Patterns of cortical reorganization in facial synkinesis:a task functional magnetic resonance imaging study

Facial synkinesis,a sequela of peripheral facial nerve palsy,is characterized by simultaneous involuntary facial movement during a voluntary desired one.Maladaptive cortical plasticity might be involved in the dysfunction of facial muscles.This cohort study investigated the cortical functional alterations in patients with unilateral facial synkinesis,using the task functional magnetic resonance imaging.Facial motor tasks,including blinking and smiling,were performed by 16 patients(aged 30.6 ± 4.5 years,14 females/2 males) and 24 age-and sex-matched healthy controls(aged 29.1 ± 4.2 years,19 females/5 males).Results demonstrated that activation in the cortico-facial motor representation area was lower during tasks in patients with facial synkinesis compared with healthy controls.Facial movements on either side performed by patients caused more intensive activation of the supplementary motor area on the contralateral side of the affected face,than those on the unaffected side.Our results revealed that there was cortical reorganization in the primary sensorimotor area and the supplementary motor area.This study was registered in Chinese Clinical Trial Registry(registration number: Chi CTR1800014630).

Usefulness of two-point Dixon fat-water separation technique in gadoxetic acid-enhanced liver magnetic resonance imaging

AIM:To compare differences between volumetric interpolated breath-hold examination(VIBE) using two-point Dixon fat-water separation(Dixon-VIBE) and chemically selective fat saturation(FS-VIBE) with magnetic resonance imaging examination.METHODS:Forty-nine patients were included, who were scanned with two VIBE sequences(Dixon-VIBE and FS-VIBE) in hepatobiliary phase after gadoxetic acid administration.Subjective evaluations including sharpness of tumor, sharpness of vessels, strength and homogeneity of fat suppression, and artifacts that were scored using a 4-point scale.The liver-to-lesion contrast was also calculated and compared.RESULTS:Dixon-VIBE with water reconstruction had significantly higher subjective scores than FS-VIBE in strength and homogeneity of fat suppression(< 0.0001) but lower scores in sharpness of tumor(P < 0.0001), sharpness of vessels(P = 0.0001), and artifacts(P = 0.034).The liver-to-lesion contrast on Dixon-VIBE images was significantly lower than that on FS-VIBE(16.6% ± 9.4% vs 23.9% ± 12.1%, P = 0.0001).CONCLUSION:Dixon-VIBE provides stronger and more homogenous fat suppression than FS-VIBE, while has lower clarity of focal liver lesions in hepatobiliary phase after gadoxetic acid administration.

^(18)F-PBR06 PET/CT imaging of inflammation and differentiation of lung cancer in mice

The present study explored the 18-kDa translocator protein radioligand ^(18)F-PBR06 as a PET imaging biomarker for diagnosis of inflammation and compared it with ^(18)F-FDG for differentiation of inflammation and lung tumors in animals.^(18)F-PBR06 was synthesized with an average decay-corrected radiochemical yield of 30–40%(end of synthesis, EOS), and the radiochemical purity was greater than 99%. The inflammation-to-blood ratio of ^(18)FPBR06(3.53 ± 0.26) was higher than the tumor-to-blood ratio(1.77 ± 0.35)(P \ 0.001). The inflammation-tomuscle ratio of ^(18)F-PBR06(2.33 ± 0.64) was also higher than the tumor-to-muscle ratio(1.45 ± 0.14)(P = 0.036).Micro-PET/CT images showed high uptake of ^(18)F-FDG in both inflamed muscles and lung tumor tissues. However,^(18)F-PBR06 uptake in inflamed muscles remained higher than that in the lung tumor tissues, following 90 min of dynamic Micro-PET/CT imaging. Further, macrophages in the inflammatory regions showed a higher fluorescence signal than in lung tumor tissues. Results of the study confirmed that ^(18)F-PBR06 PET/CT imaging allowed for diagnosis of inflammation. Moreover,^(18)F-PBR06 uptake in the inflammatory regions was significantly higher than in lung tumor tissues, suggesting that ^(18)F-PBR06 PET/CT imaging has potential to differentiate between peripheral lung cancer and inflammation nodules.

Gadoxetic acid-enhanced magnetic resonance imaging for the detection of small hepatocellular carcinoma(≤ 2.0 cm) in patients with chronic liver disease:A meta-analysis

AIM To perform a meta-analysis assessing the value of gadoxetic acid-enhanced magnetic resonance imaging(Gd-EOB-MRI)in detecting small hepatocellular carcinoma(HCC)(≤2.0 cm)in patients with chronic liver disease.METHODS Databases,including MEDLINE and EMBASE,were searched for relevant original articles published from January 2008 to February 2015.Data were extracted,and summary estimates of diagnostic accuracy indexes such as sensitivity,specificity,diagnostic odds ratio,predictive value,and areas under summary receiver operating characteristic curve were obtained using a random-effects model,with further exploration employing meta-regression and subgroup analyses.RESULTS In 10 studies evaluating 768 patients,pooled perlesion sensitivity of Gd-EOB-DTPA was 91%(95%CI:83%-95%),with a specificity of 95%(95%CI:87%-98%).Overall positive likelihood ratio was 18.1(95%CI:6.6-49.4),for negative likelihood ratio(NLR)of 0.10(95%CI:0.05-0.19)and diagnostic odds ratio of182(95%CI:57-581).Subgroup analysis suggested that diagnostic performance of Gd-EOB-MRI for sub-centimeter HCC(≤1.0 cm)detection was low,with a sensitivity of69%(95%CI:59%-78%).In studies with both Gd-EOBMRI and diffusion-weighted imaging(DWI)performed,Gd-EOB-MRI/DWI combination was more sensitive than Gd-EOB-DTPA alone,whether for small lesions(86%vs77%)or sub-centimeter ones(80%vs 56%).CONCLUSION A limited number of small studies suggested that GdEOB-MRI has good diagnostic performance in the detection of small HCC(≤2.0 cm)among patients with chronic liver disease,but relatively lower performance for detection of sub-centimeter HCC(≤1.0 cm).Combination of Gd-EOB-MRI and DWI can improve the diagnostic sensitivity of MRI.

Primary non-Hodgkin's lymphoma of the liver: sonographic and CT findings

BACKGROUND: A preoperative diagnosis of primary hepatic lymphoma(PHL) can have profound therapeutic and prognostic implications. Because of the rarity of PHL, however, there are few reports on diagnostic imaging. We reviewed the clinical and radiologic findings of 29 patients with PHL, the largest series to date, to evaluate the diagnostic features of this disease.METHODS: Clinical data and radiologic findings at presentation were retrospectively reviewed for 29 patients with pathologically confirmed PHL from January 2005 to June 2013. Imaging studies, including ultrasound(US)(n=29) and contrast-enhanced computed tomography(CECT)(n=24), were performed within 2 weeks before biopsy or surgery.RESULTS: Among the 29 patients, 23(79%) were positive for hepatitis B virus(HBV) and 26(90%) had a significantly elevated level of serum lactate dehydrogenase(LDH). There were two distinct types of PHL on imaging: diffuse(n=5) and nodular(n=24). Homogeneous or heterogeneous hepatomegaly was the only sign for diffuse PHL on both US and CECT, without any definite hepatic mass. For the nodular type, 63%(15/24) of patients had solitary lesions and 38%(9/24) had multiple lesions. On US, seven patients displayed patchy distribution with an indistinct tumor margin and a rich color flow signal. CECT showed rim-like enhancement(n=3) and slightly homogeneous or heterogeneous enhancement(n=14) in the arterial phase and isoenhancement(n=5) and hypoenhancement(n=12) in the portal venous and late phases. Furthermore, in five patients, CT revealed that hepatic vessels passed through the lesions and were not displaced from the abnormal area or appreciably compressed.CONCLUSIONS: The infiltration type of PHL was associated with the histologic subtype. Considered together with HBV positivity and elevated LDH, homogeneous or heterogeneous hepatomegaly may indicate diffuse PHL, whereas patchy distribution with a rich color flow signal on US or normal vessels extending through the lesion on CECT may be the diagnostic indicators of nodular PHL.

Role of MR in the differentiation of IgG4-related from non-IgG4-related hepatic inflammatory pseudotumor

BACKGROUND:Hepatic inflammatory pseudotumor(IPT)is classified into 2 types based on IgG 4 stain:IgG 4-related and non-IgG4-related; the two types differ not only in their pathological characteristics, but also in the clinical features. This study aimed to investigate the MR character of hepatic IPT,and differentiate the IgG4-related IPT from the non-IgG4-related IPT.METHODS:Twenty-five patients with 27 histologically proven hepatic IPTs were retrospectively analyzed. Ten lesions were diagnosed as IgG4-related IPT, and the other 17 as non-IgG4-related IPT. The MR signal features on T1,T2-weighted, dynamic-enhanced, and diffusion-weighted imaging were evaluated and compared. RESULTS:The dominant lesions were subcapsularly distributed(n=17, 63.0%) with clear boundary(n=20, 74.1%), and showed progressive enhancement pattern(n=21, 77.8%) with diffuse homogeneous(n=12, 44.4%) or heterogeneous(n=8,29.6%) hyperintensity, accompanied by delayed capsule-like enhancement(n=17, 63.0%) and central nonenhanced areas(n=18, 66.7%). Morphological features(P>0.05) were not sufficient to differentiate IgG4-related IPT from non-IgG4-related IPT; the wash-out pattern was only found in 2 IgG 4-related IPT, while the progressive enhancement pattern was more common in the non-IgG4-related lesions(n=16)(P=0.022).During portal and delayed phases, iso-/hypoenhanced lesions were only seen in 3 IgG4-related IPT, and circular-enhanced lesions(n=5) existed exceptionally in the non-IgG4-related group with significant differences(P=0.029 and 0.027). Most IgG4-related IPTs had lower apparent diffusion coefficient compared with the liver parenchyma(n=6), while most non-IgG4-related IPTs had higher apparent diffusion coefficient value(n=13)(P=0.046).CONCLUSIONS:Although MR images of hepatic IPT have certain characteristics, they are not enough to differentiate IgG4-related IPT from non-IgG4-related IPT. The enhancement pattern, signal features on portal and delayed phases, and the apparent diffusion coefficient value of the lesion may be helpful for the diagnosis.

Intrahepatic distant recurrence following complete radiofrequency ablation of small hepatocellular carcinoma: risk factors and early MRI evaluation

BACKGROUND: Radiofrequency ablation(RFA) is related to a high intrahepatic distant recurrence(IDR) rate,and the associations between IDR and relevant imaging features have not yet been fully investigated. This study aimed to determine both clinical and imaging risk factors of IDR after complete RFA for HBV-related small hepatocellular carcinoma(HCC)(≤3 cm).METHODS: Thirty-five patients(29 men and 6 women; mean age 60.7 years) with 40 HBV-related small HCCs who underwent complete RFA were included in our study. The incidence and potential clinical and MR imaging risk factors for IDR after RFA were assessed using the Kaplan-Meier method,the log-rank test and a stepwise Cox hazard model.RESULTS: The median follow-up period was 25(4-45) months,and IDR was observed in 20(57.1%) patients. The 12- and 24-month cumulative IDR-free survival rates were 76.7% and 61.3%,respectively. Univariate analysis revealed that pretreatment albumin <3.5 g/d L(P=0.026),multinodular tumor(P=0.032),ablative margin <3 mm(P=0.007),no or disrupted periablational enhancement within 24 hours(P=0.001) and at 1 month(P=0.043) after RFA,and hyperintensity of the central ablative zone on T1-weighted images(T1WI) at 1 month after RFA(P=0.004) were related to IDR. Multivariate analysis showed that pretreatment albumin <3.5 g/d L(P=0.032),mul-tinodular tumor(P=0.012),no or disrupted periablational enhancement within 24 hours after RFA(P=0.001),and hyperintensity of the central ablative zone on T1 WI at 1 month after RFA(P=0.003) were independent risk factors for IDR. During the 1-month follow-up,the apparent diffusion coefficient exhibited an up-and-down evolution without significant value in the prediction of IDR following RFA.CONCLUSIONS: Patients with HBV-related small HCC had a high IDR rate after RFA. The risk factors included low serum albumin,multiple nodules,lesions with no or disrupted periablational enhancement and persistent hyperintensity in the central ablative zone on T1 WI within 1 month after RFA.

Application of contrast-enhanced ultrasound in minimally invasive ablation of benign thyroid nodules

Objective:This study aimed to investigate the application value of contrast-enhanced ultrasound(CEUS)before and after minimally invasive ablation procedures for benign thyroid nodule(s)(BTN).Methods:This prospective study included patients with BTNs scheduled to undergo ultrasound-guided minimally invasive ablation treatment.CEUS was performed before and after ablation(at 1 day,and 1,6,and 12 months after ablation).Changes in microvascular perfusion and the volume of BTNs were noted and assessed.Results:Sixty-two patients(62 BTNs),who underwent ablation procedures between June 2016 and August 2020,were included.All lesions were confirmed by biopsy,and histopathological results were obtained before ablation treatment.On preoperative CEUS,the lesions exhibited hyperenhancement(53.23%)or iso-enhancement(46.77%)during the arterial phase,and all lesions exhibited iso-enhancement in the venous and late phases.One day after ablation,none of the BTNs exhibited obvious enhancement on CEUS.One(1.61%)lesion was retreated due to a nodule-like enhancement area detected by CEUS at the 6-month follow-up.The mean nodular volume reduction rate(VRR)at 1,6,and 12 months follow-up demonstrated no significant difference between the two ablation groups(microwave ablation versus radiofrequency ablation).Twelve months after ablation,the mean(±SD)VRR of all BTNs was 60.3±10.3%.Conclusion:CEUS helped guide treatment decisions for BTNs before ablation treatment.Moreover,it could also be used to accurately and noninvasively evaluate treatment efficacy.

Efficacy of contrast-enhanced ultrasound-guided percutaneous core needle biopsy in anterior mediastinal masses

Objective:To evaluate the efficacy and safety of percutaneous core needle biopsy(PCNB)using ultrasound(US)-guided and contrast-enhanced ultrasound(CEUS)-guided procedures for anterior mediastinal masses(AMMs).Methods:In total,284 consecutive patients(166 men,118 women;mean age,43.0±18.4 years)who underwent PCNB for AMMs were enrolled.Patients were divided into the US-guided group(n=133)and the CEUS-guided group(n=151).PCNB was performed using a core needle(16-gauge or 18-gauge).Internal necrosis,diagnostic yield,and diagnostic accuracy were compared between the two groups.Results:The predominant final diagnosis of the cases in this study was thymoma(29.7%),lymphoma(20.5%),thymic carcinoma(13.3%),and germ cell tumour(13.3%),respectively.There was no significant difference in patient age,sex,number of percutaneous biopsies,or display rate of internal necrosis on conventional US between the two groups.The rate of internal necrosis of the lesions was significantly higher after contrast agent injection(72.2%vs.41.7%;P<0.001).The CEUS-guided group had a higher diagnostic yield than the US-guided group(100%vs.89.5%,P<0.001).There was no significant difference between the diagnostic accuracy of the CEUSguided and US-guided groups(97.3%vs.97.4%;P=1.000).None of the patients experienced adverse reactions or complications after US-guided or CEUS-guided PCNB.Conclusions:CEUS-guided PCNB can improve the diagnostic yield by optimizing the biopsy procedure.

Diagnosis and management of arterioportal fistula occurring after percutaneous transhepatic portal vein cannula-assisted TIPS

To the Editor:Transjugular intrahepatic portosystemic shunt(TIPS)is usually considered the choice for managing complications of portal hypertension such as refractory ascites,esophagogastric variceal bleeding and recurrent bleeding uncontrolled with first line treatment.In recent years,TIPS has been successfully used to treat Budd-Chiari syndrome,hepatic hydrothorax,and portal vein thrombosis.

Microwave ablation combined with transarterial chemoembolization containing doxorubicin hydrochloride liposome for treating primary and metastatic liver cancers

Aims:To determine the safety and efficacy of microwave ablation(MWA)and transarterial chemoembolization(TACE)with doxorubicin hydrochloride liposome(DHL)in patients with primary liver cancer(PLC)and metastatic liver cancer(MLC).Materials and methods:The medical records of patients with primary or metastatic liver cancer who underwent MWA combined with TACE containing DHL from March 2019 to March 2022 were collected and analyzed.Treatment-related adverse events(AEs)were recorded.Local tumor response was evaluated according to the modified RECIST criteria.Local tumor progression-free survival(LTPFS)and overall survival(OS)were calculated using the Kaplan-Meier method.Results:Altogether,96 patients with liver cancer were included(PLC,n=45;MLC,n=51).Forty(41.7%)patients experienced AEs during treatment,and eight(8.3%)patients developed grade 3 AEs.Compared to before treatment,the serum total bilirubin level and neutrophil to lymphocyte ratio significantly increased after treatment.The median LTPFS was 14.5 months in patients with PLC and 10.7 months in patients with MLC.The median OS was not reached in patients with PLC or MLC.The 1-month and 3-month disease control rates reached more than 80%in both groups.Conclusion:MWA combined with TACE with DHL may be a safe and effective method for the treatment of liver cancer.

Multi-organ hereditary hemorrhagic telangiectasia:A case report

BACKGROUND Type 2 hereditary hemorrhagic telangiectasia(HHT)is a rare autosomal dominant disease and is associated with ALK1 gene mutations.Type 2 HHT patients primarily suffer from recurrent bleeding.There is currently no promising treatment.CASE SUMMARY A 5-year-old Chinese patient(III23)was admitted to Zhongshan Hospital for recurrent melena occurring over 2 mo.She had been experiencing epistaxis for years and had been diagnosed with idiopathic pulmonary hypertension 4 mo before presentation.Abdominal computed tomography examination showed hepatic arteriovenous malformation.Gene testing revealed a c.1121G>A mutation on the ALK1 gene.According to the international diagnostic criteria,this patient was diagnosed with HHT.In addition,8 more family members exhibited HHT symptoms to varying degrees.Gene testing in 5 family members(2 with HHT symptoms and 3 without HHT symptoms)revealed the ALK1 c.1121G>A mutation in the 2 family members with HHT symptoms.This missense mutation results in the substitution of arginine for glutamine at amino acid position 374(R374Q)in the conserved functional kinase domain of ALK1.Biological studies revealed that this mutation decreased the kinase activity of ALK1 and impeded the phosphorylation of its substrate Smad1.Moreover,the R374Q mutant downregulated the protein level of collagen-1,a fibrogenic factor,indicating abnormal fiber generation during vascular formation.CONCLUSION The R374Q mutant of ALK1 and its subsequent influence on fiber generation highly indicated its pathogenic role in this family with type 2 HHT.Detection of this gene mutation will facilitate early diagnosis of suspected type 2 HHT patients,and mechanistic studies will provide insights for future therapy.

Combined endovascular brachytherapy, sorafenib, and transarterial chemobolization therapy for hepatocellular carcinoma patients with portal vein tumor thrombus

AIM To evaluate the safety and efficacy of combined endovascular brachytherapy(EVBT),transarterial chemoembolization(TACE),and sorafenib to treat hepatocellular carcinoma(HCC) patients with main portal vein tumor thrombus(MPVTT).METHODS This single-center retrospective study involved 68 patients with unresectable HCC or those who were unfit for liver transplantation and percutaneous frequency ablation according to the BCLC classification. All patients had Child-Pugh classification grade A or B,Eastern Cooperative Oncology Group(ECOG)performance status of 0-2,and MPVTT. The patients received either EVBT with stent placement,TACE,and sorafenib(group A,n = 37),or TACE with sorafenib(group B,n = 31). The time to progression(TTP) and overall survival(OS) were evaluated by propensity score analysis.RESULTS In the entire cohort,the 6-,12-,and 24-mo survival rates were 88.9%,54.3%,and 14.1% in group A,and 45.8%,0%,and 0% in group B,respectively(P < 0.001). The median TTP and OS were significantly longer in group A than group B(TTP: 9.0 mo vs 3.4 mo,P < 0.001; OS: 12.3 mo vs 5.2 mo,P < 0.001). In the propensity score-matched cohort,the median OS was longer in group A than in group B(10.3 mo vs 6.0 mo,P < 0.001). Similarly,the median TTP was longer in group A than in group B(9.0 mo vs 3.4 mo,P < 0.001). Multivariate Cox analysis revealed that the EVBT combined with stent placement,TACE,and sorafenib strategy was an independent predictor of favorable OS(HR = 0.18,P < 0.001). CONCLUSION EVBT combined with stent placement,TACE,and sorafenib might be a safe and effective palliative treatment option for MPVTT.

MiR-182 is up-regulated and targeting Cebpa in hepatocellular carcinoma

MicroRNAs(miRNAs) are endogenous small non-coding RNAs that repress their targets at post transcriptional level.Existing studies have shown that miRNAs are important regulatory genes in hepatocellular carcinoma(HCC),as either tumor suppressors or oncogenes.MiR-122 is normally downregulated in HCC and regarded as a tumor suppressor.Recently miR-122 has been reported to be regulated by CEBPA,which is then involved in a novel pathway to influence proliferation of tumor cells.However it is unknown whether CEBPA is regulated by miRNAs in HCC.In this study,we find that miR-182 is upregulated in HCC model rat,and represses CEBPA in both rat and human.This further improves the current CEBPA/miR-122 pathway that controls the proliferation of tumor cells.These results suggest that miR-182 is a potential oncogene in HCC and could be used as a diagnostic marker and drug target of HCC.

Bronchial artery embolization for hemoptysis:A systematic review and meta-analysis

Objective:To assess the safety and efficacy of bronchial artery embolization(BAE)for hemoptysis.Methods and materials:Databases with articles published in English,including Pubmed,Embase,Web of science and Chochrane library,were comprehensively searched to get accurate,up-to-date and sufficient literature about BAE for hemoptysis until March 2020.The technical success rates,immediate control rates,recurrence rates,mortality rates,and total complication rates(minor and major complication rates)extracted from the articles were pooled to estimate and assess the efficacy and safety of BAE using random-effect and fixed-effect models.Results:21 articles published between 2008 and 2019,which include a total of 2511 patients,were studied to evaluate the safety and efficacy of BAE.The technical success and immediate control rates are 99.9%(95%CI:99%-100%)and 99.5%(95%CI:97.8%-99.2%),respectively.This study showed hemoptysis recurrence in 23.7%(95%CI:18.5%-28.9%)with a mortality rate of 2%(95%CI:0-3%).Additionally,the assessment of complications revealed a total complication rate of 13.4%(95%CI:7.6-19.2%),in which 0.2%(95%CI:0.2-0.4%)were major complications and 10%(95%CI:4.7-9.6%)were minor complications.Conclusion:BAE is an effective,safe,and feasible procedure with a low complication rate for hemoptysis patients.However,recurrence of hemoptysis is still at high risk after BAE due to different underlying diseases.

Percutaneous microwave ablation combined with simultaneous transarterial chemoembolization for hepatocellular carcinoma with macrovascular invasion or extrahepatic metastases

Objective:To evaluate the safety and efficacy of percutaneous microwave ablation(MWA)combined with simultaneous transarterial chemoembolization(TACE)in patients with hepatocellular carcinoma(HCC)patients with microvascular invasion(MVI)or extrahepatic metastases(EHM).Methods:Between August 2012 and April 2017,101 patients with MVI/EHM of HCC underwent percutaneous MWA combined with simultaneous TACE at our center.The clinical data were collected and analyzed for survival and prognostic factors.Results:The mean follow-up time was 23.6±14.7 months.One patient had grade 3 complications,and the median overall survival was 12.0 months(95%confidence interval 9.7-14.3).Multivariate analysis showed that ChildPugh class,serum alpha-fetoprotein level,and Eastern Cooperative Oncology Group performance status were independent factors of survival.Conclusion:Our results suggest that percutaneous MWA combined with simultaneous TACE is a safe and effective treatment for HCC with MVI/EHM.

Dual-modality magnetic resonance/optical imaging-guided sonodynamic therapy of pancreatic cancer with metal-organic nanosonosensitizer

Sonodynamic therapy(SDT)has been more attractive to carry out oncology treatments in recent years.However,imagingguided sonodynamic therapeutic nanomedicine is still a shortage in SDT development.In this work,we designed and fabricated an organic SDT system based on combination of 1,2,4,5-tetrakis(4-carboxyphenyl)-porphyrin(TCPP)and gadolinium(III)(Gd^(3+))creatively(Gd-PPNs).Gd^(3+)was traditionally used to be T_(1)-weighted magnetic resonance imaging(MRI)contrast agent and TCPP was initiatively a fluorescence imaging organic media.Therefore,these new designed nanoparticles have immense potential to integrate MRI and FLI to visualize the Gd-PPNs accumulating and keeping in tumor for a long time,which could be applied for guidance of SDT on tumors in clinical practice.Importantly,excellent SDT efficiency under imaging guidance was verified both in vitro and in vivo in this work.Our findings suggested that Gd-PPNs,as innovative imaging and therapy combinational nanomedicines,were successfully synthesized and were proved to possess excellent imaging-guided sonodynamic therapeutic efficacy.Moreover,this new designed sonosensitizer had great biocompatibility to avoid unnecessary biotoxicity.Overall,this strategy shed light on the MRI/FLI-guidance and successfully induced pancreatic tumor growth inhibition by sonodynamic therapy.

^(18)F-FDG PET/MR Imaging for Evaluating of Obstructive Jaundice:Chinese Expert Consensus

The cause of obstructive jaundice is usually complex which renders its differential diagnosis and lesion localization challenging in clinical practice.Integrated Positron Emission tomography/Magnetic Resonance(PET/MR)offers complementary information from PET and MR in the diagnosis of obstructive jaundice and is becoming widely adopted in clinical setting.While preserving its diagnostic accuracy,it is important to standardize and streamline the clinical scan protocol of PET/MR in evaluating obstructive jaundice.Based on literature review and experience of large number of clinical cases from the author group,this article reports an expert consensus on imaging protocol optimization and case interpretation template standardization.

Development of a Novel Endovascular Brachytherapy Stent:A Proof-of-concept Study

Background and Aims:Endovascular implantation of iodine-125(125I)seeds strand combined with stent is an effective method of treatment for portal vein tumor thrombosis.The aim of this study was to develop a novel endovascular brachytherapy stent(EVB-Stent)and to evaluate its feasibility of use.Methods:An EVB-Stent was implanted into the main portal vein(MPV)in a live porcine model via the percutaneous transhepatic route.Blood samples were collected and tested before and after operation,as well as before euthanasia.Single-photon emission computed tomography(SPECT)combined with CT(SPECT/CT)scan were performed directly after operation and CT scan was performed 2 months after implantation.After the CT scan was performed,all animals were euthanized and histologically examined.Results:The novel stent was successfully positioned in all six pigs.No deterioration of liver function was observed during the 2-month follow-up period.SPECT/CT revealed the uniform distribution of radiation around the seeds strand,and the hottest spot was near the center of the MPV.The patency of the stented MPV was confirmed using CT scans.The tissue-accumulated absorbed dose was 31,822.11 mGy at 10 mm transversely away from the midpoint of the 125I seeds strand,with a half-life of 59.4 days.Pathological examination results showed no significant atrophy or inflammation of adjunct liver tissue,and no obvious intima thickening or thrombosis were detected in the stented MPV.Conclusions:A liver porcine model was used to demonstrate that the transhepatic placement of a novel endovascular brachytherapy stent,EVB-Stent,is both technically feasible and safe.

Identification of CHMP4C as a new risk gene for inherited dilated cardiomyopathy

Dilated cardiomyopathy(DCM) is a primary myocardial disease of unknown cause that is characterized by ventricular enlargement and ventricular systolic dysfunction(Reichart et al., 2019). DCM exhibits obvious heterogeneity, and its outcomes extend from arrhythmia to heart failure. Early arrhythmia is a common condition that may progressively become aggravated, and death can occur at any stage of the disease. The most serious complications are heart failure and sudden death(Mc Nally et al., 2013).