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Esper Treml R, Caldonazo T, Barlem Hohmann F, Lima da Rocha D, Filho PHA, Mori AL, S. Carvalho A, S. F. Serrano J, A. T. Dall-Aglio P, Radermacher P, Silva JM. Association of chest computed tomography severity score at ICU admission and respiratory outcomes in critically ill COVID-19 patients. PLoS One 2024; 19:e0299390. [PMID: 38696477 PMCID: PMC11065208 DOI: 10.1371/journal.pone.0299390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 02/09/2024] [Indexed: 05/04/2024] Open
Abstract
OBJECTIVE To evaluate the association of a validated chest computed tomography (Chest-CT) severity score in COVID-19 patients with their respiratory outcome in the Intensive Care Unit. METHODS A single-center, prospective study evaluated patients with positive RT-PCR for COVID-19, who underwent Chest-CT and had a final COVID-19 clinical diagnosis needing invasive mechanical ventilation in the ICU. The admission chest-CT was evaluated according to a validated Chest-CT Severity Score in COVID-19 (Chest-CTSS) divided into low ≤50% (<14 points) and >50% high (≥14 points) lung parenchyma involvement. The association between the initial score and their pulmonary clinical outcomes was evaluated. RESULTS 121 patients were clustered into the > 50% lung involvement group and 105 patients into the ≤ 50% lung involvement group. Patients ≤ 50% lung involvement (<14 points) group presented lower PEEP levels and FiO2 values, respectively GEE P = 0.09 and P = 0.04. The adjusted COX model found higher hazard to stay longer on invasive mechanical ventilation HR: 1.69, 95% CI, 1.02-2.80, P = 0.042 and the adjusted logistic regression model showed increased risk ventilator-associated pneumonia OR = 1.85 95% CI 1.01-3.39 for COVID-19 patients with > 50% lung involvement (≥14 points) on Chest-CT at ICU admission. CONCLUSION COVID-19 patients with >50% lung involvement on Chest-CT admission presented higher chances to stay longer on invasive mechanical ventilation and more chances to developed ventilator-associated pneumonia.
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Affiliation(s)
- Ricardo Esper Treml
- Department of Anesthesiology and Intensive Care Medicine, Friedrich-Schiller-University, Jena, Germany
- Department of Anesthesiology, University of São Paulo, São Paulo, Brazil
| | - Tulio Caldonazo
- Department of Cardiothoracic Surgery, Friedrich-Schiller-University, Jena, Germany
| | - Fábio Barlem Hohmann
- Department of Intensive Care Medicine, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Daniel Lima da Rocha
- Department of Intensive Care Medicine, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | | | - Andréia L. Mori
- Department of Anesthesiology, Servidor Público Estadual Hospital, Sao Paulo, Brazil
| | - André S. Carvalho
- Department of Anesthesiology, Servidor Público Estadual Hospital, Sao Paulo, Brazil
| | | | | | - Peter Radermacher
- Institute for Anesthesiological Pathophysiology and Process Development, Ulm University Hospital, Ulm, Germany
| | - João M. Silva
- Department of Anesthesiology, University of São Paulo, São Paulo, Brazil
- Department of Intensive Care Medicine, Hospital Israelita Albert Einstein, São Paulo, Brazil
- Department of Anesthesiology, Servidor Público Estadual Hospital, Sao Paulo, Brazil
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Wada N, Li Y, Gagne S, Hino T, Valtchinov VI, Gay E, Nishino M, Hammer MM, Madore B, Guttmann CRG, Ishigami K, Hunninghake GM, Levy BD, Kaye KM, Christiani DC, Hatabu H. Incidence and severity of pulmonary embolism in COVID-19 infection: Ancestral, Alpha, Delta, and Omicron variants. Medicine (Baltimore) 2023; 102:e36417. [PMID: 38050198 PMCID: PMC10695578 DOI: 10.1097/md.0000000000036417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 11/10/2023] [Indexed: 12/06/2023] Open
Abstract
Little information is available regarding incidence and severity of pulmonary embolism (PE) across the periods of ancestral strain, Alpha, Delta, and Omicron variants. The aim of this study is to investigate the incidence and severity of PE over the dominant periods of ancestral strain and Alpha, Delta, and Omicron variants. We hypothesized that the incidence and the severity by proximity of PE in patients with the newer variants and vaccination would be decreased compared with those in ancestral and earlier variants. Patients with COVID-19 diagnosis between March 2020 and February 2022 and computed tomography pulmonary angiogram performed within a 6-week window around the diagnosis (-2 to +4 weeks) were studied retrospectively. The primary endpoints were the associations of the incidence and location of PE with the ancestral strain and each variant. Of the 720 coronavirus disease 2019 patients with computed tomography pulmonary angiogram (58.6 ± 17.2 years; 374 females), PE was diagnosed among 42/358 (12%) during the ancestral strain period, 5/60 (8%) during the Alpha variant period, 16/152 (11%) during the Delta variant period, and 13/150 (9%) during the Omicron variant period. The most proximal PE (ancestral strain vs variants) was located in the main/lobar arteries (31% vs 6%-40%), in the segmental arteries (52% vs 60%-75%), and in the subsegmental arteries (17% vs 0%-19%). There was no significant difference in both the incidence and location of PE across the periods, confirmed by multivariable logistic regression models. In summary, the incidence and severity of PE did not significantly differ across the periods of ancestral strain and Alpha, Delta, and Omicron variants.
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Affiliation(s)
- Noriaki Wada
- Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Yi Li
- Department of Biostatistics, University of Michigan, Ann Arbor, MI
| | - Staci Gagne
- Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Takuya Hino
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka City, Fukuoka, Japan
| | - Vladimir I. Valtchinov
- Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Elizabeth Gay
- Division of Pulmonary and Critical Care Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Mizuki Nishino
- Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Mark M. Hammer
- Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Bruno Madore
- Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Charles R. G. Guttmann
- Center for Neurological Imaging, Department of Radiology, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Kousei Ishigami
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka City, Fukuoka, Japan
| | - Gary M. Hunninghake
- Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
- Division of Pulmonary and Critical Care Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Bruce D. Levy
- Division of Pulmonary and Critical Care Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Kenneth M. Kaye
- Division of Infectious Diseases, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - David C. Christiani
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA
- Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA
| | - Hiroto Hatabu
- Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
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Hou N, Wang L, Li M, Xie B, He L, Guo M, Liu S, Wang M, Zhang R, Wang K. Do COVID-19 CT features vary between patients from within and outside mainland China? Findings from a meta-analysis. Front Public Health 2022; 10:939095. [PMID: 36311632 PMCID: PMC9616120 DOI: 10.3389/fpubh.2022.939095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Accepted: 07/25/2022] [Indexed: 01/25/2023] Open
Abstract
Background Chest computerized tomography (CT) plays an important role in detecting patients with suspected coronavirus disease 2019 (COVID-19), however, there are no systematic summaries on whether the chest CT findings of patients within mainland China are applicable to those found in patients outside. Methods Relevant studies were retrieved comprehensively by searching PubMed, Embase, and Cochrane Library databases before 15 April 2022. Quality assessment of diagnostic accuracy studies (QUADAS) was used to evaluate the quality of the included studies, which were divided into two groups according to whether they were in mainland China or outside. Data on diagnostic performance, unilateral or bilateral lung involvement, and typical chest CT imaging appearances were extracted, and then, meta-analyses were performed with R software to compare the CT features of COVID-19 pneumonia between patients from within and outside mainland China. Results Of the 8,258 studies screened, 19 studies with 3,400 patients in mainland China and 14 studies with 554 outside mainland China were included. Overall, the risk of quality assessment and publication bias was low. The diagnostic value of chest CT is similar between patients from within and outside mainland China (93, 91%). The pooled incidence of unilateral lung involvement (15, 7%), the crazy-paving sign (31, 21%), mixed ground-glass opacities (GGO) and consolidations (51, 35%), air bronchogram (44, 25%), vascular engorgement (59, 33%), bronchial wall thickening (19, 12%), and septal thickening (39, 26%) in patients from mainland China were significantly higher than those from outside; however, the incidence rates of bilateral lung involvement (75, 84%), GGO (78, 87%), consolidations (45, 58%), nodules (12, 17%), and pleural effusion (9, 15%) were significantly lower. Conclusion Considering that the chest CT features of patients in mainland China may not reflect those of the patients abroad, radiologists and clinicians should be familiar with various CT presentations suggestive of COVID-19 in different regions.
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Affiliation(s)
- Nianzong Hou
- Center of Gallbladder Disease, Shanghai East Hospital, Institute of Gallstone Disease, School of Medicine, Tongji University, Shanghai, China,Department of Hand and Foot Surgery, Zibo Central Hospital, Shandong First Medical University and Shandong Academy of Medical Sciences, Zibo, China
| | - Lin Wang
- Department of Critical Care Medicine, Zibo Central Hospital, Shandong First Medical University and Shandong Academy of Medical Sciences, Zibo, China
| | - Mingzhe Li
- School of Molecular and Cellular Biology, University of Leeds, Leeds, United Kingdom
| | - Bing Xie
- Department of Hand and Foot Surgery, Zibo Central Hospital, Shandong First Medical University and Shandong Academy of Medical Sciences, Zibo, China
| | - Lu He
- Department of Urology, Dongfeng Hospital, Hubei University of Medicine, Shiyan, China
| | - Mingyu Guo
- Department of Hand and Foot Surgery, Zibo Central Hospital, Shandong First Medical University and Shandong Academy of Medical Sciences, Zibo, China
| | - Shuo Liu
- Department of Hand and Foot Surgery, Zibo Central Hospital, Shandong First Medical University and Shandong Academy of Medical Sciences, Zibo, China
| | - Meiyu Wang
- Department of Cardiology, The People's Hospital of Zhangdian District, Zibo, China
| | - Rumin Zhang
- Department of Critical Care Medicine, Zibo Central Hospital, Shandong First Medical University and Shandong Academy of Medical Sciences, Zibo, China
| | - Kai Wang
- Department of Critical Care Medicine, Zibo Central Hospital, Shandong First Medical University and Shandong Academy of Medical Sciences, Zibo, China,*Correspondence: Kai Wang
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Inui S, Fujikawa A, Gonoi W, Kawano S, Sakurai K, Uchida Y, Ishida M, Abe O. Comparison of CT findings of coronavirus disease 2019 (COVID-19) pneumonia caused by different major variants. Jpn J Radiol 2022; 40:1246-1256. [PMID: 35763239 PMCID: PMC9244322 DOI: 10.1007/s11604-022-01301-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 06/01/2022] [Indexed: 11/25/2022]
Abstract
Purpose To explore the CT findings and pneumonnia progression pattern of the Alpha and Delta variants of SARS-CoV-2 by comparing them with the pre-existing wild type. Method In this retrospective comparative study, a total of 392 patients with COVID-19 were included: 118 patients with wild type (70 men, 56.8 ± 20.7 years), 137 with Alpha variant (93 men, 49.4 ± 17.0 years), and 137 with Delta variant (94 men, 45.4 ± 12.4). Chest CT evaluation included opacities and repairing changes as well as lesion distribution and laterality. Chest CT severity score was also calculated. These parameters were statistically compared across the variants. Results Ground glass opacity (GGO) with consolidation and repairing changes were more frequent in the order of Delta variant, Alpha variant, and wild type throughout the disease course. Delta variant showed GGO with consolidation more conspicuously than did the other two on days 1–4 (vs. wild type, Bonferroni corrected p = 0.01; vs. Alpha variant, Bonferroni corrected p = 0.003) and days 5–8 (vs. wild type, Bonferroni corrected p < 0.001; vs. Alpha variant, Bonferroni corrected-p = 0.003). Total lung CT severity scores of Delta variant were higher than those of wild type on days 1–4 and 5–8 (Bonferroni corrected p = 0.01 and Bonferroni corrected p = 0.005, respectively) and that of Alpha variant on days 1–4 (Bonferroni corrected p = 0.002). There was no difference in the CT findings between wild type and Alpha variant. Conclusions Pneumonia progression of Delta variant may be more rapid and severe in the early stage than in the other two.
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Affiliation(s)
- Shohei Inui
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
- Department of Radiology, Japan Self-Defense Forces Central Hospital, 1-2-24, Ikejiri, Setagaya-ku, Tokyo, 154-0001, Japan.
| | - Akira Fujikawa
- Department of Radiology, Japan Self-Defense Forces Central Hospital, 1-2-24, Ikejiri, Setagaya-ku, Tokyo, 154-0001, Japan
| | - Wataru Gonoi
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Shuichi Kawano
- Department of Respiratory Medicine, Japan Self-Defense Forces Central Hospital, 1-2-24, Ikejiri, Setagaya-ku, Tokyo, 154-0001, Japan
| | - Keita Sakurai
- Department of Radiology, National Center for Geriatrics and Gerontology, 7-430 Morioka-cho, Obu, Aichi, 474-8511, Japan
| | - Yuto Uchida
- Department of Neurology, Graduate School of Medicine, Nagoya City University, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan
| | - Masanori Ishida
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Osamu Abe
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
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Tsakok MT, Watson RA, Saujani SJ, Kong M, Xie C, Peschl H, Wing L, MacLeod FK, Shine B, Talbot NP, Benamore RE, Eyre DW, Gleeson F. Reduction in Chest CT Severity and Improved Hospital Outcomes in SARS-CoV-2 Omicron Compared with Delta Variant Infection. Radiology 2022; 306:261-269. [PMID: 35727150 PMCID: PMC9272784 DOI: 10.1148/radiol.220533] [Citation(s) in RCA: 50] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Background The SARS-Cov-2 Omicron variant demonstrates rapid spread but reduced disease severity. Studies evaluating lung imaging findings of Omicron infection versus non-Omicron infection remain lacking. Purpose To compare the Omicron variant with the SARS-CoV-2 Delta variant according to their chest CT radiologic pattern, biochemical parameters, clinical severity, and hospital outcomes after adjusting for vaccination status. Materials and Methods This retrospective study included hospitalized adult patients with reverse transcriptase-polymerase chain reaction test results positive for SARS-CoV-2, with CT pulmonary angiography performed within 7 days of admission between December 1, 2021, and January 14, 2022. Multiple readers performed blinded radiologic analyses that included RSNA CT classification, chest CT severity score (CTSS) (range, 0 [least severe] to 25 [most severe]), and CT imaging features, including bronchial wall thickening. Results A total of 106 patients (Delta group, n = 66; Omicron group, n = 40) were evaluated (overall mean age, 58 years ± 18 [SD]; 58 men). In the Omicron group, 37% of CT pulmonary angiograms (15 of 40 patients) were categorized as normal compared with 15% (10 of 66 patients) of angiograms in the Delta group (P = .016). A generalized linear model was used to control for confounding variables, including vaccination status, and Omicron infection was associated with a CTSS that was 7.2 points lower than that associated with Delta infection (β = -7.2; 95% CI: -9.9, -4.5; P < .001). Bronchial wall thickening was more common with Omicron infection than with Delta infection (odds ratio [OR], 2.4; 95% CI: 1.01, 5.92; P = .04). A booster shot was associated with a protective effect for chest infection (median CTSS, 5; IQR, 0-11) when compared with unvaccinated individuals (median CTSS, 11; IQR, 7.5-14.0) (P = .03). The Delta variant was associated with a higher OR of severe disease (OR, 4.6; 95% CI: 1.2, 26; P = .01) and admission to a critical care unit (OR, 7.0; 95% CI: 1.5, 66; P = .004) when compared with the Omicron variant. Conclusion The SARS-CoV-2 Omicron variant was associated with fewer and less severe changes on chest CT images compared with the Delta variant. Patients with Omicron infection had greater frequency of bronchial wall thickening but less severe disease and improved hospital outcomes when compared with patients with Delta infection. © RSNA, 2022 Online supplemental material is available for this article.
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Affiliation(s)
- Maria T. Tsakok
- From the Department of Radiology, Oxford University Hospitals NHS Foundation Trust, Headley Way, Oxford OX3 9DU, United Kingdom (M.T.T., R.A.W., S.J.S., M.K., C.X., H.P., L.W., F.K.M., B.S., N.P.T., R.E.B., D.W.E., F.G.); and Weatherall Institute of Molecular Medicine (R.A.W.), Department of Oncology (R.A.W.), Department of Physiology, Anatomy and Genetics (N.P.T.), and Big Data Institute, Nuffield Department of Population Health (D.W.E.), University of Oxford, Oxford, United Kingdom
| | - Robert A. Watson
- From the Department of Radiology, Oxford University Hospitals NHS Foundation Trust, Headley Way, Oxford OX3 9DU, United Kingdom (M.T.T., R.A.W., S.J.S., M.K., C.X., H.P., L.W., F.K.M., B.S., N.P.T., R.E.B., D.W.E., F.G.); and Weatherall Institute of Molecular Medicine (R.A.W.), Department of Oncology (R.A.W.), Department of Physiology, Anatomy and Genetics (N.P.T.), and Big Data Institute, Nuffield Department of Population Health (D.W.E.), University of Oxford, Oxford, United Kingdom
| | - Shyamal J. Saujani
- From the Department of Radiology, Oxford University Hospitals NHS Foundation Trust, Headley Way, Oxford OX3 9DU, United Kingdom (M.T.T., R.A.W., S.J.S., M.K., C.X., H.P., L.W., F.K.M., B.S., N.P.T., R.E.B., D.W.E., F.G.); and Weatherall Institute of Molecular Medicine (R.A.W.), Department of Oncology (R.A.W.), Department of Physiology, Anatomy and Genetics (N.P.T.), and Big Data Institute, Nuffield Department of Population Health (D.W.E.), University of Oxford, Oxford, United Kingdom
| | - Mark Kong
- From the Department of Radiology, Oxford University Hospitals NHS Foundation Trust, Headley Way, Oxford OX3 9DU, United Kingdom (M.T.T., R.A.W., S.J.S., M.K., C.X., H.P., L.W., F.K.M., B.S., N.P.T., R.E.B., D.W.E., F.G.); and Weatherall Institute of Molecular Medicine (R.A.W.), Department of Oncology (R.A.W.), Department of Physiology, Anatomy and Genetics (N.P.T.), and Big Data Institute, Nuffield Department of Population Health (D.W.E.), University of Oxford, Oxford, United Kingdom
| | - Cheng Xie
- From the Department of Radiology, Oxford University Hospitals NHS Foundation Trust, Headley Way, Oxford OX3 9DU, United Kingdom (M.T.T., R.A.W., S.J.S., M.K., C.X., H.P., L.W., F.K.M., B.S., N.P.T., R.E.B., D.W.E., F.G.); and Weatherall Institute of Molecular Medicine (R.A.W.), Department of Oncology (R.A.W.), Department of Physiology, Anatomy and Genetics (N.P.T.), and Big Data Institute, Nuffield Department of Population Health (D.W.E.), University of Oxford, Oxford, United Kingdom
| | - Heiko Peschl
- From the Department of Radiology, Oxford University Hospitals NHS Foundation Trust, Headley Way, Oxford OX3 9DU, United Kingdom (M.T.T., R.A.W., S.J.S., M.K., C.X., H.P., L.W., F.K.M., B.S., N.P.T., R.E.B., D.W.E., F.G.); and Weatherall Institute of Molecular Medicine (R.A.W.), Department of Oncology (R.A.W.), Department of Physiology, Anatomy and Genetics (N.P.T.), and Big Data Institute, Nuffield Department of Population Health (D.W.E.), University of Oxford, Oxford, United Kingdom
| | - Louise Wing
- From the Department of Radiology, Oxford University Hospitals NHS Foundation Trust, Headley Way, Oxford OX3 9DU, United Kingdom (M.T.T., R.A.W., S.J.S., M.K., C.X., H.P., L.W., F.K.M., B.S., N.P.T., R.E.B., D.W.E., F.G.); and Weatherall Institute of Molecular Medicine (R.A.W.), Department of Oncology (R.A.W.), Department of Physiology, Anatomy and Genetics (N.P.T.), and Big Data Institute, Nuffield Department of Population Health (D.W.E.), University of Oxford, Oxford, United Kingdom
| | - Fiona K. MacLeod
- From the Department of Radiology, Oxford University Hospitals NHS Foundation Trust, Headley Way, Oxford OX3 9DU, United Kingdom (M.T.T., R.A.W., S.J.S., M.K., C.X., H.P., L.W., F.K.M., B.S., N.P.T., R.E.B., D.W.E., F.G.); and Weatherall Institute of Molecular Medicine (R.A.W.), Department of Oncology (R.A.W.), Department of Physiology, Anatomy and Genetics (N.P.T.), and Big Data Institute, Nuffield Department of Population Health (D.W.E.), University of Oxford, Oxford, United Kingdom
| | - Brian Shine
- From the Department of Radiology, Oxford University Hospitals NHS Foundation Trust, Headley Way, Oxford OX3 9DU, United Kingdom (M.T.T., R.A.W., S.J.S., M.K., C.X., H.P., L.W., F.K.M., B.S., N.P.T., R.E.B., D.W.E., F.G.); and Weatherall Institute of Molecular Medicine (R.A.W.), Department of Oncology (R.A.W.), Department of Physiology, Anatomy and Genetics (N.P.T.), and Big Data Institute, Nuffield Department of Population Health (D.W.E.), University of Oxford, Oxford, United Kingdom
| | - Nicholas P. Talbot
- From the Department of Radiology, Oxford University Hospitals NHS Foundation Trust, Headley Way, Oxford OX3 9DU, United Kingdom (M.T.T., R.A.W., S.J.S., M.K., C.X., H.P., L.W., F.K.M., B.S., N.P.T., R.E.B., D.W.E., F.G.); and Weatherall Institute of Molecular Medicine (R.A.W.), Department of Oncology (R.A.W.), Department of Physiology, Anatomy and Genetics (N.P.T.), and Big Data Institute, Nuffield Department of Population Health (D.W.E.), University of Oxford, Oxford, United Kingdom
| | - Rachel E. Benamore
- From the Department of Radiology, Oxford University Hospitals NHS Foundation Trust, Headley Way, Oxford OX3 9DU, United Kingdom (M.T.T., R.A.W., S.J.S., M.K., C.X., H.P., L.W., F.K.M., B.S., N.P.T., R.E.B., D.W.E., F.G.); and Weatherall Institute of Molecular Medicine (R.A.W.), Department of Oncology (R.A.W.), Department of Physiology, Anatomy and Genetics (N.P.T.), and Big Data Institute, Nuffield Department of Population Health (D.W.E.), University of Oxford, Oxford, United Kingdom
| | - David W. Eyre
- From the Department of Radiology, Oxford University Hospitals NHS Foundation Trust, Headley Way, Oxford OX3 9DU, United Kingdom (M.T.T., R.A.W., S.J.S., M.K., C.X., H.P., L.W., F.K.M., B.S., N.P.T., R.E.B., D.W.E., F.G.); and Weatherall Institute of Molecular Medicine (R.A.W.), Department of Oncology (R.A.W.), Department of Physiology, Anatomy and Genetics (N.P.T.), and Big Data Institute, Nuffield Department of Population Health (D.W.E.), University of Oxford, Oxford, United Kingdom
| | - Fergus Gleeson
- From the Department of Radiology, Oxford University Hospitals NHS Foundation Trust, Headley Way, Oxford OX3 9DU, United Kingdom (M.T.T., R.A.W., S.J.S., M.K., C.X., H.P., L.W., F.K.M., B.S., N.P.T., R.E.B., D.W.E., F.G.); and Weatherall Institute of Molecular Medicine (R.A.W.), Department of Oncology (R.A.W.), Department of Physiology, Anatomy and Genetics (N.P.T.), and Big Data Institute, Nuffield Department of Population Health (D.W.E.), University of Oxford, Oxford, United Kingdom
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