Simultaneous fluorescence and Compton scattering computed tomography based on linear polarization X-ray

Purpose To propose a method for simultaneous fluorescence and Compton scattering computed tomography by using linearly polarized X-rays.Methods Monte Carlo simulations were adopted to demonstrate the feasibility of the proposed method.In the simulations,the phantom is a polytetrafluoroethylene cylinder inside which are cylindrical columns containing aluminum,water,and gold(Au)-loaded water solutions with Au concentrations ranging between 0.5 and 4.0 wt%,and a parallel-hole collimator imaging geometry was adopted.The light source was modeled based on a Thomson scattering X-ray source.The phantom images for both imaging modalities were reconstructed using a maximumlikelihood expectation maximization algorithm.Results Both the X-ray fluorescence computed tomography(XFCT)and Compton scattering computed tomography(CSCT)images of the phantom were accurately reconstructed.A similar attenuation contrast problem for the different cylindrical columns in the phantom can be resolved in the XFCT and CSCT images.The interplay between XFCT and CSCT was analyzed,and the contrast-to-noise ratio(CNR)of the reconstruction was improved by correcting for the mutual influence between the two imaging modalities.Compared with K-edge subtraction imaging,XFCT exhibits a CNR advantage for the phantom.Conclusion Simultaneous XFCT and CSCT can be realized by using linearly polarized X-rays.The synergy between the two imaging modalities would have an important application in cancer radiation therapy.

A machine learning-based strategy for predicting the mechanical strength of coral reef limestone using X-ray computed tomography

Different sedimentary zones in coral reefs lead to significant anisotropy in the pore structure of coral reef limestone(CRL),making it difficult to study mechanical behaviors.With X-ray computed tomography(CT),112 CRL samples were utilized for training the support vector machine(SVM)-,random forest(RF)-,and back propagation neural network(BPNN)-based models,respectively.Simultaneously,the machine learning model was embedded into genetic algorithm(GA)for parameter optimization to effectively predict uniaxial compressive strength(UCS)of CRL.Results indicate that the BPNN model with five hidden layers presents the best training effect in the data set of CRL.The SVM-based model shows a tendency to overfitting in the training set and poor generalization ability in the testing set.The RF-based model is suitable for training CRL samples with large data.Analysis of Pearson correlation coefficient matrix and the percentage increment method of performance metrics shows that the dry density,pore structure,and porosity of CRL are strongly correlated to UCS.However,the P-wave velocity is almost uncorrelated to the UCS,which is significantly distinct from the law for homogenous geomaterials.In addition,the pore tensor proposed in this paper can effectively reflect the pore structure of coral framework limestone(CFL)and coral boulder limestone(CBL),realizing the quantitative characterization of the heterogeneity and anisotropy of pore.The pore tensor provides a feasible idea to establish the relationship between pore structure and mechanical behavior of CRL.

M^(3)Res-Transformer:新冠肺炎胸部X-ray图像识别模型

新冠肺炎(COVID-19)自爆发以来严重影响人类生命健康,近年来残差神经网络广泛应用于COVID-19识别任务中,辅助医生快速地诊断COVID-19患者,但是COVID-19图像病变区域形状复杂、大小不一,与周围组织的边界模糊,导致网络难以提取有效特征.本文针对上述问题,提出一种M^(3)Res-Transformer的新冠肺炎胸部X-ray图像识别模型,采用Res-Transformer作为模型的主干网络,结合ResNet和ViT,有效地整合局部病变特征和全局特征;设计混合残差注意力模块(mixed residual attention Module,mraM),同时考虑通道和空间位置的相互依赖性,增强网络的特征表达能力;为了增大感受野,提取多尺度特征,通过叠加具有不同扩张率的扩张卷积构造多尺度扩张残差模块(multiscale dilated residual Module,mdrM),根据不同层次特征尺度的差异,使用3个逐渐收缩尺度的mdrM进行多尺度特征提取;提出上下文交叉感知模块(contextual cross-awareness Module,ccaM),使用深层特征中的语义信息来引导浅层特征,然后将浅层特征中的空间信息嵌入深层特征中,采用交叉加权注意力机制高效聚合深层和浅层特征,获得更丰富的上下文信息.为了验证本文所提模型的有效性,在新冠肺炎胸部X-ray图像数据集上进行实验,与先进的CNN分类模型、融合不同注意力机制的ResNet50模型、基于Transformer的分类模型对比以及消融实验.结果表明,本文所提模型的Acc、Pre、Rec、F1-Score与Spe指标分别为96.33%、96.36%、96.33%、96.35%与96.26%,在COVID-19胸部X-ray图像识别任务中有效提升了识别精度,并通过可视化方法对其进行进一步验证,为COVID-19的辅助诊断提供重要的参考价值.

X-ray在鱼体组织及微量元素检测中的应用

鱼类硬质组织物,特别是骨骼支持鱼体和保护其体内器官的组织,对其进行特征检测分析是研究鱼类游泳运动、鱼类解剖、鱼体建模等的数据基础。随着X-ray技术的发展和国产设备的广泛应用,其仪器设备成本明显降低,使得X-ray在渔业研究与自动化生产中的应用成为可能。首先介绍了X-ray技术的基本原理与其在鱼体组织检测中的应用,X-ray技术在鱼体组织及微量元素检测中的应用主要分为鱼类组织器官的无损检测和鱼体微量元素检测两部分,其中分别介绍了包括照相法、数字成像法、衍射技术和吸收光谱法等X-ray技术;然后综述其在鱼体组织器官建模、鱼骨检测、鱼类化石研究、鱼耳石分析和鱼体微量元素检测方面的应用,总结了Xray在渔业领域应用中存在的问题;最后对X-ray的渔业应用方向进行展望。

Global hybrid simulations of soft X-ray emissions in the Earth’s magnetosheath

Earth’s magnetopause is a thin boundary separating the shocked solar wind plasma from the magnetospheric plasmas,and it is also the boundary of the solar wind energy transport to the magnetosphere.Soft X-ray imaging allows investigation of the large-scale magnetopause by providing a two-dimensional(2-D)global view from a satellite.By performing 3-D global hybrid-particle-in-cell(hybrid-PIC)simulations,we obtain soft X-ray images of Earth’s magnetopause under different solar wind conditions,such as different plasma densities and directions of the southward interplanetary magnetic field.In all cases,magnetic reconnection occurs at low latitude magnetopause.The soft X-ray images observed by a hypothetical satellite are shown,with all of the following identified:the boundary of the magnetopause,the cusps,and the magnetosheath.Local X-ray emissivity in the magnetosheath is characterized by large amplitude fluctuations(up to 160%);however,the maximum line-of-sight-integrated X-ray intensity matches the tangent directions of the magnetopause well,indicating that these fluctuations have limited impact on identifying the magnetopause boundary in the X-ray images.Moreover,the magnetopause boundary can be identified using multiple viewing geometries.We also find that solar wind conditions have little effect on the magnetopause identification.The Solar wind Magnetosphere Ionosphere Link Explorer(SMILE)mission will provide X-ray images of the magnetopause for the first time,and our global hybrid-PIC simulation results can help better understand the 2-D X-ray images of the magnetopause from a 3-D perspective,with particle kinetic effects considered.

The Soft X-ray Imager(SXI)on the SMILE Mission

The Soft X-ray Imager(SXI)is part of the scientific payload of the Solar wind Magnetosphere Ionosphere Link Explorer(SMILE)mission.SMILE is a joint science mission between the European Space Agency(ESA)and the Chinese Academy of Sciences(CAS)and is due for launch in 2025.SXI is a compact X-ray telescope with a wide field-of-view(FOV)capable of encompassing large portions of Earth’s magnetosphere from the vantage point of the SMILE orbit.SXI is sensitive to the soft X-rays produced by the Solar Wind Charge eXchange(SWCX)process produced when heavy ions of solar wind origin interact with neutral particles in Earth’s exosphere.SWCX provides a mechanism for boundary detection within the magnetosphere,such as the position of Earth’s magnetopause,because the solar wind heavy ions have a very low density in regions of closed magnetic field lines.The sensitivity of the SXI is such that it can potentially track movements of the magnetopause on timescales of a few minutes and the orbit of SMILE will enable such movements to be tracked for segments lasting many hours.SXI is led by the University of Leicester in the United Kingdom(UK)with collaborating organisations on hardware,software and science support within the UK,Europe,China and the United States.

Two methods for separating the magnetospheric solar wind charge exchange soft X-ray emission from the diffuse X-ray background

Solar wind charge exchange(SWCX)is the process of solar wind high-valence ions exchanging charges with neutral components and generating soft X-rays.Recently,detecting the SWCX emission from the magnetosphere is proposed as a new technique to study the magnetosphere using panoramic soft X-ray imaging.To better prepare for the data analysis of upcoming magnetospheric soft X-ray imaging missions,this paper compares the magnetospheric SWCX emission obtained by two methods in an XMM-Newton observation,during which the solar wind changed dramatically.The two methods differ in the data used to fit the diffuse X-ray background(DXB)parameters in spectral analysis.The method adding data from the ROSAT All-Sky Survey(RASS)is called the RASS method.The method using the quiet observation data is called the Quiet method,where quiet observations usually refer to observations made by the same satellite with the same target but under weaker solar wind conditions.Results show that the spectral compositions of magnetospheric SWCX emission obtained by the two methods are very similar,and the changes in intensity over time are highly consistent,although the intensity obtained by the RASS method is about 2.68±0.56 keV cm^(-2)s^(-1)sr^(-1)higher than that obtained by the Quiet method.Since the DXB intensity obtained by the RASS method is about 2.84±0.74 keV cm^(-2)s^(-1)sr^(-1)lower than that obtained by the Quiet method,and the linear correlation coefficient between the difference of SWCX and DXB obtained by the two methods in diffe rent energy band is close to-1,the diffe rences in magnetospheric SWCX can be fully attributed to the diffe rences in the fitted DXB.The difference between the two methods is most significant when the energy is less than 0.7 keV,which is also the main energy band of SWCX emission.In addition,the difference between the two methods is not related to the SWCX intensity and,to some extent,to solar wind conditions,because SWCX intensity typically va ries with the solar wind.In summary,both methods are robust and reliable,and should be considered based on the best available options.

Exploring battery material failure mechanisms through synchrotron X-ray characterization techniques

Rechargeable battery cycling performance and related safety have been persistent concerns.It is crucial to decipher the capacity fading induced by electrode material failure via a range of techniques.Among these,synchrotron-based X-ray techniques with high flux and brightness play a key role in understanding degradation mechanisms.In this comprehensive review,we summarize recent advancements in degra-dation modes and mechanisms that were revealed by synchrotron X-ray methodologies.Subsequently,an overview of X-ray absorption spectroscopy and X-ray scattering techniques is introduced for charac-terizing failure phenomena at local coordination atomic environment and long-range order crystal struc-ture scale,respectively.At last,we envision the future of exploring material failure mechanism.

Finding the magnetopause location using soft X-ray observations and a statistical inverse method

Variability in the location and shape of the dayside magnetopause is attributed to magnetic reconnection,a fundamental process that enables the transfer of mass,energy,and momentum from the solar wind into the magnetosphere.The spatial and temporal properties of the magnetopause,under varying solar and magnetospheric conditions,remain largely unknown because empirical studies using in-situ observations are challenging to interpret.Global wide field-of-view(FOV)imaging is the only means to simultaneously observe the spatial distribution of the plasma properties over the vast dayside magnetospheric region and,subsequently,quantify the energy transport from the interplanetary medium into the terrestrial magnetosphere.Two upcoming missions,ESA/CAS SMILE and NASA’s LEXI will provide wide-field imagery of the dayside magnetosheath in soft X-rays,an emission generated by charge exchange interactions between high charge-state heavy ions of solar wind origin and exospheric neutral atoms.High-cadence two-dimensional observations of the magnetosheath will allow the estimation of dynamic properties of its inner boundary,the magnetopause,and enable studies of its response to changes in the solar wind dynamic pressure and interplanetary magnetic field orientation.This work introduces a statistically-based estimation approach based on inverse theory to estimate the spatial distribution of magnetosheath soft X-ray emissivities and,with this,identify the location of the magnetopause over the Sun−Earth line.To do so,we simulate the magnetosheath structure using the MHD-based OpenGGCM model and generate synthetic soft X-ray images using LEXI’s orbit and attitude information.Our results show that 3-D estimations using the described statistically-based technique are robust against Poisson-distributed shot noise inherent to soft X-ray images.Also,our proposed methodology shows that the accuracy of both three-dimensional(3-D)estimation and the magnetopause standoff distance calculation highly depends on the observational point.

Estimating the subsolar magnetopause position from soft X-ray images using a low-pass image filter

The Lunar Environment heliospheric X-ray Imager(LEXI)and Solar wind Magnetosphere Ionosphere Link Explorer(SMILE)missions will image the Earth’s dayside magneto pause and cusps in soft X-rays after their respective launches in the near future,to specify glo bal magnetic reconnection modes for varying solar wind conditions.To suppo rt the success of these scientific missions,it is critical to develop techniques that extract the magnetopause locations from the observed soft X-ray images.In this research,we introduce a new geometric equation that calculates the subsolar magnetopause position(RS)from a satellite position,the look direction of the instrument,and the angle at which the X-ray emission is maximized.Two assumptions are used in this method:(1)The look direction where soft X-ray emissions are maximized lies tangent to the magnetopause,and(2)the magnetopause surface near the subsolar point is almost spherical and thus RSis nea rly equal to the radius of the magneto pause curvature.We create synthetic soft X-ray images by using the Open Geospace General Circulation Model(OpenGGCM)global magnetohydrodynamic model,the galactic background,the instrument point spread function,and Poisson noise.We then apply the fast Fourier transform and Gaussian low-pass filte rs to the synthetic images to re move noise and obtain accurate look angles for the soft X-ray pea ks.From the filte red images,we calculate RS and its accuracy for different LEXI locations,look directions,and solar wind densities by using the OpenGGCM subsolar magnetopause location as ground truth.Our method estimates RS with an accuracy of<0.3 RE when the solar wind density exceeds>10 cm-3.The accuracy improves for greater solar wind densities and during southward interplanetary magnetic fields.The method ca ptures the magnetopause motion during southwa rd interplaneta ry magnetic field turnings.Consequently,the technique will enable quantitative analysis of the magnetopause motion and help reveal the dayside reconnection modes for dynamic solar wind conditions.This technique will suppo rt the LEXI and SMILE missions in achieving their scientific o bjectives.

SMILE soft X-ray Imager flight model CCD370 pre-flight device characterisation

Throughout the SMILE mission the satellite will be bombarded by radiation which gradually damages the focal plane devices and degrades their performance.In order to understand the changes of the CCD370s within the soft X-ray Imager,an initial characterisation of the devices has been carried out to give a baseline performance level.Three CCDs have been characterised,the two flight devices and the flight spa re.This has been carried out at the Open University in a bespo ke cleanroom measure ment facility.The results show that there is a cluster of bright pixels in the flight spa re which increases in size with tempe rature.However at the nominal ope rating tempe rature(-120℃) it is within the procure ment specifications.Overall,the devices meet the specifications when ope rating at -120℃ in 6 × 6 binned frame transfer science mode.The se rial charge transfer inefficiency degrades with temperature in full frame mode.However any charge losses are recovered when binning/frame transfer is implemented.

Solar wind ion charge state distributions and compound cross sections for solar wind charge exchange X-ray emission

Solar Wind Charge eXchange X-ray(SWCX) emission in the heliosphere and Ea rth’s exosphere is a hard to avoid signal in soft Xray obse rvations of astrophysical targets.On the other hand,the X-ray imaging possibilities offered by the SWCX process has led to an increasing number of future dedicated space missions for investigating the solar wind-terrestrial inte ractions and magnetospheric interfaces.In both cases,accurate modelling of the SWCX emission is key to correctly interpret its signal,and remove it from obse rvations,when needed.In this paper,we compile solar wind abundance measurements from ACE for different solar wind types,and atomic data from literature,including charge exchange cross-sections and emission probabilities,used fo r calculating the compound cross-section a for the SWCX X-ray emission.We calculate a values for charge-exchange with H and He,relevant to soft X-ray energy bands(0.1-2.0 keV)for various solar wind types and solar cycle conditions.

Microstructures and micromechanical behaviors of high -entropy alloys investigated by synchrotron X-ray and neutron diffraction techniques: A review

High-entropy alloys(HEAs)possess outstanding features such as corrosion resistance,irradiation resistance,and good mechan-ical properties.A few HEAs have found applications in the fields of aerospace and defense.Extensive studies on the deformation mech-anisms of HEAs can guide microstructure control and toughness design,which is vital for understanding and studying state-of-the-art structural materials.Synchrotron X-ray and neutron diffraction are necessary techniques for materials science research,especially for in situ coupling of physical/chemical fields and for resolving macro/microcrystallographic information on materials.Recently,several re-searchers have applied synchrotron X-ray and neutron diffraction methods to study the deformation mechanisms,phase transformations,stress behaviors,and in situ processes of HEAs,such as variable-temperature,high-pressure,and hydrogenation processes.In this review,the principles and development of synchrotron X-ray and neutron diffraction are presented,and their applications in the deformation mechanisms of HEAs are discussed.The factors that influence the deformation mechanisms of HEAs are also outlined.This review fo-cuses on the microstructures and micromechanical behaviors during tension/compression or creep/fatigue deformation and the application of synchrotron X-ray and neutron diffraction methods to the characterization of dislocations,stacking faults,twins,phases,and intergrain/interphase stress changes.Perspectives on future developments of synchrotron X-ray and neutron diffraction and on research directions on the deformation mechanisms of novel metals are discussed.

Using restored two-dimensional X-ray images to reconstruct the three-dimensional magnetopause

Astronomical imaging technologies are basic tools for the exploration of the universe,providing basic data for the research of astronomy and space physics.The Soft X-ray Imager(SXI)carried by the Solar wind Magnetosphere Ionosphere Link Explorer(SMILE)aims to capture two-dimensional(2-D)images of the Earth’s magnetosheath by using soft X-ray imaging.However,the observed 2-D images are affected by many noise factors,destroying the contained information,which is not conducive to the subsequent reconstruction of the three-dimensional(3-D)structure of the magnetopause.The analysis of SXI-simulated observation images shows that such damage cannot be evaluated with traditional restoration models.This makes it difficult to establish the mapping relationship between SXIsimulated observation images and target images by using mathematical models.We propose an image restoration algorithm for SXIsimulated observation images that can recover large-scale structure information on the magnetosphere.The idea is to train a patch estimator by selecting noise–clean patch pairs with the same distribution through the Classification–Expectation Maximization algorithm to achieve the restoration estimation of the SXI-simulated observation image,whose mapping relationship with the target image is established by the patch estimator.The Classification–Expectation Maximization algorithm is used to select multiple patch clusters with the same distribution and then train different patch estimators so as to improve the accuracy of the estimator.Experimental results showed that our image restoration algorithm is superior to other classical image restoration algorithms in the SXI-simulated observation image restoration task,according to the peak signal-to-noise ratio and structural similarity.The restoration results of SXI-simulated observation images are used in the tangent fitting approach and the computed tomography approach toward magnetospheric reconstruction techniques,significantly improving the reconstruction results.Hence,the proposed technology may be feasible for processing SXI-simulated observation images.

基于X-rayμCT技术的玉米干燥损伤定量研究

应力裂纹是玉米干燥损伤的主要形式,一些微裂纹无法肉眼观察但影响玉米的机械强度、发芽率以及活力等。为此,利用X-rayμCT技术对不同干燥条件下玉米进行扫描,使用深度学习算法分割与胚乳密度相近的胚区域并结合软件对玉米内部物性特征参数进行提取,提出了一种新的玉米内部损伤定量评价方法。结合定量研究结果提出的玉米干燥损伤模型,可为玉米损伤预测提供新思路。

On the apparent line-of-sight alignment of the peak X-ray intensity of the magnetosheath and the tangent to the magnetopause,as viewed by SMILE-SXI

The Soft X-ray Imager(SXI)on board the Solar wind Magnetosphere Ionosphere Link Explorer(SMILE)spacecraft will be able to view the Earth’s magnetosheath in soft X-rays.Simulated images of the X-ray emission visible from the position of SMILE are created for a range of solar wind densities by using 3 years of the SMILE mission orbit,together with models of the expected X-ray emissivity from the Earth’s magnetosheath.Results from global magnetohydrodynamic simulations and a simple model for exospheric neutral densities are used to compare the locations of the lines of sight along which integrated soft X-ray intensities peak with the lines of sight lying tangent to surfaces(defined here to be the magnetopause)along which local soft X-ray intensities peak or exhibit their strongest gradients,or both,for strongly southward interplanetary magnetic field conditions when no depletion or low-latitude boundary layers are expected.Where,in the parameter space of the various times and seasons,orbital phases,solar wind conditions,and magnetopause models,the alignment of the X-ray emission peak with the magnetopause tangent is good,or is not,is presented.The main results are as follows.The spacecraft needs to be positioned well outside the magnetopause;low-altitude times near perigee are not good.In addition,there are seasonal aspects:dayside-apogee orbits are generally very good because the spacecraft travels out sunward at high altitude,but nightside-apogee orbits,behind the Earth,are bad because the spacecraft only rarely leaves the magnetopause.Dusk-apogee and dawnapogee orbits are intermediate.Dayside-apogee orbits worsen slightly over the first three mission years,whereas nightside-apogee orbits improve slightly.Additionally,many more times of good agreement with the peak-to-tangent hypothesis occur when the solar wind is in a high-density state,as opposed to a low-density state.In a high-density state,the magnetopause is compressed,and the spacecraft is more often a good distance outside the magnetopause.

Hybrid-Vlasov simulation of soft X-ray emissions at the Earth’s dayside magnetospheric boundaries

Solar wind charge exchange produces emissions in the soft X-ray energy range which can enable the study of near-Earth space regions such as the magnetopause,the magnetosheath and the polar cusps by remote sensing techniques.The Solar wind Magnetosphere Ionosphere Link Explorer(SMILE)and Lunar Environment heliospheric X-ray Imager(LEXI)missions aim to obtain soft Xray images of near-Earth space thanks to their Soft X-ray Imager(SXI)instruments.While earlier modeling works have already simulated soft X-ray images as might be obtained by SMILE SXI during its mission,the numerical models used so far are all based on the magnetohydrodynamics description of the space plasma.To investigate the possible signatures of ion-kinetic-scale processes in soft Xray images,we use for the first time a global hybrid-Vlasov simulation of the geospace from the Vlasiator model.The simulation is driven by fast and tenuous solar wind conditions and purely southward interplanetary magnetic field.We first produce global X-ray images of the dayside near-Earth space by placing a virtual imaging satellite at two different locations,providing meridional and equatorial views.We then analyze regional features present in the images and show that they correspond to signatures in soft X-ray emissions of mirrormode wave structures in the magnetosheath and flux transfer events(FTEs)at the magnetopause.Our results suggest that,although the time scales associated with the motion of those transient phenomena will likely be significantly smaller than the integration time of the SMILE and LEXI imagers,mirror-mode structures and FTEs can cumulatively produce detectable signatures in the soft X-ray images.For instance,a local increase by 30%in the proton density at the dayside magnetopause resulting from the transit of multiple FTEs leads to a 12%enhancement in the line-of-sight-and time-integrated soft X-ray emissivity originating from this region.Likewise,a proton density increase by 14%in the magnetosheath associated with mirror-mode structures can result in an enhancement in the soft X-ray signal by 4%.These are likely conservative estimates,given that the solar wind conditions used in the Vlasiator run can be expected to generate weaker soft X-ray emissions than the more common denser solar wind.These results will contribute to the preparatory work for the SMILE and LEXI missions by providing the community with quantitative estimates of the effects of small-scale,transient phenomena occurring on the dayside.

Seeing through Materials:X-Ray Imaging Using Computed Tomography

X-ray computed tomography(XCT)has recently emerged as a powerful tool for characterizing the evolution of microstructure during phase transformation in three dimensional(3D)such as dendritic solidification of alloys.This paper briefly reviews the recent advances in the in-situ observation of aluminium alloys,magnesium alloys and nickel-based superalloys during solidification using laboratory XCT and synchrotron X-ray sources.The focus is on the growth kinetics of dendrites,porosity and secondary phases.In addition,in-situ characterization during the loading and corrosion process is also discussed.

Computed tomography-based nomogram of Siewert type Ⅱ/Ⅲ adenocarcinoma of esophagogastric junction to predict response to docetaxel, oxaliplatin and S-1

BACKGROUND Neoadjuvant chemotherapy(NAC)has become the standard care for advanced adenocarcinoma of esophagogastric junction(AEG),although a part of the patients cannot benefit from NAC.There are no models based on baseline computed tomography(CT)to predict response of Siewert type II or III AEG to NAC with docetaxel,oxaliplatin and S-1(DOS).AIM To develop a CT-based nomogram to predict response of Siewert type II/III AEG to NAC with DOS.METHODS One hundred and twenty-eight consecutive patients with confirmed Siewert type II/III AEG underwent CT before and after three cycles of NAC with DOS,and were randomly and consecutively assigned to the training cohort(TC)(n=94)and the validation cohort(VC)(n=34).Therapeutic effect was assessed by disease-control rate and progressive disease according to the Response Evaluation Criteria in Solid Tumors(version 1.1)criteria.Possible prognostic factors associated with responses after DOS treatment including Siewert classification,gross tumor volume(GTV),and cT and cN stages were evaluated using pretherapeutic CT data in addition to sex and age.Univariate and multivariate analyses of CT and clinical features in the TC were performed to determine independent factors associated with response to DOS.A nomogram was established based on independent factors to predict the response.The predictive performance of the nomogram was evaluated by Concordance index(C-index),calibration and receiver operating characteristics curve in the TC and VC.RESULTS Univariate analysis showed that Siewert type(52/55 vs 29/39,P=0.005),pretherapeutic cT stage(57/62 vs 24/32,P=0.028),GTV(47.3±27.4 vs 73.2±54.3,P=0.040)were significantly associated with response to DOS in the TC.Multivariate analysis of the TC also showed that the pretherapeutic cT stage,GTV and Siewert type were independent predictive factors related to response to DOS(odds ratio=4.631,1.027 and 7.639,respectively;all P<0.05).The nomogram developed with these independent factors showed an excellent performance to predict response to DOS in the TC and VC(C-index:0.838 and 0.824),with area under the receiver operating characteristic curve of 0.838 and 0.824,respectively.The calibration curves showed that the practical and predicted response to DOS effectively coincided.CONCLUSION A novel nomogram developed with pretherapeutic cT stage,GTV and Siewert type predicted the response of Siewert type II/III AEG to NAC with DOS.

Importance of computed tomography in posterior malleolar fractures:Added information to preoperative X-ray studies

BACKGROUND Ankle fractures are common lesions of the lower limbs.Approximately 40%of ankle fractures affect the posterior malleolus(PM).Historically,PM osteosynthesis was recommended when PM size in X-ray images was greater than 25%of the joint.Currently,computed tomography(CT)has been gaining traction in the preoperative evaluation of ankle fractures.AIM To elucidate the similarity in dimensions and to correlate PM size in X-ray images with the articular surface of the affected tibial plafond in the axial view on CT(AXCT)of a PM fracture.METHODS Eighty-one patients(mean age:39.4±13.5 years)were evaluated(54.3%were male).Two independent examiners measured PM size in profile X-ray images(PMXR)and sagittal CT(SAGCT)slices.The correlation of the measurements between the examiners and the difference in the PM fragment sizes between the two images were compared.Next,the PM size in PMXR was compared with the surface of the tibial plafond involved in the fracture in AXCT according to the Haraguchi classification.RESULTS The correlation rates between the examiners were 0.93 and 0.94 for PMXR and SAGCT,respectively(P<0.001).Fragments were 2.12%larger in SAGCT than in PMXR(P=0.018).In PMXR,there were 56 cases<25%and 25 cases≥25%.When PMXR was<25%,AXCT corresponded to 10.13%of the tibial plafond.When PMXR was≥25%,AXCT was 24.52%(P<0.001).According to the Haraguchi classification,fracture types I and II had similar PMXR measurements that were greater than those of type III.When analyzing AXCT,a significant difference was found between the three types,with II>I>III(P<0.001).CONCLUSION PM fractures show different sizes using X-ray or CT images.CT showed a larger PM in the sagittal plane and allowed the visualization of the real dimensions of the tibial plafond surface.