Autoimmune enteropathy (AIE) is an autoimmune disease with unclear pathophysiological mechanisms. It was more commonly observed in children but is increasingly diagnosed in adults. AIE is primarily characterized by chronic diarrhea, malabsorption and villous atrophy in the small intestine. Diagnosis is primarily based on pathological findings. Most patients respond well to corticosteroid therapy. This report presents a patient of AIE with diarrhea as the main symptom. After developing steroid dependence, the patient was switched to ustekinumab and achieved satisfactory therapeutic outcomes.

Autoimmune enteropathy (AIE) is an autoimmune disease with unclear pathophysiological mechanisms. It was more commonly observed in children but is increasingly diagnosed in adults. AIE is primarily characterized by chronic diarrhea, malabsorption and villous atrophy in the small intestine. Diagnosis is primarily based on pathological findings. Most patients respond well to corticosteroid therapy. This report presents a patient of AIE with diarrhea as the main symptom. After developing steroid dependence, the patient was switched to ustekinumab and achieved satisfactory therapeutic outcomes.

Objective To explore the application effect of artifact removal technique of Discovery RT (GE Inc) in organ segmentation and radiotherapy planning. Methods Twelve patients with head and neck tumors carrying irremovable metal dentures,who received radiotherapy at the Fourth Affiliated Hospital of Nanjing Medical University from September 2021 to February 2024,were enrolled in the study. AccuContour was used to perform organs-at-risk (OAR) segmentations separately on CT image processed by metal artifact reducing algorithm and conventional CT image. Dice similarity coefficient (DSC),Hausdorff distance (HD) and the mean CT values of OAR with or without metal artifacts were compared. Both the processed CT images and original images were transferred to Monaco planning system. Dose calculation was conducted on the images with metal artifacts,and the calculated plans were mapped to the artifact-free images for analyzing the dosimetric differences of OAR. Results The HD of the throat,oral cavity and mandible were slightly higher. The mean CT values of the tissues in images before and after artifact removal were not statistically different except for the trachea (P<0.05),and the mean oral CT value at the artifact level differed significantly in two groups (P<0.05). The radiation dose of different tissues in the radiotherapy plan before and after artifact removal only showed statistical differences in the superior constrictor musde of pharynx. The percentages of irradiation dose differences for the tissues ranged from 0 to 6.45％,with the largest fluctuation in the left lens (-2.92％±3.95％) and the right lens (1.29％±3.35％). Conclusion Manual delineation is required for the tissues close to metal artifacts due to the remarkable effects on CT values and planned dose,but there is few differences in the other tissues.

Objective To explore the application effect of artifact removal technique of Discovery RT (GE Inc) in organ segmentation and radiotherapy planning. Methods Twelve patients with head and neck tumors carrying irremovable metal dentures,who received radiotherapy at the Fourth Affiliated Hospital of Nanjing Medical University from September 2021 to February 2024,were enrolled in the study. AccuContour was used to perform organs-at-risk (OAR) segmentations separately on CT image processed by metal artifact reducing algorithm and conventional CT image. Dice similarity coefficient (DSC),Hausdorff distance (HD) and the mean CT values of OAR with or without metal artifacts were compared. Both the processed CT images and original images were transferred to Monaco planning system. Dose calculation was conducted on the images with metal artifacts,and the calculated plans were mapped to the artifact-free images for analyzing the dosimetric differences of OAR. Results The HD of the throat,oral cavity and mandible were slightly higher. The mean CT values of the tissues in images before and after artifact removal were not statistically different except for the trachea (P<0.05),and the mean oral CT value at the artifact level differed significantly in two groups (P<0.05). The radiation dose of different tissues in the radiotherapy plan before and after artifact removal only showed statistical differences in the superior constrictor musde of pharynx. The percentages of irradiation dose differences for the tissues ranged from 0 to 6.45％,with the largest fluctuation in the left lens (-2.92％±3.95％) and the right lens (1.29％±3.35％). Conclusion Manual delineation is required for the tissues close to metal artifacts due to the remarkable effects on CT values and planned dose,but there is few differences in the other tissues.