BACKGROUND Minimally invasive surgery(MIS)and craniotomy(CI)are the current treatments for spontaneous supratentorial cerebral haemorrhage(SSTICH).AIM To compare the efficacy and safety of MIS and CI for the treatment...BACKGROUND Minimally invasive surgery(MIS)and craniotomy(CI)are the current treatments for spontaneous supratentorial cerebral haemorrhage(SSTICH).AIM To compare the efficacy and safety of MIS and CI for the treatment of SSTICH.METHODS Clinical and imaging data of 557 consecutive patients with SSTICH who underwent MIS or CI between January 2017 and December 2022 were retrospectively analysed.The patients were divided into two subgroups:The MIS group and CI group.Propensity score matching was performed to minimise case selection bias.The primary outcome was a dichotomous prognostic(favourable or unfavourable)outcome based on the modified Rankin Scale(mRS)score at 3 months;an mRS score of 0–2 was considered favourable.RESULTS In both conventional statistical and binary logistic regression analyses,the MIS group had a better outcome.The outcome of propensity score matching was unexpected(odds ratio:0.582;95%CI:0.281–1.204;P=0.144),which indicated that,after excluding the interference of each confounder,different surgical modalities were more effective,and there was no significant difference in their prognosis.CONCLUSION Deciding between MIS and CI should be made based on the individual patient,considering the hematoma size,degree of midline shift,cerebral swelling,and preoperative Glasgow Coma Scale score.展开更多
Diffusion-weighted magnetic resonance imaging(DWMRI) is considered part of the standard imaging protocol for the evaluation of patients with prostate cancer.It has been proven valuable as a functional tool for qualita...Diffusion-weighted magnetic resonance imaging(DWMRI) is considered part of the standard imaging protocol for the evaluation of patients with prostate cancer.It has been proven valuable as a functional tool for qualitative and quantitative analysis of prostate cancer beyond anatomical MRI sequences such as T2-weighted imaging. This review discusses ongoing controversies in DW-MRI acquisition, including the optimal number of b-values to be used for prostate DWI, and summarizes the current literature on the use of advanced DWMRI techniques. These include intravoxel incoherent motion imaging, which better accounts for the nonmono-exponential behavior of the apparent diffusion coefficient as a function of b-value and the influence of perfusion at low b-values. Another technique is diffusion kurtosis imaging(DKI). Metrics from DKI reflect excess kurtosis of tissues, representing its deviation from Gaussian diffusion behavior. Preliminary results suggest that DKI findings may have more value than findings from conventional DW-MRI for the assessment of prostate cancer.展开更多
The aim of this article is to clarify diagnostic pitfalls of pancreatic serous cystic neoplasm(SCN) that may result in erroneous characterization. Usual and unusual imaging findings of SCN as well as potential SCN mim...The aim of this article is to clarify diagnostic pitfalls of pancreatic serous cystic neoplasm(SCN) that may result in erroneous characterization. Usual and unusual imaging findings of SCN as well as potential SCN mimickers are presented. The diagnostic key of SCN is to look for a cluster of microcysts(honeycomb pattern), which may not be always found in the center. Fibrosis in SCN may be mistaken for a mural nodule of intraductal papillary mucinous neoplasm(IPMN). The absence of cyst wall enhancement may be helpful to distinguish SCN from mucinous cystic neoplasm. However, oligocystic SCN and branch duct type IPMN may morphologically overlap. In addition, solid serous adenoma, an extremely rare variant of SCN, is difficult to distinguish from neuroendocrine tumor.展开更多
Recent retrospective studies have reported the use ofstereotactic radiosurgery(SRS) in the treatment of gy-necologic cancers. SRS uses real-time imaging and highdose radiation beams attached to precise robotic armsto ...Recent retrospective studies have reported the use ofstereotactic radiosurgery(SRS) in the treatment of gy-necologic cancers. SRS uses real-time imaging and highdose radiation beams attached to precise robotic armsto target malignant lesions while sparing normal tissue.The purpose of this review is to examine the indicationsfor SRS in gynecologic oncology, review the currentliterature regarding the use of SRS in gynecologic can-cers, and identify future directions for research in thisarea. Literature on stereotactic radiosurgery was re-viewed using the PubMed search engine. Articles writ-ten in English from 1993-2013 were reviewed, and 20 case series and clinical trials were included. The safetyand efficacy SRS has been demonstrated in all gyne-cologic disease sites including cervical, endometrial,vulvar, vaginal, and ovarian cancers. Indications for itsuse include non-central pelvic recurrences in previouslyirradiated patients, complex or non-resectable diseaserecurrence, and solitary brain metastases. Toxicitiesare usually mild, though grade 3-4 toxicities have been reported. SRS is a promising second line treatment modality for patients with primary or recurrent disease who cannot undergo standard surgical or radiation therapy. Further research is required to determine optimal dosing and fractionation schedules, delineate appropriate patient populations, and assess longterm morbidity and survival.展开更多
We acknowledge our sincere thanks to our reviewers. Many reviewers have contributed their expertise and time to the peer review, a critical process to ensure the quality of our World Series Journals. Both the editors ...We acknowledge our sincere thanks to our reviewers. Many reviewers have contributed their expertise and time to the peer review, a critical process to ensure the quality of our World Series Journals. Both the editors of the journals and authors of the manuscripts submitted to the journals are grateful to the following reviewers for reviewing the articles (either published or rejected) over the past period of time.James Chow, PhD, Radiation Physicist, Radiation Medicine Program, Princess Margaret Hospital, 610 University Avenue,Toronto,展开更多
Many reviewers have contributed their expertise and time to the peer review, a critical process to ensure the quality of World Journal of Radiology. The editors and authors of the articles submitted to the journal are...Many reviewers have contributed their expertise and time to the peer review, a critical process to ensure the quality of World Journal of Radiology. The editors and authors of the articles submitted to the journal are grateful to展开更多
AIM: To discuss the advantages of ultra-high field (7T) for 1H and 13C magnetic resonance spectroscopy (MRS) studies of metabolism.made at both 3 and 7T using 1H MRS. Measurements of glycogen and lipids in muscle were...AIM: To discuss the advantages of ultra-high field (7T) for 1H and 13C magnetic resonance spectroscopy (MRS) studies of metabolism.made at both 3 and 7T using 1H MRS. Measurements of glycogen and lipids in muscle were measured using 13C and 1H MRS respectively. RESULTS: In the brain, increased signal-to-noise ratio (SNR) and dispersion allows spectral separation of the amino-acids glutamate, glutamine and γ-aminobutyric acid (GABA), without the need for sophisticated editing sequences. Improved quantification of these me-tabolites is demonstrated at 7T relative to 3T. SNR was 36% higher, and measurement repeatability (% coefficients of variation) was 4%, 10% and 10% at 7T, vs 8%, 29% and 21% at 3T for glutamate, glutamine and GABA respectively. Measurements at 7T were used to compare metabolite levels in the anterior cingulate cortex (ACC) and insula. Creatine and glutamate levels were found to be significantly higher in the insula compared to the ACC (P 【 0.05). In muscle, the increased SNR and spectral resolution at 7T enables interleaved studies of glycogen (13C) and intra-myocellular lipid (IMCL) and extra-myocellular lipid (EMCL) (1H) following exercise and refeeding. Glycogen levels were sig-nificantly decreased following exercise (-28% at 50% VO2 max; -58% at 75% VO2 max). Interestingly, levels of glycogen in the hamstrings followed those in the quadriceps, despite reduce exercise loading. No changes in IMCL and EMCL were found in the study. CONCLUSION: The demonstrated improvements in brain and muscle MRS measurements at 7T will increase the potential for use in investigating human metabolism and changes due to pathologies.展开更多
The author tells a story of how he has become an expert of interventional radiotherapy from a graduate of middle school.In his childhood,he wanted to become an astronomer.However,he was forced to go to the countryside...The author tells a story of how he has become an expert of interventional radiotherapy from a graduate of middle school.In his childhood,he wanted to become an astronomer.However,he was forced to go to the countryside as a school graduate.In 1974,he was enrolled as a"worker-peasant-soldier"student in Henan Medical College.After graduated from the college,he was assigned to the Radiology Department of the First Affiliated Hospital of Henan Medical College where he worked hard as an assistant doctor.Then,he was transferred to Nanfang Hospital(Guangzhou,China) where he achieved great successes and thus has become an expert of interventional radiology.展开更多
Determining whether sevoflurane sedation in children leads to“pseudo”prominent leptomeningeal contrast enhancement(pLMCE)on 3 Tesla magnetic resonance imaging will help reduce overdiagnosis by radiologists and clari...Determining whether sevoflurane sedation in children leads to“pseudo”prominent leptomeningeal contrast enhancement(pLMCE)on 3 Tesla magnetic resonance imaging will help reduce overdiagnosis by radiologists and clarify the pathophysiological changes of pLMCE.展开更多
AIM: To describe our preliminary experience with simultaneous whole body ^(18)F-fluorodeoxyglucose(^(18)F-FDG)positron emission tomography and magnetic resonance imaging(PET-MRI) in the evaluation of pediatric oncolog...AIM: To describe our preliminary experience with simultaneous whole body ^(18)F-fluorodeoxyglucose(^(18)F-FDG)positron emission tomography and magnetic resonance imaging(PET-MRI) in the evaluation of pediatric oncology patients.METHODS: This prospective, observational, singlecenter study was Health Insurance Portability and Accountability Act-compliant, and institutional review board approved. To be eligible, a patient was required to:(1) have a known or suspected cancer diagnosis;(2) be under the care of a pediatric hematologist/oncologist; and(3) be scheduled for clinically indicated ^(18)F-FDG PETCT examination at our institution. Patients underwent PET-CT followed by PET-MRI on the same day. PET-CT examinations were performed using standard department protocols. PET-MRI studies were acquired with an integrated 3 Tesla PET-MRI scanner using whole body T1 Dixon, T2 HASTE, EPI diffusion-weighted imaging(DWI) and STIR sequences. No additional radiotracer was given for the PET-MRI examination. Both PET-CT and PETMRI examinations were reviewed by consensus by two study personnel. Test performance characteristics of PETMRI, for the detection of malignant lesions, including FDG maximum standardized uptake value(SUVmax) and minimum apparent diffusion coefficient(ADCmin), were calculated on a per lesion basis using PET-CT as a reference standard.RESULTS: A total of 10 whole body PET-MRI exams were performed in 7 pediatric oncology patients. The mean patient age was 16.1 years(range 12-19 years) including 6 males and 1 female. A total of 20 malignant and 21 benign lesions were identified on PET-CT. PET-MRI SUVmax had excellent correlation with PET-CT SUVmax for both benign and malignant lesions(R = 0.93). PETMRI SUVmax > 2.5 had 100% accuracy for discriminating benign from malignant lesions using PET-computed tomography(CT) reference. Whole body DWI was also evaluated: the mean ADCmin of malignant lesions(780.2 + 326.6) was significantly lower than that of benign lesions(1246.2 + 417.3; P = 0.0003; Student's t test). A range of ADCmin thresholds for malignancy were evaluated, from 0.5-1.5 × 10^(-3) mm^2/s. The 1.0 × 10^(-3) ADCmin threshold performed best compared with PETCT reference(68.3% accuracy). However, the accuracy of PET-MRI SUVmax was significantly better than ADCmin for detecting malignant lesions compared with PET-CT reference(P < 0.0001; two-tailed Mc Nemar's test).CONCLUSION: These results suggest a clinical role for simultaneous whole body PET-MRI in evaluating pediatric cancer patients.展开更多
Congenital central nervous system tumors diagnosed during pregnancy are rare, and often have a poor prognosis. The most frequent type is the teratoma. Use of ultrasound and magnetic resonance image allows the suspicio...Congenital central nervous system tumors diagnosed during pregnancy are rare, and often have a poor prognosis. The most frequent type is the teratoma. Use of ultrasound and magnetic resonance image allows the suspicion of brain tumors during pregnancy. However, the definitive diagnosis is only confirmed after birth by histology. The purpose of this mini-review article is to describe the general clinical aspects of intracranial tumors and describe the main fetal brain tumors.展开更多
Splenomegaly is a common sequela of cirrhosis, and is frequently associated with decreased hematologic indices including thrombocytopenia and leukopenia. Partial splenic artery embolization(PSE) has been demonstrated ...Splenomegaly is a common sequela of cirrhosis, and is frequently associated with decreased hematologic indices including thrombocytopenia and leukopenia. Partial splenic artery embolization(PSE) has been demonstrated to effectively increase hematologic indices in cirrhotic patients with splenomegaly. This is particularly valuable amongst those cirrhotic patients who are not viable candidates for splenectomy. Although PSE was originally developed decades ago, it has recently received increased attention. Presently, PSE is being utilized to address a number of clinical concerns in the setting of cirrhosis, including: decreased hematologic indices, portal hypertension and its associated sequela, and splenic artery steal syndrome. Following PSE patients demonstrate significant increases in platelets and leukocytes. Though progressive decline of hematologic indices occur following PSE, they remain improved as compared to pre-procedural values over long-term follow-up. PSE, however, is not without risk and complications of the procedure may occur. The most common complication of PSE is post-embolization syndrome, which involves a constellation of symptoms including fever, pain, and nausea/vomiting. The rate of complications has been shown to increase as the percent of total splenic volume embolized increases. The purpose of this review is to explore the current literature in re-gards to PSE in cirrhotic patients and to highlight their techniques, and statistically summarize their results and associated complications.展开更多
AIM: To evaluate the complications and clinical outcomes of transcatheter arterial embolization (TAE) for symptoms related to severe arterioportal fistulas (APFs). METHODS: Six patients (3 males, 3 females; mean age, ...AIM: To evaluate the complications and clinical outcomes of transcatheter arterial embolization (TAE) for symptoms related to severe arterioportal fistulas (APFs). METHODS: Six patients (3 males, 3 females; mean age, 63.8 years; age range, 60-71 years) with chronic liver disease and severe APFs due to percutaneous intrahepatic treatment (n=5) and portal vein (PV) tumor thrombosis of hepatocellular carcinoma (n=1) underwent TAE for symptoms related to severe APFs [refractory ascites (n=4), hemorrhoidal hemorrhage (n=1), and hepatic encephalopathy (n=1)]. Control of symptoms related to APFs and complications were evaluated during the follow-up period (range, 4-57 mo). RESULTS: In all patients, celiac angiography revealed immediate retrograde visualization of the main PV before TAE, indicating severe APF. Selective TAE for the hepatic arteries was performed using metallic coils (MC, n=4) and both MCs and n-butyl cyanoacrylate (n=2). Three patients underwent repeated TAEs for residual APFs and ascites. Four patients developed PV thrombosis after TAE. During the follow-up period after TAE, APF obliteration and symptomatic improvement were obtained in all patients. CONCLUSION: Although TAE for severe APFs may sometimes be complicated by PV thrombosis, TAE can be an effective treatment to improve clinical symptoms related to severe APFs.展开更多
AIM:To evaluate safety and utility of coronary computed tomography angiography(CCTA) compared to invasive coronary angiography(ICA) in new cardiomyopathy.METHODS:Eighteen patients(mean age 56.5 years,10 males) who pre...AIM:To evaluate safety and utility of coronary computed tomography angiography(CCTA) compared to invasive coronary angiography(ICA) in new cardiomyopathy.METHODS:Eighteen patients(mean age 56.5 years,10 males) who presented for evaluation of new onset heart failure with evidence of systolic dysfunction(ejection fraction 【 40%) on echocardiography and recent ICA were prospectively enrolled.Patients with known coronary artery disease,atrial fibrillation,creatinine 】 1.5 g/dL,and contraindication to intravenous contrast administration were excluded.CCTA was performed using a dual source 64-slice scanner.Mean heart rate was 75 beats per minute.Stenosis was graded for each coronary segment as:none,mild(【 50%),moderate(50%-70%),severe(】 70%),or non-evaluable.Ischemic cardiomyopathy(ICM) was diagnosed if severe stenosis was present in the left main,proximal left anterior descending artery,or two or more major arteries.RESULTS:Two patients were diagnosed with ICM by ICA.CCTA correctly identified 2 patients with ICM and 16 patients as non-ICM.CCTA successfully evaluated 240/246 coronary segments with an accuracy of 97.5%,sensitivity 70%,specificity 98.7%,positive predictive value of 70%,and negative predictive value of 98.7% for identifying severe stenosis on a per-segment level.CONCLUSION:Dual source 64-slice multi-detector CCTA is a safe,accurate,and non-invasive technique for diagnosing ICM in patients presenting during the acute phase of newly diagnosed cardiomyopathy.展开更多
Lipomas of the pancreas are very rare.There are fewer than 25 reported cases of lipoma originating from the pancreas.We present a case of pancreatic lipoma in a 61-year-old woman with magnetic resonance imaging findin...Lipomas of the pancreas are very rare.There are fewer than 25 reported cases of lipoma originating from the pancreas.We present a case of pancreatic lipoma in a 61-year-old woman with magnetic resonance imaging findings and confirmatory histological findings.We discuss and highlight the radiological features distinguishing a pancreatic lipoma from other fatty lesions of the pancreas and pancreatic liposarcoma and provide a brief review of the literature.展开更多
AIM:To investigate the features of abdominal crush injuries resulting from an earthquake using multidetector computed tomography(MDCT). METHODS:Fifty-one survivors with abdominal crush injuries due to the 2008 Sichuan...AIM:To investigate the features of abdominal crush injuries resulting from an earthquake using multidetector computed tomography(MDCT). METHODS:Fifty-one survivors with abdominal crush injuries due to the 2008 Sichuan earthquake underwent emergency non-enhanced scans with 16-row MDCT. Data were reviewed focusing on anatomic regions including lumbar vertebrae,abdominal wall soft tissue, retroperitoneum and intraperitoneal space;and types of traumatic lesions. RESULTS:Fractures of lumbar vertebrae and abdominal wall soft tissue injuries were more common than retro-and intraperitoneal injuries(P【0.05).With regard to the 49 lumbar vertebral fractures in 24 patients,these occurred predominantly in the transverse process(P【0.05),and 66.67%of patients(16/24) had fractures of multiple vertebrae,predominantly two vertebrae in 62.5%of patients(10/16),mainly in L1-3 vertebrae in 81.63%of the vertebrae(40/49). Retroperitoneal injuries occurred more frequently than intraperitoneal injuries(P【0.05),and renal and liver injuries were most often seen in the retroperitoneum and in the intraperitoneal space,respectively(all P【 0.05). CONCLUSION:Transverse process fractures in two vertebrae among L1-3 vertebrae,injury of abdominal wall soft tissue,and renal injury might be features of earthquake-related crush abdominal injury.展开更多
AIM:To measure the dose distribution,related to the treatment planning calculations,in the contralateral mammary gland of breast cancer patients treated with accelerated hypofractionated 3-dimensional conformal radiot...AIM:To measure the dose distribution,related to the treatment planning calculations,in the contralateral mammary gland of breast cancer patients treated with accelerated hypofractionated 3-dimensional conformal radiotherapy.METHODS:Thirty-four prospectively selected female patients with right breast cancer (pN0,negative surgical margins) were treated with breast-conserving surgery.A total dose of 42.5 Gy (2.66 Gy/fraction) was prescribed;it was requested that planning target volumes be covered by the 95% isodose line.The contralateral mam-mary gland was defined on CT simulation.The dose received was evaluated by dose volume histograms.RESULTS:The measured contralateral breast doses were:(1) Dose maximum:290-448 cGy [Equivalent (Eq) 337-522 cGy];(2) Mean dose:45-70 cGy (Eq 524815 cGy);and (3) Median dose:29-47 cGy (337-547 cGy) for total primary breast dose of 42.5 Gy in 16 equal fractions.The spearman rho correlation showed statistical significance between the contralateral breast volume and maximum dose (P=0.0292),as well as mean dose (P=0.0025) and median dose (P=0.046) to the breast.CONCLUSION:Minimizing the dose to the contralateral breast has to be one of the priorities of the radiation oncologist when using short schedules because of the radiosensitivity of this organ at risk.Further study is necessary to assess the long-term clinical impact of this schedule.展开更多
Solid malignancies have to develop their own blood supply for their aggressive growth and metastasis;a process known as tumor angiogenesis.Angiogenesis is largely involved in tumor survival,progression and spread,whic...Solid malignancies have to develop their own blood supply for their aggressive growth and metastasis;a process known as tumor angiogenesis.Angiogenesis is largely involved in tumor survival,progression and spread,which are known to be significantly attributed to treatment failures.Over the past decades,efforts have been made to understand the difference between nor-mal and tumor vessels.It has been demonstrated that tumor vasculature is structurally immature with chaotic and leaky phenotypes,which provides opportunities for developing novel anticancer strategies.Targeting tumor vasculature is not only a unique therapeutic interven-tion to starve neoplastic cells,but also enhances the efficacy of conventional cancer treatments.Vascular dis-rupting agents(VDAs) have been developed to disrupt the already existing neovasculature in actively growing tumors,cause catastrophic vascular shutdown within short time,and induce secondary tumor necrosis.VDAs are cytostatic;they can only inhibit tumor growth,but not eradicate the tumor.This novel drug mechanism has urged us to develop multiparametric imaging biomark-ers to monitor early hemodynamic alterations,cellular dysfunctions and metabolic impairments before tumor dimensional changes can be detected.In this article,we review the characteristics of tumor vessels,tubulin-destabilizing mechanisms of VDAs,and in vivo effects of the VDAs that have been mostly studied in preclinical studies and clinical trials.We also compare the differ-ent tumor models adopted in the preclinical studies on VDAs.Multiparametric imaging biomarkers,mainly diffu-sion-weighted imaging and dynamic contrast-enhanced imaging from magnetic resonance imaging,are evalu-ated for their potential as morphological and functional imaging biomarkers for monitoring therapeutic effects of VDAs.展开更多
Significant hemobilia due to arterio-biliary fistula is a very rare complication of chemoradiation therapy(CRT) for unresectable intrahepatic cholangiocarcinoma(ICC).Here we report a case of arterio-biliary fistula af...Significant hemobilia due to arterio-biliary fistula is a very rare complication of chemoradiation therapy(CRT) for unresectable intrahepatic cholangiocarcinoma(ICC).Here we report a case of arterio-biliary fistula after CRT for unresectable ICC demonstrated by angiographic examinations.This fistula was successfully treated by endovascular embolization.Hemobilia is a rare complication,but arterio-biliary fistula should be considered after CRT of ICC.展开更多
基金Supported by The Technology Innovation Guidance Programme of Science and Technology,Department of Hunan Province,No.2020SK51708The Scientific Research Programme of Hunan Provincial Health Commission,No.B2019110 and No.20201959The Hunan Nature Science Foundation,No.S2023JJMSXM1898.
文摘BACKGROUND Minimally invasive surgery(MIS)and craniotomy(CI)are the current treatments for spontaneous supratentorial cerebral haemorrhage(SSTICH).AIM To compare the efficacy and safety of MIS and CI for the treatment of SSTICH.METHODS Clinical and imaging data of 557 consecutive patients with SSTICH who underwent MIS or CI between January 2017 and December 2022 were retrospectively analysed.The patients were divided into two subgroups:The MIS group and CI group.Propensity score matching was performed to minimise case selection bias.The primary outcome was a dichotomous prognostic(favourable or unfavourable)outcome based on the modified Rankin Scale(mRS)score at 3 months;an mRS score of 0–2 was considered favourable.RESULTS In both conventional statistical and binary logistic regression analyses,the MIS group had a better outcome.The outcome of propensity score matching was unexpected(odds ratio:0.582;95%CI:0.281–1.204;P=0.144),which indicated that,after excluding the interference of each confounder,different surgical modalities were more effective,and there was no significant difference in their prognosis.CONCLUSION Deciding between MIS and CI should be made based on the individual patient,considering the hematoma size,degree of midline shift,cerebral swelling,and preoperative Glasgow Coma Scale score.
文摘Diffusion-weighted magnetic resonance imaging(DWMRI) is considered part of the standard imaging protocol for the evaluation of patients with prostate cancer.It has been proven valuable as a functional tool for qualitative and quantitative analysis of prostate cancer beyond anatomical MRI sequences such as T2-weighted imaging. This review discusses ongoing controversies in DW-MRI acquisition, including the optimal number of b-values to be used for prostate DWI, and summarizes the current literature on the use of advanced DWMRI techniques. These include intravoxel incoherent motion imaging, which better accounts for the nonmono-exponential behavior of the apparent diffusion coefficient as a function of b-value and the influence of perfusion at low b-values. Another technique is diffusion kurtosis imaging(DKI). Metrics from DKI reflect excess kurtosis of tissues, representing its deviation from Gaussian diffusion behavior. Preliminary results suggest that DKI findings may have more value than findings from conventional DW-MRI for the assessment of prostate cancer.
文摘The aim of this article is to clarify diagnostic pitfalls of pancreatic serous cystic neoplasm(SCN) that may result in erroneous characterization. Usual and unusual imaging findings of SCN as well as potential SCN mimickers are presented. The diagnostic key of SCN is to look for a cluster of microcysts(honeycomb pattern), which may not be always found in the center. Fibrosis in SCN may be mistaken for a mural nodule of intraductal papillary mucinous neoplasm(IPMN). The absence of cyst wall enhancement may be helpful to distinguish SCN from mucinous cystic neoplasm. However, oligocystic SCN and branch duct type IPMN may morphologically overlap. In addition, solid serous adenoma, an extremely rare variant of SCN, is difficult to distinguish from neuroendocrine tumor.
文摘Recent retrospective studies have reported the use ofstereotactic radiosurgery(SRS) in the treatment of gy-necologic cancers. SRS uses real-time imaging and highdose radiation beams attached to precise robotic armsto target malignant lesions while sparing normal tissue.The purpose of this review is to examine the indicationsfor SRS in gynecologic oncology, review the currentliterature regarding the use of SRS in gynecologic can-cers, and identify future directions for research in thisarea. Literature on stereotactic radiosurgery was re-viewed using the PubMed search engine. Articles writ-ten in English from 1993-2013 were reviewed, and 20 case series and clinical trials were included. The safetyand efficacy SRS has been demonstrated in all gyne-cologic disease sites including cervical, endometrial,vulvar, vaginal, and ovarian cancers. Indications for itsuse include non-central pelvic recurrences in previouslyirradiated patients, complex or non-resectable diseaserecurrence, and solitary brain metastases. Toxicitiesare usually mild, though grade 3-4 toxicities have been reported. SRS is a promising second line treatment modality for patients with primary or recurrent disease who cannot undergo standard surgical or radiation therapy. Further research is required to determine optimal dosing and fractionation schedules, delineate appropriate patient populations, and assess longterm morbidity and survival.
文摘We acknowledge our sincere thanks to our reviewers. Many reviewers have contributed their expertise and time to the peer review, a critical process to ensure the quality of our World Series Journals. Both the editors of the journals and authors of the manuscripts submitted to the journals are grateful to the following reviewers for reviewing the articles (either published or rejected) over the past period of time.James Chow, PhD, Radiation Physicist, Radiation Medicine Program, Princess Margaret Hospital, 610 University Avenue,Toronto,
文摘Many reviewers have contributed their expertise and time to the peer review, a critical process to ensure the quality of World Journal of Radiology. The editors and authors of the articles submitted to the journal are grateful to
基金Supported by The Haldane-Spearman Consortium for PhD funding for Dr. Gunner F, Swecarb AB for provision of the carbo-hydrate drink,and Pfizer for funding the 1H Repeatability work Dr.Stephenson M was supported by the University of Notting-ham’s Mansfield Fellowship scheme+2 种基金7T work was supported by grant G9900259 from the Medical Research CouncilPfizer and grant G0901321 from the Medical Research CouncilThe 7 T MR Scanner in Nottingham, was funded by a Joint Infrastructure Fund Grant from the Wellcome Trust UK
文摘AIM: To discuss the advantages of ultra-high field (7T) for 1H and 13C magnetic resonance spectroscopy (MRS) studies of metabolism.made at both 3 and 7T using 1H MRS. Measurements of glycogen and lipids in muscle were measured using 13C and 1H MRS respectively. RESULTS: In the brain, increased signal-to-noise ratio (SNR) and dispersion allows spectral separation of the amino-acids glutamate, glutamine and γ-aminobutyric acid (GABA), without the need for sophisticated editing sequences. Improved quantification of these me-tabolites is demonstrated at 7T relative to 3T. SNR was 36% higher, and measurement repeatability (% coefficients of variation) was 4%, 10% and 10% at 7T, vs 8%, 29% and 21% at 3T for glutamate, glutamine and GABA respectively. Measurements at 7T were used to compare metabolite levels in the anterior cingulate cortex (ACC) and insula. Creatine and glutamate levels were found to be significantly higher in the insula compared to the ACC (P 【 0.05). In muscle, the increased SNR and spectral resolution at 7T enables interleaved studies of glycogen (13C) and intra-myocellular lipid (IMCL) and extra-myocellular lipid (EMCL) (1H) following exercise and refeeding. Glycogen levels were sig-nificantly decreased following exercise (-28% at 50% VO2 max; -58% at 75% VO2 max). Interestingly, levels of glycogen in the hamstrings followed those in the quadriceps, despite reduce exercise loading. No changes in IMCL and EMCL were found in the study. CONCLUSION: The demonstrated improvements in brain and muscle MRS measurements at 7T will increase the potential for use in investigating human metabolism and changes due to pathologies.
文摘The author tells a story of how he has become an expert of interventional radiotherapy from a graduate of middle school.In his childhood,he wanted to become an astronomer.However,he was forced to go to the countryside as a school graduate.In 1974,he was enrolled as a"worker-peasant-soldier"student in Henan Medical College.After graduated from the college,he was assigned to the Radiology Department of the First Affiliated Hospital of Henan Medical College where he worked hard as an assistant doctor.Then,he was transferred to Nanfang Hospital(Guangzhou,China) where he achieved great successes and thus has become an expert of interventional radiology.
基金Supported by the Chongging Medical Scientific Research Project(Joint Project of Chongqing Health Commission and Science and Technology Bureau),No.2022QNXM013 and No.2023MSXM016.
文摘Determining whether sevoflurane sedation in children leads to“pseudo”prominent leptomeningeal contrast enhancement(pLMCE)on 3 Tesla magnetic resonance imaging will help reduce overdiagnosis by radiologists and clarify the pathophysiological changes of pLMCE.
文摘AIM: To describe our preliminary experience with simultaneous whole body ^(18)F-fluorodeoxyglucose(^(18)F-FDG)positron emission tomography and magnetic resonance imaging(PET-MRI) in the evaluation of pediatric oncology patients.METHODS: This prospective, observational, singlecenter study was Health Insurance Portability and Accountability Act-compliant, and institutional review board approved. To be eligible, a patient was required to:(1) have a known or suspected cancer diagnosis;(2) be under the care of a pediatric hematologist/oncologist; and(3) be scheduled for clinically indicated ^(18)F-FDG PETCT examination at our institution. Patients underwent PET-CT followed by PET-MRI on the same day. PET-CT examinations were performed using standard department protocols. PET-MRI studies were acquired with an integrated 3 Tesla PET-MRI scanner using whole body T1 Dixon, T2 HASTE, EPI diffusion-weighted imaging(DWI) and STIR sequences. No additional radiotracer was given for the PET-MRI examination. Both PET-CT and PETMRI examinations were reviewed by consensus by two study personnel. Test performance characteristics of PETMRI, for the detection of malignant lesions, including FDG maximum standardized uptake value(SUVmax) and minimum apparent diffusion coefficient(ADCmin), were calculated on a per lesion basis using PET-CT as a reference standard.RESULTS: A total of 10 whole body PET-MRI exams were performed in 7 pediatric oncology patients. The mean patient age was 16.1 years(range 12-19 years) including 6 males and 1 female. A total of 20 malignant and 21 benign lesions were identified on PET-CT. PET-MRI SUVmax had excellent correlation with PET-CT SUVmax for both benign and malignant lesions(R = 0.93). PETMRI SUVmax > 2.5 had 100% accuracy for discriminating benign from malignant lesions using PET-computed tomography(CT) reference. Whole body DWI was also evaluated: the mean ADCmin of malignant lesions(780.2 + 326.6) was significantly lower than that of benign lesions(1246.2 + 417.3; P = 0.0003; Student's t test). A range of ADCmin thresholds for malignancy were evaluated, from 0.5-1.5 × 10^(-3) mm^2/s. The 1.0 × 10^(-3) ADCmin threshold performed best compared with PETCT reference(68.3% accuracy). However, the accuracy of PET-MRI SUVmax was significantly better than ADCmin for detecting malignant lesions compared with PET-CT reference(P < 0.0001; two-tailed Mc Nemar's test).CONCLUSION: These results suggest a clinical role for simultaneous whole body PET-MRI in evaluating pediatric cancer patients.
文摘Congenital central nervous system tumors diagnosed during pregnancy are rare, and often have a poor prognosis. The most frequent type is the teratoma. Use of ultrasound and magnetic resonance image allows the suspicion of brain tumors during pregnancy. However, the definitive diagnosis is only confirmed after birth by histology. The purpose of this mini-review article is to describe the general clinical aspects of intracranial tumors and describe the main fetal brain tumors.
文摘Splenomegaly is a common sequela of cirrhosis, and is frequently associated with decreased hematologic indices including thrombocytopenia and leukopenia. Partial splenic artery embolization(PSE) has been demonstrated to effectively increase hematologic indices in cirrhotic patients with splenomegaly. This is particularly valuable amongst those cirrhotic patients who are not viable candidates for splenectomy. Although PSE was originally developed decades ago, it has recently received increased attention. Presently, PSE is being utilized to address a number of clinical concerns in the setting of cirrhosis, including: decreased hematologic indices, portal hypertension and its associated sequela, and splenic artery steal syndrome. Following PSE patients demonstrate significant increases in platelets and leukocytes. Though progressive decline of hematologic indices occur following PSE, they remain improved as compared to pre-procedural values over long-term follow-up. PSE, however, is not without risk and complications of the procedure may occur. The most common complication of PSE is post-embolization syndrome, which involves a constellation of symptoms including fever, pain, and nausea/vomiting. The rate of complications has been shown to increase as the percent of total splenic volume embolized increases. The purpose of this review is to explore the current literature in re-gards to PSE in cirrhotic patients and to highlight their techniques, and statistically summarize their results and associated complications.
文摘AIM: To evaluate the complications and clinical outcomes of transcatheter arterial embolization (TAE) for symptoms related to severe arterioportal fistulas (APFs). METHODS: Six patients (3 males, 3 females; mean age, 63.8 years; age range, 60-71 years) with chronic liver disease and severe APFs due to percutaneous intrahepatic treatment (n=5) and portal vein (PV) tumor thrombosis of hepatocellular carcinoma (n=1) underwent TAE for symptoms related to severe APFs [refractory ascites (n=4), hemorrhoidal hemorrhage (n=1), and hepatic encephalopathy (n=1)]. Control of symptoms related to APFs and complications were evaluated during the follow-up period (range, 4-57 mo). RESULTS: In all patients, celiac angiography revealed immediate retrograde visualization of the main PV before TAE, indicating severe APF. Selective TAE for the hepatic arteries was performed using metallic coils (MC, n=4) and both MCs and n-butyl cyanoacrylate (n=2). Three patients underwent repeated TAEs for residual APFs and ascites. Four patients developed PV thrombosis after TAE. During the follow-up period after TAE, APF obliteration and symptomatic improvement were obtained in all patients. CONCLUSION: Although TAE for severe APFs may sometimes be complicated by PV thrombosis, TAE can be an effective treatment to improve clinical symptoms related to severe APFs.
基金Supported by Grants from the NYU Department of Radiology and Society of Computed Body Tomography and Magnetic Resonance
文摘AIM:To evaluate safety and utility of coronary computed tomography angiography(CCTA) compared to invasive coronary angiography(ICA) in new cardiomyopathy.METHODS:Eighteen patients(mean age 56.5 years,10 males) who presented for evaluation of new onset heart failure with evidence of systolic dysfunction(ejection fraction 【 40%) on echocardiography and recent ICA were prospectively enrolled.Patients with known coronary artery disease,atrial fibrillation,creatinine 】 1.5 g/dL,and contraindication to intravenous contrast administration were excluded.CCTA was performed using a dual source 64-slice scanner.Mean heart rate was 75 beats per minute.Stenosis was graded for each coronary segment as:none,mild(【 50%),moderate(50%-70%),severe(】 70%),or non-evaluable.Ischemic cardiomyopathy(ICM) was diagnosed if severe stenosis was present in the left main,proximal left anterior descending artery,or two or more major arteries.RESULTS:Two patients were diagnosed with ICM by ICA.CCTA correctly identified 2 patients with ICM and 16 patients as non-ICM.CCTA successfully evaluated 240/246 coronary segments with an accuracy of 97.5%,sensitivity 70%,specificity 98.7%,positive predictive value of 70%,and negative predictive value of 98.7% for identifying severe stenosis on a per-segment level.CONCLUSION:Dual source 64-slice multi-detector CCTA is a safe,accurate,and non-invasive technique for diagnosing ICM in patients presenting during the acute phase of newly diagnosed cardiomyopathy.
文摘Lipomas of the pancreas are very rare.There are fewer than 25 reported cases of lipoma originating from the pancreas.We present a case of pancreatic lipoma in a 61-year-old woman with magnetic resonance imaging findings and confirmatory histological findings.We discuss and highlight the radiological features distinguishing a pancreatic lipoma from other fatty lesions of the pancreas and pancreatic liposarcoma and provide a brief review of the literature.
基金Supported by The National Natural Science Foundation of China,No.30870688The Science Foundation for Distinguished Young Scholars of Sichuan Province,No.2010JQ0039
文摘AIM:To investigate the features of abdominal crush injuries resulting from an earthquake using multidetector computed tomography(MDCT). METHODS:Fifty-one survivors with abdominal crush injuries due to the 2008 Sichuan earthquake underwent emergency non-enhanced scans with 16-row MDCT. Data were reviewed focusing on anatomic regions including lumbar vertebrae,abdominal wall soft tissue, retroperitoneum and intraperitoneal space;and types of traumatic lesions. RESULTS:Fractures of lumbar vertebrae and abdominal wall soft tissue injuries were more common than retro-and intraperitoneal injuries(P【0.05).With regard to the 49 lumbar vertebral fractures in 24 patients,these occurred predominantly in the transverse process(P【0.05),and 66.67%of patients(16/24) had fractures of multiple vertebrae,predominantly two vertebrae in 62.5%of patients(10/16),mainly in L1-3 vertebrae in 81.63%of the vertebrae(40/49). Retroperitoneal injuries occurred more frequently than intraperitoneal injuries(P【0.05),and renal and liver injuries were most often seen in the retroperitoneum and in the intraperitoneal space,respectively(all P【 0.05). CONCLUSION:Transverse process fractures in two vertebrae among L1-3 vertebrae,injury of abdominal wall soft tissue,and renal injury might be features of earthquake-related crush abdominal injury.
文摘AIM:To measure the dose distribution,related to the treatment planning calculations,in the contralateral mammary gland of breast cancer patients treated with accelerated hypofractionated 3-dimensional conformal radiotherapy.METHODS:Thirty-four prospectively selected female patients with right breast cancer (pN0,negative surgical margins) were treated with breast-conserving surgery.A total dose of 42.5 Gy (2.66 Gy/fraction) was prescribed;it was requested that planning target volumes be covered by the 95% isodose line.The contralateral mam-mary gland was defined on CT simulation.The dose received was evaluated by dose volume histograms.RESULTS:The measured contralateral breast doses were:(1) Dose maximum:290-448 cGy [Equivalent (Eq) 337-522 cGy];(2) Mean dose:45-70 cGy (Eq 524815 cGy);and (3) Median dose:29-47 cGy (337-547 cGy) for total primary breast dose of 42.5 Gy in 16 equal fractions.The spearman rho correlation showed statistical significance between the contralateral breast volume and maximum dose (P=0.0292),as well as mean dose (P=0.0025) and median dose (P=0.046) to the breast.CONCLUSION:Minimizing the dose to the contralateral breast has to be one of the priorities of the radiation oncologist when using short schedules because of the radiosensitivity of this organ at risk.Further study is necessary to assess the long-term clinical impact of this schedule.
基金Supported by(partially) The grants awarded by Fonds voor Wetenschappelijk Onderzoek-Vlaanderen(FWO Vlaanderen) Impulsfinanciering project(ZWAP/05/018)Geconcerteerde Onderzoeksactie of the Flemish Government,OT project(OT/06/70)+1 种基金the K.U.Leuven Molecular Small Animal Imaging Center MoSAIC (KUL EF/05/08)the center of excellence In vivo Molecular Imaging Research of K.U.Leuven and a EU project Asia-Link CfP 2006-EuropeAid/123738/C/ACT/Multi-Proposal No.128-498/111
文摘Solid malignancies have to develop their own blood supply for their aggressive growth and metastasis;a process known as tumor angiogenesis.Angiogenesis is largely involved in tumor survival,progression and spread,which are known to be significantly attributed to treatment failures.Over the past decades,efforts have been made to understand the difference between nor-mal and tumor vessels.It has been demonstrated that tumor vasculature is structurally immature with chaotic and leaky phenotypes,which provides opportunities for developing novel anticancer strategies.Targeting tumor vasculature is not only a unique therapeutic interven-tion to starve neoplastic cells,but also enhances the efficacy of conventional cancer treatments.Vascular dis-rupting agents(VDAs) have been developed to disrupt the already existing neovasculature in actively growing tumors,cause catastrophic vascular shutdown within short time,and induce secondary tumor necrosis.VDAs are cytostatic;they can only inhibit tumor growth,but not eradicate the tumor.This novel drug mechanism has urged us to develop multiparametric imaging biomark-ers to monitor early hemodynamic alterations,cellular dysfunctions and metabolic impairments before tumor dimensional changes can be detected.In this article,we review the characteristics of tumor vessels,tubulin-destabilizing mechanisms of VDAs,and in vivo effects of the VDAs that have been mostly studied in preclinical studies and clinical trials.We also compare the differ-ent tumor models adopted in the preclinical studies on VDAs.Multiparametric imaging biomarkers,mainly diffu-sion-weighted imaging and dynamic contrast-enhanced imaging from magnetic resonance imaging,are evalu-ated for their potential as morphological and functional imaging biomarkers for monitoring therapeutic effects of VDAs.
文摘Significant hemobilia due to arterio-biliary fistula is a very rare complication of chemoradiation therapy(CRT) for unresectable intrahepatic cholangiocarcinoma(ICC).Here we report a case of arterio-biliary fistula after CRT for unresectable ICC demonstrated by angiographic examinations.This fistula was successfully treated by endovascular embolization.Hemobilia is a rare complication,but arterio-biliary fistula should be considered after CRT of ICC.