Computed tomography-based nomogram of Siewert type Ⅱ/Ⅲ adenocarcinoma of esophagogastric junction to predict response to docetaxel, oxaliplatin and S-1

BACKGROUND Neoadjuvant chemotherapy(NAC)has become the standard care for advanced adenocarcinoma of esophagogastric junction(AEG),although a part of the patients cannot benefit from NAC.There are no models based on baseline computed tomography(CT)to predict response of Siewert type II or III AEG to NAC with docetaxel,oxaliplatin and S-1(DOS).AIM To develop a CT-based nomogram to predict response of Siewert type II/III AEG to NAC with DOS.METHODS One hundred and twenty-eight consecutive patients with confirmed Siewert type II/III AEG underwent CT before and after three cycles of NAC with DOS,and were randomly and consecutively assigned to the training cohort(TC)(n=94)and the validation cohort(VC)(n=34).Therapeutic effect was assessed by disease-control rate and progressive disease according to the Response Evaluation Criteria in Solid Tumors(version 1.1)criteria.Possible prognostic factors associated with responses after DOS treatment including Siewert classification,gross tumor volume(GTV),and cT and cN stages were evaluated using pretherapeutic CT data in addition to sex and age.Univariate and multivariate analyses of CT and clinical features in the TC were performed to determine independent factors associated with response to DOS.A nomogram was established based on independent factors to predict the response.The predictive performance of the nomogram was evaluated by Concordance index(C-index),calibration and receiver operating characteristics curve in the TC and VC.RESULTS Univariate analysis showed that Siewert type(52/55 vs 29/39,P=0.005),pretherapeutic cT stage(57/62 vs 24/32,P=0.028),GTV(47.3±27.4 vs 73.2±54.3,P=0.040)were significantly associated with response to DOS in the TC.Multivariate analysis of the TC also showed that the pretherapeutic cT stage,GTV and Siewert type were independent predictive factors related to response to DOS(odds ratio=4.631,1.027 and 7.639,respectively;all P<0.05).The nomogram developed with these independent factors showed an excellent performance to predict response to DOS in the TC and VC(C-index:0.838 and 0.824),with area under the receiver operating characteristic curve of 0.838 and 0.824,respectively.The calibration curves showed that the practical and predicted response to DOS effectively coincided.CONCLUSION A novel nomogram developed with pretherapeutic cT stage,GTV and Siewert type predicted the response of Siewert type II/III AEG to NAC with DOS.

Seeing through Materials:X-Ray Imaging Using Computed Tomography

X-ray computed tomography(XCT)has recently emerged as a powerful tool for characterizing the evolution of microstructure during phase transformation in three dimensional(3D)such as dendritic solidification of alloys.This paper briefly reviews the recent advances in the in-situ observation of aluminium alloys,magnesium alloys and nickel-based superalloys during solidification using laboratory XCT and synchrotron X-ray sources.The focus is on the growth kinetics of dendrites,porosity and secondary phases.In addition,in-situ characterization during the loading and corrosion process is also discussed.

Importance of computed tomography in posterior malleolar fractures:Added information to preoperative X-ray studies

BACKGROUND Ankle fractures are common lesions of the lower limbs.Approximately 40%of ankle fractures affect the posterior malleolus(PM).Historically,PM osteosynthesis was recommended when PM size in X-ray images was greater than 25%of the joint.Currently,computed tomography(CT)has been gaining traction in the preoperative evaluation of ankle fractures.AIM To elucidate the similarity in dimensions and to correlate PM size in X-ray images with the articular surface of the affected tibial plafond in the axial view on CT(AXCT)of a PM fracture.METHODS Eighty-one patients(mean age:39.4±13.5 years)were evaluated(54.3%were male).Two independent examiners measured PM size in profile X-ray images(PMXR)and sagittal CT(SAGCT)slices.The correlation of the measurements between the examiners and the difference in the PM fragment sizes between the two images were compared.Next,the PM size in PMXR was compared with the surface of the tibial plafond involved in the fracture in AXCT according to the Haraguchi classification.RESULTS The correlation rates between the examiners were 0.93 and 0.94 for PMXR and SAGCT,respectively(P<0.001).Fragments were 2.12%larger in SAGCT than in PMXR(P=0.018).In PMXR,there were 56 cases<25%and 25 cases≥25%.When PMXR was<25%,AXCT corresponded to 10.13%of the tibial plafond.When PMXR was≥25%,AXCT was 24.52%(P<0.001).According to the Haraguchi classification,fracture types I and II had similar PMXR measurements that were greater than those of type III.When analyzing AXCT,a significant difference was found between the three types,with II>I>III(P<0.001).CONCLUSION PM fractures show different sizes using X-ray or CT images.CT showed a larger PM in the sagittal plane and allowed the visualization of the real dimensions of the tibial plafond surface.

Can visceral fat parameters based on computed tomography be used to predict occult peritoneal metastasis in gastric cancer?

BACKGROUND The preoperative prediction of peritoneal metastasis(PM)in gastric cancer would prevent unnecessary surgery and promptly indicate an appropriate treatment plan.AIM To explore the predictive value of visceral fat(VF)parameters obtained from preoperative computed tomography(CT)images for occult PM and to develop an individualized model for predicting occult PM in patients with gastric carcinoma(GC).METHODS A total of 128 confirmed GC cases(84 male and 44 female patients)that underwent CT scans were analyzed and categorized into PM-positive(n=43)and PM-negative(n=85)groups.The clinical characteristics and VF parameters of two regions of interest(ROIs)were collected.Univariate and stratified analyses based on VF volume were performed to screen for predictive characteristics for occult PM.Prediction models with and without VF parameters were established by multivariable logistic regression analysis.RESULTS The mean attenuations of VF_(ROI 1)and VF_(ROI 2)varied significantly between the PM-positive and PMnegative groups(P=0.044 and 0.001,respectively).The areas under the receiver operating characteristic curves(AUCs)of VF_(ROI 1)and VF_(ROI 2)were 0.599 and 0.657,respectively.The mean attenuation of VF_(ROI 2)was included in the final prediction combined model,but not an independent risk factor of PM(P=0.068).No significant difference was observed between the models with and without mean attenuation of VF(AUC:0.749 vs 0.730,P=0.339).CONCLUSION The mean attenuation of VF is a potential auxiliary parameter for predicting occult PM in patients with GC.

Pancreatic neuroendocrine tumor detected by technetium-99m methoxy-2-isobutylisonitrile single photon emission computed tomography/computed tomography:A case report

BACKGROUND Pancreatic neuroendocrine tumors(NETs)account for about 1%–2%of pancreatic tumors and about 8%of all NETs.Computed tomography(CT),magnetic resonance imaging,and endoscopic ultrasound are common imaging modalities for the diagnosis of pancreatic NETs.Furthermore,somatostatin receptor imaging is of great value for diagnosing pancreatic NETs.Herein,we report the efficacy of technetium-99m methoxy-2-isobutylisonitrile(99mTc-MIBI)single photon emission CT(SPECT)/CT for detecting pancreatic NETs.CASE SUMMARY A 57-year-old woman presented to our hospital with a 1-d history of persistent upper abdominal distending pain.The distending pain in the upper abdomen was aggravated after eating,with nausea and retching.Routine blood test results showed a high neutrophil percentage,low leukomonocyte and monocyte percentages,and low leukomonocyte and eosinophil counts.Amylase,liver and kidney function,and tumor markers alpha-fetoprotein,carcinoembryonic antigen,and cancer antigen(CA)125,CA72-4,CA19-9,and CA153 were normal.Abdominal CT showed a mass,with multiple calcifications between the pancreas and the spleen.The boundary between the mass and the pancreas and spleen was poorly defined.Contrast-enhanced CT revealed that the upper abdominal mass was unevenly and gradually enhanced.99mTc-MIBI SPECT/CT revealed that a focal radioactive concentration,with mild radioactive concentration extending into the upper abdominal mass,was present at the pancreatic body and tail.The 99mTc-MIBI SPECT/CT manifestations were consistent with the final pathological diagnosis of pancreatic NET.CONCLUSION 99mTc-MIBI SPECT/CT appears to be a valuable tool for detecting pancreatic NETs.

Use of high-resolution X-ray computed tomography and 3D image analysis to quantify mineral dissemination and pore space in oxide copper ore particles

Mineral dissemination and pore space distribution in ore particles are important features that influence heap leaching performance. To quantify the mineral dissemination and pore space distribution of an ore particle, a cylindrical copper oxide ore sample (I center dot 4.6 mm x 5.6 mm) was scanned using high-resolution X-ray computed tomography (HRXCT), a nondestructive imaging technology, at a spatial resolution of 4.85 mu m. Combined with three-dimensional (3D) image analysis techniques, the main mineral phases and pore space were segmented and the volume fraction of each phase was calculated. In addition, the mass fraction of each mineral phase was estimated and the result was validated with that obtained using traditional techniques. Furthermore, the pore phase features, including the pore size distribution, pore surface area, pore fractal dimension, pore centerline, and the pore connectivity, were investigated quantitatively. The pore space analysis results indicate that the pore size distribution closely fits a log-normal distribution and that the pore space morphology is complicated, with a large surface area and low connectivity. This study demonstrates that the combination of HRXCT and 3D image analysis is an effective tool for acquiring 3D mineralogical and pore structural data.

Effects of dry-wet cycles on three-dimensional pore structure and permeability characteristics of granite residual soil using X-ray micro computed tomography

Due to seasonal climate alterations,the microstructure and permeability of granite residual soil are easily affected by multiple dry-wet cycles.The X-ray micro computed tomography(micro-CT)acted as a nondestructive tool for characterizing the microstructure of soil samples exposed to a range of damage levels induced by dry-wet cycles.Subsequently,the variations of pore distribution and permeability due to drywet cycling effects were revealed based on three-dimensional(3D)pore distribution analysis and seepage simulations.According to the results,granite residual soils could be separated into four different components,namely,pores,clay,quartz,and hematite,from micro-CT images.The reconstructed 3D pore models dynamically demonstrated the expanding and connecting patterns of pore structures during drywet cycles.The values of porosity and connectivity are positively correlated with the number of dry-wet cycles,which were expressed by exponential and linear functions,respectively.The pore volume probability distribution curves of granite residual soil coincide with the χ^(2)distribution curve,which verifies the effectiveness of the assumption of χ^(2)distribution probability.The pore volume distribution curves suggest that the pores in soils were divided into four types based on their volumes,i.e.micropores,mesopores,macropores,and cracks.From a quantitative and visual perspective,considerable small pores are gradually transformed into cracks with a large volume and a high connectivity.Under the action of dry-wet cycles,the number of seepage flow streamlines which contribute to water permeation in seepage simulation increases distinctly,as well as the permeability and hydraulic conductivity.The calculated hydraulic conductivity is comparable with measured ones with an acceptable error margin in general,verifying the accuracy of seepage simulations based on micro-CT results.

Microstructure Evolution of Sandstone Cemented by Microbe Cement Using X-ray Computed Tomography

The bio-sandstone, which was cemented by microbe cement, was firstly prepared, and then the microstructure evolution process was studied by X-ray computed tomography （X-CT） technique. The experimental results indicate that the microstructure of bio-sandstone becomes dense with the development of age. The evolution of inner structure at different positions is different due to the different contents of microbial induced precipitation calcite. Besides, the increase rate of microbial induced precipitation calcite gradually decreases because of the reduction of microbe absorption content with the decreasing pore size in bio-sandstone.

In situ compression and X-ray computed tomography of flow battery electrodes

Redox flow batteries offer a potential solution to an increase in renewable energy generation on the grid by offering long-term, large-scale storage and regulation of power. However, they are currently un- derutilised due to cost and performance issues, many of which are linked to the microstructure of the porous carbon electrodes used. Here, for the first time, we offer a detailed study of the in situ effects of compression on a commercially available carbon felt electrode. Visualisation of electrode structure us- ing X-ray computed tomography shows the non-linear way that these materials compress and various metrics are used to elucidate the changes in porosity, pore size distribution and tortuosity factor under compressions from 0%-90%.

Performance evaluation of the simpli¯ed spherical harmonics approximation for cone-beam X-ray luminescence computed tomography imaging

As an emerging molecular imaging modality,cone-beam X-ray luminescence computed tomog-raphy(CB-XLCT)uses X-ray-excitable probes to produce near-infrared(NIR)luminescence and then reconst ructs three-dimensional(3D)distribution of the probes from surface measurements.A proper photon-transportation model is critical to accuracy of XLCT.Here,we presented a systematic comparison between the common-used Monte Carlo model and simplified spherical harmonics(SPN).The performance of the two methods was evaluated over several main spec-trums using a known XLCT material.We designed both a global measurement based on the cosine similarity and a locally-averaged relative error,to quantitatively assess these methods.The results show that the SP_(3) could reach a good balance between the modeling accuracy and computational efficiency for all of the tested emission spectrums.Besides,the SP_(1)(which is equivalent to the difusion equation(DE))can be a reasonable alternative model for emission wavelength over 692nm.In vivo experiment further demonstrates the reconstruction perfor-mance of the SP:and DE.This study would provide a valuable guidance for modeling the photon-transportation in CB-XLCT.

Distinct root system acclimation patterns of seagrass Zostera japonica in sediments of different trophic status:a research by X-ray computed tomography

Conspecific seagrass living in differing environments may develop different root system acclimation patterns.We applied X-ray computed tomography(CT)for imaging and quantifying roots systems of Zostera japonica collected from typical oligotrophic and eutrophic sediments in two coastal sites of northern China,and determined sediment physicochemical properties that might influence root system morphology,density,and distribution.The trophic status of sediments had little influence on the Z.japonica root length,and diameters of root and rhizome.However,Z.japonica in oligotrophic sediment developed the root system with longer rhizome node,deeper rhizome distribution,and larger allocation to below-ground tissues in order to acquire more nutrients and relieve the N deficiency.And the lower root and rhizome densities of Z.japonica in eutrophic sediment were mainly caused by fewer shoots and shorter longevity,which was resulted from the more serious sulfide inhibition.Our results systematically revealed the effect of sediment trophic status on the phenotypic plasticity,quantity,and distribution of Z.japonica root system,and demonstrated the feasibly of X-ray CT in seagrass root system research.

X-ray Computed Tomography Characterization of 3D Tufted Twill Textile Composite for Aerostructures

Damage assessments in three dimensional (3D) textile composites subjected to mechanical loading can be performed by non-destructive and destructive techniques.This paper applies the two techniques to investigate the fracture behavior of 3D tufted textile composites.X-ray computed tomography as a non-destructive evaluation method is appropriate to detect damage locations and identify their progression in 3D textile composites.Destructive methods such as sectioning toward observing damage provide valuable information about damage patterns.The results of this research could be utilized to evaluate the initial cause of rupture in 3D tufted composites used in aerospace structures and analyze fracture modes and damage progression.

Isotropic compression behavior of granular assembly with non-spherical particles by X-ray micro-computed tomography and discrete element modeling

The particle morphological properties,such as sphericity,concavity and convexity,of a granular assembly significantly affect its macroscopic and microscopic compressive behaviors under isotropic loading condition.However,limited studies on investigating the microscopic behavior of the granular assembly with real particle shapes under isotropic compression were reported.In this study,X-ray computed tomography(mCT)and discrete element modeling(DEM)were utilized to investigate isotropic compression behavior of the granular assembly with regard to the particle morphological properties,such as particle sphericity,concavity and interparticle frictions.The mCT was first used to extract the particle morphological parameters and then the DEM was utilized to numerically investigate the influences of the particle morphological properties on the isotropic compression behavior.The image reconstruction from mCT images indicated that the presented particle quantification algorithm was robust,and the presented microscopic analysis via the DEM simulation demonstrated that the particle surface concavity significantly affected the isotropic compression behavior.The observations of the particle connectivity and local void ratio distribution also provided insights into the granular assembly under isotropic compression.Results found that the particle concavity and interparticle friction influenced the most of the isotropic compression behavior of the granular assemblies.

Review of X-ray and computed tomography scan findings with a promising role of point of care ultrasound in COVID-19 pandemic

As healthcare professionals continue to combat the coronavirus disease 2019(COVID-19)infection worldwide,there is an increasing interest in the role of imaging and the relevance of various modalities.Since imaging not only helps assess the disease at the time of diagnosis but also aids evaluation of response to management,it is critical to examine the role of different modalities currently in use,such as baseline X-rays and computed tomography scans carefully.In this article,we will draw attention to the critical findings for the radiologist.Further,we will look at point of care ultrasound,an increasingly a popular tool in diagnostic medicine,as a component of COVID-19 management.

X-Ray Computed Tomography for Root Quantification

Soil cores from a field growing barley and barley mutants without root hairs under conventional and minimum tillage were sampled. They were X-ray scanned to produce a 3D image and then the roots were washed out and weight and length were determined by conventional means. Root volume and surface area were then calculated from the 3D images using state of the art software and methodology, and the measured and calculated measures were correlated. The only strong and significant correlation was between measured weight and calculated volume for mutants without root hairs. It is concluded that the software cannot segment out very small roots, but segmentation accuracy also depends on root structure in some unknown way. Any study using X-ray computed tomography to quantify roots as they grow in situ should start with a calibration for the conditions in question.

Usefulness of Chest Computed Tomography for Diagnosis of Idiopathic Pneumomediastinum with Negative Findings on Plain X-Ray

Idiopathic pneumomediastinum is rare in children. Few cases of patients with pneumomediastinum show negative findings on X-ray examination. Chest computed tomography (CT) was very useful for the diagnosis and evaluation of the extent of pneumomediastinum. We report here a case of idiopathic pneumomediastinum in a 15-year-old boy who exhibited no significant chest X-ray finding. The patient was referred to our institute for the further evaluation of pre-cordial pain and breathing difficulty. Precordial pain suddenly developed, when he was carrying a portable shrine on his shoulder (day of onset). He was admitted to another institute 3 days after onset because of worsening precordial pain. On admission, he presented with 98% saturation of hemoglobin in the peripheral blood under room air. Plain chest X-ray also revealed no abnormal findings. A half-dissolved gastrographin swallow showed no leakage of gastrographin from the pharynx and esophagus to the mediastinum, and no diverticulum within the esophagus. Plain chest CT revealed extensive emphysema around the trachea from the neck to the portion inferior to the carina of trachea. The patient was diagnosed with idiopathic pneumomediastinum because the cause was unclear. We decided to admit him to our institute under fasting conditions and rest. His symptoms improved 3 days after onset. The lesion had disap-peared 8 days after onset on chest CT. When young people experience precordial pain which increases on inspiration, we must consider pneumomediastinum in a differential diagnosis, and it is important to perform chest CT.

Computed tomography versus transthoracic echocardiography in the detection of complex congenial heart diseases in china:a meta-analysis

Objective:To perform a meta-analysis to evaluate the diagnostic performance of computed tomography(CT) and transthoracic echocardiography(TTE) in complex congenital heart diseases(CHD) in China.Methods:MEDLINE,Cochrane library and China National Knowledge Infrastructure(CNKI) database from January 1966 to October 2010,were searched for initial studies in China.All the studies,published in English or Chinese,used TTE,CT,or both as diagnostic tests for CHD and reported the rate of true-positive,true-negative,false-positive and false-negative diagnoses of CHD from TTE and CT findings with the surgical results as the 'gold-standard'(15 studies,XX patients) were collected.The statistic software package,'Meta-Disc 1.4',was used to conduct data analysis.A covariate analysis was used to evaluate the influence of patient or study-related factors on sensitivity.Results:Pooled sensitivity for diagnosis of CHD were 95% [95% confidence interval(CI):94%~96%] for CT studies and 87%(95% CI:85%~88%) for TTE studies.The difference between the pooled sensitivity of CT and that of TTE was statistically significant(P<0.001).TTE had higher sensitivity [0.96(95% CI:0.94~0.97)] for cardiac malformation but lower sensitivity [0.78(95% CI:0.76~0.81)] for extracardiac malformation than CT.Conclusion:CT can provide added diagnostic information compared with TTE in patients with CHD in China,especially for patients suspected of extracardiac malformation.

Radiomic features from computed tomography to differentiate invasive pulmonary adenocarcinomas from non-invasive pulmonary adenocarcinomas appearing as part-solid groundglass nodules

Objective:We aim to investigate radiomic imaging features extracted in computed tomography(CT)images to differentiate invasive pulmonary adenocarcinomas(IPAs)from non-IPAs appearing as part-solid ground-glass nodules(GGNs),and to incorporate significant radiomic features with other clinically-assessed features to develop a diagnostic nomogram model for IPAs.Methods:This retrospective study was performed,with Institutional Review Board approval,on 88 patients with a total of 100 part-solid nodules(56 IPAs and 44 non-IPAs)that were surgically confirmed between February 2014and November 2016 in the First Affiliated Hospital of China Medical University.Quantitative radiomic features were computed automatically on 3D nodule volume segmented from arterial-phase contrast-enhanced CT images.A set of regular risk factors and visually-assessed qualitative CT imaging features were compared with the radiomic features using logistic regression analysis.Three diagnostic models,i.e.,a basis model using the clinical factors and qualitative CT features,a radiomics model using significant radiomic features,and a nomogram model combining all significant features,were built and compared in terms of receiver operating characteristic(ROC)curves.Decision curve analysis was performed for the nomogram model to explore its potential clinical benefit.Results:In addition to three visually-assessed qualitative imaging features,another three quantitative features selected from hundreds of radiomic features were found to be significantly(all P<0.05)associated with IPAs.The diagnostic nomogram model showed a significantly higher performance[area under the ROC curve(AUC)=0.903]in differentiating IPAs from non-IPAs than either the basis model(AUC=0.853,P=0.0009)or the radiomics model(AUC=0.769,P<0.0001).Decision curve analysis indicates a potential benefit of using such a nomogram model in clinical diagnosis.Conclusions:Quantitative radiomic features provide additional information over clinically-assessed qualitative features for differentiating IPAs from non-IPAs appearing as GGNs,and a diagnostic nomogram model including all these significant features may be clinically useful in preoperative strategy planning.

Application of computed tomography-based radiomics in differential diagnosis of adenocarcinoma and squamous cell carcinoma at the esophagogastric junction

BACKGROUND The biological behavior of carcinoma of the esophagogastric junction(CEGJ)is different from that of gastric or esophageal cancer.Differentiating squamous cell carcinoma of the esophagogastric junction(SCCEG)from adenocarcinoma of the esophagogastric junction(AEG)can indicate Siewert stage and whether the surgical route for patients with CEGJ is transthoracic or transabdominal,as well as aid in determining the extent of lymph node dissection.With the development of neoadjuvant therapy,preoperative determination of pathological type can help in the selection of neoadjuvant radiotherapy and chemotherapy regimens.AIM To establish and evaluate computed tomography(CT)-based multiscale and multiphase radiomics models to distinguish SCCEG and AEG preoperatively.METHODS We retrospectively analyzed the preoperative contrasted-enhanced CT imaging data of single-center patients with pathologically confirmed SCCEG(n=130)and AEG(n=130).The data were divided into either a training(n=182)or a test group(n=78)at a ratio of 7:3.A total of 1409 radiomics features were separately extracted from two dimensional(2D)or three dimensional(3D)regions of interest in arterial and venous phases.Intra-/inter-observer consistency analysis,correlation analysis,univariate analysis,least absolute shrinkage and selection operator regression,and backward stepwise logical regression were applied for feature selection.Totally,six logistic regression models were established based on 2D and 3D multi-phase features.The receiver operating characteristic curve analysis,the continuous net reclassification improvement(NRI),and the integrated discrimination improvement(IDI)were used for assessing model discrimination performance.Calibration and decision curves were used to assess the calibration and clinical usefulness of the model,respectively.RESULTS The 2D-venous model(5 features,AUC:0.849)performed better than 2D-arterial(5 features,AUC:0.808).The 2D-arterial-venous combined model could further enhance the performance(AUC:0.869).The 3D-venous model(7 features,AUC:0.877)performed better than 3D-arterial(10 features,AUC:0.876).And the 3D-arterial-venous combined model(AUC:0.904)outperformed other single-phase-based models.The venous model showed a positive improvement compared with the arterial model(NRI>0,IDI>0),and the 3D-venous and combined models showed a significant positive improvement compared with the 2D-venous and combined models(P<0.05).Decision curve analysis showed that combined 3D-arterial-venous model and 3D-venous model had a higher net clinical benefit within the same threshold probability range in the test group.CONCLUSION The combined arterial-venous CT radiomics model based on 3D segmentation can improve the performance in differentiating EGJ squamous cell carcinoma from adenocarcinoma.

Infective severe acute pancreatitis:A comparison of ^(99m)Tc-ciprofloxacin scintigraphy and computed tomography

AIM:To evaluate 99mTc-ciprofloxacin scintigraphy compared with computed tomography(CT)for detecting secondary infections associated with severe acute pancreatitis(SAP)in swine.METHODS:Six healthy swine were assigned to a normal control group(group A,n = 6).SAP was induced in group B(n = 9)and C(n = 18),followed by inoculation of the resulting pancreatic necroses with inactive Escherichia coli(E.coli)(group B)and active E.coli(group C),respectively.At 7 d after inoculation,a CT scan and a series of analyses using infecton imaging(at 0.5,1,2,3,4 and 6 h after the administration of 370 MBq of intravenous infecton)were performed.The scintigrams were visually evaluated and semi-quantitatively analyzed using region of interest assignments.The differences in infecton uptake and changes in the lesion-background radioactive count ratios(L/B)in the 3 groups were recorded and compared.After imaging detection,histopathology and bacterial examinations were performed,and infected SAP was regarded as positive.The imaging findings were compared with histopathological and bacteriological results.RESULTS:In group A,6 animals survived without infection in the pancreas.In group B,7/9 swine survived and one suffered from infection.In group C,15/18 animals survived with infection.Hence,the number of normal,non-infected and infected SAP swine was 6,6 and 16,respectively.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of the infecton method were 93.8%(15/16),91.7%(11/12),92.9%(26/28),93.8%(15/16)and 91.7%(11/12),whereas these values for CT were 12.5%(2/16),100.0%(12/12),50.0%(14/28),100.0%(2/2)and 46.2%(12/26),respectively.The changes in L/B for the infected SAP were significantly different from those of the non-infected and normal swine(P < 0.001).The mean L/B of the infectious foci at 0.5,1,2,3,4 and 6 h was 1.17 ± 0.10,1.71 ± 0.30,2.46 ± 0.45,3.36 ± 0.33,2.04 ± 0.37 and 1.1988 ± 0.09,respectively.At 3 h,the radioactive counts(2350.25 ± 602.35 k)and the mean L/B of the infectious foci were significantly higher than that at 0.5 h(P = 0.000),1 h(P = 0.000),2 h(P = 0.04),4 h(P = 0.000)and 6 h(P = 0.000).CONCLUSION:99m Tc-ciprofloxacin scintigraphy may be an effective procedure for detecting SAP secondary infections with higher sensitivity and accuracy than CT.