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Purpose To evaluate the predictive value of myosteatosis as an opportunistic finding in coronary artery calcium (CAC) CT scans for clinically diagnosed chronic obstructive pulmonary disease (COPD) and compare it with an artificial intelligence (AI)-measured biomarker of emphysema derived from the same scans. Materials and Methods In this prospective study, baseline CAC CT scans and 20-year follow-up data were analyzed. Myosteatosis was defined as the lowest quartile of thoracic skeletal muscle mean attenuation (males < 33.5 HU, females < 27.0 HU). The emphysema-like lung biomarker was quantified as the percentage of lung voxels below -950 HU in CAC CT scans. COPD was identified using the International Classification of Diseases, Ninth Revision, Clinical Modification, and International Classification of Diseases, 10th Revision, Clinical Modification diagnostic codes from hospital discharge records. Hazard ratios (HRs) for COPD were calculated using proportional hazard regression models, comparing the bottom versus top quartiles of myosteatosis and emphysema-like lung measurements. Results Among 5535 participants in the Multi-Ethnic Study of Atherosclerosis (mean age ± SD, 62.2 years ± 10.3, 47.6% males), 396 (7.1%) were diagnosed with COPD over the 20-year follow-up period. Myosteatosis showed a stronger association with COPD than emphysema (unadjusted HRs, 5.98 [95% CI: 4.14, 8.63] and 2.12 [95% CI: 1.61, 2.78], respectively [P < .001]). After adjusting for covariates (age, sex, smoking status, body mass index, race, asthma, physical activity, inflammatory markers, and insulin resistance), the HRs were reduced to 2.74 (95% CI: 1.81, 4.16) and 1.50 (95% CI: 1.12, 2.00), respectively (P = .02). Conclusion AI-measured myosteatosis in CAC CT scans strongly predicted future diagnosed COPD independently of known risk factors. Keywords: Applications-CT, Pulmonary, Thorax, Adipose Tissue (Obesity Studies), Chronic Obstructive Pulmonary Disease, Metabolic Disorders, Myosteatosis, Coronary Artery Calcium Scan, Emphysema, AI-CVD ClinicalTrials.gov: NCT00005487 Supplemental material is available for this article. © The Author(s) 2026. Published by the Radiological Society of North America under a CC BY 4.0 license.
Metastasis is an inefficient cellular process in which most disseminated tumor cells fail to form secondary lesions in distant tissues due to hostile conditions, such as protective immune surveillance. The few cells that survive these threats can seed subclinical metastatic lesions, known as micrometastases, which are the least-known stage of the metastatic cascade. In this study, we review micrometastasis immunobiology, which differs from that of larger, clinically manifested metastasis. Key mechanisms such as epithelial-to-mesenchymal transition, stemness, dormancy, and immune evasion shape this bottleneck of metastasis, determining long-term disease evolution, therapy responses, and patient outcomes. Understanding micrometastasis immunology may reveal therapeutic opportunities to fully eradicate disseminated cells. Thus, we discuss emerging time-tailored immunopreventive strategies to intercept the progression to overt metastasis.
Plasma phosphorylated tau-217 (pTau-217) has emerged as a sensitive biomarker for early Alzheimer's disease (AD) pathology, including the cognitively healthy (CH) stage when compensatory frontal activity has been reported. This study focused on hemodynamic changes measured using functional near-infrared spectroscopy (fNIRS) in the prefrontal cortex (PFC) in CH older adults. The fNIRS data from 41 CH older adults during resting state, as well as during a color-word Stroop interference task were analyzed. Primary measures included oxyhemoglobin (HbO) responses at left lateral, left medium, right medium, and right lateral PFC regions, exploratory measures included heart rate, Weighted Phase Lag Index (wPLI) for functional connectivity (FC), and correlation between HbO and heart rate (HR) to assess heart–brain coupling. The study revealed that compared to low tertile group, individuals with high tertile pTau-217 exhibited slower response times during the task and region-specific hemodynamic changes - reduced HbO during eyes-open rest (FDR-adjusted p = 0.037) but increased activation during Stroop congruent trials (False Discovery Rate (FDR)-adjusted p < 0.0001), which are supported by sensitivity analysis. Additionally, high tertile pTau-217 group showed strong positive correlation between post-task HR and right-lateral prefrontal HbO (ρ = 0.85, p < 0.001) versus a negative correlation in the low tertile group (ρ = −0.55, p = 0.043) and attenuated interhemispheric synchronization by FC (measured by wPLI), particularly during eyes-open resting state. Overall, the primary findings demonstrate pTau-217-associated differences in prefrontal hemodynamic responses, while the exploratory heart–brain coupling and FC findings are hypothesis-generating and require independent validation. Larger and more diverse cohorts are needed to confirm and generalize these findings.
