Predicting the BRAF mutation with pretreatment MRI radiomics features for melanoma brain metastases receiving Gamma Knife radiosurgery

AIM

To develop a model using radiomics features extracted from magnetic resonance imaging (MRI) images of Gamma Knife radiosurgery (GKRS) to predict the BRAF mutation in patients with melanoma brain metastases (MBM).

MATERIALS AND METHODS

Data of 220 tumours were classified into two groups. One was a group whose BRAF mutation was identified, and the other group whose BRAF mutation was not identified. We extracted 1,962 radiomics features from gadolinium contrast-enhanced T1-weighted MRI treatment-planning images. Synthetic Minority Over-sampling TEchnique (SMOTE) was performed to address the unbalanced data-related issues. A single-layer neural network (NN) was used to build predictive models with radiomics features. The sensitivity, specificity, accuracy, and the area under the curve (AUC) were evaluated to assess the model performance.

RESULTS

The prediction performance for the final evaluation without the SMOTE had an accuracy of 77.14%, a specificity of 82.44%, a sensitivity of 81.85%, and an AUC of 0.79. The application of SMOTE improved the prediction model to an accuracy of 83.1%, a specificity of 87.07%, a sensitivity of 78.82%, and an AUC of 0.82.

CONCLUSION

The current study showed the feasibility of generating a highly accurate NN model for the BRAF mutation prediction. The prediction performance improved with SMOTE. The model assists physicians to obtain more accurate expectations of the treatment outcome without a genetic test.

A Nomogram Based on Pretreatment Radiomics and Dosiomics Features for Predicting Overall Survival for Esophageal Squamous Cell Cancer: Multi-Institutional Study

PURPOSE/OBJECTIVE(S)

The current study aims to propose a nomogram-based 2- and 3-years survival prediction model for esophageal squamous cell carcinoma treated by definitive radiotherapy using pretreatment computed tomography (CT), positron emission tomography (FDG PET) radiomic features and dosiomics features in addition to the common clinical factors using multi-institution data.

MATERIALS/METHODS

Data of 112 patients from one institution and 28 patients from the other institution were retrospectively collected. Radiomics and dosiomics features were extracted using five segmentations on CT and PET images and dose distribution. The least absolute shrinkage and selection operator (LASSO) with logistic regression was used to select radiomics and dosiomics features by calculating the radiomics and dosiomics scores (Rad-score and Dos-score), respectively, in the training model. The predictive clinical factors, Rad-score, and Dos-score were identified to develop a nomogram model.

RESULTS

We extracted 15219 features from the radiomics and dosiomics analysis. By LASSO Cox regression analysis, 13 CT-based radiomics features, 11 PET-based radiomics features, and 19 dosiomics features were selected. Clinical factors of T-stage, N-stage, and clinical stage were selected as significant prognostic factors by univariate Cox regression analysis. A predictive nomogram for prognosis in was established using these factors. In the external validation cohort, the C-index of the combined model of CT-based radiomics, PET-based radiomics, and dosiomics features with clinical factors were 0.74, 0.82, and 0.92, respectively. Moreover, we divided the cohort into high-risk and low-risk groups using the median nomogram score. Significant differences in overall survival (OS) in the combine model of CT-based radiomics, PET-based radiomics, and dosiomics features with clinical factors were observed between the high-risk and low-risk groups (P = 0.019, P = 0.038, and 0.014, respectively).

CONCLUSION

The current study established and validated 2- and 3-year survival prediction models based on radiomics and dosiomics features with clinical factors. The prediction model with dosiomics analysis could better predict OS than CT- and PET-based radiomics analysis in esophageal cancer patients treated with radiotherapy.

Predictive Modeling of Radiation Pneumonitis Induced by Chemoradiotherapy for Locally Advanced Non-Small Cell Lung Cancer Using Radiomics and Clinical Features

PURPOSE/OBJECTIVE(S)

The purpose of this study is to establish a prediction model for the development of grade 2 or higher radiation pneumonitis (RP) using radiomics analysis of pretreatment CT images, PET images, and dose distribution, in addition to clinical factors, in patients with locally advanced non-small cell lung cancer (NSCLC) treated with radical chemoradiotherapy.

MATERIALS/METHODS

We retrospectively evaluated 128 cases of locally advanced NSCLC treated with radical radiotherapy at our institution from 2008 to 2021. Clinical factors included age, sex, performance status (PS), KL-6, smoking history, histological type, clinical stage, and total radiation dose. Radiomics analysis was performed by analyzing treatment planning CT images, PET images, and dose distribution, and Rad-score (Radiomics-score) was calculated for the extracted features using Lasso-Cox regression. Rad-score (Radiomics-score) was calculated by Lasso-Cox regression for the extracted features. Risk factors were selected by univariate/multivariate analysis of clinical factors and Rad-score. Three models for predicting RP were developed from the identified risk factors using Nomogram: Clinical, Rad-score, and Combined model. The model was evaluated using area under the curve (AUC) based on receiver operating characteristic (ROC) curves and concordance index (C-index). RP was evaluated using the Common Terminology Criteria for Adverse Events (CTCAE) version 5.0. The cumulative incidence of Grade 2 or higher RP was evaluated using the Kaplan-Meier method.

RESULTS

Of the 128 cases, grade 2 or higher RP was observed in 50 cases (39%). Regarding clinical factors, gender, smoking status, and histology were selected as significant predictors of RP. Lasso-Cox analysis of radiomics features selected 11 features from CT images, 7 features from PET images, and 16 features from dose distribution as predictors of RP, yielding a total of 34 factors. The combined model (C-index: 0.96, AUC: 0.92) showed the best discrimination performance compared to the clinical model (C-index: 0.73, AUC: 0.56) and the Rad-score model (C-index: 0.87, AUC: 0.92). Risk classification using the combined model showed that the 1-year cumulative incidence of grade 2 or higher RP was 65% in the high-risk group, significantly higher than 15% in the low-risk group (p<0.001).

CONCLUSION

The combined model with Rad-score and clinical factors can predict grade 2 or higher RP in NSCLC patients with high accuracy.

Prognostic significance of preoperative inflammatory response biomarkers in patients undergoing curative thoracoscopic esophagectomy for esophageal squamous cell carcinoma

BACKGROUND

Recent studies have revealed significant relationships between the lymphocyte-to-monocyte ratio (LMR), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) and survival in various cancers. The purpose of this study was to confirm whether the LMR, NLR, and PLR have prognostic values, independent of clinicopathological criteria, in patients undergoing curative resection for esophageal cancer.

METHODS

The LMR, NLR and PLR were calculated in 147 consecutive patients who underwent curative esophagectomy between January 2006 and December 2014. Receiver operating characteristics (ROC) curve analysis was conducted to identify the optimal cutoff values of each biomarkers.

RESULTS

In multivariate analysis for cancer-specific survival (CSS), pTNM stage (p < 0.0001) and low LMR (p = 0.0081) were selected as independent prognostic factor. Similarly, pTNM stage(p < 0.0001) and low LMR (p = 0.0225) were found to be independent prognostic factor for overall survival (OS). There was no significant relationship between LMR, NLR and PLR and survival in patients with stage I or II, however, significant relationships between LMR and CSS or OS were observed in patients with stage III esophageal cancer.

CONCLUSIONS

LMR can be used as a novel predictor of postoperative CSS and OS in patients with esophageal cancer and that it may be useful in identifying patients with a poor prognosis even after radical esophagectomy.

Ethnic socialization, perceived discrimination, and psychological adjustment among transracially adopted and nonadopted ethnic minority adults

Little is known on how transracial adoptees (TRA) navigate issues of race and ethnicity. Using Shared Fate Theory as a framework, this study was interested in the moderating role of adoption status among a group of ethnic minority adults in explaining the relationship between ethnic socialization, perceived discrimination, and mental health outcomes. Nonadopted (NA; n = 83) and TRA (n = 87) ethnic minorities responded to measures on ethnic socialization, perceived discrimination, and psychological outcomes administered online. TRA and NA ethnic minorities reported similar levels of ethnic socialization, perceived discrimination, and psychological outcomes (depression and self-esteem). Perceived discrimination was significantly associated with depression for both TRA and NA ethnic minorities. Ordinal Least Squares (OLS) regressions that were run for a moderated moderational analysis suggest that the protective role of ethnic socialization depended on adoption status. Among the different forms of ethnic socialization, cultural socialization and preparation for bias significantly buffered against the effects of perceived discrimination, but the effects were more pronounced for TRA than for NA ethnic minorities. Because NA and TRA ethnic minorities were similarly affected by discrimination, it suggests that being a TRA does not confer any additional risk when experiencing discrimination. Additionally, the study found that ethnic socialization may continue to serve a protective role against the effects of discrimination into adulthood for TRA, but less so for NA ethnic minorities. These results have policy implications regarding the role of parental ethnicity in adoption decisions as well as the importance of educating adopted parents about ethnic socialization for ethnic minority children. (PsycINFO Database Record

An introduction to the 2011 National Multicultural Conference & Summit keynote addresses

This article provides and introduction to the 2011 National Multicultural Conference & Summit Keynote Addresses. The authors explain that they chose to focus on the tension and possibilities within multicultural psychology at the seventh biennial National Multicultural Conference & Summit (NMCS), which was held on January 27-28, 2011, at The Westin-Seattle Hotel. During the 2-day conference, nearly 900 attendees engaged with one another and heard from experts in the field as we focused on the theme, "Unification through Diversity: Bridging Psychological Science & Practice in the Public Interest. Two key sets of presentations are highlighted.

Electron microscopic investigation on the osteogenesis at titanium implant/bone marrow interface under masticatory loading

Electron microscopic investigation on osteogenetic process at the implant surface of threadless rod-type titanium implants with different surface roughness of Ra 0.4 +/- 0.01 microm, Sm 2.6 +/- 0.3 microm and Ra 2.0 +/- 0.12 microm, Sm 36 +/- 9.1 microm was performed at the early stage of 21 and 42 days post implantation into the jawbones of four beagles under the load bearing condition of functional mastication. The implant surfaces were covered with a blood clot and haematopoietic stem cells (HSC) including phagocytic monocytes immediately after the implantation. Successively, osteogenic stem cells (OSC) migrated from cortical and/or trabecular endosteum to the HSC-layer on the implant surface. The new bone formation at the implant/bone marrow interface was developed by collaboration of osteomediator cells (OMC) differentiated from monocytes of HSC and osteoblast phenotype cells of OSC derived from endosteum of cortical bone and/or trabecular. The new bone layer at the implant surface consisted of two layers, solution-mediated calcification layer of pseudo bone and cell (osteoblast) -mediated calcification layer of true bone. The pseudo bone was produced by solution-mediated calcification of OMC- and HSC-remnants near by the implant surface. The bone healing process at the implant/bone marrow interface depended upon two factors; the migration of OSC from cortical and/or trabecular endosteum to the implant surface and the healing potentiality. Topographic dependency upon the bone healing potential at implant/bone marrow interface was not confirmed in this experiment under the load bearing condition of functional mastication.

No evidence to indicate topographic dependency on bone formation around cp titanium implants under masticatory loading

In vitro studies have proved the topographic dependency upon osteogenesis on titanium plate by investigating the cell-adhesion, -shape, -proliferation, -differentiation, ALP activity and osteocalcin production of osteogenic stem cells, MG36, MC3T3-E1 and wild strains of bone formative cells from animal and human. However, this in vivo study on bone growth around cp titanium dental implants under masticatory loading did not demonstrate significant difference among the different surface roughness in the range of Ra 0.4-1.9 microm, Rz 2.8-11.2 microm, Rmax 3.6-28.1 microm and Sm 2.9-41.0 microm, which was estimated by measuring the bone contacts, bone occupancies and bone bonding strengths at the implant/bone marrow interface. It is revealed that the topographic dependency on the osteogenetic activity is apt to be covered with wide variation in bone healing potential under the clinical condition with functional biting load.

In vitro study on bone formation and surface topography from the standpoint of biomechanics

Effect of surface topography upon cell-adhesion, -orientation and -differentiation was investigated by in vitro study on cellular responses to titanium substratum with different surface roughness. Cell-shape, -function and -differentiation depending upon the surface topography were clarified by use of bone formative group cells (BFGCs) derived from bone marrow of beagle's femur. BFGCs consisted of hematopoietic stem cells (HSC) and osteogenetic stem cells (OSC). Cell differentiation of BFGCs was expressed and promoted by structural changes of cytoskeleton, and cell-organella, which was caused by mechanical stress with cytoplasmic stretching of cell adhesions to the substratum. Phagocytic monocytes of HSC differentiated to osteomediator cells (OMC) by cytoplasmic stretching with cell adhesion to the substratum. The OMC mediated and promoted cell differentiation from OSC to osteoblast through osteoblastic phenotype cell (OBC) by cell-aggregation of nodules with "pile up" phenomenon of OBC onto OMC. The osteogenesis might be performed by coupling work of both cells, OMC originated from monocyte of HSC and OBC originated from OSC, which were explained by SEM, TEM and fluorescent probe investigation on BFGCs on the test plate of cp titanium plates with different topographies. This osteogenetic process was proved by investigating cell proliferation, DNA contents, cell-adhesion, alkaline phosphatase activity and osteocalcine productivity for cells on the titanium plates with different topographies. The study showed increased osteogenic effects for cells cultured on Ti with increased surface roughness. Possible mechanisms were discussed from a biomechanical perspective.

Morphologic studies on the biologic seal of titanium dental implants. Report II. In vivo study on the defending mechanism of epithelial adhesions/attachment against invasive factors

Clinical measurements on gingival indices and morphologic observations were performed in this study to verify the defending mechanism of gingival soft tissue against foreign invasions from the perspective of epithelial adhesion/attachment to implant surfaces in the monkey mandible. The following zones were observed using scanning electron microscopy: (1) plaque zone, suggesting susceptibility of the gingival tissue to bacterial invasion; (2) nude zone, demonstrating indirect adhesion of epithelial cells to the implant surface through the mucous layer and preventing bacterial invasion; and (3) epithelial cell attached zone, having greater bond strength of epithelial cells at the cell-implant interface as compared to cell-cell bonding within the epithelial cell layer. This study suggested that epithelial cell attachment/adhesion may play a dominant role in retaining the successful condition of a dental implant.

Morphologic studies on the biologic seal of titanium dental implants. Report I. In vitro study on the epithelialization mechanism around the dental implant

To propose a mechanism for apical epithelialization at the implant-tissue interface, cell contact to titanium surfaces and adhesive strength of epithelial-like (HGE) and fibroblastic (HGF) cells derived from human gingiva were investigated under three different media conditions containing plaque extracts: nonfiltered, 5-micron pore filtered, and 0.22-micron pore filtered. The plaque extracts had a greater effect in decreasing the growth rate of the HGF than of the HGE. Similarly, the HGE exhibited greater adhesive strength than the HGF. These differences in the cells' resistance to plaque extracts were also observed using light and electron microscopy. Evidence from this study suggests that the difference in growth, contact, and adhesive strength of the HGE and HGF cells to titanium surfaces may promote apical epithelialization under the pathologic condition.

Surface characterization of radio-frequency glow discharged and autoclaved titanium surfaces

To characterize titanium surfaces treated with radio-frequency glow discharge (RFGD) after media exposure, surface chemical analyses were performed using x-ray photoelectron spectroscopy. Auger electron spectroscopy, and Fourier transform infrared-reflection absorption spectroscopy (FTIR-RAS). The RFGD treatments resulted in a cleaner surface as compared to as-sputtered or as-autoclaved titanium specimens. The oxide thickness of RFGD-treated titanium specimens was not statistically different from the as-autoclaved and as-sputter cleaned titanium specimens. Exposure to a phosphate-buffered saline solution revealed a greater deposition of calcium and phosphorous on the RFGD-treated surfaces. Auger electron spectroscopy depth profiles showed that calcium and phosphorous ions diffused into the titanium oxide layer. The calcium and phosphorous deposits were identified as amorphous calcium phosphate compounds using FTIR-RAS. These results suggest that RFGD treatments of titanium enhance calcium and/or phosphate affinity because of an increase in elemental interactions at the surface, thereby resulting in the formation of amorphous calcium phosphate compounds.

[Usefulness of collagen gel matrix culture for biological evaluation of dental materials (in vitro)]

Cytotoxicity of zinc oxide-eugenol cement was investigated using collagen gel matrix culture. Diffusibility of the main components into the collagen gel was measured by either atomic absorption or ultraviolet spectroscopy. The agar overlay culture method was also carried out for comparison. Results from solution cultures containing diluted collagen were similar to those with diluted agar. Longer culture with either cement liquid, eugenol, or zinc chloride solution, resulted in more depressed cell growth. The lower the powder/liquid ratio for mixing, the higher the cytotoxicity for all the materials tested in gelled collagen. Also, cytotoxicity levels were always lower in cultures with collagen than in those with agar. Diffusibility of the materials into collagen gel was similar to that into agar, but the of diffused components in collagen gel was less. Thus, the usefulness of collagen gel matrix culture for biological evaluation of dental materials was equivalent to that of agar overlay culture. However, it is suggested that collagen as a tissue matrix might provide a favorable environment for cell culture, and hence allow biocompatibility testing of biomaterials under simulated conditions.

Ice cream in the diet of insulin-dependent diabetic patients

We investigated the effect of ice cream ingestion on blood glucose control in conventionally treated and intensively treated insulin-dependent (type I) diabetic patients. After the ingestion of 100 g of ice cream, plasma glucose excursions as measured by the peak increment (90 +/- 30 mg/dL) and area under the curve (166 +/- 59 mg/dL X hour) were modest and not significantly different between the subgroups of intensively treated and conventionally treated diabetics. A small dose (3 to 5 units) of rapid-acting insulin given 30 minutes before ingestion of ice cream reduced the modest plasma glucose excursion. A modest amount of ice cream may be included in weight-maintaining diets of insulin-dependent diabetics. Small doses of rapid-acting insulin prevent any adverse effect of the ice cream on blood glucose control.