Zhangvick9051

68, 95% CI 2.02-6.70) and PFS (HR 3.69, 95% CI 2.09-6.50). In a landmark analysis at day 200, prolonged immunoparesis was associated with reduced OS (HR 3.22, 95% CI 1.14-9.11). Allogeneic stem cell transplantation offers an additional treatment element that may lead to long-term remission in selected patients with poor prognosis, probably exploiting graft-versus-myeloma effects. Immunoparesis could potentially serve as an indicator for impaired survival following allogeneic transplantation, an observation to be further studied prospectively.Purpose The objective of this study was to investigate whether computed tomography texture analysis can be used to differentiate papillary renal cell carcinoma (PRCC) subtypes. Method Sixty-two PRCC tumors were retrospectively evaluated, with 30 type 1 tumors and 32 type 2 tumors. Texture parameters quantified from three-phase contrast-enhanced CT images were compared with least absolute shrinkage and selection operator (LASSO) regression. Receiver operating characteristic (ROC) analysis was performed, and the area under the ROC curve (AUC) was calculated for each parameter. The selected texture parameters of each phase were used to generate support vector machine (SVM) classifiers. Decision curve analysis (DCA) of the classification was performed. Results The two texture parameters with the top two AUC values were - 333-7 Correlation (AUC = 0.772) and 45-7 Entropy (AUC = 0.753) in the corticomedullary phase, 333-4 Correlation (AUC = 0.832) and 45-7 Entropy (AUC = 0.841) in the nephrographic phase, and 135-7 Entropy (AUC = 0.858) and - 333-1 InformationMeasureCorr2 (AUC = 0.849) in the excretory phase. Entropy and Correlation have a high correlation with the two types of PRCC and are increased in type 2 PRCC. A model incorporating the texture parameters with the top two AUC values in each phase produced an AUC of 0.922 with an accuracy of 84% (sensitivity = 89% and specificity = 80%). The nephrographic-phase model and the model combining the texture parameters of the three phases can differentiate the two types with the largest net benefit. Conclusions Computed tomography texture analysis can be used to distinguish type 2 PRCC from type 1 with high accuracy, which may be clinically important.Purpose To evaluate the pancreatic duct cutoff sign in detecting pancreatic adenocarcinoma using CT and MRI. Methods A retrospective analysis of patients with a pancreatic duct (PD) cutoff sign on CT or MRI from 2000 to 2019 was performed. The primary outcome measured was the presence or absence of a malignant pancreatic tumor. Variables evaluated included imaging characteristics of patients with a malignant versus non-malignant cause of duct cutoff and included PD size and PD-to-parenchyma ratio, contour abnormality, abnormal enhancement, diffusion abnormality, and upstream parenchymal atrophy. Results Seventy-two patients (4428 MF, mean age 64 years) were identified with a PD cutoff sign. Fifty-eight percent (42/72) of these patients were diagnosed with malignancy, 62% (26/42) of whom were diagnosed with pancreatic ductal adenocarcinoma. NSC-2260804 nmr In patients diagnosed with a non-malignant cause of duct cutoff, 37% (11/30) were diagnosed with chronic pancreatitis. Eighty-eight percent (37/42) of patients with malignant causes and 33% (10/30) of patients with non-malignant causes were noted to have an associated mass on imaging. The presence of contour abnormality, diffusion abnormality, or abnormal enhancement at the level of the pancreatic cutoff was significantly higher in patients with malignancy (p less then 0.05). There was no difference between groups in location of the pancreatic duct cutoff, degree of pancreatic duct dilatation, PD-to-parenchyma ratio, or presence of upstream atrophy. Conclusion Abrupt cutoff of the pancreatic duct was associated with an increased likelihood of detecting malignancy. All patients who demonstrate this sign should undergo expedited workup with dedicated MRI and EUS with biopsy.Purpose To identify the frequency, source, and management impact of discrepancies between the initial radiology report and expert reinterpretation occurring in the context of a hepatobiliary multidisciplinary tumor board (MTB). Methods This retrospective study included 974 consecutive patients discussed at a weekly MTB at a large tertiary care academic medical center over a 2-year period. A single radiologist with dedicated hepatobiliary imaging expertise attended all conferences to review and discuss the relevant liver imaging and rated the concordance between original and re-reads based on RADPEER scoring criteria. Impact on management was based on the conference discussion and reflected changes in follow-up imaging, recommendations for biopsy/surgery, or liver transplant eligibility. Results Image reinterpretation was discordant with the initial report in 19.9% (194/974) of cases (59.8%, 34.5%, 5.7% RADPEER 2/3/4 discrepancies, respectively). A change in LI-RADS category occurred in 59.8% of discrepancies. Most common causes of discordance included re-classification of a lesion as benign rather than malignant (16.0%) and missed tumor recurrence (13.9%). Impact on management occurred in 99.0% of discordant cases and included loco-regional therapy instead of follow-up imaging (19.1%), follow-up imaging instead of treatment (17.5%), and avoidance of biopsy (12.4%). 11.3% received OPTN exception scores due to the revised interpretation, and 8.8% were excluded from listing for orthotopic liver transplant. Conclusion Even in a sub-specialized abdominal imaging academic practice, expert radiologist review in the MTB setting identified discordant interpretations and impacted management in a substantial fraction of patients, potentially impacting transplant allocation. The findings may impact how abdominal imaging sections best staff advanced MTBs.N-Doped silicon quantum dots (N-SiQD) were synthesized using N-[3-(trimethoxysily)propyl]-ethylenediamine and citric acid as silicon source and reduction agent, respectively. The N-SiQD shows a strong blue fluorescence with a high quantum yield of about 53%. It is found that a selective static quenching process occurs between N-SiQDs and Cu2+. Glyphosate can inhibit this phenomenon and trigger the rapid fluorescence enhancement of the quenched N-SiQDs/Cu2+ system due to the specific interaction between Cu2+ and glyphosate. With such a design, a turn-on fluorescent nanoprobe based on N-SiQD/Cu2+ system was established for rapid determination of glyphosate. The determination signal of N-SiQD/Cu2+ was measured at the optimum emission wavelength of 460 nm after excitation at 360 nm. Under optimal conditions, the turn-on nanoprobe showed a linear relationship between fluorescent response and glyphosate concentrations in the range 0.1 to 1 μg mL-1. The limit of determination was calculated to 7.8 ng mL-1 (3σ/S). Satisfactory recoveries were obtained in the determination of spiked water samples, indicating the potential use for environmental monitoring.