Publications by authors named "Elaine Yuen Phin Lee"

Objectives: The study aimed to compare the diagnostic accuracies of 2-[F]FDG PET/CT and contrast-enhanced CT (ceCT) after neoadjuvant chemotherapy (NACT) in advanced ovarian cancer (OC).

Materials And Methods: This study consisted historical observational cohort and prospective validation cohort. Patients with newly diagnosed stage III-IV OC scheduled for NACT were recruited, with imaging performed after three to six cycles of NACT before interval debulking surgery.

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Over the last quarter of a century, fluorine-18-fluorodeoxyglucose (FDG) PET/computed tomography (CT) has revolutionized the diagnostic algorithm of ovarian cancer, impacting on the initial disease evaluation including staging and surgical planning, treatment response assessment and prognostication, to the most important role in detection of recurrent disease. The role of FDG PET/CT is expanding with the adoption of new therapeutic agents. Other non-FDG tracers have been explored with fibroblast activation protein inhibitor being promising.

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Introduction: Large language models, in particular ChatGPT, have showcased remarkable language processing capabilities. Given the substantial workload of university medical staff, this study aims to assess the quality of multiple-choice questions (MCQs) produced by ChatGPT for use in graduate medical examinations, compared to questions written by university professoriate staffs based on standard medical textbooks.

Methods: 50 MCQs were generated by ChatGPT with reference to two standard undergraduate medical textbooks (Harrison's, and Bailey & Love's).

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Article Synopsis
  • The study aimed to create noninvasive imaging signatures for HER2 and hormone receptor (HR) status in invasive breast cancer patients to aid in treatment decisions and prognostic assessments.
  • Using data from 222 patients, 1316 image features were analyzed to develop and validate these signatures, demonstrating high accuracy in predicting pathological complete response (pCR) to neoadjuvant chemotherapy.
  • Both HER2 and HR image signatures showed strong repeatability and reproducibility, with significant associations with pCR, indicating that patients identified with high imaging signatures were more likely to respond favorably to treatment.
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  • The study investigates a machine learning method using Dempster-Shafer (D-S) evidence theory to improve preoperative histologic grading of breast cancer, utilizing MRI slices of 489 lesions.
  • Various classifiers (SVM, Random Forest, KNN) were analyzed, revealing that the combined D-S method achieved an accuracy of 92.86%, outperforming the individual classifiers, which had accuracies between 78.85% and 87.82%.
  • The results suggest that integrating multiple classifiers via D-S evidence theory significantly enhances the prediction accuracy for determining breast cancer histologic grades.
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Background: Quantitative muscle and fat data obtained through body composition analysis are expected to be a new stable biomarker for the early and accurate prediction of treatment-related toxicity, treatment response, and prognosis in patients with lung cancer. The use of these biomarkers can enable the adjustment of individualized treatment regimens in a timely manner, which is critical to further improving patient prognosis and quality of life. We aimed to develop a deep learning model based on attention for fully automated segmentation of the abdomen from computed tomography (CT) to quantify body composition.

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  • Predicting the EGFR gene mutation status in non-small cell lung cancer (NSCLC) using integrated PET/CT imaging is a cost-effective and noninvasive approach that enhances targeted therapy.
  • Using the EfficientNet-V2 deep learning model, researchers fused PET and CT images to extract and analyze 3D pulmonary nodules for mutation prediction.
  • The model achieved an accuracy of 86.25% in training and 81.92% in validation datasets, outperforming traditional radiomics methods in predicting both EGFR and non-EGFR mutations.
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Frozen sections of uterine smooth muscle tumors are infrequently required, and related diagnostic difficulties are seldom discussed. We analyzed the clinicopathologic features of 112 frozen sections of uterine smooth muscle tumors and determined the accuracy, reasons for deferrals, and causes of interpretational errors. Most patients (median age, 45 y) presented with pelvic mass symptoms (53%).

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Objective: To examine the associations of intravoxel incoherent motion (IVIM) parameters with treatment response in cervical cancer following concurrent chemoradiotherapy (CCRT).

Materials And Methods: Forty-five patients, median age of 58 years (range: 28-82), with pre-CCRT and post-CCRT MRI, were retrospectively analysed. The IVIM parameters pure diffusion coefficient (D) and perfusion fraction (f) were estimated using the full b-value distribution (BVD) as well as an optimised subsample BVD.

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Objective: To examine the associations of histogram features of T2-weighted (T2W) images and apparent diffusion coefficient (ADC) with treatment response in locally advanced cervical cancer (LACC) following concurrent chemoradiotherapy (CCRT).

Materials And Methods: Fifty-eight patients who underwent a 4-week CCRT regimen with MRI prior to treatment (pre-CCRT) and after treatment (post-CCRT) were retrospectively analysed. Histogram features were calculated from volumes of interest (VOIs) from one radiologist on T2W images and ADC maps.

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Background: Magnetic resonance imaging (MRI) has limited accuracy in detecting pelvic lymph node (PLN) metastasis. This study aimed to examine the use of intravoxel incoherent motion (IVIM) in classifying pelvic lymph node (PLN) involvement in cervical cancer patients.

Methods: Fifty cervical cancer patients with pre-treatment magnetic resonance imaging (MRI) were examined for PLN involvement by one subspecialist and one non-subspecialist radiologist.

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Background Current coronavirus disease 2019 (COVID-19) radiologic literature is dominated by CT, and a detailed description of chest radiography appearances in relation to the disease time course is lacking. Purpose To describe the time course and severity of findings of COVID-19 at chest radiography and correlate these with real-time reverse transcription polymerase chain reaction (RT-PCR) testing for severe acute respiratory syndrome coronavirus 2, or SARS-CoV-2, nucleic acid. Materials and Methods This is a retrospective study of patients with COVID-19 confirmed by using RT-PCR and chest radiographic examinations who were admitted across four hospitals and evaluated between January and March 2020.

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Incorporation of point-of-care ultrasound in the undergraduate medical curriculum is of great importance to ensure early exposure and safe use of the modality. We aimed to assess the students' learning experiences following implementing an ultrasound module in the medical curriculum at the University of Hong Kong. Medical students in semester 6 (n = 221) were enrolled in the module in 2018.

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Objective: This study aimed to find the optimal number of b-values for intravoxel incoherent motion (IVIM) imaging analysis, using simulated and data from cervical cancer patients.

Materials And Methods: Simulated data were generated using literature pooled means, which served as reference values for simulations. data from 100 treatment-naïve cervical cancer patients with IVIM imaging (13 b-values, scan time, 436 seconds) were retrospectively reviewed.

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Objectives: To qualitatively and quantitatively compare the image quality between single-shot echo-planar (SS-EPI) and multi-shot echo-planar (IMS-EPI) diffusion-weighted imaging (DWI) in female pelvis METHODS: This was a prospective study involving 80 females who underwent 3.0T pelvic magnetic resonance imaging (MRI). SS-EPI and IMS-EPI DWI were acquired with 3 b values (0, 400, 800 s/mm).

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Purpose: To investigate bone marrow changes after chemoradiation (CRT) using intravoxel incoherent motion magnetic resonance imaging (IVIM-MRI) and correlate imaging changes with hematological toxicity (HT) in patients with locally advanced cervical cancer.

Materials And Methods: Thirty-nine patients with newly diagnosed cervical cancer were prospectively recruited for two sequential 3.0T IVIM-MRI studies: before treatment (MRI-1) and 3-4 weeks after standardized CRT (MRI-2).

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Extranodal lymphoma can be the primary presentation or secondary to systemic involvement of lymphoma. 2-(fluorine-18) fluoro-2-deoxy-d-glucose positron emission tomography with computer tomography (FDG-PET/CT) is useful in detecting extranodal sites during staging, treatment response assessment or recurrence detection in patients with lymphoma. In this article, we reviewed the imaging features and FDG avidity of primary extranodal lymphoma of various organs and systems on FDG-PET/CT, demonstrating the pearls and pitfalls of FDG-PET/CT in evaluating this disease entity and cross-referencing to other imaging modalities that aid in diagnosis and management.

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Background: Upper abdominal pregnancy is rare. Most patients present with hemoperitoneum, requiring emergency laparotomy.

Case: A 32-year-old woman presented with acute abdominal pain and an elevated beta-human chorionic gonadotropin (β-hCG) level.

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Lymphoepithelioma-like carcinoma (LELC) is a rare Epstein-Barr virus (EBV)-related disease, which commonly originates from the lung and is associated with more favourable treatment outcomes compared with other non-LELC thoracic carcinomas. Radiological assessment utilizing fluorine-18 fluorodeoxyglucose PET combined with computed tomography (F-FDG PET/CT) is important for initial disease staging to tailor the treatment strategy, evaluation of treatment response and detection of disease recurrence. The aim of this article was to highlight the utility of F-FDG PET/CT in different stages of disease evaluation of LELC.

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Endometriosis is a common gynecologic condition of the premenopausal years. However, postmenopausal endometriosis is rare (2.2%) and thought to be related to high level of circulating estrogen, especially in hormonal replacement therapy.

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Objective: To evaluate the diagnostic accuracy of PET/computed tomography (CT) in detecting marrow infiltration in indolent non-Hodgkin lymphoma (NHL) with histopathological correlation.

Methods: All treatment-naive newly diagnosed indolent NHL with staging PET/CT were retrospectively evaluated for marrow infiltration and categorized on the basis of the PET/CT uptake pattern: normal (PET/CT negative), focal/diffuse (PET/CT positive). Bone marrow biopsy (BMB) was considered the standard, except in focal PET/CT uptake, which was confirmed to be positive or negative by serial PET/CT.

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Purpose: Epidermal growth factor receptor (EGFR) mutation status is important in treatment stratification of stage IV lung adenocarcinoma. We evaluated the relationship between the SUV max measured on PET/CT and EGFR mutations and the value of SUV max in predicting EGFR mutations.

Patients And Methods: Seventy-one stage IV lung adenocarcinoma patients with verified EGFR mutations (48 EGFR mutant, 23 EGFR wild-type) having pretreatment PET/CT were retrospectively reviewed.

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Purpose: To investigate the relationship between intravoxel incoherent motion (IVIM) diffusion-weighted magnetic resonance imaging (MRI) and dynamic contrast-enhanced MRI (DCE-MRI) in cervical cancer perfusion.

Materials And Methods: Prospective newly diagnosed cervical cancer patients underwent diffusion-weighted MRI (13 b-values: 1-1000 s/mm(2) ) and DCE-MRI. The IVIM perfusion parameters, perfusion fraction (f), pseudodiffusion coefficient (D*), and flow-related parameter (fD*), were derived from a biexponential decay model.

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Unlabelled: In a prospective study of newly diagnosed or relapsed histologically proven extranodal natural killer/T-cell lymphoma (ENKTL) patients, we aimed to determine the accuracy of midtreatment (18)F-FDG PET for response assessment using both visual and quantitative analyses.

Methods: Twenty-four patients (12 men, 12 women; median age, 50 y; age range, 16-83 y) were referred for pre-, mid- (after 2-3 cycles of SMILE [prednisolone, methotrexate, ifosfamide, L-asparaginase, etoposide] chemotherapy), and end-treatment PET/CT scans (n = 24, 24, and 17, respectively) using a standardized protocol. Sixty-five PET/CT scans were analyzed visually using the Deauville 5-point score (DS), and the lesion with the highest maximum standardized uptake value (SUV(max)) was recorded.

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