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Prospective feasibility study for single-tracer sentinel node mapping by ICG (indocyanine green) fluorescence and OSNA (one-step nucleic acid amplification) assay in laparoscopic gastric cancer surgery
摘要： Background The double-tracer method has been established for sentinel node (SN) mapping in gastric cancer surgery. However, there remain several unresolved issues that prevent its widespread use in clinical practice. In this study, we aimed to demonstrate the feasibility of single-tracer SN mapping in laparoscopic surgery for gastric cancer, using indocyanine green (ICG) fluorescence imaging with a one-step nucleic acid amplification (OSNA) assay intraoperatively. Methods Patients with clinical T1N0M0 gastric adenocarcinoma preoperatively were considered for inclusion if they had a single primary lesion 4 cm or less in maximal diameter. Immunohistochemical staining with the anti-cytokeratin 19 antibody was performed on preoperative biopsy specimens, and patients with faint positive reactions were excluded. Intraoperatively, single-tracer SN biopsy with ICG fluorescence imaging was performed, followed by laparoscopic gastrectomy with modified D1+ or D2 lymph node dissection. Results Twenty eligible patients underwent SN biopsy and laparoscopic gastrectomy. SNs were identified in 17 cases (85%), with a median number of three SNs per patient. The median times for SN mapping and OSNA assay were 19 and 35 min, respectively. OSNA assay detected one metastatic lymph node, but all other nodes were negative. No adverse effects were observed in relation to SN mapping. Conclusions Single-tracer SN mapping by ICG fluorescence imaging with intraoperative diagnosis by OSNA assay is feasible and safe. SNs can be identified in most patients, without producing false-negative results. Further clinical trial to demonstrate the sensitivity is ongoing.
关键词： Fluorescence imaging,Indocyanine green,Sentinel lymph node,Surgical pathology,Gastric cancer
更新于2025-09-23 15:23:52
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Fast ScanNet: Fast and Dense Analysis of Multi-Gigapixel Whole-Slide Images for Cancer Metastasis Detection
摘要： Lymph node metastasis is one of the most important indicators in breast cancer diagnosis, that is traditionally observed under the microscope by pathologists. In recent years, with the dramatic advance of high-throughput scanning and deep learning technology, automatic analysis of histology from whole-slide images has received a wealth of interest in the field of medical image computing, which aims to alleviate pathologists’ workload and simultaneously reduce misdiagnosis rate. However, automatic detection of lymph node metastases from whole-slide images remains a key challenge because such images are typically very large, where they can often be multiple gigabytes in size. Also, the presence of hard mimics may result in a large number of false positives. In this paper, we propose a novel method with anchor layers for model conversion, which not only leverages the efficiency of fully convolutional architectures to meet the speed requirement in clinical practice, but also densely scans the whole-slide image to achieve accurate predictions on both micro- and macro-metastases. Incorporating the strategies of asynchronous sample prefetching and hard negative mining, the network can be effectively trained. The efficacy of our method are corroborated on the benchmark dataset of 2016 Camelyon Grand Challenge. Our method achieved significant improvements in comparison with the state-of-the-art methods on tumour localization accuracy with a much faster speed and even surpassed human performance on both challenge tasks.
关键词： metastasis detection,Histopathology image analysis,deep learning,whole-slide image,computational pathology
更新于2025-09-23 15:23:52
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Methodology for diagnosing crack patterns in masonry structures using photogrammetry and distinct element modeling
摘要： Understanding the causes of damages on existing structures can augment preservation, renovation, and rehabilitation efforts. The aim of this work is to outline a method for diagnosing the most probable causes of cracks on existing structures using a combination of photogrammetry and distinct element modeling (DEM). Five experimental, masonry walls were constructed and cracked; the state of the wall before and after cracking was recorded using photogrammetry. Using distinct element modeling, each test wall was subjected to a variety of loading conditions including the same load case which was used to crack the wall during experimental testing. The crack patterns in the simulations were compared to the experimental crack patterns using a combined qualitative and quantitative method. The simulation which most closely reflected the existing damage patterns was selected as the most probable cause of the damages. For each of the test walls, the real simulated load had the closest fractional distance to the existing damage patterns captured by photogrammetry. This method was then applied to diagnose possible causes of cracking on a foundation wall in the Baptistery of San Giovani in Florence, Italy.
关键词： Distinct element modeling,Masonry,Building pathology,Diagnosis,Crack propagation,Photogrammetry
更新于2025-09-23 15:23:52
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Use of Telehealth Screening to Detect Diabetic Retinopathy and Other Ocular Findings in Primary Care Settings
摘要： Purpose: To determine the incidence of diabetic retinopathy (DR) and other ocular findings in previously diagnosed diabetes using telehealth retinal screening with nonmydriatic fundus photography (nFP) in primary care physicians’ offices. Methods: A retrospective study based on electronic chart review was performed. All diabetic patients who participated in the Wills Eye Hospital (WEH) telehealth retinal screening program from July 1, 2012 to February 20, 2017 were included. In addition to evaluation of DR, other eye pathologies of the retina were detected using nFP. Results: Overall, 9,946 diabetics participated in the WEH telehealth screening system. After exclusion of missing or unreadable images, 15,180 eyes of 7,624 (76.7%) patients were eligible for final analysis. A total of 1,269 (16.6%) patients were noted to have DR changes in at least one eye. Of those, 475 (37.4%) had mild nonproliferative DR (NPDR) in the more severely affected eye, 712 (56.1%) had moderate NPDR, 33 (2.6%) had severe NPDR, 19 (1.5%) had proliferative DR, and 30 (2.4%) have received pan-retinal photocoagulation previously. In addition, there was evidence of diabetic macular edema detectable on nFP in 34 eyes of 29 patients. Other ocular findings included hypertensive retinopathy (709, 9.3%), increased or asymmetric cup-to-disc ratio (562, 7.4%), age-related cataract (379, 5.0%), cotton-wool spots (221, 2.9%), choroidal nevus (74, 1.0%), age-related macular degeneration (AMD) (66, 0.9%), and epiretinal membrane (48, 0.6%). Patients with hypertensive retinopathy, glaucomatous findings, cataract, or AMD were significantly older (p < 0.001) than those without these ocular pathologies. Conclusion: The WEH Telehealth Screening Program identified DR in approximately one out of six patients and other ocular pathologies in over 25% of the diabetic population that received screenings in Philadelphia area primary care offices. Given the importance of early detection and routine eye care to prevent vision loss for DR patients, these findings have a significant impact.
关键词： ocular pathology,diabetic retinopathy,telehealth,screening
更新于2025-09-23 15:21:01
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Multi-objective Parameter Auto-tuning for Tissue Image Segmentation Workflows
摘要： We propose a software platform that integrates methods and tools for multi-objective parameter auto-tuning in tissue image segmentation workflows. The goal of our work is to provide an approach for improving the accuracy of nucleus/cell segmentation pipelines by tuning their input parameters. The shape, size, and texture features of nuclei in tissue are important biomarkers for disease prognosis, and accurate computation of these features depends on accurate delineation of boundaries of nuclei. Input parameters in many nucleus segmentation workflows affect segmentation accuracy and have to be tuned for optimal performance. This is a time-consuming and computationally expensive process; automating this step facilitates more robust image segmentation workflows and enables more efficient application of image analysis in large image datasets. Our software platform adjusts the parameters of a nuclear segmentation algorithm to maximize the quality of image segmentation results while minimizing the execution time. It implements several optimization methods to search the parameter space efficiently. In addition, the methodology is developed to execute on high-performance computing systems to reduce the execution time of the parameter tuning phase. These capabilities are packaged in a Docker container for easy deployment and can be used through a friendly interface extension in 3D Slicer. Our results using three real-world image segmentation workflows demonstrate that the proposed solution is able to (1) search a small fraction (about 100 points) of the parameter space, which contains billions to trillions of points, and improve the quality of segmentation output by × 1.20, × 1.29, and × 1.29, on average; (2) decrease the execution time of a segmentation workflow by up to 11.79× while improving output quality; and (3) effectively use parallel systems to accelerate parameter tuning and segmentation phases.
关键词： Parameter auto-tuning,Cancer,Cell morphology,Computer-assisted image analysis,Digital pathology
更新于2025-09-23 15:21:01
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Assessment of anterior and posterior corneal indices using two Scheimpflug analyzers
摘要： Purpose: To assess the agreement between the elevation and curvature measurements of the anterior and posterior corneal surfaces obtained using the Galilei Dual Scheimpflug Analyzer and those obtained using the Pentacam single Scheimpflug system. Methods: This prospective, noninterventional, diagnostic study was conducted at the Department of Ophthalmology at the American University of Beirut (Medical Center) and included 60 eyes of 60 consecutive patients. Measurements were obtained using 2 different Scheimpflug analyzers (Galilei and Pentacam). The best-fit sphere was set at 8 mm in both machines. Pachymetry (CCT), anterior elevation (AE) and posterior elevation (PE), and curvature were assessed. Pearson’s correlation coefficients, comparison of means, and Bland-Altman plots were used to evaluate agreement between the 2 systems. Results: The average CCT (at the corneal apex) was 533 ± 35 μm and 532 ± 37 μm (p=0.980), the average central AE was 1.25 ± 3.95 μm and 2.29 ± 5.28 μm (p=0.964), and the average central PE was 4.19 ± 8.18 μm and 5.42 ± 14.05 (p=0.956) μm with the Galilei and Pentacam, respectively. Conclusion: The Scheimpflug analyzers correlated well in the assessment of pachymetry, elevation, and curvature.
关键词： Corneal pachymetry,Photography/instrumentation,Cornea/pathology,Cornea/anatomy & histology,Corneal topography
更新于2025-09-23 15:21:01
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Metabolic mapping with plasmonic nanoparticle assemblies
摘要： A rapid and simple methodology for the biomolecular analysis of single cells and microenvironments via a stick-and-peel plasmonic sensing platform is reported. Substrate-bound assemblies of plasmonic gold nanoparticles linked by reconfigurable oligonucleotides undergo disassembly upon target binding. Changes in the light scattering intensity of thousands of discrete nanoparticle assemblies are extrapolated concomitantly to yield the mapping of local target concentrations. The methodology is completely free of labelling, purification and separation steps. We quantified the intracellular ATP levels for two ovarian cancer cell lines to elucidate the differences and cellular distribution, and demonstrated the potential of the stick-and-peel platform for mapping the microenvironment of a 2D heterogeneous surface. The portable and economical analytical platform may broaden the affordability and applicability of single-cell based analyses and enable new opportunities in clinical care such as on-site molecular pathology.
关键词： stick-and-peel platform,plasmonic nanoparticle assemblies,ATP detection,single-cell analysis,molecular pathology
更新于2025-09-23 15:19:57
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Subthreshold yellow micropulse laser for treatment of diabetic macular edema: Comparison between fixed and variable treatment regimen
摘要： Purpose: To compare the efficacy between fixed and variable treatment regimens of subthreshold yellow micropulse laser for the treatment of diabetic macular edema. Methods: This is a retrospective, comparative, 12-month study of 39 eyes: 24 eyes received fixed treatment regimen of subthreshold micropulse laser treatment and 15 eyes underwent variable treatment regimen of subthreshold micropulse laser, all eyes were followed up for 12 months. Subthreshold micropulse laser was performed with the following parameters: 100 μm spot size on slit lamp, 5% duty cycle of 0.2 s, and 250 mW power. To choose the power of the variable treatment regimen of subthreshold micropulse laser group, continuous laser power was titrated to a barely visible burn and then switched to MicroPulse mode, multiplying the test burn power by 4 and using a 5% duty cycle of 0.2 s. Main outcomes included changes in central macular thickness and best-corrected visual acuity. Results: At baseline, the mean LogMAR best-corrected visual acuity was 0.297 ± 0.431 in the variable treatment regimen of subthreshold micropulse laser group and 0.228 ± 0.341 in the fixed treatment regimen of subthreshold micropulse laser group. At the end of follow-up, the mean LogMAR best-corrected visual acuity was 0.289 ± 0.473 (p = 0.785) and 0.245 ± 0.376 (p = 0.480) in the variable and fixed treatment regimens of subthreshold micropulse laser groups, respectively. Similarly, central macular thickness decreased in both groups after treatment; at baseline, the mean central macular thickness was 371.06 ± 37.8 in the variable treatment regimen of subthreshold micropulse laser group and improved to 325.60 ± 110.0 μm (p = 0.025) at the end of the follow-ups, while it was 342.30 ± 35.4 in the fixed treatment regimen of subthreshold micropulse laser group and improved to 308.51 ± 67.5 (p = 0.037). Conclusion: Both treatment regimens are effective for the treatment of mild center-involving diabetic macular edema: fixed treatment appears more suitable minimizing treatment time and reducing the possible errors due to wrong titration in the switch from continuous to micropulse mode.
关键词： Diabetic retinopathy,retina,diabetic macular edema,cystoid macular edema (CME),retina—medical therapies,retinal pathology/research
更新于2025-09-23 15:19:57
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<p>The Pimpled Gold Nanosphere: A Superior Candidate for Plasmonic Photothermal Therapy</p>
摘要： Background: The development of highly efficient nanoparticles to convert light to heat for anti-cancer applications is quite a challenging field of research. Methods: In this study, we synthesized unique pimpled gold nanospheres (PGNSs) for plasmonic photothermal therapy (PPTT). The light-to-heat conversion capability of PGNSs and PPTT damage at the cellular level were investigated using a tissue phantom model. The ability of PGNSs to induce robust cellular damage was studied during cytotoxicity tests on colorectal adenocarcinoma (DLD-1) and fibroblast cell lines. Further, a numerical model of plasmonic (COMSOL Multiphysics) properties was used with the PPTT experimental assays. Results: A low cytotoxic effect of thiolated polyethylene glycol (SH-PEG400-SH-) was observed which improved the biocompatibility of PGNSs to maintain 89.4% cell viability during cytometry assays (in terms of fibroblast cells for 24 hrs at a concentration of 300 μg/mL). The heat generated from the nanoparticle-mediated phantom models resulted in ΔT=30°C, ΔT=23.1°C and ΔT=21°C for the PGNSs, AuNRs, and AuNPs, respectively (at a 300 μg/mL concentration and for 325 sec). For the in vitro assays of PPTT on cancer cells, the PGNS group induced a 68.78% lethality (apoptosis) on DLD-1 cells. Fluorescence microscopy results showed the destruction of cell membranes and nuclei for the PPTT group. Experiments further revealed a penetration depth of sufficient PPTT damage in a physical tumor model after hematoxylin and eosin (H&E) staining through pathological studies (at depths of 2, 3 and 4 cm). Severe structural damages were observed in the tissue model through an 808-nm laser exposed to the PGNSs. Conclusion: Collectively, such results show much promise for the use of the present PGNSs and photothermal therapy for numerous anti-cancer applications.
关键词： gold nanoparticles,photothermal therapy,plasmonic,colorectal cells,pathology
更新于2025-09-23 15:19:57
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Nonmydriatic Fundus Photography in Patients with Acute Vision Loss
摘要： Background: Acute visual loss is a common chief complaint in emergency department (ED) patients, but the scarcity of ophthalmologists in most EDs limits its evaluation. Introduction: Our objective was to evaluate whether non-mydriatic fundus photography (NMFP) in the ED helps triage patients with acute visual loss. Materials and Methods: We included 213 patients with acute visual loss evaluated in the ED with NMFP as part of the Fundus Photography versus Ophthalmoscopy Trial Outcomes in the ED studies. Demographics, referral patterns, results of NMFP, and final diagnoses were recorded. Results: A final ophthalmological diagnosis was made in 109/213 (51%) patients. NMFP allowed a definite diagnosis in 51/109 (47%) patients: 14 nonglaucomatous optic neuropathies, 10 papilledema, 13 acute retinal ischemia, 2 retinal detachments, 2 choroidal metastases, 4 maculopathies, and 6 glaucoma. In 58/109 (53%) patients, NMFP was not diagnostic even when interpreted remotely by ophthalmologists due to disorders undiagnosable with NMFP. Ophthalmology consultation was requested in 109/213 (51%) patients, 41/54 (76%) patients with abnormal NMFP versus 68/159 (43%) patients with normal NMPF (p < 0.001). Discussion: Although NMFP allowed rapid diagnosis in 51/213 (24%) patients presenting to the ED with acute visual loss, NMFP alone was not sufficient to detect all ocular diseases; ophthalmology consultation was more often requested when NMFP was abnormal. Conclusions: Our study emphasizes the limitations of tele-ophthalmology with NMFP in remotely detecting ocular diseases related to acute visual loss in the ED. NMFP helped triage and referral decisions and can be used to complement ophthalmology consultations in the ED.
关键词： telehealth,acute vision loss,teleophthalmology,nonmydriatic fundus photography,emergency department,ocular pathology detection
更新于2025-09-23 15:19:57