Radiologists utilize pictures from X-rays, magnetic resonance imaging, or computed tomography scans to diagnose bone cancer. Manual methods are labor-intensive and may need specialized knowledge. As a result, creating an automated process for distinguishing between malignant and healthy bone is essential. Bones that have cancer have a different texture than bones in unaffected areas. Diagnosing hematological illnesses relies on correct labeling and categorizing nucleated cells in the bone marrow. However, timely diagnosis and treatment are hampered by pathologists' need to identify specimens, which can be sensitive and time-consuming manually. Humanity's ability to evaluate and identify these more complicated illnesses has significantly been bolstered by the development of artificial intelligence, particularly machine, and deep learning. Conversely, much research and development is needed to enhance cancer cell identification-and lower false alarm rates. We built a deep learning model for morphological analysis to solve this problem. This paper introduces a novel deep convolutional neural network architecture in which hybrid multi-objective and category-based optimization algorithms are used to optimize the hyperparameters adaptively. Using the processed cell pictures as input, the proposed model is then trained with an optimized attention-based multi-scale convolutional neural network to identify the kind of cancer cells in the bone marrow. Extensive experiments are run on publicly available datasets, with the results being measured and evaluated using a wide range of performance indicators. In contrast to deep learning models that have already been trained, the total accuracy of 99.7% was determined to be superior.
Většina nádorů kostí jsou metastázy. Primární nádory, které tvoří metastázy v kostech, se nejčastěji vyskytují v prsu, plicích, ledvinách a štítné žláze. Tato případová studie popisuje pacientku s výskytem nádoru kosti v osové kostře, původně v křížové oblasti. Primární místo nebylo určeno. Vyšetření tedy bylo nutné rozšířit o imunohistochemii, která prokázala metastatický nádor kompatibilní s endometroidním adenokarcinomem, nicméně ani po vyšetřeních nebyla v oblasti endometria nalezena aktivní léze. Tato studie byla observační a popisná, s cílem rozebrat důležitost přesnějších vyšetřovacích metod. V tomto směru imunohistochemie vyniká jako precizní metoda schopná optimalizovat diagnózu, léčbu a následně i prognózu.
Most bone tumors are metastatic. Breasts, lungs, kidneys, and thyroid are the primary sites most commonly involved in bone metastasis-type outcomes. This case study describes the involvement of a patient with a bone tumor located in the axial skeleton, initially in the sacral region. However, the primary site was undefined. Therefore, it was necessary to expand the investigation with immunohistochemistry, which demonstrated a metastatic tumor compatible with endometrioid adenocarcinoma. But even after examination, no active lesion was found in the endometrial region. The study was observational, descriptive, and aimed to discuss the importance of more specific investigative methods. In this context, immunohistochemistry stands out as an exquisite method capable of optimizing diagnosis, therapy, and consequently, prognosis.
- MeSH
- adenokarcinom diagnóza MeSH
- endometroidní karcinom * diagnóza patologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- metastázy nádorů diagnóza farmakoterapie MeSH
- nádory kostí diagnóza farmakoterapie sekundární MeSH
- nádory míchy diagnóza terapie MeSH
- protokoly protinádorové léčby MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
PURPOSE OF THE STUDY: Open (incisional) biopsies have long been accepted as the gold standard in diagnosing bone and soft tissue tumors. However, the main disadvantage of this method is that it can lead to increased contamination, hematoma, infection, and pathological fracture. Compared to open biopsies, percutaneous core needle biopsies are less invasive, do not require hospitalization, have low costs and low complication rates, and there is no need for wound healing in cases that require radiotherapy. This study evaluated the diagnostic accuracy and reliability of percutaneous core needle biopsy. MATERIAL AND METHODS: The study included the results of 250 percutaneous core needle biopsies of 244 patients who presented at the tertiary university hospital between September 2012 - September 2022 and were diagnosed with a bone or soft tissue tumor using the percutaneous core needle biopsy method and then underwent surgical excision in the Orthopaedics and Traumatology Clinic. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy rates were calculated for the percutaneous core needle biopsy method according to the compatibility of the results. RESULTS: A fluoroscopy-guided percutaneous Jamshidi needle biopsy performed by an orthopedist for lesions originating from the bone has a diagnostic accuracy of 96%. CT-guided percutaneous Jamshidi needle biopsy performed by a radiologist for lesions originating from the bone has a diagnostic accuracy of 88.9%. Percutaneous Tru-cut needle biopsy performed by an orthopedist without imaging guidance for lesions originating from soft tissue has a diagnostic accuracy of 92%. USGguided percutaneous Tru-cut needle biopsy performed by a radiologist for lesions originating from soft tissue has a diagnostic accuracy of 96,7% (p<0.001). DISCUSSION: The diagnostic accuracy of open biopsies ranges from 91% to 99% in the literature. Additionally, the diagnostic accuracy of core needle biopsies in recent studies ranges from 76% to 99%. Compared to the literature, our study has shown that biopsies performed by orthopedic specialists have a high diagnostic power (96% for bone-derived lesions; 92% for soft tissue-derived lesions). CONCLUSIONS: Percutaneous core needle biopsy is highly effective and reliable in diagnosing bone and soft tissue tumors. Managing patients by a team using a multidisciplinary approach will increase diagnostic success. KEY WORDS: core needle biopsy, percutaneous, diagnostic accuracy, radiology guided biopsy, bone and soft tissue tumors.
- MeSH
- biopsie dutou jehlou metody MeSH
- dospělí MeSH
- fluoroskopie metody MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- nádory kostí * patologie diagnóza chirurgie MeSH
- nádory měkkých tkání * patologie diagnóza MeSH
- počítačová rentgenová tomografie metody MeSH
- prediktivní hodnota testů MeSH
- reprodukovatelnost výsledků MeSH
- senioři MeSH
- senzitivita a specificita * MeSH
- ultrazvukem navigovaná biopsie metody MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- MeSH
- chondrom diagnóza patologie MeSH
- chondrosarkom diagnóza patologie terapie MeSH
- Ewingův sarkom diagnóza patologie terapie MeSH
- lidé MeSH
- metastázy nádorů MeSH
- mnohočetný myelom diagnóza patologie terapie MeSH
- myositis ossificans diagnóza etiologie terapie MeSH
- nádory kostí * diagnóza klasifikace terapie MeSH
- obrovskobuněčný nádor kosti diagnóza patologie terapie MeSH
- osteom osteoidní chirurgie diagnóza patologie MeSH
- osteom chirurgie dietoterapie etiologie MeSH
- osteosarkom diagnóza patologie terapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
- MeSH
- antitumorózní látky terapeutické užití MeSH
- bisfosfonáty terapeutické užití MeSH
- denosumab terapeutické užití MeSH
- kosti a kostní tkáň účinky léků MeSH
- lidé MeSH
- metastázy nádorů * diagnóza terapie MeSH
- nádorová bolest farmakoterapie MeSH
- nádory kostí * diagnóza terapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- práce podpořená grantem MeSH
- Klíčová slova
- ribociklib,
- MeSH
- analýza přežití MeSH
- antitumorózní látky aplikace a dávkování škodlivé účinky MeSH
- fulvestrant aplikace a dávkování MeSH
- inhibiční proteiny cyklin-dependentních kinas * aplikace a dávkování škodlivé účinky MeSH
- klinické zkoušky, fáze III jako téma MeSH
- kombinovaná farmakoterapie MeSH
- kvalita života MeSH
- lidé středního věku MeSH
- lidé MeSH
- metastázy nádorů diagnóza farmakoterapie MeSH
- nádorová bolest MeSH
- nádory kostí diagnóza farmakoterapie sekundární MeSH
- nádory prsu * farmakoterapie terapie MeSH
- nádory rekta terapie MeSH
- randomizované kontrolované studie jako téma MeSH
- výsledek terapie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
- MeSH
- antikoagulancia farmakologie terapeutické užití MeSH
- komorbidita MeSH
- lidé MeSH
- metastázy nádorů diagnostické zobrazování MeSH
- nádory kostí diagnóza sekundární MeSH
- nádory prsu * terapie MeSH
- protokoly protinádorové léčby MeSH
- senioři MeSH
- tromboembolie * diagnóza farmakoterapie MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
- MeSH
- coxa vara diagnostické zobrazování diagnóza patologie MeSH
- dítě MeSH
- kyčelní kloub * abnormality diagnostické zobrazování patologie MeSH
- lidé MeSH
- nádory kostí diagnóza komplikace patologie MeSH
- Perthesova nemoc diagnostické zobrazování diagnóza MeSH
- rentgendiagnostika metody MeSH
- vývojová dysplazie kyčelního kloubu diagnóza etiologie MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- Publikační typ
- přehledy MeSH
This is the first histological and molecular analysis of two chondrosarcomas with target-like chondrocytes that were compared with a group of conventional chondrosarcomas and enchondromas. The unique histological feature of target-like chondrocytes is the presence of unusual hypertrophic eosinophilic APAS-positive perichondrocytic rings (baskets). In the sections stained with Safranin O/Fast green, the outer part of the ring was blue and the material in the lacunar space stained orange, similarly to intercellular regions. Immunohistochemical examination showed strong positivity for vimentin, factor XIIIa, cyclin D1, osteonectin, B-cell lymphoma 2 apoptosis regulator (Bcl-2), p53 and p16. The S-100 protein was positive in 25 % of neoplastic cells. Antibodies against GFAP, D2-40 (podoplanin), CD99, CKAE1.3 and CD10 exhibited weak focal positivity. Pericellular rings/baskets contained type VI collagen in their peripheral part, in contrast to the type II collagen in intercellular interterritorial spaces. Ultrastructural examination revealed that pericellular rings contained an intralacunar component composed of microfibrils with abundant admixture of aggregates of dense amorphous non-fibrillar material. The outer extralacunar zone was made up of a layer of condensed thin collagen fibrils with admixture of non-fibrillar dense material. NGS sequencing identified a fusion transcript involving fibronectin 1 (FN1) and fibroblast growth factor receptor 2 (FGFR2) at the RNA level. At the DNA level, no significant variant was revealed except for the presumably germline variant in the SPTA1 gene.
- MeSH
- chondrocyty chemie patologie ultrastruktura MeSH
- chondrosarkom * chemie diagnóza patologie MeSH
- extracelulární matrix chemie metabolismus ultrastruktura MeSH
- imunohistochemie MeSH
- lidé MeSH
- nádory kostí * diagnóza metabolismus MeSH
- proteiny S100 metabolismus MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- MeSH
- lidé MeSH
- metastázy nádorů MeSH
- nádory kostí * diagnóza rehabilitace sekundární terapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
