New advances in radiomics of gastrointestinal stromal tumors

Gastrointestinal stromal tumors (GISTs) are uncommon neoplasms of the gastrointestinal tract with peculiar clinical, genetic, and imaging characteristics. Preoperative knowledge of risk stratification and mutational status is crucial to guide the appropriate patients’ treatment. Predicting the clinical behavior and biological aggressiveness of GISTs based on conventional computed tomography (CT) and magnetic resonance imaging (MRI) evaluation is challenging, unless the lesions have already metastasized at the time of diagnosis. Radiomics is emerging as a promising tool for the quantification of lesion heterogeneity on radiological images, extracting additional data that cannot be assessed by visual analysis. Radiomics applications have been explored for the differential diagnosis of GISTs from other gastrointestinal neoplasms, risk stratification and prediction of prognosis after surgical resection, and evaluation of mutational status in GISTs. The published researches on GISTs radiomics have obtained excellent performance of derived radiomics models on CT and MRI. However, lack of standardization and differences in study methodology challenge the application of radiomics in clinical practice. The purpose of this review is to describe the new advances of radiomics applied to CT and MRI for the evaluation of gastrointestinal stromal tumors, discuss the potential clinical applications that may impact patients’ management, report limitations of current radiomics studies, and future directions

CT Radiomic Features and Clinical Biomarkers for Predicting Coronary Artery Disease

This study was aimed to investigate the predictive value of the radiomics features extracted from pericoronaric adipose tissue & mdash; around the anterior interventricular artery (IVA) & mdash; to assess the condition of coronary arteries compared with the use of clinical characteristics alone (i.e., risk factors). Clinical and radiomic data of 118 patients were retrospectively analyzed. In total, 93 radiomics features were extracted for each ROI around the IVA, and 13 clinical features were used to build different machine learning models finalized to predict the impairment (or otherwise) of coronary arteries. Pericoronaric radiomic features improved prediction above the use of risk factors alone. In fact, with the best model (Random Forest + Mutual Information) the AUROC reached 0.820 +/- 0.076 . As a matter of fact, the combined use of both types of features (i.e., radiomic and clinical) allows for improved performance regardless of the feature selection method used. Experimental findings demonstrated that the use of radiomic features alone achieves better performance than the use of clinical features alone, while the combined use of both clinical and radiomic biomarkers further improves the predictive ability of the models. The main contribution of this work concerns: (i) the implementation of multimodal predictive models, based on both clinical and radiomic features, and (ii) a trusted system to support clinical decision-making processes by means of explainable classifiers and interpretable features

A Methodological Framework to Discover Pharmacogenomic Interactions Based on Random Forests

The identification of genomic alterations in tumor tissues, including somatic mutations, deletions, and gene amplifications, produces large amounts of data, which can be correlated with a diversity of therapeutic responses. We aimed to provide a methodological framework to discover pharmacogenomic interactions based on Random Forests. We matched two databases from the Cancer Cell Line Encyclopaedia (CCLE) project, and the Genomics of Drug Sensitivity in Cancer (GDSC) project. For a total of 648 shared cell lines, we considered 48,270 gene alterations from CCLE as input features and the area under the dose-response curve (AUC) for 265 drugs from GDSC as the outcomes. A three-step reduction to 501 alterations was performed, selecting known driver genes and excluding very frequent/infrequent alterations and redundant ones. For each model, we used the concordance correlation coefficient (CCC) for assessing the predictive performance, and permutation importance for assessing the contribution of each alteration. In a reasonable computational time (56 min), we identified 12 compounds whose response was at least fairly sensitive (CCC > 20) to the alteration profiles. Some diversities were found in the sets of influential alterations, providing clues to discover significant drug-gene interactions. The proposed methodological framework can be helpful for mining pharmacogenomic interactions

Impact of sublingual immunotherapy on seasonal asthma and skin reactivity in children allergic to Parietaria pollen treated with inhaled fluticasone propionate

Immunotherapy is a recognized treatment for allergic respiratory diseases

Paracetamol and antibiotics in childhood and subsequent development of wheezing/asthma: association or causation?

Several studies found an association between early administration of paracetamol and antibiotics and development of wheezing. This could be due to confounding: wheeze and asthmatic symptoms in early childhood are difficult to distinguish from respiratory tract infections that are widely treated with these drugs; in case of persistence of symptoms up to school age, this could explain the observed relationship

Post-operative computed tomography imaging evaluation of ascending aorta surgery

Ascending thoracic aorta disease is often a life-threatening condition. Aortic aneurysm and aortic dissection are the most frequent ascending aorta diseases requiring surgical intervention. Surgical repair techniques of the ascending aorta are various; they include reconstruction of the ascending aorta by using a graft with or without a prosthetic valve, reconstruction with a composite artificial graft or using a biological graft, and reconstruction of the ascending aorta with a composite graft preserving the native valve and arch repair. The radiologist plays a key role in the identification of post-operative complications; differentiation from normal postoperative findings is fundamental. Our aim is to discuss the main diseases affecting the ascending aorta requiring surgery and the different techniques used to treat them. We also discuss the normal computed tomography (CT) imaging findings and after-surgery complications

Safety of sublingual-swallow immunotherapy in children aged 3 to 7 years

The minimum age to start specific immunotherapy with inhalant allergens in children has not been clearly established, and position papers discourage its use in children younger than 5 years

Missense mutations in the Fas gene resulting in autoimmune lymphoproliferative syndrome: a molecular and immunological analysis

Programmed cell death (or apoptosis) is a physiological process essential to the normal development and homeostatic maintenance of the immune system. The Fas/Apo-1 receptor plays a crucial role in the regulation of apoptosis, as demonstrated by lymphoproliferation in MRL-lpr/lpr mice and by the recently described autoimmune lymphoproliferative syndrome (ALPS) in humans, both of which are due to mutations in the Fas gene. We describe a novel family with ALPS in which three affected siblings carry two distinct missense mutations on both the Fas gene alleles and show lack of Fas-induced apoptosis. The children share common clinical features including splenomegaly and lymphadenopathy, but only one developed severe autoimmune manifestations. In all three siblings, we demonstrated the presence of anergic CD3+CD4-CD8- (double negative, [DN]) T cells; moreover, a chronic lymphocyte activation was found, as demonstrated by the presence of high levels of HLA-DR expression on peripheral CD3+ cells and by the presence of high levels of serum activation markers such as soluble interleukin-2 receptor (slL-2R) and soluble CD30 (sCD30)