Medical Specialties Commons^™

Single-Nucleotide Rna M6a Mapping In Bovine Preimplantation Development Reveals Site-Specific Regulation Of Rpl12 At Zygotic Genome Activation, Hao Ming, Kinga Pajdzik, Noah R Rakestraw, Piyush K Jain, Chuan He, Chenghang Zong, Zongliang Jiang

Faculty, Staff and Students Publications

RNA N6-methyladenosine (m6A) is a key regulator of gene expression during early embryogenesis. Using SAC-seq (m6A-selective allyl chemical labeling and sequencing), an antibody-independent m6A profiling method, we generated the first single-nucleotide-resolution m6A map of bovine oocytes and preimplantation embryos. We observed both coordinated and uncoupled relationships between m6A modification and expression of protein-coding and noncoding genes. Integrative analysis of the transcriptome, m6A epitranscriptome, and translatome revealed dynamic m6A remodeling, particularly in ribosomal protein genes. Functional interrogation of a specific m6A site within the RPL12 transcript demonstrated that loss of this modification reduces protein synthesis, disrupts translation-related gene expression, impairs zygotic …

Lats1/2-Cd38 Metabolic Rewiring Links Senescence To Intraplaque Thrombosis, Sivareddy Kotla, Jonghae Lee, Kyung Ae Ko, Weiqing Chen, Venkata Subrahmanya Kumar Samanthapudi, Oanh Hoang, Gilbert F Mejia, Shengyu Li, Hani Lee, Aijun Zhang, Min Soon Cho, Keri L Schadler, Luis Antonio Rivera, Masaki Imanishi, Kay Carlene Tavares Samperio, Jung Hyun Kim, Kelia C Ostos-Mendoza, Karla N Mariscal-Reyes, Anita Deswal, John P Cooke, Keigi Fujiwara, Nicolas L Palaskas, Efstratios Koutroumpakis, Young Jin Gi, Rajneesh Pathania, Craig Morrell, Philip L Lorenzi, Lin Tan, Iqbal Mahmud, Nordin M J Hanssen, Vahid Afshar-Kharghan, Dale J Hamilton, Laurent Yvan-Charvet, Eduardo N Chini, Joerg Herrmann, Hernan G Vasquez, Ying H Shen, James F Martin, Haodong Xu, Erin H Seeley, Jared K Burks, Paul S Brookes, Guangyu Wang, Nhat-Tu Le, Jun-Ichi Abe

Faculty, Staff and Students Publications

Background: Atherothrombosis, which underlies most acute coronary syndromes and is driven by intraplaque thrombosis, preferentially occurs in regions of disturbed blood flow (d-flow). Although LATS1/2 (large tumor suppressor kinases 1 and 2) are known regulators of endothelial mechanotransduction, the mechanisms by which d-flow connects endothelial senescence, proliferation, and intraplaque thrombosis remain poorly understood.

Methods: We investigated endothelial cell (EC)-specific roles of Lats1/2 using inducible EC-specific knockout mice in a partial carotid ligation model. Spatial multiomics of human and mouse plaques was performed using imaging mass cytometry, COMET sequential immunofluorescence, and spatial metabolomics.

Results: Tamoxifen-induced deletion of both Lats1 and Lats2 …

Ct-Derived Epicardial Adipose Tissue Density And Its Association With Systemic Inflammation And Functional Impairment In Heart Failure With Preserved Ejection Fraction: A Prospective Cross-Sectional Study From Oman, Arif Albulushi, Ahmed Tawfek, Ahmed Basuoni

Journal of the Saudi Heart Association

Background: Heart failure with preserved ejection fraction (HFpEF) is strongly influenced by cardiometabolic comorbidity and systemic inflammation. Epicardial adipose tissue (EAT) is a biologically active visceral fat depot in direct contact with the myocardium, and CT-derived EAT density (attenuation) may reflect inflammatory adipose remodeling beyond adipose quantity alone. However, the clinical relevance of EAT density in HFpEF remains uncertain.

Objectives: To evaluate the association of CT-derived EAT density with systemic inflammatory biomarkers, functional capacity, health status, and echocardiographic indices of HFpEF severity in a prospective cross-sectional cohort.

Methods: In a prospective cross-sectional study conducted between January and July 2024 at …

Reducing Communicable-Disease Risk After Earthquakes: Vaccination And Prevention Lessons For Venezuela's Doublet, Wendy Moncada, Lili Vanessa Hernández-Serrano, Florencia Escarrá, Pasesa Pascuala Quispe-Torrez, Francisco Javier Membrillo, Tomás Orduna, Susana Lloveras, Tânia S S Chaves, Miguel M Cabada, Cecilia Perret, René Echavarría, Ana F Ribeiro, Melinda Tanabe, Fernando Bazzino, Maximiliano Ramirez, Baruch Diaz, Karen Mirna Loro Morejón, Karen Daly, Reinaldo Rosas, Maria Belen Lopez, Cristina Miranda, Marisa Liliana Fernandez, Yasemin Özsürekçi, Wasin Matsee, Yenddy Carrero, Cristian Biscayart, Sergio Cimerman, Maria L Avila-Aguero, Roberto Debbag, Jose Brea, Alejandro Risquez, Jaime David Acosta-España, Rolando Ulloa-Gutierrez, Carlos Espinal, Carlos N Torres-Martinez, Marta González-Sanz, Aula Abbara, Jill Weatherhead, Bernal Cordero, Virgilio Lezcano, Amanda Guerrero, Herberth Maldonado, Luis Cuellar, Ines Ceron, Yori Roque, Melisa Florentin, Rosa Infante, Ana Carvajal, Lily M Soto-Ávila, Marbelys Hernández, Hector Villaroel, Gianmary Miozzi, Rafael Navas, Moraima Hernández, Carlos Pérez-Vega, Manuela Mérida, David A Forero-Peña, Juan-Carlos Navarro, Claudia Beltrán-Arroyave, Mario Masana

Faculty, Staff and Students Publications

No abstract provided.

High-Order Brain Interactions During Ketamine-Induced State Changes: A Functional Marker Of Response In Late-Life Treatment-Resistant Depression?, Brittany O'Brien, Rahul Balakrishnan, Sanjay J Mathew, Nicholas Murphy

Faculty, Staff and Students Publications

Ketamine is a fast-acting intervention for treatment-resistant depression (TRD), yet only a subset of patients show robust clinical response, and the underlying neural mechanisms remain unclear. High-order interactions (HOI) derived from multivariate information theory provide a framework for examining nonlinear dependencies among brain regions beyond pairwise connectivity. One such metric, the O-information, captures the balance between synergistic and redundant interactions across three or more variables. In this secondary analysis of a randomized, double-blind, midazolam-controlled trial (NCT02556606), we examined EEG-derived HOI in 30 late-life veterans with TRD following a single 40-minute intravenous infusion of ketamine (0.1, 0.25, 0.5 mg/kg; n = …

Clinical Outcomes After Ulnar Collateral Ligament Reconstruction With Palmaris Longus Versus Gracilis Autograft In Baseball Players: A Cohort Analysis, Michael C. Ciccotti, Brooks Martino, Frank Cautela, Nathaniel Tchangou, Daniel Kwak, Eric Didomenico, Harrison S. Fellheimer, Christopher C. Dodson, Steven B. Cohen, Michael G. Ciccotti

Rothman Institute Papers

BACKGROUND: Ulnar collateral ligament (UCL) reconstruction (UCLR) is a common procedure for overhead athletes, particularly baseball players sustaining partial or full UCL tears. Palmaris longus (PL) and gracilis (GR) autografts are the most frequently used graft sources, yet limited data compare clinical outcomes in baseball athletes.

PURPOSE: To compare patient-reported outcomes after UCLR with PL versus GR autografts in baseball players.

STUDY DESIGN: Cohort study; Level of evidence, 3.

METHODS: Patients who underwent isolated UCLR with either PL or GR autograft and a minimum of 2 years of follow-up were identified. All reconstructions were performed using the Modified Jobe or …

Tranexamic Acid In High-Risk Shoulder Arthroplasty Patients: Safety Across Thromboembolic, Cardiac, Renal, And Neurologic Risk Profiles, Tarishi Parmar, Akin Adio, Asim Handy, Mohammad Daher, Alec Kellish, Adam Khan, Joseph A. Abboud

Rothman Institute Papers

INTRODUCTION: Tranexamic acid (TXA) effectively reduces blood loss and transfusion requirements in shoulder arthroplasty. However, concerns regarding thromboembolic, neurologic, cardiac, and renal complications have limited its use in medically high-risk patients. This study evaluated temporal trends and the safety of TXA in high-risk patients undergoing total shoulder arthroplasty (TSA).

METHODS: A retrospective cohort study was conducted using TriNetX, identifying patients who underwent shoulder arthroplasty (2012-2025). Patients were stratified by preexisting high-risk conditions, including prior thromboembolism, renal failure, atrial fibrillation, seizure disorders, and visual disturbances. Within each subgroup, patients receiving TXA were propensity score-matched to those who did not. Perioperative TXA …

Multiplexed Plasmon-Enhanced Lateral Flow Assay For Early Diagnosis Of Acute Kidney Injury, Ying Liu, Carissa Ng, Aquiles Payte, Jiaying Xu, Connor Malone, Jie Zhao, Kedhareswara Sairam Pasupuleti, Arda Aidan Arikan, Sameer Thadani, Srikanth Singamaneni, Ayse Akcan Arikan, Limei Tian

Faculty, Staff and Students Publications

Early diagnosis of acute kidney injury (AKI) remains a major clinical challenge due to the delayed and insensitive nature of conventional markers such as serum creatinine. Urinary protein biomarkers, including neutrophil gelatinase-associated lipocalin (NGAL) and cystatin C (CysC), provide earlier and complementary information on kidney injury, but their clinical translation is limited by the lack of rapid, quantitative, and multiplexed point-of-care (POC) diagnostic tests. Here, we report a multiplexed plasmonic-fluor-based lateral flow assay (p-LFA) that enables sensitive, quantitative, and simultaneous detection of NGAL and CysC. By harnessing ultrabright plasmonic-fluor nanolabels and ratiometric fluorescence analysis, the p-LFA achieves picogram-per-milliliter analytical sensitivity …

Hypoglossal Nerve Stimulation For Obstructive Sleep Apnea: A Systematic Review And Meta-Analysis On Responder-Based Outcomes And Between-Study Heterogeneity, Clemens Heiser, Marcel Braun, Colin Huntley, Michael Hutz, Thomas Michael Kaffenberger, Maurits Boon

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

Background: Hypoglossal nerve stimulation (HNS) is an established surgical therapy for adults with moderate-to-severe obstructive sleep apnea (OSA) who are intolerant to positive airway pressure. Although aggregate response rates of ~70–80% have been reported, substantial variability across clinical settings remains poorly understood. Prior meta-analyses have largely emphasized pooled continuous outcomes, limiting interpretation of responder-based endpoints and drivers of between-study heterogeneity. Methods: A PRISMA-compliant systematic review and meta-analysis was performed. MEDLINE, Embase, and Cochrane CENTRAL were searched from inception through 31 December 2025. Eligible studies enrolled adults with OSA treated with implantable HNS, reported Sher-defined response (≥50% AHI reduction and residual …

Clinical Validation Of A Novel Catheter-Tissue Contact Algorithm In Atrial Fibrillation Ablation Using Pulsed Field Ablation., Ankur Shah, Saanvi Billakanty, Andrew E Volio, Allyson Farrah, Andrea Robinson, Katelyn R Bennett, Arun K Tewari, Auroa Badin, David Nemer, Eugene Fu, Jaret Tyler, Anish K Amin, Nagesh Chopra

Heart and Vascular Articles

No abstract provided.

The Role Of Social Determinants Of Health In Hydroxyurea Adherence Among Persons With Sickle Cell Disease: A Systematic Review, Doreen O. Ugwu, Lori L. Vick, Terika Williams, Aurela Nikaj, Seyi Omeh, Benjamin Becerra Dr., Tilicia Mayo-Gamble

Journal of the Georgia Public Health Association

Objective: Georgia has one of the highest prevalences of sickle cell disease (SCD). For Georgians living with SCD, inadequate medication adherence is associated with important clinical outcomes. One important area that is understudied in SCD is the impact of social determinants of health (SDoH) on medication adherence. A foundational understanding of SDoH is needed to introduce, inform and carry out programs and interventions designed to facilitate hydroxyurea adherence through the state of Georgia.

Method: We conducted a systematic literature review to synthesize the literature on SDoH addressed in studies to improve hydroxyurea adherence in persons with SCD. SDoH were based …

Perspective On Lessons Not Learned: From Coley’S Toxins To Microbial Drug Delivery, Guidance For Institutional Review Boards (Irbs), Brian P. Hanley, Alejandro J. Betancourt, Gustavo Gross, Wilbur (Bo) Bowne

School of Medicine Publications

The bacterial and toxin methods of cancer treatment date back 130 years. This paradigm rests on nonspecific bacterial-toxin-generated immunotherapy. This high-risk oncology research is experiencing a renaissance of methods that are among the most effective yet. Glioblastomas and other resistant cancers are the modern touchpoint, because of remission history following sepsis. Spurred by recent research deaths, we discuss protocols IRBs should consider in live bacterial or synthetic immuno-stimulatory trials. Human systemic inflammatory response syndrome immunology is unique due to non-functioning SIGLEC-13 and 17, which control excessive Toll-like receptor 4 (TLR-4) signaling. This is not a technicality like human CD8+/CD4+ T …

Bi-Allelic Loss-Of-Function Variants In Tmem63b Cause Syndromic Surfactant Dysfunction Disorder, Mir Reza Bekheirnia, Lindsay C Burrage, Matthew Hoi Kin Chau, Chaerish Eint Myet Chae Htoo, Eric C Kao, Shamika Ketkar, Wan Wan Lim, Xi Luo, Rifhan Mazlan, Elizabeth Mizerik, Kein Seong Mun, Kalyani R Patel, Lorraine Potocki, Christina K Rapp, Xavier Roca, Ana Saianda, Ignacio Iglesias-Serrano, Everlyn C Siew, Donald Yuhui Sim, David R Spielberg, Sok-Kun Tae, Jing Xian Teo, Julian Warfsmann, Fan Xia, Child-Eu Registry, Saumya S Jamuar, Ee Shien Tan, Matthias Griese, Weng Khong Lim, Meow-Keong Thong, Keren Machol

Faculty, Staff and Students Publications

Transmembrane protein 63B gene (TMEM63B) encodes a mechanosensitive ion channel expressed in alveolar type II epithelial cells, where it mediates stretch-induced surfactant secretion. While heterozygous gain-of-function variants in TMEM63B have been associated with developmental and epileptic encephalopathy, no human disorder has previously been linked to bi-allelic loss-of-function variants. Here, we report five individuals from four unrelated families with childhood interstitial lung disease and bi-allelic predicted loss-of-function variants in TMEM63B. Affected individuals presented with early-onset respiratory distress, chronic hypoxemia, and diffuse parenchymal lung abnormalities on chest imaging. One individual died in infancy, two underwent bilateral lung transplantation, and two require oxygen …

The Medicine Forum Crossword, Youssef Elfatatry, Md

The Medicine Forum

ACROSS
1 One leading cause of ACS in young women

DOWN
1 A.O.A. alternative

The Parts They Don’T See, Alexis Notarianni, Md

The Medicine Forum

People think they know what resident doctors do.

They know the obvious parts: we examine patients, prescribe medications, and write notes. We diagnose infections, perform procedures, and coordinate care with nurses. We work long hours and rarely have days off. From the outside, it looks familiar enough to understand.

But there is a large portion of this job that is invisible, even to the people closest to us. It is difficult to explain, and harder still to feel understood unless you are living it.

More Than Medicine: How Advocacy, Education, And Loss Shape The Physician Within, Sheraz Qamar, Md

The Medicine Forum

Illness rarely unfolds in a linear or predictable way. Instead, it emerges through uncertainty – shaped by fragmented symptoms, gaps in access, and the limits of medical knowledge. Reflecting on three deeply personal experiences within my family, I have come to understand my role as a resident physician not only through clinical training, but through lived experience: as an advocate, an educator, and, at times, as someone profoundly affected by loss.

Holding Hands, Alexis Notarianni, Md

The Medicine Forum

My patient had already received the medications we reach for when patients are in pain and afraid — antiemetics, analgesics, and anxiolytics. The nasogastric tube was in place. What remained was not another intervention, but the simple act of being there.

My patient had been healthy until just months earlier, when his life changed abruptly. In the two hundred days since, illness had altered nearly every part of his body. Now he lay in bed in pain, breathing through a tracheostomy, receiving nutrition from a feeding tube. Tears streamed down his cheeks as he reached out and took my hand. …

Good Enough, Anne Leone, Md

The Medicine Forum

(Verse 1)
Coming out the gate a little too fast
This is not sustainable, it won’t last
Can’t turn around, I can’t backtrack
Where do I go from here
How can I maneuver this current

Ripping through and pulling me with it
Going under, air’s running out quick
but the shoreline is near

(Chorus)
Never knew that I could get through a patch so rough,
Never knew before that I was good enough,
The only thing holding me back was my own self doubt,
But I’ll let go now

(Verse 2)
hard to plan what steps to take next now …

An Examination Of Generative Ai In Medicine, J. Marco Cipriaso, Md, Trishya Srinivasan, Md

The Medicine Forum

The age of artificial intelligence (AI) is upon us. Specifically, generative AI has been transforming how we interface with the world by directly generating its own novel output.¹ Medicine is not immune to this change. AI search tools such as OpenEvidence have shown promise by providing evidence-based recommendations, already proven to perform well in primary care settings, with additional promise for future applications.² AI tools have taken over the note-writing process through ambient software, allowing physicians to dedicate more time to face-to-face interaction with their patients.³ These and other developments show clear reason to be excited about …

The Emotional Labor Of Clinicians And The Need For Reflective Support, Benedicta Olonilua, Bs, Evan Nardone, Md

The Medicine Forum

Physicians who work in Palliative Care or adjacent fields like Oncology often bear a unique emotional weight in addition to the typical responsibilities that come with the job. The nature of their work puts them in frequent contact with serious illness, dying, and grief. Additionally, they are often required to engage in conversations that are not only medically complex but also deeply personal and, at times, emotionally charged. While this emotional labor is an inherent part of the job, it can become especially heavy when there is no space to process it. Over time, this can build up and eventually …

Coping As A Team, J. Marco Cipriaso, Md

The Medicine Forum

“Medicine is the only job where someone can die, and you’re expected to go back to work, business as usual.” - Rachael Grosso MD

Methylene Blue As An Adjunctive Therapy In Refractory Septic Shock: A Case-Based Review Of Emerging Evidence, Warda Naqvi, Md, Paulina Lowery, Do, Enad Haddad, Md, Muneeba Ali, Md, Prerana Sevella, Md, Sudeep Nugooru, Md, Richard Friedenheim, Md

The Medicine Forum

Septic shock is associated with high mortality, particularly in patients who develop refractory vasoplegia despite guideline-directed therapy. Excess nitric oxide mediated vasodilation contributes to catecholamine resistance and persistent hypotension. Methylene blue (MB), an inhibitor of nitric oxide synthase and soluble guanylate cyclase, has emerged as a potential adjunctive therapy targeting this pathway. We report a case of a 36-year-old female presenting with severe septic shock secondary to aspiration pneumonia, complicated by profound hypoxemia requiring mechanical ventilation and veno-venous extracorporeal membrane oxygenation. Despite aggressive fluid resuscitation, broad-spectrum antibiotics, corticosteroids, and maximal vasopressor support, she remained hemodynamically unstable. Administration of intravenous MB …

The Intersection Of Ventilator Support And Hospice In Late Als Diagnosis, J. Marco Cipriaso, Md, Kenna Hawes, Md, Margot Noyelle, Md, Megan Cecchine, Md

The Medicine Forum

Amyotrophic lateral sclerosis (ALS) often leads to respiratory failure that can be treated with respiratory support in the form of tracheostomy plus invasive mechanical ventilation. It typically occurs late in the disease course, often allowing patients to adequately prepare by discussing their goals of care. We describe a case of a patient whose ALS was diagnosed after he had TMV initiated. As a result, the patient and family faced a daily decision on when to withdraw ventilator support, and he was unable to achieve his ultimate wish to die at home. We highlight this to recognize that serious illnesses with …

The Back Burn: A Case Report Of Mollaret’S Meningitis In A Young Male, Muneeba Ali, Md, Lubaba Mukhtar, Md, Warda Naqvi, Md, Joseph Hassey, Md, Muhammad Ayub, Md

The Medicine Forum

Mollaret’s syndrome, or benign recurrent aseptic meningitis, is a rare condition characterized by recurrent, self-limited episodes of aseptic meningitis. We present the case of a 49-year-old male with a past medical history of herpes meningitis as a teenager, who presented to the emergency department (ED) with a headache, and whose initial lumbar puncture results were consistent with viral meningitis. HSV-2 was detectable in cerebrospinal fluid (CSF) DNA by PCR but not detected on quantitative PCR. He was diagnosed with Mollaret’s meningitis, and all intravenous antiviral therapy was discontinued, with the patient making a full recovery. This case highlights the important …

Refractory Autoimmune Encephalitis In Metastatic Thymoma, Michael Predi, Do, Anna Bondonese, Md, Anish Vora, Md, Sarah W. Gordon, Do

The Medicine Forum

Thymoma-associated autoimmune encephalitis (TAAE) is a rare paraneoplastic neurological syndrome occurring in approximately 8% of thymoma patients. The condition results from thymic dysfunction leading to impaired T-cell selection and production of autoantibodies against neuronal antigens. Autoimmune encephalitis represents a severe but underrecognized complication with heterogeneous clinical presentations. Thymectomy has been shown to be the most effective treatment for TAAE.

Fever, Cytopenias, And Splenomegaly: A Hematologic Approach To Suspected Hlh In Autoimmune Liver Disease, Reed Firestone, Md, Ms

The Medicine Forum

Fever with cytopenias and splenomegaly raises concern for hematologic malignancy and hyperinflammatory syndromes such as hemophagocytic lymphohistiocytosis (HLH). Distinguishing these entities is critical, as management strategies differ significantly. In this report, we describe a 19-year-old male with autoimmune hepatitis–primary sclerosing cholangitis overlap who presented with one year of recurrent fevers, cytopenias, and splenomegaly. Extensive infectious and malignant workup, including PET imaging and bone marrow biopsy, were negative. HLH was considered; however, laboratory findings were inconsistent, including ferritin of 191 ng/mL and fibrinogen of 683 mg/dL. His course remained chronic and stable. The presentation was attributed to autoimmune liver disease with …

Delayed Immune-Related Ophthalmoplegia After Pembrolizumab Therapy: A Case Report, Mohammed Shah, Md, Smriti Nair, Md, Sarah Sulkowski, Md, Maheen Imran, Bs

The Medicine Forum

We present a case of Pembrolizumab-associated ophthalmoplegia in a patient with HNSCC who previously developed an immune checkpoint inhibitor associated hepatitis. Immune checkpoint inhibitor– associated ocular toxicities are rare, occurring in approximately <1% to 1.1% of treated patients.^1,2 This case highlights the diagnostic challenges of neuroophthalmic immune-related adverse events and the importance of prompt evaluation and immunosuppressive therapy.

Brain On Fire: A Case Of Severe Ifosfamide Encephalopathy And Utilization Of Methylene Blue, Nicholas Spyropoulos, Do, Michelle Joyner, Do

The Medicine Forum

Ifosfamide is a commonly used chemotherapeutic agent indicated for a variety of malignancies; however, given its well-documented complications including Ifosfamide induced encephalopathy (IFE), its overall use is limited. Neurotoxicity secondary to ifosfamide can range from mild confusion to severe neurologic deterioration, with the primary treatment being focused on supportive care. This clinical case highlights a 41-year-old patient with BRAF positive ameloblastic carcinoma who developed acute neurotoxic symptoms following ifosfamide chemotherapy induction. His symptoms, ranging from altered mental status, restlessness, severe headache, and peripheral neuropathy, began shortly after chemotherapy initiation. Both his lab work and imaging could not explain the acute …

Radiographic Imaging Of Power Injectable Medical Access Ports As A Supplemental Identification Tool, Nikhil Goyal, Md, Huy M. Do, Md, Alexandra P. Toscano, Bs, Lillian G. Spear, Bs Georgetown University, Lindsey A. Hazen, Rn, Les R. Folio, Do

The Medicine Forum

Medical access ports (MAPs) are implanted devices often used for intravenous administration of chemotherapeutic agents or contrast agents for CT or MR imaging. Improper MAP usage poses risk of catheter rupture; hence, proper identification and usage are essential. We demonstrate an approach for MAP identification based on their unique radiographic imaging features.

Large Language Models For Detecting Extraprostatic Extension In Free-Text Prostate Mri Radiology Reports, Nikhil Goyal, Md, Satvik Tripathi, Krishnan R. Patel, Md, Mhs, Hyun Tae Kim, Md, Mph, Tessa S. Cook, Md, Phd

The Medicine Forum

Extraprostatic extension (EPE) is a prognostically important pathologic feature of prostate cancer that is difficult to predict preoperatively. Because EPE may be microscopic, it may not be detected with conventional imaging. Several magnetic resonance imaging (MRI) features associated with EPE risk are routinely described in radiology reports and may be detectable by large language models (LLMs). This study evaluated the performance of five commercial LLMs (GPT-3.5-turbo, GPT-4, GPT-4o-mini, GPT-4o, and o3-mini) in classifying pathologic EPE from free-text prostate MRI reports for patients with confirmed prostate cancer. Among the models tested, o3-mini achieved the highest accuracy (66.3%) and positive predictive value …