Reconstruction Time Research Articles

Efficacy of lengthening right renal veins using accompanying gonadal veins in living donor kidney transplantation.

Short harvested right renal veins (RV) are quite common in living donor kidney transplantation (KT). This technical difficulty might interfere implanting and increase warm ischemic time. Several techniques to overcome this problem have been applied, including iliac vein transposition, inverted transplant, synthetic graft, saphenous vein… Application of accompanying gonadal vein (GV), which is easily approachable and less time-consuming, has been recently published. This study aims to evaluate its effectiveness and safety. Retrospective study on KT using the gonadal vein to lengthen the short right renal vein at Viet Duc University Hospital from April 2019 to April 2022. The following data were gathered: baseline characteristics, vascular imaging in CT scan/after nephrectomy and after reconstruction (mm), reconstruction and surgical time, hospitalization days. The outcomes were determined by kidney function after transplantation (plasma creatinine, creatinine clearance) and related complications. Twenty-five cases with procured right kidney with short RV from the living donor which were reconstructed and lengthened by the accompanying GV were collected. The additional length of RV was 15.9 ± 2.4mm. Average cold ischemic time, venoplasty time, warm ischemic time were 60.4 ± 8.2, 21.2 ± 5.3, and 38.1 ± 5.6min, respectively. The average hospital stay was 15.3 ± 3.2 days. Average follow-up time was 31 ± 5.2 months, creatinine clearance was around 60ml/min after 1 year, no vascular or urologic complications was observed. Accompanying GV from a living donor to lengthen short right RV in KT is a feasible, safe, and effective technique.

Performing [18F]MFBG Long-Axial-Field-of-View PET/CT Without Sedation or General Anesthesia for Imaging of Children with Neuroblastoma.

Meta-[123I]iodobenzylguanidine ([123I]MIBG) scintigraphy with SPECT/CT is the standard of care for diagnosing and monitoring neuroblastoma. Replacing [123I]MIBG with the new PET tracer meta-[18F]fluorobenzylguanidine ([18F]MFBG) and further improving sensitivity and reducing noise in a new long-axial-field-of-view (LAFOV) PET/CT scanner enable increased image quality and a faster acquisition time, allowing examinations to be performed without sedation or general anesthesia (GA). Focusing on feasibility, we present our first experience with [18F]MFBG LAFOV PET/CT and compare it with [123I]MIBG scintigraphy plus SPECT/CT for imaging in neuroblastoma in children. Methods: A pilot of our prospective, single-center study recruited children with neuroblastoma who were referred for [123I]MIBG scintigraphy with SPECT/CT. Within 1 wk of [123I]MIBG scintigraphy and SPECT/low-dose CT, [18F]MFBG LAFOV PET/ultra-low-dose CT was performed 1 h after injection (1.5-3 MBq/kg) without sedation or GA, in contrast to the 24-h postinjection interval needed for scanning with [123I]MIBG, the 2- to 2.5-h acquisition time, and the GA often needed in children less than 6 y old. Based on the spirocyclic iodonium-ylide precursor, [18F]MFBG was produced in a fully automated good manufacturing practice-compliant procedure. We present the feasibility of the study. Results: In the first paired scans of the first 10 children included (5 at diagnosis, 2 during treatment, 2 during surveillance, and 1 at relapse), [18F]MFBG PET/CT scan showed a higher number of radiotracer-avid lesions in 80% of the cases and an equal number of lesions in 20% of the cases. The SIOPEN score was higher in 50% of the cases, and the Curie score was higher in 70% of the cases. In particular, intraspinal, retroperitoneal lymph node, and bone marrow involvement was diagnosed with much higher precision. None of the children (median age, 1.6 y; range, 0.1-7.9 y) had sedation or GA during the PET procedure, whereas 80% had GA during [123I]MIBG scintigraphy with SPECT/CT. A PET acquisition time of only 2 min without motion artifacts was the data requirement of the 10-min acquisition time for reconstruction to provide a clinically useful image. Conclusion: This pilot study demonstrates the feasibility of performing [18F]MFBG LAFOV PET/CT for imaging of neuroblastoma. Further, an increased number of radiotracer-avid lesions, an increased SIOPEN score, and an increased Curie score were seen on [18F]MFBG LAFOV PET/CT compared with [123I]MIBG scintigraphy with SPECT/CT, and GA and sedation was avoided in all patients. Thus, with a 1-d protocol, a significantly shorter scan time, a higher sensitivity, and the avoidance of GA and sedation, [18F]MFBG LAFOV PET/CT shows promise for future staging and response assessment and may also have a clinical impact on therapeutic decision-making for children with neuroblastoma.

Robotic Pancreatoduodenectomy: Increasing Complexity and Decreasing Complications with Experience: Single-Center Results from 150 Consecutive Patients.

This report describes the authors' experience with 150 consecutive robotic pancreatoduodenectomies. The study enrolled 150 consecutive patients who underwent robotic pancreatoduodenectomy between 2018 and 2023. Pre- and intraoperative variables such as age, gender, indication, operation time, diagnosis, and tumor size were analyzed. The patients were divided into two groups. Group 1 comprised the first 75 patients, and group 2 comprised the last 75 cases. The median age of the patients was 62.4 years and did not differ between the two groups. Morbidity was lower in group 2. The mortality rate was 0.7% at 30 days and 1.3% at 90 days, and there was no difference between the groups. There was a significant reduction (p < 0.05) in operative time, resection time, reconstruction time, and conversion to open surgery in group 2. Partial resection of the portal vein was performed in 17 patients and more common in group 2 (p < 0.01). The number of resected lymph nodes was higher in group 2. The indication for pancreatoduodenectomy did not differ between the two groups. There was no difference in tumor size or clinical characteristics of the patients. The robotic platform is useful for pancreatoduodenectomy, facilitates adequate lymphadenectomy, and is helpful for digestive tract reconstruction after resection. Robotic pancreatoduodenectomy is safe and feasible for selected patients. It should be performed in specialized centers by surgeons experienced in open and minimally invasive pancreatic surgery.

Paper 12: Risk Factors and Failure Rates for Ramp Repair with ACL Reconstruction: An Analysis of 1037 Patients with a Mean Follow-up of 72 Months from the SANTI Study Group

Objectives: The primary objective of this study was to determine the failure rate (defined by secondary meniscectomy) of ramp repairs performed at the time of anterior cruciate ligament reconstruction (ACLR). The secondary objective was to investigate the association of patient and surgical characteristics with the risk of failure. Methods: A retrospective analysis of prospectively collected data was performed. All patients who underwent repair of a meniscal ramp lesion through a posteromedial portal at the time of primary ACLR, performed between January 2013 and December 2020, were considered for study eligibility. At the end of the study period, secondary meniscectomy rates were determined. Kaplan Meier analyses were used to evaluate repair survivorship. Risk factors associated with meniscal repair failure were analyzed using a logistic regression model. Results: 1037 patients were deemed eligible and included in the final analysis. The overall mean follow-up was 72.4 ± 27.1 months. The overall rate of secondary medial meniscectomy was 7.7%. Age, sex, Tegner score, and the duration of time between the injury and surgery were not found to be significant risk factors for secondary meniscectomy. The only significant risk factor for failure of ramp repair was the use of an isolated ACLR technique when compared to a combined ACLR + lateral extra-articular procedure (LEAP). The rate of secondary medial meniscectomy was 12.9% in the isolated ACLR group, compared to 4.8% in the combined ACLR + LEAP group (P&lt; 0.0001). The odds of having a secondary medial meniscectomy were 62% lower for patients with combined ACLR + LEAP. Conclusions: At a mean follow-up of 72.4 months after ACLR + ramp repair, the failure rate was 7.7%. The failure rate was 2 times lower when a LEAP was performed in conjunction with ACLR. The only significant risk factor identified for failure of a ramp lesion was the use of an isolated ACLR instead of a combined ACLR + LEAP.

Repair of bucket handle meniscus tears improves patient outcomes versus partial meniscectomy at the time of ACL reconstruction.

The aim of this study was to examine demographic and surgical factors that influence patient-reported knee function in patients who undergo anterior crucial ligament reconstruction (ACLR) with concurrent bucket-handle meniscal tear (BHMT) procedures. We hypothesized that repair of BHMT in the setting of concomitant ACLR and shorter time from injury to surgery would lead to improved patient-reported outcomes. Forty-one patients (mean age: 28.0 ± 9.8 years, 72% male) with BHMT at the time of ACLR completed the International Knee Documentation Committee Subjective Knee Form (IKDC-SKF) via online survey at an average of 15.2 months postop. Patient demographics and surgical characteristics, including time from injury to surgery, were compared between repair (n = 22) and meniscectomy (n = 19) groups using one-way analysis of variances; distributions of sex, graft source, BHMT compartment and zone were compared between groups using χ 2 tests. The association between IKDC-SKF score, demographics and surgical characteristics was evaluated using multivariable linear regression. A priori alpha level was p < 0.05. Meniscal repair and meniscectomy groups differed based on graft source and BHMT zone but not IKDC-SKF score (p = 0.085). Patients undergoing ACLR with autograft (p = 0.003) and with red-red zone BHMT (p < 0.001) more often underwent meniscal repair. The regression model demonstrated longer time from injury to surgery (p = 0.049), red-red tear zone (p = 0.04) and meniscectomy (p = 0.008); these were predictive of poorer IKDC-SKF scores. BHMT repair was more likely performed in ACL autograft and on red-red zone tears. Longer time from injury to surgery is an indicator of poorer IKDC-SKF score, as this may increase the risk of concomitant pathologies. White-white zone BHMTs are associated with better IKDC-SKF scores than red-red zone BHMTs, which may be due to the smaller volume of tissue removed during meniscectomy of white-white zone tears and the avoidance of iatrogenic complications of meniscal repair. Level III, therapeutic study.

High-resolution non-confocal non-line-of-sight imaging based on spherical-slice transform from spatial and temporal frequency to space and time.

Current non-confocal non-line-of-sight (NLOS) imaging faces the problems of low resolution and limited scene adaptability. We propose a non-confocal NLOS imaging method based on spherical-slice transform from spatial and temporal frequency to space and time. Simulation and experimental results show that the proposed method has high-resolution reconstruction without artifact interference, shape distortion, and position offset. Furthermore, it has strong scene adaptability. After GPU acceleration, the reconstruction time of the proposed method can be reduced to several hundred milliseconds for the PF32 photon array camera with 32 × 32 detection units. In the future, the proposed method has great potential for application in real-time NLOS imaging systems.

Reconstruction of Tomographic Size Using a Filtered Back Projection Algorithm

Due to their widespread use, image processors are among the most essential computer processors. FBP technique is one of the most widely used tomographic reconstruction methods. Images from a computed tomography (CT) scanner with 512x512 pixels of raw data for parallel beam projections are the metadata to which this approach is applied. This work is divided into three parts. Several projections are created from an input test picture termed Shepp-Logan phantom in the first section, utilizing radon transformation. The picture is rebuilt from the projection of a parallel beam in the second section to minimize reconstruction time. Finally, the proposed system filters the projections using the Ram Lak filter and the Hann window in the third section to refine the picture and then recombine the projections to generate the reconstructed image. The reconstruction procedure is performed on CT images using a filtered back-projection algorithm in this article for image optimization and then projection recombination to generate the rebuilt picture. Since CT can accurately depict anatomical elements like bones and organs and may pick slides in any orientation, it is frequently used in biological applications and diagnostics. It also offers a great spatial resolution and soft tissue contrast. We develop, create, and run computer programs when we work with MATLAB. After projecting the 2D image onto a CT scanner, a very good result in reconstructing the image is received.

Reconstruction of Tomographic Size Using a Filtered Back Projection Algorithm

Due to their widespread use, image processors are among the most essential computer processors. FBP technique is one of the most widely used tomographic reconstruction methods. Images from a computed tomography (CT) scanner with 512x512 pixels of raw data for parallel beam projections are the metadata to which this approach is applied. This work is divided into three parts. Several projections are created from an input test picture termed Shepp-Logan phantom in the first section, utilizing radon transformation. The picture is rebuilt from the projection of a parallel beam in the second section to minimize reconstruction time. Finally, the proposed system filters the projections using the Ram Lak filter and the Hann window in the third section to refine the picture and then recombine the projections to generate the reconstructed image. The reconstruction procedure is performed on CT images using a filtered back-projection algorithm in this article for image optimization and then projection recombination to generate the rebuilt picture. Since CT can accurately depict anatomical elements like bones and organs and may pick slides in any orientation, it is frequently used in biological applications and diagnostics. It also offers a great spatial resolution and soft tissue contrast. We develop, create, and run computer programs when we work with MATLAB. After projecting the 2D image onto a CT scanner, a very good result in reconstructing the image is received.

Analysis of the efficacy of left subclavian artery laser in situ fenestration combined with hybrid arch debranching surgery for aortic arch reconstruction in patients with Stanford type A aortic dissection

Objective: To observe the short-and mid-term efficacy of left subclavian artery(LSA) laser in situ fenestration combined with arch debranching surgery for aortic arch reconstruction in patients with Stanford type A aortic dissection aged 60 years and above. Methods: This is a retrospective cohort study. A total of 41 Stanford type A aortic dissection patients aged 60 years and above who received combined surgery in Department of Endovascular Surgery, the First Affiliated Hospital of Zhengzhou University from January 2018 to December 2020 were retrospectively analyzed. There were 25 males and 16 females, aged (67.3±5.9)years(range: 60 to 75 years). Among them, 19 patients underwent LSA laser in situ fenestration combined with arch debranching surgery(combined surgery group) and 22 patients underwent hybrid aortic arch debranching surgery(non-combined surgery group). Independent sample t test, χ2 test and Fisher exact probability method were used to compare the clinical characteristics of the two groups. Kaplan-Meier method was used for survival analysis, and the 5-year survival rate of the two groups was compared by Log-rank test. Results: Body mass index in the combined operation group was significantly higher than that in the non-combined operation group ((27.1±1.6)kg/m2 vs.(26.9±1.9)kg/m2; t=2.766,P=0.006), and the difference was statistically significant. There was no statistical significance in the comparison of other general data (all P>0.05). The operation time ((321.3±11.4) minutes vs. (329.6±7.3)minutes; t=-2.733, P=0.010) and LSA reconstruction time ((32.4±3.0)minutes vs. (42.4±6.0)minutes; t=-6.842, P<0.01) in the combined operation group were significantly shortened, and the difference was statistically significant. The rate of LSA reconstruction in the combined operation group (100% vs. 72.7%; P=0.023) was significantly higher than that in the non-combined operation group, and the difference was statistically significant. There were no significant differences in the incidence of pulmonary infection, unplanned second operation, continuous renal replacement therapy, neurological complications and the in-hospital mortality between the two groups. Compared with the non-combined surgery group, the total complication rate related to LSA reconstruction was significantly lower in the combined surgery group (0 vs. 27.3%; P=0.023). Kaplan-Meier survival analysis showed that there was no difference in 5-year survival rate between the combined operation group and the non-combined operation group (84.2% vs. 77.3%; χ2=0.310, P=0.578). Conclusion: Laser in situ fenestration of the LSA combined with arch debranching surgery to reconstruct the aortic arch can significantly shorten the operation and LSA reconstruction time in patients aged 60 years and above with Stanford type A aortic dissection, improve the success rate of LSA reconstruction, and reduce the occurrence rate of LSA reconstruction complications.

Deep learning-enabled high-speed, multi-parameter diffuse optical tomography.

Frequency-domain diffuse optical tomography (FD-DOT) could enhance clinical breast tumor characterization. However, conventional diffuse optical tomography (DOT) image reconstruction algorithms require case-by-case expert tuning and are too computationally intensive to provide feedback during a scan. Deep learning (DL) algorithms front-load computational and tuning costs, enabling high-speed, high-fidelity FD-DOT. We aim to demonstrate a simultaneous reconstruction of three-dimensional absorption and reduced scattering coefficients using DL-FD-DOT, with a view toward real-time imaging with a handheld probe. A DL model was trained to solve the DOT inverse problem using a realistically simulated FD-DOT dataset emulating a handheld probe for human breast imaging and tested using both synthetic and experimental data. Over a test set of 300 simulated tissue phantoms for absorption and scattering reconstructions, the DL-DOT model reduced the root mean square error by and , increased the spatial similarity by and , increased the anomaly contrast accuracy by ( ), and reduced the crosstalk by and , respectively, compared with model-based tomography. The average reconstruction time was reduced from 3.8min to 0.02s for a single reconstruction. The model was successfully verified using two tumor-emulating optical phantoms. There is clinical potential for real-time functional imaging of human breast tissue using DL and FD-DOT.

Division versus de-epithelialization of fibula osteocutaneous flap for composite oromandibular defects: A propensity score-matched analysis

BackgroundDifferent fibula osteocutaneous free flap (FOCFF) configurations have been described with a double-skin paddle (DSP) to address composite through-and-through oromandibular defects: division of the skin paddle using different perforators (div-FOCFF) or a de-epithelialized DSP FOCFF (deEpi-FOCFF). This study aimed to compare the surgical outcomes using these two methods (deEpi-FOCFF/div-FOCFF). MethodsPatients who underwent segmental mandibulectomy and reconstruction with a DSP FOCFF between 2011 and 2014 were included. We compared postoperative outcomes of patients undergoing reconstruction with deEpi-FOCFF versus div-FOCFF implementing propensity score matching. ResultsOf the 245 patients, 156 cases (78 pairs) were 1:1 matched. Demographic and oncologic variables were comparable between groups. The average age was 57.68 years. A higher number of perforators per flap was evident in the div-FOCFF group (p < 0.001). The deEpi-FOCFF group exhibited a higher total flap loss rate when compared to the div-FOCFF group (15 % versus 5 % p = 0.03). On multivariate analysis, number of perforators per flap (OR 0.31, p = 0.02), using the deEpi-FOCFF (OR 3.88, p = 0.03), and an increased reconstructive time (OR 1.01, p = 0.01) independently affected the likelihood of free flap failure. ConclusionIf the number and location of perforators are optimal, div-FOCFF improves reconstructive outcomes for composite oromandibular defects versus the deEpi-FOCFF.

LRPS‐GCN: A millimeter wave sparse imaging algorithm based on graph signal

AbstractAiming at the problems of slow speed and poor accuracy of traditional millimeter wave sparse imaging, a sparse imaging algorithm based on graph convolution model is proposed from the perspective of sparse signal recovery. The graph signal model is constructed by combining the low‐rank and piecewise smoothing(LRPS) regular terms, based on which the proximal operator is replaced by the denoising graph convolution network, and the graph convolution sparse reconstruction network LRPS‐GCN is constructed, and the recovered target image is obtained by iterating with the optimal non‐linear sparse variation. For the proposed algorithm, simulation experiments are carried out using synthetic datasets under different target densities, iteration times and noise environments, and compared with the traditional graph signal reconstruction algorithm and the deep compressed sensing reconstruction algorithm, and then use the measured data with varying degrees of sparsity to validate. The experimental results show that the reconstructed images by this algorithm have better performance in terms of normalised mean square error, target to background ratio, reconstruction time and memory usage.

Medial Femoral Trochlea Osteochondral Flap Reconstruction of the Previously Unsalvageable Kienbock-Associated Lunate With a Coronal Split

Patients with Kienbock disease can present with coronal fracture and collapse of the proximal lunate (Unified B2/Bain grade 1, 2B). Traditionally, this was considered unsalvageable. However, medial femoral trochlea (MFT) osteochondral reconstruction, used to recreate the proximal lunate surface, can be paired with reduction and repair of the coronal plane fracture, thus restoring midcarpal congruity. The purpose of this study was to report radiographic and clinical outcomes following lunate coronal fracture fixation at the time of MFT osteochondral reconstruction. This was a retrospective study performed at a single institution. We identified patients with Kienbock disease who underwent MFT osteochondral reconstruction from 2014 to 2023. Patients were included if they had a coronal fracture of the lunate distal articular surface fixed at the time of surgery. Radiographic and clinical parameters were evaluated, including carpal height ratio, union rate, presence of heterotopic ossification, need for revision surgery, and patient-reported outcome measures. Thirty-three patients were included, with a mean age of 27.5 years (range: 15-41); 19 (58%) were women. Mean radiographic follow-up time was 5.8 months, and mean clinical follow-up time was 22.6 months. Union was achieved in 30/33 patients (91%). Carpal height ratio improved from 1.32 to 1.4. Two patients (6%) required reoperation, one for removal of heterotopic ossification and another for conversion to proximal row carpectomy. Patients demonstrated meaningful improvement in brief Michigan Hand Questionnaire and Patient-Reported Outcomes Measurement Information Upper Extremity scores. Range of motion before and after surgery was similar. Lunate coronal fracture fixation with MFT osteochondral reconstruction represents an additional management option in select patients with Kienbock disease. This technique restores the midcarpal joint during lunate reconstruction and may allow patients to avoid salvage procedures. Early radiographic and clinical outcomes are promising. Therapeutic IV.

Phase noise cancellation for digital holographic microscopy based on compressed sensing iterative adaptive sparse dictionary

Digital holographic microscopy (DHM), like other digital imaging techniques, will introduce severe coherent noise, which is called random noise, due to the high coherence of the required light source and the measurement experimental environment. Random noise seriously affects the accuracy of DHM surface topography measurements. To overcome this problem, this paper proposes a DHM phase noise cancellation method based on compressed sensing (CS) iterative adaptive sparse dictionary. The holographic image is first acquired using the proposed recording method. Then a sparse dictionary more suitable for the sample is trained by dictionary learning to sparsely encode the holographic image. Finally, reconstruction is performed using the improved orthogonal matching pursuit (IOMP), which can obtain almost noise-free holographic images. The experimental results show that the reconstructed phase peak signal-to-noise ratio (PSNR) is 33.2871, which is improved by 65.01 %. The sample feature similarity is 0.9553, which is improved by 45.41 %. The proposed method can also be used with different learning modes and learning objects. On top of the original results, the reconstructed phase PSNR was able to continue to improve by 5.99 % and its reconstruction time was also accelerated by 29.57 %.

Fourier Ptychographic Microscopy Reconstruction Method Based on Residual Local Mixture Network.

Fourier Ptychographic Microscopy (FPM) is a microscopy imaging technique based on optical principles. It employs Fourier optics to separate and combine different optical information from a sample. However, noise introduced during the imaging process often results in poor resolution of the reconstructed image. This article has designed an approach based on a residual local mixture network to improve the quality of Fourier ptychographic reconstruction images. By incorporating channel attention and spatial attention into the FPM reconstruction process, the network enhances the efficiency of the network reconstruction and reduces the reconstruction time. Additionally, the introduction of the Gaussian diffusion model further reduces coherent artifacts and improves image reconstruction quality. Comparative experimental results indicate that this network achieves better reconstruction quality, and outperforming existing methods in both subjective observation and objective quantitative evaluation.

The radiated breast and autologous reconstruction: benefits and alternatives

Despite advancements in research and technology, breast cancer remains the second leading cause of cancer-related mortality affecting women worldwide. Radiation therapy is a widely recommended adjunct to surgery due to its significant role in reducing loco-regional recurrence. Its use, however, is not without consequences. Radiation triggers a series of pathophysiologic events leading to tissue injury; reactive oxygen species incites (1) vascular damage and chronic hypoxia; (2) an inflammatory response; and (3) activation of myofibroblasts to induce fibrosis. As a result, radiotherapy interferes with wound healing and negatively impacts the quality of the skin. These pathophysiologic consequences complicate the sequence of breast reconstruction and require surgeons to consider timing and the type of reconstruction (autologous vs. implant), with respect to radiotherapy to improve patient outcomes. In this article, we briefly review radiation-induced tissue effects and their impact on breast reconstruction. More specifically, we comment on the traditional use of autologous tissue, microsurgical technical pearls for irradiated fields, reconstructive timing paradigms, and lymphedema prevention. With continued progress, derivation, and innovation, plastic and reconstructive surgery has consistently advanced and revolutionized both medicine and surgery. This review considers the future implications of breast reconstruction and how it will impact patients, healthcare, and the field. While not an exhaustive review, we aim to provide a comprehensive discussion and insights. In summary, the authors discuss the possibilities of a paradigm shift in breast reconstruction, emphasizing the need for surgeons to have an armamentarium capable of all breast reconstruction options for the best possible patient outcomes.

Comparison of totally robotic and totally laparoscopic gastrectomy for gastric cancer: a propensity score matching analysis.

With the improvements in laparoscopic or robotic surgical techniques and instruments, a growing number of surgeons have attempted to complete all digestive tract reconstruction intracorporeally; these procedures include totally robotic gastrectomy (TRG) and totally laparoscopic gastrectomy (TLG). This study aimed to evaluate the safety and feasibility of the TRG and compare the short-term outcomes of the TRG and TLG in patients with gastric cancer. Between January 2018 and June 2023, 346 consecutive patients who underwent TRG or TLG at a high-volume academic gastric cancer specialty center were included. 1:1 propensity score matching (PSM) was performed to reduce confounding bias. The surgical outcomes, postoperative morbidity, and surgical burden were compared in PSM cohort. After PSM, a well-balanced cohort of 194 patients (97 in each group) was included in the analysis. The total operation time of the TRG group was significantly longer than that of the TLG group (244.9 vs. 213.0min, P < 0.001). There was no significant difference in the effective operation time between the 2 groups (217.8 vs. 207.2min, P = 0.059). The digestive tract reconstruction time of the TRG group was significantly shorter than that of the TLG group (39.4 vs. 46.7min, P < 0.001). The mean blood loss in the TRG group was less than that in the TLG group (101.1 vs. 126.8mL, P = 0.014). The TRG group had more retrieved lymph nodes in the suprapancreatic area than that in the TLG group (16.6 vs 14.2, P = 0.002). The TRG group had a lower surgery task load index (38.9 vs. 43.1, P < 0.001) than the TLG group. No significant difference was found in terms of postoperative morbidity between the 2 groups (14.4% vs. 16.5%, P = 0.691). This study demonstrated that TRG is a safe and feasible procedure, and is preferable to TLG in terms of invasion and ergonomics. The TRG may maximize the superiority of robotic surgical systems and embodies the theory of minimally invasive surgery.

Fast color fourier Ptychographic microscopic imaging technology with fusion color correction

In biomedicine, rapid and accurate acquisition of color pathology slides is of paramount importance for diagnostic analyses. Conventional microscopic full-color imaging cannot provide the physician with enough effective information at one time due to the "law of proportionality of objective lenses." Fourier ptychographic microscopy (FPM) has emerged as a solution for high-throughput digital pathology. It can simultaneously achieve a large field of view and high-resolution (HR) imaging. However, achieving color FPM typically requires capturing images separately for each of the red, green, and blue channels for reconstruction, resulting in a significant increase in the time cost. Existing improvement strategies require long coloring times, and have difficulty ensuring standardization between the reconstructed and original image colors owing to the influence of optical system stability and algorithm errors. In this study, a fast-color FPM imaging technology with fusion color correction (CCFPM) is proposed. It achieves high-precision color FPM imaging by separately capturing single low-resolution images for the red and blue channels, which are used to color the reconstructed green-channel HR grayscale image. The reconstructed HR color image is then processed using a color correction algorithm. Simulation and experimental analyses demonstrate that this method compresses the coloring algorithm's computation time to less than 1 s, reducing both the acquisition and reconstruction times by 66.7 % compared with the traditional R + G + B channel approach, achieving a significant improvement in speed. Meanwhile, it also achieves a breakthrough in algorithm speed compared with other fast color FPM solutions, compressing the coloring time to a few hundredths or even a few thousandths of the existing algorithms, and ensures the accuracy of the reconstructed image, reducing the RMSE by 50 % compared with the existing algorithms. Regarding color consistency, CCFPM can mitigate the chromatic aberration caused by fluctuations in optical system stability, maintaining consistency between the reconstructed and original image colors, thus achieving standardization of image color appearance. Therefore, the proposed method is promising for further advancements in the application of FPM in digital pathology.

Minimising warm ischaemia time during robot-assisted partial nephrectomy. A video-based assessment of tumour excision, kidney reconstruction and intermediate time.

Surgical video review is an emerging tool for assessing patient outcomes, especially in complex surgeries such as robot-assisted partial nephrectomy (RAPN). Assessing and measuring warm ischaemia time (WIT) during RAPN by dividing it into the time used for tumour excision time (ExcT), time used for kidney reconstruction time (RecT) and intermediate time (IntT) has not been performed before. This study aimed to analyse the factors that can influence all surgical times and assess their impact on positive surgical margins (PSMs) and complication rates. We evaluated 32 surgical video recordings from patients undergoing RAPN and measured WIT, ExcT, RecT and IntT with a stopwatch. Factors such as tumour characteristics and surgeon experience were also recorded. SPSS software was used to identify the predictors for all surgical times and to correlate ExcT with PSM and RecT with complication rate. We recorded a median WIT of 1,048 s (17 min and 28 s). The median of ExcT, RecT and IntT was 398 s (37.1% of WIT), 518 s (46.7% of WIT) and 180 s (16.2% of WIT), respectively. We found a significant correlation (P < 0.001) between R.E.N.A.L. score and all surgical times. No correlation was found between ExcT and PSM (P = 0.488) and between RecT and the probability of developing complications (P = 0.544). Tumour morphology influences all surgical times, and surgeon experience influences only ExcT. We observed a short RecT during RAPN though at the cost of increased ExcT, and we believe that improving surgical experience, especially for the excision of more complex tumours, can reduce WIT during RAPN.

Paired conditional generative adversarial network for highly accelerated liver 4D MRI

Purpose. 4D MRI with high spatiotemporal resolution is desired for image-guided liver radiotherapy. Acquiring densely sampling k-space data is time-consuming. Accelerated acquisition with sparse samples is desirable but often causes degraded image quality or long reconstruction time. We propose the Reconstruct Paired Conditional Generative Adversarial Network (Re-Con-GAN) to shorten the 4D MRI reconstruction time while maintaining the reconstruction quality. Methods. Patients who underwent free-breathing liver 4D MRI were included in the study. Fully- and retrospectively under-sampled data at 3, 6 and 10 times (3×, 6× and 10×) were first reconstructed using the nuFFT algorithm. Re-Con-GAN then trained input and output in pairs. Three types of networks, ResNet9, UNet and reconstruction swin transformer (RST), were explored as generators. PatchGAN was selected as the discriminator. Re-Con-GAN processed the data (3D + t) as temporal slices (2D + t). A total of 48 patients with 12 332 temporal slices were split into training (37 patients with 10 721 slices) and test (11 patients with 1611 slices). Compressed sensing (CS) reconstruction with spatiotemporal sparsity constraint was used as a benchmark. Reconstructed image quality was further evaluated with a liver gross tumor volume (GTV) localization task using Mask-RCNN trained from a separate 3D static liver MRI dataset (70 patients; 103 GTV contours). Results. Re-Con-GAN consistently achieved comparable/better PSNR, SSIM, and RMSE scores compared to CS/UNet models. The inference time of Re-Con-GAN, UNet and CS are 0.15, 0.16, and 120 s. The GTV detection task showed that Re-Con-GAN and CS, compared to UNet, better improved the dice score (3× Re-Con-GAN 80.98%; 3× CS 80.74%; 3× UNet 79.88%) of unprocessed under-sampled images (3× 69.61%). Conclusion. A generative network with adversarial training is proposed with promising and efficient reconstruction results demonstrated on an in-house dataset. The rapid and qualitative reconstruction of 4D liver MR has the potential to facilitate online adaptive MR-guided radiotherapy for liver cancer.