Safety of CT-guided percutaneous cryoablation in patients treated for clinical T1 renal cell carcinoma with the need for pre-procedural ureteral stenting: an international cohort study.

To assess the safety of computed tomography-guided percutaneous cryoablation (PCA) in patients who had pre-procedural ureteral stenting, while they were treated for clinical T1 renal cell carcinoma (RCC) with complex location. This retrospective international multicenter cohort study included patients treated between January 2016 and February 2021 at two University Hospitals, X1 and X2. Patients aged more than 18 years with suspected RCC were included. All patients underwent pre-procedural ureteral stenting. The complications were recorded within 30 days and graded according to the Clavien-Dindo classification and the Society of Interventional Radiology classification of adverse events. Major complications were defined as complications ≥ grade 3 on the Clavien-Dindo classification. The cohort included 61 patients with a median age of 66 years (IQR 55-75 years). The median tumour size was 33 mm (IQR 24-38 mm), with a median R.E.N.A.L score of 8 (IQR 7-10). A complication rate of 36% (n=22) was recorded, and major complications occurred following 10% (n=6) of the procedures. A statistically significant association was found between using more than three cryoprobes and postoperative complications (OR, 4.19; 95% CI: 1.38-12.75; p=0.010). In addition, no associations were found between postoperative complications and prophylactic antibiotics, patient age, tumour complexity, tumour size, histological type, or whether the ice ball was touching the ureter. This multicenter cohort study found a relatively high rate of postoperative complications in patients having a ureteral stent before PCA. However, no complications resulted in a chronic outflow obstruction. The number of high-complexity tumours could explain the high rate of complications.

被引量：- 发表：1970

Peritumoral and intratumoral radiomics for predicting visceral pleural invasion in lung adenocarcinoma based on preoperative computed tomography (CT).

To evaluate the prediction of peritumoral and intratumoral radiomics for visceral pleural invasion (VPI) in lung adenocarcinoma cancer (LAC) based on preoperative computed tomography (CT) radiomics. In total, 350 patients with LAC confirmed by surgery pathology were enrolled in The Second Hospital of Hebei Medical University, including 281 VPI negative patients and 69 VPI positive patients, were divided into the training cohort (n = 280) and validation cohort (n=70) at random with a ratio of 8:2. We extracted the radiomics features from the 3 region of interest (ROI), including gross tumor volume (GTV), the gross peritumoral tumor volume (GPTV) and the gross volume of the tumor rim (included the outer 4 mm of the tumor and 4mm of the tumor adjacent lung tissue on either side of the tumor contour boundary, GTR).The maximal redundancy minimal relevance (mMRM) algorithm and the least absolute shrinkage and selection operator (LASSO) was performed to reduce feature dimensionality and the radiomics score (Rad score) of the best radiomics model was combined with CT morphological characteristics with statistical significance in the univariable analysis to construct the combined model. The performance of the models was evaluated based on receiver operating characteristics (ROC) curve, calibration, and clinical usefulness. DeLong's test was used to assess differences in area under curve (AUC) between different models. There were no statistically significant differences in patient's gender, age, and BMI between the VPI positive group and VPI negative group (all p＞0.05). There were statistically significant differences in the tumor maximum diameter, tumor CT image type, vacuole sign, and pleural indentation sign between the VPI positive group and VPI negative group (all p < 0.05). The models of radiomics of GTV, GPTV, and GTR showed high predictive value in the training cohort (All AUC > 0.75). Compared with GTV, GTR radiomics models, the GPTV radiomics model constructed via the logistic regression (LR) method exhibited better prediction performance with the AUCs of 0.819, 0.827; accuracy of 0.757,0.743; sensitivity of 0.800,0.786; specificity of 0.747,0.732 in the training and validation cohorts, respectively. The LR model of GPTV radiomics was defined as the optimal model for predicting VPI, since its excellent performance in both ROC, calibration curve and decision curve analysis (DCA). Preoperative CT-based radiomics models can predict VPI in patients with LAC; the LR algorithm combined the GPTV radiomics was the optimal choice, demonstrating high sensitivity, specificity, accuracy and clinical usefulness.

被引量：- 发表：1970

EEG bispectral index sensor guidance improves accuracy and safety of procedural sedation.

被引量：- 发表：1970

Beyond the throat: Imaging of parapharyngeal space lesions.

被引量：- 发表：1970

The super-resolution reconstruction in diffusion-weighted imaging of preoperative rectal MR using generative adversarial network (GAN): Image quality and T-stage assessment.

被引量：- 发表：1970