High-grade pancreatic intraepithelial neoplasia diagnosed based on changes in magnetic resonance cholangiopancreatography findings:A case report

BACKGROUND High-grade pancreatic intraepithelial neoplasia(PanIN)exhibits no mass and is not detected by any examination modalities.However,it can be diagnosed by pancreatic juice cytology from indirect findings.Most previous cases were diagnosed based on findings of a focal stricture of the main pancreatic duct(MPD)and caudal MPD dilatation and subsequent pancreatic juice cytology using endoscopic retrograde cholangiopancreatography(ERCP).We experienced a case of high-grade PanIN with an unclear MPD over a 20-mm range,but without caudal MPD dilatation on magnetic resonance cholangiopancreatography(MRCP).CASE SUMMARY A 60-year-old female patient underwent computed tomography for a follow-up of uterine cancer post-excision,which revealed pancreatic cysts.MRCP revealed an unclear MPD of the pancreatic body at a 20-mm length without caudal MPD dilatation.Thus,course observation was performed.After 24 mo,MRCP revealed an increased caudal MPD caliber and a larger pancreatic cyst.We performed ERCP and detected atypical cells suspected of adenocarcinoma by serial pancreatic juice aspiration cytology examination.We performed a distal pancreatectomy and obtained a histopathological diagnosis of high-grade PanIN.Pancreatic parenchyma invasion was not observed,and curative resection was achieved.CONCLUSION High-grade Pan-IN may cause MPD narrowing in a long range without caudal MPD dilatation.

Tunable spectral continuous shift of high-order harmonic generation in atoms by a plasmon-assisted shaping pulse

We delve into the phenomenon of high-order harmonic generation within a helium atom under the influence of a plasmon-assisted shaping pulse.Our findings reveal an intriguing manipulation of the frequency peak position in the harmonic emission by adjusting the absolute phase parameter within the frequency domain of the shaping pulse.This phenomenon holds potential significance for experimental setups necessitating precisely tuned single harmonics.Notably,we observe a modulated shift in the created harmonic photon energy,spanning an impressive range of 1.2 eV.This frequency peak shift is rooted in the asymmetry exhibited by the rising and falling edges of the laser pulse,directly influencing the position of the peak frequency emission.Our study quantifies the dependence of this tuning range and the asymmetry of the laser pulse,offering valuable insights into the underlying mechanisms driving this phenomenon.Furthermore,our investigation uncovers the emergence of semi-integer order harmonics as the phase parameter is altered.We attribute this discovery to the intricate interference between harmonics generated by the primary and secondary return cores.This observation introduces an innovative approach for generating semi-integer order harmonics,thus expanding our understanding of high-order harmonic generation.Ultimately,our work contributes to the broader comprehension of complex phenomena in laser-matter interactions and provides a foundation for harnessing these effects in various applications,particularly those involving precise spectral control and the generation of unique harmonic patterns.

Parametric resonance of axially functionally graded pipes conveying pulsating fluid

Based on the generalized Hamilton's principle,the nonlinear governing equation of an axially functionally graded(AFG)pipe is established.The non-trivial equilibrium configuration is superposed by the modal functions of a simply supported beam.Via the direct multi-scale method,the response and stability boundary to the pulsating fluid velocity are solved analytically and verified by the differential quadrature element method(DQEM).The influence of Young's modulus gradient on the parametric resonance is investigated in the subcritical and supercritical regions.In general,the pipe in the supercritical region is more sensitive to the pulsating excitation.The nonlinearity changes from hard to soft,and the non-trivial equilibrium configuration introduces more frequency components to the vibration.Besides,the increasing Young's modulus gradient improves the critical pulsating flow velocity of the parametric resonance,and further enhances the stability of the system.In addition,when the temperature increases along the axial direction,reducing the gradient parameter can enhance the response asymmetry.This work further complements the theoretical analysis of pipes conveying pulsating fluid.

Enhanced resonance frequency in Co2FeAl thin film with different thicknesses grown on flexible graphene substrate

The flexible materials exhibit more favorable properties than most rigid substrates in flexibility,weight saving,mechanical reliability,and excellent environmental toughness.Particularly,flexible graphene film with unique mechanical properties was extensively explored in high frequency devices.Herein,we report the characteristics of structure and magnetic properties at high frequency of Co2FeAl thin film with different thicknesses grown on flexible graphene substrate at room temperature.The exciting finding for the columnar structure of Co2FeAl thin film lays the foundation for excellent high frequency property of Co2FeAl/flexible graphene structure.In-plane magnetic anisotropy field varying with increasing thickness of Co2FeAl thin film can be obtained by measurement of ferromagnetic resonance,which can be ascribed to the enhancement of crystallinity and the increase of grain size.Meanwhile,the resonance frequency which can be achieved by the measurement of vector network analyzer with the microstrip method increases with increasing thickness of Co2FeAl thin film.Moreover,in our case with graphene film,the resonance magnetic field is quite stable though folded for twenty cycles,which demonstrates that good flexibility of graphene film and the stability of high frequency magnetic property of Co2FeAl thin film grown on flexible graphene substrate.These results are promising for the design of microwave devices and wireless communication equipment.

Staging liver fibrosis with various diffusion-weighted magnetic resonance imaging models

BACKGROUND Diffusion-weighted imaging(DWI)has been developed to stage liver fibrosis.However,its diagnostic performance is inconsistent among studies.Therefore,it is worth studying the diagnostic value of various diffusion models for liver fibrosis in one cohort.AIM To evaluate the clinical potential of six diffusion-weighted models in liver fibrosis staging and compare their diagnostic performances.METHODS This prospective study enrolled 59 patients suspected of liver disease and scheduled for liver biopsy and 17 healthy participants.All participants underwent multi-b value DWI.The main DWI-derived parameters included Mono-apparent diffusion coefficient(ADC)from mono-exponential DWI,intravoxel incoherent motion model-derived true diffusion coefficient(IVIM-D),diffusion kurtosis imaging-derived apparent diffusivity(DKI-MD),stretched exponential model-derived distributed diffusion coefficient(SEM-DDC),fractional order calculus(FROC)model-derived diffusion coefficient(FROC-D)and FROC model-derived microstructural quantity(FROC-μ),and continuous-time random-walk(CTRW)model-derived anomalous diffusion coefficient(CTRW-D)and CTRW model-derived temporal diffusion heterogeneity index(CTRW-α).The correlations between DWI-derived parameters and fibrosis stages and the parameters’diagnostic efficacy in detecting significant fibrosis(SF)were assessed and compared.RESULTS CTRW-D(r=-0.356),CTRW-α(r=-0.297),DKI-MD(r=-0.297),FROC-D(r=-0.350),FROC-μ(r=-0.321),IVIM-D(r=-0.251),Mono-ADC(r=-0.362),and SEM-DDC(r=-0.263)were significantly correlated with fibrosis stages.The areas under the ROC curves(AUCs)of the combined index of the six models for distinguishing SF(0.697-0.747)were higher than each of the parameters alone(0.524-0.719).The DWI models’ability to detect SF was similar.The combined index of CTRW model parameters had the highest AUC(0.747).CONCLUSION The DWI models were similarly valuable in distinguishing SF in patients with liver disease.The combined index of CTRW parameters had the highest AUC.

Elliptically polarized high-order harmonic generation of Ar atom in an intense laser field

High-order harmonic generation(HHG) of Ar atom in an elliptically polarized intense laser field is experimentally investigated in this work.Interestingly,the anomalous ellipticity dependence on the laser ellipticity(ε) in the lower-order harmonics is observed,specifically in the 13rd-order,which displays a maximal harmonic intensity at ε ≈ 0.1,rather than at ε = 0 as expected.This contradicts the general trend of harmonic yield,which typically decreases with the increase of laser ellipticity.In this study,we attribute this phenomenon to the disruption of the symmetry of the wave function by the Coulomb effect,leading to the generation of a harmonic with high ellipticity.This finding provides valuable insights into the behavior of elliptically polarized harmonics and opens up a potential way for exploring new applications in ultrafast spectroscopy and light–matter interactions.

High-order Bragg forward scattering and frequency shift of low-frequency underwater acoustic field by moving rough sea surface

Acoustic scattering modulation caused by an undulating sea surface on the space-time dimension seriously affects underwater detection and target recognition.Herein,underwater acoustic scattering modulation from a moving rough sea surface is studied based on integral equation and parabolic equation.And with the principles of grating and constructive interference,the mechanism of this acoustic scattering modulation is explained.The periodicity of the interference of moving rough sea surface will lead to the interference of the scattering field at a series of discrete angles,which will form comb-like and frequency-shift characteristics on the intensity and the frequency spectrum of the acoustic scattering field,respectively,which is a high-order Bragg scattering phenomenon.Unlike the conventional Doppler effect,the frequency shifts of the Bragg scattering phenomenon are multiples of the undulating sea surface frequency and are independent of the incident sound wave frequency.Therefore,even if a low-frequency underwater acoustic field is incident,it will produce obvious frequency shifts.Moreover,under the action of ideal sinusoidal waves,swells,fully grown wind waves,unsteady wind waves,or mixed waves,different moving rough sea surfaces create different acoustic scattering processes and possess different frequency shift characteristics.For the swell wave,which tends to be a single harmonic wave,the moving rough sea surface produces more obvious high-order scattering and frequency shifts.The same phenomena are observed on the sea surface under fully grown wind waves,however,the frequency shift slightly offsets the multiple peak frequencies of the wind wave spectrum.Comparing with the swell and fully-grown wind waves,the acoustic scattering and frequency shift are not obvious for the sea surface under unsteady wind waves.

High-order harmonic generation of ZnO crystals in chirped and static electric fields

High harmonic generation in ZnO crystals under chirped single-color field and static electric field are investigated by solving the semiconductor Bloch equation(SBE). It is found that when the chirp pulse is introduced, the interference structure becomes obvious while the harmonic cutoff is not extended. Furthermore, the harmonic efficiency is improved when the static electric field is included. These phenomena are demonstrated by the classical recollision model in real space affected by the waveform of laser field and inversion symmetry. Specifically, the electron motion in k-space shows that the change of waveform and the destruction of the symmetry of the laser field lead to the incomplete X-structure of the crystal-momentum-resolved(k-resolved) inter-band harmonic spectrum. Furthermore, a pre-acceleration process in the solid four-step model is confirmed.

The breaking of spin symmetry in the single-particle resonances in deformed nuclei

The exploration of spin symmetry (SS) in nuclear physics has been instrumental in identifying atomic nucleus structures.In this study,we solve the Dirac equation from the relativistic mean field (RMF) in complex momentum representation.We investigated SS and its breaking in single-particle resonant states within deformed nuclei,with a focus on the illustrative nucleus168Er.This was the initial discovery of a resonant spin doublet in a deformed nucleus,with the expectation of the SS approaching the continuum threshold.With increasing single-particle energy,the splitting of the resonant spin doublets widened significantly.This escalating splitting implies diminishing adherence to the SS,indicating a departure from the expected behavior as the energy levels increase.We also analyzed the width of the resonant states,showing that lower orbital angular momentum resonances possess shorter decay times and that SS is preserved within broad resonant doublets,as opposed to narrow resonant doublets.Comparing the radial density of the upper components for the bound-state and resonant-state doublets,it becomes evident that while SS is well-preserved in the bound states,it deteriorates in the resonant states.The impact of nuclear deformation (β_(2)) on SS was examined,demonstrating that an increase in β_(2) resulted in higher energy and width splitting in the resonant spin doublets,which is attributed to increased component mixing.Furthermore,the sensitivity of spin doublets to various potential parameters such as surface diffuseness (a),radius (R),and depth (Σ0) is discussed,emphasizing the role of these parameters in SS.This study provides valuable insights into the behavior of spin doublets in deformed nuclei and their interplay with the nuclear structure,thereby advancing our understanding of SS in the resonance state.

An underdamped and delayed tri-stable model-based stochastic resonance

Stochastic resonance(SR) is investigated in an underdamped tri-stable potential system driven by Gaussian colored noise and a periodic excitation, where both displacement and velocity time-delayed states feedback are considered. It is challenging to study SR in a second-order delayed multi-stable system analytically. In this paper, the improved energy envelope stochastic average method is developed to derive the analytical expressions of stationary probability density(SPD)and spectral amplification. The effects of noise intensity, damping coefficient, and time delay on SR are analyzed. The results show that the shapes of joint SPD can be adjusted to the desired structure by choosing the time delay and feedback gains. For fixed time delay, the SR peak is increased for negative displacement or velocity feedback gain. Meanwhile, the SR peak is decreased while the optimal noise intensity increases with increasing correlation time of noise. The Monte Carlo simulations(MCS) confirm the effectiveness of the theoretical results.

Influence of exchange bias on spin torque ferromagnetic resonance for quantification of spin–orbit torque efficiency

Antiferromagnet(AFM)/ferromagnet(FM)heterostructure is a popular system for studying the spin–orbit torque(SOT)of AFMs.However,the interfacial exchange bias field induces that the magnetization in FM layer is noncollinear to the external magnetic field,namely the magnetic moment drag effect,which further influences the characteristic of SOT efficiency.In this work,we study the SOT efficiencies of IrMn/NiFe bilayers with strong interfacial exchange bias by using spin-torque ferromagnetic resonance(ST-FMR)method.A full analysis on the AFM/FM systems with exchange bias is performed,and the angular dependence of magnetization on external magnetic field is determined through the minimum rule of free energy.The ST-FMR results can be well fitted by this model.We obtained the relative accurate SOT efficiencyξ_(DL)=0.058 for the IrMn film.This work provides a useful method to analyze the angular dependence of ST-FMR results and facilitates the accurate measurement of SOT efficiency for the AFM/FM heterostructures with strong exchange bias.

Observer-based robust high-order fully actuated attitude autopilot design for spinning glide-guided projectiles

This paper investigates the design of an attitude autopilot for a dual-channel controlled spinning glideguided projectile(SGGP),addressing model uncertainties and external disturbances.Based on fixed-time stable theory,a disturbance observer with integral sliding mode and adaptive techniques is proposed to mitigate total disturbance effects,irrespective of initial conditions.By introducing an error integral signal,the dynamics of the SGGP are transformed into two separate second-order fully actuated systems.Subsequently,employing the high-order fully actuated approach and a parametric approach,the nonlinear dynamics of the SGGP are recast into a constant linear closed-loop system,ensuring that the projectile's attitude asymptotically tracks the given goal with the desired eigenstructure.Under the proposed composite control framework,the ultimately uniformly bounded stability of the closed-loop system is rigorously demonstrated via the Lyapunov method.Validation of the effectiveness of the proposed attitude autopilot design is provided through extensive numerical simulations.

Arbitrary High-Order Fully-Decoupled Numerical Schemes for Phase-Field Models of Two-Phase Incompressible Flows

Due to the coupling between the hydrodynamic equation and the phase-field equation in two-phase incompressible flows,it is desirable to develop efficient and high-order accurate numerical schemes that can decouple these two equations.One popular and efficient strategy is to add an explicit stabilizing term to the convective velocity in the phase-field equation to decouple them.The resulting schemes are only first-order accurate in time,and it seems extremely difficult to generalize the idea of stabilization to the second-order or higher version.In this paper,we employ the spectral deferred correction method to improve the temporal accuracy,based on the first-order decoupled and energy-stable scheme constructed by the stabilization idea.The novelty lies in how the decoupling and linear implicit properties are maintained to improve the efficiency.Within the framework of the spatially discretized local discontinuous Galerkin method,the resulting numerical schemes are fully decoupled,efficient,and high-order accurate in both time and space.Numerical experiments are performed to validate the high-order accuracy and efficiency of the methods for solving phase-field models of two-phase incompressible flows.

Generation of lossy mode resonances(LMR)using perovskite nanofilms

The results presented here show for the first time the experimental demonstration of the fabrication of lossy mode resonance(LMR) devices based on perovskite coatings deposited on planar waveguides. Perovskite thin films have been obtained by means of the spin coating technique and their presence was confirmed by ellipsometry, scanning electron microscopy, and X-ray diffraction testing. The LMRs can be generated in a wide wavelength range and the experimental results agree with the theoretical simulations. Overall, this study highlights the potential of perovskite thin films for the development of novel LMR-based devices that can be used for environmental monitoring, industrial sensing, and gas detection, among other applications.

Preoperative prediction of perineural invasion of rectal cancer based on a magnetic resonance imaging radiomics model:A dual-center study

BACKGROUND Perineural invasion(PNI)has been used as an important pathological indicator and independent prognostic factor for patients with rectal cancer(RC).Preoperative prediction of PNI status is helpful for individualized treatment of RC.Recently,several radiomics studies have been used to predict the PNI status in RC,demonstrating a good predictive effect,but the results lacked generalizability.The preoperative prediction of PNI status is still challenging and needs further study.AIM To establish and validate an optimal radiomics model for predicting PNI status preoperatively in RC patients.METHODS This retrospective study enrolled 244 postoperative patients with pathologically confirmed RC from two independent centers.The patients underwent preoperative high-resolution magnetic resonance imaging(MRI)between May 2019 and August 2022.Quantitative radiomics features were extracted and selected from oblique axial T2-weighted imaging(T2WI)and contrast-enhanced T1WI(T1CE)sequences.The radiomics signatures were constructed using logistic regression analysis and the predictive potential of various sequences was compared(T2WI,T1CE and T2WI+T1CE fusion sequences).A clinical-radiomics(CR)model was established by combining the radiomics features and clinical risk factors.The internal and external validation groups were used to validate the proposed models.The area under the receiver operating characteristic curve(AUC),DeLong test,net reclassification improvement(NRI),integrated discrimination improvement(IDI),calibration curve,and decision curve analysis(DCA)were used to evaluate the model performance.RESULTS Among the radiomics models,the T2WI+T1CE fusion sequences model showed the best predictive performance,in the training and internal validation groups,the AUCs of the fusion sequence model were 0.839[95%confidence interval(CI):0.757-0.921]and 0.787(95%CI:0.650-0.923),which were higher than those of the T2WI and T1CE sequence models.The CR model constructed by combining clinical risk factors had the best predictive performance.In the training and internal and external validation groups,the AUCs of the CR model were 0.889(95%CI:0.824-0.954),0.889(95%CI:0.803-0.976)and 0.894(95%CI:0.814-0.974).Delong test,NRI,and IDI showed that the CR model had significant differences from other models(P<0.05).Calibration curves demonstrated good agreement,and DCA revealed significant benefits of the CR model.CONCLUSION The CR model based on preoperative MRI radiomics features and clinical risk factors can preoperatively predict the PNI status of RC noninvasively,which facilitates individualized treatment of RC patients.

Logical stochastic resonance in a cross-bifurcation non-smooth system

This paper investigates logical stochastic resonance(LSR)in a cross-bifurcation non-smooth system driven by Gaussian colored noise.In this system,a bifurcation parameter triggers a transition between monostability,bistability and tristability.By using Novikov's theorem and the unified colored noise approximation method,the approximate Fokker-Planck equation is obtained.Then we derive the generalized potential function and the transition rates to analyze the LSR phenomenon using numerical simulations.We simulate the logic operation of the system in the bistable and tristable regions respectively.We assess the impact of Gaussian colored noise on the LSR and discover that the reliability of the logic response depends on the noise strength and the bifurcation parameter.Furthermore,it is found that the bistable region has a more extensive parameter range to produce reliable logic operation compared with the tristable region,since the tristable region is more sensitive to noise than the bistable one.

Ion heat transport in electron cyclotron resonance heated L-mode plasma on the T-10 tokamak

Anomalous ion heat transport is analyzed in the T-10 tokamak plasma heated with electron cyclotron resonance heating(ECRH) in second-harmonic extra-ordinary mode. Predictive modeling with empirical scaling for Ohmical heat conductivity shows that in ECRH plasmas the calculated ion temperature could be overestimated, so an increase of anomalous ion heat transport is required. To study this effect two scans are presented: over the EC resonance position and over the ECRH power. The EC resonance position varies from the high-field side to the low-field side by variation of the toroidal magnetic field. The scan over the heating power is presented with on-axis and mixed ECRH regimes. Discharges with high anomalous ion heat transport are obtained in all considered regimes. In these discharges the power balance ion heat conductivity exceeds the neoclassical level by up to 10 times. The high ion heat transport regimes are distinguished by three parameters: the ratio Te/Ti, the normalized electron density gradient R/■, and the ion–ion collisionality νii~*. The combination of high Te/Ti, high νii~*, and R/■=6-10 results in values of normalized anomalous ion heat fluxes up to 10 times higher than in the low transport scenario.

Simplified liver imaging reporting and data system for the diagnosis of hepatocellular carcinoma on gadoxetic acid-enhanced magnetic resonance imaging

BACKGROUND The liver imaging reporting and data system(LI-RADS)diagnostic table has 15 cells and is too complex.The diagnostic performance of LI-RADS for hepatocellular carcinoma(HCC)is not satisfactory on gadoxetic acid-enhanced magnetic resonance imaging(EOB-MRI).AIM To evaluate the ability of the simplified LI-RADS(sLI-RADS)to diagnose HCC on EOB-MRI.METHODS A total of 331 patients with 356 hepatic observations were retrospectively analysed.The diagnostic performance of sLI-RADS A-D using a single threshold was evaluated and compared with LI-RADS v2018 to determine the optimal sLIRADS.The algorithms of sLI-RADS A-D are as follows:The single threshold for sLI-RADS A and B was 10 mm,that is,classified observations≥10mm using an algorithm of 10-19 mm observations(sLI-RADS A)and≥20 mm observations(sLI-RADS B)in the diagnosis table of LI-RADS v2018,respectively,while the classification algorithm remained unchanged for observations<10 mm;the single threshold for sLI-RADS C and D was 20 mm,that is,for<20 mm observations,the algorithms for<10 mm observations(sLI-RADS C)and 10-19 mm observations(sLI-RADS D)were used,respectively,while the algorithm remained unchanged for observations≥20 mm.With hepatobiliary phase(HBP)hypointensity as a major feature(MF),the final sLI-RADS(F-sLI-RADS)was formed according to the optimal sLI-RADS,and its diagnostic performance was evaluated.The times needed to classify the observations according to F-sLIRADS and LI-RADS v2018 were compared.RESULTS The optimal sLI-RADS was sLI-RADS D(with a single threshold of 20 mm),because its sensitivity was greater than that of LI-RADS v2018(89.8%vs 87.0%,P=0.031),and its specificity was not lower(89.4%vs 90.1%,P>0.999).With HBP hypointensity as an MF,the sensitivity of F-sLI-RADS was greater than that of LI-RADS v2018(93.0%vs 87.0%,P<0.001)and sLI-RADS D(93.0%vs 89.8%,P=0.016),without a lower specificity(86.5%vs 90.1%,P=0.062;86.5%vs 89.4%,P=0.125).Compared with that of LI-RADS v2018,the time to classify lesions according to FsLI-RADS was shorter(51±21 s vs 73±24 s,P<0.001).CONCLUSION The use of sLI-RADS with HBP hypointensity as an MF may improve the sensitivity of HCC diagnosis and reduce lesion classification time.

Current status of magnetic resonance imaging radiomics in hepatocellular carcinoma:A quantitative review with Radiomics Quality Score

BACKGROUND Radiomics is a promising tool that may increase the value of magnetic resonance imaging(MRI)for different tasks related to the management of patients with hepatocellular carcinoma(HCC).However,its implementation in clinical practice is still far,with many issues related to the methodological quality of radiomic studies.AIM To systematically review the current status of MRI radiomic studies concerning HCC using the Radiomics Quality Score(RQS).METHODS A systematic literature search of PubMed,Google Scholar,and Web of Science databases was performed to identify original articles focusing on the use of MRI radiomics for HCC management published between 2017 and 2023.The methodological quality of radiomic studies was assessed using the RQS tool.Spearman’s correlation(ρ)analysis was performed to explore if RQS was correlated with journal metrics and characteristics of the studies.The level of statistical significance was set at P<0.05.RESULTS One hundred and twenty-seven articles were included,of which 43 focused on HCC prognosis,39 on prediction of pathological findings,16 on prediction of the expression of molecular markers outcomes,18 had a diagnostic purpose,and 11 had multiple purposes.The mean RQS was 8±6.22,and the corresponding percentage was 24.15%±15.25%(ranging from 0.0% to 58.33%).RQS was positively correlated with journal impact factor(IF;ρ=0.36,P=2.98×10^(-5)),5-years IF(ρ=0.33,P=1.56×10^(-4)),number of patients included in the study(ρ=0.51,P<9.37×10^(-10))and number of radiomics features extracted in the study(ρ=0.59,P<4.59×10^(-13)),and time of publication(ρ=-0.23,P<0.0072).CONCLUSION Although MRI radiomics in HCC represents a promising tool to develop adequate personalized treatment as a noninvasive approach in HCC patients,our study revealed that studies in this field still lack the quality required to allow its introduction into clinical practice.

Magnetic resonance imaging-based lymph node radiomics for predicting the metastasis of evaluable lymph nodes in rectal cancer

BACKGROUND Lymph node(LN)staging in rectal cancer(RC)affects treatment decisions and patient prognosis.For radiologists,the traditional preoperative assessment of LN metastasis(LNM)using magnetic resonance imaging(MRI)poses a challenge.AIM To explore the value of a nomogram model that combines Conventional MRI and radiomics features from the LNs of RC in assessing the preoperative metastasis of evaluable LNs.METHODS In this retrospective study,270 LNs(158 nonmetastatic,112 metastatic)were randomly split into training(n=189)and validation sets(n=81).LNs were classified based on pathology-MRI matching.Conventional MRI features[size,shape,margin,T2-weighted imaging(T2WI)appearance,and CE-T1-weighted imaging(T1WI)enhancement]were evaluated.Three radiomics models used 3D features from T1WI and T2WI images.Additionally,a nomogram model combining conventional MRI and radiomics features was developed.The model used univariate analysis and multivariable logistic regression.Evaluation employed the receiver operating characteristic curve,with DeLong test for comparing diagnostic performance.Nomogram performance was assessed using calibration and decision curve analysis.RESULTS The nomogram model outperformed conventional MRI and single radiomics models in evaluating LNM.In the training set,the nomogram model achieved an area under the curve(AUC)of 0.92,which was significantly higher than the AUCs of 0.82(P<0.001)and 0.89(P<0.001)of the conventional MRI and radiomics models,respectively.In the validation set,the nomogram model achieved an AUC of 0.91,significantly surpassing 0.80(P<0.001)and 0.86(P<0.001),respectively.CONCLUSION The nomogram model showed the best performance in predicting metastasis of evaluable LNs.