Nodule Growth Research Articles

NOT YOUR USUAL PULMONARY NODULE: CASE OF PULMONARY MALTOMA

NOT YOUR USUAL PULMONARY NODULE: CASE OF PULMONARY MALTOMA

The long-term course of subsolid nodules and predictors of interval growth on chest CT: a systematic review and meta-analysis

ObjectivesTo calculate the pooled incidence of interval growth after long-term follow-up and identify predictors of interval growth in subsolid nodules (SSNs) on chest CT.MethodsA search of MEDLINE (PubMed), Cochrane Library, Web of Science Core Collection, and Embase was performed on November 08, 2021, for relevant studies. Patient information, CT scanner, and SSN follow-up information were extracted from each included study. A random-effects model was applied along with subgroup and meta-regression analyses. Study quality was assessed by the Newcastle–Ottawa scale, and publication bias was assessed by Egger’s test.ResultsOf the 6802 retrieved articles, 16 articles were included and analyzed, providing a total of 2898 available SSNs. The pooled incidence of growth in the 2898 SSNs was 22% (95% confidence interval [CI], 15–29%). The pooled incidence of growth in the subgroup analysis of pure ground-glass nodules was 26% (95% CI: 12–39%). The incidence of SSN growth after 2 or more years of stability was only 5% (95% CI: 3–7%). An initially large SSN size was found to be the most frequent risk factor affecting the incidence of SSN growth and the time of growth.ConclusionsThe pooled incidence of SSN growth was as high as 22%, with a 26% incidence reported for pure ground-glass nodules. Although the incidence of growth was only 5% after 2 or more years of stability, long-term follow-up is needed in certain cases. Moreover, the initial size of the SSN was the most frequent risk factor for growth.Key Points• Based on a meta-analysis of 2898 available subsolid nodules in the literature, the pooled incidence of growth was 22% for all subsolid nodules and 26% for pure ground-glass nodules.• After 2 or more years of stability on follow-up CT, the pooled incidence of subsolid nodule growth was only 5%.• Given the incidence of subsolid nodule growth, management of these lesions with long-term follow-up is preferred.

Determination of the optimum definition of growth evaluation for indeterminate pulmonary nodules detected in lung cancer screening

ObjectiveTo determine the optimum definition of growth for indeterminate pulmonary nodules detected in lung cancer screening.Materials and methodsIndividuals with indeterminate nodules as defined by volume of 50–500 mm3 (solid nodules) and solid component volume of 50–500 mm3 or average diameter of non-solid component ≥8 mm (part-solid nodules) on baseline lung cancer screening low-dose chest CT (LDCT) were included. The average diameters and volumes of the nodules were measured on baseline and follow-up LDCTs with semi-automated segmentation. Sensitivities and specificities for lung cancer diagnosis of nodule growth defined by a) percentage volume growth ≥25% (defined in the NELSON study); b) absolute diameter growth >1.5 mm (defined in the Lung-RADS version 1.1); and c) subjective decision by a radiologist were evaluated. Sensitivities and specificities of diagnostic referral based on various thresholds of volume doubling time (VDT) were also evaluated.ResultsAltogether, 115 nodules (one nodule per individual; 93 solid and 22 part-solid nodules; 105 men; median age, 68 years) were evaluated (median follow-up interval: 201 days; interquartile range: 127–371 days). Percentage volume growth ≥25% exhibited higher sensitivity but lower specificity than those of diametrical measurement compared to absolute diameter growth >1.5 mm (sensitivity, 69.2% vs. 42.3%, p = 0.023; specificity, 82.0% vs. 96.6%, p = 0.002). The radiologist had an equivalent sensitivity (53.9%; p = 0.289) but higher specificity (98.9%; p = 0.002) compared to those of volume growth, but did not differ from those of diameter growth (p>0.05 both in sensitivity and specificity). Compared to the VDT threshold of 600 days (sensitivity, 61.5%; specificity, 87.6%), VDT thresholds ≤200 and ≤300 days exhibited significantly lower sensitivity (30.8%, p = 0.013) and higher specificity (94.4%, p = 0.041), respectively.ConclusionGrowth evaluation of screening-detected indeterminate nodules with volumetric measurement exhibited higher sensitivity but lower specificity compared to diametric measurements.

Constitutive overexpression of GsIMaT2 gene from wild soybean enhances rhizobia interaction and increase nodulation in soybean (Glycine max)

BackgroundSince the root nodules formation is regulated by specific and complex interactions of legume and rhizobial genes, there are still too many questions to be answered about the role of the genes involved in the regulation of the nodulation signaling pathway.ResultsThe genetic and biological roles of the isoflavone-7-O-beta-glucoside 6″-O-malonyltransferase gene GsIMaT2 from wild soybean (Glycine soja) in the regulation of nodule and root growth in soybean (Glycine max) were examined in this work. The effect of overexpressing GsIMaT2 from G. soja on the soybean nodulation signaling system and strigolactone production was investigated. We discovered that the GsIMaT2 increased nodule numbers, fresh nodule weight, root weight, and root length by boosting strigolactone formation. Furthermore, we examined the isoflavone concentration of transgenic G. max hairy roots 10 and 20 days after rhizobial inoculation. Malonyldaidzin, malonylgenistin, daidzein, and glycitein levels were considerably higher in GsMaT2-OE hairy roots after 10- and 20-days of Bradyrhizobium japonicum infection compared to the control. These findings suggest that isoflavones and their biosynthetic genes play unique functions in the nodulation signaling system in G. max.ConclusionsFinally, our results indicate the potential effects of the GsIMaT2 gene on soybean root growth and nodulation. This study provides novel insights for understanding the epistatic relationship between isoflavones, root development, and nodulation in soybean.Highlights* Cloning and Characterization of 7-O-beta-glucoside 6″-O-malonyltransferase (GsIMaT2) gene from wild soybean (G. soja).* The role of GsIMaT2 gene in the regulation of root nodule development.*Overexpression of GsMaT2 gene increases the accumulation of isoflavonoid in transgenic soybean hairy roots.* This gene could be used for metabolic engineering of useful isoflavonoid production.

Malignant Nodules Detected on Lung Cancer Screening CT: Yield of Short-Term Follow-Up CT in Showing Nodule Growth.

BACKGROUND. Lung-RADS recommends 3-month follow-up for category 4A nodules and downgrading to category 2 of all category 3 or 4 nodules that are unchanged for 3 months or longer, indicating benign behavior. This guidance may be problematic considering the potential for slow-growing cancers in that lack of nodule growth, particularly at short follow-up intervals, may provide false reassurance. OBJECTIVE. The purpose of this study was to evaluate the yield of short-term follow-up CT in showing growth among malignant nodules detected on lung cancer screening CT. METHODS. This retrospective study included 76 patients (53 women, 23 men; median age, 68 years) with a positive lung cancer screening CT result (Lung-RADS category ≥ 3) between June 2015 and May 2021 with a subsequent lung cancer diagnosis and at least one follow-up CT examination at least 3 months before diagnostic or therapeutic intervention. Semiautomated software was used for linear and volumetric nodule measurements. Diameter was defined as the mean of short- and long-axis measurements. For solid nodules, growth was defined as an at least 1.5-mm increase in mean diameter or an at least 25% increase in volume; part-solid nodules, an at least 1.5-mm increase in solid-component mean diameter or an at least 25% increase in volume; and ground-glass nodules, an at least 3-mm increase in mean diameter or development of a new solid component within the nodule. RESULTS. Median time to growth was 13 months by linear and 11 months by volumetric measurement. Frequency of growth at 3 months was 5% by linear and 7% by volumetric measurement. By linear measurement, median time to growth and frequency of growth at 3 months were 13 months and 7% (solid nodules), 18 months and 6% (part-solid nodules), not reached and 0% (ground-glass nodules), not reached and 0% (category 3 nodules), 13 months and 6% (category 4A nodule)s, 6 months and 11% (category 4B nodules), and 12 months and 10% (category 4X nodules). CONCLUSION. Malignant nodules manifest growth slowly on follow-up CT, and 3-month follow-up CT has very low yield. Stability at 3-month follow-up should not instill high confidence in benignancy, and downgrading all such nodules to Lung-RADS category 2 may be problematic. CLINICAL IMPACT. This study highlights the possibility of slow-growing malignancy and associated challenges in application of Lung-RADS to management of unchanged nodules on follow-up imaging.

The increase in O2 nodule-conductance under phosphorus deficiency varies among genotypes in Medicago truncatula.

The effect of phosphorus deficiency on plant growth, nodulation, and symbiotic nitrogen fixation as well as, the nodulated-roots oxygen consumption, nodule permeability and conductance to the oxygen diffusion of Medicago truncatula-Sinorhizobium meliloti symbiosis were studied. Three lines, namely TN6.18, originated from local populations, F83005.5 originated from Var (France) and Jemalong 6, a reference cultivar from Australia, were hydroponically grown in nutrient solution supplied with 5 µmol (P deficient) and 15 µmol (P sufficient: Control), under semi-controlled conditions in a glasshouse. A genotypic variation in tolerance to P deficiency was found: TN6.18 was the most tolerant line whereas F83005.5 was the most sensitive. The relative tolerance of TN6.18 was concomitant with the greater P requirement, the higher N2 fixation, the stimulation of nodule respiration and the less increases of conductance to the oxygen diffusion in nodules tissues. The higher P use efficiency for nodule growth and for symbiotic nitrogen fixation was detected in the tolerant line. Results suggest that the tolerance to P deficiency seems to depend on thehost plant ability to reallocate P from both leaves and roots to their nodules. P is needed in high energy demand conditions to maintain adequate nodule activity and prevent negative effects of the O2 excess on the nitrogenase.

Potential roles of synaptotagmin family members in cancers: Recent advances and prospects.

With the continuous development of bioinformatics and public database, more and more genes that play a role in cancers have been discovered. Synaptotagmins (SYTs) are abundant, evolutionarily conserved integral membrane proteins composed of a short N-terminus, a variable linker domain, a single transmembrane domain, and two C2 domains, and they constitute a family of 17 isoforms. The synaptotagmin family members are known to regulate calcium-dependent membrane fusion events. Some SYTs play roles in hormone secretion or neurotransmitter release or both, and much evidence supports SYTs as Ca2+ sensors of exocytosis. Since 5 years ago, an increasing number of studies have found that SYTs also played important roles in the occurrence and development of lung cancer, gastric cancer, colon cancer, and other cancers. Down-regulation of SYTs inhibited cell proliferation, migration, and invasion of cancer cells, but promoted cell apoptosis. Growth of peritoneal nodules is inhibited and survival is prolonged in mice administrated with siSYTs intraperitoneally. Therefore, most studies have found SYTs serve as an oncogene after overexpression and may become potential prognostic biomarkers for multiple cancers. This article provides an overview of recent studies that focus on SYT family members’ roles in cancers and highlights the advances that have been achieved.

Pisum sativum Response to Nitrate as Affected by Rhizobium leguminosarum-Derived Signals

Legumes are suitable for the development of sustainable agroecosystems because of their ability to use atmospheric N2 through symbiotic nitrogen fixation (SNF). However, a basic NO3− input is necessary before SNF takes place to ensure successful seedling establishment. Since Rhizobia not only induce nodulation but also affect root branching by stimulating the development of lateral roots, and NO3− as a signal also modulates root system architecture, we investigated whether Rhizobium-derived signals interfere in nitrate signaling. Here, we bring evidence that (i) Rhizobium-altered NO3−-mediated processes in pea expressions of major players in NO3− transport, sensing, and signaling were affected, and (ii) the characteristic limitation of root foraging and branching in response to NO3− supply was abolished. The number of tertiary roots per secondary root was higher in infected compared to uninfected peas, thus indicating that the Rhizobium effect allows for favorable management of trade-offs between nodules growth for nitrogen capture and root foraging for water and other nutrient uptake in pea. The outcome of this basic research can be used to produce molecular tools for breeding pea genotypes able to develop deep-foraging and branched root systems, and more competitive architectures and molecular levels for soil NO3− absorption during seedling establishment without jeopardizing nodulation.

Outcomes of nonsuspicious contralateral nodules with active surveillance after lobectomy in patients with papillary thyroid carcinoma.

ObjectiveTo observe the outcomes of nonsuspicious contralateral nodules with active surveillance in patients with papillary thyroid carcinoma (PTC).Methods4pt?>Consecutive patients who underwent lobectomy for PTC were retrospectively reviewed. Patients with one or more nodules with nonsuspicious ultrasonography (US) features in the contralateral lobe were included.ResultsTwo hundred and eighty-three patients were included. All patients underwent thyroid lobectomy with ipsilateral prophylactic central neck dissection. A total of 123 patients (43.5%) were classified as ATA low-risk, and 160 patients (56.5%) were classified as intermediate-risk. The median size of the contralateral nodules was 3 mm (range, 2 to 16 mm). After a period of follow-up, the median size change of contralateral nodules was 0 mm (range, -7 to 8 mm). Eight patients (2.8%) had nodule growth >3 mm, 223 patients (78.8%) had stable or decreased nodules, and 52 patients (18.4%) had no detectable nodules. Nodules in 24 patients had suspicious US features, 16 of which were diagnosed with PTMC by either cytology after FNA (in 7 patients) or histopathology after completion thyroidectomy (in 9 patients). Another four patients received completion thyroidectomy for ipsilateral cervical lymph node metastasis. The 5-year residual lobe recurrence (RLR) rate and recurrence-free survival (RFS) rate were 7.4% and 89.8%, respectively. Multivariate analysis showed that multifocality and ATA intermediate-risk were independent predictors for RLR (HR4.083, 95%CI 1.480-11.261, P = 0.007; HR 6.045, 95%CI 1.370-26.662, P = 0.017, respectively) and RFS (HR 5.240, 95%CI 2.114-12.991, P < 0.001; HR 5.223, 95%CI 1.353-17.765, P = 0.008, respectively).ConclusionsActive surveillance for nonsuspicious contralateral nodules in patients with low-risk and selected intermediate-risk PTC is safe. Multifocality and ATA intermediate-risk are predicters for recurrence. Early detection and salvage surgery are effective.

Synthesis and characterization of amorphous NiCoP alloy films by magnetic assisted jet electrodeposition

Magnetic assisted jet electrodeposition was used to prepare NiCoP alloy thin films efficiently and rapidly, in comparison with the films prepared using traditional jet electrodeposition. The surface morphology, crystal structure, magnetic properties, film adhesion, and corrosion resistance of the NiCoP alloy films were studied. The experimental results show that the magnetic assisted jet electrodeposition effectively changed the microstructure and properties of NiCoP alloy films. Magnetic assisted jet electrodeposition inhibited the growth of pores and nodules on the surface of the film, and the adhesion between the film and the substrate was enhanced. Furthermore, magnetic assisted jet electrodeposition accelerated the refinement of nanocrystallines embedded in amorphous phase of the films, which results in an obvious increase of the saturation magnetization to 201.43 emu/g. Magnetic assisted jet electrodeposition can improve the comprehensive performance of NiCoP alloy thin films, which is expected to be used in modern magnetic materials development.

Radiomics for identifying lung adenocarcinomas with predominant lepidic growth manifesting as large pure ground-glass nodules on CT images.

PurposeTo explore the value of radiomics in the identification of lung adenocarcinomas with predominant lepidic growth in pure ground-glass nodules (pGGNs) larger than 10 mm.MethodsWe retrospectively analyzed CT images of 204 patients with large pGGNs (≥ 10 mm) pathologically diagnosed as minimally invasive adenocarcinomas (MIAs), lepidic predominant adenocarcinomas (LPAs), and non-lepidic predominant adenocarcinomas (NLPAs). All pGGNs in the two groups (MIA/LPA and NLPA) were randomly divided into training and test cohorts. Forty-seven patients from another center formed the external validation cohort. Baseline features, including clinical data and CT morphological and quantitative parameters, were collected to establish a baseline model. The radiomics model was built with the optimal radiomics features. The combined model was developed using the rad_score and independent baseline predictors. The performance of the models was evaluated using the area under the receiver operating characteristic curve (AUC) and compared using the DeLong test. The differential diagnosis performance of the models was compared with three radiologists (with 20+, 10+, and 3 years of experience) in the test cohort.ResultsThe radiomics (training AUC: 0.833; test AUC: 0.804; and external validation AUC: 0.792) and combined (AUC: 0.849, 0.820, and 0.775, respectively) models performed better for discriminating than the baseline model (AUC: 0.756, 0.762, and 0.725, respectively) developed by tumor location and mean CT value of the whole nodule. The DeLong test showed that the AUCs of the combined and radiomics models were significantly increased in the training cohort. The highest AUC value of the radiologists was 0.600.ConclusionThe application of CT radiomics improved the identification performance of lung adenocarcinomas with predominant lepidic growth appearing as pGGNs larger than 10 mm.

Indeterminate pulmonary subsolid nodules in patients with no history of cancer: growing prediction, CT pattern, and pathological diagnosis.

PURPOSE We aimed to evaluate and compare the growth patterns among pathological types of inde- terminate subsolid nodules in patients without a history of cancer as observed on computed tomography (CT). METHODS This retrospective study included 77 consecutive patients with 80 indeterminate subsolid nod- ules on unenhanced thin-section CT. Subsolid nodules were classified into 2 growth pattern groups based on volume: growth (n = 35) and non-growth (n = 42). According to the pathologi- cal diagnosis, subsolid nodules were further subdivided into 3 groups: adenocarcinoma in situ (growth, n = 8 vs. non-growth, n = 22), minimally invasive adenocarcinoma (n = 14 vs. n = 15), and invasive adenocarcinoma (n=13 vs. n=5). Kaplan-Meier and Cox proportional hazards regres- sion analyses were performed to identify the risk factors for subsolid nodules growth. The CT findings of the 35 subsolid nodules in the growth group were compared among the 3 pathologi- cal groups. RESULTS In the growth group, the overall mean volume doubling time and mass doubling time (MDT) were 811.5 days and 616.5 days, respectively. Patient's age (odds ratio=1.041, P=.045) and CT subtype of non-solid nodule and part-solid nodule (odds ratio=3.430, P=.002) could predict subsolid nodule growth. The baseline volume, mass, and mean CT value were larger in the inva- sive adenocarcinoma group than in the adenocarcinoma in situ group (all P < .01). The shortest volume doubling time was observed in the invasive adenocarcinoma group, followed by the minimally invasive adenocarcinoma group and the adenocarcinoma in situ group. A shorter mass doubling time was observed in the minimally invasive adenocarcinoma group than in the adenocarcinoma in situ group (all P < .02). CONCLUSION As age increases, the risk of pulmonary subsolid nodule growth increases by 4% each year, and part-solid nodules have a 3 times higher risk of growth compared to non-solid nodules in patients with no history of cancer. Subsolid nodules with more aggressive pathological charac- teristics grow at a faster rate.

Minimally Invasive Treatment of Benign Thyroid Nodules

Background. Nodular goitre is the commonest pathology of thyroid gland. According to published evidence, the endemic prevalence of iodine deficiency varies within 19–76 % population. The high rates and lack of symptoms at progressive nodules growth warrant the development of effective organ-preserving treatments. Imaging techniques for local precision targeting of individual lesions enable maximum-preserving interventions at thyroid tissue. Today’s world experience of percutaneous ethanol sclerotherapy and radiofrequency ablation is adequate. However, there exist no clear indications for sclerotherapy and radiofrequency ablation, and their consecutive use has not been assessed.Materials and methods. We analyse minimally invasive organ-preserving treatments of benign thyroid nodules (ethanol sclerotherapy, RFA) in 63 patients at the outpatient and general surgery units of BSMU Clinic and MEGI Medical Centre, Ufa, during February 2019 — December 2020.Results and discussion. Ethanol sclerotherapy was highly effective in 46.5 % patients, as evident from discontinued nodule’s blood supply in CDI and B-mode ultrasound, which remained stable in 10.5 % and restored after 3–4 weeks in 25 % patients. Sclerotherapy in colloid goitre was efficient only in 37.5 % patients. Ethanol sclerotherapy was RFA-followed in 25.4 % patients. RFA was favoured at a low-effective sclerotherapy providing for a weak positive dynamics of nodule size, local parietal blood flow preservation and intranodular vessels recanalisation at re-examination.Conclusion. Sclerotherapy was high-effective in cystic nodules. Radiofrequency ablation can be considered most adequate for treating solid nodules. RFA-followed sclerotherapy is a rational choice in treatment of large cystic nodules (&gt;5 cm3 ).

A clinical study on prevalence and management of eyelid tumours – A prospective observational study

To study the incidence of eyelid tumours pertaining to age, sex, lid, globe or orbital involvement and analyse the various aspects of treatment modalities and their functional and cosmetic outcome. A prospective study of 40 cases of eyelid tumours over a period of 1 year, both benign and malignant eyelid lesions were included and those with inflammatory lesions were excluded. Patients were evaluated and treated with appropriate modalities and the outcome was analysed. Malignant tumours were common in the age group between 60-85 years and benign tumours were common in the age group of 30-45 years. Benign tumours were more common among males and malignant tumours more common among females. Out of the 40 cases, 28 (70 %) eyelid lesions were benign and 12 (30%) cases were malignant. Benign tumours were found more commonly in the upper lid and malignant tumours in lower lid. Squamous papilloma was found to be the most common benign tumour, followed by pyogenic granuloma. Meibomian carcinomais the most common malignant tumour. Most common presentation of malignant eyelid tumour was ulcerative growth pattern. Meibomian carcinoma presented in the form of nodule and ulcerative growth pattern. The treatment for most of the benign tumour was simple excision and malignant tumour was wide local excision with 4-5 mm margin clearance. Glabellar rotation flap was performed in one case of meibomian carcinoma involving the medial aspect of lower lid after excision. Hughes tarso-conjunctival flap was performed in two cases of squamous cell carcinoma and basal cell carcinoma, after tumour excision as the defect involved more than 75% of the lower lid without involvement of canthus. Two cases one each of sebaceous carcinoma and squamous cell carcinoma involving the lateral aspect of lower lid was reconstructed after excision, with Tenzel flap. In one case of sebaceous gland carcinoma with diffuse involvement of the upper lid the was excised and reconstructed with Cutler-Beard technique.Histopathologic examination of all excised lesion must be done as an innocuous looking lesion might be malignant. Early clinical suspicion of malignancy and confirmation by incisional biopsy will aid in planning wide excision and appropriate method of lid reconstruction depending on the amount of lid loss. After wide excision of malignant tumour appropriate lid reconstruction technique is done as a primary procedure in all our patients and we could obtain good outcomes with no recurrences. Advanced tumours with orbital involvement and recurrent tumour need adjuvant chemotherapy or radiotherapy.

Geochemical characteristics and genesis of ferromanganese nodules and crusts from the Central Rift Seamounts Group of the West Philippine Sea

There is a lack of information on the geochemical characteristics and genesis of ferromanganese nodules and crusts from the Central Rift Seamounts Group of the West Philippine Sea (CRSGWPS). This study presents the major, trace, and rare earth contents and 10Be isotopic data for ferromanganese nodules and crusts from the CRSGWPS to determine their genetic origin, classification, and growth rate. The Mn/Fe ratio of the crust is 0.96–3.97, and the Co + Ni + Cu content is 4499–6324 ppm. The crust is rich in rare earth elements (REE), with significant positive Ce and negative Y anomalies. The Mn/Fe ratio of the nodule is 0.90–1.52, and the Co + Ni + Cu is 1617–9549 ppm. Samples near the core of the nodule have a relatively low REE content, with significant positive Ce and negative Y anomalies. 10Be specific activity and thickness of the nodules and crusts show that growth rates were 2.26 mm/Ma and 2.5 mm/Ma, respectively, indicating that proliferation of nodules and crusts in this area began in the mid-Miocene (9.32–12.03 Ma). A comprehensive study of the growth rate, mineralogy, structure, and chemical characteristics of nodules/crusts in the study area indicates that their formation was mainly hydrogenic, and the early growth of nodules is affected by hydrothermal action.

Validation of a deep learning computer aided system for CT based lung nodule detection, classification, and growth rate estimation in a routine clinical population.

In this study, we evaluated a commercially available computer assisted diagnosis system (CAD). The deep learning algorithm of the CAD was trained with a lung cancer screening cohort and developed for detection, classification, quantification, and growth of actionable pulmonary nodules on chest CT scans. Here, we evaluated the CAD in a retrospective cohort of a routine clinical population. In total, a number of 337 scans of 314 different subjects with reported nodules of 3-30 mm in size were included into the evaluation. Two independent thoracic radiologists alternately reviewed scans with or without CAD assistance to detect, classify, segment, and register pulmonary nodules. A third, more experienced, radiologist served as an adjudicator. In addition, the cohort was analyzed by the CAD alone. The study cohort was divided into five different groups: 1) 178 CT studies without reported pulmonary nodules, 2) 95 studies with 1-10 pulmonary nodules, 23 studies from the same patients with 3) baseline and 4) follow-up studies, and 5) 18 CT studies with subsolid nodules. A reference standard for nodules was based on majority consensus with the third thoracic radiologist as required. Sensitivity, false positive (FP) rate and Dice inter-reader coefficient were calculated. After analysis of 470 pulmonary nodules, the sensitivity readings for radiologists without CAD and radiologist with CAD, were 71.9% (95% CI: 66.0%, 77.0%) and 80.3% (95% CI: 75.2%, 85.0%) (p < 0.01), with average FP rate of 0.11 and 0.16 per CT scan, respectively. Accuracy and kappa of CAD for classifying solid vs sub-solid nodules was 94.2% and 0.77, respectively. Average inter-reader Dice coefficient for nodule segmentation was 0.83 (95% CI: 0.39, 0.96) and 0.86 (95% CI: 0.51, 0.95) for CAD versus readers. Mean growth percentage discrepancy of readers and CAD alone was 1.30 (95% CI: 1.02, 2.21) and 1.35 (95% CI: 1.01, 4.99), respectively. The applied CAD significantly increased radiologist's detection of actionable nodules yet also minimally increasing the false positive rate. The CAD can automatically classify and quantify nodules and calculate nodule growth rate in a cohort of a routine clinical population. Results suggest this Deep Learning software has the potential to assist chest radiologists in the tasks of pulmonary nodule detection and management within their routine clinical practice.

Introducing a Pole Concept for Nodule Growth in the Thyroid Gland: Taller-than-Wide Shape, Frequency, Location and Risk of Malignancy of Thyroid Nodules in an Area with Iodine Deficiency.

Purpose: (i) To examine the criterion taller-than-wide (TTW) for the sonographic assessment of thyroid nodules in areas of iodine deficiency in terms of frequency, anatomical distribution within the thyroid gland and risk of malignancy. (ii) To develop a model for nodule growth in the thyroid gland. Methods: German multicenter study consisting of two parts. In the prospective part, thyroid nodules were sonographically measured in all three dimensions, location within the thyroid gland and contact to a protrusion-like formation (horn) in the dorsal position of thyroid gland was noted. In addition, further sonographic features such as the composition, echogenity, margins and calcifications were investigated. All nodules from the prospective part were assessed for malignancy as part of clinical routine at the decision of the treating physician adhering to institutionally based algorithms. In the retrospective part, only nodules with fine needle aspiration and/or histology were included. The risk of malignancy in TTW nodules was determined by correlating them with cyotological and histological results. Results: Prospective part: out of 441 consecutively evaluated thyroid nodules, 6 were found to be malignant (1.4%, 95% CI 0.6–2.7%). Among the 74 TTW nodules (17%), 1 was malignant (1%, 95% CI 0–4%). TTW nodules were more often located in the dorsal half of the thyroid than non-TTW nodules (factor 2.3, p = 0.01, 95% CI 2.1–2.5) and more often located in close proximity to a horn than non-TTW nodules (factor 3.0, p = 0.01, 95% CI 2.4–3.8). Retrospective part: out of 1315 histologically and/or cytologically confirmed thyroid nodules, 163 TTW nodules were retrieved and retrospectively analyzed. A TTW nodule was 1.7 times more often benign when it was dorsal (95% CI 1.1–2.5) and 2.5 times more often benign when it was associated with a horn (95% CI 1.2–5.3). The overall probability of malignancy for TTW nodules was 38% (95% CI 30–46%) in this highly preselected patient group. Conclusion: TTW nodules are common in iodine deficient areas. They are often located in the dorsal half of the thyroid gland and are frequently associated with a dorsal protrusion-like formation (horn) of the thyroid. Obviously, the shape of benign nodules follows distinct anatomical preconditions within the thyroid gland. The frequency of TTW nodules and their predominant benignity can be explained by a pole concept of goiter growth. The difference between the low malignancy risk of TTW nodules found on a prospective basis and the high risk found retrospectively may be the result of a positive preselection in the latter.

Effects of reduced nitrogen application on soil aeration and root nodule growth of relay strip intercropping soybean

<p id="C3">To study the effects of planting system and nitrogen application rate on soybean soil aeration environment and nodulation and nitrogen fixation, we adopted a two-factor split area experiment design, with the main area of planting pattern [soybean monoculture (SS), maize/soybean relay strip intercropping (MS)], and the sub-regions of different nitrogen application rates [no nitrogen application (NN: 0 kg hm^-2), reduced nitrogen application (RN: 45 kg hm^-2), and constant nitrogen application (CN: 60 kg hm^-2)]. The dynamic changes of soil O₂ content and soil respiration rate during soybean growth period was monitored, the differences of soil water-stable aggregates, bulk density, and porosity of each treatment were analyzed, and the variation characteristics of nodulation amount and nitrogen fixation capacity during soybean growth period were discussed. Two years’ data showed that, compared with monoculture soybean, relay strip intercropping soybeans increased soil O₂ content, the percentage of aggregates with a particle size &gt; 2 mm, significantly increased soil porosity and soil respiration rate during the late growth period in soybean; reduced the percentage of aggregates with a particle size of &lt; 1 mm and soil porosity. There was no significant difference in the dry weight of nodules at R5 stage, but the number of nodules was significantly increased by 39.9%. Nitrogenase activity and nitrogen fixation potential were also significantly higher than those of monocrops. Among the various nitrogen application rates, the soil O₂ content, the percentage content of 0.25-1.00 mm particle size, and the soil respiration rate of relay strip intercropping soybean were the highest in RN treatment. Nitrogen application decreased the percentage content of water-stable aggregates with particle size &lt; 0.25 mm and soil bulk density; nitrogen application significantly inhibited the nodulation amount, nitrogenase activity and nitrogen fixation potential of monoculture soybean in the early stage, but the inhibitory effect of nitrogen fertilizer was alleviated at R5 stage. Reduced nitrogen application increased nodulation at the late stage of relay strip intercropping soybean, and it could significantly enhance the nitrogenase activity and nitrogen fixation potential of soybeans during the growth period. Relay strip intercropping soybean combined with reduced nitrogen application promoted the formation of large aggregates, increased soil porosity, improved soybean soil aeration environment, maintained higher soil O₂ content, promoted soil respiration, and facilitated the nodulation and nitrogen fixation of soybean at later stages.

Comparison Between Magnetic Resonance Imaging and Computed Tomography in the Detection and Volumetric Assessment of Lung Nodules: A Prospective Study.

Rationale and ObjectivesComputed tomography (CT) lung nodule assessment is routinely performed and appears very promising for lung cancer screening. However, the radiation exposure through time remains a concern. With the overall goal of an optimal management of indeterminate lung nodules, the objective of this prospective study was therefore to evaluate the potential of optimized ultra-short echo time (UTE) MRI for lung nodule detection and volumetric assessment.Materials and MethodsEight (54.9 ± 13.2 years) patients with at least 1 non-calcified nodule ≥4 mm were included. UTE under high-frequency non-invasive ventilation (UTE-HF-NIV) and in free-breathing at tidal volume (UTE-FB) were investigated along with volumetric interpolated breath-hold examination at full inspiration (VIBE-BH). Three experienced readers assessed the detection rate of nodules ≥4 mm and ≥6 mm, and reported their location, 2D-measurements and solid/subsolid nature. Volumes were measured by two experienced readers. Subsequently, two readers assessed the detection and volume measurements of lung nodules ≥4mm in gold-standard CT images with soft and lung kernel reconstructions. Volumetry was performed with lesion management software (Carestream, Rochester, New York, USA).ResultsUTE-HF-NIV provided the highest detection rate for nodules ≥4 mm (n = 66) and ≥6 mm (n = 32) (35 and 50%, respectively). No dependencies were found between nodule detection and their location in the lung with UTE-HF-NIV (p > 0.4), such a dependency was observed for two readers with VIBE-BH (p = 0.002 and 0.03). Dependencies between the nodule's detection and their size were noticed among readers and techniques (p < 0.02). When comparing nodule volume measurements, an excellent concordance was observed between CT and UTE-HF-NIV, with an overestimation of 13.2% by UTE-HF-NIV, <25%-threshold used for nodule's growth, conversely to VIBE-BH that overestimated the nodule volume by 28.8%.ConclusionUTE-HF-NIV is not ready to replace low-dose CT for lung nodule detection, but could be used for follow-up studies, alternating with CT, based on its volumetric accuracy.

Tubulin Cytoskeleton Organization in Cells of Determinate Nodules.

Plant cell differentiation is based on rearrangements of the tubulin cytoskeleton; this is also true for symbiotic nodules. Nevertheless, although for indeterminate nodules (with a long-lasting meristem) the organization of microtubules during nodule development has been studied for various species, for determinate ones (with limited meristem activity) such studies are rare. Here, we investigated bacteroid morphology and dynamics of the tubulin cytoskeleton in determinate nodules of four legume species: Glycine max, Glycine soja, Phaseolus vulgaris, and Lotus japonicus. The most pronounced differentiation of bacteroids was observed in G. soja nodules. In meristematic cells in incipient nodules of all analyzed species, the organization of both cortical and endoplasmic microtubules was similar to that described for meristematic cells of indeterminate nodules. In young infected cells in developing nodules of all four species, cortical microtubules formed irregular patterns (microtubules were criss-crossed) and endoplasmic ones were associated with infection threads and infection droplets. Surprisingly, in uninfected cells the patterns of cortical microtubules differed in nodules of G. max and G. soja on the one hand, and P. vulgaris and L. japonicus on the other. The first two species exhibited irregular patterns, while the remaining two exhibited regular ones (microtubules were oriented transversely to the longitudinal axis of cell) that are typical for uninfected cells of indeterminate nodules. In contrast to indeterminate nodules, in mature determinate nodules of all four studied species, cortical microtubules formed a regular pattern in infected cells. Thus, our analysis revealed common patterns of tubulin cytoskeleton in the determinate nodules of four legume species, and species-specific differences were associated with the organization of cortical microtubules in uninfected cells. When compared with indeterminate nodules, the most pronounced differences were associated with the organization of cortical microtubules in nitrogen-fixing infected cells. The revealed differences indicated a possible transition during evolution of infected cells from anisotropic growth in determinate nodules to isodiametric growth in indeterminate nodules. It can be assumed that this transition provided an evolutionary advantage to those legume species with indeterminate nodules, enabling them to host symbiosomes in their infected cells more efficiently.