Automatic early detection of acromegaly is theoretically possible from facial photographs, which can lessen the prevalence and increase the cure probability. In this study, several popular machine learning algorithms were used to train a retrospective development dataset consisting of 527 acromegaly patients and 596 normal subjects. We firstly used OpenCV to detect the face bounding rectangle box, and then cropped and resized it to the same pixel dimensions. From the detected faces, locations of facial landmarks which were the potential clinical indicators were extracted. Frontalization was then adopted to synthesize frontal facing views to improve the performance. Several popular machine learning methods including LM, KNN, SVM, RT, CNN, and EM were used to automatically identify acromegaly from the detected facial photographs, extracted facial landmarks, and synthesized frontal faces. The trained models were evaluated using a separate dataset, of which half were diagnosed as acromegaly by growth hormone suppression test. The best result of our proposed methods showed a PPV of 96%, a NPV of 95%, a sensitivity of 96% and a specificity of 96%. Artificial intelligence can automatically early detect acromegaly with a high sensitivity and specificity.

Peritumoral edema impedes the full delineation of fiber tracts due to partial volume effects in image voxels that contain a mixture of cerebral parenchyma and extracellular water. The purpose of this study is to investigate the effect of incorporating a free water (FW) model of edema for white matter tractography in the presence of edema. We retrospectively evaluated 26 consecutive brain tumor patients with diffusion MRI and T2-weighted images acquired presurgically. Tractography of the arcuate fasciculus (AF) was performed using the two-tensor unscented Kalman filter tractography (UKFt) method, the UKFt method with a reduced fiber tracking stopping fractional anisotropy (FA) threshold (UKFt+rFA), and the UKFt method with the addition of a FW compartment (UKFt+FW). An automated white matter fiber tract identification approach was applied to delineate the AF. Quantitative measurements included tract volume, edema volume, and mean FW fraction. Visual comparisons were performed by three experts to evaluate the quality of the detected AF tracts. The AF volume in edematous brain hemispheres was significantly larger using the UKFt+FW method (p<0.0001) compared to UKFt, but not significantly larger (p = 0.0996) in hemispheres without edema. The AF size increase depended on the volume of edema: a significant correlation was found between AF volume affected by (intersecting) edema and AF volume change with the FW model (Pearson r = 0.806, p<0.0001). The mean FW fraction was significantly larger in tracts intersecting edema (p = 0.0271). Compared to the UKFt+rFA method, there was a significant increase of the volume of the AF tract that intersected the edema using the UKFt+FW method, while the whole AF volumes were similar. Expert judgment results, based on the five patients with the smallest AF volumes, indicated that the expert readers generally preferred the AF tract obtained by using the FW model, according to their anatomical knowledge and considering the potential influence of the final results on the surgical route. Our results indicate that incorporating biophysical models of edema can increase the sensitivity of tractography in regions of peritumoral edema, allowing better tract visualization in patients with high grade gliomas and metastases.

Background: To fully understand the clinical features and prognosis of Glioblastoma (GBM), we extracted the data from the Surveillance, Epidemiology, and End Results (SEER) database and performed a series of analyses. Methods: We retrospectively analyzed the data of 1674 patients with GBM obtained from the SEER database from 1983 to 2015. Kaplan–Meier analysis was performed to calculate the survival rate, and the log-rank test was used to analyze the survival outcomes. Results: Older patients with GBM had a worse survival period (P < .05). Laterality had no effect on the prognosis (P > .05). Patients with high-grade gliomas may have a shorter lifespan (P < .05). In terms of overall survival (OS) and disease specificity, all 3 classical treatments failed to improve the life expectancy (P > .05). In adult patients with GBM, we found that age, tumor grade, surgery, radiotherapy, and chemotherapy were independent risk factors for all-cause mortality. In the univariate disease-specific analysis, age, tumor grade, surgery, radiotherapy, and chemotherapy were independent risk factors. However, in multivariate disease-specific analysis, the results showed that only tumor grade and surgery were independent risk factors for GBM. Conclusions: Older patients diagnosed with GBM have worse survival, and patients with glioma of higher grades have a shorter lifespan. Age, grade, surgery, radiation therapy, and chemotherapy were independent prognostic factors for patients with GBM.

Traumatic brain injury (TBI) is identified as a risk factor for Parkinson’s disease (PD), which is a neurodegenerative disease characterized by the loss of dopaminergic neurons in the substantia nigra (SN). However, the precise mechanism by which chronic TBI initiates PD pathogenesis is not yet fully understood. In our present study, we assessed the chronic progression and pathogenesis of PD-like behavior at different intervals in TBI mice. More than half of the mice exhibited PD-like behavior at 6 months post injury. PD-like behavioral dysfunction and pathological changes were aggravated with the injured time extension in chronic phase of TBI. The loss of tyrosine hydroxylase positive (TH⁺) neurons in the SN were partly associated with the accumulation of misfolded a-Synuclein and the cytoplasmic translocation of TDP-43 from nuclear. Moreover, the present of chronic inflammation was observed in SN of TBI mice, as evidenced by the enhancement of proinflammatory cytokines and reactive astrocytes and microgliosis post lesion. The enhanced phagocytosis of reactive microglia accounted for the reduction of dendrite spines. Our results revealed that chronic inflammation associated with the damage of TH⁺ neurons and the development of progressive PD-like pathology after chronic TBI in mice. Our study shed new light on the TBI-triggered molecular events on PD-like pathology. Additional research is required to have a deeper understanding of the molecular factors underlying the impairment of dopaminergic neurons following TBI.

Background: Intraoperative radiotherapy (IORT) is an emerging local therapy in the surgery of intra-axial brain tumors to improve clinical outcomes and accelerate the adjuvant oncologic therapy. Despite its use in neuro-oncology, the data regarding the role of IORT in the treatment of high-grade gliomas (HGGs) is sparse. Here we reported our single-institutional evidence concerning the efficacy and safety of IORT in the management of HGGs.Methods: A total of thirty patients diagnosed with HGGs who underwent surgical treatment and IORT at our center between October 2021 and October 2023 were included. Clinical data were collected and analyzed, including surgical parameters such as the gross total resection (GTR) rate, follow-up assessments of treatment responses (Karnofsky Performance Status [KPS] scores), treatment-related complications, overall survival (OS), and subsequent therapeutic interventions. Multivariable Cox regression analyses were performed to identify independent risk factors for survival in patients with HGGs.Results: The median IORT dose was 12 Gy prescribed to the applicator surface using the INTRABEAM system. The median OS was 11.0 months (IQR: 7.8–14.3), with a 1-year survival rate of 46.7%. No severe radiation-related adverse events, such as cerebral radiation necrosis or wound-related complications, were recorded. Kaplan-Meier analyses showed that patients who received post-operative radiotherapy and chemotherapy after IORT had better clinical outcomes than those who did not. Multivariable regression analyses indicated post-operative radiotherapy was independently correlated with favorable clinical outcomes.Conclusion: Low-dose X-rays based IORT at doses of 10-12 Gy is generally safe for HGGs. Future prospective large-scale studies are needed to further evaluate the efficacy and safety of IORT with escalating doses. Even with the use of IORT, post-operative radiotherapy is essential for improving clinical outcomes of HGGs. This study provides clinical data on IORT for HGGs, which may represent a promising therapeutic approach for managing this disease.