{"id":"https://openalex.org/W7223287013","doi":"https://doi.org/10.3389/fonc.2026.1936989","title":"Dynamic contrast-enhanced MRI deep learning model combined with clinical model for noninvasive differentiation of hepatocellular carcinoma from mass-forming intrahepatic cholangiocarcinoma","display_name":"Dynamic contrast-enhanced MRI deep learning model combined with clinical model for noninvasive differentiation of hepatocellular carcinoma from mass-forming intrahepatic cholangiocarcinoma","publication_year":2026,"publication_date":"2026-10-23","ids":{"openalex":"https://openalex.org/W7223287013","doi":"https://doi.org/10.3389/fonc.2026.1936989"},"language":"en","primary_location":{"id":"doi:10.3389/fonc.2026.1936989","doi":"https://doi.org/10.3389/fonc.2026.1936989","is_oa":true,"landing_page_url":"https://doi.org/10.3389/fonc.2026.1936989","pdf_url":"https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2026.1936989/pdf","source":{"id":"https://openalex.org/S2596394214","display_name":"Frontiers in Oncology","issn_l":"2234-943X","issn":["2234-943X"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","norway-1","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320527","host_organization_name":"Frontiers Media","host_organization_lineage":["https://openalex.org/P4310320527"],"host_organization_lineage_names":["Frontiers Media"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Frontiers in Oncology","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","doaj"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2026.1936989/pdf","any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5158244191","display_name":"Huijie Zhang","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210152095","display_name":"Xinxiang Central Hospital","ror":"https://ror.org/006zn6z18","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210152095"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Huijie Zhang","raw_affiliation_strings":["Department of Medical Imaging, Xinxiang Central Hospital"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Medical Imaging, Xinxiang Central Hospital","institution_ids":["https://openalex.org/I4210152095"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5159349319","display_name":"Lijuan Guo","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I80626142","display_name":"Henan Medical University","ror":"https://ror.org/038hzq450","country_code":"CN","type":"education","lineage":["https://openalex.org/I80626142"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Lijuan Guo","raw_affiliation_strings":["Department of Nuclear Medicine, The First Affiliated Hospital of Henan Medical University"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Nuclear Medicine, The First Affiliated Hospital of Henan Medical University","institution_ids":["https://openalex.org/I80626142"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5103010544","display_name":"Fei Jia","orcid":"https://orcid.org/0009-0005-0676-4612","observed_orcids":["https://orcid.org/0009-0005-0676-4612"]},"institutions":[{"id":"https://openalex.org/I4210124531","display_name":"Lanzhou University Second Hospital","ror":"https://ror.org/02erhaz63","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210124531"]},{"id":"https://openalex.org/I76214153","display_name":"Lanzhou University","ror":"https://ror.org/01mkqqe32","country_code":"CN","type":"education","lineage":["https://openalex.org/I76214153"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Fei Jia","raw_affiliation_strings":["Department of Magnetic Resonance, The Second Hospital and Clinical Medical School, Lanzhou University","Gansu Medical MRI Equipment Application Industry Technology Center","Gansu Province Clinical Research Center for Functional and Molecular Imaging"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Magnetic Resonance, The Second Hospital and Clinical Medical School, Lanzhou University","institution_ids":["https://openalex.org/I4210124531","https://openalex.org/I76214153"]},{"raw_affiliation_string":"Gansu Medical MRI Equipment Application Industry Technology Center","institution_ids":[]},{"raw_affiliation_string":"Gansu Province Clinical Research Center for Functional and Molecular Imaging","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5121476737","display_name":"Wenling Liu","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I80626142","display_name":"Henan Medical University","ror":"https://ror.org/038hzq450","country_code":"CN","type":"education","lineage":["https://openalex.org/I80626142"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Wenling Liu","raw_affiliation_strings":["Department of Magnetic Resonance, The First Affiliated Hospital of Henan Medical University"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Magnetic Resonance, The First Affiliated Hospital of Henan Medical University","institution_ids":["https://openalex.org/I80626142"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5159299403","display_name":"Meng Zhang","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I80626142","display_name":"Henan Medical University","ror":"https://ror.org/038hzq450","country_code":"CN","type":"education","lineage":["https://openalex.org/I80626142"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Meng Zhang","raw_affiliation_strings":["Department of Magnetic Resonance, The First Affiliated Hospital of Henan Medical University"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Magnetic Resonance, The First Affiliated Hospital of Henan Medical University","institution_ids":["https://openalex.org/I80626142"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5025065561","display_name":"\u674e\u950b","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210152095","display_name":"Xinxiang Central Hospital","ror":"https://ror.org/006zn6z18","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210152095"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Feng Li","raw_affiliation_strings":["Department of Medical Imaging, Xinxiang Central Hospital"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Medical Imaging, Xinxiang Central Hospital","institution_ids":["https://openalex.org/I4210152095"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5159368985","display_name":"Jun Zhou","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210120234","display_name":"Zhongnan Hospital of Wuhan University","ror":"https://ror.org/01v5mqw79","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210120234"]}],"countries":["CN"],"is_corresponding":true,"raw_author_name":"Jun Zhou","raw_affiliation_strings":["Interventional Diagnostic and Therapeutic Center, Zhongnan Hospital of Wuhan University"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Interventional Diagnostic and Therapeutic Center, Zhongnan Hospital of Wuhan University","institution_ids":["https://openalex.org/I4210120234"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5016341229","display_name":"Baolin Wu","orcid":"https://orcid.org/0000-0003-4574-9747","observed_orcids":["https://orcid.org/0000-0003-4574-9747"]},"institutions":[{"id":"https://openalex.org/I4210089761","display_name":"West China Hospital of Sichuan University","ror":"https://ror.org/007mrxy13","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210089761"]}],"countries":["CN"],"is_corresponding":true,"raw_author_name":"Baolin Wu","raw_affiliation_strings":["Department of Radiology, Huaxi MR Research Center (HMRRC), Institute of Radiology and Medical Imaging, West China Hospital of Sichuan University","Psychoradiology Key Laboratory of Sichuan Province, West China Hospital of Sichuan University"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Radiology, Huaxi MR Research Center (HMRRC), Institute of Radiology and Medical Imaging, West China Hospital of Sichuan University","institution_ids":["https://openalex.org/I4210089761"]},{"raw_affiliation_string":"Psychoradiology Key Laboratory of Sichuan Province, West China Hospital of Sichuan University","institution_ids":["https://openalex.org/I4210089761"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":6,"corresponding_author_ids":["https://openalex.org/A5016341229","https://openalex.org/A5159368985"],"corresponding_institution_ids":["https://openalex.org/I4210089761","https://openalex.org/I4210120234"],"apc_list":{"value":3150,"currency":"CHF","value_usd":3801},"apc_paid":{"value":3150,"currency":"CHF","value_usd":3801},"fwci":0.0,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":{"value":0.77920344,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"16","issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T12422","display_name":"Radiomics and Machine Learning in Medical Imaging","score":0.6104000210762024,"subfield":{"id":"https://openalex.org/subfields/2741","display_name":"Radiology, Nuclear Medicine and Imaging"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T12422","display_name":"Radiomics and Machine Learning in Medical Imaging","score":0.6104000210762024,"subfield":{"id":"https://openalex.org/subfields/2741","display_name":"Radiology, Nuclear Medicine and Imaging"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11885","display_name":"MRI in cancer diagnosis","score":0.28760001063346863,"subfield":{"id":"https://openalex.org/subfields/2741","display_name":"Radiology, Nuclear Medicine and Imaging"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10862","display_name":"AI in cancer detection","score":0.04740000143647194,"subfield":{"id":"https://openalex.org/subfields/1702","display_name":"Artificial Intelligence"},"field":{"id":"https://openalex.org/fields/17","display_name":"Computer Science"},"domain":{"id":"https://openalex.org/domains/3","display_name":"Physical Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/hepatocellular-carcinoma","display_name":"hepatocellular carcinoma","score":0.9990000128746033},{"id":"https://openalex.org/keywords/dce-mri","display_name":"DCE-MRI","score":0.8799999952316284},{"id":"https://openalex.org/keywords/deep-learning","display_name":"deep learning","score":0.6589999794960022},{"id":"https://openalex.org/keywords/preoperative-differential-diagnosis","display_name":"preoperative differential diagnosis","score":0.7850000262260437},{"id":"https://openalex.org/keywords/non-invasive-diagnosis","display_name":"non-invasive diagnosis","score":0.6480000019073486},{"id":"https://openalex.org/keywords/liver-cancer","display_name":"liver cancer","score":0.4970000088214874}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.7775999903678894},{"id":"https://openalex.org/C2778019345","wikidata":"https://www.wikidata.org/wiki/Q1148337","display_name":"Hepatocellular carcinoma","level":2,"score":0.722000002861023},{"id":"https://openalex.org/C108583219","wikidata":"https://www.wikidata.org/wiki/Q197536","display_name":"Deep learning","level":2,"score":0.6901000142097473},{"id":"https://openalex.org/C2909135397","wikidata":"https://www.wikidata.org/wiki/Q124292","display_name":"Intrahepatic Cholangiocarcinoma","level":2,"score":0.6845999956130981},{"id":"https://openalex.org/C72563966","wikidata":"https://www.wikidata.org/wiki/Q1303415","display_name":"Cohort","level":2,"score":0.6761999726295471},{"id":"https://openalex.org/C143409427","wikidata":"https://www.wikidata.org/wiki/Q161238","display_name":"Magnetic resonance imaging","level":2,"score":0.5785999894142151},{"id":"https://openalex.org/C154945302","wikidata":"https://www.wikidata.org/wiki/Q11660","display_name":"Artificial intelligence","level":1,"score":0.5026000142097473},{"id":"https://openalex.org/C126838900","wikidata":"https://www.wikidata.org/wiki/Q77604","display_name":"Radiology","level":1,"score":0.4519999921321869},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.37779998779296875},{"id":"https://openalex.org/C143998085","wikidata":"https://www.wikidata.org/wiki/Q162555","display_name":"Oncology","level":1,"score":0.3716999888420105},{"id":"https://openalex.org/C2779185275","wikidata":"https://www.wikidata.org/wiki/Q2267963","display_name":"Selective internal radiation therapy","level":3,"score":0.3483000099658966},{"id":"https://openalex.org/C58471807","wikidata":"https://www.wikidata.org/wiki/Q327120","display_name":"Receiver operating characteristic","level":2,"score":0.3248000144958496},{"id":"https://openalex.org/C2779974597","wikidata":"https://www.wikidata.org/wiki/Q28448986","display_name":"Clinical Practice","level":2,"score":0.32100000977516174},{"id":"https://openalex.org/C121608353","wikidata":"https://www.wikidata.org/wiki/Q12078","display_name":"Cancer","level":2,"score":0.31929999589920044},{"id":"https://openalex.org/C50644808","wikidata":"https://www.wikidata.org/wiki/Q192776","display_name":"Artificial neural network","level":2,"score":0.28940001130104065},{"id":"https://openalex.org/C2776909242","wikidata":"https://www.wikidata.org/wiki/Q1514021","display_name":"Hepatectomy","level":3,"score":0.2890999913215637},{"id":"https://openalex.org/C119857082","wikidata":"https://www.wikidata.org/wiki/Q2539","display_name":"Machine learning","level":1,"score":0.28769999742507935},{"id":"https://openalex.org/C38180746","wikidata":"https://www.wikidata.org/wiki/Q1952580","display_name":"Multivariate analysis","level":2,"score":0.28360000252723694},{"id":"https://openalex.org/C2776231280","wikidata":"https://www.wikidata.org/wiki/Q623031","display_name":"Liver cancer","level":3,"score":0.28189998865127563},{"id":"https://openalex.org/C201903717","wikidata":"https://www.wikidata.org/wiki/Q1778788","display_name":"Cohort study","level":2,"score":0.2784999907016754}],"mesh":[],"locations_count":2,"locations":[{"id":"doi:10.3389/fonc.2026.1936989","doi":"https://doi.org/10.3389/fonc.2026.1936989","is_oa":true,"landing_page_url":"https://doi.org/10.3389/fonc.2026.1936989","pdf_url":"https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2026.1936989/pdf","source":{"id":"https://openalex.org/S2596394214","display_name":"Frontiers in Oncology","issn_l":"2234-943X","issn":["2234-943X"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","norway-1","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320527","host_organization_name":"Frontiers Media","host_organization_lineage":["https://openalex.org/P4310320527"],"host_organization_lineage_names":["Frontiers Media"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Frontiers in Oncology","raw_type":"journal-article"},{"id":"pmh:oai:doaj.org/article:419cb8be34eb4329b60b67a8cdcc8e3c","doi":null,"is_oa":false,"landing_page_url":"https://doaj.org/article/419cb8be34eb4329b60b67a8cdcc8e3c","pdf_url":null,"source":{"id":"https://openalex.org/S4306401280","display_name":"DOAJ (DOAJ: Directory of Open Access Journals)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Frontiers in Oncology, Vol 16 (2026)","raw_type":"article"}],"best_oa_location":{"id":"doi:10.3389/fonc.2026.1936989","doi":"https://doi.org/10.3389/fonc.2026.1936989","is_oa":true,"landing_page_url":"https://doi.org/10.3389/fonc.2026.1936989","pdf_url":"https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2026.1936989/pdf","source":{"id":"https://openalex.org/S2596394214","display_name":"Frontiers in Oncology","issn_l":"2234-943X","issn":["2234-943X"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","norway-1","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320527","host_organization_name":"Frontiers Media","host_organization_lineage":["https://openalex.org/P4310320527"],"host_organization_lineage_names":["Frontiers Media"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Frontiers in Oncology","raw_type":"journal-article"},"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being","score":0.98580002784729}],"study_designs":[],"awards":[],"funders":[],"has_content":{"pdf":true,"grobid_xml":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7223287013.pdf","grobid_xml":"https://content.openalex.org/works/W7223287013.grobid-xml"},"referenced_works_count":20,"referenced_works":["https://openalex.org/W1989565979","https://openalex.org/W2542061061","https://openalex.org/W2763355946","https://openalex.org/W2797875367","https://openalex.org/W2947683811","https://openalex.org/W3005876735","https://openalex.org/W3044997014","https://openalex.org/W4283015024","https://openalex.org/W4294838953","https://openalex.org/W4306803151","https://openalex.org/W4308946414","https://openalex.org/W4313402121","https://openalex.org/W4382795923","https://openalex.org/W4390519917","https://openalex.org/W4391348273","https://openalex.org/W4402038035","https://openalex.org/W4408883020","https://openalex.org/W4413137805","https://openalex.org/W4415243121","https://openalex.org/W7124278006"],"related_works":["https://openalex.org/W4391775460","https://openalex.org/W4406951726","https://openalex.org/W4413137805","https://openalex.org/W4414483677","https://openalex.org/W4391636458","https://openalex.org/W7204100399","https://openalex.org/W4396934779","https://openalex.org/W2941514461","https://openalex.org/W4416135667","https://openalex.org/W4389394546"],"abstract_inverted_index":{"Rationale":[0],"and":[1,33,53,57,72,93,111,115,169,202,238],"objectives":[2],"This":[3],"study":[4],"aims":[5],"to":[6,241],"develop":[7],"a":[8,65,142,181,283],"framework":[9],"integrating":[10,272],"dynamic":[11],"contrast-enhanced":[12],"magnetic":[13],"resonance":[14],"imaging":[15],"(DCE-MRI)-based":[16],"multi-channel":[17,123,182,210],"deep":[18,101,124,162,278],"learning":[19,102,125,163,173,279],"combined":[20],"with":[21,51,55,91,95,159,275],"clinical":[22,143,212,273],"modeling":[23],"for":[24,218,265,286],"the":[25,61,133,138,160,177,189,195,215,219,234,242,261],"non-invasive":[26],"preoperative":[27],"discrimination":[28,186],"between":[29],"hepatocellular":[30],"carcinoma":[31],"(HCC)":[32],"mass-forming":[34],"intrahepatic":[35],"cholangiocarcinoma":[36],"(MF-ICC).":[37],"Methods":[38],"The":[39,81,206,269],"internal":[40,74,196,235],"development":[41],"cohort":[42,67,76,85,245],"comprised":[43],"334":[44],"surgically":[45],"confirmed":[46],"patients,":[47,88],"including":[48],"231":[49],"patients":[50],"HCC":[52,92,222,289],"103":[54],"MF-ICC,":[56,224],"was":[58,127,145,156,167],"divided":[59],"at":[60],"patient":[62],"level":[63],"into":[64],"training":[66],"(":[68,77],"n":[69,78],"=":[70,79,192,247],"233)":[71],"an":[73,226],"validation":[75,84,197,236,244],"101).":[80],"independent":[82,149],"external":[83,243],"included":[86],"50":[87],"comprising":[89],"40":[90],"10":[94],"MF-ICC.":[96,291],"We":[97],"constructed":[98],"separate":[99],"two-dimensional":[100],"models":[103,119,262],"based":[104,147],"on":[105,148],"arterial":[106],"phase,":[107,110],"portal":[108],"venous":[109],"delayed":[112],"phase":[113],"images":[114,135,179],"then":[116],"developed":[117,129],"fusion":[118,204,270],"(2D":[120],"model).":[121],"A":[122],"model":[126,144,174,213,271],"further":[128],"by":[130],"directly":[131,175],"inputting":[132],"three-phase":[134,178],"stacked":[136],"along":[137],"channel":[139],"dimension.":[140],"Moreover,":[141],"built":[146],"predictors":[150,274],"identified":[151],"through":[152],"multivariate":[153],"analysis,":[154],"which":[155],"ultimately":[157],"integrated":[158],"best-performing":[161],"model.":[164],"Model":[165],"performance":[166,217],"evaluated":[168],"compared.":[170],"Results":[171],"Deep":[172],"feeding":[176],"as":[180],"input":[183],"achieved":[184],"better":[185],"(area":[187],"under":[188],"curve":[190],"[AUC]":[191],"0.814":[193],"in":[194,233,256],"cohort)":[198],"than":[199],"all":[200],"single-phase":[201],"corresponding":[203],"models.":[205],"comprehensive":[207],"2D":[208],"+":[209,211],"showed":[214],"best":[216],"differentiation":[220],"of":[221,228],"from":[223,290],"achieving":[225],"AUC":[227],"0.887":[229],"(95%":[230],"CI,":[231,250],"0.819\u20130.954)":[232],"cohort,":[237],"generalized":[239],"well":[240],"(AUC":[246],"0.908;":[248],"95%":[249],"0.811\u20131.000).":[251],"However,":[252],"no":[253],"significant":[254],"differences":[255],"AUCs":[257],"were":[258],"found":[259],"among":[260],"after":[263],"correction":[264],"multiple":[266],"comparisons.":[267],"Conclusion":[268],"DCE-MRI":[276],"multi-phase":[277],"feature":[280],"may":[281],"provide":[282],"valuable":[284],"tool":[285],"preoperatively":[287],"differentiating":[288]},"counts_by_year":[],"updated_date":"2026-10-26T11:51:55.731654","created_date":"2026-10-24T00:00:00"}
