Prediction of Lung Shunt Fraction for Yttrium-90 Treatment of Hepatic Tumors Using Dynamic Contrast Enhanced MRI with Quantitative Perfusion Processing
Round 1
Reviewer 1 Report
Dear Editor and Authors,
I read the paper entitled 'Noninvasive Prediction of Lung Shunt Fraction for Yttrium-90 Treatment of Hepatic Tumors Using Dynamic Contrast Enhanced MRI with Quantitative Perfusion Processing' with great interest.
This paper concerns novel and interesting topic regarding non-invasive estimation of lung shunting fraction in patients with liver tumors undergoing Yttrium-90 therapy. The title describes the core message of the paper. The abstract incorporates key messages, in a concise manner. The structure of the paper is accurate. Importantly, paper demonstrates that non-invasive prediction of lung shunting fraction is feasible from dynamic contrast enhanced MRI with quantitative transport mapping velocity postprocessing.
However, I have same suggestions regarding this paper.
1. There is no information if there were any statistical differences between the presented AUC for predicting low versus high risk for different investigated parameters.
2. There is some interpunctions and formatting mistakes, such as no spaces between some characters or too many spaces.
Author Response
1.There is no information if there were any statistical differences between the presented AUC for predicting low versus high risk for different investigated parameters.
Response: Thank you for the insightful question. We have added statistical power assessment of AUC difference and included in the discussion the limitation of small sample.
2.There is some interpunctions and formatting mistakes, such as no spaces between some characters or too many spaces.
Response: Thank you. We have tried to clean up these typos.
Reviewer 2 Report
It is noteworthy that this technique is not non-invasive and is actually a Minimally Invasive because of the yttrium-90 is a radioactive isotope. I suggest to correct the title.
-Line 7, page 9 words "Catherization" mean: Catheterization
- In order to evaluate the parameter estimates of the model based on the literature
- Improving the structure of text and literature,
- Treatment for Y90 are variable depending on stage at the time of diagnosis be described in the article.
Author Response
1.It is noteworthy that this technique is not non-invasive and is actually a Minimally Invasive because of the yttrium-90 is a radioactive isotope. I suggest to correct the title.
Response: Thank you. We have changed to minimal invasive.
2.Line 7, page 9 words "Catherization" mean: Catheterization
Response: Thank you. We have corrected the typo.
3. In order to evaluate the parameter estimates of the model based on the literature.
Response: Thank you. We have cited literature on Kety’s parameter values on liver tumors.
4.Improving the structure of text and literature
Response: Thank you. We have made English edits by native speaker coauthors.
5. Treatment for Y90 are variable depending on stage at the time of diagnosis be described in the article.
Response: Thank you. We have clarified that these cohort patients were determined to receive Y90 treatment based on diagnosis and the dose was determined by either the body surface area (BSA) or medical internal radiation dose (MIRD) method.