RESUMO
PURPOSE: To evaluate an MRI-based radiomic texture classifier alone and combined with radiologist qualitative assessment in predicting pathological complete response (pCR) using restaging MRI with internal training and external validation. METHODS: Consecutive patients with locally advanced rectal cancer (LARC) who underwent neoadjuvant therapy followed by total mesorectal excision from March 2012 to February 2016 (Memorial Sloan Kettering Cancer Center/internal dataset, n = 114, 41% female, median age = 55) and July 2014 to October 2015 (Instituto do Câncer do Estado de São Paulo/external dataset, n = 50, 52% female, median age = 64.5) were retrospectively included. Two radiologists (R1, senior; R2, junior) independently evaluated restaging MRI, classifying patients (radiological complete response vs radiological partial response). Model A (n = 33 texture features), model B (n = 91 features including texture, shape, and edge features), and two combination models (model A + B + R1, model A + B + R2) were constructed. Pathology served as the reference standard for neoadjuvant treatment response. Comparison of the classifiers' AUCs on the external set was done using DeLong's test. RESULTS: Models A and B had similar discriminative ability (P = 0.3; Model B AUC = 83%, 95% CI 70%-97%). Combined models increased inter-reader agreement compared with radiologist-only interpretation (κ = 0.82, 95% CI 0.70-0.89 vs k = 0.25, 95% CI 0.11-0.61). The combined model slightly increased junior radiologist specificity, positive predictive value, and negative predictive values (93% vs 90%, 57% vs 50%, and 91% vs 90%, respectively). CONCLUSION: We developed and externally validated a combined model using radiomics and radiologist qualitative assessment, which improved inter-reader agreement and slightly increased the diagnostic performance of the junior radiologist in predicting pCR after neoadjuvant treatment in patients with LARC.
Assuntos
Inteligência Artificial , Neoplasias Retais , Brasil , Quimiorradioterapia , Feminino , Humanos , Imageamento por Ressonância Magnética , Espectroscopia de Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Radiologistas , Neoplasias Retais/diagnóstico por imagem , Neoplasias Retais/patologia , Neoplasias Retais/terapia , Estudos Retrospectivos , Resultado do TratamentoRESUMO
BACKGROUND: Leprosy is a chronic infectious disease produced by Mycobacterium leprae. In 1997 Venezuela reached the goal of elimination of leprosy as a public health problem (according to the World Health Organization a prevalence rate of ≤ 1/10,000 inhabitants), but five states still had prevalence rates over that goal. For this study we selected Cojedes State, where prevalence rates remain over the elimination goal. OBJECTIVE: Evaluate the real leprosy situation in high-prevalence areas of Cojedes State. MATERIALS AND METHODS: Seven communities of Cojedes State were selected because they had the highest historic prevalence, as well as the highest prevalence in the year to be studied (1997). RESULTS: A rank correlation using Spearman's test comparing historical prevalence rates (1946-1996) and detection rates (1998-2004) gave a statistically significant P < 0.05 value. Diagnosed leprosy cases were as follows: age: 3.2% under 15 years old; sex: male/female rates between 60% and 91.66% males. The highest number of cases were paucibacillary forms: indeterminate leprosy (33.07%) and borderline tuberculoid leprosy (32.28%); tuberculoid leprosy (7.00%); and multibacillary cases (lepromatous leprosy, LL) were only 2.36%. Bacteriologically, 18.52 patients were M. leprae positive. At the moment of diagnosis, 96.6% showed no disabilities, 3.4% showed grade I disabilities, and there were no grade II or III disabilities. CONCLUSION: This study confirms that several communities in Cojedes State have extremely high leprosy rates.
Assuntos
Doenças Endêmicas , Hanseníase/epidemiologia , Feminino , Humanos , Hanseníase/diagnóstico , Masculino , Prevalência , Sistema de Registros , Venezuela/epidemiologiaRESUMO
En el artículo se describe el funcionamiento de los depuradores biológicos compactos en cuanto a su eficiencia y capacidad de trabajo. Los DBC son equipos de tratamiento secundario que tienen un proceso de aireación prolongado. Es una variante del proceso de flujo pistón con recirculación, donde todas las partículas que entran en el reactor biológico, permanecen en el interios del mismo durante idéntico periodo de tiempo degradando los desechos cloacales en componentes más sencillos mediante un proceso biológico aeróbico
Assuntos
Tratamento Secundário , Purificação da ÁguaRESUMO
En el artículo se describe el funcionamiento de los depuradores biológicos compactos en cuanto a su eficiencia y capacidad de trabajo. Los DBC son equipos de tratamiento secundario que tienen un proceso de aireación prolongado. Es una variante del proceso de flujo pistón con recirculación, donde todas las partículas que entran en el reactor biológico, permanecen en el interios del mismo durante idéntico periodo de tiempo degradando los desechos cloacales en componentes más sencillos mediante un proceso biológico aeróbico