET and with a workflow commonly used in previous studies, which uses different general-purpose segmentation, [http://www.slicer.org '''3D Slicer'''] and modeling software (3Matic and COMSOL Multiphysics). PIRET outperformed the other workflow by 65 minutes (× 1.7 faster), thanks to the improved user experience during treatment setup and model building. Both approaches computed similarly accurate electric field distributions, with average Dice scores higher than 0.93.

Conclusion: A platform which integrates all the required tools for electroporation treatment planning is presented. Treatment plan can be performed rapidly with minimal user interaction in a stand-alone platform.

Significance: This platform is, to the best of our knowledge, the most complete software for treatment planning of irreversible electroporation. It can potentially be used for other electroporation applications.
|}

==Surgically Assisted Maxillary Expansion With or Without Pterygoid Disjunction Alters Maxillomandibular Positioning==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/35426586/ Oral Maxillofac Surg. 2023 Jun;27(2):269-281. PMID: 35426586]

'''Authors:''' Carvalho FSR, Soares ECS, de Medeiros JR, Júnior JMM, Hyppolito JOP, de Barros Silva PG, Ribeiro TR, Costa FWG.

'''Institution:''' Department of Oral and Maxillofacial Surgery, Federal University of Ceará Campus Sobral, Brazil.

'''Abstract:'''
Purpose: This study aimed to analyze alterations in mandibular positioning after surgically assisted maxillary expansion (SARME) with and without pterygoid disjunction (PD).

Methods: Cone-beam computed tomography scans of 24 healthy individuals (18-45 years old) with transverse deficiency, superior to 5 mm, underwent SARME with or without PD. The aspects prospectively assessed were (1) alignment and position of the head (ITK-Snap and [http://www.slicer.org '''3D Slicer'''] software); (2) McNamara's and Steiner-Tweed-Wits' cephalometric analysis (Dolphin Imaging®); and (3) colorimetric evaluation based on 3D correspondence analysis ([http://www.slicer.org '''3D Slicer'''] software).

Results: A decrease in 1-NA and 1-SN angles as well as an increased occlusal plane in both groups was observed. Superior-inferior and anteroposterior spatial displacements of the chin were statistically significant in the PD group. Altered colorimetric patterns were also observed in the PD group.

Conclusions: This study found more evident tooth inclination in the group without PD; mandibular alterations were more evident in the PD group. Further studies with 3D analysis are strongly recommended for more comprehensive results.
|}

==ERCP 2.0: Biliary 3D-Reconstruction in Patients With Malignant Hilar Stricture==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37379653 Clin Res Hepatol Gastroenterol. 2023 Jun 26;47(7):102172. PMID: 37379653]

'''Authors:''' Becq A, Szewczyk J, Salin G, Chartier M, Chaput U, Leenhardt R, Dray X, Arrive L, Camus M.

'''Institution:''' Department of Gastroenterology, Henri-Mondor University Hospital, AP-HP, EA 7375, Université Paris Est Créteil, France.

'''Abstract:'''
Background: Endoscopic retrograde cholangiopancreatography (ERCP) for malignant hilar strictures is challenging. The correlation between Magnetic resonance cholangiopancreatography (MRCP) and per ERCP 2D fluoroscopic images is not obvious. The aim of this study was to evaluate the feasibility and potential usefulness of MRCP-based handmade biliary 3D reconstruction in this setting.

Methods: Methods Patients who underwent MRCP followed by ERCP for biliary drainage of a malignant hilar stricture at our institution between 2018 and 2020 were reviewed. A handmade 3D segmentation using [http://www.slicer.org '''3D Slicer'''] (Kitware, France) was fashioned and reviewed with an expert radiologist. The primary outcome was the feasibility of biliary segmentation.

Results: A total of 16 patients were included. The mean age was 70.1 (+/- 8.6) years-old and 68.8% had hilar cholangiocarcinoma. Handmade segmentation was successful in all cases. The agreement between the MRCP interpretation and the 3D reconstruction was 37.5%, as per the Bismuth classification. 3D reconstruction available prior to ERCP could have helped guide for better stent placement in 11 cases (68.8%).

Conclusions: MRCP-based biliary 3D segmentation-reconstruction, in patients with malignant hilar stricture is feasible and seems to provide a better anatomical understanding compared to MRCP and could help improve endoscopic management.
|}

==3D Printing Personalized Guide Plate in the Management of Recurrent Intramuscular Venous Malformations: A Single Center Experience==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/36967547/ Phlebology. 2023 Jun;38(5):307-314. PMID: 36967547]

'''Authors:''' Han T, Jiang S, Xiong J, Cui J, Shen W.

'''Institution:''' Department of Burns and Plastic Surgery, Children's Hospital of Nanjing Medical University, Nanjing, China.

'''Abstract:'''
Objective: This study aimed to investigate the feasibility and effectiveness of 3D printing personalized guide plate in the management of recurrent intramuscular venous malformations (IVM).

Methods: Fifteen patients with recurrent IVM were retrospectively assessed. [http://www.slicer.org '''3D Slicer'''] software was used to extract and reconstruct the imaging data from CT and/or MRI to highlight the morphology, size, and puncture depth of the lesion. With the guidance of personalized plate, complete excision of the IVM was adopted along the pre-marked (methylene blue, MB) margin.

Results: Personalized guide plate matched involved extremity well, and MB-puncture approach was consistent with preoperative design. All IVMs were removed radically in one single session. Complete pain relief was obtained in all cases postoperatively.

Conclusion: The application of 3D printing guide plate can be safe, effective, and reliable to confirming the precise margin of IVM, renders a promising technique with a high practical value in resection of recurrent lesion.
|}

==White Matter Hyperintensities: A Possible Link Between Sarcopenia and Cognitive Impairment in Patients With Mild to Moderate Alzheimer's Disease==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37330930 Eur Geriatr Med. 2023 Jun 18. PMID: 37330930]

'''Authors:''' Weng X, Liu S, Li M, Zhang Y, Zhu J, Liu C, Hu H.

'''Institution:''' Department of Neurology, The Second Affiliated Hospital of Soochow University, Jiangsu, China.

'''Abstract:'''
Purpose: Alzheimer's disease (AD) has been reported to be associated with sarcopenia. White matter hyperintensities (WMH) are common in AD patients. However, the effect of WMH on sarcopenia in AD remains unclear. We hence aimed to investigate the possible association between regional WMH volumes and sarcopenic parameters in AD.

Methods: 57 mild to moderate AD patients and 22 normal controls (NC) were enrolled. Sarcopenic parameters were assessed, including appendicular skeletal mass index (ASMI), grip strength, 5-times sit-to-stand (5-STS) time, and gait speed. The volumes of periventricular hyperintensities (PVH) and deep white matter hyperintensities (DWMH) were quantified using [http://www.slicer.org '''3D Slicer'''] software.

Results: AD subjects exhibited a lower ASMI, a slower gait speed, an increased 5-STS time, and larger volumes of PVH and DWMH than those in the NC group. In AD subjects, total WMH and PVH volumes were related to cognitive impairment, particularly executive function decline. Moreover, total WMH volume and PVH volume were negatively correlated with gait speed across various clinical stages of AD. Multiple linear regression analysis showed that PVH volume was independently associated with 5-STS time and gait speed, whereas DWMH volume was only independently associated with gait speed.

Conclusion: WMH volume was associated with cognitive decline and various sarcopenic parameters. It thereby suggested that WMH may serve as the connection between sarcopenia and cognitive dysfunction in AD. Further studies are needed to confirm these findings and to determine whether sarcopenia interventions reduce WMH volume and improve cognitive function in AD.
|}

==CT Angiography Radiomics Combining Traditional Risk Factors to Predict Brain Arteriovenous Malformation Rupture: a Machine Learning, Multicenter Study==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37311939 Transl Stroke Res. 2023 Jun 13. PMID: 37311939]

'''Authors:''' Zhang S, Wang J, Sun S, Zhang Q, Zhai Y, Wang X, Ge P, Shi Z, Zhang D.

'''Institution:''' Department of Neurosurgery, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.

'''Abstract:'''
This study aimed to develop a machine learning model for predicting brain arteriovenous malformation (bAVM) rupture using a combination of traditional risk factors and radiomics features. This multicenter retrospective study enrolled 586 patients with unruptured bAVMs from 2010 to 2020. All patients were grouped into the hemorrhage (n = 368) and non-hemorrhage (n = 218) groups. The bAVM nidus were segmented on CT angiography images using [http://www.slicer.org '''3D Slicer'''] software, and radiomic features were extracted using Pyradiomics. The dataset included a training set and an independent testing set. The machine learning model was developed on the training set and validated on the testing set by merging numerous base estimators and a final estimator based on the stacking method. The area under the receiver operating characteristic (ROC) curve, precision, and the f1 score were evaluated to determine the performance of the model. A total of 1790 radiomics features and 8 traditional risk factors were contained in the original dataset, and 241 features remained for model training after L1 regularization filtering. The base estimator of the ensemble model was Logistic Regression, whereas the final estimator was Random Forest. In the training set, the area under the ROC curve of the model was 0.982 (0.967-0.996) and 0.893 (0.826-0.960) in the testing set. This study indicated that radiomics features are a valuable addition to traditional risk factors for predicting bAVM rupture. In the meantime, ensemble learning can effectively improve the performance of a prediction model.
|}

==Real-Time Integration Between Microsoft HoloLens 2 and 3D Slicer With Demonstration in Pedicle Screw Placement Planning==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37310561 Int J Comput Assist Radiol Surg. 2023 Jun 13. PMID: 37310561]

'''Authors:''' Pose-Díez-de-la-Lastra A, Ungi T, Morton D, Fichtinger G, Pascau J.

'''Institution:''' Departamento de Bioingeniería, Universidad Carlos III de Madrid, Spain.

'''Abstract:'''
Purpose: Up to date, there has been a lack of software infrastructure to connect [http://www.slicer.org '''3D Slicer'''] to any augmented reality (AR) device. This work describes a novel connection approach using Microsoft HoloLens 2 and OpenIGTLink, with a demonstration in pedicle screw placement planning.

Methods: We developed an AR application in Unity that is wirelessly rendered onto Microsoft HoloLens 2 using Holographic Remoting. Simultaneously, Unity connects to [http://www.slicer.org '''3D Slicer'''] using the OpenIGTLink communication protocol. Geometrical transform and image messages are transferred between both platforms in real time. Through the AR glasses, a user visualizes a patient's computed tomography overlaid onto virtual 3D models showing anatomical structures. We technically evaluated the system by measuring message transference latency between the platforms. Its functionality was assessed in pedicle screw placement planning. Six volunteers planned pedicle screws' position and orientation with the AR system and on a 2D desktop planner. We compared the placement accuracy of each screw with both methods. Finally, we administered a questionnaire to all participants to assess their experience with the AR system.

Results: The latency in message exchange is sufficiently low to enable real-time communication between the platforms. The AR method was non-inferior to the 2D desktop planner, with a mean error of 2.1 ± 1.4 mm. Moreover, 98% of the screw placements performed with the AR system were successful, according to the Gertzbein-Robbins scale. The average questionnaire outcomes were 4.5/5.

Conclusions: Real-time communication between Microsoft HoloLens 2 and 3D Slicer is feasible and supports accurate planning for pedicle screw placement.
|}

==Delirium After Traumatic Brain Injury: Prediction by Location and Size of Brain Lesion==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37317796 Ann Rehabil Med. 2023 Jun 7. PMID: 37317796] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10326395/pdf/arm-23008.pdf PDF]

'''Authors:''' Han SJ, Suh JH, Lee JY, Kim SJ.

'''Institution:''' Department of Rehabilitation Medicine, College of Medicine, Ewha Womans University, Seoul, Korea.

'''Abstract:'''
Objective: To examine (1) the location of brain lesion that would predict post-traumatic delirium and (2) the association between volume of brain lesion and occurrence of delirium in patients with traumatic brain injury (TBI).

Methods: A retrospective study was conducted by reviewing medical records of 68 TBI patients, categorized into two groups: the delirious group (n=38) and non-delirious group (n=30). The location and volume of TBI were investigated with the [http://www.slicer.org '''3D Slicer'''] software.

Results: The TBI region in the delirious group mainly involved the frontal or temporal lobe (p=0.038). All 36 delirious patients had brain injury on the right side (p=0.046). The volume of hemorrhage in the delirious group was larger by about 95 mL compared to the non-delirious group, but this difference was not statistically significant (p=0.382).

Conclusion: Patients with delirium after TBI had significantly different injury site and side, but not lesion size compared to patients without delirium.
|}

==Mitral Paravalvular Leak 3D Printing from 3D-Transesophageal Echocardiography==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37288866 Anatol J Cardiol. 2023 Jun 7. PMID: 37288866] | [https://doi.org/10.14744/AnatolJCardiol.2023.3008 PDF]

'''Authors:''' Jedrzejek M, Kozlowski M, Peszek-Przybyla E, Jadczyk T, Pysz P, Wojakowski W, Smolka G.

'''Institution:''' Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland.

'''Abstract:'''
Background: Paravalvular leaks can be detected in almost 15% of patients after mitral valve prosthesis implantation. This complication can result in congestive heart failure and hemolysis. Despite advancements in non-invasive imaging, percutaneous closure of paravalvular leaks is not always successful. Therefore, efforts are made to improve treatment outcomes by using 3D-printed models of defects as pre-procedural support for interventional cardiologists.

Methods: Retrospectively, 3D-transesophageal echocardiography recordings of 8 patients with clinically significant mitral paravalvular leaks were analyzed. Qlab Software was used to export DICOM images of each paravalvular leak channel, including surrounding tissue. Image segmentation was performed in [http://www.slicer.org '''3D Slicer'''], a free, open-source software package used for imaging research. Models were printed to actual size with the poly jet Stratasys Objet 30 printer with a transparent, rigid material.

Results: Duration of model preparation and printing, as well as the total cost, was calculated. Mean total time of model preparation was 430.5 ± 196 minutes.

Conclusion: 3D-printing from 3D-transesophageal echocardiography is technically feasible. Both shape and location of paravalvular leaks are preserved during model preparation and printing. It remains to be tested if 3D-printing would improve outcomes of percutaneous paravalvular leaks closure.
|}

==Prediction of Ki-67 Expression in Gastrointestinal Stromal Tumors Using Radiomics of Plain and Multiphase Contrast-Enhanced CT==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37266658 Eur Radiol. 2023 Jun 2. PMID: 37266658]

'''Authors:''' Liu Y, He C, Fang W, Peng L, Shi F 4, Xia Y, Zhou Q, Zhang R 5, Li C.

'''Institution:''' Medical Imaging Department, Chongqing University Central Hospital, Chongqing Emergency Medical Center, Chongqing, China.

'''Abstract:'''
Objective: To study the value of radiomics models based on plain and multiphase contrast-enhanced CT to predict Ki-67 expression in gastrointestinal stromal tumors (GISTs).

Methods: A total of 215 patients with GISTs were retrospectively analyzed, including 150 patients in one hospital as the training set and 65 patients in another hospital as the external verification set. The tumor at the largest level of CT images was delineated as the region of interest (ROI). The maximum diameter of the ROI was defined as the tumor size. A total of 851 radiomics features were extracted from each ROI by [http://www.slicer.org '''3D Slicer'''] Radiomics. After dimensionality reduction, three machine learning classification algorithms including logistic regression (LR), random forest (RF), and support vector machine (SVM) were used for Ki-67 expression prediction. Using a multivariable logistic model, a nomogram was established to predict the expression of Ki-67 individually.

Results: Delong tests showed that the SVM models had the highest accuracy in the arterial phase (Z value 0.217-1.139) and venous phase (Z value 0.022-1.396). For the plain phase, LR and SVM models had the highest accuracy (Z value 0.874-1.824, 1.139-1.763). For the delayed phase, LR models had the highest accuracy (Z value 0.056-1.824). For the combined phase, RF models had the highest accuracy (Z value 0.232-1.978). There was no significant difference among the above models for KI-67 expression prediction (Z value 0.022-1.978). A nomogram was developed with a C-index of 0.913 (95% CI, 0.878 to 0.956).

Conclusions: Radiomics of both plain and enhanced CT images could accurately predict the expression of Ki-67 in GIST. For patients who were not suitable to use contrast agents, plain scan could be used as an alternative.
|}

==Accuracy of Imaging Software for 3d Rendering of Tooth Structures, Usable in Clinical Settings==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37272346 Int J Comput Dent. 2023 Jun 5;0(0):0. PMID: 37272346]

'''Authors:''' Ronsivalle V, Venezia P, Migliorati M, Grippaudo C, Barbato E, Nucci L, Isola G, Leonardi RM, Lo Giudice A.

'''Institution:''' Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Policlinico Universitario "Vittorio Emanuele-G. Rodolico", Catania, Italy.

'''Abstract:'''
Aim: The aim of this study was to evaluate the segmentation accuracy of dentition testing four free-source semi-automatic software.

Materials and methods: A total of 20 cone-beam computed tomography (CBCT) were selected to perform semi-automatic segmentation of maxillary and mandibular dentition. The software tested were Invesalius, ITK-Snap, [http://www.slicer.org '''3D Slicer'''] and Seg3D. Each tooth model was also manually segmented (Mimics software) and set as the gold standard (GS) reference of the investigation. A specific 3D imaging technology was used to perform the superimposition between the teeth models obtained with semi-automatic software and the GS model, and to perform the surface-to-surface matching analysis. The accuracy of semi-automatic segmentation was evaluated calculating the volumetric mean differences (mean bias and limits of agreement) and the percentage of matching of the tooth models compared to the manual segmentation (GS). Qualitative assessments were performed using color-coded maps. All data were statistically analysed to perform software comparisons.

Result: Statistically significant differences were found in the volumetric and matching percentage data (p < 0,05). Invesalius was the most accurate software for 3D rendering of the dentition with a volumetric bias (Mimics) ranging from 4,59 mm3 to 85,79 mm3; instead, ITK-SNAP showed the higher volumetric bias, ranging from 30,22 mm3 to 319,83 mm3. The dis-matched area was mainly located at the radicular region of the teeth. Volumetric data showed excellent inter-software reliability with coefficient values ranging from 0,951 to 0,997.

Conclusion: Different semi-automatic software algorithms could generate different patterns of inaccuracy error in the segmentation of teeth.
|}

==A Retrospective Three-Dimensional Study of the Mandibular Growth During Preoperative Orthodontics in Late Adolescent Patients With Skeletal Class III Malocclusion==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37271262 J Stomatol Oral Maxillofac Surg. 2023 Jun 2:101526. PMID: 37271262]

'''Authors:''' Yuan M, Zheng Z, Li H, Wang P, Liu Y, Bi R.

'''Institution:''' State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthognathic and TMJ Surgery, West China Hospital of Stomatology, Sichuan University, China.

'''Abstract:'''
Introduction: The mandible's ongoing development presents a contraindication for combined orthodontic-orthognathic treatment. The aim of this study was to evaluate the mandibular stability before and after preoperative orthodontic treatment in late adolescent patients with skeletal Class III malocclusion and to investigate the most appropriate time to start preoperative orthodontic treatment.

Material and methods: The study population consisted of 58 adolescents, aged between 15 and 21 years, with skeletal Class III malocclusion; the adolescents underwent CT scans at the beginning (T1) and the end (T2) of preoperative orthodontic treatment. The CT data were analyzed using ITK-SNAP and [http://www.slicer.org '''3D Slicer'''] software, and the effects of age and gender on mandibular development were investigated.

Results: In these 58 patients, there were no significant local bone alterations in the condyle and anterior chin point between T1 and T2 and no significant changes in the mandibular branch height, mandibular body length, condylar distance, and mandibular angle distance (p>0.05). The mandibular growth at the angel of mandible was statistically significant (p<0.05), but it was not clinically significant because the mean value of the growth was small (right: 0.416±0.986 mm, left: 0.328±0.886 mm). No effect of age and gender on mandibular development was observed.

Conclusion: The mandibular morphology was stable during preoperative orthodontic treatment in patients at the late adolescent stage. This study provides evidence for the possibility of early implementation of preoperative orthodontics.
|}

==Assessment of Variabilities in Lung-Contouring Methods on CBCT Preclinical Radiomics Outputs==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37345013 Cancers (Basel). 2023 May 9;15(10):2677. PMID: 37345013] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10216427/pdf/cancers-15-02677.pdf PDF]

'''Authors:''' Brown KH, Illyuk J, Ghita M, Walls GM, McGarry CK, Butterworth KT.

'''Institution:''' Patrick G. Johnston Centre for Cancer Research, Queen's University Belfast, UK.

'''Abstract:'''
Radiomics image analysis has the potential to uncover disease characteristics for the development of predictive signatures and personalised radiotherapy treatment. Inter-observer and inter-software delineation variabilities are known to have downstream effects on radiomics features, reducing the reliability of the analysis. The purpose of this study was to investigate the impact of these variabilities on radiomics outputs from preclinical cone-beam computed tomography (CBCT) scans. Inter-observer variabilities were assessed using manual and semi-automated contours of mouse lungs (n = 16). Inter-software variabilities were determined between two tools ([http://www.slicer.org '''3D Slicer'''] and ITK-SNAP). The contours were compared using Dice similarity coefficient (DSC) scores and the 95th percentile of the Hausdorff distance (HD95p) metrics. The good reliability of the radiomics outputs was defined using intraclass correlation coefficients (ICC) and their 95% confidence intervals. The median DSC scores were high (0.82-0.94), and the HD95p metrics were within the submillimetre range for all comparisons. the shape and NGTDM features were impacted the most. Manual contours had the most reliable features (73%), followed by semi-automated (66%) and inter-software (51%) variabilities. From a total of 842 features, 314 robust features overlapped across all contouring methodologies. In addition, our results have a 70% overlap with features identified from clinical inter-observer studies.
|}

==A Training Tool for Clinicians in Segmenting Medical Images to Make 3D Models==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37342255 Ann Surg Open. 2023 May 23;4(2):e275. PMID: 37342255] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7614675/pdf/EMS170894.pdf PDF]

'''Authors:''' Chegini S, Tahim A, Liu M, Chooi Y, Edwards E, Clarkson M, Schilling C.

'''Institution:''' Department of Head and Neck Surgery, University College London Hospital, London, UK.

'''Abstract:'''
Introduction: 3D models produced from medical imaging can be used to plan treatment, design prosthesis, teach and for communication. Despite the clinical benefit, few clinicians have experience of how 3D models are produced.This is the first study evaluating a training tool to teach clinicians to produce 3D models and reporting the perceived impact on their clinical practice.

Method: Following ethical approval, 10 clinicians completed a bespoke training tool, comprising written and video material alongside online support. Each clinician and 2 technicians (included as control) were sent 3 CT scans and asked to produce 6 fibula 3D models using an open-source software, [http://www.slicer.org '''3D Slicer''']. The produced models were compared to those produced by the technicians using Hausdorff distance calculation. Thematic analysis was used to study the post-intervention questionnaire.

Results: The mean Hausdorff distance between the final model produced by the clinicians and technicians was 0.65mm SD0.54mm. The first model made by clinicians took a mean time of 1hr 25mins and the final model took 16:04mins (5:00-46:00mins). 100% of learners reported finding the training tool useful and will employ it in future practice.

Discussion: The training tool described in this paper is able to successfully train clinicians to produce fibula models from CT scans. Learners were able to produce comparable models to technicians within an acceptable timeframe. This does not replace technicians. However, the learners perceived this training will allow them to use this technology in more cases, with appropriate case selection and they appreciate the limits of this technology.
|}

==3D Slicer Combined With Neuroendoscope in Treatment of a Distal Segment Aneurysm of the Anterior Choroidal Artery Complicated Intraventricular Hemorrhage: A Case Report and Literature Review==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37251467 Heliyon. 2023 May 18;9(6):e16193. PMID: 37251467] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10220353/pdf/main.pdf PDF]

'''Authors:''' Zhou L, Ren Y, Li Z, Zhang H, Wei H, Song P, Cheng L, Wang W, Gao L, Lei P, Hua Q, Chen Q, Zhou J, Li G, Cai Q.

'''Institution:''' Department of Neurosurgery, Renmin Hospital of Wuhan University, Wuhan, China.

'''Abstract:'''
Introduction: Pure ventricular hemorrhage is often secondary to Moyamoya disease, rarely caused by rupture of ventricular aneurysm. The surgical treatment of the latter is very challenging. [http://www.slicer.org '''3D Slicer'''] reconstruction technology can accurately locate small intracranial lesions and combined with minimally invasive surgery with transcranial neuroendoscope is a new attempt to treat the above diseases.

Case presentation: We report a case of pure intraventricular hemorrhage secondary to rupture of a distal segment aneurysm of the anterior choroidal artery. Brain computed tomography (CT) before admission showed pure ventricular hemorrhage, and brain CT angiography (CTA) before operation showed a distal segment aneurysm of the anterior choroidal artery. We used [http://www.slicer.org '''3D Slicer'''] reconstruction and precise location of the focus before the operation and used the minimally invasive surgery technique with transcranial neuroendoscope to completely remove the hematoma in the ventricle, and found the responsible aneurysm located in the ventricle.

Conclusion: Pure intraventricular hemorrhage requires vigilance against the distal segment aneurysm of the anterior choroidal artery. At present, conventional microscopic craniotomy and intravascular interventional therapy have limitations, and [http://www.slicer.org '''3D Slicer'''] reconstruction and precise positioning technology combined with transcranial neuroendoscope minimally invasive surgery may be a good choice.
|}

==Application of Preoperative Multimodal Image Fusion Technique in Microvascular Decompression Surgery via Suboccipital Retrosigmoid Approach==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36716853 World Neurosurg. 2023 May;173:e37-e47. PMID: 36716853] | [https://pdf.sciencedirectassets.com/280061/AIP/1-s2.0-S1878875023001031/main.pdf PDF]

'''Authors:''' Liao CC, Wu KH, Chen G.

'''Institution:''' Department of Neurosurgery, Zhuhai People's Hospital (Zhuhai Hospital Affiliated with Jinan University,China), Zhuhai, China.

'''Abstract:'''
'''Objective:''' To explore the application value of preoperative multimodal image fusion technique in microvascular decompression (MVD) surgery via the suboccipital retrosigmoid approach.

'''Methods:''' Comprehensive data of 13 patients with primary trigeminal neuralgia (TN) and 13 patients with hemifacial spasm (HFS) treated by MVD surgery via the suboccipital retrosigmoid approach at the Department of Neurosurgery in Zhuhai People's Hospital from January 2021 to December 2021 were retrospectively analyzed. Preoperatively, all patients underwent cranial thin-section computed tomography and magnetic resonance examinations. Three-dimensional (3D) digital images of the skull, brainstem, nerves, and blood vessels were constructed by the [http://www.slicer.org '''3D Slicer'''] software or RadiAnt DICOM Viewer, which were then applied to design the surgical approach and surgical plan. The multimodal image fusion results, clinical characteristics, intraoperative data, surgical outcomes, and complications of all patients were summarized.

'''Results:''' The 3D digital images after fusion reconstruction can vividly show the anatomical relationship between the skull, brainstem, nerves, and blood vessels and was helpful to tailor the surgical strategy. All 26 patients underwent a smooth surgery. During the surgery, the key points were accurately located, the corners of the transverse sinus and sigmoid sinus were completely exposed, and no venous sinus injury occurred in all 26 patients. The key point was approximately located at the top point of the digastric groove, 12.3 ± 0.46 mm vertically above and 6.3 ± 0.6 mm laterally to the Frankfurt horizontal plane. The average cranial opening time was 30.4 (±3.6) min, and the mean operating time was 104.7 (±12.1) min. The diameter of the bone window was about 2.0 cm-3.0 cm, and the bone flap was restored. Among the 13 patients with primary TN, 12 (92.3%) exhibited complete relief of pain and 1 had significant relief. Complications of surgery included facial sensory numbness in 1 case, vertigo in 2 cases, and herpes at the corners of the mouth in 1 case. Of the 13 patients with HFS, 12 (92.3%) had complete relief of facial twitching symptoms and 1 had significant relief, and the complications included mild facial palsy in 2 (15.4%) cases and facial sensory numbness in another 2 (15.4%) cases. The mean follow-up time after surgery ranged from 6-16 months, and 1 of 26 patients experienced recurrence of HFS during the follow-up period.

'''Conclusions:''' Preoperative multimodal image fusion technology can provide adequate preoperative assessment for patients and assistance in designing surgical approaches, which is an important guideline for MVD surgery via the suboccipital retrosigmoid approach for primary TN and facial muscle spasm.
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==An Interactive App with Multi-parametric MRI - Whole-Mount Histology Correlation for Enhanced Prostate MRI Training of Radiology Residents==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37137744 Acad Radiol. 2023 May 1:S1076-6332(23)00183-6. PMID: 37137744]

'''Authors:''' Chatterjee A, Szasz T, Munakami M, Karademir I, Yusufishaq MS, Martens S, Wheeler C, Antic T, Thomas S, Karczmar GS, Oto A.

'''Institution:''' Department of Radiology, University of Chicago, Chicago, IL, USA.

'''Abstract:'''
Rationale and objectives: To validate the educational value of a newly created learning application in enhancing prostate MRI training of radiologists for detecting prostate cancer using an observer study.

Materials and methods: An interactive learning app, LearnRadiology, was developed using a web-based framework to display multi-parametric prostate MRI images with whole-mount histology for 20 cases curated for unique pathology and teaching points. Twenty new prostate MRI cases, different from the ones used in the web app, were uploaded on [http://www.slicer.org '''3D Slicer''']. Three radiologists (R1: radiologist; R2, R3: residents) blinded to pathology results were asked to mark areas suspected of cancer and provide a confidence score (1-5, with 5 being high confidence level). Then after a minimum memory washout period of 1 month, the same radiologists used the learning app and then repeated the same observer study. The diagnostic performance for detecting cancers before and after accessing the learning app was measured by correlating MRI with whole-mount pathology by an independent reviewer.

Results: The 20 subjects included in the observer study had 39 cancer lesions (13 Gleason 3 + 3, 17 Gleason 3 + 4, 7 Gleason 4 + 3, and 2 Gleason 4 + 5 lesions). The sensitivity (R1: 54% → 64%, P = 0.08; R2: 44% → 59%, P = 0.03; R3: 62% → 72%, P = 0.04) and positive predictive value (R1: 68% → 76%, P = 0.23; R2: 52% → 79%, P = 0.01; R3: 48% → 65%, P = 0.04) for all 3 radiologists improved after using the teaching app. The confidence score for true positive cancer lesion also improved significantly (R1: 4.0 ± 1.0 → 4.3 ± 0.8; R2: 3.1 ± 0.8 → 4.0 ± 1.1; R3: 2.8 ± 1.2 → 4.1 ± 1.1; P < 0.05).

Conclusion: The web-based and interactive LearnRadiology app learning resource can support medical student and postgraduate education by improving diagnostic performance of trainees for detecting prostate cancer.
|}

==3D Printed Guide Tube System for Acute Neuropixels Probe Recordings in Non-Human Primates==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37105161 J Neural Eng. 2023 May 11;20(3):036009. PMID: 37105161] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10172811/pdf/jne_20_3_036009.pdf PDF]

'''Authors:''' Bauer DL, Pobiel B, Hilber K, Verma AK, Wang J, Vitek J, Johnson M, Johnson L.

'''Institution:''' Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, USA.

'''Abstract:'''
Objective.
Neuropixels (NP) probes are a significant advance in electrophysiological recording technology that enable monitoring of hundreds of neurons in the brain simultaneously at different depths. Application of this technology has been predominately in rodents, however widespread use in non-human primates (NHPs) such as rhesus macaques has been limited. In this study we sought to overcome two overarching challenges that impede acute NP implantation in NHPs: (1) traditional microdrive systems that mount to cephalic chambers are commonly used to access cortical areas for microelectrode recordings but are not designed to accommodate NP probes, and (2) NHPs have thick dura mater and tissue growth within the cephalic chambers which poses a challenge for insertion of the extremely fragile NP probe.
Approach.
In this study we present a novel NP guide tube system that can be adapted to commercial microdrive systems and demonstrate an implant method using the NP guide tube system. This system was developed using a combination of CAD design, 3D printing, and small part machining. Software programs, [http://www.slicer.org '''3D Slicer'''] and SolidWorks were used to target cortical areas, approximate recording depths and locations, and for in-silico implant testing.
Main results.
We performedin vivotesting to validate our methodology, successfully implanting, explanting, and reimplanting NP probes. We collected stable neurophysiological recordings in the premotor cortex of a rhesus macaque at rest and during performance of a reaching task.Significance.In this study we demonstrate a robust Neuropixels implant system that allows multiple penetrations with the same NP probe and share design files that will facilitate the adoption of this powerful recording technology for NHP studies.
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==Diagnostic Value of 18F-FDG PET/CT-Based Radiomics Nomogram in Bone Marrow Involvement of Pediatric Neuroblastoma==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/36117128 Acad Radiol. 2023 May;30(5):940-51. PMID: 36117128]

'''Authors:''' Feng L, Yang X, Lu X, Kan Y, Wang C, Zhang H, Wang W, Yang J.

'''Institution:''' Department of Nuclear Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing, China.

'''Abstract:'''
Objectives: To develop and validate an 18F-FDG PET/CT-based radiomics nomogram and evaluate the value of the 18F-FDG PET/CT-based radiomics nomogram for the diagnosis of bone marrow involvement (BMI) in pediatric neuroblastoma.

Materials and methods: A total of 144 patients with neuroblastoma (100 in the training cohort and 44 in the validation cohort) were retrospectively included. The PET/CT images of patients were visually assessed. The results of bone marrow aspirates or biopsies were used as the gold standard for BMI. Radiomics features and conventional PET parameters were extracted using [http://www.slicer.org '''3D Slicer''']. Features were selected by the least absolute shrinkage and selection operator regression, and radiomics signature was constructed. Univariate and multivariate logistic regression analyses were applied to identify the independent clinical risk factors and construct the clinical model. Other different models, including the conventional PET model, combined PET-clinical model and combined radiomics model, were built using logistic regression. The combined radiomics model was based on clinical factors, conventional PET parameters and radiomics signature, which was presented as a radiomics nomogram. The diagnostic performance of the different models was evaluated by receiver operating characteristic (ROC) curves and decision curve analysis (DCA).

Results: By visual assessment, BMI was observed in 80 patients. Four conventional PET parameters (SUVmax, SUVmean, metabolic tumor volume, and total lesion glycolysis) were extracted. And 15 radiomics features were selected to build the radiomics signature. The 11q aberration, neuron-specific enolase and vanillylmandelic acid were identified as the independent clinical risk factors to establish the clinical model. The radiomics nomogram incorporating the radiomics signature, the independent clinical risk factors and SUVmean demonstrated the best diagnostic value for identifying BMI, with an area under the curve (AUC) of 0.963 and 0.931 in the training and validation cohorts, respectively. And the DCA demonstrated that the radiomics nomogram was clinically useful.

Conclusion: The 18F-FDG PET/CT-based radiomics nomogram which incorporates radiomics signature, independent clinical risk factors and conventional PET parameters could improve the diagnostic performance for BMI of pediatric neuroblastoma without additional medical costs and radiation exposure.
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==Opportunistic Screening for Osteoporosis Using CT Scans of the Knee: A Pilot Study==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37203533 Stud Health Technol Inform. 2023 May 18;302:909-910. PMID: 37203533]

'''Authors:''' Elmahdy M, Sebro R.

'''Institution:''' Department of Radiology, Mayo Clinic, Jacksonville, FL, USA.

'''Abstract:'''
Knee CT scans are used for planning for total knee arthroplasties in patients who are often simultaneously at risk for frailty fractures due to low bone mineral density. We retrospectively identified 200 patients (85.5% female) with concurrent CT scans of the knee and Dual energy x-ray absorptiometry (DXA). The mean CT attenuation of the distal femur, proximal tibia and fibula, and patella, were calculated using volumetric 3-dimensional segmentation using [http://www.slicer.org '''3D Slicer''']. Data were split randomly into training 80% and test 20% datasets. The optimal CT attenuation threshold for the proximal fibula was obtained in the training dataset and evaluated in the test dataset. A support vector machine (SVM) with radial basis function (RBF) using C-classification was trained and tuned using 5-fold cross-validation in the training dataset and then evaluated in the test dataset. The SVM had a higher area-under-the curve (AUC) of 0.937 and better performance to detect osteoporosis/osteopenia than the CT attenuation of the fibula (AUC of 0.717) (P=0.015). Opportunistic screening for osteoporosis/osteopenia could be accomplished using CT scans of the knee.
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==Sustainable 3D Printing of Oral Films With Tunable Characteristics Using CMC-Based Inks From Durian Rind Wastes==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/36933810 Eur J Pharm Biopharm. 2023 May;186:30-42. PMID: 36933810]

'''Authors:''' Panraksa P, Rachtanapun P, Thipchai P, Lesniewska E, Brachais CH, Debeaufort F, Chambin O, Jantrawut P.

'''Institution:''' Department of Pharmaceutical Sciences, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, Thailand.

'''Abstract:'''
With the growing interest in environmentally friendly and personalized medicines, new concept for combining three-dimensional printing (3DP) with natural-based biomaterials derived from agro-food wastes has emerged. This approach provides sustainable solutions for agricultural waste management and potential for developing of novel pharmaceutical products with tunable characteristics. This work demonstrated the feasibility of fabricating personalized theophylline films with four different structures (Full, Grid, Star, and Hilbert) using syringe extrusion 3DP and carboxymethyl cellulose (CMC) derived from durian rind wastes. Our findings suggested that all the CMC-based inks with shear thinning properties capable of being extruded smoothly through a small nozzle could potentially be used to fabricate the films with various complex printing patterns and high structural fidelity. The results also demonstrated that the film characteristics and release profiles could be easily modified by simply changing the slicing parameters (e.g., infill density and printing pattern). Amongst all formulations, Grid film, which was 3D-printed with 40 % infill and a grid pattern, demonstrated a highly porous structure with high total pore volume. The voids between printing layers in Grid film increased theophylline release (up to 90 % in 45 min) through improved wetting and water penetration. All findings in this study provide significant insight into how to modify film characteristics simply by digitally changing the printing pattern in [http://www.slicer.org '''3D Slicer'''] software without creating a new CAD model. This approach could help to simplify the 3DP process so that non-specialist users can easily implement it in community pharmacies or hospital on demand.
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==An Automated Landmark Method to Describe Geometric Changes in the Human Mandible During Growth==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/36893681 Arch Oral Biol. 2023 May;149:105663. PMID: 36893681]

'''Authors:''' Fournier G, Maret D, Telmon N, Savall F.

'''Institution:''' Faculté de Chirurgie Dentaire, Université Paul Sabatier, Centre Hospitalier Universitaire, Toulouse, France.

'''Abstract:'''
Objective: The principal aim of this study was to assess an automatic landmarking approach to human mandibles based on the atlas method. The secondary aim was to identify the areas of greatest variation in the mandibles of middle-aged to older adults.

Design: Our sample consisted of 160 mandibles from computed tomography scans of 80 men and 80 women aged between 40 and 79 years. Eleven anatomical landmarks were placed manually on mandibles. The automated landmarking through point cloud alignment and correspondence (ALPACA) method implemented in [http://www.slicer.org '''3D Slicer'''] was used to automatically place landmarks to all meshes. Euclidean distances, normalized centroid size, and Procrustes ANOVA were calculated for both methods. A pseudo-landmarks approach was followed using ALPACA to identify areas of changes among our sample.

Results: The ALPACA method showed significant differences in Euclidean distances for all landmarks compared to the manual method. A mean Euclidean distance of 1.7 mm was found for the ALPACA method and 0.99 mm for the manual method. Both methods found that sex, age, and size had a significant effect on mandibular shape. The greatest variations were observed in the condyle, ramus, and symphysis regions.

Conclusion: The results obtained using the ALPACA method are acceptable and promising. This approach can automatically place landmarks with an average accuracy of less than 2 mm, which may be sufficient in most anthropometric analyses. In the light of our results, however, odontological application such as occlusal analysis is not recommended.
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==Clinical Study of Puncture Technique in Single Division of the Trigeminal Ganglion Intumescentia==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37183316 Pain Pract. 2023 May 14. PMID: 37183316] | [https://onlinelibrary.wiley.com/doi/epdf/10.1111/papr.13239 PDF]

'''Authors:''' Zhang L, Guo Y, Xu J, He Y, Qi Z, Chen H, Zhang H.

'''Institution:''' Department of Neurosurgery, Jianhu Hospital Affiliated to Nantong University, Yancheng, China.

'''Abstract:'''
Objective: We explored the feasibility of single-division puncture in the ophthalmic division, maxillary division, and mandibular division of the trigeminal ganglion intumescentia (TGI) and the feasibility of radiofrequency treatment of trigeminal neuralgia.

Methods: According to the previous anatomical image studies, [http://www.slicer.org '''3D Slicer'''] software was used to analyze the CT images of the patients. The trigeminal ganglion fossa (TGF) was used as the imaging sign. TGI was identified in the sagittal plane along the fiber. The puncture path starts from the TGI center-foramen ovale line, extending outward to the epidermis as the needle insertion point, and extending inward to the division boundary. For lateral puncture, which is blocked by the mandible, the positions of closed mouth, open mouth, and over-open mouth were used. Multiple targets were generated using straight electrodes and curved electrodes to achieve full coverage of TGI. According to the preoperative design, general anesthesia surgery was performed. Xper CT was used for imaging, and the puncture was guided by Xper Guide. Radiofrequency treatment of TGI was conducted.

Results: In total, 45 patients with trigeminal neuralgia underwent 50 single-division TGI punctures. The procedure was smooth and the compliance with the design was good. Continuous radiofrequency (CRF) was performed, the VAS scores were 25 times at 70°C, 19 times at 65°C, two times at 60°C, and two times at 50°C (both in the ophthalmic division). Pulsed radiofrequency (PRF) was conducted two times. Within 24 h after the procedure, the VAS scores were all 0. From 1 to 7 days after the procedure, pain recurrence was found in three cases, of whom two cases received pulsed radiofrequency treatment. Patients were followed up for 1-24 months and there were no recurrence. After continuous radiofrequency at 65-70°C, the moderate tactile loss was observed, and nearly half of the patients had food residues on the surgical side after 6 months. After continuous radiofrequency at 60°C, there was mild tactile loss and no food residue. The tactile sensation was slightly decreased after continuous radiofrequency at 50°C, and the tactile sensation was normal the next day.

Conclusion: Trigeminal ganglion intumescentia single-division radiofrequency is effective and feasible for the treatment of trigeminal neuralgia.
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==Three-Dimensional Volume Rendering of Pelvic Floor Anatomy with Focus on Fibroids in Relation to the Lower Urogenital Tract Based on Cross-Sectional MRI Images==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37171621 J Med Syst. 2023 May 12;47(1):62. PMID: 37171621] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10181971/pdf/10916_2023_Article_1947.pdf PDF]

'''Authors:''' Fan KS, Durnea C, Nygaard CC, Khalil M, Doumouchtsis SK.

'''Institution:''' Institute for Medical and Biomedical Education, St. George's University of London, London, UK.

'''Abstract:'''
We aimed to assess the feasibility of developing three-dimensional (3D) models of pelvic organs using cross-sectional MRI images of patients with uterine fibroids and urinary symptoms and of obtaining anatomical information unavailable in 2D imaging modalities. We also aimed to compare two image processing applications. We performed a feasibility study analysing MRI scans from three women, aged 30 to 58 years old, with fibroids and urinary symptoms. Cross-sectional images were used to render 3D models of pelvic anatomy, including bladder, uterus and fibroids, using [http://www.slicer.org '''3D Slicer'''] and OsiriX. Dimensions, volumes and anatomical relationships of the pelvic organs were evaluated. Comparisons between anatomical landmarks and measurements obtained from the two image processing applications were undertaken. Rendered 3D pelvic models yielded detailed anatomical information and data on spatial relationships that were unobtainable from cross-sectional images. Models were rendered in sufficient resolution to aid understanding of spatial relationships between urinary bladder, uterus and fibroid(s). Measurements of fibroid volumes ranged from 5,336 to 418,012 mm3 and distances between the fibroid and urinary bladder ranged from 0.10 to 83.60 mm. Statistical analysis of measurements showed no significant differences in measurements between the two image processing applications. To date, limited data exist on the use of 3D volume reconstructions of routine MRI scans, to investigate pelvic pathologies such as fibroids in women with urinary symptoms. This study suggests that post-MRI image processing can provide additional information over standard MRI. Further studies are required to assess the role of these data in clinical practice, surgical planning and training. Three-dimensional reconstruction of routine two-dimensional magnetic resonance imaging provides additional anatomical information and may improve our understanding of anatomical relationships, their role in clinical presentations and possibly guide clinical and surgical management.
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==The First Endovascular Rat Glioma Model for Pre-Clinical Evaluation of Intra-Arterial Therapeutics==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37157800 Interv Neuroradiol. 2023 May 8:15910199231169597. PMID: 37157800]

'''Authors:''' Lim J, Baig AA, Donnelly BM, Chaves LD, Pol SU, Koenigsknecht C, Pionessa D, Levy BR, Gutierrez L, Tutino VM, Levy EI, Siddiqui AH.

'''Institution:''' Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA.

'''Abstract:'''
Background: Several translational animal models have been described assessing intra-arterial (IA) treatments for malignant gliomas. We describe the first endovascular animal model that allows testing of IA drug delivery as a first-line treatment, which is difficult to do in actual patients. We report a unique protocol for vascular access and IA delivery in the rat model that, unlike prior reports, does not require direct puncture and opening of proximal cerebrovasculature which carries risk of ischemia in the animal brain post-delivery.

Methods: Wistar rats underwent left femoral artery catherization with a Balt Magic 1.2F catheter or Marathon Flow directed 1.5F Microcatheter with an Asahi Chikai 0.008 micro-guidewire which was navigated to the left internal carotid artery under x-ray. 25% mannitol was administered to test blood brain barrier breakdown (BBBB). Additional rats were implanted with C6 glioma cells in the left frontal lobe. C6 Glioma-Implanted Rats (C6GRs) were monitored for overall survival and tumor growth. Tumor volumes from MRI images were calculated utilizing [http://www.slicer.org '''3D Slicer''']. Additional rats underwent femoral artery catheterization with Bevacizumab, carboplatin, or irinotecan injected into the left internal carotid artery to test feasibility and safety.

Results: A successful endovascular access and BBBB protocol was established. BBBB was confirmed with positive Evans blue staining. 10 rats were successfully implanted with C6 gliomas with confirmed growths on MRI. Overall survival was 19.75 ± 2.21 days. 5 rats were utilized for the development of our femoral catheterization protocol and BBBB testing. With regards to IA chemotherapy dosage testing, control rats tolerated targeted 10 mg/kg of bevascizumab, 2.4 mg/kg of carboplatin, and 15 mg/kg of irinotecan IA ICA injections without any complications.

Conclusions: We present the first endovascular IA rat glioma model that allows selective catheterization of the intracranial vasculature and assessment of IA therapies for gliomas without need for access and sacrifice of proximal cerebrovasculature.
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==Muscle Magnetic Resonance Characterization of STIM1 Tubular Aggregate Myopathy Using Unsupervised Learning==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37155641 PLoS One. 2023 May 8;18(5):e0285422. PMID: 37155641] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10166478/pdf/pone.0285422.pd PDF]

'''Authors:''' Lupi A, Spolaor S, Favero A, Bello L, Stramare R, Pegoraro E, Nobile MS.

'''Institution:''' Institute of Radiology, Department of Medicine-DIMED, University of Padua, Padua, Italy.

'''Abstract:'''
Purpose: Congenital myopathies are a heterogeneous group of diseases affecting the skeletal muscles and characterized by high clinical, genetic, and histological variability. Magnetic Resonance (MR) is a valuable tool for the assessment of involved muscles (i.e., fatty replacement and oedema) and disease progression. Machine Learning is becoming increasingly applied for diagnostic purposes, but to our knowledge, Self-Organizing Maps (SOMs) have never been used for the identification of the patterns in these diseases. The aim of this study is to evaluate if SOMs may discriminate between muscles with fatty replacement (S), oedema (E) or neither (N).

Methods: MR studies of a family affected by tubular aggregates myopathy (TAM) with the histologically proven autosomal dominant mutation of the STIM1 gene, were examined: for each patient, in two MR assessments (i.e., t0 and t1, the latter after 5 years), fifty-three muscles were evaluated for muscular fatty replacement on the T1w images, and for oedema on the STIR images, for reference. Sixty radiomic features were collected from each muscle at t0 and t1 MR assessment using [http://www.slicer.org '''3D Slicer'''] software, in order to obtain data from images. A SOM was created to analyze all datasets using three clusters (i.e., 0, 1 and 2) and results were compared with radiological evaluation.

Results: Six patients with TAM STIM1-mutation were included. At t0 MR assessments, all patients showed widespread fatty replacement that intensifies at t1, while oedema mainly affected the muscles of the legs and appears stable at follow-up. All muscles with oedema showed fatty replacement, too. At t0 SOM grid clustering shows almost all N muscles in Cluster 0 and most of the E muscles in Cluster 1; at t1 almost all E muscles appear in Cluster 1.

Conclusion: Our unsupervised learning model appears to be able to recognize muscles altered by the presence of edema and fatty replacement.
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==Quantifying the Effect of an Endo-Vaginal Probe on Position of the Pelvic Floor Viscera and Muscles==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37145123 Int Urogynecol J. 2023 May 5. PMID: 37145123]

'''Authors:''' Chill HH, Martin LC, Abramowitch SD, Rostaminia G.

'''Institution:''' Female Pelvic Medicine and Reconstructive Surgery (FPMRS) Division, University of Chicago Pritzker School of Medicine, Northshore University HealthSystem, Skokie, IL, USA.

'''Abstract:'''
Introduction and hypothesis: Endovaginal ultrasound has long been hypothesized to have a significant effect on locations of what it visualizes. However, little work has directly quantified its effect. This study aimed to quantify it.

Methods: This cross-sectional study consisted of 20 healthy asymptomatic volunteers who underwent both endovaginal ultrasound and MRI. The urethra, vagina, rectum, pelvic floor, and pubic bone were segmented in both ultrasound and MRI using [http://www.slicer.org '''3D Slicer''']. Then, using [http://www.slicer.org '''3D Slicer''']'s transform tool the volumes were rigidly aligned based on the posterior curvature of the pubic bone. The organs were then split into thirds along their long axis to compare their distal, middle, and proximal sections. Using Houdini, we compared the location of the centroid of each of the urethra, vagina, and rectum and the surface-to-surface difference of the urethra and rectum. The anterior curvature of the pelvic floor was also compared. Normality of all variables was assessed by Shapiro-Wilk test.

Results: The largest amount of surface-to-surface distance was observed in the proximal region for the urethra and rectum. Across all three organs, the majority of the deviation was in the anterior direction for geometries obtained from ultrasound versus those from MRI. For each subject, the trace defining the midline of the levator plate was more anterior for ultrasound compared to MRI.

Conclusions: While it has often been assumed that placing a probe in the vagina probably distorts the anatomy, this study quantified the distortion and displacement of the pelvic viscera. This allows for better interpretation of clinical and research findings based on this modality.
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==Laser Interstitial Thermal Therapy in the Treatment of Brain Metastases: The Relationship Between Changes in Postoperative Magnetic Resonance Imaging Characteristics and Tumor Recurrence==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36823478 Acta Neurochir (Wien). 2023 May;165(5):1379-1387. PMID: 36823478]

'''Authors:''' Xue Z, Guan X, Yuan L, Kang P, Zhang C, Li D, Jia G, Jia W.

'''Institution:''' Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, China.

'''Abstract:'''
'''Background:''' Laser interstitial thermal therapy (LITT) has been used to treat brain metastases (BMs) in several countries, and its safety and effectiveness have been confirmed. In most cases, magnetic resonance imaging (MRI) reveals an increase in tumor volume with an enhanced margin after LITT. However, little is known about the relationship between this MRI change and tumor recurrence.

'''Objective:''' We report the first case series of BMs treated by LITT in China to evaluate the clinical characteristics and predictive factors of tumor recurrence.

'''Material and Methods:''' Patients with less than four brain metastatic lesions and a Karnofsky performance status (KPS) > 70 were eligible for study inclusion. Standard LITT procedures were performed, and a follow-up MRI was performed to analyze the radiographic changes, especially the volume ratio of the enhanced margin and the whole lesion on MRI at 30 days postoperatively. All the volume-related data were delineated and calculated using [http://www.slicer.org '''3D Slicer'''] software. Related predictors were also collected to evaluate the correlation with local tumor control.

'''Results:''' Eighteen patients with nineteen lesions were enrolled for treatment and follow-up. Primary tumor histology included pulmonary carcinoma (n = 11) and breast cancer (n = 4). On average, the tumor size measured 3.01 cm3 (range, 0.40-7.40 cm3), the total ablation time was 13.58 min (range, 2.88-37.15 min), and the complete ablation rate was 92.4% (range, 29.2-100%). Comparing 3s0-day follow-up MRI results with preoperative MRI findings, 18 lesions showed a 2.28-fold (range, 1.21-4.88) volume increase; all the lesions displayed an enhanced component with a volume ratio of 42.35% (range, 10.14-100%). Five patients experienced tumor recurrence, and the local tumor control rates at 90 days and 180 days of follow-up were 68.4% and 66.7%, respectively. Univariate analysis indicated that the primary tumor, ablation rate, and enhanced volume ratio (EVR) > 40% in the 30-day MRI were associated with tumor recurrence, whereas multivariate analysis showed that only EVR > 40% was a predictive factor of local control.

'''Conclusion:''' LITT is a minimally invasive method used to ablate brain metastases which can be used as the first-line treatment for BM patients under certain indications. After LITT, most tumors showed volume enlargement on the 30-day MRI scan, and EVR > 40% on the 30-day MRI may indicate late tumor recurrence.
|}

==Image Data and Computational Grids for Computing Brain Shift and Solving the Electrocorticography Forward Problem==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37128587/ Data Brief. 2023 Apr 7;48:109122. PMID: 37128587] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10147975/pdf/main.pdf PDF]

'''Authors:''' Zwick BF, Safdar S, Bourantas GC, Joldes GR, Hyde DE, Warfield SK, Wittek A, Miller K.

'''Institution:''' Intelligent Systems for Medicine Laboratory, The University of Western Australia, 35 Stirling Highway, Perth, WA, Australia.

'''Abstract:'''
This article describes the dataset applied in the research reported in NeuroImage article "Patient-specific solution of the electrocorticography forward problem in deforming brain" [1] that is available for download from the Zenodo data repository (https://zenodo.org/record/7687631) [2]. Preoperative structural and diffusion-weighted magnetic resonance (MR) and postoperative computed tomography (CT) images of a 12-year-old female epilepsy patient under evaluation for surgical intervention were obtained retrospectively from Boston Children's Hospital. We used these images to conduct the analysis at The University of Western Australia's Intelligent Systems for Medicine Laboratory using SlicerCBM [3], our open-source software extension for the [http://www.slicer.org '''3D Slicer'''] medical imaging platform. As part of the analysis, we processed the images to extract the patient-specific brain geometry; created computational grids, including a tetrahedral grid for the meshless solution of the biomechanical model and a regular hexahedral grid for the finite element solution of the electrocorticography forward problem; predicted the postoperative MRI and DTI that correspond to the brain configuration deformed by the placement of subdural electrodes using biomechanics-based image warping; and solved the patient-specific electrocorticography forward problem to compute the electric potential distribution within the patient's head using the original preoperative and predicted postoperative image data. The well-established and open-source file formats used in this dataset, including Nearly Raw Raster Data (NRRD) files for images, STL files for surface geometry, and Visualization Toolkit (VTK) files for computational grids, allow other research groups to easily reuse the data presented herein to solve the electrocorticography forward problem accounting for the brain shift caused by implantation of subdural grid electrodes.
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==ImFinite Element Analysis of a Healthy Knee Joint at Deep Squatting for the Study of Tibiofemoral and Patellofemoral Contact==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37143926 J Orthop. 2023 Apr 21;40:7-16. PMID: 37143926]

'''Authors:''' Kothurkar R, Lekurwale R, Gad M, Rathod CM.

'''Institution:''' Department of Mechanical Engineering, K. J. Somaiya College of Engineering, Mumbai, India.

'''Abstract:'''
Background: In non-western countries, deep squatting is a daily activity, and prolonged deep squatting is common among occupational squatters. Household tasks, taking a bath, socializing, using toilets, and performing religious acts are among the activities frequently carried out while squatting by the Asian population. High knee loading is responsible for a knee injury and osteoarthritis. Finite element analysis is an effective tool to determine stresses on the knee joint.

Methods: Magnetic Resonance Imaging (MRI) and Computed Tomographic (CT) images were acquired of one adult without knee injuries. The CT images were acquired at the fully extended knee and one more set of images was acquired with the knee at a deeply flexed knee position. The MRI was acquired with the fully extended knee. 3 Dimensional models of bones were created using CT and soft tissue using MRI with the help of [http://www.slicer.org '''3D Slicer'''] software. Kinematics and finite element analysis of the knee was performed for standing and deep squatting posture using Ansys Workbench 2022.

Results: High peak stresses were observed at deep squatting compared to standing along with the reduction in the contact area. Peak von Mises stresses on femoral cartilage, tibial cartilage, patellar cartilage, and meniscus were increased from 3.3 MPa to 19.9 MPa, 2.9 MPa to 12.4 MPa, 1.5 MPa to 16.7 MPa and 15.8 MPa to 32.8 MPa respectively during deep squatting. Posterior translation of 7.01 mm, and 12.58 mm was observed for medial and lateral femoral condyle respectively from full extension to 153° knee flexion.

Conclusions: Increased stresses in the knee joint at deep squat posture may cause cartilage damage. A sustained deep squat posture should be avoided for healthy knee joints. More posterior translations of the medial femoral condyle at higher knee flexion angle warrant further investigation.
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==A Comparison of Machine Learning Models for Survival Prediction of Patients with Glioma Using Radiomic Features from MRI Scans==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37362372/ Indian J Radiol Imaging. 2023 Apr 28;33(3):338-343. PMID: 37362372] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10289839/pdf/10-1055-s-0043-1767786.pdf PDF]

'''Authors:''' Manjunath M, Saravanakumar S, Kiran S, Chatterjee J.

'''Institution:''' Department of Biotechnology, People's Education Society University, Bangalore, Karnataka, India.

'''Abstract:'''
Background Glioma is a primary, malignant, highly aggressive brain tumor, with patients having an average life expectancy of 14 to 16 months after diagnosis. Magnetic resonance imaging (MRI) scans of these patients can be used to extract and analyze quantifiable features with potential clinical significance. We hypothesize that there is a correlation between radiomic features extracted from MRI scans and survival. Along with clinical data, the radiomic features could be used in survival prediction of patients, providing beneficial information for clinicians to design personalized treatment plans. Methods In our study, we have utilized [http://www.slicer.org '''3D Slicer'''] for tumor segmentation and feature extraction and performed survival prediction of patients with glioma using four different machine learning models. Results and Conclusion Among the models compared, we have achieved a maximum prediction accuracy of 64.4% using the k-nearest neighbors model, which was trained and tested on a combination of clinical data and radiomic features extracted from MRI images provided in the BraTS 2020 dataset.
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==Circular RNA hsa_circ_0000690 as a Potential Biomarker for Diagnosis and Prognosis of Intracranial Aneurysm: Closely Relating to the Volume of Hemorrhage==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36879365 Brain Behav. Apr;13(4):e2929. PMID: 36879365] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10097068/pdf/BRB3-13-e2929.pdf PDF]

'''Authors:'''Huang Y, Cao H, Qi X, Guan C, Que S.

'''Institution:''' Department of Neurosurgery, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, Fujian, China.

'''Abstract:'''

'''Purpose:''' This study aimed to explore circular RNA (circRNA) hsa_circ_0000690 as a potential biomarker for diagnosis and prognosis of intracranial aneurysm (IA) and its relationship with clinical factors and complications of IA.

'''Material/Methods:''' 216 IA patients admitted to the neurosurgery department of our hospital from January 2019 to December 2020 were selected as the experimental group, and 186 healthy volunteers were selected as the control group. The expression of hsa_circ_0000690 in peripheral blood was detected by quantitative real-time PCR, and its diagnostic value was assessed by receiver operating characteristic curve. Relationship between hsa_circ_0000690 and clinical factors of IA was assessed by chi-square test. Nonparametric test was used in univariate analysis, and regression analysis was used in multivariate analysis. Multivariate Cox proportional hazards regression analysis was used to analyze the survival time.

'''Results:''' CircRNA hsa_circ_0000690 of IA patients was relatively lower than that in the control group (p < .001). The AUC of hsa_circ_0000690 was 0.752, the specificity was 0.780, and sensitivity was 0.620, with diagnostic threshold of 0.0449. In addition, hsa_circ_0000690 expression was correlated with Glasgow Coma Scale, the volume of subarachnoid hemorrhage, modified Fisher scale, Hunt-Hess levels and surgical type. For hydrocephalus and delayed cerebral ischemia, hsa_circ_0000690 was significant in univariate analysis, but nonsignificant in multivariate analysis. For prognosis, hsa_circ_0000690 was significantly associated with modified Rankin Scales after surgery for 3 months, but not associated with survival time.

'''Conclusions:''' The expression of hsa_circ_0000690 can act as a diagnostic marker for IA and predict the prognosis of 3 months after operation and is closely related to the volume of hemorrhage.

'''Keywords:''' [http://www.slicer.org '''3D Slicer''']; biomarker; circRNA; diagnosis; intracranial aneurysm; prognosis; subarachnoid hemorrhage
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==Can Quantitative Peritumoral CT Radiomics Features Predict the Prognosis of Patients With Non-Small Cell Lung Cancer? A Systematic Review==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36307554 Eur Radiol. 2023 Mar;33(3):2105-17. PMID: 36307554] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9935659/pdf/330_2022_Article_9174.pdf PDF]

'''Authors:''' Wu L, Lou X, Kong N, Xu M, Gao C.

'''Institution:''' Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China.

'''Abstract:''' Objectives: To provide an overarching evaluation of the value of peritumoral CT radiomics features for predicting the prognosis of non-small cell lung cancer and to assess the quality of the available studies.

'''Methods:''' The PubMed, Embase, Web of Science, and Cochrane Library databases were searched for studies predicting the prognosis in patients with non-small cell lung cancer (NSCLC) using CT-based peritumoral radiomics features. Information about the patient, CT-scanner, and radiomics analyses were all extracted for the included studies. Study quality was assessed using the Radiomics Quality Score (RQS) and the Prediction Model Risk of Bias Assessment Tool (PROBAST).

'''Results:''' Thirteen studies were included with 2942 patients from 2017 to 2022. Only one study was prospective, and the others were all retrospectively designed. Manual segmentation and multicenter studies were performed by 69% and 46% of the included studies, respectively. [http://www.slicer.org '''3D Slicer'''] and MATLAB software were most commonly used for the segmentation of lesions and extraction of features. The peritumoral region was most frequently defined as dilated from the tumor boundary of 15 mm, 20 mm, or 30 mm. The median RQS of the studies was 13 (range 4-19), while all of included studies were assessed as having a high risk of bias (ROB) overall.

'''Conclusions:''' Peritumoral radiomics features based on CT images showed promise in predicting the prognosis of NSCLC, although well-designed studies and further biological validation are still needed.

'''Key points:''' Peritumoral radiomics features based on CT images are promising and encouraging for predicting the prognosis of non-small cell lung cancer. The peritumoral region was often dilated from the tumor boundary of 15 mm or 20 mm because these were considered safe margins. The median Radiomics Quality Score of the included studies was 13 (range 4-19), and all of studies were considered to have a high risk of bias overall.
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==Three Dimensional Assessment of Radiographic Changes after Indirect Pulp Capping using Silver Diamine Fluoride with or without Potassium Iodide in Young Permanent Teeth (12-month RCT)==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36878216 Caries Res. 2023;57(2):177-188. PMID: 36878216]

'''Authors:''' Baraka MMAL, Cevidanes L, Tekeya M, Bakry N, Ruellas A, Botero T, Benavides E, Fontana M.

'''Institution:''' Department of Experimental Oncology, European Institute of Oncology, IRCCS, 20139 Milan, Italy.

'''Abstract:''' The aim was to have a three-dimensional evaluation of radiographic changes after indirect pulp capping (IPC) with silver diamine fluoride (SDF) with or without potassium iodide (KI) and resin modified glass ionomer cement (RMGIC) in deep carious young permanent molars using cone beam computed tomography (CBCT). 108 first permanent molars with deep occlusal cavitated caries lesions, in forty-nine 6-9-year-old children, were randomly allocated to one of 3 groups (n=36) and treated with SDF+KI, SDF and RMGIC as IPC materials. CBCT scans were taken at 0 and at 12-months to assess tertiary dentin formation (volume and grey level intensity), increase in root length, and pathological changes as secondary caries, periapical radiolucency, internal resorption and obliteration of the pulp. The three-dimensional image analysis procedures were performed using ITK-SNAP and [http://www.slicer.org '''3D Slicer'''] CMF. Comparisons were made using analysis of variance with a fixed effect for treatment and random effects for patient, and patient-by-treatment to account for within-patient correlations. A two-sided 5% significance level was used. There were no significant differences among the three groups regarding tertiary dentin volume (p=0.712) and grey level intensity (p=0.660), increase in root length (p=0.365), prevention of secondary caries (p=0.63) and periapical radiolucency (p=0.80) in the analysed 69 CBCT scans. The study did not find differences among the groups regarding quality and quantity of tertiary dentin formed, increase in root length, absence of secondary caries and other signs of failure as shown by CBCT.

'''Clinical Significance:''' The results show no significant differences in radiographic outcomes (quality and quantity of tertiary dentin formed, increase in root length, absence of secondary caries and other signs of failure) when using SDF+KI, SDF and RMGIC in IPC. The results of this study can help guide treatment decision making regarding use of SDF and SDF+KI as IPC materials in deep cavitated lesions.
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==Cross-Sectional Reliability and Concurrent Validity of a Quantitative 2-Dimensional Ultrasound Image Analysis of Effusion and Synovial Hypertrophy in Knee Osteoarthritis==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37008822/ Osteoarthr Cartil Open. 2023 Mar 16;5(2):100356. PMID: 37008822] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10060736/pdf/main.pdf PDF]

'''Authors:''' Dima R, Birmingham TB, Philpott HT, Bryant D, Fenster A, Appleton CT.

'''Institution:''' Faculty of Health Sciences, University of Western Ontario, London, ON, Canada.

'''Abstract:'''
Objective: Effusion-synovitis is related to pain and progression in knee osteoarthritis (OA), but current gold standard ultrasound (US) measures are limited to semi-quantitative grading of joint distension or 1-dimensional thickness measures. A novel quantitative 2-dimensional image analysis methodology is applied to US images of effusion-synovitis; reliability and concurrent validity was assessed in patients with knee OA.

Methods: Cross sectional analysis of US images collected from 51 patients with symptomatic knee OA were processed in ImageJ and segmented in [http://www.slicer.org '''3D Slicer'''] to produce a binary mask of the supra-patellar synovitis region of interest (ROI). Area measures (mm2) of total synovitis, effusion and hypertrophy components were exported. Intra-rater reliability and test-retest reliability (1-14 days washout) were estimated with intra-class correlation coefficients (ICCs). Concurrent validity was measured by Spearman correlations between quantitative measures and gold standard OMERACT and caliper measurements of synovitis.

Results: Intra-rater reliability for hypertrophy area was estimated at 0.98, 0.99 for effusion area, and 0.99 for total synovitis area. The test-retest reliability for total synovitis area was 0.63 (SEM 87.8 mm2), 0.59 for hypertrophy area (SEM 21.0 mm2), and 0.64 for effusion area (SEM 73.8 mm2). Correlation between total synovitis area and OMERACT grade was 0.84, 0.81 between total synovitis area and effusion-synovitis calipers, and 0.81 between total effusion area and effusion calipers.

Conclusion: This new research tool for image analysis demonstrated excellent intra-rater reliability, good concurrent validity, and moderate test-retest reliability. Quantitative 2D US measures of effusion-synovitis and its individual components may enhance the study and management of knee OA.
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==Patient-Specific Needle Guidance Templates Drilled Intraprocedurally for Image Guided Intervention: Feasibility Study in Swine==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36173542 Int J Comput Assist Radiol Surg. 2023 Mar;18(3):537-44. PMID: 36173542]

'''Authors:''' Glossop N, Bale R, Xu S, Pritchard WF, Karanian JW, Wood BJ.

'''Institution:''' Queen's University, Kingston, ON, Canada.

'''Abstract:'''
'''purpose:''' Thermal ablation of large tumors may benefit from simultaneous placement of multiple needles, but accurate placement becomes challenging as the number of needles increases. The aim of this work was to evaluate use of personalized needle guidance grid templates based on intraprocedural CT and fabricated at the point of care to implement ablation treatment plans with multiple needles in vivo.

'''Methods:''' A plastic frame was designed to hold two parallel plastic guide plates in a rigid relationship, fixed over the abdomen by a mounting arm. Steel ball targets (1.5 mm) were implanted under ultrasound in the livers of two domestic swine under general anesthesia. Following breath-hold CT of the subject and frame, the targets and frame were identified using customized [http://www.slicer.org '''3D Slicer''']-based planning software. Multiple needle trajectories targeting the balls were planned, including complex off-plane trajectories. A machining program for drilling the hole pattern corresponding to the planned needle trajectories was generated. The pattern was drilled in the two plates with a numerical-controlled milling machine in the suite. The plates were attached to the frame and needles passed through the paired holes to the calculated depth. Placement accuracy was defined as needle tip-to-target distance on post-placement CT.

'''Results:''' The planning process and manufacturing required approximately 6 and 15 min, respectively. Needles were rapidly inserted (n = 11) to the target points without complications or traversing nontarget anatomy. The mean needle tip-to-target distance error was 3.4 ± 2.2, range 0-7 mm.

'''Conclusion:''' Rapid and accurate needle placement was feasible using a subject-specific, custom-drilled, needle guidance grid template fabricated intraprocedurally. Targeting accuracy and performance were similar to more complex and expensive tracking systems which may enable accurate intraprocedural implementation of treatment plans in the liver or other organs. This may be of value in complex ablation cases or in areas where more advanced guidance systems are not available.
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==Automatic Landmark Identification in Cone-Beam Computed Tomography==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36811276 Orthod Craniofac Res. 2023 Feb 21. PMID: 36811276]

'''Authors:''' Gillot M, Miranda F, Baquero B, Ruellas A, Gurgel M, Al Turkestani N, Anchling L, Hutin N, Biggs E, Yatabe M, Paniagua B, Fillion-Robin JC, Allemang D, Bianchi J, Cevidanes L, Prieto JC.

'''Institution:''' Department of Orthodontics and Pediatric Dentistry, School of Dental Medicine, University of Michigan, Ann Arbor, MI, USA.

'''Abstract:'''
'''Objective:''' To present and validate an open-source fully automated landmark placement (ALICBCT) tool for cone-beam computed tomography scans.

'''Material and Methods:''' One hundred and forty-three large and medium field of view cone-beam computed tomography (CBCT) were used to train and test a novel approach, called ALICBCT that reformulates landmark detection as a classification problem through a virtual agent placed inside volumetric images. The landmark agents were trained to navigate in a multi-scale volumetric space to reach the estimated landmark position. The agent movements decision relies on a combination of DenseNet feature network and fully connected layers. For each CBCT, 32 ground truth landmark positions were identified by 2 clinician experts. After validation of the 32 landmarks, new models were trained to identify a total of 119 landmarks that are commonly used in clinical studies for the quantification of changes in bone morphology and tooth position.

'''Results:''' Our method achieved a high accuracy with an average of 1.54±0.87 mm error for the 32 landmark positions with rare failures, taking an average of 4.2s computation time to identify each landmark in one large 3D-CBCT scan using a conventional GPU.

'''Conclusion:''' The ALICBCT algorithm is a robust automatic identification tool that has been deployed for clinical and research use as an extension in the 3D Slicer platform allowing continuous updates for increased precision.
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==Development and In-Silico and Ex-Vivo Validation of a Software for a Semi-Automated Segmentation of the Round Window Niche to Design a Patient Specific Implant to Treat Inner Ear Disorders==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36826970 J Imaging. 2023 Feb 20;9(2):51. PMID: 36826970] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9965310/pdf/jimaging-09-00051.pdf PDF]

'''Authors:''' Matin-Mann F, Gao Z, Wei C, Repp F, Artukarslan EN, John S, Alcacer Labrador D, Lenarz T, Scheper V.

'''Institution:''' Lower Saxony Center for Biomedical Engineering, Implant Research and Development (NIFE), Department of Otorhinolaryngology, Head and Neck Surgery, Hannover Medical School, Hannover, Germany.

'''Abstract:''' The aim of this study was to develop and validate a semi-automated segmentation approach that identifies the round window niche (RWN) and round window membrane (RWM) for use in the development of patient individualized round window niche implants (RNI) to treat inner ear disorders. Twenty cone beam computed tomography (CBCT) datasets of unilateral temporal bones of patients were included in the study. Defined anatomical landmarks such as the RWM were used to develop a customized [http://www.slicer.org '''3D Slicer'''] plugin for semi-automated segmentation of the RWN. Two otolaryngologists (User 1 and User 2) segmented the datasets manually and semi-automatically using the developed software. Both methods were compared in-silico regarding the resulting RWM area and RWN volume. Finally, the developed software was validated ex-vivo in N = 3 body donor implantation tests with additively manufactured RNI. The independently segmented temporal bones of the different Users showed a strong consistency in the volume of the RWN and the area of the RWM. The volume of the semi-automated RWN segmentations were 48 ± 11% smaller on average than the manual segmentations and the area of the RWM of the semi-automated segmentations was 21 ± 17% smaller on average than the manual segmentation. All additively manufactured implants, based on the semi-automated segmentation method could be implanted successfully in a pressure-tight fit into the RWN. The implants based on the manual segmentations failed to fit into the RWN and this suggests that the larger manual segmentations were over-segmentations. This study presents a semi-automated approach for segmenting the RWN and RWM in temporal bone CBCT scans that is efficient, fast, accurate, and not dependent on trained users. In addition, the manual segmentation, often positioned as the gold-standard, actually failed to pass the implantation validation.
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==Design and Analysis of HSC-BPPV Diagnostic Maneuver Based on Virtual Simulation==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36873445 Front Neurol. 2023 Feb 17;14:1132343. PMID: 36873445] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9981954/pdf/fneur-14-1132343.pdf PDF]

'''Authors:''' Li Y, Yang X.

'''Institution:''' Department of Research Center, Third Affiliated Hospital of Shanghai University, Wenzhou Third Clinical Institute Affiliated to Wenzhou Medical University, Wenzhou People's Hospital, Wenzhou, China.

'''Abstract:'''
'''Background:''' The preferred supine roll test for the diagnosis of horizontal semicircular canal BPPV has several disadvantages, including difficulty in locating the affected ear, inconsistent nystagmus performance on repeated testing, and lack of a typical latency period, resulting in insensitive diagnosis.

Objectives: To investigate novel diagnostic techniques with more scientific design, more accessible application, and better diagnostic sensitivity and specificity.

'''Materials and Methods:''' Based on clinical microscopic CT data, we created a virtual simulation model of BPPV using Unity software. The physical simulation of the traditional supine roll test was performed to observe and analyse the movement of the otoliths, whose initial position was the typical stable position. In addition, the normal vectors of the plane and crista ampullaris of the horizontal semicircular canal were measured using [http://www.slicer.org '''3D Slicer'''] software. Based on this, we analyzed the critical steps for designing diagnostic maneuvers for BPPV in the horizontal semicircular canal. For a more accurate diagnosis of horizontal semicircular canal BPPV, it is critical to rotate the horizontal semicircular canal to be parallel to gravity. It is also necessary to move the otolith by swinging the head. As a result, we developed two diagnostic maneuvers: the 60° roll test and the prone roll test. We also performed simulations to observe otolith movement and predict nystagmus performance.

'''Conclusions:''' The 60° roll test and the prone roll test can complement the supine roll test. Compared to the supine roll test, they not only effectively differentiate canalolithiasis from cupulolithiasis, but also make it easier to determine the position of the otoliths, and the characteristics of the nystagmus are more pronounced. Significant diagnostic features have significant potential benefits for home and telemedicine.
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==The Simplified Tailor-Made Workflows for a [http://www.slicer.org '''3D Slicer''']-Based Craniofacial Implant Design==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36801943 Sci Rep. 2023 Feb 17;13(1):2850. PMID: 36801943] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9938178/pdf/41598_2023_Article_30117.pdf PDF]

'''Authors:''' Tantisatirapong S, Khunakornpattanakarn S, Suesatsakul T, Boonpratatong A, Benjamin I, Tongmeesee S, Kangkorn T, Chanwimalueang

'''Institution:''' Department of Biomedical Engineering, Faculty of Engineering, Srinakharinwirot University, Nakhon Nayok, Thailand.

'''Abstract:''' A specific design of craniofacial implant model is vital and urgent for patients with traumatic head injury. The mirror technique is commonly used for modeling these implants, but it requires the presence of a healthy skull region opposite to the defect. To address this limitation, we propose three processing workflows for modeling craniofacial implants: the mirror method, the baffle planner, and the baffle-based mirror guideline. These workflows are based on extension modules on the [http://www.slicer.org '''3D Slicer'''] platform and were developed to simplify the modeling process for a variety of craniofacial scenarios. To evaluate the effectiveness of these proposed workflows, we investigated craniofacial CT datasets collected from four accidental cases. The designed implant models were created using the three proposed workflows and compared to reference models created by an experienced neurosurgeon. The spatial properties of the models were evaluated using performance metrics. Our results show that the mirror method is suitable for cases where a healthy skull region can be completely reflected to the defect region. The baffle planner module offers a flexible prototype model that can be fit independently to any defect location, but it requires customized refinement of contour and thickness to fill the missing region seamlessly and relies on the user's experience and expertise. The proposed baffle-based mirror guideline method strengthens the baffle planner method by tracing the mirrored surface. Overall, our study suggests that the three proposed workflows for craniofacial implant modeling simplify the process and can be practically applied to a variety of craniofacial scenarios. These findings have the potential to improve the care of patients with traumatic head injuries and could be used by neurosurgeons and other medical professionals.
|}

==Predicting Transient Ischemic Attack Risk in Patients With Mild Carotid Stenosis Using Machine Learning and CT Radiomics==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36846119 Front Neurol. 2023 Feb 8;14:1105616. PMID: 36846119] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9944715/pdf/fneur-14-1105616.pdf PDF]

'''Authors:''' Xia H, Yuan L, Zhao W, Zhang C, Zhao L, Hou J, Luan Y, Bi Y, Feng Y.

'''Institution:''' Department of Vascular Surgery, The First Affiliated Hospital of Kunming Medical University, Kunming, China.

'''Abstract:'''
'''Objective:''' This study aims to establish a radiomics-based machine learning model that predicts the risk of transient ischemic attack in patients with mild carotid stenosis (30-50% North American Symptomatic Carotid Endarterectomy Trial) using extracted computed tomography radiomics features and clinical information.

'''Methods:''' A total of 179 patients underwent carotid computed tomography angiography (CTA), and 219 carotid arteries with a plaque at the carotid bifurcation or proximal to the internal carotid artery were selected. The patients were divided into two groups; patients with symptoms of transient ischemic attack after CTA and patients without symptoms of transient ischemic attack after CTA. Then we performed random sampling methods stratified by the predictive outcome to obtain the training set (N = 165) and testing set (N = 66). [http://www.slicer.org '''3D Slicer'''] was employed to select the site of plaque on the computed tomography image as the volume of interest. An open-source package PyRadiomics in Python was used to extract radiomics features from the volume of interests. The random forest and logistic regression models were used to screen feature variables, and five classification algorithms were used, including random forest, eXtreme Gradient Boosting, logistic regression, support vector machine, and k-nearest neighbors. Data on radiomic feature information, clinical information, and the combination of these pieces of information were used to generate the model that predicts the risk of transient ischemic attack in patients with mild carotid artery stenosis (30-50% North American Symptomatic Carotid Endarterectomy Trial).

'''Results:''' The random forest model that was built based on the radiomics and clinical feature information had the highest accuracy (area under curve = 0.879; 95% confidence interval, 0.787-0.979). The combined model outperformed the clinical model, whereas the combined model showed no significant difference from the radiomics model.

'''Conclusion:''' The random forest model constructed with both radiomics and clinical information can accurately predict and improve discriminative power of computed tomography angiography in identifying ischemic symptoms in patients with carotid atherosclerosis. This model can aid in guiding the follow-up treatment of patients at high risk.
|}

==Deep Learning Enabled Multi-Organ Segmentation of Mouse Embryos==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36802342 Biol Open. 2023 Feb 15;12(2):bio059698. PMID: 36802342] | [https://cob.silverchair-cdn.com/cob/content_public/journal/bio/12/2/10.1242_bio.059698/2/bio059698.pdf PDF]

'''Authors:''' Rolfe SM, Whikehart SM, Maga AM.

'''Institution:''' Center for Developmental Biology and Regenerative Medicine, Seattle Children's Research Institute, Seattle, WA, USA.

'''Abstract:''' The International Mouse Phenotyping Consortium (IMPC) has generated a large repository of three-dimensional (3D) imaging data from mouse embryos, providing a rich resource for investigating phenotype/genotype interactions. While the data is freely available, the computing resources and human effort required to segment these images for analysis of individual structures can create a significant hurdle for research. In this paper, we present an open source, deep learning-enabled tool, Mouse Embryo Multi-Organ Segmentation (MEMOS), that estimates a segmentation of 50 anatomical structures with a support for manually reviewing, editing, and analyzing the estimated segmentation in a single application. MEMOS is implemented as an extension on the [http://www.slicer.org '''3D Slicer'''] platform and is designed to be accessible to researchers without coding experience. We validate the performance of MEMOS-generated segmentations through comparison to state-of-the-art atlas-based segmentation and quantification of previously reported anatomical abnormalities in a Cbx4 knockout strain. This article has an associated First Person interview with the first author of the paper.
|}

==Development and Validation of an 18FFDG-PET/CT Radiomic Model for Predicting Progression-Free Survival for Patients With Stage II - III Thoracic Esophageal Squamous Cell Carcinoma Who Are Treated With Definitive Chemoradiotherapy==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36794365 Acta Oncol. 2023 Feb;62(2):159-65. PMID: 36794365]

'''Authors:''' Takahashi N, Tanaka S, Umezawa R, Takanami K, Takeda K, Yamamoto T, Suzuki Y, Katsuta Y, Kadoya N, Jingu K.

'''Institution:''' Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Japan.

'''Abstract:'''
'''Background:''' Radiomics is a method for extracting a large amount of information from images and used to predict treatment outcomes, side effects and diagnosis. In this study, we developed and validated a radiomic model of [18F]FDG-PET/CT for predicting progression-free survival (PFS) of definitive chemoradiotherapy (dCRT) for patients with esophageal cancer.

'''Material and Methods:''' Patients with stage II - III esophageal cancer who underwent [18F]FDG-PET/CT within 45 days before dCRT between 2005 and 2017 were included. Patients were randomly assigned to a training set (85 patients) and a validation set (45 patients). Radiomic parameters inside the area of standard uptake value ≥ 3 were calculated. The open-source software [http://www.slicer.org '''3D Slicer'''] and Pyradiomics were used for segmentation and calculating radiomic parameters, respectively. Eight hundred sixty radiomic parameters and general information were investigated.In the training set, a radiomic model for PFS was made from the LASSO Cox regression model and Rad-score was calculated. In the validation set, the model was applied to Kaplan-Meier curves. The median value of Rad-score in the training set was used as a cutoff value in the validation set. JMP was used for statistical analysis. RStudio was used for the LASSO Cox regression model. p < 0.05 was defined as significant.

'''Results:''' The median follow-up periods were 21.9 months for all patients and 63.4 months for survivors. The 5-year PFS rate was 24.0%. In the training set, the LASSO Cox regression model selects 6 parameters and made a model. The low Rad-score group had significantly better PFS than that the high Rad-score group (p = 0.019). In the validation set, the low Rad-score group had significantly better PFS than that the high Rad-score group (p = 0.040).

'''Conclusions:''' The [18F]FDG-PET/CT radiomic model could predict PFS for patients with esophageal cancer who received dCRT.
|}

==Minimizing Magnetic Resonance Image Geometric Distortion at 7 Tesla for Frameless Presurgical Planning Using Skin-Adhered Fiducials==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36301228 Med Phys. 2023 Feb;50(2):694-701. PMID: 36301228]

'''Authors:''' Kirby KM, Koons EK, Welker KM, Fagan AJ.

'''Institution:''' Department of Radiology, Mayo Clinic, Rochester, MN, USA.

'''Abstract:'''
'''Background:''' 7T MRI offers significant benefits to spatial and contrast resolution compared to lower field strengths. This superior image quality can help better delineate targets in stereotactic neurosurgical procedures; however, the potential for increased geometric distortions at 7T has impaired its widespread use for these applications. Image geometric distortions can be due to distortions of B0 arising from tissue magnetic susceptibility effects or inherent field inhomogeneities, and nonlinearity of the magnetic field gradients.

'''Purpose:''' The purpose of this study was to investigate the use of 7T MRI for neurosurgical frameless stereotactic navigation procedures. Image geometric distortions at the skin surface in 7T images were minimized and compared to results from clinical 3T frameless imaging protocols.

'''Methods:''' A 3D-printed grid phantom filled with oil was designed to perform a fine calibration of the 7T imaging gradients, and an oil-filled head phantom with internal targets was used to determine ground truth (from computed tomography [CT]) positioning errors. Three volunteers and the head phantom were imaged consecutively at 3T and 7T. Ten skin-adhesive fiducial markers were placed on each subject's exposed skin surface at standard clinical placement locations for frameless procedures. Imaging sequences included MPRAGE (three bandwidths at 7T: 400, 690, and 1020 Hz/pixel, and one at 3T: 400 Hz/pixel), T2 SPACE, and T2 SPACE FLAIR acquisitions. An additional GRE field map was acquired on both scanners using a multi-echo GRE sequence. Custom Matlab code was used to perform additional distortion correction of the images using the unwrapped field maps. Fiducial localization was performed with [http://www.slicer.org '''3D Slicer'''], with absolute fiducial positioning errors determined in phantom experiments following rigid registration to the CT images. For human experiments, 3T and 7T images were registered and relative differences in fiducial locations were compared using two-tailed paired t-tests.

'''Results:''' Phantom measurements at 7T yielded gradient distance scaling errors of 1.1%, 2.2%, and 1.0% along the x-, y-, and z-axes, respectively. These system miscalibrations were traced back to phantom manufacturing deviations in the sphericity of the vendor's gradient calibration phantom. Correction factors along each gradient axis were applied, and afterward, geometric distortions of less than 1 mm were obtained in the 7T MR head phantom images for the 1020 Hz/pixel bandwidth MPRAGE sequence. For the human subjects, four fiducial locations were excluded from the analysis due to patient positioning differences. Differences between 3T and 7T MPRAGE with low/medium/high bandwidth were 2.2 /2.6/2.3 mm, respectively, before the correction, reducing to 1.6/1.3/1.0 mm after the correction (p < 0.001). T2 SPACE and T2 SPACE FLAIR yielded a similar pattern when the correction was applied, decreasing from 2.1 to 0.8 mm, and 2.6 to 1.0 mm, respectively.

'''Conclusions:''' 7T MRI can be used to perform frameless presurgical planning with skin-adhesive fiducials. Geometric distortions can be reduced to a clinically relevant level (errors < ∼1 mm) with no significant susceptibility-related distortions, by using high receiver bandwidth, ensuring gradients are properly calibrated, and placing skin fiducials in areas where distortions from patient positioning are minimal.
|}

==Acute Colonic Pseudo-Obstruction Secondary to Renal Calculus: A Case Report and Review of Pathophysiology==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36777972 Cureus. 2023 Feb 7;15(2):e34756. PMID: 36777972] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9905947/pdf/cureus-0015-00000034756.pdf PDF]

'''Authors:''' Gillies M, AlDujaili T.

'''Institution:''' General Surgery, Goulburn Valley Health, Shepparton, Australia

'''Abstract:''' Acute colonic pseudo-obstruction (ACPO) is obstruction of the large bowel without a mechanical cause. The exact mechanism remains incompletely understood but is thought to result from disruption to the autonomic regulation of the colon, typically in the context of hospitalized patients with medical illness, precipitating medications, or recent surgical intervention. This paper presents an unusual case of ACPO in an ambulatory patient with a recently passed renal calculus, explores the anatomy and physiology underlying the autonomic dysfunction theory of ACPO pathogenesis in the context of the case, and provides a 3D reconstruction of the patient's CT to illustrate the abrupt caliber change at the splenic flexure characteristic of ACPO.

'''Keywords:''' 3d reconstruction; acute colonic pseudo-obstruction; ogilvie's syndrome; renal calculi; [http://www.slicer.org '''3D Slicer'''] software.
|}

==A Novel Stereotactic Aspiration Technique for Intracerebral Hemorrhage==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36270590 World Neurosurg. 2023 Feb;170:e28-e36. PMID: 36270590]

'''Authors:''' Xu HZ, Guo J, Wang C, Liu X, Song ZQ, Chen RF, Qiu B, Wang Q, Huang Y.

'''Institution:''' Department of Neurosurgery, Civil Aviation General Hospital, Beijing, China.

'''Abstract:'''

'''Background:''' Minimally invasive surgery is effective and recommended for treatment of intracerebral hemorrhage; however, neurosurgeons in grass-root hospitals in underdeveloped countries lack effective and precise minimally invasive surgery techniques. The aim of this study was to present a technique of computed tomography angiography-based three-dimensional-printed navigation mold-guided stereotactic aspiration and demonstrate its clinical application using a hard needle in a series of patients.

'''Methods:''' The novel stereotactic aspiration technique was performed in 18 patients with spontaneous intracerebral hemorrhage at our center, and clinical outcomes were reported. We compared the volume of hematoma measured by 3 different methods: ABC/2 formula, manual segmentation with OsiriX, and manual segmentation with [http://www.slicer.org '''3D Slicer'''].

'''Results:''' The surgery was completed safely within an average operative time of 15.11 minutes, achieving the goal of <15 mL residual clot volume or >70% clot removal in all patients. No intracranial rebleeding or infection was observed postoperatively. At the end of the 6-month follow-up, 61.11% (11/18) of patients achieved a modified Rankin Scale score <3. There was overall better agreement of hematoma measurement using segmentation with [http://www.slicer.org '''3D Slicer'''] rather than ABC/2 measurement or hematoma measurement using segmentation with OsiriX.

'''Conclusions:''' Our novel method of stereotactic aspiration benefited patients in this study with good percent clot removal, few surgery-related complications, and a favorable prognosis. Manual segmentation with [http://www.slicer.org '''3D Slicer'''] could be used to provide the neurosurgeon with dependable information about hematoma volume. This cheap and convenient technique may be applied in grass-root hospitals in underdeveloped countries. Assessment in multicenter prospective clinical trials is needed.
|}

==Morphological Evaluation of the Normal and Hydrocephalic Third Ventricle on Cranial Magnetic Resonance Imaging in Children: A Retrospective Study==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35994062 Pediatr Radiol. 2023 Feb;53(2):282-96. PMID: 35994062]

'''Authors:''' Isıklar S, Turan Ozdemir S, Ozkaya G, Ozpar R, Parlak M.

'''Institution:''' Medical Imaging Techniques Program, Vocational School of Health Services, Bursa Uludag University, 16240, Bursa, Turkey.

'''Abstract:'''
'''Background:''' Third ventricle morphological changes reflect changes in the ventricular system in pediatric hydrocephalus, so visual inspection of the third ventricle shape is standard practice. However, normal pediatric reference data are not available.

'''Objective:''' To investigate both the normal development of the third ventricle in the 0-18-year age group and changes in its biometry due to hydrocephalus.

'''Materials and Methods:''' For this retrospective study, we selected individuals ages 0-18 years who had magnetic resonance imaging (MRI) from 2012 to 2020. We included 700 children (331 girls) who had three-dimensional (3-D) T1-weighted sequences without and 25 with hydrocephalus (11 girls). We measured the distances between the anatomical structures limiting the third ventricle by dividing the third ventricle into anterior and posterior regions. We made seven linear measurements and three index calculations using 3DSlicer and MRICloud pipeline, and we analyzed the results of 23 age groups in normal and hydrocephalic patients using SPSS (v. 23).

'''Results:''' Salient findings are: (1) The posterior part of the third ventricle is more affected by both developmental and hydrocephalus-related changes. (2) For third ventricle measurements, gender was insignificant while age was significant. (3) Normal third ventricular volumetric development showed a segmental increase in the 0-18 age range. The hydrocephalic third ventricle volume cut-off value in this age group was 3 cm3.

'''Conclusion:''' This study describes third ventricle morphometry using a linear measurement method. The ratios defined in the midsagittal plane were clinically useful for diagnosing the hydrocephalic third ventricle. The linear and volumetric reference data and ratios are expected to help increase diagnostic accuracy in distinguishing normal and hydrocephalic third ventricles.
|}

==Henri IV of France's Larynx 3D Reconstitution==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36149490 Eur Arch Otorhinolaryngol. 2023 Feb;280(2):919-24. PMID: 36149490]

'''Authors:''' Baudouin R, Amelot A, Laprie Y, Crevier-Buchman L, Maeda S, Huynh-Charlier I, Hans S, Charlier P.

'''Institution:''' Department of Otolaryngology-Head & Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Université Paris Saclay), Montigny-le-Bretonneux, France.

'''Abstract:''' Objectives: King Henri IV of France (reign from 1589 to 1610) was one of the most important kings of France. Embalmed and buried in Saint-Denis, his remains were beheaded in 1793. His head (including his larynx) survived in successive private collections until its definitive identification in 2010. The purpose of the study was to provide a morphologic study of the larynx with a 3D reconstitution.

'''Methods:''' A flexible endoscopy was performed via the mouth and via the trachea. Measures of the larynx (vocal folds lengths, thickness, width, larynx height) were collected from the CT-scan by a panel of experts blind each other. The segmentation of the laryngeal anatomical components (vocal folds, cartilages) was performed using [http://www.slicer.org '''3D Slicer''']. Mesh smoothing and 3D reconstitution were performed using Fusion 360®. Reconstitution was discussed between the experts. Decision was made by consensus after discussion.

'''Results:''' Cricoid, thyroid, arytenoid cartilages, vocal folds and hyoid bone were identified and a computed 3D reconstitution of the larynx was made. The laryngeal 3D model appeared morphologically similar to a living subject. Measures were similar but smaller than those of a modern subject.

'''Conclusions:''' The 3D reconstitution of the larynx of Henri IV of France was conducted from the CT-scan of his mummified head. This work constitutes a first valuable morphologic analysis of a larynx from an embalmed individual. This anatomical work is the first step towards the reconstruction of the voice of this historical character, which we hope to concretize with computer modeling tools in a second step.
|}

==Development and External Validation of a Novel Nomogram to Predict Prostate Cancer in Biopsy-Naïve Patients With PSA <10 Ng/Ml and PI-RADS v2.1 = 3 Lesions==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35920264 Cancer Med. 2023 Feb;12(3):2560-71. PMID: 35920264] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9939143/pdf/CAM4-12-2560.pdf PDF]

'''Authors:''' Hu C, Sun J, Xu Z, Zhang Z, Zhou Q, Xu J, Chen H, Wang C, Ouyang J.

'''Institution:''' Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.

'''Abstract:'''
'''Objective:''' To develop and externally validate a novel nomogram in biopsy-naïve patients with prostate-specific antigen (PSA) <10 ng/ml and PI-RADS v2.1 = 3 lesions.

'''Methods:''' We retrospectively collected 307 men that underwent initial biopsy from October 2015 to January 2022 in Cohort 1 (The First Affiliated Hospital of Soochow University). External cohort (Cohort 2, Kunshan Hospital) included 109 men that met our criteria from July 2016 to June 2021. By [http://www.slicer.org '''3D Slicer'''] Software, the volume of all lesions was divided into two subgroups (PI-RADS v2.1 = 3a and 3b). Logistic regression analysis was performed to screen for variables and construct nomogram by analyzing clinical data from Cohort 1. Receiver operating characteristics curve analysis, calibration plot and decision curve analysis (DCA) were plotted to validate the nomogram in external cohort.

'''Results:''' A total of 70 (22.8%) patients was diagnosed with prostate cancer in Institution 1. Among them, 34 (11.1%) had clinically significant prostate cancer (csPCa). Age, prostate-specific antigen density, digital rectal examination, PI-RADS v2.1 = 3 subgroups (3a and 3b) and apparent diffusion coefficient (ADC, <750 mm2 /s) were predictive factors for prostate cancer (PCa) and csPCa. High area under the curve of the nomogram was found in Cohort 1 and Cohort 2 for PCa (0.857 vs. 0.850) and for csPCa (0.896 vs. 0.893). Calibration curves showed excellent agreement between the predicted probability and actual risk for the models in internal and external validation. The DCA demonstrated net benefit of our nomogram.

'''Conclusion:''' Until now, this is the first nomogram that predicts PCa and csPCa in biopsy-naïve patients with PSA <10 ng/ml and PI-RADS v2.1 = 3 lesions. Furthermore, PI-RADS v2.1 = 3 subgroups were considered to be an independent risk factor in our model. Our nomogram may assist urologists in biopsy decision making for these so-called "double gray zone" patients.
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==A Three-Dimensionally Printed Otological Model for Cholesteatoma Mastoidectomy Training==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35789285 Eur Arch Otorhinolaryngol. 2023 Feb;280(2):671-80. PMID: 35789285]

'''Authors:''' de Souza MA, Bento RF, Lopes PT.

'''Institution:''' Otolaryngology Department, University of São Paulo School of Medicine, São Paulo, Brazil.

'''Abstract:'''
'''purpose:''' To relate the creation and expert validation (face and content validity) of an affordable three-dimensional (3D) printed model of temporal bones with chronic otitis media with cholesteatoma (COMC) as a simulator for mastoidectomy.

'''Methods:''' We performed computed tomography (CT) of the temporal bones of a patient with COMC followed at the University of São Paulo (USP) Hospital with [http://www.slicer.org '''3D Slicer'''] to create a 3-D model of the affected bone using light-curing resin and silicone (cholesteatoma). The final 3-D printed images were scored by 10 otologists using a customized version of the Michigan Standard Simulation Scale Experience (MiSSES). Internal consistency and inter-rater reliability were assessed using Cronbach's α and intraclass correlations.

'''Results:''' Otologists consistently scored the model positively for fidelity, educational value, reactions, and the overall model quality. Nine otologists agreed that the model was a good educational device for surgical training of COMC. All experts deemed the model ready-or nearly ready-for use. The final cost of the model, including raw materials and manufacturing, was 120 USD.

'''Conclusions:''' Using 3D printing technology, we created the first anatomically accurate, low-cost, disease-reproducing 3D model of temporal bones for mastoidectomy training for cholesteatoma.
|}

==Development of a Navigable 3D Virtual Model of Temporal Bone Anatomy==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36704866 J Vis Commun Med. 2023 Jan 26:1-5. PMID: 36704866] | [https://www.tandfonline.com/doi/full/10.1080/17453054.2023.2169110 PDF]

'''Authors:''' Sareen K.

'''Institution:''' Sant Parmanand Hospital, New Delhi, India.

'''Abstract:'''
'''Background:''' Computed Tomography (CT) scanning offers an accurate structural definition of bones, blood vessels, and soft tissues; however, mental integration of cross-sectional 2D CT images for a 3D understanding of complex anatomical structures becomes difficult when the field of view is confined to the temporal bone. This project tried to provide a feasible solution to this problem by creating a navigable 3D virtual model which may aid in better comprehension of the temporal bone anatomy.

'''Methods:''' A helical-CT scan was used to obtain high-resolution cross-sectional slices of a cadaveric human temporal bone. Using the volume-rendering capabilities of [http://www.slicer.org '''3D Slicer'''], which involves volume data management, cropping of the data set, and threshold painting, detailed anatomical structures were segmented based on the intensity captured from different regions. This volumetric data was converted to an interactive virtual model using Blender®.

'''Results:''' The final product is a web page that allows interaction and navigation with a 3D annotated model of the temporal bone, which can be accessed from any device with a web browser.

'''Conclusion:''' This model can function as a training tool for students, teachers, and practitioners to understand and review the complex anatomy of the temporal bone.
|}

==Maxillary Antral Pseudocyst Drift after Osteotome Sinus Floor Elevation with Simultaneous Implant Placement: A Case Report and Literature Review==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36769568 J Clin Med. 2023 Jan 24;12(3):920. PMID: 36769568] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9917374/pdf/jcm-12-00920.pdf PDF]

'''Authors:''' Wang P, Huang N, Ren J, Gong P, Long J, Huang B.

'''Institution:''' West China School of Stomatology, Sichuan University, Chengdu, China.

'''Abstract:''' This report describes maxillary antral pseudocyst drift after maxillary sinus floor augmentation through osteotome sinus floor elevation with simultaneous implant placement. [http://www.slicer.org '''3D Slicer'''] was used to measure the pseudocyst and maxilla for the placement of the implants; follow-up visits were scheduled at 6, 12, and 22 months. No adverse effects were observed during or after surgery, and all implants exhibited osseointegration without mobility. At 6 months after surgery, the pseudocyst had moved posterolaterally from the preoperative position near the anterior medial maxillary sinus, then returned to its original position at 12 months. However, it had remigrated to the posterolateral position at 22 months. The preoperative volume of the pseudocyst was 3.795 mm3; it was 2.370, 3.439, and 2.930 mm3 at 6, 12, and 22 months after surgery, respectively. The changes in pseudocyst drift and volume did not have a substantial negative influence on the implants, presumably because of cystic attachment and the recurrence of multiple pseudocysts at different locations. The risks associated with changes in a pseudocyst can be avoided, if an appropriate treatment plan is selected.
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==Radiomic Analysis Based on Magnetic Resonance Imaging for Predicting PD-L2 Expression in Hepatocellular Carcinoma==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36672315 Cancers (Basel). 2023 Jan 5;15(2):365. PMID: 36672315] | [http://www.ncbi.nlm.nih.gov/pmc/articles/pmc9856314/ PDF]

'''Authors:''' Tao YY, Shi Y, Gong XQ, Li L, Li ZM, Yang L, Zhang XM.

'''Institution:''' Medical Imaging Key Laboratory of Sichuan Province, Interventional Medical Center, Department of Radiology, Medical Research Center, Affiliated Hospital of North Sichuan Medical College, Nanchong, China.

'''Abstract:''' Hepatocellular carcinoma (HCC) is the sixth most common malignant tumour and the third leading cause of cancer death in the world. The emerging field of radiomics involves extracting many clinical image features that cannot be recognized by the human eye to provide information for precise treatment decision making. Radiomics has shown its importance in HCC identification, histological grading, microvascular invasion (MVI) status, treatment response, and prognosis, but there is no report on the preoperative prediction of programmed death ligand-2 (PD-L2) expression in HCC. The purpose of this study was to investigate the value of MRI radiomic features for the non-invasive prediction of immunotherapy target PD-L2 expression in hepatocellular carcinoma (HCC). A total of 108 patients with HCC confirmed by pathology were retrospectively analysed. Immunohistochemical analysis was used to evaluate the expression level of PD-L2. [http://www.slicer.org '''3D Slicer'''] software was used to manually delineate volumes of interest (VOIs) and extract radiomic features on preoperative T2-weighted, arterial-phase, and portal venous-phase MR images. Least absolute shrinkage and selection operator (LASSO) was performed to find the best radiomic features. Multivariable logistic regression models were constructed and validated using fivefold cross-validation. The area under the receiver characteristic curve (AUC) was used to evaluate the predictive performance of each model. The results show that among the 108 cases of HCC, 50 cases had high PD-L2 expression, and 58 cases had low PD-L2 expression. Radiomic features correlated with PD-L2 expression. The T2-weighted, arterial-phase, and portal venous-phase and combined MRI radiomics models showed AUCs of 0.789 (95% CI: 0.702-0.875), 0.727 (95% CI: 0.632-0.823), 0.770 (95% CI: 0.682-0.875), and 0.871 (95% CI: 0.803-0.939), respectively. The combined model showed the best performance. The results of this study suggest that prediction based on the radiomic characteristics of MRI could noninvasively predict the expression of PD-L2 in HCC before surgery and provide a reference for the selection of immune checkpoint blockade therapy.
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==Correlation Between Unilateral Internal Carotid Artery Stenosis and Asymmetric Distribution of Enlarged Perivascular Spaces in Patients With Acute Cerebral Infarction==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36649988 Zhonghua Yi Xue Za Zhi. 2023 Jan 17;103(3):178-185. PMID: 36649988]

'''Authors:''' Jian XL, Zhang M, Yun WW.

'''Abstract:'''
'''Objective:''' To explore the correlation between unilateral internal carotid artery (ICA) stenosis and asymmetrical distribution of enlarged perivascular spaces (EPVS) in patients with acute cerebral infarction.

'''Methods:''' Acute cerebral infarction patients with unilateral ICA stenosis hospitalized in Changzhou Second People's Hospital from October 2020 to December 2021 were collected. Routine cranial MRI and CT angiography were completed for each patient. The [http://www.slicer.org '''3D Slicer'''] software was used to quantitatively analyze the volume of patient's EPVS. Patients were divided into moderate stenosis group and severe stenosis/occlusion group according to the degree of ICA stenosis. Baseline data were compared between the two groups. Patients were further divided into three groups: moderate stenosis, severe stenosis and occlusion groups, and the ipsilateral and contralateral EPVS volume of ICA stenosis patients was compared. The asymmetry index (AI) was calculated for EPVS in the basal ganglia region (BG-EPVS) and EPVS in the centrum semiovale (CSO-EPVS). Patients with AI≥0.2 were included in the EPVS asymmetry group, while the rest were in the EPVS symmetry group, and the degree of unilateral ICA stenosis was compared between the two groups. Multivariate logistic regression model was used to analyze the relationship between ICA severe stenosis/occlusion and the asymmetric distribution of BG-EPVS.

'''Results:''' A total of 122 patients (96 males and 26 females) were enrolled, aged (70±10) years, with 81 cases in the unilateral ICA severe stenosis/occlusion group (46 cases of severe stenosis and 35 of occlusion) and 41 cases in the moderate stenosis group. Patients in the unilateral ICA severe stenosis/occlusion group had greater BG-EPVS volume [(4.08±0.76) mm3]and proportion of asymmetric distribution of BG-EPVS [75.3%(61/81)] than those of the moderate stenosis group [(3.12±0.85) mm3 and 39.0% (16/41)], with statistically significant differences (both P<0.001). The BG-EPVS volumes of the ipsilateral side of the stenosis in the severe stenosis group and the occlusion group [(3.34±0.86) mm3 and (3.93±0.60) mm3] were significantly greater than those of the contralateral side [(2.65±1.28) mm3 and (3.21±0.88) mm3], with statistically significant differences (both P<0.001). Correlation analysis indicated that the degree of unilateral ICA stenosis was positively correlated with the BG-EPVS volume on the stenosis side (r=0.62, P<0.001). Further comparison of the degree of unilateral ICA stenosis between the EPVS symmetric and asymmetric groups showed that the proportion of unilateral ICA severe stenosis/occlusion in the BG-EPVS asymmetry group was higher than that in the symmetric group [79.2%(61/77) vs 44.4%(20/45),P<0.001]. Multivariate logistic regression analysis showed that unilateral ICA severe stenosis/occlusion (OR=4.280, 95%CI: 1.743-10.508, P =0.002) and age (OR=1.055, 95%CI: 1.001-1.112, P=0.044) were risk factors for asymmetric distribution of BG-EPVS.

'''Conclusions:''' The severe stenosis/occlusion of the unilateral ICA and age are the risk factors for the asymmetric distribution of the BG-EPVS in patients with acute cerebral infarction. The ipsilateral EPVS volume of unilateral ICA stenosis is larger than that of the contralateral side, and the degree of ICA stenosis is positively correlated with the severity of BG-EPVS.
|}

==Radiomics to Predict the Mortality of Patients With Rheumatoid Arthritis-Associated Interstitial Lung Disease: A Proof-of-Concept Study==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36698825 Front Med (Lausanne). 2023 Jan 9;9:1069486. PMID: 36698825] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9870287/pdf/fmed-09-1069486.pdf PDF]

'''Authors:''' Venerito V, Manfredi A, Lopalco G, Lavista M, Cassone G, Scardapane A, Sebastiani M, Iannone F.

'''Institution:''' Rheumatology Unit, Department of Emergency and Organ Transplantation, University of Bari Aldo Moro, Bari, Italy.

'''Abstract:''' Objectives: Patients with rheumatoid arthritis (RA) and interstitial lung disease (ILD) have increased mortality compared to the general population and factors capable of predicting RA-ILD long-term clinical outcomes are lacking. In oncology, radiomics allows the quantification of tumour phenotype by analysing the characteristics of medical images. Using specific software, it is possible to segment organs on high-resolution computed tomography (HRCT) images and extract many features that may uncover disease characteristics that are not detected by the naked eye. We aimed to investigate whether features from whole lung radiomic analysis of HRCT may alone predict mortality in RA-ILD patients.

'''Methods:''' High-resolution computed tomographies of RA patients from January 2012 to March 2022 were analyzed. The time between the first available HRCT and the last follow-up visit or ILD-related death was recorded. We performed a volumetric analysis in [http://www.slicer.org '''3D Slicer'''], automatically segmenting the whole lungs and trachea via the Lung CT Analyzer. A LASSO-Cox model was carried out by considering ILD-related death as the outcome variable and extracting radiomic features as exposure variables.

'''Results:''' We retrieved the HRCTs of 30 RA-ILD patients. The median survival time (interquartile range) was 48 months (36-120 months). Thirteen out of 30 (43.33%) patients died during the observation period. Whole line segmentation was fast and reliable. The model included either the median grey level intensity within the whole lung segmentation [high-resolution (HR) 9.35, 95% CI 1.56-55.86] as a positive predictor of death and the 10th percentile of the number of included voxels (HR 0.20, 95% CI 0.05-0.84), the voxel-based pre-processing information (HR 0.23, 95% CI 0.06-0.82) and the flatness (HR 0.42, 95% CI 0.18-0.98), negatively correlating to mortality. The correlation of grey level values to their respective voxels (HR 1.52 95% CI 0.82-2.83) was also retained as a confounder.

'''Conclusion:''' Radiomic analysis may predict RA-ILD patients' mortality and may promote HRCT as a digital biomarker regardless of the clinical characteristics of the disease.
|}

==Evaluation of the Prognosis of Acute Subdural Hematoma According to the Density Differences Between Gray and White Matter==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36686517 Front Neurol. 2023 Jan 6;13:1024018. PMID: 36686517] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9853902/ PDF]

'''Authors:''' Li Z, Feng Y, Wang P, Han S, Zhang K, Zhang C, Lu S, Lv C, Zhu F, Bie L.

'''Institution:''' Department of Neurosurgery of the First Clinical Hospital, Jilin University, Changchun, China.

'''Abstract:'''
'''Objective:''' Acute subdural hematoma (ASDH) is a common neurological emergency, and its appearance on head-computed tomographic (CT) imaging helps guide clinical treatment. To provide a basis for clinical decision-making, we analyzed that the density difference between the gray and white matter of the CT image is associated with the prognosis of patients with ASDH.

'''Methods:''' We analyzed the data of 194 patients who had ASDH as a result of closed traumatic brain injury (TBI) between 2018 and 2021. The patients were subdivided into surgical and non-surgical groups, and the non-surgical group was further subdivided into "diffused [hematoma]" and "non-diffused" groups. The control group's CT scans were normal. The [http://www.slicer.org '''3D Slicer'''] software was used to quantitatively analyze the density of gray and white matter depicted in the CT images.

'''Results:''' Imaging evaluation showed that the median difference in density between the gray and white matter on the injured side was 4.12 HU (IQR, 3.91-4.22 HU; p < 0.001) and on the non-injured side was 4.07 HU (IQR, 3.90-4.19 HU; p < 0.001), and the hematoma needs to be surgically removed. The median density difference value of the gray and white matter on the injured side was 3.74 HU (IQR, 3.53-4.01 HU; p < 0.001) and on the non-injured side was 3.71 HU (IQR, 3.69-3.73 HU; p < 0.001), and the hematoma could diffuse in a short time.

'''Conclusion:''' Quantitative analysis of the density differences in the gray and white matter of the CT images can be used to evaluate the clinical prognosis of patients with ASDH.
|}

==The Knosp Criteria Revisited: 3-Dimensional Volumetric Analysis as a Predictive Tool for Extent of Resection in Complex Endoscopic Pituitary Surgery==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36170168 Front Oncol. Neurosurgery. 2023 Jan 1;92(1):179-85. PMID: 36170168]

'''Authors:''' DiRisio AC, Feng R, Shuman WH, Platt S, Price G, Dullea JT, Gilja S, D'Andrea MR, Delman BN, Bederson JB, Shrivastava RK.

'''Institution:''' Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.

'''Abstract:'''
'''Background:''' The Knosp criteria have been the historical standard for predicting cavernous sinus invasion, and therefore extent of surgical resection, of pituitary macroadenomas. Few studies have sought to reappraise the utility of this tool after recent advances in visualization and modeling of tumors in complex endoscopic surgery.

'''Objective:''' To evaluate our proposed alternative method, using 3-dimensional (3D) volumetric imaging, and whether it can better predict extent of resection in nonfunctional pituitary adenomas.

'''Methods:''' Patients who underwent endoscopic transsphenoidal resection of pituitary macroadenomas at our institution were reviewed. Information was collected on neurological, endocrine, and visual function. Volumetric segmentation was performed using [http://www.slicer.org '''3D Slicer'''] software. Relationship of tumor volume, clinical features, and Knosp grade on extent of resection was examined.

'''Results:''' One hundred forty patients were identified who had transsphenoidal resection of nonfunctional pituitary adenomas. Macroadenomas had a median volume of 6 cm3 (IQR 3.4-8.7), and 17% had a unilateral Knosp grade of at least 3B. On multiple logistic regression, only smaller log-transformed preoperative tumor volume was independently associated with increased odds of gross total resection (GTR; odds ratio: 0.27, 95% CI: 0.07-0.89, P < .05) when controlling for tumor proliferative status, age, and sex (area under the curve 0.67). The Knosp criteria did not independently predict GTR in this cohort (P > .05, area under the curve 0.46).

'''Conclusion:''' Increasing use of volumetric 3D imaging may better anticipate extent of resection compared with the Knosp grade metric and may have a greater positive predictive value for GTR. More research is needed to validate these findings and implement them using automated methods.
|}

==Differentiation of Lung Metastases Originated From Different Primary Tumors Using Radiomics Features Based on CT Imaging==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35577699 Acad Radiol. 2023 Jan;30(1):40-6. PMID: 35577699]

'''Authors:''' Shang H, Li J, Jiao T, Fang C, Li K, Yin D, Zeng Q.

'''Institution:''' Department of Radiology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, No. 16766 Jingshi Road, Jinan, Shandong, China.

'''Abstract:''' Rationale and objectives: To explore the feasibility of differentiating three predominant metastatic tumor types using lung computed tomography (CT) radiomics features based on supervised machine learning.

'''Materials and Methods:''' This retrospective analysis included 252 lung metastases (LM) (from 78 patients), which were divided into the training (n = 176) and test (n = 76) cohort randomly. The metastases originated from colorectal cancer (n = 97), breast cancer (n = 87), and renal carcinoma (n = 68). An additional 77 LM (from 35 patients) were used for external validation. All radiomics features were extracted from lung CT using an open-source software, [http://www.slicer.org '''3D Slicer''']. The least absolute shrinkage and selection operator (LASSO) method selected the optimal radiomics features to build the model. Random forest and support vector machine (SVM) were selected to build three-class and two-class models. The performance of the classification model was evaluated with the area under the receiver operating characteristic curve (AUC) by two strategies: one-versus-rest and one-versus-one.

'''Results:''' Eight hundred and fifty-one quantitative radiomics features were extracted from lung CT. By LASSO, 23 optimal features were extracted in three-class, and 25, 29, and 35 features in two-class for differentiating every two of three LM (colorectal cancer vs. renal carcinoma, colorectal cancer vs. breast cancer, and breast cancer vs. renal carcinoma, respectively). The AUCs of the three-class model were 0.83 for colorectal cancer, 0.79 for breast cancer, and 0.91 for renal carcinoma in the test cohort. In the external validation cohort, the AUCs were 0.77, 0.83, and 0.81, respectively. Swarmplot shows the distribution of radiomics features among three different LM types. In the two-class model, high accuracy and AUC were obtained by SVM. The AUC of discriminating colorectal cancer LM from renal carcinoma LM was 0.84, and breast cancer LM from colorectal cancer LM and renal carcinoma LM were 0.80 and 0.94, respectively. The AUCs were 0.77, 0.78, and 0.84 in the external validation cohort.

'''Conclusion:''' Quantitative radiomics features based on Lung CT exhibited good discriminative performance in LM of primary colorectal cancer, breast cancer, and renal carcinoma.
|}

==MRI Radiomic Features of Peritumoral Edema May Predict the Recurrence Sites of Glioblastoma Multiforme==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36686829 Front Oncol. 2023 Jan 4;12:1042498. PMID: 36686829] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9845721/pdf/fonc-12-1042498.pdf PDF]

'''Authors:''' Long H, Zhang P, Bi Y, Yang C, Wu M, He D, Huang S, Yang K, Qi S, Wang J.

'''Institution:''' Department of Neurosurgery, Nanfang Hospital, Southern Medical University, Guangzhou, China.

'''Abstract:'''

'''Background and Purpose:''' As one of the most aggressive malignant tumor in the central nervous system, the main cause of poor outcome of glioblastoma (GBM) is recurrence, a non-invasive method which can predict the area of recurrence pre-operation is necessary.To investigate whether there is radiological heterogeneity within peritumoral edema and identify the reproducible radiomic features predictive of the sites of recurrence of glioblastoma(GBM), which may be of value to optimize patients' management.

'''Materials and Methods:''' The clinical information and MR images (contrast-enhanced T1 weighted and FLAIR sequences) of 22 patients who have been histologically proven glioblastoma, were retrospectively evaluated. Kaplan-Meier methods was used for survival analysis. Oedematous regions were manually segmented by an expert into recurrence region, non-recurrence region. A set of 94 radiomic features were obtained from each region using the function of analyzing MR image of [http://www.slicer.org '''3D Slicer''']. Paired t test was performed to identify the features existing significant difference. Subsequently, the data of two patients from TCGA database was used to evaluate whether these features have clinical value.

'''Results:''' Ten features with significant differences between the recurrence and non-recurrence subregions were identified and verified on two individual patients from the TCGA database with pathologically confirmed diagnosis of GBM.

'''Conclusions:''' Our results suggested that heterogeneity does exist in peritumoral edema, indicating that the radiomic features of peritumoral edema from routine MR images can be utilized to predict the sites of GBM recurrence. Our findings may further guide the surgical treatment strategy for GBM.
|}

==Clinical Study on Application of 3D Slicer Software Assisted Domestic Frameless Stereotactic Robot in Biopsy of Intracranial Lesions==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36603886 Zhonghua Wai Ke Za Zhi. 2023 Jan 1;61(1):61-65. PMID: 36603886] | [http://www.ncbi.nlm.nih.gov/pmc/articles/pmc9849352/ PDF]

'''Authors:''' Chen H, Yan X, He F, Ding SC, Diao JF, Guo H, Cao SM, Yang CJ, Yin F.

'''Institution:''' Department of Neurosurgery, Aerospace Central Hospital, Beijing, China.

'''Abstract:'''
'''Objective:''' To examine the application value of [http://www.slicer.org '''3D Slicer'''] software assisted domestic frameless stereotactic robot in biopsy of intracranial lesions.

'''Methods:''' A retrospective analysis was performed on 80 patients who admitted consecutively and underwent intracerebral lesions biopsy with the domestic frameless stereotactic robot at Department of Neurosurgery, Aerospace Central Hospital from January 2019 to December 2021. There were 36 males and 44 females, with a mean age of (38.5±18.0) years (range: 6 to 71 years). Before surgery only enhanced T1-weighted three-dimensional magnetization prepared gradient echo sequences and diffusion tensor imaging scans were performed. Self-reconstruction of intracranial lesions, cerebral cortex and blood vessels was carried out using 3D Slicer software system after the DICOM format imaging data of 80 patients were collected. These imaging data were merged to the workstation of the domestic frameless stereotactic robot for preoperative surgical planning and the surgical puncture path was designed to avoid blood vessels in the brain functional area, cerebral cortex and sulcus.

'''Results:''' All frameless stereotactic biopsy were successfully performed. Postoperative pathological diagnosis included 50 cases of diffuse astrocytic and oligodendroglioma, 15 cases of lymphoma, 5 cases of metastatic tumors, 5 cases of inflammatory demyelinating disease, 2 cases of inflammatory granuloma, 1 case of hemangioma, 1 case of acute lymphoblastic leukemia intracranial invasion and 1 case of seminoma. The positive diagnosis rate was 100% (80/80). Postoperative imaging confirmed that the puncture path and target were accurately implemented according to the preoperative planning, and the target error was (1.32±0.44) mm (range: 0.55 to 1.99 mm). One case of puncture-related bleeding occurred at the target after surgery and improved after treatment.

'''Conclusion:''' The three-dimensional multimodal images reconstructed by the 3D Slicer software before operation could help the surgeons make the preoperative planning and reduce the risk of stereotactic brain biopsy.
|}

==Liver Cirrhosis and Tumor Location Can Affect the Range of Intrahepatic Microwave Ablation Zone==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36854449 Int J Hyperthermia. 2023;40(1):2181843. PMID: 36854449] | [https://www.tandfonline.com/doi/epdf/10.1080/02656736.2023.2181843?needAccess=true&role=button PDF]

'''Authors:''' Ding WZ, Wei H, Wu JP, Cheng ZG, Han ZY, Liu FY, Yu J, Liang P.

'''Institution:''' Fifth Medical Center of Chinese, PLA General Hospital, Beijing, China.

'''Abstract:'''
'''Background:''' The range of an ablation zone (AZ) plays a crucial role in the treatment effect of microwave ablation (MWA). The aim of this study was to analyze the factors influencing the AZ range.

'''Methods:''' Fourteen factors in four areas were included: patient-related factors (sex, age), disease-related factors (tumor location, liver cirrhosis), serological factors (ALT, AST, total protein, albumin, total bilirubin, direct bilirubin, and platelets), and MWA parameters (ablation time, power, and needle type). Multiple sequence MRI was used to delineate AZ by three radiologists using [http://www.slicer.org '''3D Slicer''']. MATLAB was used to calculate the AZ length, width, and area of the largest section. Linear regression analysis was used to analyze influencing factors. Moreover, a subgroup analysis was conducted for patients with viral hepatitis.

'''Result:''' 220 patients with 290 tumors were included between 2010-2021. In addition to MWA parameters, cirrhosis and tumor location were significant factors that influenced AZ (p < 0.001). The standardized coefficient (beta) of cirrhosis (cirrhosis vs. non-cirrhosis) was positive, which meant cirrhosis would lead to a decrease in AZ range. The beta of tumor location (near the hepatic hilar zone, intermediate zone, and periphery zone) was negative, indicating that AZ range decreased as the tumor location approached the hepatic hilum. For viral hepatitis patients, Fibrosis 4 (FIB4) score was a significant factor influencing AZ (p < 0.001), and the beta was negative, indicating that AZ range decreased as FIB4 increased.

'''Conclusion:''' Liver cirrhosis, tumor location, and FIB4 affect the AZ range and should be considered when planning MWA parameters.
|}

==A Magnetic Resonance Imaging Based Radiomics Model to Predict Mitosis Cycles in Intracranial Meningioma==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36653482 Sci Rep. 2023 Jan 18;13(1):969. PMID: 36653482] | [http://www.ncbi.nlm.nih.gov/pmc/articles/pmc9849352/ PDF]

'''Authors:'''Krähling H, Musigmann M, Akkurt BH, Sartoretti T, Sartoretti E, Henssen DJHA, Stummer W, Heindel W, Brokinkel B, Mannil M.

'''Institution:''' University Clinic for Radiology, University Hospital Muenster, Westfälische Wilhelms-University Muenster, Muenster, Germany.

'''Abstract:''' The aim of this study was to develop a magnetic resonance imaging (MRI) based radiomics model to predict mitosis cycles in intracranial meningioma grading prior to surgery. Preoperative contrast-enhanced T1-weighted (T1CE) cerebral MRI data of 167 meningioma patients between 2015 and 2020 were obtained, preprocessed and segmented using the [http://www.slicer.org '''3D Slicer'''] software and the PyRadiomics plugin. In total 145 radiomics features of the T1CE MRI images were computed. The criterion on the basis of which the feature selection was made is whether the number of mitoses per 10 high power field (HPF) is greater than or equal to zero. Our analyses show that machine learning algorithms can be used to make accurate predictions about whether the number of mitoses per 10 HPF is greater than or equal to zero. We obtained our best model using Ridge regression for feature pre-selection, followed by stepwise logistic regression for final model construction. Using independent test data, this model resulted in an AUC (Area under the Curve) of 0.8523, an accuracy of 0.7941, a sensitivity of 0.8182, a specificity of 0.7500 and a Cohen's Kappa of 0.5576. We analyzed the performance of this model as a function of the number of mitoses per 10 HPF. The model performs well for cases with zero mitoses as well as for cases with more than one mitosis per 10 HPF. The worst model performance (accuracy = 0.6250) is obtained for cases with one mitosis per 10 HPF. Our results show that MRI-based radiomics may be a promising approach to predict the mitosis cycles in intracranial meningioma prior to surgery. Specifically, our approach may offer a non-invasive means of detecting the early stages of a malignant process in meningiomas prior to the onset of clinical symptoms.
|}

==Advantages of a Training Course for Surgical Planning in Virtual Reality for Oral and Maxillofacial Surgery: Crossover Study==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36656632 JMIR Serious Games. 2023 Jan 19;11:e40541. PMID: 36656632] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9947820/?report=printable PDF]

'''Authors:''' Ulbrich M, Van den Bosch V, Bönsch A, Gruber LJ, Ooms M, Melchior C, Motmaen I, Wilpert C, Rashad A, Kuhlen TW, Hölzle F, Puladi B.

'''Institution:''' Department of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Aachen, Germany.

'''Abstract:'''
'''Background:''' As an integral part of computer-assisted surgery, virtual surgical planning (VSP) leads to significantly better surgery results, such as for oral and maxillofacial reconstruction with microvascular grafts of the fibula or iliac crest. It is performed on a 2D computer desktop screen (DS) based on preoperative medical imaging. However, in this environment, VSP is associated with shortcomings, such as a time-consuming planning process and the requirement of a learning process. Therefore, a virtual reality (VR)-based VSP application has great potential to reduce or even overcome these shortcomings due to the benefits of visuospatial vision, bimanual interaction, and full immersion. However, the efficacy of such a VR environment has not yet been investigated.

'''Objective:''' This study aimed to demonstrate the possible advantages of a VR environment through a substep of VSP, specifically the segmentation of the fibula (calf bone) and os coxae (hip bone), by conducting a training course in both DS and VR environments and comparing the results.

'''Methods:''' During the training course, 6 novices were taught how to use a software application in a DS environment, [http://www.slicer.org '''3D Slicer''']) and in a VR environment (Elucis) for the segmentation of the fibula and os coxae, and they were asked to carry out the maneuvers as accurately and quickly as possible. Overall, 13 fibula and 13 os coxae were segmented for each participant in both methods (VR and DS), resulting in 156 different models (78 fibula and 78 os coxae) per method (VR and DS) and 312 models in total. The individual learning processes in both environments were compared using objective criteria (time and segmentation performance) and self-reported questionnaires. The models resulting from the segmentation were compared mathematically (Hausdorff distance and Dice coefficient) and evaluated by 2 experienced radiologists in a blinded manner.

'''Results:''' A much faster learning curve was observed for the VR environment than the DS environment (β=.86 vs β=.25). This nearly doubled the segmentation speed (cm3/min) by the end of training, leading to a shorter time (P<.001) to reach a qualitative result. However, there was no qualitative difference between the models for VR and DS (P=.99). The VR environment was perceived by participants as more intuitive and less exhausting, and was favored over the DS environment.

'''Conclusions:''' The more rapid learning process and the ability to work faster in the VR environment could save time and reduce the VSP workload, providing certain advantages over the DS environment.
|}

==Lesion Size and Long-Term Cognitive Outcome After Pediatric Stroke: A Comparison Between Two Techniques to Assess Lesion Size==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36641854 Eur J Paediatr Neurol. 2023 Jan 7;42:126-32. PMID: 36641854]

'''Authors:''' Everts R, Bertato S, Steinlin M, Slavova N, Grunt S, Steiner L.

'''Institution:''' Division of Neuropediatrics, Development and Rehabilitation, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.

'''Abstract:'''
'''Background:''' There is little consensus on how lesion size impacts long-term cognitive outcome after pediatric arterial ischemic stroke (AIS). This study, therefore, compared two techniques to assessed lesion size in the chronic phase after AIS and determined their measurement agreement in relation to cognitive functions in patients after pediatric stroke.

'''Methods:''' Twenty-five patients after pediatric AIS were examined in the chronic phase (>2 years after stroke) in respect to intelligence, memory, executive functions, visuo-motor functions, motor abilities, and disease-specific outcome. Lesion size was measured using the ABC/2 formula and segmentation technique ([http://www.slicer.org '''3D Slicer''']). Correlation analysis determined the association between volumetry techniques and outcome measures in respect to long-term cognitive outcome.

'''Results:''' The measurements from the ABC/2 and segmentation technique were strongly correlated (r = 0.878, p < .001) and displayed agreement in particular for small lesions. Lesion size from both techniques was significantly correlated with disease-specific outcome (p < .001) and processing speed (p < .005) after controlling for age at stroke and multiple comparison.

'''Conclusion:''' The two techniques showed convergent validity and were both significantly correlated with long-term outcome after pediatric AIS. Compared to the time-consuming segmentation technique, ABC/2 facilitates clinical and research work as it requires relatively little time and is easy to apply.
|}

==Association Between Emphysema and Other Pulmonary Computed Tomography Patterns in COVID-19 Pneumonia==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36358023 J Med Virol. 2023 Jan;95(1):e28293. PMID: 36358023] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9828029/pdf/JMV-95-0.pdf PDF]

'''Authors:''' Han K, Wang J, Zou Y, Zhang Y, Zhou L, Yin Y.

'''Institution:''' Fetal-Neonatal Neuroimaging and Developmental Science Center, Division of Newborn Medicine, Boston Children's Hospital, Boston, USA.

'''Abstract:''' To evaluate the chest computed tomography (CT) findings of patients with Corona Virus Disease 2019 (COVID-19) on admission to hospital. And then correlate CT pulmonary infiltrates involvement with the findings of emphysema. We analyzed the different infiltrates of COVID-19 pneumonia using emphysema as the grade of pneumonia. We applied open-source assisted software, [http://www.slicer.org '''3D Slicer'''] to model the lungs and lesions of 66 patients with COVID-19, which were retrospectively included. we divided the 66 COVID-19 patients into the following two groups: (A) 12 patients with less than 10% emphysema in the low-attenuation area less than -950 Hounsfield units (%LAA-950), (B) 54 patients with greater than or equal to 10% emphysema in %LAA-950. Imaging findings were assessed retrospectively by two authors and then pulmonary infiltrates and emphysema volumes were measured on CT using [http://www.slicer.org '''3D Slicer'''] software. Differences between pulmonary infiltrates, emphysema, Collapsed, affected of patients with CT findings were assessed by Kruskal-Wallis and Wilcoxon test, respectively. Statistical significance was set at p < 0.05. The left lung (A) affected left lung 20.00/affected right lung 18.50, (B) affected left lung 13.00/affected right lung 11.50 was most frequently involved region in COVID-19. In addition, collapsed left lung, (A) collapsed left lung 4.95/collapsed right lung 4.65, (B) collapsed left lung 3.65/collapsed right lung 3.15 was also more severe than the right one. There were significant differences between the Group A and Group B in terms of the percentage of CT involvement in each lung region (p < 0.05), except for the inflated affected total lung (p = 0.152). The median percentage of collapsed left lung in the Group A was 20.00 (14.00-30.00), right lung was 18.50 (13.00-30.25) and the total was 19.00 (13.00-30.00), while the median percentage of collapsed left lung in the Group B was 13.00 (10.00-14.75), right lung was 11.50 (10.00-15.00) and the total was 12.50 (10.00-15.00). The percentage of affected left lung is an independent predictor of emphysema in COVID-19 patients. We need to focus on the left lung of the patient as it is more affected. The people with lower levels of emphysema may have more collapsed segments. The more collapsed segments may lead to more serious clinical feature.
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==A High-Resolution Pediatric Female Whole-Body Numerical Model With Comparison to a Male Model==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36595234 Phys Med Biol. 2023 Jan 13;68(2). PMID: 36595234]

'''Authors:''' Ntolkeras G, Jeong H, Zöllei L, Dmytriw AA, Purvaziri A, Lev MH, Grant PE, Bonmassar G.

'''Institution:''' Fetal-Neonatal Neuroimaging and Developmental Science Center, Division of Newborn Medicine, Boston Children's Hospital, Boston, USA.

'''Abstract:'''
'''Objective:''' Numerical models are central in designing and testing novel medical devices and in studying how different anatomical changes may affect physiology. Despite the numerous adult models available, there are only a few whole-body pediatric numerical models with significant limitations. In addition, there is a limited representation of both male and female biological sexes in the available pediatric models despite the fact that sex significantly affects body development, especially in a highly dynamic population. As a result, we developed Athena, a realistic female whole-body pediatric numerical model with high-resolution and anatomical detail.

'''Approach:''' We segmented different body tissues through Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) images of a healthy 3.5 year-old female child using 3D Slicer. We validated the high anatomical accuracy segmentation through two experienced sub-specialty-certified neuro-radiologists and the inter and intra-operator variability of the segmentation results comparing sex differences in organ metrics with physiologic values. Finally, we compared Athena with Martin, a similar male model, showing differences in anatomy, organ metrics, and MRI dosimetric exposure.

'''Main results:'''We segmented 267 tissue compartments, which included 50 brain tissue labels. The tissue metrics of Athena displayed no deviation from the literature value of healthy children. We show the variability of brain metrics in the male and female models. Finally, we offer an example of computing Specific Absorption Rate and Joule heating in a toddler/preschooler at 7T MRI.

'''Significance:''' This study introduces a female realistic high-resolution numerical model using MRI and CT scans of a 3.5 year-old female child, the use of which includes but is not limited to radiofrequency safety studies for medical devices (e.g. an implantable medical device safety in MRI), neurostimulation studies, and radiation dosimetry studies. This model will be open source and available on the Athinoula A. Martinos Center for Biomedical Imaging website.
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==Anatomical Morphology and Related Angles of Foramen Ovale: A Three-dimensional Computed Tomography Reconstruction==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36597246 J Coll Physicians Surg Pak. 2023 Jan;33(1):109-11. PMID: 36597246]

'''Authors:''' Cheng Z, Hu YL, Sun YX, Liang LZ, Pan DD, Wang DW.

'''Institution:''' Department of Neurosurgery, The Second Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, China.

'''Abstract:''' This study aimed to report the three-dimensional reconstruction of the foramen ovale (FO) based on computed tomography angiography and describe its shape and related angles. A retrospective analysis of 199 adult patients who were hospitalised at the Department of Neurosurgery, The Second Affiliated Hospital of Bengbu Medical College, Bengbu, China, from January to December 2020 was conducted. The original DICOM files of patients' computed tomography scans were processed by [http://www.slicer.org '''3D Slicer'''] software to reconstruct the three-dimensional skull. The morphological characteristics of the FO on both sides were analysed. Their size, related angles and volumes, and the differences between the two sides and gender were compared. A total of 398 FO from 199 patients were studied. The most frequent shape of the FO was oval, accounting for 54.27%. The mean lengths of the right and the left sides were 5.40±1.51 and 5.10±1.18mm, respectively. The mean width on the right and left sides was 3.23±1.16 and 3.33±1.19 mm, respectively. The FO is most commonly oval in shape. Clinicians may use the anatomical characteristics regarding the size and shape of the FO for diagnosis and treatment.
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Main Page/SlicerCommunity/2023

2023-07-25T16:45:08Z

Marianna: /* Mitral Paravalvular Leak 3D Printing from 3D-Transesophageal Echocardiography */

{{:Main_Page/SlicerCommunity}}

__TOC__

=2023=
==Augmented Reality Presentation of the Extracranial Facial Nerve: An Innovation in Parotid Surgery==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37328316 Br J Oral Maxillofac Surg. 2023 Jul;61(6):428-36. PMID: 37328316]

'''Authors:''' Saadya A, Chegini S, Morley S, McGurk M.

'''Institution:''' University College London Hospital, UK.

'''Abstract:'''
Surgeons used to be unaware of the facial nerve's position during parotid surgery. Now, with special magnetic resonance imaging (MRI) sequences, it can be located and converted into a 3D model displayed on an augmented reality (AR) device for surgeons to study and manipulate. This study explores the accuracy and usefulness of the technique for the treatment of benign and malignant parotid tumours. A total of 20 patients with parotid tumours had 3-Tesla MRI scans, and their anatomical structures were segmented using [http://www.slicer.org '''3D Slicer'''] software. The structures were imported into a Microsoft HoloLens 2® device, displayed in 3D, and shown to the patient for consent. Intraoperative video recording was used to record the position of the facial nerve in relation to the tumour. The predicted path of the nerve taken from the 3D model was combined with surgical observation and video recording in all cases. The imaging proved to have application in both benign and malignant disease. It also improved the process of informed patient consent. Three-dimensional MRI imaging of the facial nerve within the parotid gland and its display in a 3D model is an innovative technique for parotid surgery. Surgeons can now see the nerve's position and tailor their approach to each patient's tumour, providing personalised care. The technique eliminates the surgeon's blind spot and is a significant advantage in parotid surgery.
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==Magnetic Resonance Imaging in Naso-Oropharyngeal Carcinoma: Role of Texture Analysis in the Assessment of Response to Radiochemotherapy, a Preliminary Study==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37336860/ Radiol Med. 2023 Jul;128(7):839-52. PMID: 37336860]

'''Authors:''' Bicci E, Nardi C, Calamandrei L, Barcali E, Pietragalla M, Calistri L, Desideri I, Mungai F, Bonasera L, Miele V.

'''Institution:''' Department of Experimental and Clinical Biomedical Sciences, Radiodiagnostic Unit #2, University of Florence, Florence, Italy.

'''Abstract:'''
Objective: Identifying MRI texture parameters able to distinguish inflammation, fibrosis, and residual cancer in patients with naso-oropharynx carcinoma after radiochemotherapy (RT-CHT).

Material and methods: In this single-centre, observational, retrospective study, texture analysis was performed on ADC maps and post-gadolinium T1 images of patients with histological diagnosis of naso-oropharyngeal carcinoma treated with RT-CHT. An initial cohort of 99 patients was selected; 57 of them were later excluded. The final cohort of 42 patients was divided into 3 groups (inflammation, fibrosis, and residual cancer) according to MRI, 18F-FDG-PET/CT performed 3-4 months after RT-CHT, and biopsy. Pre-RT-CHT lesions and the corresponding anatomic area post-RT-CHT were segmented with [http://www.slicer.org '''3D Slicer'''] software from which 107 textural features were derived. T-Student and Wilcoxon signed-rank tests were performed, and features with p-value < 0.01 were considered statistically significant. Cut-off values-obtained by ROC curves-to discriminate post-RT-CHT non-tumoural changes from residual cancer were calculated for the parameters statistically associated to the diseased status at follow-up.

Results: Two features-Energy and Grey Level Non-Uniformity-were statistically significant on T1 images in the comparison between 'positive' (residual cancer) and 'negative' patients (inflammation and fibrosis). Energy was also found to be statistically significant in both patients with fibrosis and residual cancer. Grey Level Non-Uniformity was significant in the differentiation between residual cancer and inflammation. Five features were statistically significant on ADC maps in the differentiation between 'positive' and 'negative' patients. The reduction in values of such features between pre- and post-RT-CHT was correlated with a good response to therapy.

Conclusions: Texture analysis on post-gadolinium T1 images and ADC maps can differentiate residual cancer from fibrosis and inflammation in early follow-up of naso-oropharyngeal carcinoma treated with RT-CHT.
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==BabelBrain: An Open-Source Application for Prospective Modeling of Transcranial Focused Ultrasound for Neuromodulation Applications==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37155375/ IEEE Trans Ultrason Ferroelectr Freq Control. 2023 Jul;70(7):587-99. PMID: 37155375]

'''Authors:''' Pichardo S.

'''Institution:''' Department of Radiology, University of Calgary, Calgary, Canada.

'''Abstract:'''
BabelBrain is an open-source standalone graphic-user-interface application designed for studies of neuromodulation using transcranial-focused ultrasound (FUS). It calculates the transmitted acoustic field in the brain tissue, taking into account the distortion effects caused by the skull barrier. The simulation is prepared using scans from magnetic resonance imaging (MRI) and, if available, computed tomography (CT) and zero-echo time MRI scans. It also calculates the thermal effects based on a given ultrasound regime, such as the total duration of exposure, the duty cycle, and acoustic intensity. The tool is designed to work in tandem with neuronavigation and visualization software, such as [http://www.slicer.org '''3D Slicer''']. It uses image processing to prepare domains for ultrasound simulation and uses the BabelViscoFDTD library for transcranial modeling calculations. BabelBrain supports multiple GPU backends, including Metal, OpenCL, and CUDA, and works on all major operating systems including Linux, macOS, and Windows. This tool is particularly optimized for Apple ARM64 systems, which are common in brain imaging research. The article presents the modeling pipeline used in BabelBrain and a numerical study where different methods of acoustic properties mapping were tested to select the best method that can reproduce the transcranial pressure transmission efficiency reported in the literature.
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==Volumetric Analysis of the Sinus and Orbit in Silent Sinus Syndrome After Endoscopic Sinus Surgery==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/36939460/ Otolaryngol Head Neck Surg. 2023 Jul;169(1):151-156. PMID: 36939460]

'''Authors:'''
Amin D, Chitguppi C, Xu V, Haghshenas C, Gorniak R, Rabinowitz M, Toskala E, Rosen M, Nyquist G.

'''Institution:''' Department of Otolaryngology-Head & Neck Surgery, Thomas Jefferson University, Philadelphia, PA, USA.

'''Abstract:'''
Objective: The term "silent sinus syndrome" (SSS) describes spontaneous enophthalmos secondary to subclinical maxillary sinus atelectasis. Debate remains on whether treatment with endoscopic maxillary antrostomy alone is adequate in reversing atelectasis and globe displacement. This study aims to determine the degree of volume change of the diseased sinus and orbit as well as the change in orbital height in patients treated with endoscopic antrostomy without orbital floor augmentation.

Study design: Retrospective review with image analysis.

Setting: Single tertiary care institution.

Methods: Three-dimensional (3D) analysis of computed tomographic imaging data was performed using [http://www.slicer.org '''3D Slicer''']. 3D models of the maxillary sinus and orbit of the diseased and normal sides were created, and volume measurements were calculated using the segmentation program.

Results: Thirteen patients with SSS who underwent endoscopic sinus surgery (ESS) and had follow-up computed tomographic imaging were analyzed. After endoscopic antrostomy, the mean volume of the diseased maxillary sinus significantly increased by 9.82%, from 6.37 to 7.00 cm3 (p = .0302). There was no significant change in mean orbital volume; however, the mean orbital height decreased by 5.67%, from 38.09 to 35.93 mm from pretreatment to posttreatment samples (p = .0101). All patients had resolution of clinical or radiographic enophthalmos and orbital displacement with ESS alone.

Conclusion: Endoscopic maxillary antrostomy alone in the treatment of SSS significantly increased maxillary sinus volume and decreased diseased orbital height. These changes were associated with clinical and radiographic improvement in globe displacement. These findings support performing ESS alone, reserving orbital augmentation for patients who do not exhibit adequate clinical improvement.
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==Safety and Efficacy of Thoracic Endovascular Aortic Repair for Acute Stanford Type B Aortic Dissection With Retrograde Type a Intramural Hematoma==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/36921645/ J Vasc Surg. 2023 Jul;78(1):61-69.e4. PMID: 36921645] | [https://www.jvascsurg.org/action/showPdf?pii=S0741-5214%2823%2900438-X PDF]

'''Authors:''' Wang J, Li M, Li J, He H, Zhou Y, Li X, Li Q, Gu F, Ye Z, Dardik A, Shu C.

'''Institution:''' Department of Vascular Surgery, Second Xiangya Hospital, Central South University, Changsha, China; Institute of Vascular Diseases, Central South University, Changsha, China.

'''Abstract:'''
Objective: The aim of this study was to evaluate safety and efficacy of thoracic endovascular aortic repair (TEVAR) for acute Stanford type B aortic dissection (TBAD) with retrograde type A intramural hematoma (TAIMH).

Methods: Patients with acute TBAD with retrograde TAIMH treated with TEVAR between January 1, 2014, to March 31, 2022, were retrospectively reviewed. Aortic diameter and distance were measured using the [http://www.slicer.org '''3D Slicer'''] image computing platform. Patients' characteristics, procedural, in-hospital and follow-up data, and aortic remodeling were analyzed.

Results: Fifty-two patients (average age, 52.6 years; 42 males [80.8%]) were included. The median interval from symptom onset to TEVAR was 11 days (interquartile range, 7.0-16.8 days). The maximal diameter of the ascending aorta (AA) was <50 mm, and the hematoma thickness in the AA was ≤10 mm in all patients. Both the in-hospital and 30-day mortality rates were 0%. The 30-day complication rate was 11.5%. The overall cumulative survival rates were 100% at 1 year, 97.1% at 3 years, and 92.6% at 5 years. Four of 52 patients (7.7%) developed retrograde type A aortic dissection at 10 days to 4 months postoperatively, and one of 52 patients (1.9%) developed an isolated AA dissection 4 months postoperatively; these five patients were treated and alive at late follow-up in March 2022. The rates of cumulative freedom from thoracic aortic re-intervention were 93.7% at 1 year and 90.7% at 5 years. Positive AA remodeling was observed in 92.3% (48/52) of patients during follow-up. The maximal diameter of AA (mean ± standard error of mean) at admission was 42.7 ± 0.8 mm, which decreased to 39.5 ± 0.9 mm at last follow-up. The maximal AA hematoma thickness at admission was 7.6 ± 0.3 mm, which reduced to 2.2 ± 0.9 mm at last follow-up.

Conclusions: For selected patients of acute Stanford TBAD with retrograde TAIMH, endovascular repair may be a safe, effective, and durable alternative treatment, if the maximum diameter of the AA is <50 mm and the intramural hematoma thickness in the AA is ≤10 mm.
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==The Traction Force of the Pulled Limb in Hip Arthroscopic Surgery Is Determined by Stiffness Coefficient Which Is Significantly Related to Muscle Volume==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/36477348/ Knee Surg Sports Traumatol Arthrosc. 2023 Jul;31(7):2708-2715. PMID: 36477348]

'''Authors:''' Yin Y, Xue S, Zhang X, Yang G, Xu Y, Wang J, Huang H.

'''Institution:''' Department of Sports Medicine, Beijing Key Laboratory of Sports Injuries, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing, People's Republic of China.

'''Abstract:'''
Purpose: To verify the relationship between muscle volume, lateral centre-edge angle (LCEA), alpha angle (AA), body mass index (BMI) and Beighton score with stiffness coefficient (SC). To analyse the difference of traction force at different physical states of hip joint capsule.

Methods: Thirty-six patients who underwent hip arthroscopy operation were included. The volumes of some related muscles were measured in MRI images by [http://www.slicer.org '''3D Slicer''']. We recorded and tested differences in traction force of five joint capsule physical states, including before (State 1) and after joint capsule puncture (State 2), after the establishment of anterolateral and mid-anterior approaches (State 3) and after incision of the joint capsule through these two approaches (States 4, 5). The correlation between muscle volume, BMI, LCEA, AA and SC was verified by Spearman test. Poisson regression was used to explain confounding variables.

Results: The average force at State 1 was 531.8 N. There were significant differences in traction force between these five states (p < 0.001). There was a significant positive correlation between muscle volumes and SC (p < 0.001). BMI had no correlation with SC (n.s.). The preoperative LCEA of the affected side was correlated with SC (p = 0.043). AA and SC were not correlated (n.s.).

Conclusion: The physical states of the hip joint capsule affected traction force. Muscle volume rather than BMI is an ideal index to estimate preoperative traction force. LCEA affected traction force, whilst AA and Beighton score did not. Measuring the muscle volume can help estimate the most suitable traction force for the patient.
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==Three-Dimensional Assessment of Tongue Cancer Prognosis by Preoperative MRI==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/35426211/ Oral Dis. 2023 Jul;29(5):2006-2011. PMID: 35426211]

'''Authors:''' Li C, Zhu L, Guo Y, Ji T, Ren Z.

'''Institution:''' Department of Oral and Maxillofacial Head and Neck Oncology, The Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

'''Abstract:'''
Purpose: To obtain the relative volume by measuring the tongue volume and the lesion volume, and further explore its relationship with the prognosis of patients, hoping to supplement the TNM staging with a new index.

Methods: ITK-SANP software was used to outline the patients' MRI. After MRI reconstruction and measurement, [http://www.slicer.org '''3D Slicer'''] software was used to estimate tumor volume.

Results: A total of 64 patients with tongue cancer who met the inclusion criteria were included in the study. The estimated tumor volume after MRI reconstruction revealed a significant and robust correlation with tumor stage (p < 0.05, Rs = 0.6207) and a substantial and medium correlation with early lymph node metastasis (p < 0.05, Rs = 0.4873).

Conclusions: We classified tongue cancer into three grades based on tumor volume (Stage I, tumors smaller than 1500 mm³; Stage II, tumors 1500-9000 mm³; and Stage III, tumors larger than 9000 mm³), and such grading could be used as a reference for tumor staging, lymph node metastasis, and patient prognosis to a certain extent.
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==Multimodal Measurements of Levator Bowl Volume in Nulligravid Asymptomatic Women: Endovaginal Ultrasound Versus MRI==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36656345 Int Urogynecol J. 2023 Jul;34(7):1627-33. PMID: 36656345]

'''Authors:''' Chill HH, Martin LC, Abramowitch SD, Rostaminia G.

'''Institution:''' Female Pelvic Medicine and Reconstructive Surgery (FPMRS), Division of Urogynecology, University of Chicago, Northshore University HealthSystem, Skokie, IL, USA.

'''Abstract:''' Introduction and hypothesis: Measurements of levator bowl volume using advanced imaging, may be predictive of pelvic floor muscle function. The aim of this study was to compare the volume of the levator bowl using both magnetic resonance imaging (MRI) and endovaginal ultrasound (EVU) of healthy asymptomatic women.

'''Methods:''' All participants underwent a comprehensive interview including completion of the Pelvic Floor Distress Inventory Questionnaire-20 questionnaire, pelvic examination with a pelvic organ prolapse quantification evaluation, MRI, and EVU. The pelvic floor was segmented using [http://www.slicer.org '''3D Slicer'''] and the MRI segmentations were trimmed using two methods: soft-tissue landmarks and the field of view (FOV) of the ultrasound volume. The levator bowl volume of the 3D segmented shapes was measured using Blender's 3D printing toolkit. Normality was tested using the Shapiro-Wilks test and comparisons were made using self-paired t tests.

'''Results:''' The final analysis included 19 patients. Levator bowl volume measured via MRI was larger than that measured in EVU (46.1 ± 7.9 cm3 vs 27.4 ± 5.9 cm3, p<0.001). Reducing the FOV of the MRI to that of EVU caused the MRI volume to be much closer to the EVU volume (35.5 ± 3.3 cm3 vs 27.4 ± 5.9 cm3, p<0.001); however, it remained significantly larger.

'''Conclusion:''' Levator bowl volume measured using MRI was larger than that measured using EVU no matter the method of delineation of the levator muscles. Although EVU is safe, cheap, and easy to perform, it captures a smaller volume of levator bowel than MRI.
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==Pectoralis Muscle Area Measured at T4 Level Is Closely Associated With Adverse COVID-19 Outcomes in Hospitalized Patients==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37259659 J Musculoskelet Neuronal Interact. 2023 Jun 1;23(2):196-204. PMID: 37259659] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10233225/pdf/JMNI-23-196.pdf PDF]

'''Authors:''' Tekin ZN, Dogruoz Karatekin B, Dogan MB, Bilgi Z.

'''Institution:''' Istanbul Medeniyet University, Goztepe Prof Dr Suleyman Yalcin City Hospital, Radiology, Istanbul, Turkey.

'''Abstract:'''
Objectives: Skeletal muscle area (SMA) at T4 level on chest computed tomography (CT) is a newly available method that can be used as a surrogate sarcopenia marker. The objective of this study is to evaluate association of SMA with adverse COVID-19 outcomes in hospitalized patients.

Methods: Hospitalized COVID-19 patients were prospectively recorded in a database containing age, gender, date of admission, date of outcome (discharge, mortality, presence of intensive care unit (ICU) stay, additional coding information (comorbidities, superimposed conditions). Admission CT-scans were retrospectively evaluated for segmentation (bilateral pectoralis major/minor, erector spinae, levator scapulae, rhomboideus minor and major and transversospinalis muscles) and SMA calculation using [http://www.slicer.org '''3D Slicer'''] software.

Results: 167 cases were evaluated (68 male, 72 female, 140 survived, 27 dead). Muscle area was lower in patients with ICU stay (p=0.023, p=0.018, p=0.008) and mortality outcome (p=0.004, p=0.007, p=0.002) for pectoralis, back and SMA. In multivariate Cox-regression analysis, hazard ratio (HR) value for the pectoralis muscle area value below 2800 mm2 was found to be 3.138(95% CI: 1.171-8.413) for mortality and 2.361(95% CI: 1.012-5.505) for ICU.

Conclusions: Pectoralis muscle area measured at T4 level with 3-D slicer was closely associated with adverse outcomes (mortality, ICU stay) in hospitalized COVID-19 patients. Since early treatment methods for COVID-19 are being evaluated, this method may be a useful adjunct to clinical decision making in regard to prioritization.
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==Dosimetric Assessment of Gadolinium-159 for Hepatic Radioembolization: Tomographic Images and Monte Carlo Simulation==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37393764 Appl Radiat Isot. 2023 Jun 27;199:110916. PMID: 37393764]

'''Authors:''' Musa AS, Abdul Hadi MFR, Hashikin NAA, Ashour NI, Ying CK.

'''Institution:''' School of Physics, Universiti Sains Malaysia, Penang, Malaysia.

'''Abstract:'''
A common therapeutic radionuclide used in hepatic radioembolization is yttrium-90 (90Y). However, the absence of gamma emissions makes it difficult to verify the post-treatment distribution of 90Y microspheres. Gadolinium-159 (159Gd) has physical properties that are suitable for therapy and post-treatment imaging in hepatic radioembolization procedures. The current study is innovative for conducting a dosimetric investigation of the use of 159Gd in hepatic radioembolization by simulating tomographic images using the Geant4 application for tomographic emission (GATE) Monte Carlo (MC) simulation. For registration and segmentation, tomographic images of five patients with hepatocellular carcinoma (HCC) who had undergone transarterial radioembolization (TARE) therapy were processed using a [http://www.slicer.org '''3D Slicer''']. The tomographic images with 159Gd and 90Y separately were simulated using the GATE MC Package. The output of simulation (dose image) was uploaded to [http://www.slicer.org '''3D Slicer'''] to compute the absorbed dose for each organ of interests. 159Gd were able to provide a recommended dose of 120 Gy to the tumour, with normal liver and lungs absorbed doses close to that of 90Y and less than the respective maximum permitted doses of 70 Gy and 30 Gy, respectively. Compared to 90Y, 159Gd requires higher administered activity approximately 4.92 times to achieve a tumour dose of 120 Gy. Thus; this research gives new insights into the use of 159Gd as a theranostic radioisotope, with the potential to be used as a90Y alternative for liver radioembolization.
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==Precise Location of the Ventricular Catheter Tip in Ventriculoperitoneal Shunt Placement Guided by 3D Printed Individualized Guide==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37086587/ Clin Neurol Neurosurg. 2023 Jun;229:107730. PMID: 37086587]

'''Authors:''' Tian Q, Yi J, Wu Y, Wang S, Qu Y, Cai Q.

'''Institution:''' Department of Neurosurgery, Tangdu hospital, Air Force Medical University, Shaanxi, China.

'''Abstract:'''
Objective: Improper placement of the ventricular catheter tip is the most common cause of shunting disorders after ventriculoperitoneal shunt (VPS) placement surgery. Here, through two illustrative cases, we described a novel method of precise ventricular catheter tip location.

Methods: [http://www.slicer.org '''3D Slicer'''] software was used to define the ventricle puncture path and determine the ventricle catheter tip location preoperatively, and the 3D individualized guide model was printed.

Results: The ventricular puncture was performed under the guidance of the 3D guide to achieve precise ventricle catheter tip location intraoperatively.

Conclusions: This technique is safe, simple, efficient and cost-effective, which facilitates its clinical implementation and promotion.
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==PIRET-A Platform for Treatment Planning in Electroporation-Based Therapies==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37015676/ IEEE Trans Biomed Eng. 2023 Jun;70(6):1902-10. PMID: 37015676]

'''Authors:''' Perera-Bel E, Aycock KN, Salameh ZS, Gomez-Barea M, Davalos RV, Ivorra A, Ballester MAG.

'''Institution:''' BCN MedTech, Department of Information and Communication Technologies, Universitat Pompeu Fabra, Barcelona, Spain.

'''Abstract:'''
Tissue electroporation is the basis of several therapies. Electroporation is performed by briefly exposing tissues to high electric fields. It is generally accepted that electroporation is effective where an electric field magnitude threshold is overreached. However, it is difficult to preoperatively estimate the field distribution because it is highly dependent on anatomy and treatment parameters.

Objective: We developed PIRET, a platform to predict the treatment volume in electroporation-based therapies.

Methods: The platform seamlessly integrates tools to build patient-specific models where the electric field is simulated to predict the treatment volume. Patient anatomy is segmented from medical images and 3D reconstruction aids in placing the electrodes and setting up treatment parameters.

Results: Four canine patients that had been treated with high-frequency irreversible electroporation were retrospectively planned with PIRET and with a workflow commonly used in previous studies, which uses different general-purpose segmentation, [http://www.slicer.org '''3D Slicer'''] and modeling software (3Matic and COMSOL Multiphysics). PIRET outperformed the other workflow by 65 minutes (× 1.7 faster), thanks to the improved user experience during treatment setup and model building. Both approaches computed similarly accurate electric field distributions, with average Dice scores higher than 0.93.

Conclusion: A platform which integrates all the required tools for electroporation treatment planning is presented. Treatment plan can be performed rapidly with minimal user interaction in a stand-alone platform.

Significance: This platform is, to the best of our knowledge, the most complete software for treatment planning of irreversible electroporation. It can potentially be used for other electroporation applications.
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==Surgically Assisted Maxillary Expansion With or Without Pterygoid Disjunction Alters Maxillomandibular Positioning==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/35426586/ Oral Maxillofac Surg. 2023 Jun;27(2):269-281. PMID: 35426586]

'''Authors:''' Carvalho FSR, Soares ECS, de Medeiros JR, Júnior JMM, Hyppolito JOP, de Barros Silva PG, Ribeiro TR, Costa FWG.

'''Institution:''' Department of Oral and Maxillofacial Surgery, Federal University of Ceará Campus Sobral, Brazil.

'''Abstract:'''
Purpose: This study aimed to analyze alterations in mandibular positioning after surgically assisted maxillary expansion (SARME) with and without pterygoid disjunction (PD).

Methods: Cone-beam computed tomography scans of 24 healthy individuals (18-45 years old) with transverse deficiency, superior to 5 mm, underwent SARME with or without PD. The aspects prospectively assessed were (1) alignment and position of the head (ITK-Snap and [http://www.slicer.org '''3D Slicer'''] software); (2) McNamara's and Steiner-Tweed-Wits' cephalometric analysis (Dolphin Imaging®); and (3) colorimetric evaluation based on 3D correspondence analysis ([http://www.slicer.org '''3D Slicer'''] software).

Results: A decrease in 1-NA and 1-SN angles as well as an increased occlusal plane in both groups was observed. Superior-inferior and anteroposterior spatial displacements of the chin were statistically significant in the PD group. Altered colorimetric patterns were also observed in the PD group.

Conclusions: This study found more evident tooth inclination in the group without PD; mandibular alterations were more evident in the PD group. Further studies with 3D analysis are strongly recommended for more comprehensive results.
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==ERCP 2.0: Biliary 3D-Reconstruction in Patients With Malignant Hilar Stricture==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37379653 Clin Res Hepatol Gastroenterol. 2023 Jun 26;47(7):102172. PMID: 37379653]

'''Authors:''' Becq A, Szewczyk J, Salin G, Chartier M, Chaput U, Leenhardt R, Dray X, Arrive L, Camus M.

'''Institution:''' Department of Gastroenterology, Henri-Mondor University Hospital, AP-HP, EA 7375, Université Paris Est Créteil, France.

'''Abstract:'''
Background: Endoscopic retrograde cholangiopancreatography (ERCP) for malignant hilar strictures is challenging. The correlation between Magnetic resonance cholangiopancreatography (MRCP) and per ERCP 2D fluoroscopic images is not obvious. The aim of this study was to evaluate the feasibility and potential usefulness of MRCP-based handmade biliary 3D reconstruction in this setting.

Methods: Methods Patients who underwent MRCP followed by ERCP for biliary drainage of a malignant hilar stricture at our institution between 2018 and 2020 were reviewed. A handmade 3D segmentation using [http://www.slicer.org '''3D Slicer'''] (Kitware, France) was fashioned and reviewed with an expert radiologist. The primary outcome was the feasibility of biliary segmentation.

Results: A total of 16 patients were included. The mean age was 70.1 (+/- 8.6) years-old and 68.8% had hilar cholangiocarcinoma. Handmade segmentation was successful in all cases. The agreement between the MRCP interpretation and the 3D reconstruction was 37.5%, as per the Bismuth classification. 3D reconstruction available prior to ERCP could have helped guide for better stent placement in 11 cases (68.8%).

Conclusions: MRCP-based biliary 3D segmentation-reconstruction, in patients with malignant hilar stricture is feasible and seems to provide a better anatomical understanding compared to MRCP and could help improve endoscopic management.
|}

==3D Printing Personalized Guide Plate in the Management of Recurrent Intramuscular Venous Malformations: A Single Center Experience==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/36967547/ Phlebology. 2023 Jun;38(5):307-314. PMID: 36967547]

'''Authors:''' Han T, Jiang S, Xiong J, Cui J, Shen W.

'''Institution:''' Department of Burns and Plastic Surgery, Children's Hospital of Nanjing Medical University, Nanjing, China.

'''Abstract:'''
Objective: This study aimed to investigate the feasibility and effectiveness of 3D printing personalized guide plate in the management of recurrent intramuscular venous malformations (IVM).

Methods: Fifteen patients with recurrent IVM were retrospectively assessed. [http://www.slicer.org '''3D Slicer'''] software was used to extract and reconstruct the imaging data from CT and/or MRI to highlight the morphology, size, and puncture depth of the lesion. With the guidance of personalized plate, complete excision of the IVM was adopted along the pre-marked (methylene blue, MB) margin.

Results: Personalized guide plate matched involved extremity well, and MB-puncture approach was consistent with preoperative design. All IVMs were removed radically in one single session. Complete pain relief was obtained in all cases postoperatively.

Conclusion: The application of 3D printing guide plate can be safe, effective, and reliable to confirming the precise margin of IVM, renders a promising technique with a high practical value in resection of recurrent lesion.
|}

==White Matter Hyperintensities: A Possible Link Between Sarcopenia and Cognitive Impairment in Patients With Mild to Moderate Alzheimer's Disease==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37330930 Eur Geriatr Med. 2023 Jun 18. PMID: 37330930]

'''Authors:''' Weng X, Liu S, Li M, Zhang Y, Zhu J, Liu C, Hu H.

'''Institution:''' Department of Neurology, The Second Affiliated Hospital of Soochow University, Jiangsu, China.

'''Abstract:'''
Purpose: Alzheimer's disease (AD) has been reported to be associated with sarcopenia. White matter hyperintensities (WMH) are common in AD patients. However, the effect of WMH on sarcopenia in AD remains unclear. We hence aimed to investigate the possible association between regional WMH volumes and sarcopenic parameters in AD.

Methods: 57 mild to moderate AD patients and 22 normal controls (NC) were enrolled. Sarcopenic parameters were assessed, including appendicular skeletal mass index (ASMI), grip strength, 5-times sit-to-stand (5-STS) time, and gait speed. The volumes of periventricular hyperintensities (PVH) and deep white matter hyperintensities (DWMH) were quantified using [http://www.slicer.org '''3D Slicer'''] software.

Results: AD subjects exhibited a lower ASMI, a slower gait speed, an increased 5-STS time, and larger volumes of PVH and DWMH than those in the NC group. In AD subjects, total WMH and PVH volumes were related to cognitive impairment, particularly executive function decline. Moreover, total WMH volume and PVH volume were negatively correlated with gait speed across various clinical stages of AD. Multiple linear regression analysis showed that PVH volume was independently associated with 5-STS time and gait speed, whereas DWMH volume was only independently associated with gait speed.

Conclusion: WMH volume was associated with cognitive decline and various sarcopenic parameters. It thereby suggested that WMH may serve as the connection between sarcopenia and cognitive dysfunction in AD. Further studies are needed to confirm these findings and to determine whether sarcopenia interventions reduce WMH volume and improve cognitive function in AD.
|}

==CT Angiography Radiomics Combining Traditional Risk Factors to Predict Brain Arteriovenous Malformation Rupture: a Machine Learning, Multicenter Study==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37311939 Transl Stroke Res. 2023 Jun 13. PMID: 37311939]

'''Authors:''' Zhang S, Wang J, Sun S, Zhang Q, Zhai Y, Wang X, Ge P, Shi Z, Zhang D.

'''Institution:''' Department of Neurosurgery, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.

'''Abstract:'''
This study aimed to develop a machine learning model for predicting brain arteriovenous malformation (bAVM) rupture using a combination of traditional risk factors and radiomics features. This multicenter retrospective study enrolled 586 patients with unruptured bAVMs from 2010 to 2020. All patients were grouped into the hemorrhage (n = 368) and non-hemorrhage (n = 218) groups. The bAVM nidus were segmented on CT angiography images using [http://www.slicer.org '''3D Slicer'''] software, and radiomic features were extracted using Pyradiomics. The dataset included a training set and an independent testing set. The machine learning model was developed on the training set and validated on the testing set by merging numerous base estimators and a final estimator based on the stacking method. The area under the receiver operating characteristic (ROC) curve, precision, and the f1 score were evaluated to determine the performance of the model. A total of 1790 radiomics features and 8 traditional risk factors were contained in the original dataset, and 241 features remained for model training after L1 regularization filtering. The base estimator of the ensemble model was Logistic Regression, whereas the final estimator was Random Forest. In the training set, the area under the ROC curve of the model was 0.982 (0.967-0.996) and 0.893 (0.826-0.960) in the testing set. This study indicated that radiomics features are a valuable addition to traditional risk factors for predicting bAVM rupture. In the meantime, ensemble learning can effectively improve the performance of a prediction model.
|}

==Real-Time Integration Between Microsoft HoloLens 2 and 3D Slicer With Demonstration in Pedicle Screw Placement Planning==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37310561 Int J Comput Assist Radiol Surg. 2023 Jun 13. PMID: 37310561]

'''Authors:''' Pose-Díez-de-la-Lastra A, Ungi T, Morton D, Fichtinger G, Pascau J.

'''Institution:''' Departamento de Bioingeniería, Universidad Carlos III de Madrid, Spain.

'''Abstract:'''
Purpose: Up to date, there has been a lack of software infrastructure to connect [http://www.slicer.org '''3D Slicer'''] to any augmented reality (AR) device. This work describes a novel connection approach using Microsoft HoloLens 2 and OpenIGTLink, with a demonstration in pedicle screw placement planning.

Methods: We developed an AR application in Unity that is wirelessly rendered onto Microsoft HoloLens 2 using Holographic Remoting. Simultaneously, Unity connects to [http://www.slicer.org '''3D Slicer'''] using the OpenIGTLink communication protocol. Geometrical transform and image messages are transferred between both platforms in real time. Through the AR glasses, a user visualizes a patient's computed tomography overlaid onto virtual 3D models showing anatomical structures. We technically evaluated the system by measuring message transference latency between the platforms. Its functionality was assessed in pedicle screw placement planning. Six volunteers planned pedicle screws' position and orientation with the AR system and on a 2D desktop planner. We compared the placement accuracy of each screw with both methods. Finally, we administered a questionnaire to all participants to assess their experience with the AR system.

Results: The latency in message exchange is sufficiently low to enable real-time communication between the platforms. The AR method was non-inferior to the 2D desktop planner, with a mean error of 2.1 ± 1.4 mm. Moreover, 98% of the screw placements performed with the AR system were successful, according to the Gertzbein-Robbins scale. The average questionnaire outcomes were 4.5/5.

Conclusions: Real-time communication between Microsoft HoloLens 2 and 3D Slicer is feasible and supports accurate planning for pedicle screw placement.
|}

==Delirium After Traumatic Brain Injury: Prediction by Location and Size of Brain Lesion==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37317796 Ann Rehabil Med. 2023 Jun 7. PMID: 37317796] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10326395/pdf/arm-23008.pdf PDF]

'''Authors:''' Han SJ, Suh JH, Lee JY, Kim SJ.

'''Institution:''' Department of Rehabilitation Medicine, College of Medicine, Ewha Womans University, Seoul, Korea.

'''Abstract:'''
Objective: To examine (1) the location of brain lesion that would predict post-traumatic delirium and (2) the association between volume of brain lesion and occurrence of delirium in patients with traumatic brain injury (TBI).

Methods: A retrospective study was conducted by reviewing medical records of 68 TBI patients, categorized into two groups: the delirious group (n=38) and non-delirious group (n=30). The location and volume of TBI were investigated with the [http://www.slicer.org '''3D Slicer'''] software.

Results: The TBI region in the delirious group mainly involved the frontal or temporal lobe (p=0.038). All 36 delirious patients had brain injury on the right side (p=0.046). The volume of hemorrhage in the delirious group was larger by about 95 mL compared to the non-delirious group, but this difference was not statistically significant (p=0.382).

Conclusion: Patients with delirium after TBI had significantly different injury site and side, but not lesion size compared to patients without delirium.
|}

==Mitral Paravalvular Leak 3D Printing from 3D-Transesophageal Echocardiography==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37288866 Anatol J Cardiol. 2023 Jun 7. PMID: 37288866] | [https://doi.org/10.14744/AnatolJCardiol.2023.3008 PDF]

'''Authors:''' Jedrzejek M, Kozlowski M, Peszek-Przybyla E, Jadczyk T, Pysz P, Wojakowski W, Smolka G.

'''Institution:''' Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland.

'''Abstract:'''
Background: Paravalvular leaks can be detected in almost 15% of patients after mitral valve prosthesis implantation. This complication can result in congestive heart failure and hemolysis. Despite advancements in non-invasive imaging, percutaneous closure of paravalvular leaks is not always successful. Therefore, efforts are made to improve treatment outcomes by using 3D-printed models of defects as pre-procedural support for interventional cardiologists.

Methods: Retrospectively, 3D-transesophageal echocardiography recordings of 8 patients with clinically significant mitral paravalvular leaks were analyzed. Qlab Software was used to export DICOM images of each paravalvular leak channel, including surrounding tissue. Image segmentation was performed in [http://www.slicer.org '''3D Slicer'''], a free, open-source software package used for imaging research. Models were printed to actual size with the poly jet Stratasys Objet 30 printer with a transparent, rigid material.

Results: Duration of model preparation and printing, as well as the total cost, was calculated. Mean total time of model preparation was 430.5 ± 196 minutes.

Conclusion: 3D-printing from 3D-transesophageal echocardiography is technically feasible. Both shape and location of paravalvular leaks are preserved during model preparation and printing. It remains to be tested if 3D-printing would improve outcomes of percutaneous paravalvular leaks closure.
|}

==Prediction of Ki-67 Expression in Gastrointestinal Stromal Tumors Using Radiomics of Plain and Multiphase Contrast-Enhanced CT==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37266658 Eur Radiol. 2023 Jun 2. PMID: 37266658]

'''Authors:''' Liu Y, He C, Fang W, Peng L, Shi F 4, Xia Y, Zhou Q, Zhang R 5, Li C.

'''Institution:''' Medical Imaging Department, Chongqing University Central Hospital, Chongqing Emergency Medical Center, Chongqing, China.

'''Abstract:'''
Objective: To study the value of radiomics models based on plain and multiphase contrast-enhanced CT to predict Ki-67 expression in gastrointestinal stromal tumors (GISTs).

Methods: A total of 215 patients with GISTs were retrospectively analyzed, including 150 patients in one hospital as the training set and 65 patients in another hospital as the external verification set. The tumor at the largest level of CT images was delineated as the region of interest (ROI). The maximum diameter of the ROI was defined as the tumor size. A total of 851 radiomics features were extracted from each ROI by [http://www.slicer.org '''3D Slicer'''] Radiomics. After dimensionality reduction, three machine learning classification algorithms including logistic regression (LR), random forest (RF), and support vector machine (SVM) were used for Ki-67 expression prediction. Using a multivariable logistic model, a nomogram was established to predict the expression of Ki-67 individually.

Results: Delong tests showed that the SVM models had the highest accuracy in the arterial phase (Z value 0.217-1.139) and venous phase (Z value 0.022-1.396). For the plain phase, LR and SVM models had the highest accuracy (Z value 0.874-1.824, 1.139-1.763). For the delayed phase, LR models had the highest accuracy (Z value 0.056-1.824). For the combined phase, RF models had the highest accuracy (Z value 0.232-1.978). There was no significant difference among the above models for KI-67 expression prediction (Z value 0.022-1.978). A nomogram was developed with a C-index of 0.913 (95% CI, 0.878 to 0.956).

Conclusions: Radiomics of both plain and enhanced CT images could accurately predict the expression of Ki-67 in GIST. For patients who were not suitable to use contrast agents, plain scan could be used as an alternative.
|}

==Accuracy of Imaging Software for 3d Rendering of Tooth Structures, Usable in Clinical Settings==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37272346 Int J Comput Dent. 2023 Jun 5;0(0):0. PMID: 37272346]

'''Authors:''' Ronsivalle V, Venezia P, Migliorati M, Grippaudo C, Barbato E, Nucci L, Isola G, Leonardi RM, Lo Giudice A.

'''Institution:''' Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Policlinico Universitario "Vittorio Emanuele-G. Rodolico", Catania, Italy.

'''Abstract:'''
Aim: The aim of this study was to evaluate the segmentation accuracy of dentition testing four free-source semi-automatic software.

Materials and methods: A total of 20 cone-beam computed tomography (CBCT) were selected to perform semi-automatic segmentation of maxillary and mandibular dentition. The software tested were Invesalius, ITK-Snap, [http://www.slicer.org '''3D Slicer'''] and Seg3D. Each tooth model was also manually segmented (Mimics software) and set as the gold standard (GS) reference of the investigation. A specific 3D imaging technology was used to perform the superimposition between the teeth models obtained with semi-automatic software and the GS model, and to perform the surface-to-surface matching analysis. The accuracy of semi-automatic segmentation was evaluated calculating the volumetric mean differences (mean bias and limits of agreement) and the percentage of matching of the tooth models compared to the manual segmentation (GS). Qualitative assessments were performed using color-coded maps. All data were statistically analysed to perform software comparisons.

Result: Statistically significant differences were found in the volumetric and matching percentage data (p < 0,05). Invesalius was the most accurate software for 3D rendering of the dentition with a volumetric bias (Mimics) ranging from 4,59 mm3 to 85,79 mm3; instead, ITK-SNAP showed the higher volumetric bias, ranging from 30,22 mm3 to 319,83 mm3. The dis-matched area was mainly located at the radicular region of the teeth. Volumetric data showed excellent inter-software reliability with coefficient values ranging from 0,951 to 0,997.

Conclusion: Different semi-automatic software algorithms could generate different patterns of inaccuracy error in the segmentation of teeth.
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==A Retrospective Three-Dimensional Study of the Mandibular Growth During Preoperative Orthodontics in Late Adolescent Patients With Skeletal Class III Malocclusion==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37271262 J Stomatol Oral Maxillofac Surg. 2023 Jun 2:101526. PMID: 37271262]

'''Authors:''' Yuan M, Zheng Z, Li H, Wang P, Liu Y, Bi R.

'''Institution:''' State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthognathic and TMJ Surgery, West China Hospital of Stomatology, Sichuan University, China.

'''Abstract:'''
Introduction: The mandible's ongoing development presents a contraindication for combined orthodontic-orthognathic treatment. The aim of this study was to evaluate the mandibular stability before and after preoperative orthodontic treatment in late adolescent patients with skeletal Class III malocclusion and to investigate the most appropriate time to start preoperative orthodontic treatment.

Material and methods: The study population consisted of 58 adolescents, aged between 15 and 21 years, with skeletal Class III malocclusion; the adolescents underwent CT scans at the beginning (T1) and the end (T2) of preoperative orthodontic treatment. The CT data were analyzed using ITK-SNAP and [http://www.slicer.org '''3D Slicer'''] software, and the effects of age and gender on mandibular development were investigated.

Results: In these 58 patients, there were no significant local bone alterations in the condyle and anterior chin point between T1 and T2 and no significant changes in the mandibular branch height, mandibular body length, condylar distance, and mandibular angle distance (p>0.05). The mandibular growth at the angel of mandible was statistically significant (p<0.05), but it was not clinically significant because the mean value of the growth was small (right: 0.416±0.986 mm, left: 0.328±0.886 mm). No effect of age and gender on mandibular development was observed.

Conclusion: The mandibular morphology was stable during preoperative orthodontic treatment in patients at the late adolescent stage. This study provides evidence for the possibility of early implementation of preoperative orthodontics.
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==Assessment of Variabilities in Lung-Contouring Methods on CBCT Preclinical Radiomics Outputs==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37345013 Cancers (Basel). 2023 May 9;15(10):2677. PMID: 37345013] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10216427/pdf/cancers-15-02677.pdf PDF]

'''Authors:''' Brown KH, Illyuk J, Ghita M, Walls GM, McGarry CK, Butterworth KT.

'''Institution:''' Patrick G. Johnston Centre for Cancer Research, Queen's University Belfast, UK.

'''Abstract:'''
Radiomics image analysis has the potential to uncover disease characteristics for the development of predictive signatures and personalised radiotherapy treatment. Inter-observer and inter-software delineation variabilities are known to have downstream effects on radiomics features, reducing the reliability of the analysis. The purpose of this study was to investigate the impact of these variabilities on radiomics outputs from preclinical cone-beam computed tomography (CBCT) scans. Inter-observer variabilities were assessed using manual and semi-automated contours of mouse lungs (n = 16). Inter-software variabilities were determined between two tools ([http://www.slicer.org '''3D Slicer'''] and ITK-SNAP). The contours were compared using Dice similarity coefficient (DSC) scores and the 95th percentile of the Hausdorff distance (HD95p) metrics. The good reliability of the radiomics outputs was defined using intraclass correlation coefficients (ICC) and their 95% confidence intervals. The median DSC scores were high (0.82-0.94), and the HD95p metrics were within the submillimetre range for all comparisons. the shape and NGTDM features were impacted the most. Manual contours had the most reliable features (73%), followed by semi-automated (66%) and inter-software (51%) variabilities. From a total of 842 features, 314 robust features overlapped across all contouring methodologies. In addition, our results have a 70% overlap with features identified from clinical inter-observer studies.
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==A Training Tool for Clinicians in Segmenting Medical Images to Make 3D Models==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37342255 Ann Surg Open. 2023 May 23;4(2):e275. PMID: 37342255] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7614675/pdf/EMS170894.pdf PDF]

'''Authors:''' Chegini S, Tahim A, Liu M, Chooi Y, Edwards E, Clarkson M, Schilling C.

'''Institution:''' Department of Head and Neck Surgery, University College London Hospital, London, UK.

'''Abstract:'''
Introduction: 3D models produced from medical imaging can be used to plan treatment, design prosthesis, teach and for communication. Despite the clinical benefit, few clinicians have experience of how 3D models are produced.This is the first study evaluating a training tool to teach clinicians to produce 3D models and reporting the perceived impact on their clinical practice.

Method: Following ethical approval, 10 clinicians completed a bespoke training tool, comprising written and video material alongside online support. Each clinician and 2 technicians (included as control) were sent 3 CT scans and asked to produce 6 fibula 3D models using an open-source software, [http://www.slicer.org '''3D Slicer''']. The produced models were compared to those produced by the technicians using Hausdorff distance calculation. Thematic analysis was used to study the post-intervention questionnaire.

Results: The mean Hausdorff distance between the final model produced by the clinicians and technicians was 0.65mm SD0.54mm. The first model made by clinicians took a mean time of 1hr 25mins and the final model took 16:04mins (5:00-46:00mins). 100% of learners reported finding the training tool useful and will employ it in future practice.

Discussion: The training tool described in this paper is able to successfully train clinicians to produce fibula models from CT scans. Learners were able to produce comparable models to technicians within an acceptable timeframe. This does not replace technicians. However, the learners perceived this training will allow them to use this technology in more cases, with appropriate case selection and they appreciate the limits of this technology.
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==3D Slicer Combined With Neuroendoscope in Treatment of a Distal Segment Aneurysm of the Anterior Choroidal Artery Complicated Intraventricular Hemorrhage: A Case Report and Literature Review==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37251467 Heliyon. 2023 May 18;9(6):e16193. PMID: 37251467] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10220353/pdf/main.pdf PDF]

'''Authors:''' Zhou L, Ren Y, Li Z, Zhang H, Wei H, Song P, Cheng L, Wang W, Gao L, Lei P, Hua Q, Chen Q, Zhou J, Li G, Cai Q.

'''Institution:''' Department of Neurosurgery, Renmin Hospital of Wuhan University, Wuhan, China.

'''Abstract:'''
Introduction: Pure ventricular hemorrhage is often secondary to Moyamoya disease, rarely caused by rupture of ventricular aneurysm. The surgical treatment of the latter is very challenging. [http://www.slicer.org '''3D Slicer'''] reconstruction technology can accurately locate small intracranial lesions and combined with minimally invasive surgery with transcranial neuroendoscope is a new attempt to treat the above diseases.

Case presentation: We report a case of pure intraventricular hemorrhage secondary to rupture of a distal segment aneurysm of the anterior choroidal artery. Brain computed tomography (CT) before admission showed pure ventricular hemorrhage, and brain CT angiography (CTA) before operation showed a distal segment aneurysm of the anterior choroidal artery. We used [http://www.slicer.org '''3D Slicer'''] reconstruction and precise location of the focus before the operation and used the minimally invasive surgery technique with transcranial neuroendoscope to completely remove the hematoma in the ventricle, and found the responsible aneurysm located in the ventricle.

Conclusion: Pure intraventricular hemorrhage requires vigilance against the distal segment aneurysm of the anterior choroidal artery. At present, conventional microscopic craniotomy and intravascular interventional therapy have limitations, and [http://www.slicer.org '''3D Slicer'''] reconstruction and precise positioning technology combined with transcranial neuroendoscope minimally invasive surgery may be a good choice.
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==Application of Preoperative Multimodal Image Fusion Technique in Microvascular Decompression Surgery via Suboccipital Retrosigmoid Approach==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36716853 World Neurosurg. 2023 May;173:e37-e47. PMID: 36716853] | [https://pdf.sciencedirectassets.com/280061/AIP/1-s2.0-S1878875023001031/main.pdf PDF]

'''Authors:''' Liao CC, Wu KH, Chen G.

'''Institution:''' Department of Neurosurgery, Zhuhai People's Hospital (Zhuhai Hospital Affiliated with Jinan University,China), Zhuhai, China.

'''Abstract:'''
'''Objective:''' To explore the application value of preoperative multimodal image fusion technique in microvascular decompression (MVD) surgery via the suboccipital retrosigmoid approach.

'''Methods:''' Comprehensive data of 13 patients with primary trigeminal neuralgia (TN) and 13 patients with hemifacial spasm (HFS) treated by MVD surgery via the suboccipital retrosigmoid approach at the Department of Neurosurgery in Zhuhai People's Hospital from January 2021 to December 2021 were retrospectively analyzed. Preoperatively, all patients underwent cranial thin-section computed tomography and magnetic resonance examinations. Three-dimensional (3D) digital images of the skull, brainstem, nerves, and blood vessels were constructed by the [http://www.slicer.org '''3D Slicer'''] software or RadiAnt DICOM Viewer, which were then applied to design the surgical approach and surgical plan. The multimodal image fusion results, clinical characteristics, intraoperative data, surgical outcomes, and complications of all patients were summarized.

'''Results:''' The 3D digital images after fusion reconstruction can vividly show the anatomical relationship between the skull, brainstem, nerves, and blood vessels and was helpful to tailor the surgical strategy. All 26 patients underwent a smooth surgery. During the surgery, the key points were accurately located, the corners of the transverse sinus and sigmoid sinus were completely exposed, and no venous sinus injury occurred in all 26 patients. The key point was approximately located at the top point of the digastric groove, 12.3 ± 0.46 mm vertically above and 6.3 ± 0.6 mm laterally to the Frankfurt horizontal plane. The average cranial opening time was 30.4 (±3.6) min, and the mean operating time was 104.7 (±12.1) min. The diameter of the bone window was about 2.0 cm-3.0 cm, and the bone flap was restored. Among the 13 patients with primary TN, 12 (92.3%) exhibited complete relief of pain and 1 had significant relief. Complications of surgery included facial sensory numbness in 1 case, vertigo in 2 cases, and herpes at the corners of the mouth in 1 case. Of the 13 patients with HFS, 12 (92.3%) had complete relief of facial twitching symptoms and 1 had significant relief, and the complications included mild facial palsy in 2 (15.4%) cases and facial sensory numbness in another 2 (15.4%) cases. The mean follow-up time after surgery ranged from 6-16 months, and 1 of 26 patients experienced recurrence of HFS during the follow-up period.

'''Conclusions:''' Preoperative multimodal image fusion technology can provide adequate preoperative assessment for patients and assistance in designing surgical approaches, which is an important guideline for MVD surgery via the suboccipital retrosigmoid approach for primary TN and facial muscle spasm.
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==An Interactive App with Multi-parametric MRI - Whole-Mount Histology Correlation for Enhanced Prostate MRI Training of Radiology Residents==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37137744 Acad Radiol. 2023 May 1:S1076-6332(23)00183-6. PMID: 37137744]

'''Authors:''' Chatterjee A, Szasz T, Munakami M, Karademir I, Yusufishaq MS, Martens S, Wheeler C, Antic T, Thomas S, Karczmar GS, Oto A.

'''Institution:''' Department of Radiology, University of Chicago, Chicago, IL, USA.

'''Abstract:'''
Rationale and objectives: To validate the educational value of a newly created learning application in enhancing prostate MRI training of radiologists for detecting prostate cancer using an observer study.

Materials and methods: An interactive learning app, LearnRadiology, was developed using a web-based framework to display multi-parametric prostate MRI images with whole-mount histology for 20 cases curated for unique pathology and teaching points. Twenty new prostate MRI cases, different from the ones used in the web app, were uploaded on [http://www.slicer.org '''3D Slicer''']. Three radiologists (R1: radiologist; R2, R3: residents) blinded to pathology results were asked to mark areas suspected of cancer and provide a confidence score (1-5, with 5 being high confidence level). Then after a minimum memory washout period of 1 month, the same radiologists used the learning app and then repeated the same observer study. The diagnostic performance for detecting cancers before and after accessing the learning app was measured by correlating MRI with whole-mount pathology by an independent reviewer.

Results: The 20 subjects included in the observer study had 39 cancer lesions (13 Gleason 3 + 3, 17 Gleason 3 + 4, 7 Gleason 4 + 3, and 2 Gleason 4 + 5 lesions). The sensitivity (R1: 54% → 64%, P = 0.08; R2: 44% → 59%, P = 0.03; R3: 62% → 72%, P = 0.04) and positive predictive value (R1: 68% → 76%, P = 0.23; R2: 52% → 79%, P = 0.01; R3: 48% → 65%, P = 0.04) for all 3 radiologists improved after using the teaching app. The confidence score for true positive cancer lesion also improved significantly (R1: 4.0 ± 1.0 → 4.3 ± 0.8; R2: 3.1 ± 0.8 → 4.0 ± 1.1; R3: 2.8 ± 1.2 → 4.1 ± 1.1; P < 0.05).

Conclusion: The web-based and interactive LearnRadiology app learning resource can support medical student and postgraduate education by improving diagnostic performance of trainees for detecting prostate cancer.
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==3D Printed Guide Tube System for Acute Neuropixels Probe Recordings in Non-Human Primates==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37105161 J Neural Eng. 2023 May 11;20(3):036009. PMID: 37105161] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10172811/pdf/jne_20_3_036009.pdf PDF]

'''Authors:''' Bauer DL, Pobiel B, Hilber K, Verma AK, Wang J, Vitek J, Johnson M, Johnson L.

'''Institution:''' Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, USA.

'''Abstract:'''
Objective.
Neuropixels (NP) probes are a significant advance in electrophysiological recording technology that enable monitoring of hundreds of neurons in the brain simultaneously at different depths. Application of this technology has been predominately in rodents, however widespread use in non-human primates (NHPs) such as rhesus macaques has been limited. In this study we sought to overcome two overarching challenges that impede acute NP implantation in NHPs: (1) traditional microdrive systems that mount to cephalic chambers are commonly used to access cortical areas for microelectrode recordings but are not designed to accommodate NP probes, and (2) NHPs have thick dura mater and tissue growth within the cephalic chambers which poses a challenge for insertion of the extremely fragile NP probe.
Approach.
In this study we present a novel NP guide tube system that can be adapted to commercial microdrive systems and demonstrate an implant method using the NP guide tube system. This system was developed using a combination of CAD design, 3D printing, and small part machining. Software programs, [http://www.slicer.org '''3D Slicer'''] and SolidWorks were used to target cortical areas, approximate recording depths and locations, and for in-silico implant testing.
Main results.
We performedin vivotesting to validate our methodology, successfully implanting, explanting, and reimplanting NP probes. We collected stable neurophysiological recordings in the premotor cortex of a rhesus macaque at rest and during performance of a reaching task.Significance.In this study we demonstrate a robust Neuropixels implant system that allows multiple penetrations with the same NP probe and share design files that will facilitate the adoption of this powerful recording technology for NHP studies.
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==Diagnostic Value of 18F-FDG PET/CT-Based Radiomics Nomogram in Bone Marrow Involvement of Pediatric Neuroblastoma==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/36117128 Acad Radiol. 2023 May;30(5):940-51. PMID: 36117128]

'''Authors:''' Feng L, Yang X, Lu X, Kan Y, Wang C, Zhang H, Wang W, Yang J.

'''Institution:''' Department of Nuclear Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing, China.

'''Abstract:'''
Objectives: To develop and validate an 18F-FDG PET/CT-based radiomics nomogram and evaluate the value of the 18F-FDG PET/CT-based radiomics nomogram for the diagnosis of bone marrow involvement (BMI) in pediatric neuroblastoma.

Materials and methods: A total of 144 patients with neuroblastoma (100 in the training cohort and 44 in the validation cohort) were retrospectively included. The PET/CT images of patients were visually assessed. The results of bone marrow aspirates or biopsies were used as the gold standard for BMI. Radiomics features and conventional PET parameters were extracted using [http://www.slicer.org '''3D Slicer''']. Features were selected by the least absolute shrinkage and selection operator regression, and radiomics signature was constructed. Univariate and multivariate logistic regression analyses were applied to identify the independent clinical risk factors and construct the clinical model. Other different models, including the conventional PET model, combined PET-clinical model and combined radiomics model, were built using logistic regression. The combined radiomics model was based on clinical factors, conventional PET parameters and radiomics signature, which was presented as a radiomics nomogram. The diagnostic performance of the different models was evaluated by receiver operating characteristic (ROC) curves and decision curve analysis (DCA).

Results: By visual assessment, BMI was observed in 80 patients. Four conventional PET parameters (SUVmax, SUVmean, metabolic tumor volume, and total lesion glycolysis) were extracted. And 15 radiomics features were selected to build the radiomics signature. The 11q aberration, neuron-specific enolase and vanillylmandelic acid were identified as the independent clinical risk factors to establish the clinical model. The radiomics nomogram incorporating the radiomics signature, the independent clinical risk factors and SUVmean demonstrated the best diagnostic value for identifying BMI, with an area under the curve (AUC) of 0.963 and 0.931 in the training and validation cohorts, respectively. And the DCA demonstrated that the radiomics nomogram was clinically useful.

Conclusion: The 18F-FDG PET/CT-based radiomics nomogram which incorporates radiomics signature, independent clinical risk factors and conventional PET parameters could improve the diagnostic performance for BMI of pediatric neuroblastoma without additional medical costs and radiation exposure.
|}

==Opportunistic Screening for Osteoporosis Using CT Scans of the Knee: A Pilot Study==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37203533 Stud Health Technol Inform. 2023 May 18;302:909-910. PMID: 37203533]

'''Authors:''' Elmahdy M, Sebro R.

'''Institution:''' Department of Radiology, Mayo Clinic, Jacksonville, FL, USA.

'''Abstract:'''
Knee CT scans are used for planning for total knee arthroplasties in patients who are often simultaneously at risk for frailty fractures due to low bone mineral density. We retrospectively identified 200 patients (85.5% female) with concurrent CT scans of the knee and Dual energy x-ray absorptiometry (DXA). The mean CT attenuation of the distal femur, proximal tibia and fibula, and patella, were calculated using volumetric 3-dimensional segmentation using [http://www.slicer.org '''3D Slicer''']. Data were split randomly into training 80% and test 20% datasets. The optimal CT attenuation threshold for the proximal fibula was obtained in the training dataset and evaluated in the test dataset. A support vector machine (SVM) with radial basis function (RBF) using C-classification was trained and tuned using 5-fold cross-validation in the training dataset and then evaluated in the test dataset. The SVM had a higher area-under-the curve (AUC) of 0.937 and better performance to detect osteoporosis/osteopenia than the CT attenuation of the fibula (AUC of 0.717) (P=0.015). Opportunistic screening for osteoporosis/osteopenia could be accomplished using CT scans of the knee.
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==Sustainable 3D Printing of Oral Films With Tunable Characteristics Using CMC-Based Inks From Durian Rind Wastes==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/36933810 Eur J Pharm Biopharm. 2023 May;186:30-42. PMID: 36933810]

'''Authors:''' Panraksa P, Rachtanapun P, Thipchai P, Lesniewska E, Brachais CH, Debeaufort F, Chambin O, Jantrawut P.

'''Institution:''' Department of Pharmaceutical Sciences, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, Thailand.

'''Abstract:'''
With the growing interest in environmentally friendly and personalized medicines, new concept for combining three-dimensional printing (3DP) with natural-based biomaterials derived from agro-food wastes has emerged. This approach provides sustainable solutions for agricultural waste management and potential for developing of novel pharmaceutical products with tunable characteristics. This work demonstrated the feasibility of fabricating personalized theophylline films with four different structures (Full, Grid, Star, and Hilbert) using syringe extrusion 3DP and carboxymethyl cellulose (CMC) derived from durian rind wastes. Our findings suggested that all the CMC-based inks with shear thinning properties capable of being extruded smoothly through a small nozzle could potentially be used to fabricate the films with various complex printing patterns and high structural fidelity. The results also demonstrated that the film characteristics and release profiles could be easily modified by simply changing the slicing parameters (e.g., infill density and printing pattern). Amongst all formulations, Grid film, which was 3D-printed with 40 % infill and a grid pattern, demonstrated a highly porous structure with high total pore volume. The voids between printing layers in Grid film increased theophylline release (up to 90 % in 45 min) through improved wetting and water penetration. All findings in this study provide significant insight into how to modify film characteristics simply by digitally changing the printing pattern in [http://www.slicer.org '''3D Slicer'''] software without creating a new CAD model. This approach could help to simplify the 3DP process so that non-specialist users can easily implement it in community pharmacies or hospital on demand.
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==An Automated Landmark Method to Describe Geometric Changes in the Human Mandible During Growth==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/36893681 Arch Oral Biol. 2023 May;149:105663. PMID: 36893681]

'''Authors:''' Fournier G, Maret D, Telmon N, Savall F.

'''Institution:''' Faculté de Chirurgie Dentaire, Université Paul Sabatier, Centre Hospitalier Universitaire, Toulouse, France.

'''Abstract:'''
Objective: The principal aim of this study was to assess an automatic landmarking approach to human mandibles based on the atlas method. The secondary aim was to identify the areas of greatest variation in the mandibles of middle-aged to older adults.

Design: Our sample consisted of 160 mandibles from computed tomography scans of 80 men and 80 women aged between 40 and 79 years. Eleven anatomical landmarks were placed manually on mandibles. The automated landmarking through point cloud alignment and correspondence (ALPACA) method implemented in [http://www.slicer.org '''3D Slicer'''] was used to automatically place landmarks to all meshes. Euclidean distances, normalized centroid size, and Procrustes ANOVA were calculated for both methods. A pseudo-landmarks approach was followed using ALPACA to identify areas of changes among our sample.

Results: The ALPACA method showed significant differences in Euclidean distances for all landmarks compared to the manual method. A mean Euclidean distance of 1.7 mm was found for the ALPACA method and 0.99 mm for the manual method. Both methods found that sex, age, and size had a significant effect on mandibular shape. The greatest variations were observed in the condyle, ramus, and symphysis regions.

Conclusion: The results obtained using the ALPACA method are acceptable and promising. This approach can automatically place landmarks with an average accuracy of less than 2 mm, which may be sufficient in most anthropometric analyses. In the light of our results, however, odontological application such as occlusal analysis is not recommended.
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==Clinical Study of Puncture Technique in Single Division of the Trigeminal Ganglion Intumescentia==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37183316 Pain Pract. 2023 May 14. PMID: 37183316] | [https://onlinelibrary.wiley.com/doi/epdf/10.1111/papr.13239 PDF]

'''Authors:''' Zhang L, Guo Y, Xu J, He Y, Qi Z, Chen H, Zhang H.

'''Institution:''' Department of Neurosurgery, Jianhu Hospital Affiliated to Nantong University, Yancheng, China.

'''Abstract:'''
Objective: We explored the feasibility of single-division puncture in the ophthalmic division, maxillary division, and mandibular division of the trigeminal ganglion intumescentia (TGI) and the feasibility of radiofrequency treatment of trigeminal neuralgia.

Methods: According to the previous anatomical image studies, [http://www.slicer.org '''3D Slicer'''] software was used to analyze the CT images of the patients. The trigeminal ganglion fossa (TGF) was used as the imaging sign. TGI was identified in the sagittal plane along the fiber. The puncture path starts from the TGI center-foramen ovale line, extending outward to the epidermis as the needle insertion point, and extending inward to the division boundary. For lateral puncture, which is blocked by the mandible, the positions of closed mouth, open mouth, and over-open mouth were used. Multiple targets were generated using straight electrodes and curved electrodes to achieve full coverage of TGI. According to the preoperative design, general anesthesia surgery was performed. Xper CT was used for imaging, and the puncture was guided by Xper Guide. Radiofrequency treatment of TGI was conducted.

Results: In total, 45 patients with trigeminal neuralgia underwent 50 single-division TGI punctures. The procedure was smooth and the compliance with the design was good. Continuous radiofrequency (CRF) was performed, the VAS scores were 25 times at 70°C, 19 times at 65°C, two times at 60°C, and two times at 50°C (both in the ophthalmic division). Pulsed radiofrequency (PRF) was conducted two times. Within 24 h after the procedure, the VAS scores were all 0. From 1 to 7 days after the procedure, pain recurrence was found in three cases, of whom two cases received pulsed radiofrequency treatment. Patients were followed up for 1-24 months and there were no recurrence. After continuous radiofrequency at 65-70°C, the moderate tactile loss was observed, and nearly half of the patients had food residues on the surgical side after 6 months. After continuous radiofrequency at 60°C, there was mild tactile loss and no food residue. The tactile sensation was slightly decreased after continuous radiofrequency at 50°C, and the tactile sensation was normal the next day.

Conclusion: Trigeminal ganglion intumescentia single-division radiofrequency is effective and feasible for the treatment of trigeminal neuralgia.
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==Three-Dimensional Volume Rendering of Pelvic Floor Anatomy with Focus on Fibroids in Relation to the Lower Urogenital Tract Based on Cross-Sectional MRI Images==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37171621 J Med Syst. 2023 May 12;47(1):62. PMID: 37171621] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10181971/pdf/10916_2023_Article_1947.pdf PDF]

'''Authors:''' Fan KS, Durnea C, Nygaard CC, Khalil M, Doumouchtsis SK.

'''Institution:''' Institute for Medical and Biomedical Education, St. George's University of London, London, UK.

'''Abstract:'''
We aimed to assess the feasibility of developing three-dimensional (3D) models of pelvic organs using cross-sectional MRI images of patients with uterine fibroids and urinary symptoms and of obtaining anatomical information unavailable in 2D imaging modalities. We also aimed to compare two image processing applications. We performed a feasibility study analysing MRI scans from three women, aged 30 to 58 years old, with fibroids and urinary symptoms. Cross-sectional images were used to render 3D models of pelvic anatomy, including bladder, uterus and fibroids, using [http://www.slicer.org '''3D Slicer'''] and OsiriX. Dimensions, volumes and anatomical relationships of the pelvic organs were evaluated. Comparisons between anatomical landmarks and measurements obtained from the two image processing applications were undertaken. Rendered 3D pelvic models yielded detailed anatomical information and data on spatial relationships that were unobtainable from cross-sectional images. Models were rendered in sufficient resolution to aid understanding of spatial relationships between urinary bladder, uterus and fibroid(s). Measurements of fibroid volumes ranged from 5,336 to 418,012 mm3 and distances between the fibroid and urinary bladder ranged from 0.10 to 83.60 mm. Statistical analysis of measurements showed no significant differences in measurements between the two image processing applications. To date, limited data exist on the use of 3D volume reconstructions of routine MRI scans, to investigate pelvic pathologies such as fibroids in women with urinary symptoms. This study suggests that post-MRI image processing can provide additional information over standard MRI. Further studies are required to assess the role of these data in clinical practice, surgical planning and training. Three-dimensional reconstruction of routine two-dimensional magnetic resonance imaging provides additional anatomical information and may improve our understanding of anatomical relationships, their role in clinical presentations and possibly guide clinical and surgical management.
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==The First Endovascular Rat Glioma Model for Pre-Clinical Evaluation of Intra-Arterial Therapeutics==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37157800 Interv Neuroradiol. 2023 May 8:15910199231169597. PMID: 37157800]

'''Authors:''' Lim J, Baig AA, Donnelly BM, Chaves LD, Pol SU, Koenigsknecht C, Pionessa D, Levy BR, Gutierrez L, Tutino VM, Levy EI, Siddiqui AH.

'''Institution:''' Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA.

'''Abstract:'''
Background: Several translational animal models have been described assessing intra-arterial (IA) treatments for malignant gliomas. We describe the first endovascular animal model that allows testing of IA drug delivery as a first-line treatment, which is difficult to do in actual patients. We report a unique protocol for vascular access and IA delivery in the rat model that, unlike prior reports, does not require direct puncture and opening of proximal cerebrovasculature which carries risk of ischemia in the animal brain post-delivery.

Methods: Wistar rats underwent left femoral artery catherization with a Balt Magic 1.2F catheter or Marathon Flow directed 1.5F Microcatheter with an Asahi Chikai 0.008 micro-guidewire which was navigated to the left internal carotid artery under x-ray. 25% mannitol was administered to test blood brain barrier breakdown (BBBB). Additional rats were implanted with C6 glioma cells in the left frontal lobe. C6 Glioma-Implanted Rats (C6GRs) were monitored for overall survival and tumor growth. Tumor volumes from MRI images were calculated utilizing [http://www.slicer.org '''3D Slicer''']. Additional rats underwent femoral artery catheterization with Bevacizumab, carboplatin, or irinotecan injected into the left internal carotid artery to test feasibility and safety.

Results: A successful endovascular access and BBBB protocol was established. BBBB was confirmed with positive Evans blue staining. 10 rats were successfully implanted with C6 gliomas with confirmed growths on MRI. Overall survival was 19.75 ± 2.21 days. 5 rats were utilized for the development of our femoral catheterization protocol and BBBB testing. With regards to IA chemotherapy dosage testing, control rats tolerated targeted 10 mg/kg of bevascizumab, 2.4 mg/kg of carboplatin, and 15 mg/kg of irinotecan IA ICA injections without any complications.

Conclusions: We present the first endovascular IA rat glioma model that allows selective catheterization of the intracranial vasculature and assessment of IA therapies for gliomas without need for access and sacrifice of proximal cerebrovasculature.
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==Muscle Magnetic Resonance Characterization of STIM1 Tubular Aggregate Myopathy Using Unsupervised Learning==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37155641 PLoS One. 2023 May 8;18(5):e0285422. PMID: 37155641] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10166478/pdf/pone.0285422.pd PDF]

'''Authors:''' Lupi A, Spolaor S, Favero A, Bello L, Stramare R, Pegoraro E, Nobile MS.

'''Institution:''' Institute of Radiology, Department of Medicine-DIMED, University of Padua, Padua, Italy.

'''Abstract:'''
Purpose: Congenital myopathies are a heterogeneous group of diseases affecting the skeletal muscles and characterized by high clinical, genetic, and histological variability. Magnetic Resonance (MR) is a valuable tool for the assessment of involved muscles (i.e., fatty replacement and oedema) and disease progression. Machine Learning is becoming increasingly applied for diagnostic purposes, but to our knowledge, Self-Organizing Maps (SOMs) have never been used for the identification of the patterns in these diseases. The aim of this study is to evaluate if SOMs may discriminate between muscles with fatty replacement (S), oedema (E) or neither (N).

Methods: MR studies of a family affected by tubular aggregates myopathy (TAM) with the histologically proven autosomal dominant mutation of the STIM1 gene, were examined: for each patient, in two MR assessments (i.e., t0 and t1, the latter after 5 years), fifty-three muscles were evaluated for muscular fatty replacement on the T1w images, and for oedema on the STIR images, for reference. Sixty radiomic features were collected from each muscle at t0 and t1 MR assessment using [http://www.slicer.org '''3D Slicer'''] software, in order to obtain data from images. A SOM was created to analyze all datasets using three clusters (i.e., 0, 1 and 2) and results were compared with radiological evaluation.

Results: Six patients with TAM STIM1-mutation were included. At t0 MR assessments, all patients showed widespread fatty replacement that intensifies at t1, while oedema mainly affected the muscles of the legs and appears stable at follow-up. All muscles with oedema showed fatty replacement, too. At t0 SOM grid clustering shows almost all N muscles in Cluster 0 and most of the E muscles in Cluster 1; at t1 almost all E muscles appear in Cluster 1.

Conclusion: Our unsupervised learning model appears to be able to recognize muscles altered by the presence of edema and fatty replacement.
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==Quantifying the Effect of an Endo-Vaginal Probe on Position of the Pelvic Floor Viscera and Muscles==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37145123 Int Urogynecol J. 2023 May 5. PMID: 37145123]

'''Authors:''' Chill HH, Martin LC, Abramowitch SD, Rostaminia G.

'''Institution:''' Female Pelvic Medicine and Reconstructive Surgery (FPMRS) Division, University of Chicago Pritzker School of Medicine, Northshore University HealthSystem, Skokie, IL, USA.

'''Abstract:'''
Introduction and hypothesis: Endovaginal ultrasound has long been hypothesized to have a significant effect on locations of what it visualizes. However, little work has directly quantified its effect. This study aimed to quantify it.

Methods: This cross-sectional study consisted of 20 healthy asymptomatic volunteers who underwent both endovaginal ultrasound and MRI. The urethra, vagina, rectum, pelvic floor, and pubic bone were segmented in both ultrasound and MRI using [http://www.slicer.org '''3D Slicer''']. Then, using [http://www.slicer.org '''3D Slicer''']'s transform tool the volumes were rigidly aligned based on the posterior curvature of the pubic bone. The organs were then split into thirds along their long axis to compare their distal, middle, and proximal sections. Using Houdini, we compared the location of the centroid of each of the urethra, vagina, and rectum and the surface-to-surface difference of the urethra and rectum. The anterior curvature of the pelvic floor was also compared. Normality of all variables was assessed by Shapiro-Wilk test.

Results: The largest amount of surface-to-surface distance was observed in the proximal region for the urethra and rectum. Across all three organs, the majority of the deviation was in the anterior direction for geometries obtained from ultrasound versus those from MRI. For each subject, the trace defining the midline of the levator plate was more anterior for ultrasound compared to MRI.

Conclusions: While it has often been assumed that placing a probe in the vagina probably distorts the anatomy, this study quantified the distortion and displacement of the pelvic viscera. This allows for better interpretation of clinical and research findings based on this modality.
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==Laser Interstitial Thermal Therapy in the Treatment of Brain Metastases: The Relationship Between Changes in Postoperative Magnetic Resonance Imaging Characteristics and Tumor Recurrence==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36823478 Acta Neurochir (Wien). 2023 May;165(5):1379-1387. PMID: 36823478]

'''Authors:''' Xue Z, Guan X, Yuan L, Kang P, Zhang C, Li D, Jia G, Jia W.

'''Institution:''' Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, China.

'''Abstract:'''
'''Background:''' Laser interstitial thermal therapy (LITT) has been used to treat brain metastases (BMs) in several countries, and its safety and effectiveness have been confirmed. In most cases, magnetic resonance imaging (MRI) reveals an increase in tumor volume with an enhanced margin after LITT. However, little is known about the relationship between this MRI change and tumor recurrence.

'''Objective:''' We report the first case series of BMs treated by LITT in China to evaluate the clinical characteristics and predictive factors of tumor recurrence.

'''Material and Methods:''' Patients with less than four brain metastatic lesions and a Karnofsky performance status (KPS) > 70 were eligible for study inclusion. Standard LITT procedures were performed, and a follow-up MRI was performed to analyze the radiographic changes, especially the volume ratio of the enhanced margin and the whole lesion on MRI at 30 days postoperatively. All the volume-related data were delineated and calculated using [http://www.slicer.org '''3D Slicer'''] software. Related predictors were also collected to evaluate the correlation with local tumor control.

'''Results:''' Eighteen patients with nineteen lesions were enrolled for treatment and follow-up. Primary tumor histology included pulmonary carcinoma (n = 11) and breast cancer (n = 4). On average, the tumor size measured 3.01 cm3 (range, 0.40-7.40 cm3), the total ablation time was 13.58 min (range, 2.88-37.15 min), and the complete ablation rate was 92.4% (range, 29.2-100%). Comparing 3s0-day follow-up MRI results with preoperative MRI findings, 18 lesions showed a 2.28-fold (range, 1.21-4.88) volume increase; all the lesions displayed an enhanced component with a volume ratio of 42.35% (range, 10.14-100%). Five patients experienced tumor recurrence, and the local tumor control rates at 90 days and 180 days of follow-up were 68.4% and 66.7%, respectively. Univariate analysis indicated that the primary tumor, ablation rate, and enhanced volume ratio (EVR) > 40% in the 30-day MRI were associated with tumor recurrence, whereas multivariate analysis showed that only EVR > 40% was a predictive factor of local control.

'''Conclusion:''' LITT is a minimally invasive method used to ablate brain metastases which can be used as the first-line treatment for BM patients under certain indications. After LITT, most tumors showed volume enlargement on the 30-day MRI scan, and EVR > 40% on the 30-day MRI may indicate late tumor recurrence.
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==Image Data and Computational Grids for Computing Brain Shift and Solving the Electrocorticography Forward Problem==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37128587/ Data Brief. 2023 Apr 7;48:109122. PMID: 37128587] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10147975/pdf/main.pdf PDF]

'''Authors:''' Zwick BF, Safdar S, Bourantas GC, Joldes GR, Hyde DE, Warfield SK, Wittek A, Miller K.

'''Institution:''' Intelligent Systems for Medicine Laboratory, The University of Western Australia, 35 Stirling Highway, Perth, WA, Australia.

'''Abstract:'''
This article describes the dataset applied in the research reported in NeuroImage article "Patient-specific solution of the electrocorticography forward problem in deforming brain" [1] that is available for download from the Zenodo data repository (https://zenodo.org/record/7687631) [2]. Preoperative structural and diffusion-weighted magnetic resonance (MR) and postoperative computed tomography (CT) images of a 12-year-old female epilepsy patient under evaluation for surgical intervention were obtained retrospectively from Boston Children's Hospital. We used these images to conduct the analysis at The University of Western Australia's Intelligent Systems for Medicine Laboratory using SlicerCBM [3], our open-source software extension for the [http://www.slicer.org '''3D Slicer'''] medical imaging platform. As part of the analysis, we processed the images to extract the patient-specific brain geometry; created computational grids, including a tetrahedral grid for the meshless solution of the biomechanical model and a regular hexahedral grid for the finite element solution of the electrocorticography forward problem; predicted the postoperative MRI and DTI that correspond to the brain configuration deformed by the placement of subdural electrodes using biomechanics-based image warping; and solved the patient-specific electrocorticography forward problem to compute the electric potential distribution within the patient's head using the original preoperative and predicted postoperative image data. The well-established and open-source file formats used in this dataset, including Nearly Raw Raster Data (NRRD) files for images, STL files for surface geometry, and Visualization Toolkit (VTK) files for computational grids, allow other research groups to easily reuse the data presented herein to solve the electrocorticography forward problem accounting for the brain shift caused by implantation of subdural grid electrodes.
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==ImFinite Element Analysis of a Healthy Knee Joint at Deep Squatting for the Study of Tibiofemoral and Patellofemoral Contact==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37143926 J Orthop. 2023 Apr 21;40:7-16. PMID: 37143926]

'''Authors:''' Kothurkar R, Lekurwale R, Gad M, Rathod CM.

'''Institution:''' Department of Mechanical Engineering, K. J. Somaiya College of Engineering, Mumbai, India.

'''Abstract:'''
Background: In non-western countries, deep squatting is a daily activity, and prolonged deep squatting is common among occupational squatters. Household tasks, taking a bath, socializing, using toilets, and performing religious acts are among the activities frequently carried out while squatting by the Asian population. High knee loading is responsible for a knee injury and osteoarthritis. Finite element analysis is an effective tool to determine stresses on the knee joint.

Methods: Magnetic Resonance Imaging (MRI) and Computed Tomographic (CT) images were acquired of one adult without knee injuries. The CT images were acquired at the fully extended knee and one more set of images was acquired with the knee at a deeply flexed knee position. The MRI was acquired with the fully extended knee. 3 Dimensional models of bones were created using CT and soft tissue using MRI with the help of [http://www.slicer.org '''3D Slicer'''] software. Kinematics and finite element analysis of the knee was performed for standing and deep squatting posture using Ansys Workbench 2022.

Results: High peak stresses were observed at deep squatting compared to standing along with the reduction in the contact area. Peak von Mises stresses on femoral cartilage, tibial cartilage, patellar cartilage, and meniscus were increased from 3.3 MPa to 19.9 MPa, 2.9 MPa to 12.4 MPa, 1.5 MPa to 16.7 MPa and 15.8 MPa to 32.8 MPa respectively during deep squatting. Posterior translation of 7.01 mm, and 12.58 mm was observed for medial and lateral femoral condyle respectively from full extension to 153° knee flexion.

Conclusions: Increased stresses in the knee joint at deep squat posture may cause cartilage damage. A sustained deep squat posture should be avoided for healthy knee joints. More posterior translations of the medial femoral condyle at higher knee flexion angle warrant further investigation.
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==A Comparison of Machine Learning Models for Survival Prediction of Patients with Glioma Using Radiomic Features from MRI Scans==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37362372/ Indian J Radiol Imaging. 2023 Apr 28;33(3):338-343. PMID: 37362372] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10289839/pdf/10-1055-s-0043-1767786.pdf PDF]

'''Authors:''' Manjunath M, Saravanakumar S, Kiran S, Chatterjee J.

'''Institution:''' Department of Biotechnology, People's Education Society University, Bangalore, Karnataka, India.

'''Abstract:'''
Background Glioma is a primary, malignant, highly aggressive brain tumor, with patients having an average life expectancy of 14 to 16 months after diagnosis. Magnetic resonance imaging (MRI) scans of these patients can be used to extract and analyze quantifiable features with potential clinical significance. We hypothesize that there is a correlation between radiomic features extracted from MRI scans and survival. Along with clinical data, the radiomic features could be used in survival prediction of patients, providing beneficial information for clinicians to design personalized treatment plans. Methods In our study, we have utilized [http://www.slicer.org '''3D Slicer'''] for tumor segmentation and feature extraction and performed survival prediction of patients with glioma using four different machine learning models. Results and Conclusion Among the models compared, we have achieved a maximum prediction accuracy of 64.4% using the k-nearest neighbors model, which was trained and tested on a combination of clinical data and radiomic features extracted from MRI images provided in the BraTS 2020 dataset.
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==Circular RNA hsa_circ_0000690 as a Potential Biomarker for Diagnosis and Prognosis of Intracranial Aneurysm: Closely Relating to the Volume of Hemorrhage==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36879365 Brain Behav. Apr;13(4):e2929. PMID: 36879365] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10097068/pdf/BRB3-13-e2929.pdf PDF]

'''Authors:'''Huang Y, Cao H, Qi X, Guan C, Que S.

'''Institution:''' Department of Neurosurgery, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, Fujian, China.

'''Abstract:'''

'''Purpose:''' This study aimed to explore circular RNA (circRNA) hsa_circ_0000690 as a potential biomarker for diagnosis and prognosis of intracranial aneurysm (IA) and its relationship with clinical factors and complications of IA.

'''Material/Methods:''' 216 IA patients admitted to the neurosurgery department of our hospital from January 2019 to December 2020 were selected as the experimental group, and 186 healthy volunteers were selected as the control group. The expression of hsa_circ_0000690 in peripheral blood was detected by quantitative real-time PCR, and its diagnostic value was assessed by receiver operating characteristic curve. Relationship between hsa_circ_0000690 and clinical factors of IA was assessed by chi-square test. Nonparametric test was used in univariate analysis, and regression analysis was used in multivariate analysis. Multivariate Cox proportional hazards regression analysis was used to analyze the survival time.

'''Results:''' CircRNA hsa_circ_0000690 of IA patients was relatively lower than that in the control group (p < .001). The AUC of hsa_circ_0000690 was 0.752, the specificity was 0.780, and sensitivity was 0.620, with diagnostic threshold of 0.0449. In addition, hsa_circ_0000690 expression was correlated with Glasgow Coma Scale, the volume of subarachnoid hemorrhage, modified Fisher scale, Hunt-Hess levels and surgical type. For hydrocephalus and delayed cerebral ischemia, hsa_circ_0000690 was significant in univariate analysis, but nonsignificant in multivariate analysis. For prognosis, hsa_circ_0000690 was significantly associated with modified Rankin Scales after surgery for 3 months, but not associated with survival time.

'''Conclusions:''' The expression of hsa_circ_0000690 can act as a diagnostic marker for IA and predict the prognosis of 3 months after operation and is closely related to the volume of hemorrhage.

'''Keywords:''' [http://www.slicer.org '''3D Slicer''']; biomarker; circRNA; diagnosis; intracranial aneurysm; prognosis; subarachnoid hemorrhage
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==Can Quantitative Peritumoral CT Radiomics Features Predict the Prognosis of Patients With Non-Small Cell Lung Cancer? A Systematic Review==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36307554 Eur Radiol. 2023 Mar;33(3):2105-17. PMID: 36307554] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9935659/pdf/330_2022_Article_9174.pdf PDF]

'''Authors:''' Wu L, Lou X, Kong N, Xu M, Gao C.

'''Institution:''' Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China.

'''Abstract:''' Objectives: To provide an overarching evaluation of the value of peritumoral CT radiomics features for predicting the prognosis of non-small cell lung cancer and to assess the quality of the available studies.

'''Methods:''' The PubMed, Embase, Web of Science, and Cochrane Library databases were searched for studies predicting the prognosis in patients with non-small cell lung cancer (NSCLC) using CT-based peritumoral radiomics features. Information about the patient, CT-scanner, and radiomics analyses were all extracted for the included studies. Study quality was assessed using the Radiomics Quality Score (RQS) and the Prediction Model Risk of Bias Assessment Tool (PROBAST).

'''Results:''' Thirteen studies were included with 2942 patients from 2017 to 2022. Only one study was prospective, and the others were all retrospectively designed. Manual segmentation and multicenter studies were performed by 69% and 46% of the included studies, respectively. [http://www.slicer.org '''3D Slicer'''] and MATLAB software were most commonly used for the segmentation of lesions and extraction of features. The peritumoral region was most frequently defined as dilated from the tumor boundary of 15 mm, 20 mm, or 30 mm. The median RQS of the studies was 13 (range 4-19), while all of included studies were assessed as having a high risk of bias (ROB) overall.

'''Conclusions:''' Peritumoral radiomics features based on CT images showed promise in predicting the prognosis of NSCLC, although well-designed studies and further biological validation are still needed.

'''Key points:''' Peritumoral radiomics features based on CT images are promising and encouraging for predicting the prognosis of non-small cell lung cancer. The peritumoral region was often dilated from the tumor boundary of 15 mm or 20 mm because these were considered safe margins. The median Radiomics Quality Score of the included studies was 13 (range 4-19), and all of studies were considered to have a high risk of bias overall.
|}

==Three Dimensional Assessment of Radiographic Changes after Indirect Pulp Capping using Silver Diamine Fluoride with or without Potassium Iodide in Young Permanent Teeth (12-month RCT)==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36878216 Caries Res. 2023;57(2):177-188. PMID: 36878216]

'''Authors:''' Baraka MMAL, Cevidanes L, Tekeya M, Bakry N, Ruellas A, Botero T, Benavides E, Fontana M.

'''Institution:''' Department of Experimental Oncology, European Institute of Oncology, IRCCS, 20139 Milan, Italy.

'''Abstract:''' The aim was to have a three-dimensional evaluation of radiographic changes after indirect pulp capping (IPC) with silver diamine fluoride (SDF) with or without potassium iodide (KI) and resin modified glass ionomer cement (RMGIC) in deep carious young permanent molars using cone beam computed tomography (CBCT). 108 first permanent molars with deep occlusal cavitated caries lesions, in forty-nine 6-9-year-old children, were randomly allocated to one of 3 groups (n=36) and treated with SDF+KI, SDF and RMGIC as IPC materials. CBCT scans were taken at 0 and at 12-months to assess tertiary dentin formation (volume and grey level intensity), increase in root length, and pathological changes as secondary caries, periapical radiolucency, internal resorption and obliteration of the pulp. The three-dimensional image analysis procedures were performed using ITK-SNAP and [http://www.slicer.org '''3D Slicer'''] CMF. Comparisons were made using analysis of variance with a fixed effect for treatment and random effects for patient, and patient-by-treatment to account for within-patient correlations. A two-sided 5% significance level was used. There were no significant differences among the three groups regarding tertiary dentin volume (p=0.712) and grey level intensity (p=0.660), increase in root length (p=0.365), prevention of secondary caries (p=0.63) and periapical radiolucency (p=0.80) in the analysed 69 CBCT scans. The study did not find differences among the groups regarding quality and quantity of tertiary dentin formed, increase in root length, absence of secondary caries and other signs of failure as shown by CBCT.

'''Clinical Significance:''' The results show no significant differences in radiographic outcomes (quality and quantity of tertiary dentin formed, increase in root length, absence of secondary caries and other signs of failure) when using SDF+KI, SDF and RMGIC in IPC. The results of this study can help guide treatment decision making regarding use of SDF and SDF+KI as IPC materials in deep cavitated lesions.
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==Cross-Sectional Reliability and Concurrent Validity of a Quantitative 2-Dimensional Ultrasound Image Analysis of Effusion and Synovial Hypertrophy in Knee Osteoarthritis==

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'''Publication:''' [https://pubmed.ncbi.nlm.nih.gov/37008822/ Osteoarthr Cartil Open. 2023 Mar 16;5(2):100356. PMID: 37008822] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10060736/pdf/main.pdf PDF]

'''Authors:''' Dima R, Birmingham TB, Philpott HT, Bryant D, Fenster A, Appleton CT.

'''Institution:''' Faculty of Health Sciences, University of Western Ontario, London, ON, Canada.

'''Abstract:'''
Objective: Effusion-synovitis is related to pain and progression in knee osteoarthritis (OA), but current gold standard ultrasound (US) measures are limited to semi-quantitative grading of joint distension or 1-dimensional thickness measures. A novel quantitative 2-dimensional image analysis methodology is applied to US images of effusion-synovitis; reliability and concurrent validity was assessed in patients with knee OA.

Methods: Cross sectional analysis of US images collected from 51 patients with symptomatic knee OA were processed in ImageJ and segmented in [http://www.slicer.org '''3D Slicer'''] to produce a binary mask of the supra-patellar synovitis region of interest (ROI). Area measures (mm2) of total synovitis, effusion and hypertrophy components were exported. Intra-rater reliability and test-retest reliability (1-14 days washout) were estimated with intra-class correlation coefficients (ICCs). Concurrent validity was measured by Spearman correlations between quantitative measures and gold standard OMERACT and caliper measurements of synovitis.

Results: Intra-rater reliability for hypertrophy area was estimated at 0.98, 0.99 for effusion area, and 0.99 for total synovitis area. The test-retest reliability for total synovitis area was 0.63 (SEM 87.8 mm2), 0.59 for hypertrophy area (SEM 21.0 mm2), and 0.64 for effusion area (SEM 73.8 mm2). Correlation between total synovitis area and OMERACT grade was 0.84, 0.81 between total synovitis area and effusion-synovitis calipers, and 0.81 between total effusion area and effusion calipers.

Conclusion: This new research tool for image analysis demonstrated excellent intra-rater reliability, good concurrent validity, and moderate test-retest reliability. Quantitative 2D US measures of effusion-synovitis and its individual components may enhance the study and management of knee OA.
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==Patient-Specific Needle Guidance Templates Drilled Intraprocedurally for Image Guided Intervention: Feasibility Study in Swine==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36173542 Int J Comput Assist Radiol Surg. 2023 Mar;18(3):537-44. PMID: 36173542]

'''Authors:''' Glossop N, Bale R, Xu S, Pritchard WF, Karanian JW, Wood BJ.

'''Institution:''' Queen's University, Kingston, ON, Canada.

'''Abstract:'''
'''purpose:''' Thermal ablation of large tumors may benefit from simultaneous placement of multiple needles, but accurate placement becomes challenging as the number of needles increases. The aim of this work was to evaluate use of personalized needle guidance grid templates based on intraprocedural CT and fabricated at the point of care to implement ablation treatment plans with multiple needles in vivo.

'''Methods:''' A plastic frame was designed to hold two parallel plastic guide plates in a rigid relationship, fixed over the abdomen by a mounting arm. Steel ball targets (1.5 mm) were implanted under ultrasound in the livers of two domestic swine under general anesthesia. Following breath-hold CT of the subject and frame, the targets and frame were identified using customized [http://www.slicer.org '''3D Slicer''']-based planning software. Multiple needle trajectories targeting the balls were planned, including complex off-plane trajectories. A machining program for drilling the hole pattern corresponding to the planned needle trajectories was generated. The pattern was drilled in the two plates with a numerical-controlled milling machine in the suite. The plates were attached to the frame and needles passed through the paired holes to the calculated depth. Placement accuracy was defined as needle tip-to-target distance on post-placement CT.

'''Results:''' The planning process and manufacturing required approximately 6 and 15 min, respectively. Needles were rapidly inserted (n = 11) to the target points without complications or traversing nontarget anatomy. The mean needle tip-to-target distance error was 3.4 ± 2.2, range 0-7 mm.

'''Conclusion:''' Rapid and accurate needle placement was feasible using a subject-specific, custom-drilled, needle guidance grid template fabricated intraprocedurally. Targeting accuracy and performance were similar to more complex and expensive tracking systems which may enable accurate intraprocedural implementation of treatment plans in the liver or other organs. This may be of value in complex ablation cases or in areas where more advanced guidance systems are not available.
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==Automatic Landmark Identification in Cone-Beam Computed Tomography==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36811276 Orthod Craniofac Res. 2023 Feb 21. PMID: 36811276]

'''Authors:''' Gillot M, Miranda F, Baquero B, Ruellas A, Gurgel M, Al Turkestani N, Anchling L, Hutin N, Biggs E, Yatabe M, Paniagua B, Fillion-Robin JC, Allemang D, Bianchi J, Cevidanes L, Prieto JC.

'''Institution:''' Department of Orthodontics and Pediatric Dentistry, School of Dental Medicine, University of Michigan, Ann Arbor, MI, USA.

'''Abstract:'''
'''Objective:''' To present and validate an open-source fully automated landmark placement (ALICBCT) tool for cone-beam computed tomography scans.

'''Material and Methods:''' One hundred and forty-three large and medium field of view cone-beam computed tomography (CBCT) were used to train and test a novel approach, called ALICBCT that reformulates landmark detection as a classification problem through a virtual agent placed inside volumetric images. The landmark agents were trained to navigate in a multi-scale volumetric space to reach the estimated landmark position. The agent movements decision relies on a combination of DenseNet feature network and fully connected layers. For each CBCT, 32 ground truth landmark positions were identified by 2 clinician experts. After validation of the 32 landmarks, new models were trained to identify a total of 119 landmarks that are commonly used in clinical studies for the quantification of changes in bone morphology and tooth position.

'''Results:''' Our method achieved a high accuracy with an average of 1.54±0.87 mm error for the 32 landmark positions with rare failures, taking an average of 4.2s computation time to identify each landmark in one large 3D-CBCT scan using a conventional GPU.

'''Conclusion:''' The ALICBCT algorithm is a robust automatic identification tool that has been deployed for clinical and research use as an extension in the 3D Slicer platform allowing continuous updates for increased precision.
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==Development and In-Silico and Ex-Vivo Validation of a Software for a Semi-Automated Segmentation of the Round Window Niche to Design a Patient Specific Implant to Treat Inner Ear Disorders==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36826970 J Imaging. 2023 Feb 20;9(2):51. PMID: 36826970] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9965310/pdf/jimaging-09-00051.pdf PDF]

'''Authors:''' Matin-Mann F, Gao Z, Wei C, Repp F, Artukarslan EN, John S, Alcacer Labrador D, Lenarz T, Scheper V.

'''Institution:''' Lower Saxony Center for Biomedical Engineering, Implant Research and Development (NIFE), Department of Otorhinolaryngology, Head and Neck Surgery, Hannover Medical School, Hannover, Germany.

'''Abstract:''' The aim of this study was to develop and validate a semi-automated segmentation approach that identifies the round window niche (RWN) and round window membrane (RWM) for use in the development of patient individualized round window niche implants (RNI) to treat inner ear disorders. Twenty cone beam computed tomography (CBCT) datasets of unilateral temporal bones of patients were included in the study. Defined anatomical landmarks such as the RWM were used to develop a customized [http://www.slicer.org '''3D Slicer'''] plugin for semi-automated segmentation of the RWN. Two otolaryngologists (User 1 and User 2) segmented the datasets manually and semi-automatically using the developed software. Both methods were compared in-silico regarding the resulting RWM area and RWN volume. Finally, the developed software was validated ex-vivo in N = 3 body donor implantation tests with additively manufactured RNI. The independently segmented temporal bones of the different Users showed a strong consistency in the volume of the RWN and the area of the RWM. The volume of the semi-automated RWN segmentations were 48 ± 11% smaller on average than the manual segmentations and the area of the RWM of the semi-automated segmentations was 21 ± 17% smaller on average than the manual segmentation. All additively manufactured implants, based on the semi-automated segmentation method could be implanted successfully in a pressure-tight fit into the RWN. The implants based on the manual segmentations failed to fit into the RWN and this suggests that the larger manual segmentations were over-segmentations. This study presents a semi-automated approach for segmenting the RWN and RWM in temporal bone CBCT scans that is efficient, fast, accurate, and not dependent on trained users. In addition, the manual segmentation, often positioned as the gold-standard, actually failed to pass the implantation validation.
|}

==Design and Analysis of HSC-BPPV Diagnostic Maneuver Based on Virtual Simulation==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36873445 Front Neurol. 2023 Feb 17;14:1132343. PMID: 36873445] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9981954/pdf/fneur-14-1132343.pdf PDF]

'''Authors:''' Li Y, Yang X.

'''Institution:''' Department of Research Center, Third Affiliated Hospital of Shanghai University, Wenzhou Third Clinical Institute Affiliated to Wenzhou Medical University, Wenzhou People's Hospital, Wenzhou, China.

'''Abstract:'''
'''Background:''' The preferred supine roll test for the diagnosis of horizontal semicircular canal BPPV has several disadvantages, including difficulty in locating the affected ear, inconsistent nystagmus performance on repeated testing, and lack of a typical latency period, resulting in insensitive diagnosis.

Objectives: To investigate novel diagnostic techniques with more scientific design, more accessible application, and better diagnostic sensitivity and specificity.

'''Materials and Methods:''' Based on clinical microscopic CT data, we created a virtual simulation model of BPPV using Unity software. The physical simulation of the traditional supine roll test was performed to observe and analyse the movement of the otoliths, whose initial position was the typical stable position. In addition, the normal vectors of the plane and crista ampullaris of the horizontal semicircular canal were measured using [http://www.slicer.org '''3D Slicer'''] software. Based on this, we analyzed the critical steps for designing diagnostic maneuvers for BPPV in the horizontal semicircular canal. For a more accurate diagnosis of horizontal semicircular canal BPPV, it is critical to rotate the horizontal semicircular canal to be parallel to gravity. It is also necessary to move the otolith by swinging the head. As a result, we developed two diagnostic maneuvers: the 60° roll test and the prone roll test. We also performed simulations to observe otolith movement and predict nystagmus performance.

'''Conclusions:''' The 60° roll test and the prone roll test can complement the supine roll test. Compared to the supine roll test, they not only effectively differentiate canalolithiasis from cupulolithiasis, but also make it easier to determine the position of the otoliths, and the characteristics of the nystagmus are more pronounced. Significant diagnostic features have significant potential benefits for home and telemedicine.
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==The Simplified Tailor-Made Workflows for a [http://www.slicer.org '''3D Slicer''']-Based Craniofacial Implant Design==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36801943 Sci Rep. 2023 Feb 17;13(1):2850. PMID: 36801943] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9938178/pdf/41598_2023_Article_30117.pdf PDF]

'''Authors:''' Tantisatirapong S, Khunakornpattanakarn S, Suesatsakul T, Boonpratatong A, Benjamin I, Tongmeesee S, Kangkorn T, Chanwimalueang

'''Institution:''' Department of Biomedical Engineering, Faculty of Engineering, Srinakharinwirot University, Nakhon Nayok, Thailand.

'''Abstract:''' A specific design of craniofacial implant model is vital and urgent for patients with traumatic head injury. The mirror technique is commonly used for modeling these implants, but it requires the presence of a healthy skull region opposite to the defect. To address this limitation, we propose three processing workflows for modeling craniofacial implants: the mirror method, the baffle planner, and the baffle-based mirror guideline. These workflows are based on extension modules on the [http://www.slicer.org '''3D Slicer'''] platform and were developed to simplify the modeling process for a variety of craniofacial scenarios. To evaluate the effectiveness of these proposed workflows, we investigated craniofacial CT datasets collected from four accidental cases. The designed implant models were created using the three proposed workflows and compared to reference models created by an experienced neurosurgeon. The spatial properties of the models were evaluated using performance metrics. Our results show that the mirror method is suitable for cases where a healthy skull region can be completely reflected to the defect region. The baffle planner module offers a flexible prototype model that can be fit independently to any defect location, but it requires customized refinement of contour and thickness to fill the missing region seamlessly and relies on the user's experience and expertise. The proposed baffle-based mirror guideline method strengthens the baffle planner method by tracing the mirrored surface. Overall, our study suggests that the three proposed workflows for craniofacial implant modeling simplify the process and can be practically applied to a variety of craniofacial scenarios. These findings have the potential to improve the care of patients with traumatic head injuries and could be used by neurosurgeons and other medical professionals.
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==Predicting Transient Ischemic Attack Risk in Patients With Mild Carotid Stenosis Using Machine Learning and CT Radiomics==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36846119 Front Neurol. 2023 Feb 8;14:1105616. PMID: 36846119] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9944715/pdf/fneur-14-1105616.pdf PDF]

'''Authors:''' Xia H, Yuan L, Zhao W, Zhang C, Zhao L, Hou J, Luan Y, Bi Y, Feng Y.

'''Institution:''' Department of Vascular Surgery, The First Affiliated Hospital of Kunming Medical University, Kunming, China.

'''Abstract:'''
'''Objective:''' This study aims to establish a radiomics-based machine learning model that predicts the risk of transient ischemic attack in patients with mild carotid stenosis (30-50% North American Symptomatic Carotid Endarterectomy Trial) using extracted computed tomography radiomics features and clinical information.

'''Methods:''' A total of 179 patients underwent carotid computed tomography angiography (CTA), and 219 carotid arteries with a plaque at the carotid bifurcation or proximal to the internal carotid artery were selected. The patients were divided into two groups; patients with symptoms of transient ischemic attack after CTA and patients without symptoms of transient ischemic attack after CTA. Then we performed random sampling methods stratified by the predictive outcome to obtain the training set (N = 165) and testing set (N = 66). [http://www.slicer.org '''3D Slicer'''] was employed to select the site of plaque on the computed tomography image as the volume of interest. An open-source package PyRadiomics in Python was used to extract radiomics features from the volume of interests. The random forest and logistic regression models were used to screen feature variables, and five classification algorithms were used, including random forest, eXtreme Gradient Boosting, logistic regression, support vector machine, and k-nearest neighbors. Data on radiomic feature information, clinical information, and the combination of these pieces of information were used to generate the model that predicts the risk of transient ischemic attack in patients with mild carotid artery stenosis (30-50% North American Symptomatic Carotid Endarterectomy Trial).

'''Results:''' The random forest model that was built based on the radiomics and clinical feature information had the highest accuracy (area under curve = 0.879; 95% confidence interval, 0.787-0.979). The combined model outperformed the clinical model, whereas the combined model showed no significant difference from the radiomics model.

'''Conclusion:''' The random forest model constructed with both radiomics and clinical information can accurately predict and improve discriminative power of computed tomography angiography in identifying ischemic symptoms in patients with carotid atherosclerosis. This model can aid in guiding the follow-up treatment of patients at high risk.
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==Deep Learning Enabled Multi-Organ Segmentation of Mouse Embryos==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36802342 Biol Open. 2023 Feb 15;12(2):bio059698. PMID: 36802342] | [https://cob.silverchair-cdn.com/cob/content_public/journal/bio/12/2/10.1242_bio.059698/2/bio059698.pdf PDF]

'''Authors:''' Rolfe SM, Whikehart SM, Maga AM.

'''Institution:''' Center for Developmental Biology and Regenerative Medicine, Seattle Children's Research Institute, Seattle, WA, USA.

'''Abstract:''' The International Mouse Phenotyping Consortium (IMPC) has generated a large repository of three-dimensional (3D) imaging data from mouse embryos, providing a rich resource for investigating phenotype/genotype interactions. While the data is freely available, the computing resources and human effort required to segment these images for analysis of individual structures can create a significant hurdle for research. In this paper, we present an open source, deep learning-enabled tool, Mouse Embryo Multi-Organ Segmentation (MEMOS), that estimates a segmentation of 50 anatomical structures with a support for manually reviewing, editing, and analyzing the estimated segmentation in a single application. MEMOS is implemented as an extension on the [http://www.slicer.org '''3D Slicer'''] platform and is designed to be accessible to researchers without coding experience. We validate the performance of MEMOS-generated segmentations through comparison to state-of-the-art atlas-based segmentation and quantification of previously reported anatomical abnormalities in a Cbx4 knockout strain. This article has an associated First Person interview with the first author of the paper.
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==Development and Validation of an 18FFDG-PET/CT Radiomic Model for Predicting Progression-Free Survival for Patients With Stage II - III Thoracic Esophageal Squamous Cell Carcinoma Who Are Treated With Definitive Chemoradiotherapy==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36794365 Acta Oncol. 2023 Feb;62(2):159-65. PMID: 36794365]

'''Authors:''' Takahashi N, Tanaka S, Umezawa R, Takanami K, Takeda K, Yamamoto T, Suzuki Y, Katsuta Y, Kadoya N, Jingu K.

'''Institution:''' Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Japan.

'''Abstract:'''
'''Background:''' Radiomics is a method for extracting a large amount of information from images and used to predict treatment outcomes, side effects and diagnosis. In this study, we developed and validated a radiomic model of [18F]FDG-PET/CT for predicting progression-free survival (PFS) of definitive chemoradiotherapy (dCRT) for patients with esophageal cancer.

'''Material and Methods:''' Patients with stage II - III esophageal cancer who underwent [18F]FDG-PET/CT within 45 days before dCRT between 2005 and 2017 were included. Patients were randomly assigned to a training set (85 patients) and a validation set (45 patients). Radiomic parameters inside the area of standard uptake value ≥ 3 were calculated. The open-source software [http://www.slicer.org '''3D Slicer'''] and Pyradiomics were used for segmentation and calculating radiomic parameters, respectively. Eight hundred sixty radiomic parameters and general information were investigated.In the training set, a radiomic model for PFS was made from the LASSO Cox regression model and Rad-score was calculated. In the validation set, the model was applied to Kaplan-Meier curves. The median value of Rad-score in the training set was used as a cutoff value in the validation set. JMP was used for statistical analysis. RStudio was used for the LASSO Cox regression model. p < 0.05 was defined as significant.

'''Results:''' The median follow-up periods were 21.9 months for all patients and 63.4 months for survivors. The 5-year PFS rate was 24.0%. In the training set, the LASSO Cox regression model selects 6 parameters and made a model. The low Rad-score group had significantly better PFS than that the high Rad-score group (p = 0.019). In the validation set, the low Rad-score group had significantly better PFS than that the high Rad-score group (p = 0.040).

'''Conclusions:''' The [18F]FDG-PET/CT radiomic model could predict PFS for patients with esophageal cancer who received dCRT.
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==Minimizing Magnetic Resonance Image Geometric Distortion at 7 Tesla for Frameless Presurgical Planning Using Skin-Adhered Fiducials==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36301228 Med Phys. 2023 Feb;50(2):694-701. PMID: 36301228]

'''Authors:''' Kirby KM, Koons EK, Welker KM, Fagan AJ.

'''Institution:''' Department of Radiology, Mayo Clinic, Rochester, MN, USA.

'''Abstract:'''
'''Background:''' 7T MRI offers significant benefits to spatial and contrast resolution compared to lower field strengths. This superior image quality can help better delineate targets in stereotactic neurosurgical procedures; however, the potential for increased geometric distortions at 7T has impaired its widespread use for these applications. Image geometric distortions can be due to distortions of B0 arising from tissue magnetic susceptibility effects or inherent field inhomogeneities, and nonlinearity of the magnetic field gradients.

'''Purpose:''' The purpose of this study was to investigate the use of 7T MRI for neurosurgical frameless stereotactic navigation procedures. Image geometric distortions at the skin surface in 7T images were minimized and compared to results from clinical 3T frameless imaging protocols.

'''Methods:''' A 3D-printed grid phantom filled with oil was designed to perform a fine calibration of the 7T imaging gradients, and an oil-filled head phantom with internal targets was used to determine ground truth (from computed tomography [CT]) positioning errors. Three volunteers and the head phantom were imaged consecutively at 3T and 7T. Ten skin-adhesive fiducial markers were placed on each subject's exposed skin surface at standard clinical placement locations for frameless procedures. Imaging sequences included MPRAGE (three bandwidths at 7T: 400, 690, and 1020 Hz/pixel, and one at 3T: 400 Hz/pixel), T2 SPACE, and T2 SPACE FLAIR acquisitions. An additional GRE field map was acquired on both scanners using a multi-echo GRE sequence. Custom Matlab code was used to perform additional distortion correction of the images using the unwrapped field maps. Fiducial localization was performed with [http://www.slicer.org '''3D Slicer'''], with absolute fiducial positioning errors determined in phantom experiments following rigid registration to the CT images. For human experiments, 3T and 7T images were registered and relative differences in fiducial locations were compared using two-tailed paired t-tests.

'''Results:''' Phantom measurements at 7T yielded gradient distance scaling errors of 1.1%, 2.2%, and 1.0% along the x-, y-, and z-axes, respectively. These system miscalibrations were traced back to phantom manufacturing deviations in the sphericity of the vendor's gradient calibration phantom. Correction factors along each gradient axis were applied, and afterward, geometric distortions of less than 1 mm were obtained in the 7T MR head phantom images for the 1020 Hz/pixel bandwidth MPRAGE sequence. For the human subjects, four fiducial locations were excluded from the analysis due to patient positioning differences. Differences between 3T and 7T MPRAGE with low/medium/high bandwidth were 2.2 /2.6/2.3 mm, respectively, before the correction, reducing to 1.6/1.3/1.0 mm after the correction (p < 0.001). T2 SPACE and T2 SPACE FLAIR yielded a similar pattern when the correction was applied, decreasing from 2.1 to 0.8 mm, and 2.6 to 1.0 mm, respectively.

'''Conclusions:''' 7T MRI can be used to perform frameless presurgical planning with skin-adhesive fiducials. Geometric distortions can be reduced to a clinically relevant level (errors < ∼1 mm) with no significant susceptibility-related distortions, by using high receiver bandwidth, ensuring gradients are properly calibrated, and placing skin fiducials in areas where distortions from patient positioning are minimal.
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==Acute Colonic Pseudo-Obstruction Secondary to Renal Calculus: A Case Report and Review of Pathophysiology==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36777972 Cureus. 2023 Feb 7;15(2):e34756. PMID: 36777972] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9905947/pdf/cureus-0015-00000034756.pdf PDF]

'''Authors:''' Gillies M, AlDujaili T.

'''Institution:''' General Surgery, Goulburn Valley Health, Shepparton, Australia

'''Abstract:''' Acute colonic pseudo-obstruction (ACPO) is obstruction of the large bowel without a mechanical cause. The exact mechanism remains incompletely understood but is thought to result from disruption to the autonomic regulation of the colon, typically in the context of hospitalized patients with medical illness, precipitating medications, or recent surgical intervention. This paper presents an unusual case of ACPO in an ambulatory patient with a recently passed renal calculus, explores the anatomy and physiology underlying the autonomic dysfunction theory of ACPO pathogenesis in the context of the case, and provides a 3D reconstruction of the patient's CT to illustrate the abrupt caliber change at the splenic flexure characteristic of ACPO.

'''Keywords:''' 3d reconstruction; acute colonic pseudo-obstruction; ogilvie's syndrome; renal calculi; [http://www.slicer.org '''3D Slicer'''] software.
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==A Novel Stereotactic Aspiration Technique for Intracerebral Hemorrhage==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36270590 World Neurosurg. 2023 Feb;170:e28-e36. PMID: 36270590]

'''Authors:''' Xu HZ, Guo J, Wang C, Liu X, Song ZQ, Chen RF, Qiu B, Wang Q, Huang Y.

'''Institution:''' Department of Neurosurgery, Civil Aviation General Hospital, Beijing, China.

'''Abstract:'''

'''Background:''' Minimally invasive surgery is effective and recommended for treatment of intracerebral hemorrhage; however, neurosurgeons in grass-root hospitals in underdeveloped countries lack effective and precise minimally invasive surgery techniques. The aim of this study was to present a technique of computed tomography angiography-based three-dimensional-printed navigation mold-guided stereotactic aspiration and demonstrate its clinical application using a hard needle in a series of patients.

'''Methods:''' The novel stereotactic aspiration technique was performed in 18 patients with spontaneous intracerebral hemorrhage at our center, and clinical outcomes were reported. We compared the volume of hematoma measured by 3 different methods: ABC/2 formula, manual segmentation with OsiriX, and manual segmentation with [http://www.slicer.org '''3D Slicer'''].

'''Results:''' The surgery was completed safely within an average operative time of 15.11 minutes, achieving the goal of <15 mL residual clot volume or >70% clot removal in all patients. No intracranial rebleeding or infection was observed postoperatively. At the end of the 6-month follow-up, 61.11% (11/18) of patients achieved a modified Rankin Scale score <3. There was overall better agreement of hematoma measurement using segmentation with [http://www.slicer.org '''3D Slicer'''] rather than ABC/2 measurement or hematoma measurement using segmentation with OsiriX.

'''Conclusions:''' Our novel method of stereotactic aspiration benefited patients in this study with good percent clot removal, few surgery-related complications, and a favorable prognosis. Manual segmentation with [http://www.slicer.org '''3D Slicer'''] could be used to provide the neurosurgeon with dependable information about hematoma volume. This cheap and convenient technique may be applied in grass-root hospitals in underdeveloped countries. Assessment in multicenter prospective clinical trials is needed.
|}

==Morphological Evaluation of the Normal and Hydrocephalic Third Ventricle on Cranial Magnetic Resonance Imaging in Children: A Retrospective Study==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35994062 Pediatr Radiol. 2023 Feb;53(2):282-96. PMID: 35994062]

'''Authors:''' Isıklar S, Turan Ozdemir S, Ozkaya G, Ozpar R, Parlak M.

'''Institution:''' Medical Imaging Techniques Program, Vocational School of Health Services, Bursa Uludag University, 16240, Bursa, Turkey.

'''Abstract:'''
'''Background:''' Third ventricle morphological changes reflect changes in the ventricular system in pediatric hydrocephalus, so visual inspection of the third ventricle shape is standard practice. However, normal pediatric reference data are not available.

'''Objective:''' To investigate both the normal development of the third ventricle in the 0-18-year age group and changes in its biometry due to hydrocephalus.

'''Materials and Methods:''' For this retrospective study, we selected individuals ages 0-18 years who had magnetic resonance imaging (MRI) from 2012 to 2020. We included 700 children (331 girls) who had three-dimensional (3-D) T1-weighted sequences without and 25 with hydrocephalus (11 girls). We measured the distances between the anatomical structures limiting the third ventricle by dividing the third ventricle into anterior and posterior regions. We made seven linear measurements and three index calculations using 3DSlicer and MRICloud pipeline, and we analyzed the results of 23 age groups in normal and hydrocephalic patients using SPSS (v. 23).

'''Results:''' Salient findings are: (1) The posterior part of the third ventricle is more affected by both developmental and hydrocephalus-related changes. (2) For third ventricle measurements, gender was insignificant while age was significant. (3) Normal third ventricular volumetric development showed a segmental increase in the 0-18 age range. The hydrocephalic third ventricle volume cut-off value in this age group was 3 cm3.

'''Conclusion:''' This study describes third ventricle morphometry using a linear measurement method. The ratios defined in the midsagittal plane were clinically useful for diagnosing the hydrocephalic third ventricle. The linear and volumetric reference data and ratios are expected to help increase diagnostic accuracy in distinguishing normal and hydrocephalic third ventricles.
|}

==Henri IV of France's Larynx 3D Reconstitution==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36149490 Eur Arch Otorhinolaryngol. 2023 Feb;280(2):919-24. PMID: 36149490]

'''Authors:''' Baudouin R, Amelot A, Laprie Y, Crevier-Buchman L, Maeda S, Huynh-Charlier I, Hans S, Charlier P.

'''Institution:''' Department of Otolaryngology-Head & Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Université Paris Saclay), Montigny-le-Bretonneux, France.

'''Abstract:''' Objectives: King Henri IV of France (reign from 1589 to 1610) was one of the most important kings of France. Embalmed and buried in Saint-Denis, his remains were beheaded in 1793. His head (including his larynx) survived in successive private collections until its definitive identification in 2010. The purpose of the study was to provide a morphologic study of the larynx with a 3D reconstitution.

'''Methods:''' A flexible endoscopy was performed via the mouth and via the trachea. Measures of the larynx (vocal folds lengths, thickness, width, larynx height) were collected from the CT-scan by a panel of experts blind each other. The segmentation of the laryngeal anatomical components (vocal folds, cartilages) was performed using [http://www.slicer.org '''3D Slicer''']. Mesh smoothing and 3D reconstitution were performed using Fusion 360®. Reconstitution was discussed between the experts. Decision was made by consensus after discussion.

'''Results:''' Cricoid, thyroid, arytenoid cartilages, vocal folds and hyoid bone were identified and a computed 3D reconstitution of the larynx was made. The laryngeal 3D model appeared morphologically similar to a living subject. Measures were similar but smaller than those of a modern subject.

'''Conclusions:''' The 3D reconstitution of the larynx of Henri IV of France was conducted from the CT-scan of his mummified head. This work constitutes a first valuable morphologic analysis of a larynx from an embalmed individual. This anatomical work is the first step towards the reconstruction of the voice of this historical character, which we hope to concretize with computer modeling tools in a second step.
|}

==Development and External Validation of a Novel Nomogram to Predict Prostate Cancer in Biopsy-Naïve Patients With PSA <10 Ng/Ml and PI-RADS v2.1 = 3 Lesions==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35920264 Cancer Med. 2023 Feb;12(3):2560-71. PMID: 35920264] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9939143/pdf/CAM4-12-2560.pdf PDF]

'''Authors:''' Hu C, Sun J, Xu Z, Zhang Z, Zhou Q, Xu J, Chen H, Wang C, Ouyang J.

'''Institution:''' Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.

'''Abstract:'''
'''Objective:''' To develop and externally validate a novel nomogram in biopsy-naïve patients with prostate-specific antigen (PSA) <10 ng/ml and PI-RADS v2.1 = 3 lesions.

'''Methods:''' We retrospectively collected 307 men that underwent initial biopsy from October 2015 to January 2022 in Cohort 1 (The First Affiliated Hospital of Soochow University). External cohort (Cohort 2, Kunshan Hospital) included 109 men that met our criteria from July 2016 to June 2021. By [http://www.slicer.org '''3D Slicer'''] Software, the volume of all lesions was divided into two subgroups (PI-RADS v2.1 = 3a and 3b). Logistic regression analysis was performed to screen for variables and construct nomogram by analyzing clinical data from Cohort 1. Receiver operating characteristics curve analysis, calibration plot and decision curve analysis (DCA) were plotted to validate the nomogram in external cohort.

'''Results:''' A total of 70 (22.8%) patients was diagnosed with prostate cancer in Institution 1. Among them, 34 (11.1%) had clinically significant prostate cancer (csPCa). Age, prostate-specific antigen density, digital rectal examination, PI-RADS v2.1 = 3 subgroups (3a and 3b) and apparent diffusion coefficient (ADC, <750 mm2 /s) were predictive factors for prostate cancer (PCa) and csPCa. High area under the curve of the nomogram was found in Cohort 1 and Cohort 2 for PCa (0.857 vs. 0.850) and for csPCa (0.896 vs. 0.893). Calibration curves showed excellent agreement between the predicted probability and actual risk for the models in internal and external validation. The DCA demonstrated net benefit of our nomogram.

'''Conclusion:''' Until now, this is the first nomogram that predicts PCa and csPCa in biopsy-naïve patients with PSA <10 ng/ml and PI-RADS v2.1 = 3 lesions. Furthermore, PI-RADS v2.1 = 3 subgroups were considered to be an independent risk factor in our model. Our nomogram may assist urologists in biopsy decision making for these so-called "double gray zone" patients.
|}

==A Three-Dimensionally Printed Otological Model for Cholesteatoma Mastoidectomy Training==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35789285 Eur Arch Otorhinolaryngol. 2023 Feb;280(2):671-80. PMID: 35789285]

'''Authors:''' de Souza MA, Bento RF, Lopes PT.

'''Institution:''' Otolaryngology Department, University of São Paulo School of Medicine, São Paulo, Brazil.

'''Abstract:'''
'''purpose:''' To relate the creation and expert validation (face and content validity) of an affordable three-dimensional (3D) printed model of temporal bones with chronic otitis media with cholesteatoma (COMC) as a simulator for mastoidectomy.

'''Methods:''' We performed computed tomography (CT) of the temporal bones of a patient with COMC followed at the University of São Paulo (USP) Hospital with [http://www.slicer.org '''3D Slicer'''] to create a 3-D model of the affected bone using light-curing resin and silicone (cholesteatoma). The final 3-D printed images were scored by 10 otologists using a customized version of the Michigan Standard Simulation Scale Experience (MiSSES). Internal consistency and inter-rater reliability were assessed using Cronbach's α and intraclass correlations.

'''Results:''' Otologists consistently scored the model positively for fidelity, educational value, reactions, and the overall model quality. Nine otologists agreed that the model was a good educational device for surgical training of COMC. All experts deemed the model ready-or nearly ready-for use. The final cost of the model, including raw materials and manufacturing, was 120 USD.

'''Conclusions:''' Using 3D printing technology, we created the first anatomically accurate, low-cost, disease-reproducing 3D model of temporal bones for mastoidectomy training for cholesteatoma.
|}

==Development of a Navigable 3D Virtual Model of Temporal Bone Anatomy==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36704866 J Vis Commun Med. 2023 Jan 26:1-5. PMID: 36704866] | [https://www.tandfonline.com/doi/full/10.1080/17453054.2023.2169110 PDF]

'''Authors:''' Sareen K.

'''Institution:''' Sant Parmanand Hospital, New Delhi, India.

'''Abstract:'''
'''Background:''' Computed Tomography (CT) scanning offers an accurate structural definition of bones, blood vessels, and soft tissues; however, mental integration of cross-sectional 2D CT images for a 3D understanding of complex anatomical structures becomes difficult when the field of view is confined to the temporal bone. This project tried to provide a feasible solution to this problem by creating a navigable 3D virtual model which may aid in better comprehension of the temporal bone anatomy.

'''Methods:''' A helical-CT scan was used to obtain high-resolution cross-sectional slices of a cadaveric human temporal bone. Using the volume-rendering capabilities of [http://www.slicer.org '''3D Slicer'''], which involves volume data management, cropping of the data set, and threshold painting, detailed anatomical structures were segmented based on the intensity captured from different regions. This volumetric data was converted to an interactive virtual model using Blender®.

'''Results:''' The final product is a web page that allows interaction and navigation with a 3D annotated model of the temporal bone, which can be accessed from any device with a web browser.

'''Conclusion:''' This model can function as a training tool for students, teachers, and practitioners to understand and review the complex anatomy of the temporal bone.
|}

==Maxillary Antral Pseudocyst Drift after Osteotome Sinus Floor Elevation with Simultaneous Implant Placement: A Case Report and Literature Review==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36769568 J Clin Med. 2023 Jan 24;12(3):920. PMID: 36769568] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9917374/pdf/jcm-12-00920.pdf PDF]

'''Authors:''' Wang P, Huang N, Ren J, Gong P, Long J, Huang B.

'''Institution:''' West China School of Stomatology, Sichuan University, Chengdu, China.

'''Abstract:''' This report describes maxillary antral pseudocyst drift after maxillary sinus floor augmentation through osteotome sinus floor elevation with simultaneous implant placement. [http://www.slicer.org '''3D Slicer'''] was used to measure the pseudocyst and maxilla for the placement of the implants; follow-up visits were scheduled at 6, 12, and 22 months. No adverse effects were observed during or after surgery, and all implants exhibited osseointegration without mobility. At 6 months after surgery, the pseudocyst had moved posterolaterally from the preoperative position near the anterior medial maxillary sinus, then returned to its original position at 12 months. However, it had remigrated to the posterolateral position at 22 months. The preoperative volume of the pseudocyst was 3.795 mm3; it was 2.370, 3.439, and 2.930 mm3 at 6, 12, and 22 months after surgery, respectively. The changes in pseudocyst drift and volume did not have a substantial negative influence on the implants, presumably because of cystic attachment and the recurrence of multiple pseudocysts at different locations. The risks associated with changes in a pseudocyst can be avoided, if an appropriate treatment plan is selected.
|}

==Radiomic Analysis Based on Magnetic Resonance Imaging for Predicting PD-L2 Expression in Hepatocellular Carcinoma==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36672315 Cancers (Basel). 2023 Jan 5;15(2):365. PMID: 36672315] | [http://www.ncbi.nlm.nih.gov/pmc/articles/pmc9856314/ PDF]

'''Authors:''' Tao YY, Shi Y, Gong XQ, Li L, Li ZM, Yang L, Zhang XM.

'''Institution:''' Medical Imaging Key Laboratory of Sichuan Province, Interventional Medical Center, Department of Radiology, Medical Research Center, Affiliated Hospital of North Sichuan Medical College, Nanchong, China.

'''Abstract:''' Hepatocellular carcinoma (HCC) is the sixth most common malignant tumour and the third leading cause of cancer death in the world. The emerging field of radiomics involves extracting many clinical image features that cannot be recognized by the human eye to provide information for precise treatment decision making. Radiomics has shown its importance in HCC identification, histological grading, microvascular invasion (MVI) status, treatment response, and prognosis, but there is no report on the preoperative prediction of programmed death ligand-2 (PD-L2) expression in HCC. The purpose of this study was to investigate the value of MRI radiomic features for the non-invasive prediction of immunotherapy target PD-L2 expression in hepatocellular carcinoma (HCC). A total of 108 patients with HCC confirmed by pathology were retrospectively analysed. Immunohistochemical analysis was used to evaluate the expression level of PD-L2. [http://www.slicer.org '''3D Slicer'''] software was used to manually delineate volumes of interest (VOIs) and extract radiomic features on preoperative T2-weighted, arterial-phase, and portal venous-phase MR images. Least absolute shrinkage and selection operator (LASSO) was performed to find the best radiomic features. Multivariable logistic regression models were constructed and validated using fivefold cross-validation. The area under the receiver characteristic curve (AUC) was used to evaluate the predictive performance of each model. The results show that among the 108 cases of HCC, 50 cases had high PD-L2 expression, and 58 cases had low PD-L2 expression. Radiomic features correlated with PD-L2 expression. The T2-weighted, arterial-phase, and portal venous-phase and combined MRI radiomics models showed AUCs of 0.789 (95% CI: 0.702-0.875), 0.727 (95% CI: 0.632-0.823), 0.770 (95% CI: 0.682-0.875), and 0.871 (95% CI: 0.803-0.939), respectively. The combined model showed the best performance. The results of this study suggest that prediction based on the radiomic characteristics of MRI could noninvasively predict the expression of PD-L2 in HCC before surgery and provide a reference for the selection of immune checkpoint blockade therapy.
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==Correlation Between Unilateral Internal Carotid Artery Stenosis and Asymmetric Distribution of Enlarged Perivascular Spaces in Patients With Acute Cerebral Infarction==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36649988 Zhonghua Yi Xue Za Zhi. 2023 Jan 17;103(3):178-185. PMID: 36649988]

'''Authors:''' Jian XL, Zhang M, Yun WW.

'''Abstract:'''
'''Objective:''' To explore the correlation between unilateral internal carotid artery (ICA) stenosis and asymmetrical distribution of enlarged perivascular spaces (EPVS) in patients with acute cerebral infarction.

'''Methods:''' Acute cerebral infarction patients with unilateral ICA stenosis hospitalized in Changzhou Second People's Hospital from October 2020 to December 2021 were collected. Routine cranial MRI and CT angiography were completed for each patient. The [http://www.slicer.org '''3D Slicer'''] software was used to quantitatively analyze the volume of patient's EPVS. Patients were divided into moderate stenosis group and severe stenosis/occlusion group according to the degree of ICA stenosis. Baseline data were compared between the two groups. Patients were further divided into three groups: moderate stenosis, severe stenosis and occlusion groups, and the ipsilateral and contralateral EPVS volume of ICA stenosis patients was compared. The asymmetry index (AI) was calculated for EPVS in the basal ganglia region (BG-EPVS) and EPVS in the centrum semiovale (CSO-EPVS). Patients with AI≥0.2 were included in the EPVS asymmetry group, while the rest were in the EPVS symmetry group, and the degree of unilateral ICA stenosis was compared between the two groups. Multivariate logistic regression model was used to analyze the relationship between ICA severe stenosis/occlusion and the asymmetric distribution of BG-EPVS.

'''Results:''' A total of 122 patients (96 males and 26 females) were enrolled, aged (70±10) years, with 81 cases in the unilateral ICA severe stenosis/occlusion group (46 cases of severe stenosis and 35 of occlusion) and 41 cases in the moderate stenosis group. Patients in the unilateral ICA severe stenosis/occlusion group had greater BG-EPVS volume [(4.08±0.76) mm3]and proportion of asymmetric distribution of BG-EPVS [75.3%(61/81)] than those of the moderate stenosis group [(3.12±0.85) mm3 and 39.0% (16/41)], with statistically significant differences (both P<0.001). The BG-EPVS volumes of the ipsilateral side of the stenosis in the severe stenosis group and the occlusion group [(3.34±0.86) mm3 and (3.93±0.60) mm3] were significantly greater than those of the contralateral side [(2.65±1.28) mm3 and (3.21±0.88) mm3], with statistically significant differences (both P<0.001). Correlation analysis indicated that the degree of unilateral ICA stenosis was positively correlated with the BG-EPVS volume on the stenosis side (r=0.62, P<0.001). Further comparison of the degree of unilateral ICA stenosis between the EPVS symmetric and asymmetric groups showed that the proportion of unilateral ICA severe stenosis/occlusion in the BG-EPVS asymmetry group was higher than that in the symmetric group [79.2%(61/77) vs 44.4%(20/45),P<0.001]. Multivariate logistic regression analysis showed that unilateral ICA severe stenosis/occlusion (OR=4.280, 95%CI: 1.743-10.508, P =0.002) and age (OR=1.055, 95%CI: 1.001-1.112, P=0.044) were risk factors for asymmetric distribution of BG-EPVS.

'''Conclusions:''' The severe stenosis/occlusion of the unilateral ICA and age are the risk factors for the asymmetric distribution of the BG-EPVS in patients with acute cerebral infarction. The ipsilateral EPVS volume of unilateral ICA stenosis is larger than that of the contralateral side, and the degree of ICA stenosis is positively correlated with the severity of BG-EPVS.
|}

==Radiomics to Predict the Mortality of Patients With Rheumatoid Arthritis-Associated Interstitial Lung Disease: A Proof-of-Concept Study==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36698825 Front Med (Lausanne). 2023 Jan 9;9:1069486. PMID: 36698825] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9870287/pdf/fmed-09-1069486.pdf PDF]

'''Authors:''' Venerito V, Manfredi A, Lopalco G, Lavista M, Cassone G, Scardapane A, Sebastiani M, Iannone F.

'''Institution:''' Rheumatology Unit, Department of Emergency and Organ Transplantation, University of Bari Aldo Moro, Bari, Italy.

'''Abstract:''' Objectives: Patients with rheumatoid arthritis (RA) and interstitial lung disease (ILD) have increased mortality compared to the general population and factors capable of predicting RA-ILD long-term clinical outcomes are lacking. In oncology, radiomics allows the quantification of tumour phenotype by analysing the characteristics of medical images. Using specific software, it is possible to segment organs on high-resolution computed tomography (HRCT) images and extract many features that may uncover disease characteristics that are not detected by the naked eye. We aimed to investigate whether features from whole lung radiomic analysis of HRCT may alone predict mortality in RA-ILD patients.

'''Methods:''' High-resolution computed tomographies of RA patients from January 2012 to March 2022 were analyzed. The time between the first available HRCT and the last follow-up visit or ILD-related death was recorded. We performed a volumetric analysis in [http://www.slicer.org '''3D Slicer'''], automatically segmenting the whole lungs and trachea via the Lung CT Analyzer. A LASSO-Cox model was carried out by considering ILD-related death as the outcome variable and extracting radiomic features as exposure variables.

'''Results:''' We retrieved the HRCTs of 30 RA-ILD patients. The median survival time (interquartile range) was 48 months (36-120 months). Thirteen out of 30 (43.33%) patients died during the observation period. Whole line segmentation was fast and reliable. The model included either the median grey level intensity within the whole lung segmentation [high-resolution (HR) 9.35, 95% CI 1.56-55.86] as a positive predictor of death and the 10th percentile of the number of included voxels (HR 0.20, 95% CI 0.05-0.84), the voxel-based pre-processing information (HR 0.23, 95% CI 0.06-0.82) and the flatness (HR 0.42, 95% CI 0.18-0.98), negatively correlating to mortality. The correlation of grey level values to their respective voxels (HR 1.52 95% CI 0.82-2.83) was also retained as a confounder.

'''Conclusion:''' Radiomic analysis may predict RA-ILD patients' mortality and may promote HRCT as a digital biomarker regardless of the clinical characteristics of the disease.
|}

==Evaluation of the Prognosis of Acute Subdural Hematoma According to the Density Differences Between Gray and White Matter==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36686517 Front Neurol. 2023 Jan 6;13:1024018. PMID: 36686517] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9853902/ PDF]

'''Authors:''' Li Z, Feng Y, Wang P, Han S, Zhang K, Zhang C, Lu S, Lv C, Zhu F, Bie L.

'''Institution:''' Department of Neurosurgery of the First Clinical Hospital, Jilin University, Changchun, China.

'''Abstract:'''
'''Objective:''' Acute subdural hematoma (ASDH) is a common neurological emergency, and its appearance on head-computed tomographic (CT) imaging helps guide clinical treatment. To provide a basis for clinical decision-making, we analyzed that the density difference between the gray and white matter of the CT image is associated with the prognosis of patients with ASDH.

'''Methods:''' We analyzed the data of 194 patients who had ASDH as a result of closed traumatic brain injury (TBI) between 2018 and 2021. The patients were subdivided into surgical and non-surgical groups, and the non-surgical group was further subdivided into "diffused [hematoma]" and "non-diffused" groups. The control group's CT scans were normal. The [http://www.slicer.org '''3D Slicer'''] software was used to quantitatively analyze the density of gray and white matter depicted in the CT images.

'''Results:''' Imaging evaluation showed that the median difference in density between the gray and white matter on the injured side was 4.12 HU (IQR, 3.91-4.22 HU; p < 0.001) and on the non-injured side was 4.07 HU (IQR, 3.90-4.19 HU; p < 0.001), and the hematoma needs to be surgically removed. The median density difference value of the gray and white matter on the injured side was 3.74 HU (IQR, 3.53-4.01 HU; p < 0.001) and on the non-injured side was 3.71 HU (IQR, 3.69-3.73 HU; p < 0.001), and the hematoma could diffuse in a short time.

'''Conclusion:''' Quantitative analysis of the density differences in the gray and white matter of the CT images can be used to evaluate the clinical prognosis of patients with ASDH.
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==The Knosp Criteria Revisited: 3-Dimensional Volumetric Analysis as a Predictive Tool for Extent of Resection in Complex Endoscopic Pituitary Surgery==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36170168 Front Oncol. Neurosurgery. 2023 Jan 1;92(1):179-85. PMID: 36170168]

'''Authors:''' DiRisio AC, Feng R, Shuman WH, Platt S, Price G, Dullea JT, Gilja S, D'Andrea MR, Delman BN, Bederson JB, Shrivastava RK.

'''Institution:''' Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.

'''Abstract:'''
'''Background:''' The Knosp criteria have been the historical standard for predicting cavernous sinus invasion, and therefore extent of surgical resection, of pituitary macroadenomas. Few studies have sought to reappraise the utility of this tool after recent advances in visualization and modeling of tumors in complex endoscopic surgery.

'''Objective:''' To evaluate our proposed alternative method, using 3-dimensional (3D) volumetric imaging, and whether it can better predict extent of resection in nonfunctional pituitary adenomas.

'''Methods:''' Patients who underwent endoscopic transsphenoidal resection of pituitary macroadenomas at our institution were reviewed. Information was collected on neurological, endocrine, and visual function. Volumetric segmentation was performed using [http://www.slicer.org '''3D Slicer'''] software. Relationship of tumor volume, clinical features, and Knosp grade on extent of resection was examined.

'''Results:''' One hundred forty patients were identified who had transsphenoidal resection of nonfunctional pituitary adenomas. Macroadenomas had a median volume of 6 cm3 (IQR 3.4-8.7), and 17% had a unilateral Knosp grade of at least 3B. On multiple logistic regression, only smaller log-transformed preoperative tumor volume was independently associated with increased odds of gross total resection (GTR; odds ratio: 0.27, 95% CI: 0.07-0.89, P < .05) when controlling for tumor proliferative status, age, and sex (area under the curve 0.67). The Knosp criteria did not independently predict GTR in this cohort (P > .05, area under the curve 0.46).

'''Conclusion:''' Increasing use of volumetric 3D imaging may better anticipate extent of resection compared with the Knosp grade metric and may have a greater positive predictive value for GTR. More research is needed to validate these findings and implement them using automated methods.
|}

==Differentiation of Lung Metastases Originated From Different Primary Tumors Using Radiomics Features Based on CT Imaging==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/35577699 Acad Radiol. 2023 Jan;30(1):40-6. PMID: 35577699]

'''Authors:''' Shang H, Li J, Jiao T, Fang C, Li K, Yin D, Zeng Q.

'''Institution:''' Department of Radiology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, No. 16766 Jingshi Road, Jinan, Shandong, China.

'''Abstract:''' Rationale and objectives: To explore the feasibility of differentiating three predominant metastatic tumor types using lung computed tomography (CT) radiomics features based on supervised machine learning.

'''Materials and Methods:''' This retrospective analysis included 252 lung metastases (LM) (from 78 patients), which were divided into the training (n = 176) and test (n = 76) cohort randomly. The metastases originated from colorectal cancer (n = 97), breast cancer (n = 87), and renal carcinoma (n = 68). An additional 77 LM (from 35 patients) were used for external validation. All radiomics features were extracted from lung CT using an open-source software, [http://www.slicer.org '''3D Slicer''']. The least absolute shrinkage and selection operator (LASSO) method selected the optimal radiomics features to build the model. Random forest and support vector machine (SVM) were selected to build three-class and two-class models. The performance of the classification model was evaluated with the area under the receiver operating characteristic curve (AUC) by two strategies: one-versus-rest and one-versus-one.

'''Results:''' Eight hundred and fifty-one quantitative radiomics features were extracted from lung CT. By LASSO, 23 optimal features were extracted in three-class, and 25, 29, and 35 features in two-class for differentiating every two of three LM (colorectal cancer vs. renal carcinoma, colorectal cancer vs. breast cancer, and breast cancer vs. renal carcinoma, respectively). The AUCs of the three-class model were 0.83 for colorectal cancer, 0.79 for breast cancer, and 0.91 for renal carcinoma in the test cohort. In the external validation cohort, the AUCs were 0.77, 0.83, and 0.81, respectively. Swarmplot shows the distribution of radiomics features among three different LM types. In the two-class model, high accuracy and AUC were obtained by SVM. The AUC of discriminating colorectal cancer LM from renal carcinoma LM was 0.84, and breast cancer LM from colorectal cancer LM and renal carcinoma LM were 0.80 and 0.94, respectively. The AUCs were 0.77, 0.78, and 0.84 in the external validation cohort.

'''Conclusion:''' Quantitative radiomics features based on Lung CT exhibited good discriminative performance in LM of primary colorectal cancer, breast cancer, and renal carcinoma.
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==MRI Radiomic Features of Peritumoral Edema May Predict the Recurrence Sites of Glioblastoma Multiforme==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36686829 Front Oncol. 2023 Jan 4;12:1042498. PMID: 36686829] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9845721/pdf/fonc-12-1042498.pdf PDF]

'''Authors:''' Long H, Zhang P, Bi Y, Yang C, Wu M, He D, Huang S, Yang K, Qi S, Wang J.

'''Institution:''' Department of Neurosurgery, Nanfang Hospital, Southern Medical University, Guangzhou, China.

'''Abstract:'''

'''Background and Purpose:''' As one of the most aggressive malignant tumor in the central nervous system, the main cause of poor outcome of glioblastoma (GBM) is recurrence, a non-invasive method which can predict the area of recurrence pre-operation is necessary.To investigate whether there is radiological heterogeneity within peritumoral edema and identify the reproducible radiomic features predictive of the sites of recurrence of glioblastoma(GBM), which may be of value to optimize patients' management.

'''Materials and Methods:''' The clinical information and MR images (contrast-enhanced T1 weighted and FLAIR sequences) of 22 patients who have been histologically proven glioblastoma, were retrospectively evaluated. Kaplan-Meier methods was used for survival analysis. Oedematous regions were manually segmented by an expert into recurrence region, non-recurrence region. A set of 94 radiomic features were obtained from each region using the function of analyzing MR image of [http://www.slicer.org '''3D Slicer''']. Paired t test was performed to identify the features existing significant difference. Subsequently, the data of two patients from TCGA database was used to evaluate whether these features have clinical value.

'''Results:''' Ten features with significant differences between the recurrence and non-recurrence subregions were identified and verified on two individual patients from the TCGA database with pathologically confirmed diagnosis of GBM.

'''Conclusions:''' Our results suggested that heterogeneity does exist in peritumoral edema, indicating that the radiomic features of peritumoral edema from routine MR images can be utilized to predict the sites of GBM recurrence. Our findings may further guide the surgical treatment strategy for GBM.
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==Clinical Study on Application of 3D Slicer Software Assisted Domestic Frameless Stereotactic Robot in Biopsy of Intracranial Lesions==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36603886 Zhonghua Wai Ke Za Zhi. 2023 Jan 1;61(1):61-65. PMID: 36603886] | [http://www.ncbi.nlm.nih.gov/pmc/articles/pmc9849352/ PDF]

'''Authors:''' Chen H, Yan X, He F, Ding SC, Diao JF, Guo H, Cao SM, Yang CJ, Yin F.

'''Institution:''' Department of Neurosurgery, Aerospace Central Hospital, Beijing, China.

'''Abstract:'''
'''Objective:''' To examine the application value of [http://www.slicer.org '''3D Slicer'''] software assisted domestic frameless stereotactic robot in biopsy of intracranial lesions.

'''Methods:''' A retrospective analysis was performed on 80 patients who admitted consecutively and underwent intracerebral lesions biopsy with the domestic frameless stereotactic robot at Department of Neurosurgery, Aerospace Central Hospital from January 2019 to December 2021. There were 36 males and 44 females, with a mean age of (38.5±18.0) years (range: 6 to 71 years). Before surgery only enhanced T1-weighted three-dimensional magnetization prepared gradient echo sequences and diffusion tensor imaging scans were performed. Self-reconstruction of intracranial lesions, cerebral cortex and blood vessels was carried out using 3D Slicer software system after the DICOM format imaging data of 80 patients were collected. These imaging data were merged to the workstation of the domestic frameless stereotactic robot for preoperative surgical planning and the surgical puncture path was designed to avoid blood vessels in the brain functional area, cerebral cortex and sulcus.

'''Results:''' All frameless stereotactic biopsy were successfully performed. Postoperative pathological diagnosis included 50 cases of diffuse astrocytic and oligodendroglioma, 15 cases of lymphoma, 5 cases of metastatic tumors, 5 cases of inflammatory demyelinating disease, 2 cases of inflammatory granuloma, 1 case of hemangioma, 1 case of acute lymphoblastic leukemia intracranial invasion and 1 case of seminoma. The positive diagnosis rate was 100% (80/80). Postoperative imaging confirmed that the puncture path and target were accurately implemented according to the preoperative planning, and the target error was (1.32±0.44) mm (range: 0.55 to 1.99 mm). One case of puncture-related bleeding occurred at the target after surgery and improved after treatment.

'''Conclusion:''' The three-dimensional multimodal images reconstructed by the 3D Slicer software before operation could help the surgeons make the preoperative planning and reduce the risk of stereotactic brain biopsy.
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==Liver Cirrhosis and Tumor Location Can Affect the Range of Intrahepatic Microwave Ablation Zone==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36854449 Int J Hyperthermia. 2023;40(1):2181843. PMID: 36854449] | [https://www.tandfonline.com/doi/epdf/10.1080/02656736.2023.2181843?needAccess=true&role=button PDF]

'''Authors:''' Ding WZ, Wei H, Wu JP, Cheng ZG, Han ZY, Liu FY, Yu J, Liang P.

'''Institution:''' Fifth Medical Center of Chinese, PLA General Hospital, Beijing, China.

'''Abstract:'''
'''Background:''' The range of an ablation zone (AZ) plays a crucial role in the treatment effect of microwave ablation (MWA). The aim of this study was to analyze the factors influencing the AZ range.

'''Methods:''' Fourteen factors in four areas were included: patient-related factors (sex, age), disease-related factors (tumor location, liver cirrhosis), serological factors (ALT, AST, total protein, albumin, total bilirubin, direct bilirubin, and platelets), and MWA parameters (ablation time, power, and needle type). Multiple sequence MRI was used to delineate AZ by three radiologists using [http://www.slicer.org '''3D Slicer''']. MATLAB was used to calculate the AZ length, width, and area of the largest section. Linear regression analysis was used to analyze influencing factors. Moreover, a subgroup analysis was conducted for patients with viral hepatitis.

'''Result:''' 220 patients with 290 tumors were included between 2010-2021. In addition to MWA parameters, cirrhosis and tumor location were significant factors that influenced AZ (p < 0.001). The standardized coefficient (beta) of cirrhosis (cirrhosis vs. non-cirrhosis) was positive, which meant cirrhosis would lead to a decrease in AZ range. The beta of tumor location (near the hepatic hilar zone, intermediate zone, and periphery zone) was negative, indicating that AZ range decreased as the tumor location approached the hepatic hilum. For viral hepatitis patients, Fibrosis 4 (FIB4) score was a significant factor influencing AZ (p < 0.001), and the beta was negative, indicating that AZ range decreased as FIB4 increased.

'''Conclusion:''' Liver cirrhosis, tumor location, and FIB4 affect the AZ range and should be considered when planning MWA parameters.
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==A Magnetic Resonance Imaging Based Radiomics Model to Predict Mitosis Cycles in Intracranial Meningioma==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36653482 Sci Rep. 2023 Jan 18;13(1):969. PMID: 36653482] | [http://www.ncbi.nlm.nih.gov/pmc/articles/pmc9849352/ PDF]

'''Authors:'''Krähling H, Musigmann M, Akkurt BH, Sartoretti T, Sartoretti E, Henssen DJHA, Stummer W, Heindel W, Brokinkel B, Mannil M.

'''Institution:''' University Clinic for Radiology, University Hospital Muenster, Westfälische Wilhelms-University Muenster, Muenster, Germany.

'''Abstract:''' The aim of this study was to develop a magnetic resonance imaging (MRI) based radiomics model to predict mitosis cycles in intracranial meningioma grading prior to surgery. Preoperative contrast-enhanced T1-weighted (T1CE) cerebral MRI data of 167 meningioma patients between 2015 and 2020 were obtained, preprocessed and segmented using the [http://www.slicer.org '''3D Slicer'''] software and the PyRadiomics plugin. In total 145 radiomics features of the T1CE MRI images were computed. The criterion on the basis of which the feature selection was made is whether the number of mitoses per 10 high power field (HPF) is greater than or equal to zero. Our analyses show that machine learning algorithms can be used to make accurate predictions about whether the number of mitoses per 10 HPF is greater than or equal to zero. We obtained our best model using Ridge regression for feature pre-selection, followed by stepwise logistic regression for final model construction. Using independent test data, this model resulted in an AUC (Area under the Curve) of 0.8523, an accuracy of 0.7941, a sensitivity of 0.8182, a specificity of 0.7500 and a Cohen's Kappa of 0.5576. We analyzed the performance of this model as a function of the number of mitoses per 10 HPF. The model performs well for cases with zero mitoses as well as for cases with more than one mitosis per 10 HPF. The worst model performance (accuracy = 0.6250) is obtained for cases with one mitosis per 10 HPF. Our results show that MRI-based radiomics may be a promising approach to predict the mitosis cycles in intracranial meningioma prior to surgery. Specifically, our approach may offer a non-invasive means of detecting the early stages of a malignant process in meningiomas prior to the onset of clinical symptoms.
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==Advantages of a Training Course for Surgical Planning in Virtual Reality for Oral and Maxillofacial Surgery: Crossover Study==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36656632 JMIR Serious Games. 2023 Jan 19;11:e40541. PMID: 36656632] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9947820/?report=printable PDF]

'''Authors:''' Ulbrich M, Van den Bosch V, Bönsch A, Gruber LJ, Ooms M, Melchior C, Motmaen I, Wilpert C, Rashad A, Kuhlen TW, Hölzle F, Puladi B.

'''Institution:''' Department of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Aachen, Germany.

'''Abstract:'''
'''Background:''' As an integral part of computer-assisted surgery, virtual surgical planning (VSP) leads to significantly better surgery results, such as for oral and maxillofacial reconstruction with microvascular grafts of the fibula or iliac crest. It is performed on a 2D computer desktop screen (DS) based on preoperative medical imaging. However, in this environment, VSP is associated with shortcomings, such as a time-consuming planning process and the requirement of a learning process. Therefore, a virtual reality (VR)-based VSP application has great potential to reduce or even overcome these shortcomings due to the benefits of visuospatial vision, bimanual interaction, and full immersion. However, the efficacy of such a VR environment has not yet been investigated.

'''Objective:''' This study aimed to demonstrate the possible advantages of a VR environment through a substep of VSP, specifically the segmentation of the fibula (calf bone) and os coxae (hip bone), by conducting a training course in both DS and VR environments and comparing the results.

'''Methods:''' During the training course, 6 novices were taught how to use a software application in a DS environment, [http://www.slicer.org '''3D Slicer''']) and in a VR environment (Elucis) for the segmentation of the fibula and os coxae, and they were asked to carry out the maneuvers as accurately and quickly as possible. Overall, 13 fibula and 13 os coxae were segmented for each participant in both methods (VR and DS), resulting in 156 different models (78 fibula and 78 os coxae) per method (VR and DS) and 312 models in total. The individual learning processes in both environments were compared using objective criteria (time and segmentation performance) and self-reported questionnaires. The models resulting from the segmentation were compared mathematically (Hausdorff distance and Dice coefficient) and evaluated by 2 experienced radiologists in a blinded manner.

'''Results:''' A much faster learning curve was observed for the VR environment than the DS environment (β=.86 vs β=.25). This nearly doubled the segmentation speed (cm3/min) by the end of training, leading to a shorter time (P<.001) to reach a qualitative result. However, there was no qualitative difference between the models for VR and DS (P=.99). The VR environment was perceived by participants as more intuitive and less exhausting, and was favored over the DS environment.

'''Conclusions:''' The more rapid learning process and the ability to work faster in the VR environment could save time and reduce the VSP workload, providing certain advantages over the DS environment.
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==Lesion Size and Long-Term Cognitive Outcome After Pediatric Stroke: A Comparison Between Two Techniques to Assess Lesion Size==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36641854 Eur J Paediatr Neurol. 2023 Jan 7;42:126-32. PMID: 36641854]

'''Authors:''' Everts R, Bertato S, Steinlin M, Slavova N, Grunt S, Steiner L.

'''Institution:''' Division of Neuropediatrics, Development and Rehabilitation, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.

'''Abstract:'''
'''Background:''' There is little consensus on how lesion size impacts long-term cognitive outcome after pediatric arterial ischemic stroke (AIS). This study, therefore, compared two techniques to assessed lesion size in the chronic phase after AIS and determined their measurement agreement in relation to cognitive functions in patients after pediatric stroke.

'''Methods:''' Twenty-five patients after pediatric AIS were examined in the chronic phase (>2 years after stroke) in respect to intelligence, memory, executive functions, visuo-motor functions, motor abilities, and disease-specific outcome. Lesion size was measured using the ABC/2 formula and segmentation technique ([http://www.slicer.org '''3D Slicer''']). Correlation analysis determined the association between volumetry techniques and outcome measures in respect to long-term cognitive outcome.

'''Results:''' The measurements from the ABC/2 and segmentation technique were strongly correlated (r = 0.878, p < .001) and displayed agreement in particular for small lesions. Lesion size from both techniques was significantly correlated with disease-specific outcome (p < .001) and processing speed (p < .005) after controlling for age at stroke and multiple comparison.

'''Conclusion:''' The two techniques showed convergent validity and were both significantly correlated with long-term outcome after pediatric AIS. Compared to the time-consuming segmentation technique, ABC/2 facilitates clinical and research work as it requires relatively little time and is easy to apply.
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==Association Between Emphysema and Other Pulmonary Computed Tomography Patterns in COVID-19 Pneumonia==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36358023 J Med Virol. 2023 Jan;95(1):e28293. PMID: 36358023] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9828029/pdf/JMV-95-0.pdf PDF]

'''Authors:''' Han K, Wang J, Zou Y, Zhang Y, Zhou L, Yin Y.

'''Institution:''' Fetal-Neonatal Neuroimaging and Developmental Science Center, Division of Newborn Medicine, Boston Children's Hospital, Boston, USA.

'''Abstract:''' To evaluate the chest computed tomography (CT) findings of patients with Corona Virus Disease 2019 (COVID-19) on admission to hospital. And then correlate CT pulmonary infiltrates involvement with the findings of emphysema. We analyzed the different infiltrates of COVID-19 pneumonia using emphysema as the grade of pneumonia. We applied open-source assisted software, [http://www.slicer.org '''3D Slicer'''] to model the lungs and lesions of 66 patients with COVID-19, which were retrospectively included. we divided the 66 COVID-19 patients into the following two groups: (A) 12 patients with less than 10% emphysema in the low-attenuation area less than -950 Hounsfield units (%LAA-950), (B) 54 patients with greater than or equal to 10% emphysema in %LAA-950. Imaging findings were assessed retrospectively by two authors and then pulmonary infiltrates and emphysema volumes were measured on CT using [http://www.slicer.org '''3D Slicer'''] software. Differences between pulmonary infiltrates, emphysema, Collapsed, affected of patients with CT findings were assessed by Kruskal-Wallis and Wilcoxon test, respectively. Statistical significance was set at p < 0.05. The left lung (A) affected left lung 20.00/affected right lung 18.50, (B) affected left lung 13.00/affected right lung 11.50 was most frequently involved region in COVID-19. In addition, collapsed left lung, (A) collapsed left lung 4.95/collapsed right lung 4.65, (B) collapsed left lung 3.65/collapsed right lung 3.15 was also more severe than the right one. There were significant differences between the Group A and Group B in terms of the percentage of CT involvement in each lung region (p < 0.05), except for the inflated affected total lung (p = 0.152). The median percentage of collapsed left lung in the Group A was 20.00 (14.00-30.00), right lung was 18.50 (13.00-30.25) and the total was 19.00 (13.00-30.00), while the median percentage of collapsed left lung in the Group B was 13.00 (10.00-14.75), right lung was 11.50 (10.00-15.00) and the total was 12.50 (10.00-15.00). The percentage of affected left lung is an independent predictor of emphysema in COVID-19 patients. We need to focus on the left lung of the patient as it is more affected. The people with lower levels of emphysema may have more collapsed segments. The more collapsed segments may lead to more serious clinical feature.
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==A High-Resolution Pediatric Female Whole-Body Numerical Model With Comparison to a Male Model==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36595234 Phys Med Biol. 2023 Jan 13;68(2). PMID: 36595234]

'''Authors:''' Ntolkeras G, Jeong H, Zöllei L, Dmytriw AA, Purvaziri A, Lev MH, Grant PE, Bonmassar G.

'''Institution:''' Fetal-Neonatal Neuroimaging and Developmental Science Center, Division of Newborn Medicine, Boston Children's Hospital, Boston, USA.

'''Abstract:'''
'''Objective:''' Numerical models are central in designing and testing novel medical devices and in studying how different anatomical changes may affect physiology. Despite the numerous adult models available, there are only a few whole-body pediatric numerical models with significant limitations. In addition, there is a limited representation of both male and female biological sexes in the available pediatric models despite the fact that sex significantly affects body development, especially in a highly dynamic population. As a result, we developed Athena, a realistic female whole-body pediatric numerical model with high-resolution and anatomical detail.

'''Approach:''' We segmented different body tissues through Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) images of a healthy 3.5 year-old female child using 3D Slicer. We validated the high anatomical accuracy segmentation through two experienced sub-specialty-certified neuro-radiologists and the inter and intra-operator variability of the segmentation results comparing sex differences in organ metrics with physiologic values. Finally, we compared Athena with Martin, a similar male model, showing differences in anatomy, organ metrics, and MRI dosimetric exposure.

'''Main results:'''We segmented 267 tissue compartments, which included 50 brain tissue labels. The tissue metrics of Athena displayed no deviation from the literature value of healthy children. We show the variability of brain metrics in the male and female models. Finally, we offer an example of computing Specific Absorption Rate and Joule heating in a toddler/preschooler at 7T MRI.

'''Significance:''' This study introduces a female realistic high-resolution numerical model using MRI and CT scans of a 3.5 year-old female child, the use of which includes but is not limited to radiofrequency safety studies for medical devices (e.g. an implantable medical device safety in MRI), neurostimulation studies, and radiation dosimetry studies. This model will be open source and available on the Athinoula A. Martinos Center for Biomedical Imaging website.
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==Anatomical Morphology and Related Angles of Foramen Ovale: A Three-dimensional Computed Tomography Reconstruction==

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'''Publication:''' [https://www.ncbi.nlm.nih.gov/pubmed/36597246 J Coll Physicians Surg Pak. 2023 Jan;33(1):109-11. PMID: 36597246]

'''Authors:''' Cheng Z, Hu YL, Sun YX, Liang LZ, Pan DD, Wang DW.

'''Institution:''' Department of Neurosurgery, The Second Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, China.

'''Abstract:''' This study aimed to report the three-dimensional reconstruction of the foramen ovale (FO) based on computed tomography angiography and describe its shape and related angles. A retrospective analysis of 199 adult patients who were hospitalised at the Department of Neurosurgery, The Second Affiliated Hospital of Bengbu Medical College, Bengbu, China, from January to December 2020 was conducted. The original DICOM files of patients' computed tomography scans were processed by [http://www.slicer.org '''3D Slicer'''] software to reconstruct the three-dimensional skull. The morphological characteristics of the FO on both sides were analysed. Their size, related angles and volumes, and the differences between the two sides and gender were compared. A total of 398 FO from 199 patients were studied. The most frequent shape of the FO was oval, accounting for 54.27%. The mean lengths of the right and the left sides were 5.40±1.51 and 5.10±1.18mm, respectively. The mean width on the right and left sides was 3.23±1.16 and 3.33±1.19 mm, respectively. The FO is most commonly oval in shape. Clinicians may use the anatomical characteristics regarding the size and shape of the FO for diagnosis and treatment.
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