Energy spectrum computed tomography multi-parameter imaging in preoperative assessment of vascular and neuroinvasive status in gastric cancer

BACKGROUND Vascular and nerve infiltration are important indicators for the progression and prognosis of gastric cancer(GC),but traditional imaging methods have some limitations in preoperative evaluation.In recent years,energy spectrum computed tomography(CT)multiparameter imaging technology has been gradually applied in clinical practice because of its advantages in tissue contrast and lesion detail display.AIM To explore and analyze the value of multiparameter energy spectrum CT imaging in the preoperative assessment of vascular invasion(LVI)and nerve invasion(PNI)in GC patients.METHODS Data from 62 patients with GC confirmed by pathology and accompanied by energy spectrum CT scanning at our hospital between September 2022 and September 2023,including 46 males and 16 females aged 36-71(57.5±9.1)years,were retrospectively collected.The patients were divided into a positive group(42 patients)and a negative group(20 patients)according to the presence of LVI/PNI.The CT values(CT40 keV,CT70 keV),iodine concentration(IC),and normalized IC(NIC)of lesions in the upper energy spectrum CT images of the arterial phase,venous phase,and delayed phase 40 and 70 keV were measured,and the slopes of the energy spectrum curves[K(40-70)]from 40 to 70 keV were calculated.Arterial Core Tip:To investigate the application value of multiparameter energy spectrum computed tomography(CT)imaging in the preoperative assessment of vascular and nerve infiltration in patients with gastric cancer(GC).The imaging data of GC patients were retrospectively analyzed to evaluate the accuracy and sensitivity of CT for identifying and quantifying vascular and nerve infiltration and for comparison with postoperative pathological results.The purpose of this study was to verify the clinical feasibility and potential advantages of multiparameter energy spectrum CT imaging in guiding preoperative diagnosis and treatment decision-making and to provide a new imaging basis for improving the diagnostic accuracy and prognosis of GC patients.

Evaluation of the dual vascular supply patterns in ground-glass nodules with a dynamic volume computed tomography

BACKGROUND In recent years,the detection rate of ground-glass nodules(GGNs)has been improved dramatically due to the popularization of low-dose computed tomography(CT)screening with high-resolution CT technique.This presents challenges for the characterization and management of the GGNs,which depends on a thorough investigation and sufficient diagnostic knowledge of the GGNs.In most diagnostic studies of the GGNs,morphological manifestations are used to differentiate benignancy and malignancy.In contrast,few studies are dedicated to the assessment of the hemodynamics,i.e.,perfusion parameters of the GGNs.AIM To assess the dual vascular supply patterns of GGNs on different histopathology and opacities.METHODS Forty-seven GGNs from 47 patients were prospectively included and underwent the dynamic volume CT.Histopathologic diagnoses were obtained within two weeks after the CT examination.Blood flow from the bronchial artery[bronchial flow(BF)]and pulmonary artery[pulmonary flow(PF)]as well as the perfusion index(PI)=[PF/(PF+BF)]were obtained using first-pass dual-input CT perfusion analysis and compared respectively between different histopathology and lesion types(pure or mixed GGNs)and correlated with the attenuation values of the lesions using one-way ANOVA,student’s t test and Pearson correlation analysis.RESULTS Of the 47 GGNs(mean diameter,8.17 mm;range,5.3-12.7 mm),30(64%)were carcinoma,6(13%)were atypical adenomatous hyperplasia and 11(23%)were organizing pneumonia.All perfusion parameters(BF,PF and PI)demonstrated no significant difference among the three conditions(all P>0.05).The PFs were higher than the BFs in all the three conditions(all P<0.001).Of the 30 GGN carcinomas,14 showed mixed GGNs and 16 pure GGNs with a higher PI in the latter(P<0.01).Of the 17 benign GGNs,4 showed mixed GGNs and 13 pure GGNs with no significant difference of the PI between the GGN types(P=0.21).A negative correlation(r=-0.76,P<0.001)was demonstrated between the CT attenuation values and the PIs in the 30 GGN carcinomas.CONCLUSION The GGNs are perfused dominantly by the PF regardless of its histopathology while the weight of the BF in the GGN carcinomas increases gradually during the progress of its opacification.

The diagnostic rules of peripheral lung cancer preliminary study based on data mining technique

Objective： To discuss the clinical and imaging diagnostic rules of peripheral lung cancer by data mining technique, and to explore new ideas in the diagnosis of peripheral lung cancer, and to obtain early-stage technology and knowledge support of computer-aided detecting （CAD）. Methods： 58 cases of peripheral lung cancer confirmed by clinical pathology were collected. The data were imported into the database after the standardization of the clinical and CT findings attributes were identified. The data was studied comparatively based on Association Rules （AR） of the knowledge discovery process and the Rough Set （RS） reduction algorithm and Genetic Algorithm（GA） of the generic data analysis tool （ROSETTA）, respectively. Results： The genetic classification algorithm of ROSETTA generates 5 000 or so diagnosis rules. The RS reduction algorithm of Johnson＇s Algorithm generates 51 diagnosis rules and the AR algorithm generates 123 diagnosis rules. Three data mining methods basically consider gender, age, cough, location, lobulation sign, shape, ground-glass density attributes as the main basis for the diagnosis of peripheral lung cancer. Conclusion： These diagnosis rules for peripheral lung cancer with three data mining technology is same as clinical diagnostic rules, and these rules also can be used to build the knowledge base of expert system. This study demonstrated the potential values of data mining technology in clinical imaging diagnosis and differential diagnosis.

Differential Diagnosis Value of lSF-FDG Imaging in Lung Histoplasmosis and Lung Cancer

In order to confirm the accuracy of ECT （emission computed tomography） scanning imaging in the diagnosis of lung histoplasmosis is higher than CT （computed tomography） scan. We retrospect a lung histoplasmosis patient, he was examined by the CT scan and ECT scanning, respectively. Results showed that lung cancer for CT diagnosis and large benign lesions for 18F-FDG （18F-fluorodeoxyglucose） ECT diagnosis. This indicated that the ECT diagnosis for benign lesions in the lung maybe have higher accuracy than CT scan.

乳腺癌的CT诊断

目的 评价乳腺癌的CT诊断价值。材料与方法 回顾性分析了25例经病理证实的乳腺癌CT征象,25例均作CT平扫,17例平扫后做增强扫描。结果 乳腺癌CT多表现为结节状,边缘毛刺、尖角及细小的簇状钙化具有一定的特征;增强后癌灶常明显强化,有助于发现隐匿性病灶;乳头后方的病灶易引起皮肤增厚;腋窝淋巴结大于1cm,转移较肯定。结论 CT在乳腺癌的诊断、显示病灶范围和腋窝淋巴结转移有重要价值。

Assessment of spiral CT pneumocolon in preoperative colorectal carcinoma

AIM: To investigate the value of spiral CT pneumocolon in preoperative colorectal carcinoma.METHODS: Spiral CT pneumocolon was performed prior to surgery in 64 patients with colorectal carcinoma. Spiral CT images were compared to specimens from the resected tumor.RESULTS: Spiral CT depicted the tumor in all patients.Comparison of spiral CT and histologic results showed that the sensitivity and specificity were 95.2%, 40.9% in detection of local invasion, and 75.0%, 90.9% in detection of lymph node metastasis. Compared to the Dukes classification,the disease was correctly staged as A in 6 of 18 patients,as B in 18 of 23, as C in 10 of 15, and as D in 7 of 8. Overall,spiral CT correctly staged 64.1% of patients.CONCLUSION: Spiral CT pneumocolon may be useful in the preoperative assessment of patients with colorectal carcinoma as a means for assisting surgical planning.