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.

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.

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.

全膝关节置换中BrainlabKnee3导航辅助间隙平衡技术的应用优势

背景:近年来,计算机导航技术辅助关节置换逐渐受到医疗领域的关注。文献报道计算机导航在全膝关节置换中的应用临床效果不一。为了探索新一代Brainlab Knee 3导航系统的临床效果,进行了此项研究。目的:分析计算机导航系统(Brainlab Knee 3)结合间隙平衡技术在全膝关节置换中的应用效果。方法:2020年11月至2021年5月大连市第二人民医院关节外科收治71例行全膝关节置换患者,导航组35例,术中采用计算机导航结合间隙平衡技术行全膝关节置换;传统组36例,术中采用传统手术器械定位截骨。比较两组患者术中内、外侧关节间隙差;膝关节活动度、KSS评分;髋膝踝角;冠状面股骨组件角、冠状面胫骨组件角和矢状面胫骨组件角偏差值。结果与结论:①导航组伸直位内外侧间隙差0,1,2 mm的患者分别为19,14,2例;屈膝90°位内外侧间隙差0,1,2 mm的患者分别为18,15,2例。传统组伸直位内外侧间隙差0,1,2 mm的患者分别为10,20,6例;屈膝90°位内外侧间隙差0,1,2 mm的患者分别为10,15,8例。②导航组手术时间长于传统组(P<0.05),导航组有2例患者术后形成下肢肌间静脉血栓,传统组患者均无并发症。③置换后6,12个月两组患者膝关节活动度均明显增加,导航组膝关节活动度高于传统组(P<0.05)。④置换后12个月两组患者KSS评分均明显增加,导航组KSS评分高于传统组(P<0.05)。⑤置换后6个月髋膝踝角、冠状面股骨组件角、冠状面胫骨组件角、矢状面胫骨组件角偏差值均显著小于传统组(P<0.05)。⑥结果表明,采用计算机导航结合间隙平衡技术辅助全膝关节置换对关节活动度、下肢力线、胫骨假体组件位置的准确性方面具有优势,置换后关节功能恢复良好。

Can visceral fat parameters based on computed tomography be used to predict occult peritoneal metastasis in gastric cancer?

BACKGROUND The preoperative prediction of peritoneal metastasis(PM)in gastric cancer would prevent unnecessary surgery and promptly indicate an appropriate treatment plan.AIM To explore the predictive value of visceral fat(VF)parameters obtained from preoperative computed tomography(CT)images for occult PM and to develop an individualized model for predicting occult PM in patients with gastric carcinoma(GC).METHODS A total of 128 confirmed GC cases(84 male and 44 female patients)that underwent CT scans were analyzed and categorized into PM-positive(n=43)and PM-negative(n=85)groups.The clinical characteristics and VF parameters of two regions of interest(ROIs)were collected.Univariate and stratified analyses based on VF volume were performed to screen for predictive characteristics for occult PM.Prediction models with and without VF parameters were established by multivariable logistic regression analysis.RESULTS The mean attenuations of VF_(ROI 1)and VF_(ROI 2)varied significantly between the PM-positive and PMnegative groups(P=0.044 and 0.001,respectively).The areas under the receiver operating characteristic curves(AUCs)of VF_(ROI 1)and VF_(ROI 2)were 0.599 and 0.657,respectively.The mean attenuation of VF_(ROI 2)was included in the final prediction combined model,but not an independent risk factor of PM(P=0.068).No significant difference was observed between the models with and without mean attenuation of VF(AUC:0.749 vs 0.730,P=0.339).CONCLUSION The mean attenuation of VF is a potential auxiliary parameter for predicting occult PM in patients with GC.

Use of high-resolution X-ray computed tomography and 3D image analysis to quantify mineral dissemination and pore space in oxide copper ore particles

Mineral dissemination and pore space distribution in ore particles are important features that influence heap leaching performance. To quantify the mineral dissemination and pore space distribution of an ore particle, a cylindrical copper oxide ore sample (I center dot 4.6 mm x 5.6 mm) was scanned using high-resolution X-ray computed tomography (HRXCT), a nondestructive imaging technology, at a spatial resolution of 4.85 mu m. Combined with three-dimensional (3D) image analysis techniques, the main mineral phases and pore space were segmented and the volume fraction of each phase was calculated. In addition, the mass fraction of each mineral phase was estimated and the result was validated with that obtained using traditional techniques. Furthermore, the pore phase features, including the pore size distribution, pore surface area, pore fractal dimension, pore centerline, and the pore connectivity, were investigated quantitatively. The pore space analysis results indicate that the pore size distribution closely fits a log-normal distribution and that the pore space morphology is complicated, with a large surface area and low connectivity. This study demonstrates that the combination of HRXCT and 3D image analysis is an effective tool for acquiring 3D mineralogical and pore structural data.

Microstructure Evolution of Sandstone Cemented by Microbe Cement Using X-ray Computed Tomography

The bio-sandstone, which was cemented by microbe cement, was firstly prepared, and then the microstructure evolution process was studied by X-ray computed tomography （X-CT） technique. The experimental results indicate that the microstructure of bio-sandstone becomes dense with the development of age. The evolution of inner structure at different positions is different due to the different contents of microbial induced precipitation calcite. Besides, the increase rate of microbial induced precipitation calcite gradually decreases because of the reduction of microbe absorption content with the decreasing pore size in bio-sandstone.

Effects of dry-wet cycles on three-dimensional pore structure and permeability characteristics of granite residual soil using X-ray micro computed tomography

Due to seasonal climate alterations,the microstructure and permeability of granite residual soil are easily affected by multiple dry-wet cycles.The X-ray micro computed tomography(micro-CT)acted as a nondestructive tool for characterizing the microstructure of soil samples exposed to a range of damage levels induced by dry-wet cycles.Subsequently,the variations of pore distribution and permeability due to drywet cycling effects were revealed based on three-dimensional(3D)pore distribution analysis and seepage simulations.According to the results,granite residual soils could be separated into four different components,namely,pores,clay,quartz,and hematite,from micro-CT images.The reconstructed 3D pore models dynamically demonstrated the expanding and connecting patterns of pore structures during drywet cycles.The values of porosity and connectivity are positively correlated with the number of dry-wet cycles,which were expressed by exponential and linear functions,respectively.The pore volume probability distribution curves of granite residual soil coincide with the χ^(2)distribution curve,which verifies the effectiveness of the assumption of χ^(2)distribution probability.The pore volume distribution curves suggest that the pores in soils were divided into four types based on their volumes,i.e.micropores,mesopores,macropores,and cracks.From a quantitative and visual perspective,considerable small pores are gradually transformed into cracks with a large volume and a high connectivity.Under the action of dry-wet cycles,the number of seepage flow streamlines which contribute to water permeation in seepage simulation increases distinctly,as well as the permeability and hydraulic conductivity.The calculated hydraulic conductivity is comparable with measured ones with an acceptable error margin in general,verifying the accuracy of seepage simulations based on micro-CT results.

Review of X-ray and computed tomography scan findings with a promising role of point of care ultrasound in COVID-19 pandemic

As healthcare professionals continue to combat the coronavirus disease 2019(COVID-19)infection worldwide,there is an increasing interest in the role of imaging and the relevance of various modalities.Since imaging not only helps assess the disease at the time of diagnosis but also aids evaluation of response to management,it is critical to examine the role of different modalities currently in use,such as baseline X-rays and computed tomography scans carefully.In this article,we will draw attention to the critical findings for the radiologist.Further,we will look at point of care ultrasound,an increasingly a popular tool in diagnostic medicine,as a component of COVID-19 management.

Kernel crack characteristics for X-ray computed microtomography(μCT)and their relationship with the breakage rate of maize varieties

The most significant problem of maize grain mechanical harvesting quality in China at present is the high grain breakage rate(BR).BR is often the key characteristic that is measured to select hybrids desirable for mechanical grain harvesting.However,conventional BR evaluation and measurement methods have challenges and limitations.Microstructural crack parameters evaluation of maize kernel is of great importance to BR.In this connection,X-ray computed microtomography(μ-CT)has proven to be a quite useful method for the assessment of microstructure,as it provides important microstructural parameters,such as object volume,surface,surface/volume ratio,number of closed pores,and others.X-ray computed microtomography is a non-destructive technique that enables the reuse of samples already measured and also yields bidimensional(2D)cross-sectional images of the sample as well as volume rendering.In this paper,six different maize hybrid genotypes are used as materials,and the BR of the maize kernels of each variety is tested in the field mechanical grain harvesting,and the BR is used as an index for evaluating the breakage resistance of the variety.The crack characteristic parameters of kernel were detected by X-ray micro-computed tomography,and the relationship between the BR and the kernel crack characteristics was analyzed by stepwise regression analysis.Establishing a relationship between crack characteristic parameters and BR of maize is vital for judging breakage resistance.The results of stepwise multiple linear regression(MLR)showed that the crack characteristics of the object surface,number of closed pores,surface of closed pores,and closed porosity percent were significantly correlated to the BR of field mechanical grain harvesting,with the standard partial regression coefficients of–0.998,–0.988,–0.999,and–0.998,respectively.The R2 of this model was 0.999.Results validation showed that the Stepwise MLR Model could well predict the BR of maize based on these four variables.

Pancreatic neuroendocrine tumor detected by technetium-99m methoxy-2-isobutylisonitrile single photon emission computed tomography/computed tomography:A case report

BACKGROUND Pancreatic neuroendocrine tumors(NETs)account for about 1%–2%of pancreatic tumors and about 8%of all NETs.Computed tomography(CT),magnetic resonance imaging,and endoscopic ultrasound are common imaging modalities for the diagnosis of pancreatic NETs.Furthermore,somatostatin receptor imaging is of great value for diagnosing pancreatic NETs.Herein,we report the efficacy of technetium-99m methoxy-2-isobutylisonitrile(99mTc-MIBI)single photon emission CT(SPECT)/CT for detecting pancreatic NETs.CASE SUMMARY A 57-year-old woman presented to our hospital with a 1-d history of persistent upper abdominal distending pain.The distending pain in the upper abdomen was aggravated after eating,with nausea and retching.Routine blood test results showed a high neutrophil percentage,low leukomonocyte and monocyte percentages,and low leukomonocyte and eosinophil counts.Amylase,liver and kidney function,and tumor markers alpha-fetoprotein,carcinoembryonic antigen,and cancer antigen(CA)125,CA72-4,CA19-9,and CA153 were normal.Abdominal CT showed a mass,with multiple calcifications between the pancreas and the spleen.The boundary between the mass and the pancreas and spleen was poorly defined.Contrast-enhanced CT revealed that the upper abdominal mass was unevenly and gradually enhanced.99mTc-MIBI SPECT/CT revealed that a focal radioactive concentration,with mild radioactive concentration extending into the upper abdominal mass,was present at the pancreatic body and tail.The 99mTc-MIBI SPECT/CT manifestations were consistent with the final pathological diagnosis of pancreatic NET.CONCLUSION 99mTc-MIBI SPECT/CT appears to be a valuable tool for detecting pancreatic NETs.

X-ray Computed Tomography Characterization of 3D Tufted Twill Textile Composite for Aerostructures

Damage assessments in three dimensional (3D) textile composites subjected to mechanical loading can be performed by non-destructive and destructive techniques.This paper applies the two techniques to investigate the fracture behavior of 3D tufted textile composites.X-ray computed tomography as a non-destructive evaluation method is appropriate to detect damage locations and identify their progression in 3D textile composites.Destructive methods such as sectioning toward observing damage provide valuable information about damage patterns.The results of this research could be utilized to evaluate the initial cause of rupture in 3D tufted composites used in aerospace structures and analyze fracture modes and damage progression.

In situ compression and X-ray computed tomography of flow battery electrodes

Redox flow batteries offer a potential solution to an increase in renewable energy generation on the grid by offering long-term, large-scale storage and regulation of power. However, they are currently un- derutilised due to cost and performance issues, many of which are linked to the microstructure of the porous carbon electrodes used. Here, for the first time, we offer a detailed study of the in situ effects of compression on a commercially available carbon felt electrode. Visualisation of electrode structure us- ing X-ray computed tomography shows the non-linear way that these materials compress and various metrics are used to elucidate the changes in porosity, pore size distribution and tortuosity factor under compressions from 0%-90%.

Isotropic compression behavior of granular assembly with non-spherical particles by X-ray micro-computed tomography and discrete element modeling

The particle morphological properties,such as sphericity,concavity and convexity,of a granular assembly significantly affect its macroscopic and microscopic compressive behaviors under isotropic loading condition.However,limited studies on investigating the microscopic behavior of the granular assembly with real particle shapes under isotropic compression were reported.In this study,X-ray computed tomography(mCT)and discrete element modeling(DEM)were utilized to investigate isotropic compression behavior of the granular assembly with regard to the particle morphological properties,such as particle sphericity,concavity and interparticle frictions.The mCT was first used to extract the particle morphological parameters and then the DEM was utilized to numerically investigate the influences of the particle morphological properties on the isotropic compression behavior.The image reconstruction from mCT images indicated that the presented particle quantification algorithm was robust,and the presented microscopic analysis via the DEM simulation demonstrated that the particle surface concavity significantly affected the isotropic compression behavior.The observations of the particle connectivity and local void ratio distribution also provided insights into the granular assembly under isotropic compression.Results found that the particle concavity and interparticle friction influenced the most of the isotropic compression behavior of the granular assemblies.

Performance evaluation of the simpli¯ed spherical harmonics approximation for cone-beam X-ray luminescence computed tomography imaging

As an emerging molecular imaging modality,cone-beam X-ray luminescence computed tomog-raphy(CB-XLCT)uses X-ray-excitable probes to produce near-infrared(NIR)luminescence and then reconst ructs three-dimensional(3D)distribution of the probes from surface measurements.A proper photon-transportation model is critical to accuracy of XLCT.Here,we presented a systematic comparison between the common-used Monte Carlo model and simplified spherical harmonics(SPN).The performance of the two methods was evaluated over several main spec-trums using a known XLCT material.We designed both a global measurement based on the cosine similarity and a locally-averaged relative error,to quantitatively assess these methods.The results show that the SP_(3) could reach a good balance between the modeling accuracy and computational efficiency for all of the tested emission spectrums.Besides,the SP_(1)(which is equivalent to the difusion equation(DE))can be a reasonable alternative model for emission wavelength over 692nm.In vivo experiment further demonstrates the reconstruction perfor-mance of the SP:and DE.This study would provide a valuable guidance for modeling the photon-transportation in CB-XLCT.

X-Ray Computed Tomography for Root Quantification

Soil cores from a field growing barley and barley mutants without root hairs under conventional and minimum tillage were sampled. They were X-ray scanned to produce a 3D image and then the roots were washed out and weight and length were determined by conventional means. Root volume and surface area were then calculated from the 3D images using state of the art software and methodology, and the measured and calculated measures were correlated. The only strong and significant correlation was between measured weight and calculated volume for mutants without root hairs. It is concluded that the software cannot segment out very small roots, but segmentation accuracy also depends on root structure in some unknown way. Any study using X-ray computed tomography to quantify roots as they grow in situ should start with a calibration for the conditions in question.

Assessing efficacy of standard impregnation techniques on die-cast aluminum alloys using X-ray micro-CT

Utilizing lightweight Al alloys in various industrial applications requires achieving precise pressure tightness and leak requirements.Vacuum pressure impregnation(VPI)with thermosetting polymers is commonly used to address leakage defects in die-cast Al alloys.In this study,the efficacy of the VPI technique in sealing alloy parts was investigated using a combination of nondestructive micro X-ray computed tomography(micro XCT)and a standard leak test.The results demonstrate that the commonly used water leak test is insufficient for determining the sealing performance.Instead,micro XCT shows distinct advantages by enabling more comprehensive analysis.It reveals the presence of a low atomic number impregnates sealant within casting defects,which has low grey contrast and allows for visualizing primary leakage paths in 3D.The effective atomic number of impregnated resin is 6.75 and that of Al alloy is 13.69 by dual-energy X-ray CT.This research findings will contribute to enhancing the standard VPI process parameters and the properties of impregnating sealants to improve quality assurance for impregnation in industrial metals.

Addressing metallosis in knee arthroplasty:From diagnostic challenges to innovative treatments

In this editorial,we comment on the article by Toro et al published in the recent issue of World Journal of Orthopedics.This editorial review provides a comprehensive exploration of the landscape surrounding knee arthroplasty metallosis,focusing on key aspects ranging from the mechanisms influencing susceptibility to clinical implications and advanced treatment strategies.We elucidate the complex interplay of implant design,patient-specific variables,and wear-related processes contributing to metallosis.Furthermore,we seek to shed light on diagnostic challenges,the necessity of a multidisciplinary approach,and the imperative for vigilant implant surveillance.Uni-on-uni revision,as a targeted treatment modality,is discussed,highlighting its potential to address metallosis in unicompartmental knee arthroplasty(UKA).There is a need for heightened awareness among clinicians regarding the subtle presentations of metallosis,coupled with the limitations of traditional imaging techniques.Addressing metallosis requires a collaborative,multidisciplinary approach to effectively navigate the complexities associated with this complication.Furthermore,the review emphasizes the evolving paradigm of personalized care,with uni-on-uni revision emerging as a promising surgical solution.In conclusion,the editorial outlines the dynamic nature of knee arthroplasty metallosis and its multifaceted impact on clinical practice.It calls for ongoing collaboration,education,and integration of innovative solutions to enhance diagnostic accuracy,proactive management,and overall patient outcomes in the realm of UKA.

Distinct root system acclimation patterns of seagrass Zostera japonica in sediments of different trophic status:a research by X-ray computed tomography

Conspecific seagrass living in differing environments may develop different root system acclimation patterns.We applied X-ray computed tomography(CT)for imaging and quantifying roots systems of Zostera japonica collected from typical oligotrophic and eutrophic sediments in two coastal sites of northern China,and determined sediment physicochemical properties that might influence root system morphology,density,and distribution.The trophic status of sediments had little influence on the Z.japonica root length,and diameters of root and rhizome.However,Z.japonica in oligotrophic sediment developed the root system with longer rhizome node,deeper rhizome distribution,and larger allocation to below-ground tissues in order to acquire more nutrients and relieve the N deficiency.And the lower root and rhizome densities of Z.japonica in eutrophic sediment were mainly caused by fewer shoots and shorter longevity,which was resulted from the more serious sulfide inhibition.Our results systematically revealed the effect of sediment trophic status on the phenotypic plasticity,quantity,and distribution of Z.japonica root system,and demonstrated the feasibly of X-ray CT in seagrass root system research.

Usefulness of Chest Computed Tomography for Diagnosis of Idiopathic Pneumomediastinum with Negative Findings on Plain X-Ray

Idiopathic pneumomediastinum is rare in children. Few cases of patients with pneumomediastinum show negative findings on X-ray examination. Chest computed tomography (CT) was very useful for the diagnosis and evaluation of the extent of pneumomediastinum. We report here a case of idiopathic pneumomediastinum in a 15-year-old boy who exhibited no significant chest X-ray finding. The patient was referred to our institute for the further evaluation of pre-cordial pain and breathing difficulty. Precordial pain suddenly developed, when he was carrying a portable shrine on his shoulder (day of onset). He was admitted to another institute 3 days after onset because of worsening precordial pain. On admission, he presented with 98% saturation of hemoglobin in the peripheral blood under room air. Plain chest X-ray also revealed no abnormal findings. A half-dissolved gastrographin swallow showed no leakage of gastrographin from the pharynx and esophagus to the mediastinum, and no diverticulum within the esophagus. Plain chest CT revealed extensive emphysema around the trachea from the neck to the portion inferior to the carina of trachea. The patient was diagnosed with idiopathic pneumomediastinum because the cause was unclear. We decided to admit him to our institute under fasting conditions and rest. His symptoms improved 3 days after onset. The lesion had disap-peared 8 days after onset on chest CT. When young people experience precordial pain which increases on inspiration, we must consider pneumomediastinum in a differential diagnosis, and it is important to perform chest CT.