PONE-D-24-37385A Novel Real-Time Ultrasound-Based Imaging Analysis Software for Monitoring Radiofrequency Ablation and Visualizing Ablation AreasPLOS ONE

Dear Dr. Sato,

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Ashraf Elbahrawy

Academic Editor

PLOS ONE

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #2: Yes

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

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3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: I would like to thank you for this interesting , novel and creative work.

I just want few explained points.

1. as regard mentioned HCCs, were they the first time to be treated and assessed (i mean, not treated before).

2. In your opinion, what is the expected time to apply bio trace map , (during ablation, or short time after ablation)

3. What would happen, if we re ablated the same lesion at the same time time due to insufficient ablation.?. Would bio trace map work well?

4.Is there a difference in results, if we compare the efficacy of bio trace map in different segments of liver?

.

At the end , I am appreciating this impressive work.

Thanks for all authors.

Reviewer #2: The authors of this manuscript presented a novel Real-Time Ultrasound-based imaging analysis software for monitoring radiofrequency ablation and visualizing ablation areas. This title is worthy of investigation and the study is well organized and well structured. However, some comments are mentioned below that need more clarification, explanation, or modification.

1. The abstract of the study is better to be structured.

2. All the abbreviations in the manuscript like CT, MRI, etc. should first be mentioned in their complete forms followed by their abbreviated forms.

3. Please mention the type of study in the method section.

4. How many times each experiment was applied? Please explain.

5. Was the sample size enough to reach an accurate and robust result? Please explain.

6. Did your study involve any sort of follow-ups or not?

7. Please mention exactly the control groups that you have utilized in your study.

Wish you luck and prosperity in revising the manuscript.

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Reviewer #1: Yes: Mohammed ElFayoumie

Reviewer #2: Yes: Ali Kashkooe

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Attachments

Attachment

Submitted filename: Reviewer comments and recommendations.docx

PONE-D-24-37385R1A Novel Real-Time Ultrasound-Based Imaging Analysis Software for Monitoring Radiofrequency Ablation and Visualizing Ablation AreasPLOS ONE

Dear Dr. Sato,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

Please submit your revised manuscript by Feb 01 2025 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file.

Please include the following items when submitting your revised manuscript:

• A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'.
• A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'.
• An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'.

If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter.

If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: https://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols. Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols.

We look forward to receiving your revised manuscript.

Kind regards,

Ashraf Elbahrawy

Academic Editor

PLOS ONE

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #1: All comments have been addressed

Reviewer #3: All comments have been addressed

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #3: Partly

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3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #3: Yes

**********

4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #3: Yes

**********

5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #3: Yes

**********

6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: (No Response)

Reviewer #3: In the current study you compared performance of BTM( pre ablation prediction) with CECT 24 hours after ablation, please mention this in a clear statement in methodology section. In addition, BTM system is not activated during the procedure in the current study. So I think the title should be modified express the work in the study.

Please revise the following:

((A Novel Real-Time Ultrasound-Based Imaging Analysis Software for Monitoring Radiofrequency Ablation and Visualizing Ablation Areas))

In the current study you said in page 15” Although the current system has been designed for real-time monitoring, it was not activated during the procedure in this study.

Page 14” It provides comparable performance in assessing the treatment response of radiofrequency ablation (RFA).”

Unfortunately, the study design is not compatible with prospective observational study! You compared performance of BTM with CECT 24 hours after ablation in the same group.

What is/are the extra benefit/s expected from BTM in contrast to ablation under the guidance of contrast-enhanced ultrasonography? Both are ultrasound based and real time technique!

Page 8, you mentioned “The dynamics of microbubbles, reflecting the tissue’s response to heat, varies according to the applied temperature” I think there are multiple variables other than temperature should be considered e.g., biological nature of lesion, pathological background of liver. I mean HCC on top of chronic hepatitis, cirrhosis or viral VS metabolic liver disease, fibrotic load within the liver,……

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7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #1: Yes: Mohammed Elfayoumie

Reviewer #3: Yes: Ali Madian

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[NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.]

While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step.

Retrospective Evaluation of a Novel Ultrasound-Based Imaging Analysis Software for Predicting Radiofrequency Ablation Areas

PONE-D-24-37385R2

Dear Dr. Sato,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

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Kind regards,

Ashraf Elbahrawy

Academic Editor

PLOS ONE

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