Explainable Self-Supervised Dynamic Neuroimaging Using Time Reversal.

Objective: Functional magnetic resonance imaging data pose significant challenges due to their inherently noisy and complex nature, making traditional statistical models less effective in capturing predictive features. While deep learning models offer superior performance through their non-linear capabilities, they often lack transparency, reducing trust in their predictions. This study introduces the Time Reversal (TR) pretraining method to address these challenges.

"Innovative multidisciplinary care in pediatric magnet aspiration: A case report".

Introduction: Foreign body (FB) inhalation is a potentially life-threatening condition in children. Magnets, being rare, aspirated objects, pose significant threat due to their physical and magnetic properties.

Case Presentation: A 10-year-old girl with a history of magnet aspiration went into respiratory distress due to dislodgement of magnet to opposite main bronchus following failed attempt of removal via Rigid Bronchoscopy.

Development of a fibrin-targeted theranostic for gastric cancer.

Patients with advanced gastric cancer (GCa) have limited treatment options, and alternative treatment approaches are necessary to improve their clinical outcomes. Because fibrin is abundant in gastric tumors but not in healthy tissues, we hypothesized that fibrin could be used as a high-concentration depot for a high-energy beta-emitting cytotoxic radiopharmaceutical delivered to tumor cells. We showed that fibrin is present in 64 to 75% of primary gastric tumors and 50 to 100% of metastatic gastric adenocarcinoma cores.

An atypical abdominal manifestation of retroperitoneal teratoma: Case report.

Introduction & Importance: Teratomas, typically situated in midline areas like the sacrococcygeal region, may rarely manifest in the retroperitoneal region. Often asymptomatic and incidentally discovered, they can lead to complications such as infection, tumor rupture, or, exceptionally, peritonitis.

Case Presentation: In a 2-year-old child with a history of trauma, an atypical presentation of acute abdomen and peritonitis was observed.

A simple but tough-to-beat baseline for fMRI time-series classification.

Current neuroimaging studies frequently use complex machine learning models to classify human fMRI data, distinguishing healthy and disordered brains, often to validate new methods or enhance prediction accuracy. Yet, where prediction accuracy is a concern, our results suggest that precision in prediction does not always require such sophistication. When a classifier as simple as logistic regression is applied to feature-engineered fMRI data, it can match or even outperform more sophisticated recent models.

Optimizing outcomes and personalizing care with targeted agents in advanced cholangiocarcinoma.

Traditional chemotherapy and immunotherapy-based systemic treatments for locally advanced or metastatic cholangiocarcinoma have been associated with poor clinical outcomes driven partly by molecular heterogeneity promoting early treatment resistance and a higher toxicity profile associated with these regimens. Few patients are eligible for upfront surgical resection and clinical studies have been traditionally difficult to conduct due to the orphan nature of this disease. However, increasing use of genomic profiling in clinical practice have led to active investigations of aberrant albeit promising mechanistic therapeutic targets such as IDH-1, FGFRs, BRAF, HER-2 and NTRK.

Evaluating the Impact of Adjunctive Partial Cryoablation on Dual Checkpoint Inhibitor Immunotherapy Response in a Murine Model.

Purpose To evaluate the impact of adjunctive partial cryoablation on checkpoint inhibitor (CPI) immunotherapy response. Materials and Methods One hundred fifty-six mice (equal number of male and female animals) with dual-implanted tumor models were treated with dual CPI or a vehicle and randomized to treatment of a single tumor with partial cryoablation. Tumors were followed for 60 days following cryoablation for response assessment.

Proton therapy toxicity outcomes for localized prostate cancer: Long-term results at a comprehensive cancer center.

Background: Proton therapy (PT) has unique biologic properties with excellent clinical outcomes for the management of localized prostate cancer. Here, we aim to characterize the toxicity of PT for patients with localized prostate cancer and propose mitigation strategies using a large institutional database.

Methods: We reviewed medical records of 2772 patients with localized prostate cancer treated with definitive PT between May 2006 through January 2020.

Standardization of scan protocols for RT CT simulator from different vendors using quantitative image quality technique.

Objective: To investigate the feasibility of standardizing RT simulation CT scanner protocols between vendors using target-based image quality (IQ) metrics.

Method And Materials: A systematic assessment process in phantom was developed to standardize clinical scan protocols for scanners from different vendors following these steps: (a) images were acquired by varying CTDI and using an iterative reconstruction (IR) method (IR: iDose and model-based iterative reconstruction [IMR] of CT-Philips Big Bore scanner, SAFIRE of CT-Siemens biograph PETCT scanner), (b) CT exams were classified into body and brain protocols, (c) the rescaled noise power spectrum (NPS) was calculated, (d) quantified the IQ change due to varied CTDI and IR, and (e) matched the IR strength level. IQ metrics included noise and texture from NPS, contrast, and contrast-to-noise ratio (CNR), low contrast detectability (d').

Stratification to Neoadjuvant Radiotherapy in Rectal Cancer by Regimen and Transcriptional Signatures.

Unlabelled: Response to neoadjuvant radiotherapy (RT) in rectal cancer has been associated with immune and stromal features that are captured by transcriptional signatures. However, how such associations perform across different chemoradiotherapy regimens and within individual consensus molecular subtypes (CMS) and how they affect survival remain unclear. In this study, gene expression and clinical data of pretreatment biopsies from nine cohorts of primary rectal tumors were combined (N = 826).

Identification and validation of a machine learning model of complete response to radiation in rectal cancer reveals immune infiltrate and TGFβ as key predictors.

Background: It is uncertain which biological features underpin the response of rectal cancer (RC) to radiotherapy. No biomarker is currently in clinical use to select patients for treatment modifications.

Methods: We identified two cohorts of patients (total N = 249) with RC treated with neoadjuvant radiotherapy (45Gy/25) plus fluoropyrimidine.

A prospective study of HER3 expression pre and post neoadjuvant therapy of different breast cancer subtypes: implications for HER3 imaging therapy guidance.

Purpose: HER3, a member of the EGFR receptor family, plays a central role in driving oncogenic cell proliferation in breast cancer. Novel HER3 therapeutics are showing promising results while recently developed HER3 PET imaging modalities aid in predicting and assessing early treatment response. However, baseline HER3 expression, as well as changes in expression while on neoadjuvant therapy, have not been well-characterized.

Role of robot-assisted laparoscopy in deep infiltrating endometriosis with bowel involvement: a systematic review and application of the IDEAL framework.

Aims: This review aims to evaluate the feasibility of robot-assisted laparoscopic surgery (RALS) as an alternative to standard laparoscopic surgery (SLS) for the treatment of bowel deep-infiltrative endometriosis. Additionally, it aims to provide guidance for future study design, by gaining insight into the current state of research, in accordance with the IDEAL framework.

Method: A systematic review was conducted to identify relevant studies on RALS for bowel deep infiltrating endometriosis in Medline, Embase, Cochrane Library and PubMed databases up to August 2023 and reported in keeping with PRISMA guidelines.

Determinants of radiation exposure during mobile cone-beam CT-guided robotic-assisted bronchoscopy.

Background And Objective: Robotic-assisted bronchoscopy (RAB) is an emerging modality to sample pulmonary lesions. Cone-beam computed tomography (CBCT) can be incorporated into RAB. We investigated the magnitude and predictors of patient and staff radiation exposure during mobile CBCT-guided shape-sensing RAB.

Granzyme B PET Imaging for Assessment of Disease Activity in Inflammatory Bowel Disease.

Developing a noninvasive imaging method to detect immune system activation with a high temporal resolution is key to improving inflammatory bowel disease (IBD) management. In this study, granzyme B (GZMB), typically released from cytotoxic T and natural killer cells, was targeted using PET with Ga-NOTA-GZP (where GZP is β-Ala-Gly-Gly-Ile-Glu-Phe-Asp-CHO) to detect early intestinal inflammation in murine models of colitis. Bioinformatic analysis was used to assess the potential of GZMB as a biomarker for detecting IBD and predicting response to treatment.

Neoadjuvant management of locally advanced pancreatic ductal adenocarcinoma - Heading towards a promising change in treatment paradigm.

Traditional chemotherapy-based adjuvant therapies for locally advanced pancreatic ductal adenocarcinoma (PDAC) have been associated with poor clinical outcomes driven partly by its complex anatomy and molecular heterogeneity. Treatment for PDAC is challenged by presence of a dense tumour microenvironment involving an interplay of multiple tumoural and stromal components which promote metastatic oncogenic behaviour. PDAC also involves aberrations in multiple signalling pathways with paucity of treatment options against the most common mutations including KRAS, TP53, CDKN2A andSMAD4.

An adult and pediatric size-based contrast administration reduction phantom study for single and dual-energy CT through preservation of contrast-to-noise ratio.

Background: Global shortages of iodinated contrast media (ICM) during COVID-19 pandemic forced the imaging community to use ICM more strategically in CT exams.

Purpose: The purpose of this work is to provide a quantitative framework for preserving iodine CNR while reducing ICM dosage by either lowering kV in single-energy CT (SECT) or using lower energy virtual monochromatic images (VMI) from dual-energy CT (DECT) in a phantom study.

Materials And Methods: In SECT study, phantoms with effective diameters of 9.

Mechanism of Action and Translational Potential of ()-Meclizine in Preemptive Prophylaxis Against Stroke.

Background: Mild chemical inhibition of mitochondrial respiration can confer resilience against a subsequent stroke or myocardial infarction, also known as preconditioning. However, the lack of chemicals that can safely inhibit mitochondrial respiration has impeded the clinical translation of the preconditioning concept. We previously showed that meclizine, an over-the-counter antivertigo drug, can toggle metabolism from mitochondrial respiration toward glycolysis and protect against ischemia-reperfusion injury in the brain, heart, and kidney.

An automated technique for global noise level measurement in CT image with a conjunction of image gradient.

Automated assessment of noise level in clinical computed tomography (CT) images is a crucial technique for evaluating and ensuring the quality of these images. There are various factors that can impact CT image noise, such as statistical noise, electronic noise, structure noise, texture noise, artifact noise, etc. In this study, a method was developed to measure the global noise index (GNI) in clinical CT scans due to the fluctuation of x-ray quanta.

Different methods of 3D QRS area calculation from vectorcardiographic X, Y, and Z Leads.

3DQRSarea is a strong marker for cardiac resynchronization therapy and can be obtained by taking the (i) summation or the (ii) difference of the areas subtended by positive and negative deflections in X, Y, Z vectorcardiographic electrocardiogram (ECG) leads. We correlated both methods with the instantaneous-absolute-3D-voltage-time-integral (VTI). 3DQRSarea consistently underestimated the VTI , but the summation method was a closer and more reliable approximation.

Artificial intelligence in medicine: mitigating risks and maximizing benefits via quality assurance, quality control, and acceptance testing.

The adoption of artificial intelligence (AI) tools in medicine poses challenges to existing clinical workflows. This commentary discusses the necessity of context-specific quality assurance (QA), emphasizing the need for robust QA measures with quality control (QC) procedures that encompass (1) acceptance testing (AT) before clinical use, (2) continuous QC monitoring, and (3) adequate user training. The discussion also covers essential components of AT and QA, illustrated with real-world examples.

Comprehensive Examination of Cholangiocarcinoma Patients Treated with Novel Targeted Therapies after Extended Molecular Profiling on Liquid Biopsies.

Background: Cholangiocarcinoma (CCA) is associated with poor outcomes and limited treatment options, leading to increased use of targeted therapies for its management. Here, we performed one of the largest single-centre reviews evaluating outcomes following personalised targeted agents in CCA patients.

Methods: All consecutive CCA patients receiving systemic therapy between January 2010 and April 2023 at UCLH were included.