Background: Accurate lymph nodes (LNs) assessment is important for rectal cancer (RC) staging in multiparametric magnetic resonance imaging (mpMRI). However, it is incredibly time-consumming to identify all the LNs in scan region. This study aims to develop and validate a deep-learning-based, fully-automated lymph node detection and segmentation (auto-LNDS) model based on mpMRI. Methods: In total, 5789 annotated LNs (diameter 3 mm) in mpMRI from 293 patients with RC in a single center were enrolled. Fused T2-weighted images (T2WI) and diffusion-weighted images (DWI) provided input for the deep learning framework Mask R-CNN through transfer learning to generate the auto-LNDS model. The model was then validated both on the internal and external datasets consisting of 935 LNs and 1198 LNs, respectively. The performance for LNs detection was evaluated using sensitivity, positive predictive value (PPV), and false positive rate per case (FP/vol), and segmentation performance was evaluated using the Dice similarity coefficient (DSC). Findings: For LNs detection, auto-LNDS achieved sensitivity, PPV, and FP/vol of 80.0%, 73.5% and 8.6 in internal testing, and 62.6%, 64.5%, and 8.2 in external testing, respectively, significantly better than the performance of junior radiologists. The time taken for model detection and segmentation was 1.3 s/case, compared with 200 s/ case for the radiologists. For LNs segmentation, the DSC of the model was in the range of 0.81À0.82. Interpretation: This deep learningÀbased auto-LNDS model can achieve pelvic LNseffectively based on mpMRI for RC, and holds great potential for facilitating N-staging in clinical practice.

Hyperthermia induced by the alternating magnetic field (AMF) to heat magnetic nanomaterials localized within the tumor has attracted wide attention due to its ability in effective tumor ablation, low side effects, and deep tissue penetration. However, rather strong AMFs are often needed to realize effective magnetic hyperthermia of tumors. Herein, it is discovered that nonmagnetic gallium–indium liquid metal (GaIn LM) above certain sizes prepared by the shearing force could be effectively heated up under AMF with a low field intensity owing to the eddy‐thermal effect, which could be utilized for AMF‐induced hyperthermia treatment of tumors. As demonstrated in experiments using mice bearing subcutaneous 4T1 breast tumors and rats with deeply seated orthotopic liver tumors, local injection of GaIn LM followed by AMF treatment could result in effective ablation of those tumors. With great in vitro biocompatibility, such GaIn LM also shows no appreciable in vivo toxicity to mice within two months. This work thus presents a new type of thermal ablation therapy using nonmagnetic, biocompatible, and injectable LM to ablate tumors under a low‐field‐intensity AMF, with the eddy‐thermal heating mechanism distinctive from that in conventional magnetic hyperthermia therapies using magnetic nanoagents.

Objective: To compare the outcomes of transarterial chemoembolization (TACE) combined with sorafenib versus TACE alone for treating patients with unresectable hepatocellular carcinoma (HCC). Methods: This retrospective analysis included all patients receiving either TACE plus sorafenib therapy or TACE alone for unresectable HCC between February 2008 and August 2015 at the First Affiliated Hospital of Soochow University, China. Propensity score matching (PSM) was carried out to reduce bias due to confounding variables. The primary outcome was overall survival (OS), calculated from the date of the first TACE treatment until the date of death of any cause. A multivariate Cox proportional hazards analysis was conducted to examine determinants of OS. Results: A total of 308 patients were included in the study: 61 receiving TACE plus sorafenib treatment and 247 receiving TACE monotherapy. The PSM cohort included 61 subjects receiving TACE plus sorafenib and 122 subjects receiving TACE alone. In the overall analysis that included all patients, the median OS in the combination group was significantly longer than that in the monotherapy group (29.0 ± 7.2 vs. 14.9 ± 1.1 months; P = 0.008). In the PCM cohort, the median OS was also significantly longer in the combination group (29.0 ± 7.2 vs. 14.9 ± 1.5 months; P = 0.018). Subgroup analysis revealed longer OS in patients receiving combination treatment in both the BCLC-B and BCLC-C subgroups (P < 0.05 for both). Multivariate analyses in the PSM cohort revealed that treatment methods (P = 0.003), number of nodules (P = 0.010), tumor size (P = 0.012), vascular invasion (P = 0.005), and number of TACE (P = 0.029) were independent prognostic factors of OS. The most common adverse events were hand-foot skin reaction (75.4%) and diarrhea (47.5%) in the combination group, and fatigue (19.0%) and liver dysfunction (18.2%) in the monotherapy group. There were no treatment-related deaths in either group. Conclusion: The combined use of TACE and sorafenib is generally well tolerated and could significantly increase OS of patients with unresectable HCC.

Magnetic hyperthermia therapy (MHT) is able to ablate tumors using an alternating magnetic field (AMF) to heat up magnetocaloric agents (e.g., magnetic nanoparticles) administrated in the tumors. For clinical applications, there is still a demand to find new magnetocaloric agents with strong AMF-induced heating performance and excellent biocompatibility. As a kind of biocompatible and biodegradable materials, magnesium (Mg) and its alloys have been extensively used in the clinic as the implant metal. Herein, we discovered that the eddy-thermal effect of the magnesium alloy (MgA) could be employed for MHT to effectively ablate tumors. Under low-field-intensity AMFs, MgA rods could be rapidly heated, resulting in temperature increase in their nearby tissues. Such AMF-induced eddy-thermal heating of MgA could not only be used to kill tumor cells in vitro, but also be employed for effective and accurate ablation of tumors in vivo. In addition to killing tumors on mice, we further demonstrated that VX2 tumors with much larger sizes growing on rabbits after implantation of MgA rods could also be eliminated after exposure to AMF, illustrating the ability of MgA-based MHT in killing large-sized tumors. Moreover, the implanted MgA rods showed excellent biocompatibility and ∼20% of its mass was degraded within three months. Our work thus for the first time discovered that non-magnetic biodegradable MgA, an extensively used implant metal in clinic, could be used for effective magnetic thermal ablation of tumors under a low-field-intensity AMF. Such a strategy could be readily translated into the clinical use.

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