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(...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.展开更多
Lung cancer is the leading cause of cancer-related mortality worldwide. Non-small cell carcinoma and small cell carcinoma are the main histological subtypes and constitutes around 85% and 15% of all lung cancer respec...Lung cancer is the leading cause of cancer-related mortality worldwide. Non-small cell carcinoma and small cell carcinoma are the main histological subtypes and constitutes around 85% and 15% of all lung cancer respectively. Multimodality treatment plays a key role in the successful management of lung cancer depending upon the histological subtype, stage of disease, and performance status. Imaging modalities play an important role in the diagnosis and accurate staging of the disease, in assessing the response to neoadjuvant therapy, and in the follow-up of the patients. Last decade has witnessed voluminous upsurge in the use of positron emission tomography-computed tomography(PET-CT); role of PET-CT has widened exponentially in the management of lung cancer. The present article reviews the role of 18-fluoro-deoxyglucose PET-CT in the management of non small cell lung cancer with emphasis on staging of the disease and the assessment of response to neoadjuvant therapy based on available literature.展开更多
BACKGROUND: The peripheral morphologic characteristics of hepatocellular carcinoma (HCC) reflect tumor growth patterns. Computed tomography (CT) perfusion is a new method to analyze hemodynamic changes in tissues...BACKGROUND: The peripheral morphologic characteristics of hepatocellular carcinoma (HCC) reflect tumor growth patterns. Computed tomography (CT) perfusion is a new method to analyze hemodynamic changes in tissues. We assessed the relationship between CT perfusion and histopathologic findings in the periphery of HCC lesions. METHODS: Non-contrast CT, enhanced dual-phase CT, and CT perfusion were performed on 77 subjects (47 patients and 30 controls). Based on the imaging findings of enhanced dual- phase CT, the tumor edges were classified into three types: type Ⅰ (sharp); type Ⅱ (blurry); and type Ⅲ (mixed). The CT perfusion parameters included hepatic blood flow, hepatic arterial fraction, hepatic arterial perfusion, and hepatic portal perfusion. The tissue sections from resected specimens were subjected to routine hematoxylin and eosin staining and immunohistochemical staining for CD34. The correlations between microvessel density (MVD) and the CT perfusion parameters were analyzed using Pearson's product-moment correlation coefficient. Changes in the perfusion parameters in tumor edges of different tumor types were evaluated. RESULTS: Type Ⅰ (sharp): the pathologic findings showed fibrous connective tissue capsules in the tumor edges, and an MVD 〈30/ram2. Type Ⅱ (blurry): the histology showed that the edges were clear with no capsules and an MVD 〉30/ram2. Type Ⅲ (mixed): the pathology was similar to that of types I and II, and an MVD 〉30/mm~. Hepatic blood flow, hepatic arterial fraction, hepatic arterial perfusion, and hepatic portal perfusion were significantly increased in the tumor edges of HCC patients compared to those of the controls (P〈0.05). The correlation between CT perfusion parameters and MVD was higher in blurry tumor edges of type II than in those of types Ⅰ or Ⅲ. CONCLUSION: CT perfusion imaging of tumor edges may be helpful in revealing histopathological features, and indirectly reflect angiogenic changes of HCCs.展开更多
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 viscera...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.展开更多
BACKGROUND Primary carcinoma ex pleomorphic adenoma arising from the tracheobronchial system is rarely reported.CASE SUMMARY We present a patient with primary carcinoma ex pleomorphic adenoma of the bronchus and revie...BACKGROUND Primary carcinoma ex pleomorphic adenoma arising from the tracheobronchial system is rarely reported.CASE SUMMARY We present a patient with primary carcinoma ex pleomorphic adenoma of the bronchus and review the associated literature for further comparison,including age,clinical manifestations,and diagnostic process.This patient had no history of neoplasms of the salivary gland.CONCLUSION Positron emission tomography played an important role in the staging work-up of primary carcinoma of ex pleomorphic adenoma.Long-term follow-up was necessary for further prognosis analysis.展开更多
In order to evaluate correlation of glucose metabolism and DNA ploidity of tumors, the uptake of 18F-Deoxyglucose (FDG) by PET prior to surgery and the DNA cotent and DNA-grading of malignancy (DNA-MG) of Schiff-stain...In order to evaluate correlation of glucose metabolism and DNA ploidity of tumors, the uptake of 18F-Deoxyglucose (FDG) by PET prior to surgery and the DNA cotent and DNA-grading of malignancy (DNA-MG) of Schiff-stained nuclei obtained from fresh tumor fragments by means of image cytometry were studied, and thereafter the correlation between standardized uptake value (SUV) and (DNA-MG) was analysed in forty-nine patients with histologically proven non-small cell lung carcinoma (NSCLC). As a result of the DNA histograms of these 49 patients, 46 (93.88%) were aneuploid and only 3(6.12%) were tetraploid. A linear correlation of the SUV versus the (DNA-MG) (r=0.336, p=0.024) was found, demonstrating that 18F-FDG PET as a non-invasive metabolic imaging technique, may also provide inforrnation correlated to malignant DNA patterns which may be valuable in malignant differentiation and prognostic prediction.展开更多
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...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.展开更多
BACKGROUND Lung cancer is the leading cause of cancer-related death.Early diagnosis is critical to improving a patient’s chance of survival.However,lung cancer associated with cystic airspaces is often misdiagnosed o...BACKGROUND Lung cancer is the leading cause of cancer-related death.Early diagnosis is critical to improving a patient’s chance of survival.However,lung cancer associated with cystic airspaces is often misdiagnosed or underdiagnosed due to the absence of clinical symptoms,poor imaging specificity,and high risk of biopsy-related complications.CASE SUMMARY We report an unusual case of cancer in a 55-year-old man,in which the lesion evolved from a small solitary thin-walled cyst to lung squamous cell carcinoma(SCC)with metastases in both lungs.The SCC manifested as rare clustered cystic lesions,detected on chest computed tomography.There were air-fluid levels,compartments,and bronchial arteries in the cystic lesions.Additionally,there was no clear extrathoracic metastasis.After chemotherapy,the patient achieved a partial response,type I respiratory failure was relieved,and the lung lesions became a clustered thin-walled cyst.CONCLUSION Pulmonary cystic lesions require regular imaging follow-up.Lung SCC should be a diagnostic consideration in cases of thin-walled cysts as well as multiple clustered cystic lesions.展开更多
目的观察基于平扫CT瘤内及瘤周影像组学模型联合临床及常规CT特征鉴别肺原位腺癌(AIS)与微浸润性腺癌(MIA)的价值。方法回顾性分析180例孤立性AIS及180例孤立性MIA肺结节患者,随机将其中各160例纳入训练集(n=320)、各20例纳入测试集(n=...目的观察基于平扫CT瘤内及瘤周影像组学模型联合临床及常规CT特征鉴别肺原位腺癌(AIS)与微浸润性腺癌(MIA)的价值。方法回顾性分析180例孤立性AIS及180例孤立性MIA肺结节患者,随机将其中各160例纳入训练集(n=320)、各20例纳入测试集(n=40)。以训练集AIS与MIA间差异有统计学意义的临床及常规CT特征构建临床模型;勾画瘤内(CTi)及包含瘤周2 mm(CTi+p2mm)、4 mm(CTi+p4mm)ROI,提取并筛选其影像组学特征,分别以之构建CTi模型、CTi+p2mm模型及CTi+p4mm模型;绘制受试者工作特征(ROC)曲线,计算曲线下面积(AUC),评价各模型效能,遴选预测测试集MIA效能最佳者,联合临床及常规CT特征构建联合模型,观察临床模型、最佳影像组学模型及联合模型的AUC、校准度及净收益。结果训练集内,相比AIS,MIA结节直径较大、密度不均匀、伴血管穿行结节占比较高(P均<0.05)。CTi+p2mm模型鉴别测试集MIA与AIS效能最高(AUC=0.838,P<0.05);以之结合临床及常规CT特征构建的联合模型鉴别诊断效能更佳(AUC=0.867,P<0.05)。联合模型的校准度及0.60~0.90阈值概率区间的临床净收益较高。结论基于平扫CT构建的瘤内和瘤周2 mm ROI影像组学模型能有效鉴别肺MIA与AIS,联合临床及常规CT特征可进一步提高模型鉴别效能。展开更多
BACKGROUND: Multirow-detector helical CT (MDCT) allows faster Z-axis coverage and improves longitudinal re- solution to scan the entire liver. This study was to evaluate the value of multiphase hepatic CT scans using ...BACKGROUND: Multirow-detector helical CT (MDCT) allows faster Z-axis coverage and improves longitudinal re- solution to scan the entire liver. This study was to evaluate the value of multiphase hepatic CT scans using MDCT in diagnosing hypervascular hepatocellular carcinoma (HCC). METHODS: Multiphase hepatic CT scans in 40 patients were carried out with a Marconi Mx8000 MDCT scanner. The scans of early arterial phase (EAP), late arterial phase (LAP) and portal venous phase (PVP) were started at 21, 34 and 85 seconds after injection of contrast medium, re- spectively. The number of detected lesions was calculated in each phase. The density of the liver and tumor was great- er than 1 cm for HCC, and the density of the liver and tumor in each phase was statistically calculated. RESULTS: A total of 61 lesions were found in the 40 pa- tients , and lesions greater than 1 cm were seen in 47 cases. The density differences between the liver and tumor were statistically significant (P<0.05) at the LAP and EAP and between the LAP, EAP and PVP. In the 61 lesions, the de- tectability in the EAP, LAP and the double arterial phases (DAP) was 32%, 87%, and 94%, respectively. Significant difference was found between the LAP plus PVP and the EAP plus PVP; but no significant difference was observed between the DAP plus PVP and the LAP plus PVP. CONCLUSIONS: The utility of MDCT scan in the liver has optimized the protocol of arterial phase scan. MDCT is possible to scan the entire liver in a real arterial phase and it is very valuable in the detection of small HCC.展开更多
The study examined the association between calcified liver metastases and the histopathology of the primary colorectal carcinoma in Chinese.The clinical,pathological and CT data were retrospectively analyzed in 210 pa...The study examined the association between calcified liver metastases and the histopathology of the primary colorectal carcinoma in Chinese.The clinical,pathological and CT data were retrospectively analyzed in 210 patients (mean age:54.2 years) with liver metastases from colorectal carcinoma.Plain CT scanning and contrast-enhanced scanning were performed in all the patients.For the contrast-enhanced examination,iohexol was injected by using a high pressure syringe at a flow rate of 2.5-3.0 mL/s.The arterial phase lasted approximately 25 s and the portal venous phase about 60 s.All patients had no history of chronic liver diseases and had never received interventional treatments.χ 2-test was used to analyze the rate of calcification in the liver metastasis from colorectal cancer of different differentiation degrees.Among the 210 cases of liver metastases,22 patients (10.5%) were found to have calcified liver metastases on CT scan.Two patients with calcified liver metastasis received lumpectomy and developed calcification in recurrent tumors.Another two patients had calcification in newly developed tumor masses.And the calcification in the newly developed masses was similar to that of their primary counterparts in terms of morphology and distribution.On the enhanced CT scan,the tumors exhibited no enhancement during hepatic arterial phase and showed slight rim enhancement during portal venous scan in the 22 cases.The calcification became obscure on contrast-enhanced scans.Histopathologically,the primary tumors were well-differentiated adenocarcinoma in 6 cases,moderately-differentiated adenocarcinoma in 10,poorly-differentiated adenocarcinoma in 4 and mucinous adenocarcinoma in 2 among the 22 cases.No statistical correlation was noted between the incidence of calcified liver metastasis and the pathological subtypes and differentiation degrees of the primary colorectal carcinoma.It was concluded that calcified liver metastases may result from colorectal adenocarcinomata of different differentiation degrees or mucinous adenocarcinomata in Chinese population.There is no correlation between calcification of liver metastases and the pathological subtype of the primary colorectal carcinoma in Chinese,which is different from the findings that calcified metastases were associated with colorectal mucinous adenocarcinoma in other ethnic groups.展开更多
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 techn...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.展开更多
基金supported by the National Natural Science Foundation of China (No. 81301222)the Special Research Grant for Non-profit Public Service (No. 201402013)the Science and Technology Department Project of Liaoning province (No. 2012020073-302)
文摘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.
文摘Lung cancer is the leading cause of cancer-related mortality worldwide. Non-small cell carcinoma and small cell carcinoma are the main histological subtypes and constitutes around 85% and 15% of all lung cancer respectively. Multimodality treatment plays a key role in the successful management of lung cancer depending upon the histological subtype, stage of disease, and performance status. Imaging modalities play an important role in the diagnosis and accurate staging of the disease, in assessing the response to neoadjuvant therapy, and in the follow-up of the patients. Last decade has witnessed voluminous upsurge in the use of positron emission tomography-computed tomography(PET-CT); role of PET-CT has widened exponentially in the management of lung cancer. The present article reviews the role of 18-fluoro-deoxyglucose PET-CT in the management of non small cell lung cancer with emphasis on staging of the disease and the assessment of response to neoadjuvant therapy based on available literature.
基金supported by grants from the National Nature Science Foundation of China (81471736)Heilongjiang Province Foundation for Returness (LC2013C38)
文摘BACKGROUND: The peripheral morphologic characteristics of hepatocellular carcinoma (HCC) reflect tumor growth patterns. Computed tomography (CT) perfusion is a new method to analyze hemodynamic changes in tissues. We assessed the relationship between CT perfusion and histopathologic findings in the periphery of HCC lesions. METHODS: Non-contrast CT, enhanced dual-phase CT, and CT perfusion were performed on 77 subjects (47 patients and 30 controls). Based on the imaging findings of enhanced dual- phase CT, the tumor edges were classified into three types: type Ⅰ (sharp); type Ⅱ (blurry); and type Ⅲ (mixed). The CT perfusion parameters included hepatic blood flow, hepatic arterial fraction, hepatic arterial perfusion, and hepatic portal perfusion. The tissue sections from resected specimens were subjected to routine hematoxylin and eosin staining and immunohistochemical staining for CD34. The correlations between microvessel density (MVD) and the CT perfusion parameters were analyzed using Pearson's product-moment correlation coefficient. Changes in the perfusion parameters in tumor edges of different tumor types were evaluated. RESULTS: Type Ⅰ (sharp): the pathologic findings showed fibrous connective tissue capsules in the tumor edges, and an MVD 〈30/ram2. Type Ⅱ (blurry): the histology showed that the edges were clear with no capsules and an MVD 〉30/ram2. Type Ⅲ (mixed): the pathology was similar to that of types I and II, and an MVD 〉30/mm~. Hepatic blood flow, hepatic arterial fraction, hepatic arterial perfusion, and hepatic portal perfusion were significantly increased in the tumor edges of HCC patients compared to those of the controls (P〈0.05). The correlation between CT perfusion parameters and MVD was higher in blurry tumor edges of type II than in those of types Ⅰ or Ⅲ. CONCLUSION: CT perfusion imaging of tumor edges may be helpful in revealing histopathological features, and indirectly reflect angiogenic changes of HCCs.
基金Supported by Henan Province 2023 Scientific Research Projects Focused on Higher Education Project,China,No.23A320059.
文摘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.
文摘BACKGROUND Primary carcinoma ex pleomorphic adenoma arising from the tracheobronchial system is rarely reported.CASE SUMMARY We present a patient with primary carcinoma ex pleomorphic adenoma of the bronchus and review the associated literature for further comparison,including age,clinical manifestations,and diagnostic process.This patient had no history of neoplasms of the salivary gland.CONCLUSION Positron emission tomography played an important role in the staging work-up of primary carcinoma of ex pleomorphic adenoma.Long-term follow-up was necessary for further prognosis analysis.
基金Partly Supported by International Atomic Energy Agency (Fellowship Code No. CPR/99070P)
文摘In order to evaluate correlation of glucose metabolism and DNA ploidity of tumors, the uptake of 18F-Deoxyglucose (FDG) by PET prior to surgery and the DNA cotent and DNA-grading of malignancy (DNA-MG) of Schiff-stained nuclei obtained from fresh tumor fragments by means of image cytometry were studied, and thereafter the correlation between standardized uptake value (SUV) and (DNA-MG) was analysed in forty-nine patients with histologically proven non-small cell lung carcinoma (NSCLC). As a result of the DNA histograms of these 49 patients, 46 (93.88%) were aneuploid and only 3(6.12%) were tetraploid. A linear correlation of the SUV versus the (DNA-MG) (r=0.336, p=0.024) was found, demonstrating that 18F-FDG PET as a non-invasive metabolic imaging technique, may also provide inforrnation correlated to malignant DNA patterns which may be valuable in malignant differentiation and prognostic prediction.
文摘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.
基金Yantai City Science and Technology Development Plan Item,No.2019YD008.
文摘BACKGROUND Lung cancer is the leading cause of cancer-related death.Early diagnosis is critical to improving a patient’s chance of survival.However,lung cancer associated with cystic airspaces is often misdiagnosed or underdiagnosed due to the absence of clinical symptoms,poor imaging specificity,and high risk of biopsy-related complications.CASE SUMMARY We report an unusual case of cancer in a 55-year-old man,in which the lesion evolved from a small solitary thin-walled cyst to lung squamous cell carcinoma(SCC)with metastases in both lungs.The SCC manifested as rare clustered cystic lesions,detected on chest computed tomography.There were air-fluid levels,compartments,and bronchial arteries in the cystic lesions.Additionally,there was no clear extrathoracic metastasis.After chemotherapy,the patient achieved a partial response,type I respiratory failure was relieved,and the lung lesions became a clustered thin-walled cyst.CONCLUSION Pulmonary cystic lesions require regular imaging follow-up.Lung SCC should be a diagnostic consideration in cases of thin-walled cysts as well as multiple clustered cystic lesions.
文摘目的观察基于平扫CT瘤内及瘤周影像组学模型联合临床及常规CT特征鉴别肺原位腺癌(AIS)与微浸润性腺癌(MIA)的价值。方法回顾性分析180例孤立性AIS及180例孤立性MIA肺结节患者,随机将其中各160例纳入训练集(n=320)、各20例纳入测试集(n=40)。以训练集AIS与MIA间差异有统计学意义的临床及常规CT特征构建临床模型;勾画瘤内(CTi)及包含瘤周2 mm(CTi+p2mm)、4 mm(CTi+p4mm)ROI,提取并筛选其影像组学特征,分别以之构建CTi模型、CTi+p2mm模型及CTi+p4mm模型;绘制受试者工作特征(ROC)曲线,计算曲线下面积(AUC),评价各模型效能,遴选预测测试集MIA效能最佳者,联合临床及常规CT特征构建联合模型,观察临床模型、最佳影像组学模型及联合模型的AUC、校准度及净收益。结果训练集内,相比AIS,MIA结节直径较大、密度不均匀、伴血管穿行结节占比较高(P均<0.05)。CTi+p2mm模型鉴别测试集MIA与AIS效能最高(AUC=0.838,P<0.05);以之结合临床及常规CT特征构建的联合模型鉴别诊断效能更佳(AUC=0.867,P<0.05)。联合模型的校准度及0.60~0.90阈值概率区间的临床净收益较高。结论基于平扫CT构建的瘤内和瘤周2 mm ROI影像组学模型能有效鉴别肺MIA与AIS,联合临床及常规CT特征可进一步提高模型鉴别效能。
文摘BACKGROUND: Multirow-detector helical CT (MDCT) allows faster Z-axis coverage and improves longitudinal re- solution to scan the entire liver. This study was to evaluate the value of multiphase hepatic CT scans using MDCT in diagnosing hypervascular hepatocellular carcinoma (HCC). METHODS: Multiphase hepatic CT scans in 40 patients were carried out with a Marconi Mx8000 MDCT scanner. The scans of early arterial phase (EAP), late arterial phase (LAP) and portal venous phase (PVP) were started at 21, 34 and 85 seconds after injection of contrast medium, re- spectively. The number of detected lesions was calculated in each phase. The density of the liver and tumor was great- er than 1 cm for HCC, and the density of the liver and tumor in each phase was statistically calculated. RESULTS: A total of 61 lesions were found in the 40 pa- tients , and lesions greater than 1 cm were seen in 47 cases. The density differences between the liver and tumor were statistically significant (P<0.05) at the LAP and EAP and between the LAP, EAP and PVP. In the 61 lesions, the de- tectability in the EAP, LAP and the double arterial phases (DAP) was 32%, 87%, and 94%, respectively. Significant difference was found between the LAP plus PVP and the EAP plus PVP; but no significant difference was observed between the DAP plus PVP and the LAP plus PVP. CONCLUSIONS: The utility of MDCT scan in the liver has optimized the protocol of arterial phase scan. MDCT is possible to scan the entire liver in a real arterial phase and it is very valuable in the detection of small HCC.
文摘The study examined the association between calcified liver metastases and the histopathology of the primary colorectal carcinoma in Chinese.The clinical,pathological and CT data were retrospectively analyzed in 210 patients (mean age:54.2 years) with liver metastases from colorectal carcinoma.Plain CT scanning and contrast-enhanced scanning were performed in all the patients.For the contrast-enhanced examination,iohexol was injected by using a high pressure syringe at a flow rate of 2.5-3.0 mL/s.The arterial phase lasted approximately 25 s and the portal venous phase about 60 s.All patients had no history of chronic liver diseases and had never received interventional treatments.χ 2-test was used to analyze the rate of calcification in the liver metastasis from colorectal cancer of different differentiation degrees.Among the 210 cases of liver metastases,22 patients (10.5%) were found to have calcified liver metastases on CT scan.Two patients with calcified liver metastasis received lumpectomy and developed calcification in recurrent tumors.Another two patients had calcification in newly developed tumor masses.And the calcification in the newly developed masses was similar to that of their primary counterparts in terms of morphology and distribution.On the enhanced CT scan,the tumors exhibited no enhancement during hepatic arterial phase and showed slight rim enhancement during portal venous scan in the 22 cases.The calcification became obscure on contrast-enhanced scans.Histopathologically,the primary tumors were well-differentiated adenocarcinoma in 6 cases,moderately-differentiated adenocarcinoma in 10,poorly-differentiated adenocarcinoma in 4 and mucinous adenocarcinoma in 2 among the 22 cases.No statistical correlation was noted between the incidence of calcified liver metastasis and the pathological subtypes and differentiation degrees of the primary colorectal carcinoma.It was concluded that calcified liver metastases may result from colorectal adenocarcinomata of different differentiation degrees or mucinous adenocarcinomata in Chinese population.There is no correlation between calcification of liver metastases and the pathological subtype of the primary colorectal carcinoma in Chinese,which is different from the findings that calcified metastases were associated with colorectal mucinous adenocarcinoma in other ethnic groups.
文摘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.