scholarly journals Measuring Kidney Perfusion, pH, and Renal Clearance Consecutively Using MRI and Multispectral Optoacoustic Tomography

2019 ◽  
Vol 22 (3) ◽  
pp. 494-503 ◽  
Author(s):  
Atul S. Minhas ◽  
Jack Sharkey ◽  
Edward A. Randtke ◽  
Patricia Murray ◽  
Bettina Wilm ◽  
...  
Keyword(s):  
Renal Clearance ◽  
Clearance Rate ◽  
Area Under The Curve ◽  
Kidney Cortex ◽  
Imaging Method ◽  
Ph Measurements ◽  
Optoacoustic Tomography ◽  
Significant Difference ◽  
Kidney Perfusion ◽  
Magnetic Resonance Imaging Mri

Abstract Purpose: To establish multi-modal imaging for the assessment of kidney pH, perfusion, and clearance rate using magnetic resonance imaging (MRI) and multispectral optoacoustic tomography (MSOT) in healthy mice. Kidney pH and perfusion values were measured on a pixel-by-pixel basis using the MRI acidoCEST and FAIR-EPI methods. Kidney filtration rate was measured by analyzing the renal clearance rate of IRdye 800 using MSOT. To test the effect of one imaging method on the other, a set of 3 animals were imaged with MSOT followed by MRI, and a second set of 3 animals were imaged with MRI followed by MSOT. In a subsequent study, the reproducibility of pH, perfusion, and renal clearance measurements were tested by imaging 4 animals twice, separated by 4 days. The contrast agents used for acidoCEST based pH measurements influenced the results of MSOT. Specifically, the exponential decay time from the kidney cortex, as measured by MSOT, was significantly altered when MRI was performed prior to MSOT. However, no significant difference in the cortex to pelvis area under the curve (AUC) was noted. When the order of experiments was reversed, no significant differences were noted in the pH or perfusion values. Reproducibility measurements demonstrated similar pH and cortex to pelvis AUC; however, perfusion values were significantly different with the cortex values being higher and the pelvic values being lower in the second imaging time. We demonstrate that using a combination of MRI and MSOT, physiological measurements of pH, blood flow, and clearance rates can be measured in the mouse kidney in the same imaging session.

scholarly journals Intravoxel Incoherent Motion Model in Differentiating the Pathological Grades of Esophageal Carcinoma: Comparison of Mono-Exponential and Bi-Exponential Fit Model

2021 ◽  
Vol 11 ◽  
Author(s):  
Nian Liu ◽  
Xiongxiong Yang ◽  
Lixing Lei ◽  
Ke Pan ◽  
Qianqian Liu ◽  
...  
Keyword(s):  
Sensitivity And Specificity ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
Exponential Model ◽  
Intravoxel Incoherent Motion ◽  
Imaging Method ◽  
Diagnostic Efficiency ◽  
Pathological Grade ◽  
Significant Difference ◽  
Exponential Fit

PurposeTo compare the diagnostic efficiency of the mono-exponential model and bi-exponential model deriving from intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) in differentiating the pathological grade of esophageal squamous cell carcinoma (ESCC).MethodsFifty-four patients with ESCC were divided into three groups of poorly-differentiated (PD), moderately-differentiated (MD), and well-differentiated (WD), and underwent the IVIM-DWI scan. Mono-exponential (Dmono, D*mono, and fmono) and bi-exponential fit parameters (Dbi, D*bi, and fbi) were calculated using the IVIM data for the tumors. Mean parameter values of three groups were compared using a one-way ANOVA followed by post hoc tests. The receiver operating characteristic curve was drawn for differentiating pathological grade of ESCC. Correlations between pathological grades and IVIM parameters were analyzed.ResultsThere were significant differences in fmono and fbi among the PD, MD and WD ESCC groups (all p<0.05). The fmono were 0.32 ± 0.07, 0.23 ± 0.08, and 0.16 ± 0.05, respectively, and the fbi were 0.35 ± 0.08, 0.26 ± 0.10, and 0.18 ± 0.07, respectively. There was a significant difference in the Dmono between the WD and the PD group (1.48 ± 0.51* 10-3 mm2/s versus 1.05 ± 0.44*10-3 mm2/s, p<0.05), but there was no significant difference between the WD and MD groups, MD and PD groups (all p>0.05). The D*mono, Dbi, and D*bi showed no significant difference among the three groups (all p>0.05). The area under the curve (AUC) of Dmono, fmono and fbi in differentiating WD from PD ESCC were 0.764, 0.961 and 0.932, and the sensitivity and specificity were 92.9% and 60%, 92.9% and 90%, 85.7% and 100%, respectively. The AUC of fmono and fbi in differentiating MD from PD ESCC were 0.839 and 0.757, and the sensitivity and specificity were 78.6% and 80%, 85.7% and 70%, respectively. The AUC of fmono and fbi in differentiating MD from WD ESCC were 0.746 and 0.740, and the sensitivity and specificity were 65% and 85%, 80% and 60%, respectively. The pathologically differentiated grade was correlated with all IVIM parameters (all p<0.05).ConclusionsThe mono-exponential IVIM model is superior to the bi-exponential IVIM model in differentiating pathological grades of ESCC, which may be a promising imaging method to predict pathological grades of ESCC.

Diagnostic accuracy and validity of the O-RADS MRI score based on a simplified MRI protocol: a single tertiary center retrospective study

2021 ◽  
pp. 028418512110604
Author(s):  
Serdar Aslan ◽  
Sebnem Alanya Tosun
Keyword(s):  
Area Under The Curve ◽  
Imaging Method ◽  
Predictive Values ◽  
Experienced Radiologist ◽  
Tertiary Center ◽  
Mri Protocol ◽  
Study Population ◽  
Magnetic Resonance Imaging Mri ◽  
Sensitivity Specificity ◽  
Mri Score

Background Adnexal masses (AM) are a common gynecological problem. It is important to use a reliable imaging method in the differentiation of benign and malignant AMs. Purpose To assess the accuracy and validity of the O-RADS magnetic resonance imaging (MRI) score for characterizing AM using a simplified MRI protocol. Material and Methods The study population comprised 332 women who underwent MRI due to the detection of indeterminate AM on ultrasonography between January 2018 and June 2020. An experienced radiologist calculated the O-RADS MRI score into five categories, using an MRI protocol with a simplified dynamic study. Sensitivity, specificity, positive and negative predictive values, and area under the curve (AUC) were calculated (cutoff for malignancy, score ≥ 4). The reference standard was histopathologic diagnosis or imaging findings during >24 months of follow-up. Results Of 237 AMs, 28 (11.9%) were malignant. The malignancy rates of AMs with scores of 1, 2, 3, 4, and 5 were 0% (0/12), 0% (0/111), 1.2% (1/77), 50% (10/20), and 100% (17/17), respectively. The O-RADS MRI score showed 96.3% sensitivity, 95.2% specificity, and 95.3% accuracy in malignancy prediction. The AUC for the differentiation of benign and malignant masses were 0.983. False positivity rate was high in cases with an O-RADS MRI score of 4 (50%). Conclusion The O-RADS MRI score, based on a simplified MRI protocol, has high accuracy and validity in distinguishing benign from malignant sonographically indeterminate AMs. Its use in clinical practice can classify the malignancy risks of masses and prevent unnecessary surgery in benign lesions.

GROWTH HORMONE RESPONSES TO FRUCTOSE IN DIABETES MELLITUS

1974 ◽  
Vol 75 (3) ◽  
pp. 497-502
Author(s):  
Mayer B. Davidson ◽  
Roger M. Steele
Keyword(s):  
Diabetes Mellitus ◽  
Growth Hormone ◽  
Fasting Glucose ◽  
Area Under The Curve ◽  
Oral Glucose ◽  
Gh Secretion ◽  
Significant Difference ◽  
Duration Of Disease ◽  
Hormone Responses

ABSTRACT Since fructose is normally metabolized in diabetics and has recently been shown to stimulate GH secretion, it was used to assess GH responses in diabetics. Fourteen diabetics (9 on insulin) and 8 controls matched for weight were studied. Fructose, infused over 10 min, was compared to arginine, infused over 30 min, both at 0.5 g/kg. Samples were collected at 0, 30, 60, 90 and 120 min and GH responses assessed as area under the curve minus the fasting area. There was no significant difference between the GH responses in diabetics and controls to either agent. Responses to arginine and fructose were significantly correlated (r = 0.60, P < 0.01) in all subjects, but not related to therapy, duration of disease or fasting glucose (75–287 mg/100 ml) in the diabetics. Oral glucose blunted the GH response to fructose in 2 controls. It is concluded that 1) fructose can stimulate GH secretion in male diabetics; 2) however, fructose-stimulated GH responses are not increased in diabetes mellitus.

Physical Activity Level and Motor Aptitude: Motor Domains and Identification Capacity of Brazilian Insufficiently Active Older Adults

2020 ◽  
Vol 13 ◽  
Author(s):  
Lucia Maria Andreis ◽  
Fernando de Aguiar Lemos ◽  
Lorenna Walesca de Lima Silva ◽  
Cassiana Luiza Pistorello Garcia ◽  
Gabrielli Veras ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Physical Activity Level ◽  
Area Under The Curve ◽  
The Elderly ◽  
Activity Level ◽  
General Motor ◽  
Body Scheme ◽  
Significant Difference ◽  
Global Coordination

Background: A decrease in the physical activity level in old age is common, which results in an increase in the number of falls and chronic conditions. Associated with that occurs the decline in motor skills as a result of the deficit in the interaction of cognitive and motor processes. Physical activity level can be associated differently with each motor domains. Objective: We analyzed the relationship between physical activity level and motor aptitude, and to identify which motor domains were most sensitive to detect insufficiently active level in older adults. Methods: Participated in the study 385 elderly people of both sexes. For the evaluation of the subjects were adopted the International Questionnaire on Physical Activity and the Motor Scale for Older Adults. Results: The majority of the elderly were active. In the comparison of motor aptitude between active and insufficiently active (IAC) elders a significant difference was found in the Global Coordination, Balance, Body Scheme and General Motor Aptitude. From the analysis of the area under the curve (AUC), we verified that these domains also were the ones that presented adequate diagnostic accuracy to identify IAC elderly. Besides that active elderly have presented the General Motor Aptitude classified within normality while the IAC below the normal. Conclusion: Our data suggest that IAC older adults present lower motor aptitude than the active elderly, especially in the domains of Global Coordination, Balance, Body Scheme and General Motor Aptitude, and that these domains were sensitive to indicate IAC older adults.

Video rate optoacoustic tomography of mouse kidney perfusion

2010 ◽  
Vol 35 (14) ◽  
pp. 2475 ◽  
Author(s):  
Andreas Buehler ◽  
Eva Herzog ◽  
Daniel Razansky ◽  
Vasilis Ntziachristos
Keyword(s):  
Mouse Kidney ◽  
Optoacoustic Tomography ◽  
Kidney Perfusion

scholarly journals Utility of the optical quality analysis system for decision-making in Nd: YAG laser posterior capsulotomy in patients with light posterior capsule opacity

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Bo Lu ◽  
Weijie Zhu ◽  
Yu Fan ◽  
Dong Shi ◽  
Liwei Ma
Keyword(s):  
Area Under The Curve ◽  
Quality Parameters ◽  
Optical Quality ◽  
Quality Analysis ◽  
Posterior Capsule ◽  
Clinical Trial Registry ◽  
Posterior Capsulotomy ◽  
Significant Difference ◽  
Analysis System ◽  
Scattering Index

Abstract Background A prospective cohort study was performed to evaluate whether the Optical Quality Analysis System (OQAS) can serve as a valuable additional indicator for appropriate posterior capsulotomy referral. Methods One hundred and five eyes from 96 patients undergoing capsulotomy were divided into precapsulotomy logMAR CDVA ≤0.1 group and logMAR CDVA > 0.1 group. CDVA, and the Visual Function 14 index (VF-14) score were estimated before and 1 month after capsulotomy. The objective scattering index (OSI) value was measured by using the OQAS. Posterior capsule opacification (PCO) severity was assessed with Evaluation of PCO 2000 (EPCO 2000) software. Results In logMAR CDVA > 0.1 group, the correlations of OSI, logMAR CDVA, EPCO score and VF-14 score were very strong preoperatively. In logMAR CDVA ≤0.1 group, preoperatively, OSI was correlated with logMAR CDVA (r = 0.451), EPCO score (r = 0.789), and VF-14 score (r = 0.852). LogMAR CDVA has weak correlation with VF-14 score (r = − 0.384) and EPCO score (r = 0.566). VF-14 score was correlated with EPCO score (r = − 0.669). In the logMAR CDVA ≤0.1 group, there was no significant difference in logMAR CDVA between precapsulotomy and postcapsulotomy (P > 0.05). In the two groups, all the other optical quality parameters were significantly improved after capsulotomy (P < 0.05). In logMAR CDVA > 0.1 group, the area under the curve of the ROC of the OSI was 0.996 (P = 0.000). In logMAR CDVA ≤0.1 group, the area under the curve of the ROC of the OSI was 0.943 (P = 0.000). Conclusions The OSI was useful for evaluating of PCO and prediction of beneficial capsulotomy. Especially for patients with slight PCO and better visual acuity, OSI is more valuable than CDVA and completely objective examination. Trial registration The study protocol was registered at the Chinese Clinical Trial Registry. Register: ChiCTR1800018842 (Registered Date: October 13th, 2018).

scholarly journals Expert opinion paper on cardiac imaging after ischemic stroke

2021 ◽  
Author(s):  
Renate B. Schnabel ◽  
Stephan Camen ◽  
Fabian Knebel ◽  
Andreas Hagendorff ◽  
Udo Bavendiek ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Expert Opinion ◽  
Cardiac Imaging ◽  
Controlled Trial ◽  
Case Series ◽  
Stroke Care ◽  
Imaging Method ◽  
Cardiac Evaluation ◽  
Magnetic Resonance Imaging Mri ◽  
Ischemic Attack

AbstractThis expert opinion paper on cardiac imaging after acute ischemic stroke or transient ischemic attack (TIA) includes a statement of the “Heart and Brain” consortium of the German Cardiac Society and the German Stroke Society. The Stroke Unit-Commission of the German Stroke Society and the German Atrial Fibrillation NETwork (AFNET) endorsed this paper. Cardiac imaging is a key component of etiological work-up after stroke. Enhanced echocardiographic tools, constantly improving cardiac computer tomography (CT) as well as cardiac magnetic resonance imaging (MRI) offer comprehensive non- or less-invasive cardiac evaluation at the expense of increased costs and/or radiation exposure. Certain imaging findings usually lead to a change in medical secondary stroke prevention or may influence medical treatment. However, there is no proof from a randomized controlled trial (RCT) that the choice of the imaging method influences the prognosis of stroke patients. Summarizing present knowledge, the German Heart and Brain consortium proposes an interdisciplinary, staged standard diagnostic scheme for the detection of risk factors of cardio-embolic stroke. This expert opinion paper aims to give practical advice to physicians who are involved in stroke care. In line with the nature of an expert opinion paper, labeling of classes of recommendations is not provided, since many statements are based on expert opinion, reported case series, and clinical experience.

scholarly journals THU0433 TREATMENT WITH PEGLOTICASE IMPROVES HEPATIC FIBROSIS ESTIMATED BY FIBROSIS-4 INDEX IN SUBJECTS WITH CHRONIC REFRACTORY GOUT

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 454.1-454
Author(s):  
N. Schlesinger ◽  
A. Yeo ◽  
P. Lipsky
Keyword(s):  
Liver Disease ◽  
Linear Regression ◽  
Rank Order ◽  
Linear Regression Analysis ◽  
Area Under The Curve ◽  
Serum Urate ◽  
Complete Analysis ◽  
Alcoholic Fatty Liver ◽  
Significant Difference ◽  
The Impact

Background:Hyperuricemia is associated with non-alcoholic fatty liver disease (NAFLD)1,2, but the relationship to fibrosis remains uncertain3. Moreover, it is not known whether lowering serum urate will affect the course of NAFLD. The availability of data from two randomized trials of pegloticase, a pegylated recombinant mammalian uricase, that profoundly decreases serum urate afforded the opportunity to test the hypothesis that lowering urate might improve NAFLD.Objectives:To determine whether treatment of chronic refractory gout patients with pegloticase was associated with improvement in NAFLD determined by Fibrosis 4 index (Fib4).Methods:Databases from patients with chronic refractory gout who participated in two randomized 6 month clinical trials (RCTs) of pegloticase were analyzed4. Sub-sets who had persistent urate lowering to levels <1 mg/dL in response to biweekly pegloticase (Responders, n=36) were compared to those who received placebo (n=43). Since liver biopsy information was not available on these subjects, we relied on Fib4, a validated non-invasive estimate of liver fibrosis in a variety of liver diseases5,6calculated from measurements of AST, ALT, platelet count and age (Age x AST/platelets x √ALT). A Fib4 value of 1.3 is an indication that further evaluation of liver disease is warranted.Results:At baseline, the mean Fib4 values were 1.40 ± 0.86 in pegloticase responders and 1.04 ± 0.53 in subjects receiving placebo. As shown in figure 1, subjects receiving placebo exhibited a change of 0.26 ± 0.41 in the Fib4 score over the six months of the RCTs compared with 0.13 ± 0.62 in the pegloticase responders (p=0.048; by linear regression). When only the subjects with a Fib4 value > 1.3 were considered, a significant difference in the change in the Fib4 values over the 6 months of the trial between pegloticase responders and those receiving placebo was also observed (-0.15 ± 0.67 vs 0.37 ± 0.42, p=0.004, by linear regression). The correlations between serum urate area under the curve (AUC) over the 6 months of the trial and the change in Fib4 value was rs=0.33, p=0.0.0004 (Spearman rank-order correlation coefficient). Finally, multiple linear regression analysis indicated serum urate AUC (as a surrogate measure for group) is the main contributor to the change in Fib4 (p=0.018 by linear regression).Conclusion:The data are consistent with the conclusion that persistent lowering of serum urate had a significant impact on Fib4 levels, implying a possible effect on the course of NAFLD. The results support a more complete analysis involving biopsy examination of the impact of urate on liver inflammation and fibrosis.References:[1]Yang C et al. PlosOne2017; 12:e0177249[2]Jaruvongvanich V et al. Eur J Gastroenterol Hepatol 2017; 29:1031[3]Jaruvongvanich V et al. Eur J Gastroenterol Hepatol 2017; 29:694[4]Sundy JS, et al. JAMA. 2011; 306 (7):711-20[5]Sterling RK et al. Hepatol 2006; 43:1317[6]Shah AG et al. Clin Gastroenterol Hepatol 2009;7:1104Disclosure of Interests: :Naomi Schlesinger Grant/research support from: Pfizer, Amgen, Consultant of: Novartis, Horizon Therapeutics, Selecta Biosciences, Olatec, IFM Therapeutics, Mallinckrodt Pharmaceuticals, Anthony Yeo Employee of: Horizon Therapeutics, Peter Lipsky Consultant of: Horizon Therapeutics

Factors affecting progression to permanent atrial fibrillation in an unselected population of patients with non-permanent form of atrial fibrillation

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
V.L Malavasi ◽  
E Fantecchi ◽  
V Tordoni ◽  
L Melara ◽  
A Barbieri ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cox Regression ◽  
Area Under The Curve ◽  
Roc Curves ◽  
Factors Affecting ◽  
Cox Proportional Hazard ◽  
Significant Difference ◽  
History Of ◽  
Unselected Population ◽  
Cox Proportional Hazard Regression

Abstract Background Natural history of atrial fibrillation (AF) shows a progression of arrhythmia from non-permanent to permanent AF. Permanent AF was found associated with a worse prognosis than non-permanent one. Aim To assess the factors associated with progression to permanent AF in an unselected population of AF patients with non-permanent AF. Methods In this prospective study we enrolled in- as well as out-patients with non-permanent AF and age ≥18 years, with at least one episode of ECG-documented AF within 1 year. The patients were followed-up at 1 month and every 6 months thereafter. Results Out of 523 patients, 314 (60%) were in non-permanent AF (80 [25.5%] paroxysmal AF, 165 [52.5%] persistent AF, 69 [2%] first diagnosed AF), mostly male (188, 59.9%), median age 71 years (IQ range 62–77), median CHA2DS2VASc 3 (1–4), median HATCH score 1 (1–2). After a median follow-up of 701 (IQ range 437–902) days, 66 patients (21%) showed permanent AF. CHA2DS2VASc and HATCH scores were incrementally associated to progression to permanent AF (CHA2DS2VASc χ2 p=0.001; HATCH χ2 p=0.017; p for trend CHA2DS2VASc &lt;0.001, HATCH p=0.001). At multivariable Cox proportional hazard regression the following variables were significantly associated with AF progression: age (hazard ratio [HR] 1.041; 95% CI: 1.004–1.079; p=0.028), at least moderate left atrial (LA) enlargement (&gt;42 ml/m2) (HR 2.092; 95% CI: 1.132–3.866; p=0.018), antiarrhythmics drugs after the enrollment (HR 0.087; 95% CI: 0.011–0.662; p=0.018), EHRA score &gt;2 (HR 0.351; 95% CI: 0.158–0.779; p=0.010) and Valvular HD (HR 2.161; 95% CI: 1.057–4.420; p=0.035). Adding LA dilation to HATCH score (HATCH-LA) and assigning 2 points based on multivariable Cox regression, HATCH-LA was statistically better in ROC curves in prediction of AF progression vs HATCH score (area under the curve 0.695 vs 0.636; DeLong p=0.0225). Survival-free curves on freedom from permanent AF using as discriminator HATCH-LA score ≤2 vs &gt;2 led to a statistically significant difference (χ2=16.080 p&lt;0.001), but the same was not found for HATCH score (χ2 =3.099; p=0.078). Conclusions In patients without permanent AF, progression of AF was independentely related to age, LA dilation, AF symptoms severity, antiarrhythmic drugs and Valvular HD. HATCH score predicted AF progression and adding to it LA dilation (at least moderate) improved patients stratification for the risk of evolution to permanent AF. Funding Acknowledgement Type of funding source: None

scholarly journals Prognostic Value of Plasma hPG80 (Circulating Progastrin) in Metastatic Renal Cell Carcinoma

Cancers ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 375
Author(s):  
Manish Kohli ◽  
Winston Tan ◽  
Bérengère Vire ◽  
Pierre Liaud ◽  
Mélina Blairvacq ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Prognostic Value ◽  
Risk Model ◽  
Predictive Accuracy ◽  
Area Under The Curve ◽  
Risk Groups ◽  
Prognostic Impact ◽  
Significant Difference

Precise management of kidney cancer requires the identification of prognostic factors. hPG80 (circulating progastrin) is a tumor promoting peptide present in the blood of patients with various cancers, including renal cell carcinoma (RCC). In this study, we evaluated the prognostic value of plasma hPG80 in 143 prospectively collected patients with metastatic RCC (mRCC). The prognostic impact of hPG80 levels on overall survival (OS) in mRCC patients after controlling for hPG80 levels in non-cancer age matched controls was determined and compared to the International Metastatic Database Consortium (IMDC) risk model (good, intermediate, poor). ROC curves were used to evaluate the diagnostic accuracy of hPG80 using the area under the curve (AUC). Our results showed that plasma hPG80 was detected in 94% of mRCC patients. hPG80 levels displayed high predictive accuracy with an AUC of 0.93 and 0.84 when compared to 18–25 year old controls and 50–80 year old controls, respectively. mRCC patients with high hPG80 levels (>4.5 pM) had significantly lower OS compared to patients with low hPG80 levels (<4.5 pM) (12 versus 31.2 months, respectively; p = 0.0031). Adding hPG80 levels (score of 1 for patients having hPG80 levels > 4.5 pM) to the six variables of the IMDC risk model showed a greater and significant difference in OS between the newly defined good-, intermediate- and poor-risk groups (p = 0.0003 compared to p = 0.0076). Finally, when patients with IMDC intermediate-risk group were further divided into two groups based on hPG80 levels within these subgroups, increased OS were observed in patients with low hPG80 levels (<4.5 pM). In conclusion, our data suggest that hPG80 could be used for prognosticating survival in mRCC alone or integrated to the IMDC score (by adding a variable to the IMDC score or by substratifying the IMDC risk groups), be a prognostic biomarker in mRCC patients.

Sign in / Sign up

Export Citation Format

Share Document