scholarly journals Impact of region-of-interest size and location on quantitative contrast-enhanced ultrasound of canine splenic perfusion

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Simona Morabito ◽  
Simona Di Pietro ◽  
Luca Cicero ◽  
Annastella Falcone ◽  
Luigi Liotta ◽  
...  
Keyword(s):  
Quantitative Analysis ◽  
Regional Blood Flow ◽  
Mean Transit Time ◽  
Renal Perfusion ◽  
Contrast Enhanced Ultrasound ◽  
Time Intensity Curve ◽  
Optimal Method ◽  
Software Analysis ◽  
Splenic Parenchyma ◽  
Contrast Enhanced

Abstract Background During contrast enhanced ultrasound (CEUS), the features of the regions of interest (ROI) can affect the value of the perfusion-related parameters obtained from a time intensity curve (TIC). In veterinary medicine, conflicting have been reported on the influence of ROI size and location on renal CEUS. There are some disagreeing evidences regarding the optimal method for selecting ROI in quantitative analysis of renal perfusion using CEUS. The aim of this study was to evaluate the effect of the size and location of ROIs in the spleen of conscious dogs on perfusion variables determined using sulphur hexafluoride contrast-enhanced ultrasounds. Results A prospective observational study on 15 client-owned mixed-breed adult dogs was performed using a system equipped with contrast-tuned imaging technology. Qualitative and quantitative assessments of the spleen enhancement pattern were carried out. Three square ROIs (0.05 cm2) were manually drawn in a row and spaced 1 mm apart, placing adjacent ROIs at three different depths. Three medium rectangular ROIs (0.3 cm2) include the 3 smallest ROIs in each row, indicated by the letters A, B and C, and a single large square ROI (1 cm2) was drawn containing all previous ROIs. Software analysis of time-intensity curves generated within each ROI allowed us to calculate the perfusion-related parameters: peak enhancement, time to peak, regional blood flow, mean transit time and regional blood volume. The coefficient of variation for all blood-related parameters was always lower in the larger ROI than in the other smaller ROIs. ROI A and B, positioned proximally and medially, levels respectively, showed similar coefficients of variation to the largest ROI. The analysis of variance model exhibited a significant effect of location and size of the ROIs in the quantitative analysis of canine spleen perfusion, with a reduction of perfusion-related parameters in the distal ROI. Conclusions The recommendation for a quantitative CEUS examination of a dog’s spleen is to analyze splenic perfusion by drawing a sufficiently large ROI proximal to the ultrasound beam on the splenic parenchyma. This may be of clinical relevance in the diagnosis of splenic diseases.

scholarly journals Impact of Region- of-interest Size and Location on Quantitative Contrast-enhanced Ultrasound of Canine Splenic Perfusion

2020 ◽  
Author(s):  
Simona Morabito ◽  
Simona Di Pietro ◽  
Luca Cicero ◽  
Annastella Falcone ◽  
Luigi Liotta ◽  
...  
Keyword(s):  
Regional Blood Flow ◽  
Mean Transit Time ◽  
Clinical Importance ◽  
Region Of Interest ◽  
Contrast Enhanced Ultrasound ◽  
Software Analysis ◽  
Time To Peak ◽  
Splenic Parenchyma ◽  
Peak Enhancement ◽  
Contrast Enhanced

Abstract BackgroundDuring the contrast enhanced ultrasound (CEUS) the features of regions of interest (ROI) can affects the value of the perfusion parameters obtained from a time intensity curves (TIC). In veterinary medicine, the influence of ROI size and location during the CEUS exam has been described using the kidney as target organ, with contrasting results. No guidelines have been reported for the ideal placement or size of the ROI during the quantitative analysis of CEUS in canine spleen.The aim of this study was to evaluate the effect of the size and location of ROIs in the spleen of conscious dogs on perfusion variables determined using contrast-enhanced ultrasonography with sulphur hexafluoride. ResultsA prospective, observational study on 15 adult client-owned mixed-breed dogs was performed using a system equipped with contrast-tuned imaging technology. Qualitative and quantitative assessment of the enhancement pattern of the spleen were performed. Three square ROIs (0.05 cm2) were manually drawn in a row and spaced 1mm apart, placing adjacent ROIs at three different depths. Three medium rectangular ROIs (0.3 cm2 ) encompass the 3 smaller ROIs of each row and a single large square ROI (1 cm2) containing all the previous ROIs were drawn. Software analysis of generated time-intensity curves within each ROI allowed to calculate the perfusion parameters: peak enhancement, time to peak, regional blood flow and volume and mean transit time. The coefficient of variation for all parameters was always lowest in the largest ROI in comparison with the other smaller ROIs. The ROI A and B, positioned in proximal and middle levels respectively, showed coefficients of variation similar to the largest ROI. The analysis of variance model showed a significant effect of location and size of ROIs in the quantitative perfusion analysis of the canine spleen, with a reduction of perfusion parameters in the distal ROI.Conclusions The analysis of splenic perfusion through quantitative evaluation of enhancement with a contrast agent into a large enough and proximal to the ultrasound beam area of ​​splenic parenchyma may be of clinical importance in the diagnosis of splenic disorders.

scholarly journals Количественный анализ трансректального ультразвукового исследования с контрастным усилением в диагностике рака предстательной железы (индексы): предварительные результаты

2020 ◽  
pp. 12-25
Keyword(s):  
Prostate Cancer ◽  
Quantitative Analysis ◽  
Transit Time ◽  
Rise Time ◽  
Mean Transit Time ◽  
Contrast Enhanced Ultrasound ◽  
Time To Peak ◽  
Quantitative Parameters ◽  
Peak Intensity ◽  
Contrast Enhanced

Цель исследования - выявление наиболее информативных относительных количественных показателей (индексов) ТРУЗИ с КУ в диагностике РПЖ с использованием результатов прицельной биопсии под контролем ТРУЗИ. Материал и методы исследования: обследовано 75 пациентов с подозрением на рак предстательной железы по данным пальцевого ректального исследования и (или) повышением уровня общего простатспецифического антигена сыворотки крови. При этом обязательным условием было наличие гипоэхогенных очагов в периферической зоне предстательной железы. Всем пациентам проводилась системная и прицельная биопсия. Прицельная биопсия осуществлялась из гипоэхогенных очагов - зон интереса, которые были предварительно выбраны для количественного анализа контрастного усиления. В соответствии с морфологическими данными были выделены две группы очагов: 30 очагов в группе “РПЖ” (основная группа) и 45 очагов в группе “не РПЖ” (группа сравнения). ТРУЗИ выполнялись на аппарате Epiq 5 (Philips, Нидерланды) внутриполостным микроконвексным датчиком 4-10 МГц. Использовался ультразвуковой контрастный препарат Соновью (Bracco Swiss S.A., Швейцария). При анализе кривой “время-интенсивность” оценивались следующие безразмерностные индексы, представляющие собой отношение соответствующих абсолютных параметров в зоне интереса и эталонной зоне: индекс WIR (wash-in rate), индекс TTP (time to peak), индекс PI (peak intensity), индекс MTT (mean transit time), индекс TPH (time from peak to one half) и индекс RT (rise time). Результаты исследования: достоверные различия между группами получены по индексам WIR (P 0,0001), PI (P 0,0001), TTP (P = 0,0008) и RT (P = 0,0248). Тест “индекс PI > 1,174 - рак предстательной железы” характеризуется чувствительностью 83,3%, специфичностью 88,9%, предсказательной ценностью положительного теста 83,3%, предсказательной ценностью отрицательного теста 88,9%, AUC 0,910. Тест “индекс WIR > 1,432 - рак предстательной железы” характеризуется чувствительностью 76,7%, специфичностью 82,2%, предсказательной ценностью положительного теста 74,2%, предсказательной ценностью отрицательного теста 84,1%, AUC 0,808. Тест “индекс TTP ≤ 0,936 - рак предстательной железы” характеризуется чувствительностью 73,3%, специфичностью 66,7%, предсказательной ценностью положительного теста 59,5%, предсказательной ценностью отрицательного теста 78,9%, AUC 0,729. Определяется достоверная корреляция умеренной силы между суммой Глисона и индексом PI (rS = 0,394, P = 0,0311). Выводы: использование относительных параметров (индексов) количественного анализа трансректального ультразвукового исследования с контрастным усилением может привести к повышению эффективности прицельных биопсий. Индексы отличаются большей информативностью, чем абсолютные параметры. Ключевые слова: ультразвуковое исследование с контрастным усилением, количественный анализ, количественные относительные параметры, индексы, перфузия, предстательная железа, рак предстательной железы, contrast-enhanced ultrasound (CEUS), quantitative analysis, relative quantitative parameters, indices, perfusion, prostate, prostate cancer

Contrast-Enhanced Ultrasound for Early Prediction of Response of Breast Cancer to Neoadjuvant Chemotherapy

2018 ◽  
Vol 40 (02) ◽  
pp. 194-204 ◽  
Author(s):  
Youn Lee ◽  
Sung Kim ◽  
Bong Kang ◽  
Yun Kim
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Characteristic Curve ◽  
Mean Transit Time ◽  
Early Time ◽  
Early Prediction ◽  
Contrast Enhanced Ultrasound ◽  
Time Intensity Curve ◽  
Minor Response ◽  
Contrast Enhanced

Abstract Purpose To evaluate the time-intensity curve (TIC) parameters on contrast-enhanced ultrasound (CEUS) for early prediction of the response of breast cancer to neoadjuvant chemotherapy (NAC). Materials and Methods This prospective study included 41 patients with breast cancer. CEUS was performed before and after the first cycle of NAC. TIC parameters were analyzed for different regions of interest (ROIs). ROI 1 targeted the hotspot area of greatest enhancement, ROI 2 delineated the area of hyperenhancement, ROI 3 included the entire tumor on grayscale ultrasound, and ROI 4 encircled the normal parenchyma. The TIC perfusion values for ROI 1, 2, and 3 were divided by the ROI 4 value. Results 11 (26.8 %) of the 41 patients showed a good response (Miller-Payne score 4 or 5) and 30 (73.2 %) showed a minor response (Miller-Payne score 1, 2, or 3). There were significant differences in the wash-out area under the curve, the wash-in and wash-out areas under the curve on ROI 1/4 after the first cycle of NAC, pre-NAC mean transit time local (mTTl) on ROI 2/4, and pre-NAC mTTl on ROI 3/4 between good and minor responders (area under the receiver-operating characteristic curve > 0.70, p < 0.05). Conclusion Some TIC parameters obtained by CEUS may allow prediction of the response of breast cancer to NAC at a very early time point.

scholarly journals Contrast-enhanced ultrasound evaluation of testicular interstitial cell tumours in conscious non-sedated dogs

2018 ◽  
Vol 63 (No. 3) ◽  
pp. 125-130 ◽  
Author(s):  
M. Quartuccio ◽  
C. Mangano ◽  
F. Macri ◽  
M. Rizzo ◽  
S. Di Pietro ◽  
...  
Keyword(s):  
Interstitial Cell ◽  
Regional Blood Flow ◽  
Mean Transit Time ◽  
Cell Tumour ◽  
Surrounding Tissue ◽  
Histological Evaluation ◽  
Single Type ◽  
Contrast Enhanced Ultrasound ◽  
Ultrasound Evaluation ◽  
Contrast Enhanced

Testicular tumours are the most common neoplasms of the genital system in male dogs. The three main types reported in dogs are interstitial cell tumour, seminoma and Sertoli cell tumour. Interstitial cell tumour is related to the presence of single or multiple nodules inside the testicular parenchyma, and it is detected by palpation or is often an incidental finding during ultrasonography examination. Contrast-enhanced ultrasound allows characterisation of the perfusion of the testicular lesion and reveals the micro-vascularisation; however, perfusion parameters may be strongly influenced by sedative drug administration, so our aim was to evaluate qualitative and quantitative perfusion of a single type of tumour (interstitial cell tumour) with contrast-enhanced ultrasound in conscious dogs to exclude any influence of pharmacological agents on vascular flow. Thirty dogs with focal testicular lesions found by palpation and/or by ultrasound (B-mode and Doppler) examination were selected; contrast-enhanced ultrasound was performed only in subjects that presented testicular focal lesions. After orchiectomy, testes were submitted to histological evaluation; 2-minute clips recorded during contrast-enhanced ultrasound were analysed only in the case of dogs with interstitial cell tumours (n = 12). Contrast medium showed wash-in at around 25–30 seconds, at the same time as the surrounding tissue: lesions were hyperenhancing, homogeneous or inhomogeneous with rim enhancement and contained prominent inner vessels; however, enhancement of small regions was absent. Quantitative analysis demonstrated significantly higher PI% (P = 0.005), regional blood volume (P = 0.02) and regional blood flow (P = 0.007) values in lesions than in surrounding tissue; no differences were found for time-to-peak and mean transit time. In conclusion, the contrast-enhanced ultrasound pattern observed in conscious non-sedated dogs with interstitial cell tumour was similar to the pattern described in a previous study in dogs after intramuscular administration of medetomidine (10 µg/kg) and butorphanol (0.2 mg/kg).

scholarly journals Количественный анализ трансректального ультразвукового исследования с контрастным усилением в диагностике рака предстательной железы (абсолютные параметры): предварительные результаты

2020 ◽  
pp. 13-26
Keyword(s):  
Prostate Cancer ◽  
Quantitative Analysis ◽  
Transit Time ◽  
Rise Time ◽  
Mean Transit Time ◽  
Contrast Enhanced Ultrasound ◽  
Time To Peak ◽  
Peak Intensity ◽  
Contrast Enhanced

Цель исследования - выявление наиболее информативных абсолютных количественных показателей трансректального ультразвукового исследования с контрастным усилением в диагностике рака предстательной железы. Обследовано 75 пациентов с подозрением на рак предстательной железы. Критериями включения являлись подозрительные результаты пальце вого ректального исследования и (или) повышение уровня общего простатспецифического антигена сыворотки крови при наличии подозрительных (гипоэхогенных) очагов в периферической зоне ПЖ, выявленных при серошкальном ТРУЗИ. Во всех случаях трансректальное ультразвуковое исследование с контрастным усилением было выполнено до установления окончательного диагноза. Ультразвуковые исследования выполнялись на аппарате Epiq 5 (Philips, Нидерланды) с помощью высокочастотного внутриполостного датчика, работающего в диапазоне частот 4-10 МГц. Использовался ультразвуковой контрастный препарат Соновью (Bracco Swiss S.A., Швейцария). Прицельная биопсия осуществлялась из гипоэхогенных очагов - зон интереса, которые были предварительно выбраны для количественного анализа контрастного усиления. В зависимости от результатов гистологического исследования материала, полученного при помощи прицельной биопсии, исследуемые очаги были распределены на две группы: основная группа (РПЖ), включающая верифицированный рак предстательной железы в зоне интереса (n = 30), и группа сравнения (не РПЖ), включающая отсутствие верификации рака предстательной железы в зоне интереса (n = 45). При анализе кривой “время-интенсивность” оценивались следующие параметры: 1) скорость нарастания (WIR (wash-in rate)) (дБ/с); 2) время до пика интенсивности (TTP (time to peak)) (с); 3) пиковая интенсивность (PI (peak intensity)) (дБ); 4) среднее время транзита (MTT (mean transit time)) (с); 5) время полувыведения (DT/2 (descending time/2)) (с); 6) время роста (RT (rise time)) (с). Достоверные различия в зонах интереса между группами получены по пара метрам WIR (P = 0,0026) и RT (P = 0,0047). Тест “WIR > 2,114 дБ/с - рак предстательной железы” характеризуется чувствительностью 50,0%, специфичностью 84,4%, предсказательной ценностью положительного теста 68,2%, предска зательной ценностью отрицательного теста 71,7%, AUC 0,706. Тест “RT ≤ 6,718 с - рак предстательной железы” характеризуется чувствительностью 70,0%, специфичностью 66,7%, предсказательной ценностью положительного теста 58,3%, предсказательной ценностью отрицательного теста 76,9%, AUC 0,694. Определяются достоверные корреляции суммы Глисона с WIR (rS = 0,521, P = 0,0032), TTP (rS = -0,503, P = 0,0046) и PI (rS = 0,378, P = 0,0393). Использование абсолютных параметров количественного анализа трансректального ультразвукового исследования с контрастным усилением может привести к повышению эффективности прицельных биопсий. Ключевые слова: трансректальное ультразвуковое исследование с контрастным усилением, количественный анализ, перфузия, предстательная железа, рак предстательной железы, contrast-enhanced ultrasound (CEUS), quantitative analysis, perfusion, prostate, prostate cancer

Contrast-Enhanced Ultrasound for Early Prediction of Response of Breast Cancer to Neoadjuvant Chemotherapy

2019 ◽  
Vol 16 (04) ◽  
pp. 302-312
Author(s):  
Youn Joo Lee ◽  
Sung Hun Kim ◽  
Bong Joo Kang ◽  
Yun Ju Kim
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Characteristic Curve ◽  
Mean Transit Time ◽  
Early Time ◽  
Early Prediction ◽  
Contrast Enhanced Ultrasound ◽  
Time Intensity Curve ◽  
Minor Response ◽  
Contrast Enhanced

Abstract Purpose To evaluate the time-intensity curve (TIC) parameters on contrast-enhanced ultrasound (CEUS) for early prediction of the response of breast cancer to neoadjuvant chemotherapy (NAC). Materials and Methods This prospective study included 41 patients with breast cancer. CEUS was performed before and after the first cycle of NAC. TIC parameters were analyzed for different regions of interest (ROIs). ROI 1 targeted the hotspot area of greatest enhancement, ROI 2 delineated the area of hyperenhancement, ROI 3 included the entire tumor on grayscale ultrasound, and ROI 4 encircled the normal parenchyma. The TIC perfusion values for ROI 1, 2, and 3 were divided by the ROI 4 value. Results 11 (26.8 %) of the 41 patients showed a good response (Miller-Payne score 4 or 5) and 30 (73.2 %) showed a minor response (Miller-Payne score 1, 2, or 3). There were significant differences in the wash-out area under the curve, the wash-in and wash-out areas under the curve on ROI 1/4 after the first cycle of NAC, pre-NAC mean transit time local (mTTl) on ROI 2/4, and pre-NAC mTTl on ROI 3/4 between good and minor responders (area under the receiver-operating characteristic curve > 0.70, p < 0.05). Conclusion Some TIC parameters obtained by CEUS may allow prediction of the response of breast cancer to NAC at a very early time point.

scholarly journals The Value of the Model and Quantitative Parameters of Contrast-Enhanced Ultrasound in Judging the Severity of SHPT

2016 ◽  
Vol 2016 ◽  
pp. 1-5
Author(s):  
Xing-xin Liang ◽  
Fan Li ◽  
Feng Gao ◽  
Yang Liu ◽  
Xiao-hui Qiao ◽  
...  
Keyword(s):  
Arrival Time ◽  
Statistical Significance ◽  
Mean Transit Time ◽  
Contrast Enhanced Ultrasound ◽  
Intensity Curve ◽  
Time Intensity Curve ◽  
Time To Peak ◽  
Quantitative Parameters ◽  
Contrast Enhanced ◽  
Two Phases

Using the model and quantitative parameters of contrast-enhanced ultrasound (CEUS) to assess the severity of secondary hyperparathyroidism (SHPT) was proposed. 42 SHPT patients who underwent CEUS examination were divided into three groups, light, moderate, and heavy as per parathyroid hormone (PTH). The process of CEUS was divided into two phases, wash-in phase and wash-out phase. The three groups were analyzed with their enhancing model in the two phases. The quantitative parameters of CEUS such as Arrival Time (AT), Time to Peak (TTP), Mean Transit Time (MTT), and Maximum Intensity (IMAX) were measured by time-intensity curve (TIC) and compared among the three groups. The enhancing model of light SHPT, moderate SHPT, and heavy SHPT showed statistical significance in wash-in phase and wash-out phase (P<0.05). No difference was observed in AT and TTP among the three groups (P>0.05) while MTT and IMAX showed statistical significance (P<0.05). The CEUS of light SHPT was characterized by “slow-in, fast-out, and lower-enhancement” with short enhancement time; the CEUS of moderate SHPT was characterized by “fast-in, fast-out, and higher-enhancement” with slightly long enhancement time; the CEUS of heavy SHPT was characterized by “fast-in, slow-out, and higher-enhancement” with long enhancement time. Therefore, the model and quantitative parameters of CEUS can be benefit for the assessment of the severity of SHPT.

Interobserver reproducibility of contrast-enhanced ultrasound in diabetic nephropathy

2021 ◽  
Author(s):  
Lin Lin ◽  
Yiru Wang ◽  
Lin Yan ◽  
Nan Li ◽  
Xiaoqi Tian ◽  
...  
Keyword(s):  
Diabetic Nephropathy ◽  
Mean Transit Time ◽  
Left Kidney ◽  
Intraclass Correlation ◽  
Renal Perfusion ◽  
Peak Time ◽  
Contrast Enhanced Ultrasound ◽  
Interobserver Reproducibility ◽  
Contrast Enhanced ◽  
The Right

Objective: To investigate the interobserver reproducibility of contrast-enhanced ultrasound (CEUS) in patients with diabetic nephropathy. Methods: A total of 40 patients with diabetic nephropathy were enrolled in this retrospective study. We measured peak intensity (PEAK), time-to-peak (TP), area under the curve (AUC) and mean transit time (MTT) of renal CEUS in each patient. Each parameter was performed by two independent observers. The interobserver reproducibility was assessed using intraclass correlation coefficients (ICCs) with 95% confidence intervals (CIs) and Bland–Altman plots by mean difference with 95% limits of agreement (LOAs). Results: The parameters of the left and right kidneys showed moderate or good reliability. The best was the left kidney AUC parameters (ICC,0.945),with a 95% CI of 0.896–0.971.The Bland–Altman plots showed that the mean differences between the right renal parameters (PEAK, TP, AUC and MTT) obtained between the observers 1 and 2 were −6.63%,2.54%,−11.30%,−2.22%, and the 95% LOAs are −30.78 to 17.52%, −30.15 to 35.23%, −43.95 to 21.35%, −44.50 to 40.06%. While the left ones were −2.89%, 0.32%, −8.26%, 1.25% , and the 95% LOAs were −38.50 to 32.72%, −31.98 to 32.62%, −57.89 to 41.37%, −37.21 to 39.71%, respectively. Conclusion: Quantitative CEUS can show good interobserver reproducibility, which is better for the right kidney. It seems necessary to establish standardized techniques for obtaining contrast-enhanced quantitative analysis of renal blood perfusion. Advances in knowledge: Quantitative assessment of renal perfusion by CEUS in patients with diabetic nephropathy provides diagnostic information. Furthermore, renal perfusion assessment in patients with diabetic nephropathy using CEUS has good reproducibility.

scholarly journals Diagnosis of parotid gland tumours with Contrast-Enhanced Ultrasound: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Salahaden R Sultan ◽  
Mohammed AlKharaiji ◽  
Shahad H Rajab
Keyword(s):  
Parotid Gland ◽  
Meta Analysis ◽  
Mean Transit Time ◽  
Cochrane Review ◽  
Contrast Enhanced Ultrasound ◽  
Malignant Tumours ◽  
Time Intensity Curve ◽  
Eligibility Criteria ◽  
Contrast Enhanced ◽  
Parotid Gland Tumours

Aim: Contrast-enhanced ultrasound (CEUS) appears to be a promising application for the diagnosis of parotid gland tumours. We aimed to systematically review and meta-analyse the ability of CEUS in distinguishing benign from malignant parotid gland tumours.Material and methods: PubMed was searched for relevant studies. Data on area under time intensity curve (AUC) in arbitrary unit (AU), and mean transit time (MTT) in seconds (sec) were analysed using the Cochrane Review Manager Software.Results: Nine studies met the eligibility criteria comprising a total number of 498 parotid gland tumours (benign, number (n)=423; malignant, n=75). Descriptive evaluation of parotid gland tumours following CEUS administration showed overlap characteristics in benign and malignancies. Two publications assessed AUC and MTT in 72 and 60 parotid gland tumours, respectively. AUC was significantly lower in benign compared to malignant tumours following contrast administration (AUC, mean difference (MD) -266.77 AU, 95% confidence intervals (CI) -433.22, -100.33, p=0.002). No significant different in MTT between benign and malignant tumours (p=0.12). Heterogeneity was statistically significant in AUC (p=0.04) and MTT (p<0.00001).Conclusion: Descriptive evaluation of parotid gland tumours showed overlap CEUS characteristics. Perfusion related CEUS parameters analysis is promising in differentiating benign parotid tumours from malignancies.

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