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Uterine Artery Embolization for Pure Adenomyosis: Predictive Factors Affecting Outcomes

2026-04-14T07:23:13Z

Title: Uterine Artery Embolization for Pure Adenomyosis: Predictive Factors Affecting Outcomes Authors: Han, Kichang; Kim, Man-Deuk; Kwon, Joon Ho; Seo, Seok Kyo; Alqarni, Abdullah Ali; Park, Juil; Kim, Gyoung Min; Won, Jong Yun; Cho, Jaesung; Jeong, Seok Min Abstract: Purpose: To identify factors associated with postprocedural necrosis after uterine artery embolization (UAE) for pure adenomyosis. Materials and Methods: This study included patients who underwent UAE for pure symptomatic adenomyosis between January 2011 and May 2025. Adenomyosis characteristics, including T2-weighted signal intensity, adenomyosis morphology (Types I and II), and focal versus diffuse location, were evaluated using preprocedural magnetic resonance (MR) imaging. Contrast-enhanced MR imaging was used to assess adenomyosis necrosis 3 months after UAE. Symptom severity scores (SSSs) and health-related quality of life (HRQOL) were evaluated before and 3 months after the procedure. Univariate and multivariate analyses were performed to identify factors associated with incomplete necrosis of the adenomyotic tissue. Results: Of the 147 patients (mean age, 42.7 years [SD +/- 4.2]) who underwent UAE for adenomyosis, 116 (78.9%) exhibited complete necrosis. In multivariate analysis, Type II adenomyosis (odds ratio [OR], 10.492; 95% CI, 3.492-31.523; P < .001) and heterogeneous T2 signal intensity (OR, 4.003; 95% CI, 1.565-10.242; P = .003) were significant predictive factors for incomplete necrosis. The rates of incomplete necrosis were 13.6% (17/125) for Type I adenomyosis and 63.6% (14/22) for Type II adenomyosis. The postprocedural SSS and HRQOL scores were significantly improved in patients with complete necrosis compared with those with incomplete necrosis. Conclusions: Type II morphology arising from the subserosa and a heterogeneous T2 signal are associated with an increased risk of incomplete necrosis after UAE. Incorporating these features into preprocedural counseling may help improve clinical outcomes.

Feasibility and Reproducibility of a Structure-Guided Deep Learning Model for Automatic Detection of the Standard Sagittal Plane in First-Trimester Nuchal Translucency Assessment Using 3D Ultrasound

2026-06-10T05:55:41Z

Title: Feasibility and Reproducibility of a Structure-Guided Deep Learning Model for Automatic Detection of the Standard Sagittal Plane in First-Trimester Nuchal Translucency Assessment Using 3D Ultrasound Authors: Kwon, Hayan; Hur, Hyewon; Cho, Hyun Cheol; Jung, Yun ji; Kim, Suhra; Kwon, Ja-Young Abstract: Objectives Accurate nuchal translucency (NT) measurement for assessing the risk of fetal genetic abnormalities requires precise acquisition of the mid-sagittal plane (MSP). However, achieving an appropriate MSP is technically challenging due to anatomical variability and operator dependence inherent in conventional 2-dimensional (2D) ultrasound. This study aimed to develop and validate a novel deep learning algorithm for automated fetal MSP extraction from 3-dimensional (3D) ultrasound volumes utilizing intracranial structure segmentation to overcome the limitations of conventional methods reliant on facial landmarks.Methods In this prospective study, we developed and evaluated "3D MSP-net," a convolutional neural network (CNN)-based model for automated MSP extraction, involving singleton pregnant women undergoing first-trimester NT screening. Using achieved 3D volume data, 3D MSP-net was validated against the conventional 2D manual method and a commercially available rule-based automated system (5D NT (TM)). Two maternal-fetal medicine (MFM) specialists independently assessed the resulting MPSs to determine the performance for demonstrating the feasibility and high reproducibility of the 3D MSP-net.Results 3D MSP-net achieved an MSP extraction success rate of 91.6%, comparable to that of the conventional 2D manual method and significantly superior to the rule-based 3D algorithm. NT measurements were comparable between the conventional 2D manual approach and MSPs derived from 3D MSP-net (1.4 +/- 0.5 mm versus 1.4 +/- 0.4 mm; p = .444). These results were reproducible on external validation. Moreover, the 3D MSP-net maintained robust performance even under challenging conditions, such as increased maternal body mass index and different scan deviation angles.Conclusion The 3D MSP-net, our artificial intelligence (AI) model that utilizes intracranial landmarks for MSP reconstruction, enables improved efficiency, standardization, and reliability for first-trimester fetal screening addressing a key challenge in prenatal diagnostics.

A randomized phase III clinical trial of weekly versus tri-weekly cisplatin-based chemoradiotherapy for locally advanced cervical cancer: results of the TACO (GCIG/KGOG 1027/THAI 2012) study

2026-03-31T00:52:39Z

Title: A randomized phase III clinical trial of weekly versus tri-weekly cisplatin-based chemoradiotherapy for locally advanced cervical cancer: results of the TACO (GCIG/KGOG 1027/THAI 2012) study Authors: Y. Ryu, S.; Nam, B. H.; Kim, M. H.; Jang, W. I.; Sitathanee, C.; Linh, T. D.; Lee, K. H.; Lee, W. M.; Kim, E. T.; Kang, S. B.; Kim, J. H.; V. Park, J.; Lee, K. B.; Cho, C. H.; Lou, H.; Kim, Y. H.; Kim, Y. T.; Lee, Y. H.; Wu, X.; Kim, J. W.; Park, S. I.; Jeon, S.; Thinh, D. H.; Kry, S. F.; Gaffney, D.; Small, W.; Wilailak, S. Abstract: Background The standard treatment for locally advanced cervical cancer is cisplatin-based chemoradiotherapy; however, the optimal dose and dosing schedule of cisplatin remain debated. The aim of this study was to compare the clinical outcomes of weekly cisplatin at 40 mg/m(2) versus those of tri-weekly cisplatin at 75 mg/m(2) during radiation in patients with locally advanced cervical cancer. Patients and methods In this prospective, randomized clinical trial, we enrolled 314 patients with stage IIB-IVA cervical cancer, randomly assigning them in a 1 : 1 ratio into two arms. The weekly arm received a weekly dose of 40 mg/m(2) cisplatin for six cycles, whereas the tri-weekly arm received a tri-weekly dose of 75 mg/m(2) cisplatin for three cycles, both concurrently with radiotherapy. The primary endpoints included 3-year recurrence-free survival according to a superiority design, with P < 0.05 indicative of statistical significance. Overall survival, toxicity profiles, and quality of life (QOL) were also analyzed. Results Chemotherapy delay was more frequent in the weekly arm than in the tri-weekly arm (P = 0.008). However, the 3-year recurrence-free survival rate between the two arms did not significantly differ (78.7% in the weekly arm, 84.1% in the tri-weekly arm; hazard ratio 0.71, 95% confidence interval 0.39-1.32, P = 0.28). The pattern of recurrence did not differ significantly between the two arms. Grade 3 and 4 hematological toxicities occurred less frequently in the tri-weekly arm (P < 0.001). Furthermore, the tri-weekly arm had better QOL scores across several domains compared with the weekly arm. Conclusion In this study, tri-weekly cisplatin-based chemoradiotherapy was not statistically superior to a weekly schedule in terms of survival outcomes for patients with locally advanced cervical cancer. However, the tri-weekly regimen exhibited a more favorable toxicity profile and improved QOL compared with the weekly regimen. These results suggest tri-weekly cisplatin administration as a feasible alternative for chemoradiotherapy in cervical cancer.

Plain language summary of results from the DUO-E study: durvalumab given with or without olaparib in patients with advanced endometrial cancer

2026-04-28T05:00:48Z

Title: Plain language summary of results from the DUO-E study: durvalumab given with or without olaparib in patients with advanced endometrial cancer Authors: Westin, Shannon N.; Moore, Kathleen; Chon, Hye Sook; Lee, Jung-Yun; Thomes Pepin, Jessica; Sundborg, Michael; Shai, Ayelet; de la Garza, Joseph; Nishio, Shin; Gold, Michael A.; Wang, Ke; McIntyre, Kristi; Tillmanns, Todd D.; Blank, Stephanie V.; Liu, Ji-Hong; McCollum, Michael; Contreras Mejia, Fernando; Nishikawa, Tadaaki; Pennington, Kathryn; Novak, Zoltan; De Melou, Andreia Cristina; Sehouli, Jalid; Klasa-Mazurkiewicz, Dagmara; Papadimitriou, Christos; Gil-Martin, Marta; Brasiuniene, Birute; Donnelly, Conor; Liu, Xiaochun; Nieuwenhuysen, Els Van