Background Magnetic resonance imaging (MRI) is key in evaluating central cartilage tumors. The BACTIP (Birmingham Atypical Cartilaginous Tumour Imaging Protocol) protocol assesses central cartilage tumor risk based on the tumor size and degree of endosteal scalloping on MRI. It provides a management protocol for assessment, follow-up, or referral of central cartilage tumors. Objective Our study compared four MRI sequences: T1-weighted (T1-w), fluid sensitive (Short Tau Inversion Recovery (STIR)- weighted, STIR-w), and grayscale inversions (T1-w GSI and short tau inversion recovery [STIR] GSI) to see how reliably endosteal scalloping was detected. Materials and Methods Two senior consultant musculoskeletal radiologists with experience reviewed randomly selected 60 representative central cartilage tumor cases with varying degree of endosteal scalloping to reflect a spectrum of BACTIP pathologies. The endosteal scalloping was graded as per the definition of BACTIP A, B, and C. They agreed on a consensus BACTIP grade for each of the 240 key images (60 cases x 4 sequences), which was considered the final "consensus" BACTIP grade. These 240 images were then randomized into a test set and given to two fellowship-trained consultant musculoskeletal radiologists for analysis. They assigned a BACTIP grade to each of the 240 selected images while being blinded to the final "consensus" BACTIP grade. The training set was further subdivided into three groups based on the MR image quality (good quality, average quality, and poor quality) to ascertain if the quality of the acquired images influenced intraobserver and interobserver agreements on the BACTIP grading. The two observers were blinded to the grade assigned to the image quality. Results Linearly weighted kappa analysis was performed to measure the agreement between the BACTIP grading answers by two observers and the "consensus" BACTIP grading answers, as well as the BACTIP grading agreement between the two observers themselves. The analysis revealed that T1-w and STIR-w sequences demonstrated more consistent and higher agreement across different image qualities. However, the T1-w GSI and STIR-w GSI sequences exhibited lower agreement, particularly for poor-quality images. T1-w imaging demonstrated substantial agreement between BACTIP gradings for poor-quality images, suggesting potential resilience of T1-w sequence in challenging imaging conditions. Conclusion T1-w imaging is the best sequence for BACTIP grading of endosteal scalloping, followed by fluid-sensitive STIR sequences.

BACKGROUND:Peer review is the established method for evaluating the quality and validity of research manuscripts in scholarly publishing. However, scientific peer review faces challenges as the volume of submitted research has steadily increased in recent years. Time constraints and peer review quality assurance can place burdens on reviewers, potentially discouraging their participation. Some artificial intelligence (AI) tools might assist in relieving these pressures. This study explores the efficiency and effectiveness of one of the artificial intelligence (AI) chatbots, ChatGPT (Generative Pre-trained Transformer), in the peer review process.METHODS:Twenty-one peer-reviewed research articles were anonymised to ensure unbiased evaluation. Each article was reviewed by two humans and by versions 3.5 and 4.0 of ChatGPT. The AI was instructed to provide three positive and three negative comments on the articles and recommend whether they should be accepted or rejected. The human and AI results were compared using a 5-point Likert scale to determine the level of agreement. The correlation between ChatGPT responses and the acceptance or rejection of the papers was also examined.RESULTS:Subjective review similarity between human reviewers and ChatGPT showed a mean score of 3.6/5 for ChatGPT 3.5 and 3.76/5 for ChatGPT 4.0. The correlation between human and AI review scores was statistically significant for ChatGPT 3.5, but not for ChatGPT 4.0.CONCLUSION:ChatGPT can complement human scientific peer review, enhancing efficiency and promptness in the editorial process. However, a fully automated AI review process is currently not advisable, and ChatGPT's role should be regarded as highly constrained for the present and near future.

Objective To report the incidence of indeterminate pulmonary nodules (IPN) and the rate of progression of IPNs to metastasis in patients with primary bone cancers. We also aimed to evaluate clinical or radiological parameters that may identify IPNs more likely to progress to metastatic disease and their effect on overall or event-free survival in patients with primary bone sarcoma. Methods A systematic search of the electronic databases Medline, Embase, and Cochrane Library was undertaken for eligible articles on IPNs in patients with primary bone sarcomas, published in the English language from inception of the databases to 2023. The Newcastle-Ottawa Quality Assessment Form for Cohort Studies was utilized to evaluate risk of bias in included studies. Results Six studies, involving 1667 patients, were included in this systematic review. Pooled quantitative analysis found the rate of incidence of IPN to be 18.1% (302 out of 1667) and the rate of progression to metastasis to be 45.0% (136 out of 302). Nodule size (more than 5 mm diameter), number (more than or equal to 4), distribution (bilaterally distributed), incomplete calcification, and lobulated margins were associated with an increased likelihood of IPNs progressing to metastasis, however, their impact on overall or event-free survival remains unclear. Conclusion The risk of IPNs progressing to metastasis in patients with primary bone sarcoma is non-negligible. Large IPNs have a high risk to be an actual metastasis. We suggest that IPNs in these patients be followed up for a minimum of 2 years with CT imaging at 3, 6, and 12 month intervals, particularly for nodules measuring >5 mm in average diameter. Advances in knowledge This is the first systematic review on IPNs in patients with primary bone sarcomas only and proposes viable management strategies for such patients.