scholarly journals Brain MRI Radiomics Analysis of School-Aged Children with Tetralogy of Fallot

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Yiwei Pu ◽  
Songmei Li ◽  
Siyu Ma ◽  
Yuanli Hu ◽  
Qinghui Hu ◽  
...  
Keyword(s):  
Early Diagnosis ◽  
Roc Curve ◽  
Functional Outcomes ◽  
Brain Mri ◽  
Imaging Biomarkers ◽  
Lasso Regression ◽  
Final Model ◽  
Neurological Outcomes ◽  
School Aged Children ◽  
Conventional Mri

Introduction. Radiomics could be potential imaging biomarkers by capturing and analyzing the features. Children and adolescents with CHD have worse neurodevelopmental and functional outcomes compared with their peers. Early diagnosis and intervention are the necessity to improve neurological outcomes in CHD patients. Methods. School-aged TOF patients and their healthy peers were recruited for MRI and neurodevelopmental assessment. LASSO regression was used for dimension reduction. ROC curve graph showed the performance of the model. Results. Six related features were finally selected for modeling. The final model AUC was 0.750. The radiomics features can be potential significant predictors for neurodevelopmental diagnoses. Conclusion. The radiomics on the conventional MRI can help predict the neurodevelopment of school-aged children and provide parents with rehabilitation advice as early as possible.

Reliability of Hammersmith Examination in Prediction of Neurological Outcomes (REHAPENO) - Research Protocol (Preprint)

2018 ◽  
Author(s):  
Mohamed Fleifel ◽  
Rawya Abdelghani ◽  
Mohamed Ameen
Keyword(s):  
Magnetic Resonance ◽  
Magnetic Resonance Image ◽  
Current Practice ◽  
Surgical Intervention ◽  
Brain Mri ◽  
Developmental Outcomes ◽  
Research Protocol ◽  
Neurological Outcomes ◽  
Mri Brain ◽  
Brain Ultrasound

BACKGROUND Background: Studying the neurological developmental outcomes and comparing correlations with MRI (Magnetic resonance image) versus the Hammersmith Infant Neurological Examination (HINE) OBJECTIVE Objective: To investigate the non-inferiority of MRI to HINE in infant developmental outcomes METHODS Settings: Hospital settings including pediatrics and neonatal care units Intervention: No medical or surgical intervention is planned, only correlation and extra analyses would take place to standardize the current practice Measurements: HINE, Brain MRI, Brain Ultrasound and developmental outcomes after 12 months RESULTS Results: The observations collected and correlations measured to figure out the reliability of both HINE and MRI in order to figure to what extent can we rely on HINE alone in expecting the developmental outcomes CONCLUSIONS The more reliability would expressed by HINE assessment the accurate expectation of developmental in preterm infants CLINICALTRIAL https://clinicaltrials.gov/ct2/show/NCT03580252

scholarly journals Development of a Survival Model Based on Autophagy-Associated Genes for Predicting Prognosis of Gastric Cancer

2020 ◽  
Author(s):  
Wanli Yang ◽  
Lili Duan ◽  
Xinhui Zhao ◽  
Liaoran Niu ◽  
Yiding Li ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Regression Analysis ◽  
Prediction Model ◽  
Roc Curve ◽  
Survival Model ◽  
Differentially Expressed ◽  
Lasso Regression ◽  
Prognosis Prediction ◽  
Cellular Processes ◽  
Model Based

Abstract Background: Gastric cancer (GC) is one of lethal diseases worldwide. Autophagy-associated genes play a crucial role in the cellular processes of GC. Our study aimed to investigate and identify the prognostic potential of autophagy-associated genes signature in GC. Methods: RNA-seq and clinical information of GC and normal controls were downloaded from The Cancer Genome Atlas (TCGA) database. Then, the Wilcoxon signed-rank test was used to pick out the differentially expressed autophagy-associated genes. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses were performed to investigate the potential roles and mechanisms of autophagy-associated genes in GC. Cox proportional hazard regression analysis and Lasso regression analysis were carried out to identify the overall survival (OS) related autophagy-associated genes, which were then collected to construct a predictive model. Kaplan-Meier method and receiver operating characteristic (ROC) curve were utilized to validate the accuracy of this model. Finally, a clinical nomogram was established by combining the clinical factors and autophagy-associated genes signature. Results: A total of 28 differentially expressed autophagy-associated genes were identified. GO and KEGG analyses revealed that several important cellular processes and signaling pathways were correlated with these genes. Through Cox regression and Lasso regression analyses, we identified 4 OS-related autophagy-associated genes (GRID2, ATG4D, GABARAPL2, and CXCR4) and constructed a prognosis prediction model. GC Patients with high-risk had a worse OS than those in low-risk group (5-year OS, 27.7% vs 38.3%; P=9.524e-07). The area under the ROC curve (AUC) of the prediction model was 0.67. The nomogram was demonstrated to perform better for predicting 3-year and 5-year survival possibility for GC patients with a concordance index (C-index) of 0.70 (95% CI: 0.65-0.72). The calibration curves also presented good concordance between nomogram-predicted survival and actual survival. Conclusions: We constructed and evaluated a survival model based on the autophagy-associated genes for GC patients, which may improve the prognosis prediction in GC.

scholarly journals TRLS-02. Trial in Progress: A Multicenter Phase 3 Study to Establish the Diagnostic Performance of 18F-Fluciclovine PET in Detecting Recurrent Brain Metastases after Radiation Therapy (REVELATE)

2021 ◽  
Vol 3 (Supplement_3) ◽  
pp. iii5-iii5
Author(s):  
Eugene Teoh ◽  
Alain Chaglassian ◽  
Nancy Tainer
Keyword(s):  
Radiation Therapy ◽  
Brain Metastases ◽  
Diagnostic Performance ◽  
Brain Mri ◽  
Primary Objective ◽  
Open Label ◽  
Conventional Mri ◽  
Specificity And Sensitivity ◽  
Neurosurgical Intervention

Abstract Background Brain metastases occur in up to 40% of patients with cancer and are associated with poor prognosis and considerable levels of recurrence. Consequently, close follow-up with serial brain MRI is performed post-treatment to monitor for recurrent disease. Although conventional MRI (CE-T1-weighted and FLAIR/T2-weighted) is the recommended follow-up modality, it has poor specificity with limited ability to differentiate between true disease recurrence and treatment-related changes such as radiation necrosis. Therefore, alternative imaging options are sought in order to help physicians confidently diagnose treatment-related changes and thus reliably stratify the risk of continuation of a therapeutic regimen, especially given the morbidity associated with current treatments. Amino acid PET imaging agent, 18F-fluciclovine, has increased uptake in brain tumors relative to normal tissue and may be useful for detecting recurrent brain metastases. Methods NCT04410133 is a prospective, open-label, single-arm, single-dose (185 MBq ±20%) study with a primary objective to confirm the diagnostic performance of 18F-fluciclovine PET (read with conventional MRI for anatomical reference) for detection of recurrent brain metastases where MRI is equivocal. Approximately 150 subjects with solid tumor brain metastases who have undergone radiation therapy will be enrolled in this multicenter trial (~18 US sites) if they have a lesion considered equivocal on MRI that requires further confirmatory diagnostic procedures such as biopsy/neurosurgical intervention or clinical follow-up. Subjects will undergo 18F-fluciclovine PET <28 days after the equivocal MRI and 2–21 days pre-biopsy/neurosurgical intervention. Clinical follow-up will occur for 6m post-18F-fluciclovine PET. Secondary objectives include evaluation of subject- and lesion-level 18F-fluciclovine negative and positive percent agreement (equivalent to specificity and sensitivity respectively) for recurrent brain metastases, inter-reader and intra-reader agreement, and safety evaluations. Enrolment began in October 2020 and the trial is open at the time of submission.

scholarly journals NEIM-02. TRIAL IN PROGRESS: A MULTICENTER PHASE 3 STUDY TO ESTABLISH THE DIAGNOSTIC PERFORMANCE OF 18F-FLUCICLOVINE PET IN DETECTING RECURRENT BRAIN METASTASES AFTER RADIATION THERAPY (REVELATE)

2021 ◽  
Vol 3 (Supplement_4) ◽  
pp. iv6-iv7
Author(s):  
Samuel T Chao ◽  
Alain Chaglassian ◽  
Nancy Tainer ◽  
Eugene J Teoh
Keyword(s):  
Radiation Therapy ◽  
Brain Metastases ◽  
Diagnostic Performance ◽  
Brain Mri ◽  
Primary Objective ◽  
Open Label ◽  
Conventional Mri ◽  
Specificity And Sensitivity ◽  
Neurosurgical Intervention

Abstract BACKGROUND Brain metastases occur in up to 40% of patients with cancer and are associated with poor prognosis and considerable levels of recurrence. Consequently, close follow-up with serial brain MRI is performed post-treatment to monitor for recurrent disease. Although conventional MRI (CE-T1-weighted and FLAIR/T2-weighted) is the recommended follow-up modality, it has poor specificity with limited ability to differentiate between true disease recurrence and treatment-related changes such as radiation necrosis. Therefore, alternative imaging options are sought in order to help physicians confidently diagnose treatment-related changes and thus reliably stratify the risk of continuation of a therapeutic regimen, especially given the morbidity associated with current treatments. Amino acid PET imaging agent, 18F-fluciclovine, has increased uptake in brain tumors relative to normal tissue and may be useful for detecting recurrent brain metastases. METHODS NCT04410133 is a prospective, open-label, single-arm, single-dose (185 MBq ±20%) study with a primary objective to confirm the diagnostic performance of 18F-fluciclovine PET (read with conventional MRI for anatomical reference) for detection of recurrent brain metastases where MRI is equivocal. Approximately 150 subjects with solid tumor brain metastases who have undergone radiation therapy will be enrolled in this multicenter trial (~18 US sites) if they have a lesion considered equivocal on MRI that requires further confirmatory diagnostic procedures such as biopsy/neurosurgical intervention or clinical follow-up. Subjects will undergo 18F-fluciclovine PET <42 days after the equivocal MRI and 1–21 days pre-biopsy/neurosurgical intervention. Clinical follow-up will occur for 6m post-18F-fluciclovine PET. Secondary objectives include evaluation of subject- and lesion-level 18F-fluciclovine negative and positive percent agreement (equivalent to specificity and sensitivity, respectively) for recurrent brain metastases, inter-reader and intra-reader agreement, and safety evaluations. Enrolment began in October 2020 and the trial is open at the time of submission.

Abstract WP106: Redefined Measure of Early Neurological Improvement Shows Treatment Benefit of Intravenous Tissue Plasminogen Activator Treatment in NINDS Rt-PA Acute Stroke Trial at 24 Hours

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Shashank Agarwal ◽  
Erica Scher ◽  
Aaron Lord ◽  
Jennifer Frontera ◽  
Koto Ishida ◽  
...  
Keyword(s):  
Roc Curve ◽  
Functional Outcomes ◽  
Infarct Volume ◽  
Surrogate Marker ◽  
Percentage Change ◽  
Treatment Benefit ◽  
Nihss Score ◽  
Neurological Improvement ◽  
Percent Change ◽  
Stroke Study

Background and Purpose: The first of the 2 NINDS Stroke Study trials did not show a significant increase in early neurological improvement (ENI), defined as NIHSS improvement by ≥ 4, with alteplase treatment. We hypothesized that ENI defined as a percentage change in NIHSS (percent change NIHSS) at 24 hours is superior to other definitions in predicting 3-month functional outcomes and using this definition there would be treatment benefit of alteplase over placebo at 24 hours. Methods: We analyzed the NINDS rt-PA Stroke Study (Parts 1 and 2) trial data. Percent change NIHSS was defined as [(admission NIHSS score–24-hour NIHSS score)x100/admission NIHSS score] and delta NIHSS as (admission NIHSS score–24-hour NIHSS score). We compared ENI using these definitions between alteplase vs. placebo patients. We also used receiver operating characteristic (ROC) curve to determine the predictive association of ENI with excellent 3-month functional outcomes [Barthel Index (BI) score 95 – 100 and modified Rankin scale (mRS) 0-1], good 3-month functional outcome (mRS 0-2) and 3-month infarct volume. Results: There was a significantly greater improvement in the 24-hour median percent change NIHSS among patients treated with alteplase compared to the placebo group (28% vs. 15%, p = 0.045) but not median delta NIHSS (3 vs. 2, p = 0.471). ROC curve comparison showed that percent change NIHSS (ROC percent ) was better than delta NIHSS (ROC delta ) and admission NIHSS (ROC admission ) with regards to excellent 3-month BI (ROC percent 0.83, ROC delta 0.76, ROS admission 0.75), excellent 3-month mRS (ROC percent 0.83, ROC delta 0.74, ROS admission 0.78), and good 3-month mRS (ROC percent 0.83, ROC delta 0.76, ROS admission 0.78). Percentage change had a stronger association with 90-day infarct volume than delta NIHSS score and both delta NIHSS and percent change in NIHSS were more pronounced with faster treatment times. Conclusion: In the NINDS rt-PA trial, alteplase was associated with a significant percent change improvement in NIHSS at 24 hours. Percent change in NIHSS may be a better surrogate marker of thrombolytic activity and 3-month outcomes.

Abstract TP176: Carotid Arterial Diameters as an Effect Modifier of Pulsatile Hemodynamics and Brain Perivascular Spaces

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Jose Gutierrez ◽  
Chuanhui Dong ◽  
Mitchell Elkind ◽  
Noam Alperin ◽  
Ahmet Bagci ◽  
...  
Keyword(s):  
Arterial Stiffness ◽  
Linear Models ◽  
Brain Mri ◽  
Mechanical Effect ◽  
Brain Parenchyma ◽  
Brain Diseases ◽  
Imaging Biomarkers ◽  
Perivascular Spaces ◽  
The Right ◽  
Arterial Diameters

Introduction: Brain perivascular spaces (PVS) are associated with higher pulse pressures and may be imaging biomarkers of systemic arterial stiffness. We hypothesized that larger proximal arterial diameters act as effect modifiers between downstream PVS and surrogate measures of arterial stiffness. Methods: Stroke-free Northern Manhattan Study participants with brain MRI and carotid ultrasound were analyzed. Perivascular spaces were rated semi-quantitatively as ≤ 3 mm voids on axial T1 images without associated FLAIR hyperintensities. Intracranial brain arterial diameters were measured on MRA. The right common carotid artery (CCA) was assessed by high resolution B-mode ultrasound to obtain systolic and diastolic diameters. CCA stiffness was calculated as a ratio between log n transformed systolic-diastolic blood pressure and (systolic - diastolic diameter)/diastolic diameter. We created generalized linear models using and pulse pressure (PP) and CCA stiffness as predictors as independent variables and right anterior PVS score as the outcome, adjusting for demographics, risk factors, head size. Results: Among 941 participants (N=941, mean age 71 ± 9 year, 60% women, 66% Hispanic), PP was associated with PVS score (B=0.003, P=0.04) in an adjusted model. There was a statistical interaction between PP, right CCA diastolic diameter, and right intracranial arterial diameters as predictors of right anterior PVS score (P=0.03), but this interaction was not significant for posterior fossa PVS score (B=0.015, P=0.191), or when substituting right intracranial arterial diameters with the basilar artery diameter (B=-0.004, P=0.191). The association between PP (P=0.003) or carotid stiffness (P=0.002) with right anterior PVS score was greater among participants with larger right intracranial arterial and larger CCA diameters. Conclusions: Arterial stiffness is related to downstream PVS in those with larger proximal arterial diameters. These results suggest a mechanical effect of pulsatility on brain parenchyma and further studies are needed to enhance our understanding of the link between systemic hemodynamics and brain diseases such as dementia and stroke.

scholarly journals Nomogram-Based Prediction of the Risk of Diabetic Retinopathy: A Retrospective Study

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Ruohui Mo ◽  
Rong Shi ◽  
Yuhong Hu ◽  
Fan Hu
Keyword(s):  
Diabetic Retinopathy ◽  
Regression Analysis ◽  
Roc Curve ◽  
External Validation ◽  
Curve Analysis ◽  
Postprandial Blood Glucose ◽  
Lasso Regression ◽  
Prediction Ability ◽  
Decision Curve Analysis ◽  
Course Of Disease

Objectives. This study is aimed at developing a risk nomogram of diabetic retinopathy (DR) in a Chinese population with type 2 diabetes mellitus (T2DM). Methods. A questionnaire survey, biochemical indicator examination, and physical examination were performed on 4170 T2DM patients, and the collected data were used to evaluate the DR risk in T2DM patients. By operating R software, firstly, the least absolute shrinkage and selection operator (LASSO) regression analysis was used to optimize variable selection by running cyclic coordinate descent with 10 times K cross-validation. Secondly, multivariable logistic regression analysis was applied to build a predicting model introducing the predictors selected from the LASSO regression analysis. The nomogram was developed based on the selected variables visually. Thirdly, calibration plot, receiver operating characteristic (ROC) curve, and decision curve analysis were used to validate the model, and further assessment was running by external validation. Results. Seven predictors were selected by LASSO from 19 variables, including age, course of disease, postprandial blood glucose (PBG), glycosylated haemoglobin A1c (HbA1c), uric creatinine (UCR), urinary microalbumin (UMA), and systolic blood pressure (SBP). The model built by these 7 predictors displayed medium prediction ability with the area under the ROC curve of 0.700 in the training set and 0.715 in the validation set. The decision curve analysis curve showed that the nomogram could be applied clinically if the risk threshold is between 21% and 57% and 21%-51% in external validation. Conclusion. Introducing age, course of disease, PBG, HbA1c, UCR, UMA, and SBP, the risk nomogram is useful for prediction of DR risk in T2DM individuals.

scholarly journals Addition of arterial spin-labelled MR perfusion to conventional brain MRI: clinical experience in a retrospective cohort study

BMJ Open ◽  
2020 ◽  
Vol 10 (6) ◽  
pp. e036785
Author(s):  
Puneet Belani ◽  
Shingo Kihira ◽  
Felipe Pacheco ◽  
Puneet Pawha ◽  
Giuseppe Cruciata ◽  
...  
Keyword(s):  
Retrospective Cohort ◽  
Primary Outcome ◽  
Brain Mri ◽  
Hospital Setting ◽  
Tertiary Hospital ◽  
Supplementary Information ◽  
Acquisition Time ◽  
Mr Perfusion ◽  
Conventional Mri ◽  
Acute Infarct

ObjectiveThe usage of arterial spin labelling (ASL) perfusion has exponentially increased due to improved and faster acquisition time and ease of postprocessing. We aimed to report potential additional findings obtained by adding ASL to routine unenhanced brain MRI for patients being scanned in a hospital setting for various neurological indications.DesignRetrospective.SettingLarge tertiary hospital.Participants676 patients.Primary outcomeAdditional findings from ASL sequence compared with conventional MRI.ResultsOur patient cohorts consisted of 676 patients with 257 with acute infarcts and 419 without an infarct. Additional findings from ASL were observed in 13.9% (94/676) of patients. In the non-infarct group, additional findings from ASL were observed in 7.4% (31/419) of patients, whereas in patients with an acute infarct, supplemental information was obtained in 24.5% (63/257) of patients.ConclusionThe addition of an ASL sequence to routine brain MRI in a hospital setting provides additional findings compared with conventional brain MRI in about 7.4% of patients with additional supplementary information in 24.5% of patients with acute infarct.

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