Category: Nevin Manimala

Eur Radiol. 2025 Aug 30. doi: 10.1007/s00330-025-11976-5. Online ahead of print.

ABSTRACT

OBJECTIVES: The rising global cancer burden underscores the need for efficient screening strategies. Whole-body magnetic resonance imaging (WB-MRI) has emerged as a promising modality for cancer screening, with growing use in research and commercial settings. This study aimed to evaluate the opportunistic cancer detection rate and the feasibility of WB-MRI in asymptomatic individuals.

MATERIALS AND METHODS: A systematic review and meta-analysis were conducted per PRISMA guidelines. A literature search was performed across multiple databases from January 2015 to April 2025. Eligible studies used WB-MRI for cancer detection in asymptomatic individuals. Studies were excluded if they combined WB-MRI with other imaging methods or included patients with active malignancy or comorbidities/genetic syndromes associated with increased cancer risk. Random-effects meta-analyses estimated pooled proportions of confirmed cancer diagnoses. Risk of bias was assessed using the ROBINS-I tool. Sensitivity and subgroup analyses, publication bias assessment, and meta-regression were performed.

RESULTS: Ten studies were included, comprising 9024 participants. The pooled detection rate for confirmed cancer was 1.57% (95% CI: 1.22-2.03%; I² = 31.3%). Results were robust in sensitivity and meta-regression analyses. No significant subgroup differences or publication bias were found. Most studies had a moderate to serious risk of bias.

CONCLUSION: Although WB-MRI shows potential as an opportunistic non-invasive cancer detection tool, modest detection rates, frequent incidental findings, unstandardized protocols, and lack of long-term outcome or cost-effectiveness data limit its current clinical utility.

KEY POINTS: Question Can whole-body magnetic resonance imaging (WB-MRI) serve as an effective cancer detection tool for asymptomatic individuals across various clinical and geographic settings? Findings This meta-analysis of over 9000 asymptomatic individuals found a lack of information on cost-effectiveness, unstandardized protocols, a modest cancer detection rate and high rates of incidental findings. Clinical relevance Despite the need for effective cancer screening tools and growing popularity in commercial and research centers, whole-body MRI lacks sufficient diagnostic yield, follow-up reports and standardization for opportunistic cancer detection in asymptomatic individuals and may lead to unnecessary investigations.

PMID:40884613 | DOI:10.1007/s00330-025-11976-5

Eur Radiol. 2025 Aug 30. doi: 10.1007/s00330-025-11931-4. Online ahead of print.

ABSTRACT

OBJECTIVE: T2 mapping allows for the classification of focal liver lesions, differentiating malignancies from the most common benign liver lesions, hemangiomas, and bile duct hamartomas (BDH). Partial volume (PV) due to the presence of liver and lesion within the same voxel confounds the classification of small lesions. Our objective is to develop a robust two-component T2 estimation technique (SEPG2-SP) to enable accurate T2 estimation in the presence of PV.

MATERIALS AND METHODS: T2 estimation accuracy was evaluated using computer simulations, physical phantom data, and in vivo in 27 subjects with focal liver lesions (16 males, 62.4 ± 14.3 years old; 11 females, 66.8 ± 5.8 years old) imaged at 1.5 T with a radial turbo spin-echo (RADTSE) technique. The SEPG2-SP model was compared to a single-component model, which does not account for PV. The area under the receiver operator characteristic curve (AUROC) was used to analyze lesion classification.

RESULTS: Phantom data showed that the SEPG2-SP model had a T2 estimation error of 2-9% while the single component model had a larger error of 9-23%. Analysis of in vivo data from 68 focal liver lesions (33 malignancies, 7 hemangiomas, and 28 BDH) showed that the SEPG2-SP model classified all lesions correctly (AUROC = 1), regardless of their size. On the other hand, with the single-component model, there was overlap between malignancies and benign lesions driven by misclassification of hemangiomas as malignancies (AUROC = 0.84).

CONCLUSIONS: The two-component T2 model improved the characterization of focal liver lesions affected by PV, yielding complete separation of malignancies from the most common benign liver lesions.

KEY POINTS: Question Partial volume effects result in T2 estimation errors that confound the classification of small focal liver lesions. Findings The proposed two-component T2 estimation technique improves T2 estimation accuracy and allows accurate characterization of focal liver lesions in the presence of partial volume. Clinical relevance The T2 mapping technique described here offers a practical and reliable approach for quantitatively classifying focal liver lesions. It enables differentiation between the most common benign liver lesions and malignancies, even in small tumors impacted by partial volume effects.

PMID:40884612 | DOI:10.1007/s00330-025-11931-4

Eur Radiol. 2025 Aug 30. doi: 10.1007/s00330-025-11928-z. Online ahead of print.

ABSTRACT

OBJECTIVES: This study aims to explore the feasibility of employing generative adversarial networks (GAN) to generate synthetic contrast-enhanced ultrasound (CEUS) from grayscale ultrasound images of patients with thyroid nodules while dispensing with the need for ultrasound contrast agents injection.

MATERIALS AND METHODS: Patients who underwent preoperative thyroid CEUS examinations between January 2020 and July 2022 were collected retrospectively. The cycle-GAN framework integrated paired and unpaired learning modules was employed to develop the non-invasive image generation process. The synthetic CEUS images was generated in three phases: pre-arterial, plateau, and venous. The evaluation included quantitative similarity metrics, classification performance, and qualitative assessment by radiologists.

RESULTS: CEUS videos of 360 thyroid nodules from 314 patients (45 years ± 12 [SD]; 272 women) in the internal dataset and 202 thyroid nodules from 183 patients (46 years ± 13 [SD]; 148 women) in the external dataset were included. In the external testing dataset, quantitative analysis revealed a significant degree of similarity between real and synthetic CEUS images (structure similarity index, 0.89 ± 0.04; peak signal-to-noise ratio, 28.17 ± 2.42). Radiologists deemed 126 of 132 [95%] synthetic CEUS images diagnostically useful. The accuracy of radiologists in distinguishing between real and synthetic images was 55.6% (95% CI: 0.49, 0.63), with an AUC of 61.0% (95% CI: 0.65, 0.68). No statistically significant difference (p > 0.05) was observed when radiologists assessed peak intensity and enhancement patterns using real CEUS and synthetic CEUS.

CONCLUSION: Both quantitative analysis and radiologist evaluations exhibited that synthetic CEUS images generated by generative adversarial networks were similar to real CEUS images.

KEY POINTS: QuestionIt is feasible to generate synthetic thyroid contrast-enhanced ultrasound images using generative adversarial networks without ultrasound contrast agents injection. FindingsCompared to real contrast-enhanced ultrasound images, synthetic contrast-enhanced ultrasound images exhibited high similarity and image quality. Clinical relevanceThis non-invasive and intelligent transformation may reduce the requirement for ultrasound contrast agents in certain cases, particularly in scenarios where ultrasound contrast agents administration is contraindicated, such as in patients with allergies, poor tolerance, or limited access to resources.

PMID:40884611 | DOI:10.1007/s00330-025-11928-z

Eur Radiol. 2025 Aug 30. doi: 10.1007/s00330-025-11968-5. Online ahead of print.

ABSTRACT

OBJECTIVE: Massive haemoptysis due to central pulmonary artery (CPA) rupture in patients with advanced lung cancer is a fatal complication with limited early diagnostic tools. This study aimed to identify risk factors associated with pulmonary artery rupture and to propose a grading model to facilitate early diagnosis and timely endovascular intervention.

MATERIALS AND METHODS: This retrospective study included patients with advanced lung cancer who experienced in-hospital sudden haemoptysis-related death and received endovascular treatment for CPA abnormalities. Propensity score matching (PSM; 1:2) balanced covariates between haemoptysis-related and other in-hospital deaths. Following PSM, multivariable logistic regression was performed to identify independent risk factors. Patients were categorised into two cohorts: Group A (2012-2018) and Group B (2019-2024), the latter reflecting the implementation of early detection and endovascular management. Overall survival (OS) was compared using Kaplan-Meier analysis and log-rank testing.

RESULTS: Among 886 in-hospital deaths, sudden haemoptysis accounted for 4.63% (41/886), with 90.24% (37/41) exhibiting CPA abnormalities. CPA abnormalities, tumour necrosis, cavitation, and progressive bloody or malodorous sputum were identified as significant risk factors (p < 0.05). The haemoptysis group had significantly shorter OS than controls (p < 0.001). A three-tier grading system for pulmonary arterial blowout syndrome (PABS) was developed, with acute PABS being the most prevalent (67.26%). Patients in Group B demonstrated significantly improved OS compared with Group A (p < 0.001).

CONCLUSION: The PABS grading model enables risk stratification of life-threatening haemoptysis secondary to CPA rupture. Early identification and endovascular intervention may significantly improve clinical outcomes in advanced lung cancer.

KEY POINTS: Question What are the clinical characteristics and risk stratification criteria for life-threatening haemoptysis arising from CPA rupture in advanced lung cancer? Findings In-hospital sudden haemoptysis mortality was 4.63% and strongly associated with CPA abnormalities. A PABS grading model characterises this fatal condition. Clinical relevance The PABS grading system enables early recognition of high-risk CPA rupture in advanced lung cancer. Prompt identification and endovascular intervention may substantially improve patient outcomes.

PMID:40884610 | DOI:10.1007/s00330-025-11968-5

Eur J Orthop Surg Traumatol. 2025 Aug 30;35(1):368. doi: 10.1007/s00590-025-04496-x.

ABSTRACT

BACKGROUND: Shoulder instability is a common condition among young athletes, with high recurrence rates following conservative treatment. Bankart repair is a widely used surgical approach, but its failure rate remains significant, even for non-engaging defects. Combining Bankart repair with remplissage has been proposed to reduce recurrence rates.

METHODS: This retrospective, single-center study analyzed the long-term outcomes of young athletes (18-30 years old) who underwent Bankart repair combined with remplissage after a first anterior glenohumeral dislocation. Patients were evaluated at least five years postoperatively for recurrence rates, functional outcomes (Walch-Duplay, WOSI, Quick-DASH), return to sports, and the need for revision surgery.

RESULTS: Twenty-five patients were included, with an average follow-up of 81.4 months. The recurrence rate was 12% (3/25), with one patient requiring revision surgery. Functional scores were satisfactory (Walch-Duplay: 89.5, WOSI: 10.95, Quick-DASH: 14.30), and 84% of patients returned to sports at their previous level or higher. No significant complications were reported.

CONCLUSION: Bankart repair combined with remplissage appears to be an effective first-line treatment for young athletes with a first anterior shoulder dislocation, achieving a low recurrence rate and high return-to-sport levels. Further prospective, comparative studies are needed to validate these findings.

PMID:40884607 | DOI:10.1007/s00590-025-04496-x

CNS Drugs. 2025 Aug 30. doi: 10.1007/s40263-025-01221-4. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVES: The rising prescription rates and opioid-related harms in France highlight the need for local data. Evaluating this association may help identify vulnerable subgroups and guide safer prescribing practices. This study aimed to assess the association between opioid analgesic dispensation and the risk of suicide attempt in the French population. Secondary objectives included evaluation of a dose-response relationship and examination of the potential additive effects of co-prescriptions with benzodiazepines or gabapentinoids.

METHODS: We conducted a nationwide, population-based case-crossover study using data from the French National Health Insurance Database (Système National des Données de Santé, SNDS), covering 98.8% of the French population. Adults aged 18 years or older who were hospitalized for a first suicide attempt between 1 January 2013 and 31 December 2020, and who had received at least one opioid analgesic dispensation in the preceding year (excluding buprenorphine and methadone) were included. Opioid analgesic exposure during the 84 days before the attempt was compared with three earlier 84-day control periods.

RESULTS: Among 158,400 patients (mean age 47.0 years; 64.0% women), opioid analgesic dispensation was associated with a higher risk of suicide attempt (odds ratio [OR] = 1.26; 95% confidence interval 1.25-1.28). The risk was greater for strong opioid analgesics (OR = 1.73) and higher morphine-equivalent doses. Co-prescription with benzodiazepines or gabapentinoids further increased risk.

CONCLUSIONS: Opioid analgesic use, especially at higher doses or in combination with benzodiazepines or gabapentinoids, was associated with an increased risk of suicide attempt. Clinical vigilance is warranted when prescribing these medications.

TRIAL REGISTRATION: NCT04211077, registered 3 January 2020 (retrospectively registered).

PMID:40884605 | DOI:10.1007/s40263-025-01221-4

Bull Math Biol. 2025 Aug 30;87(10):138. doi: 10.1007/s11538-025-01518-x.

ABSTRACT

The community composition of vectors and hosts plays a critical role in determining risk of vector-borne disease transmission. Aedes aegypti and Aedes albopictus, two mosquito species that both transmit the viruses that cause dengue, chikungunya, and Zika, share habitat requirements and compete for resources at the larval stage. Ae. albopictus is generally considered a better competitor under many conditions, while Ae. aegypti is able to tolerate higher temperatures and is generally a more competent vector for many pathogens. We develop a stage-structured ordinary differential equation model that incorporates competition between the juvenile stages of two mosquito populations. We incorporate experimental constraints on competition coefficients for high and low quality food resources and explore differences in the potential outcomes of competition. We then incorporate temperature-dependent fecundity rates, juvenile development rates, and adult mortality rates for each species, and we explore competition outcomes as a function of temperature. We show that regions of coexistence and competitive exclusion depend on food quality and relative values of temperature-dependent life history parameters. Finally, we investigate the combined impacts of temperature and competition on the potential for dengue transmission, and we discuss our results in the context of present and future risk of mosquito-borne disease transmission.

PMID:40884588 | DOI:10.1007/s11538-025-01518-x

Support Care Cancer. 2025 Aug 30;33(9):823. doi: 10.1007/s00520-025-09876-x.

ABSTRACT

PURPOSE: Cancer patients must develop food literacy to successfully adapt to dietary changes and enhance their health management. This study is aimed at assessing the perceived food literacy of women undergoing chemotherapy for gynecologic cancer.

METHOD: This descriptive, cross-sectional study was conducted with 136 gynecologic cancer patients undergoing chemotherapy at the Chemotherapy Unit of the Department of Gynecologic Oncology Surgery in a university hospital in Turkey. Data were collected using the “Participant Information Form” and the “Perceived Food Literacy Scale.” Statistical analysis was performed using the Kolmogorov-Smirnov test, Kruskal-Wallis test, and Mann-Whitney U test.

RESULTS: The mean age of the participants was 53.92 ± 13.04 years, with 49.3% diagnosed with endometrial cancer and 38.2% with ovarian cancer. The average number of chemotherapy cycles was 2.86 ± 1.87. The median total score for perceived food literacy was 104.00 (IQR = 20.00), indicating a high level of food literacy. Women with an income exceeding their expenses, those who consumed 1-2 daily snacks, those who had received nutrition education, and those with prior knowledge of food literacy had notably higher median perceived food literacy scores.

CONCLUSIONS: This study found that women with gynecologic cancer receiving chemotherapy had a high level of food literacy.

PRACTICE IMPLICATIONS: Food literacy is necessary for living well beyond individual and physical health. Cancer patients must acquire food literacy to implement effective dietary modifications and enhance their health management. Healthcare professionals should emphasize the nutritional practices of women with gynecologic cancer throughout the entire chemotherapy process, and oncology nurses should design patients’ nutrition plans based on food literacy.

PMID:40884583 | DOI:10.1007/s00520-025-09876-x

Vet Ophthalmol. 2025 Aug 29. doi: 10.1111/vop.70073. Online ahead of print.

ABSTRACT

OBJECTIVE: To characterize the conjunctival bacterial flora of laboratory-housed New Zealand White (NZW) rabbits using conventional culture techniques and quantitative bacterial analysis.

ANIMALS STUDIED: This experimental study involved the collection of conjunctival fornix samples from 24 eyes of 12 healthy laboratory-housed NZW rabbits.

PROCEDURES: Conjunctival samples were obtained using sterile dry swabs and processed using standard microbiological techniques. Bacterial identification was performed via mass spectrometry (MALDI-TOF), and quantification was expressed in colony-forming units per milliliter (CFU/mL).

RESULTS: Bacterial growth was observed in 74% of the samples (17/24 eyes), with seven species identified: Moraxella cuniculi, Corynebacterium spp., coagulase-negative Staphylococcus, Bacillus spp., Staphylococcus aureus, Streptococcus viridans group, and Tsukamurella spp. Although most isolates were Gram-positive, M. cuniculi-a Gram-negative bacterium-was the predominant species. It exhibited the highest bacterial load (CFU/mL) and demonstrated a statistically significant difference compared to the other species (Kruskal-Wallis, p = 0.01). M. cuniculi also exhibited the highest variability in CFU/mL values among all isolates.

CONCLUSIONS: Despite the predominance of Gram-positive isolates, M. cuniculi was identified as the predominant species in the conjunctival flora of healthy NZW rabbits, both in frequency and bacterial load. These findings contribute to a more detailed characterization of the ocular microbiota in this commonly used laboratory model.

PMID:40883865 | DOI:10.1111/vop.70073

Clin Chem Lab Med. 2025 Sep 1. doi: 10.1515/cclm-2025-0747. Online ahead of print.

ABSTRACT

OBJECTIVES: Our previous study revealed a correlation between fecal leukocyte esterase and fecal calprotectin levels. This study assessed the predictive value of fecal leukocyte esterase compared with fecal calprotectin and C-reactive protein of inflammatory bowel disease.

METHODS: Patients with inflammatory bowel disease who underwent ileocolonoscopy at National Taiwan University Hospital from March 2022 to March 2024 were included. Fecal leukocyte esterase and fecal calprotectin levels from stool samples collected within one month of endoscopy were analyzed. Active ulcerative colitis and Crohn’s disease were defined as Mayo endoscopic score ≥2 or simple endoscopic score for Crohn’s disease ≥7, respectively. Sensitivity, specificity, predictive values, and areas under the receiver operating characteristic curve were calculated using IBM SPSS Statistics 29.

RESULTS: Of the 203 patients (100 with ulcerative colitis and 103 with Crohn’s disease), fecal leukocyte esterase levels were significantly correlated with fecal calprotectin levels (r=0.425, p<0.001) and endoscopic severity in ulcerative colitis (r=0.432, p<0.001) and Crohn’s disease (r=0.311, p=0.001). For predicting Mayo endoscopic scores ≥2 in ulcerative colitis using fecal leukocyte esterase, fecal calprotectin, and C-reactive protein, areas under the curve were 0.731, 0.785, and 0.558, respectively. For predicting simple endoscopic scores for Crohn’s disease ≥7, areas under the curve were 0.706, 0.800, and 0.770, respectively. No significant difference was observed between fecal leukocyte esterase and fecal calprotectin.

CONCLUSIONS: Fecal leukocyte esterase correlates with fecal calprotectin and predicts endoscopic severity in inflammatory bowel disease.

PMID:40883864 | DOI:10.1515/cclm-2025-0747