During the first wave of the pandemic,coronavirus disease 2019(COVID-19)infection has been considered mainly as a pulmonary infection.However,different clinical and radiological manifestations were observed over time,...During the first wave of the pandemic,coronavirus disease 2019(COVID-19)infection has been considered mainly as a pulmonary infection.However,different clinical and radiological manifestations were observed over time,including involvement of abdominal organs.Nowadays,the liver is considered one of the main affected abdominal organs.Hepatic involvement may be caused by either a direct damage by the virus or an indirect damage related to COVID-19 induced thrombosis or to the use of different drugs.After clinical assessment,radiology plays a key role in the evaluation of liver involvement.Ultrasonography(US),computed tomography(CT)and magnetic resonance imaging(MRI)may be used to evaluate liver involvement.US is widely available and it is considered the first-line technique to assess liver involvement in COVID-19 infection,in particular liver steatosis and portal-vein thrombosis.CT and MRI are used as second-and third-line techniques,respectively,considering their higher sensitivity and specificity compared to US for assessment of both parenchyma and vascularization.This review aims to the spectrum of COVID-19 liver involvement and the most common imaging features of COVID-19 liver damage.展开更多
BACKGROUND Lymphovascular invasion(LVI)and perineural invasion(PNI)are important prognostic factors for gastric cancer(GC)that indicate an increased risk of metastasis and poor outcomes.Accurate preoperative predictio...BACKGROUND Lymphovascular invasion(LVI)and perineural invasion(PNI)are important prognostic factors for gastric cancer(GC)that indicate an increased risk of metastasis and poor outcomes.Accurate preoperative prediction of LVI/PNI status could help clinicians identify high-risk patients and guide treatment deci-sions.However,prior models using conventional computed tomography(CT)images to predict LVI or PNI separately have had limited accuracy.Spectral CT provides quantitative enhancement parameters that may better capture tumor invasion.We hypothesized that a predictive model combining clinical and spectral CT parameters would accurately preoperatively predict LVI/PNI status in GC patients.AIM To develop and test a machine learning model that fuses spectral CT parameters and clinical indicators to predict LVI/PNI status accurately.METHODS This study used a retrospective dataset involving 257 GC patients(training cohort,n=172;validation cohort,n=85).First,several clinical indicators,including serum tumor markers,CT-TN stages and CT-detected extramural vein invasion(CT-EMVI),were extracted,as were quantitative spectral CT parameters from the delineated tumor regions.Next,a two-step feature selection approach using correlation-based methods and information gain ranking inside a 10-fold cross-validation loop was utilized to select informative clinical and spectral CT parameters.A logistic regression(LR)-based nomogram model was subsequently constructed to predict LVI/PNI status,and its performance was evaluated using the area under the receiver operating characteristic curve(AUC).RESULTS In both the training and validation cohorts,CT T3-4 stage,CT-N positive status,and CT-EMVI positive status are more prevalent in the LVI/PNI-positive group and these differences are statistically significant(P<0.05).LR analysis of the training group showed preoperative CT-T stage,CT-EMVI,single-energy CT values of 70 keV of venous phase(VP-70 keV),and the ratio of standardized iodine concentration of equilibrium phase(EP-NIC)were independent influencing factors.The AUCs of VP-70 keV and EP-NIC were 0.888 and 0.824,respectively,which were slightly greater than those of CT-T and CT-EMVI(AUC=0.793,0.762).The nomogram combining CT-T stage,CT-EMVI,VP-70 keV and EP-NIC yielded AUCs of 0.918(0.866-0.954)and 0.874(0.784-0.936)in the training and validation cohorts,which are significantly higher than using each of single independent factors(P<0.05).CONCLUSION The study found that using portal venous and EP spectral CT parameters allows effective preoperative detection of LVI/PNI in GC,with accuracy boosted by integrating clinical markers.展开更多
AIM: To assess the diagnostic accuracy of multidetectorrow computed tomography(MDCT) as compared with conventional magnetic resonance imaging(MRI), in identifying mesorectal fascia(MRF) invasion in rectal cancer patie...AIM: To assess the diagnostic accuracy of multidetectorrow computed tomography(MDCT) as compared with conventional magnetic resonance imaging(MRI), in identifying mesorectal fascia(MRF) invasion in rectal cancer patients.METHODS: Ninety-one patients with biopsy proven rectal adenocarcinoma referred for thoracic and abdominal CT staging were enrolled in this study. The contrast-enhanced MDCT scans were performed on a 256 row scanner(ICT, Philips) with the following acquisition parameters: tube voltage 120 KV, tube current 150-300 m As. Imaging data were reviewed as axial and as multiplanar reconstructions(MPRs) images along the rectal tumor axis. MRI study, performed on 1.5 T with dedicated phased array multicoil, included multiplanar T2 and axial T1 sequences and diffusion weighted images(DWI). Axial and MPR CT images independently were compared to MRI and MRF involvement was determined. Diagnostic accuracy of both modalities was compared and statistically analyzed.RESULTS: According to MRI, the MRF was involved in 51 patients and not involved in 40 patients. DWI allowed to recognize the tumor as a focal mass with high signal intensity on high b-value images, compared with the signal of the normal adjacent rectal wall or with the lower tissue signal intensity background. The number of patients correctly staged by the native axial CT images was 71 out of 91(41 with involved MRF; 30 with not involved MRF), while by using the MPR 80 patients were correctly staged(45 with involved MRF; 35 with not involved MRF). Local tumor staging suggested by MDCT agreed with those of MRI, obtaining for CT axial images sensitivity and specificity of 80.4% and 75%, positive predictive value(PPV) 80.4%, negative predictive value(NPV) 75% and accuracy 78%; while performing MPR the sensitivity and specificity increased to 88% and 87.5%, PPV was 90%, NPV 85.36% and accuracy 88%. MPR images showed higher diagnostic accuracy, in terms of MRF involvement, than native axial images, as compared to the reference magnetic resonance images. The difference in accuracy was statistically significant(P = 0.02). CONCLUSION: New generation CT scanner, using high resolution MPR images, represents a reliable diagnostic tool in assessment of loco-regional and whole body staging of advanced rectal cancer, especially in patients with MRI contraindications.展开更多
OBJECTIVE Major depressive disorder(MDD) is a highly heterogeneous mental illness.Further classification may help characterize its heterogeneity.The purpose of this study was to examine metabolomic and brain connectom...OBJECTIVE Major depressive disorder(MDD) is a highly heterogeneous mental illness.Further classification may help characterize its heterogeneity.The purpose of this study was to examine metabolomic and brain connectomic associations with traditional Chinese medicine(TCM) diagnostic classification of MDD.METHODS Fifty unmedicated depressed patients were classified into Liver Qi Stagnation(LQS,n=30) and Heart and Spleen Deficiency(HSD,n=20) subtypes according to TCM diagnosis.Healthy volunteers(n=28) were included as controls.Gas chromatography-mass spectrometry(GC-MS) and diffusion tensor imaging were used to detect serum and urinary metabolomic profiles and whole-brain white matter connectivity,respectively.RESULTS In metabolomic analysis,28 metabolites were identified for good separations between TCM subtypes and healthy controls in serum and urine samples.While both TCM subtypes had similar profiles in proteinogenic branched-chain amino acids and energy metabolism-related metabolites that were differentiated from healthy controls,the LQS subtype additionally differed from healthy controls in multiple amino acid metabolites that are involved in the biosynthesis of monoamine and amino acid neurotransmitters.Several metabolites are differentially associated with the two subtypes.In connectomic analysis,The LQS subtype showed significant differences in multiple network metrics of the angular gyrus,middle occipital gyrus,calcarine sulcus,and Heschl′ s gyrus when compared to the other two groups.The HSD subtype had markedly greater regional connectivity of the insula,parahippocampal gyrus,and posterior cingulate gyrus than the other two groups,and microstructural abnormalities of the frontal medial orbital gyrus and middle temporal pole.The insular betweenness centrality was strongly inversely correlated with the severity of depression and dichotomized the two subtypes at the optimal cutoff value with acceptable sensitivity and specificity.CONCLUSION The LQS subtype may represent an MDD subpopulation mainly characterized by abnormalities in the biosynthesis of monoamine and amino acid neurotransmitters,closer associations with stress-related pathophysiology,and aberrant connectivity of the audiovisual perception-related temporal-occipital network,whereas the HSD subtype is more closely associated with hyperconnectivity and microstructural abnormalities of the limbicparalimbic network.Certain metabolomic and connectomic variables are potential biomarkers for TCM diagnostic subtypes which is perhaps an alternative classification for depressive disorders.展开更多
BACKGROUND:Closed loop bowel obstruction is a specific type of mechanical obstruction with a high risk of strangulation and bowel infarction,especially in the small bowel.It is associated with a high mortality rate.He...BACKGROUND:Closed loop bowel obstruction is a specific type of mechanical obstruction with a high risk of strangulation and bowel infarction,especially in the small bowel.It is associated with a high mortality rate.Hence,it is important for emergency physicians to identify the presence of strangulation,while making the diagnosis of closed loop small bowel obstruction.METHODS:We reported three patients with strangulated closed loop small bowel obstruction associated with severe abdominal pain,who had been treated at the emergency department.Urgent computerized tomography was performed in the patients.RESULTS:Two patients were discharged with stable conditions,and one patient died after hemodialysis.CONCLUSION:Urgent computerized tomography of the abdomen serves as an important diagnostic tool in view of its ability to detect the site,level and cause of obstruction along with the distinctive CT appearance of closed loop small bowel obstruction and signs of ischemia.Early definitive diagnosis will guide subsequent management and improve outcomes.展开更多
Retrospective study was done at KAUH to determine the sonographic characteristics in predicting the malignancy of thyroid nodules. The sample was 120 patients consisting of 70 benign nodules and 50 malignant nodules. ...Retrospective study was done at KAUH to determine the sonographic characteristics in predicting the malignancy of thyroid nodules. The sample was 120 patients consisting of 70 benign nodules and 50 malignant nodules. Out of 120 patients, 106 (88.3%) female and 14 (11.7%) male patients. Out of 106 female patients, 64 (91.45) had benign and 42 had malignant thyroid nodules. Out of 14 (11.7) male patients, 6 had benign and 8 had malignant thyroid nodules. The youngest patient in our study was 31 years and the oldest patient was 76 years. The common range of patients age was ≥ 60 years and consisting of twenty (28.6%) benign thyroid nodules and fourteen (28%) malignant thyroid nodules. The majority of patients’ age group with malignant thyroid nodules were between 50 - 60 years and consisting of twenty (40%) malignant nodules. In our study, according to the result of gray scale and color Doppler ultrasonography, hypo-echogenicity, solid echo structure, micro-calcification and intra-nodular vascularity were the significant characteristics of malignancy in nodules with sensitivity (72%, 74%, 48% and 88% respectively), specificity (66%, 63%, 94% and 69% respectively), PPV (60%, 59%, 86% and 67% respectively) and NPV (77%, 77%, 72% and 89% respectively).展开更多
The post-hepatectomy recurrence rate of hepatocellular carcinoma(HCC)is persistently high,affecting the prognosis of patients.An effective therapeutic option is crucial for achieving long-term survival in patients wit...The post-hepatectomy recurrence rate of hepatocellular carcinoma(HCC)is persistently high,affecting the prognosis of patients.An effective therapeutic option is crucial for achieving long-term survival in patients with postoperative recurrences.Local ablative therapy has been established as a treatment option for resectable and unresectable HCCs,and it is also a feasible approach for recurrent HCC(RHCC)due to less trauma,shorter operation times,fewer complications,and faster recovery.This review focused on ablation techniques,description of potential candidates,and therapeutic and prognostic implications of ablation for guiding its application in treating intrahepatic RHCC.展开更多
The present letter to the editor corresponds to the article entitled“Comprehensive literature review on the radiographic findings,imaging modalities,and the role of radiology in the coronavirus disease 2019(COVID-19)...The present letter to the editor corresponds to the article entitled“Comprehensive literature review on the radiographic findings,imaging modalities,and the role of radiology in the coronavirus disease 2019(COVID-19)pandemic”by Pal et al,published in World J Radiol.2021;13(9):258-282.With zero to unknown prevalence,COVID-19 has created a heterogeneous and unforeseen situation across the world.Healthcare providers encountered new challenges in image interpretation,characterization,and prognostication of the disease.Pal et al delineated the radiological findings,which would guide the radiologists to identify the early signs of severe infection.展开更多
AIM: To analyze the 5-year disease-free survival(DFS) of primary orbital lymphoma(POL) by clinical characteristics and imaging features.METHODS: A total of 72 patients, 43 males and 29 females, with histologically con...AIM: To analyze the 5-year disease-free survival(DFS) of primary orbital lymphoma(POL) by clinical characteristics and imaging features.METHODS: A total of 72 patients, 43 males and 29 females, with histologically confirmed POL, were retrospectively recruited between January 2012 and May 2017. The information on clinical characteristics, imaging features, and 5-year DFS was obtained. Univariate and multivariate forward logistic regression analyses were used to identify the variables significantly associated with 5-year DFS. Kaplan-Meier was applied for survival analysis. RESULTS: Univariate analysis revealed that uni-or bilateral orbital involvement, single or multiple lesions, treatment methods, and contrast enhancement pattern on images were significant for 5-year DFS(P=0.022, 0.042, <0.001, and 0.028, respectively), while in multivariate logistic regression analysis, only uni-or bilateral orbital involvement, treatment methods and contrast enhancement pattern on images were significant(r=0.453, 0.897, and 0.556, P=0.038, <0.001 and 0.022, respectively). The survival curves for DFS were obtained. CONCLUSION: The majority of POL are B-cell lymphomas. Unilateral orbital involvement, homogeneous contrast enhancement on images, and the appropriate treatment schemes result to be significant factors for a good prognosis for POL.展开更多
Irreversible electroporation(IRE) employs the use of an electric field to cause irreversible permeability of the cell membrane, inducing apoptosis. The use of IRE for locally advanced pancreatic cancer(LAPC) was first...Irreversible electroporation(IRE) employs the use of an electric field to cause irreversible permeability of the cell membrane, inducing apoptosis. The use of IRE for locally advanced pancreatic cancer(LAPC) was first described in 2012. The crucial advantage of IRE compared with other devices employing thermal ablation is the safety around vital structures such as vessels and ducts. This makes it an attractive option for use in the pancreas due to the close proximity of multiple major vascular structures, biliary ducts, and adjacent gastrointestinal organs. Over the past decade, IRE has established itself as a useful treatment adjunct and may soon become the standard of care, particularly for LAPC. This article will explore the current evidence and provide a concise summary of pertinent issues, including patient selection, preoperative management, clinical outcomes, radiological response and future prospects of IRE in pancreatic cancer.展开更多
The medical sector values time when it determines life in its totality. Any waste of time, especially in critical conditions, compromises patients and puts lives at stake. From a diagnosis and treatment perspective, e...The medical sector values time when it determines life in its totality. Any waste of time, especially in critical conditions, compromises patients and puts lives at stake. From a diagnosis and treatment perspective, efficient use of time determines the success of procedures. Whether it be the inclusion of computing technologies or it be the implementation of informatics, the benefits of medical technology have been tremendous to the healthcare sector. This research has looked at the impact of the Radiology Information System (RIS) on CT reporting time in the King Khalid Hospital (KKH) in the Kingdom of Saudi Arabia. The approach of the study has been quasi-experimental, using the power calculation of a pair of 381 CT scan reports of 40,000 after which the data was collected and analyzed by using SPSS to deduce the impact that RIS has on CT reporting time. The comparison of CT reporting time is done between two distinct timeframes Pre- and Post-installation of RIS. The patients in the current study were organized into three primary categories: emergency patients, inpatients, and outpatients. The results show that the turnaround time was impacted positively with the incorporation of RIS and related technologies in CT scan patients. The outpatient department saw the most improvement among the three categories indicating the highest average percentage of reduction in Turnaround Time. Thus, it was concluded that the RIS has an overall positive impact on CT reporting time.展开更多
Central nervous system abnormalities in fetuses are fairly common,happening in 0.1%to 0.2%of live births and in 3%to 6%of stillbirths.So initial detection and categorization of fetal Brain abnormalities are critical.M...Central nervous system abnormalities in fetuses are fairly common,happening in 0.1%to 0.2%of live births and in 3%to 6%of stillbirths.So initial detection and categorization of fetal Brain abnormalities are critical.Manually detecting and segmenting fetal brain magnetic resonance imaging(MRI)could be timeconsuming,and susceptible to interpreter experience.Artificial intelligence(AI)algorithms and machine learning approaches have a high potential for assisting in the early detection of these problems,improving the diagnosis process and follow-up procedures.The use of AI and machine learning techniques in fetal brain MRI was the subject of this narrative review paper.Using AI,anatomic fetal brain MRI processing has investigated models to predict specific landmarks and segmentation automatically.All gestation age weeks(17-38 wk)and different AI models(mainly Convolutional Neural Network and U-Net)have been used.Some models'accuracy achieved 95%and more.AI could help preprocess and postprocess fetal images and reconstruct images.Also,AI can be used for gestational age prediction(with one-week accuracy),fetal brain extraction,fetal brain segmentation,and placenta detection.Some fetal brain linear measurements,such as Cerebral and Bone Biparietal Diameter,have been suggested.Classification of brain pathology was studied using diagonal quadratic discriminates analysis,Knearest neighbor,random forest,naive Bayes,and radial basis function neural network classifiers.Deep learning methods will become more powerful as more large-scale,labeled datasets become available.Having shared fetal brain MRI datasets is crucial because there aren not many fetal brain pictures available.Also,physicians should be aware of AI's function in fetal brain MRI,particularly neuroradiologists,general radiologists,and perinatologists.展开更多
The embolization of gastric varices is an established technique for acute bleeding in patients with portal hypertension. Here, we report an attempt to embolize a gastrorenal shunt to facilitate esophagectomy in a pati...The embolization of gastric varices is an established technique for acute bleeding in patients with portal hypertension. Here, we report an attempt to embolize a gastrorenal shunt to facilitate esophagectomy in a patient with an esophageal malignancy. To our knowledge, this is the first case in the literature to highlight the role of interventional medicine in the treatment of patients with esophageal malignancy.展开更多
Cardioembolic stroke is a potentially devastating condition and tends to have a poor prognosis compared with other ischemic stroke subtypes.Therefore,it is important for proper therapeutic management to identify a car...Cardioembolic stroke is a potentially devastating condition and tends to have a poor prognosis compared with other ischemic stroke subtypes.Therefore,it is important for proper therapeutic management to identify a cardiac source of embolism in stroke patients.Cardiac computed tomography(CCT)can detect the detailed visualization of various cardiac pathologies in the cardiac chambers,interatrial and interventricular septum,valves,and myocardium with few motion artifacts and few dead angles.Multiphase reconstruction images of the entire cardiac cycle make it possible to demonstrate cardiac structures in a dynamic manner.Consequently,CCT has the ability to provide high-quality information about causal heart disease in cardioembolic stroke.In addition,CCT can simultaneously evaluate obstructive coronary artery disease,which may be helpful in surgical planning in patients who need urgent surgery,such as cardiac tumors or infective endocarditis.This review will introduce the potential clinical applications of CCT in an ischemic stroke population,with a focus on diagnosing cardioembolic sources using CCT.展开更多
In the ever-evolving landscape of cancer research and treatment,the quest for novel and non-invasive imaging techniques has become crucial for accurate diagnosis and effective therapy.This study[1]successfully develop...In the ever-evolving landscape of cancer research and treatment,the quest for novel and non-invasive imaging techniques has become crucial for accurate diagnosis and effective therapy.This study[1]successfully developed a good manufacturing practices(GMP)grade ^(89)Zr-labeled anti-Claudin18.2(CLDN18.2)recombinant humanized antibody TST001.^(89)Zr-DFO-TST001 exhibited high radiochemical purity(>99%)and specific activity(24.15±1.34 GBq/mmol).It demonstrated good specificity and rapid tumor accumulation in vivo and in vivo.Through immuno-PET imaging,it enables non-invasive visualization and quantification of CLDN18.2 expression level in CLDN18.2-positive gastrointestinal tumor models.展开更多
Introduction: Polycystic ovary syndrome (PCOS) is one of the most common endocrine and metabolic disorders in premenopausal women affecting 5% - 10% women in reproductive age. Many studies show that good dietary habit...Introduction: Polycystic ovary syndrome (PCOS) is one of the most common endocrine and metabolic disorders in premenopausal women affecting 5% - 10% women in reproductive age. Many studies show that good dietary habits and balanced diet in addition to regular exercise can significantly improve the symptoms of the syndrome. The prevalence rate in the Kingdom of Saudi Arabia reached 42.8%. This study aimed to measure the awareness of Jazan females about the nutrition related effects of polycystic ovary syndrome and investigate the association between age and awareness of nutrition related effect on PCOS. Method: Cross sectional study was conducted during a period from January 9<sup>th</sup> to February 5<sup>th</sup> 2023, by a questionnaire used to measure the awareness of female in Jazan region about the nutrition related effects of poly cystic ovary syndrome. Data was collected using Google questionnaire survey and it was randomly distributed to Jazan women from 18 to 50 years old. The questionnaire was about general information about PCOS, nutrition-related effects of PCOS, the effects of eating patterns on PCOS, physical activity, and sleeping. The sample size was 384 women. Results: The total response was about 363 women. The results showed that women in the Jazan region did not have sufficient knowledge about PCOS 51.5% and 63.4% had no knowledge about diet recommendations for PCOS. However, there was awareness about healthy eating patterns that reduce the symptoms of PCOS. The level of awareness of PCOS and its association with age among Jazan women was higher in young adult groups (21 to 29 years old). Conclusion: Based on the results of this study, the level of knowledge about PCOS among Jazan women is insufficient. Also, their awareness about diet and lifestyle interventions was low. There is a relationship between age and awareness of the nutrition-related effects of PCOS. Promoting the role of balanced nutrition and nutritional knowledge is an important requirement for all women, especially those with PCOS. The role of health, educational, and governmental institutions is important in spreading the link between nutrition and PCOS.展开更多
Background: Non-uniformity in signal intensity occurs commonly in magnetic resonance (MR) imaging, which may pose substantial problems when using a 3T scanner. Therefore, image non-uniformity correction is usually app...Background: Non-uniformity in signal intensity occurs commonly in magnetic resonance (MR) imaging, which may pose substantial problems when using a 3T scanner. Therefore, image non-uniformity correction is usually applied. Purpose: To compare the correction effects of the phased-array uniformity enhancement (PURE), a calibration-based image non-uniformity correction method, among three different software versions in 3T Gd-EOB-DTPA-enhanced MR imaging. Material and Methods: Hepatobiliary-phase images of a total of 120 patients who underwent Gd-EOB-DTPA-enhanced MR imaging on the same 3T scanner were analyzed retrospectively. Forty patients each were examined using three software versions (DV25, DV25.1, and DV26). The effects of PURE were compared by visual assessment, histogram analysis of liver signal intensity, evaluation of the spatial distribution of correction effects, and evaluation of quantitative indices of liver parenchymal enhancement. Results: The visual assessment indicated the highest uniformity of PURE-corrected images for DV26, followed by DV25 and DV25.1. Histogram analysis of corrected images demonstrated significantly larger variations in liver signal for DV25.1 than for the other two versions. Although PURE caused a relative increase in pixel values for central and lateral regions, such effects were weaker for DV25.1 than for the other two versions. In the evaluation of quantitative indices of liver parenchymal enhancement, the liver-to-muscle ratio (LMR) was significantly higher for the corrected images than for the uncorrected images, but the liver-to-spleen ratio (LSR) showed no significant differences. For corrected images, the LMR was significantly higher for DV25 and DV26 than for DV25.1, but the LSR showed no significant differences among the three versions. Conclusion: There were differences in the effects of PURE among the three software versions in 3T Gd-EOB-DTPA-enhanced MR imaging. Even if the non-uniformity correction method has the same brand name, correction effects may differ depending on the software version, and these differences may affect visual and quantitative evaluations.展开更多
Objective:Response Evaluation Criteria in Solid Tumors(RECIST)guideline version 1.0(RECIST 1.0)was proposed as a new guideline for evaluating tumor response and has been widely accepted as a standardized measure.With ...Objective:Response Evaluation Criteria in Solid Tumors(RECIST)guideline version 1.0(RECIST 1.0)was proposed as a new guideline for evaluating tumor response and has been widely accepted as a standardized measure.With a number of issues being raised on RECIST 1.0,however,a revised RECIST guideline version 1.1(RECIST 1.1)was proposed by the RECIST Working Group in 2009.This study was conducted to compare CT tumor response based on RECIST 1.1 vs.RECIST 1.0 in patients with advanced gastric cancer(AGC).Methods:We reviewed 61 AGC patients with measurable diseases by RECIST 1.0 who were enrolled in other clinical trials between 2008 and 2010.These patients were retrospectively re-analyzed to determine the concordance between the two response criteria using theκstatistic.Results:The number and sum of tumor diameters of the target lesions by RECIST 1.1 were significantly lower than those by RECIST 1.0(P<0.0001).However,there was excellent agreement in tumor response between RECIST 1.1 and RECIST 1.0(κ=0.844).The overall response rates(ORRs)according to RECIST1.0 and RECIST 1.1 were 32.7%(20/61)and 34.5%(20/58),respectively.One patient with partial response(PR)based on RECIST 1.0 was reclassified as stable disease(SD)by RECIST 1.1.Of two patients with SD by RECIST 1.0,one was downgraded to progressive disease and the other was upgraded to PR by RECIST 1.1.Conclusions:RECIST 1.1 provided almost perfect agreement with RECIST 1.0 in the CT assessment of tumor response of AGC.展开更多
AIM: To investigate the effect of partial splenic embolization (PSE) on platelet values in liver cirrhosis patients with thrombocytopenia and to determine the effective embolization area for platelet values improvemen...AIM: To investigate the effect of partial splenic embolization (PSE) on platelet values in liver cirrhosis patients with thrombocytopenia and to determine the effective embolization area for platelet values improvement. METHODS: Blood parameters and liver function indicators were measured on 10 liver cirrhosis patients (6 in Child-Pugh grade A and 4 in grade B) with thrombocytopenia (platelet values < 80 × 103/μL) before embolization. Computed tomography scan was also needed in advance to acquire the splenic baseline. After 2 to 3 d, angiography and splenic embolization were performed. A second computed tomography scan was made to confirm the embolization area after 2 to 3 wk of embolization. The blood parameters of patients were also examined biweekly during the 1 year follow-up period. RESULTS: According to the computed tomography images after partial splenic embolization, we divided all patients into two groups: low (< 30%), and high (≥ 30%) embolization area groups. The platelet values were increased by 3 times compared to baseline levels after 2 wk of embolization in high embolization area group. In addition, there were significant differences in platelet values between low and high embolization area groups. GPT values decreased significantly in all patients after 2 wk of embolization. The improvement in platelet and GPT values still persisted until 1 year after PSE. In addition, 3 of 4 (75%) Child-Pugh grade B patients progressed to grade A after 2 mo of PSE. The complicationrate in < 30% and ≥ 30% embolization area groups was 50% and 100%, respectively. CONCLUSION: Partial splenic embolization is an effective method to improve platelet values and GPT values in liver cirrhosis patients with thrombocytopenia and the ≥ 30% embolization area is meaningful for platelet values improvement. The relationship between the complication rate and embolization area needs further studies.展开更多
AIM:To introduce an animal model of hepatocellular carcinoma (HCC) in ACI-rats, and to evaluate the therapeutic effects of Poly-lactide-co-glycolide(PIcg)-microspheres in the transarterial chemoembolization (TACE) in ...AIM:To introduce an animal model of hepatocellular carcinoma (HCC) in ACI-rats, and to evaluate the therapeutic effects of Poly-lactide-co-glycolide(PIcg)-microspheres in the transarterial chemoembolization (TACE) in this model, as well the value of this model in the experiments of interventional therapy.展开更多
文摘During the first wave of the pandemic,coronavirus disease 2019(COVID-19)infection has been considered mainly as a pulmonary infection.However,different clinical and radiological manifestations were observed over time,including involvement of abdominal organs.Nowadays,the liver is considered one of the main affected abdominal organs.Hepatic involvement may be caused by either a direct damage by the virus or an indirect damage related to COVID-19 induced thrombosis or to the use of different drugs.After clinical assessment,radiology plays a key role in the evaluation of liver involvement.Ultrasonography(US),computed tomography(CT)and magnetic resonance imaging(MRI)may be used to evaluate liver involvement.US is widely available and it is considered the first-line technique to assess liver involvement in COVID-19 infection,in particular liver steatosis and portal-vein thrombosis.CT and MRI are used as second-and third-line techniques,respectively,considering their higher sensitivity and specificity compared to US for assessment of both parenchyma and vascularization.This review aims to the spectrum of COVID-19 liver involvement and the most common imaging features of COVID-19 liver damage.
基金Supported by Science and Technology Project of Fujian Province,No.2022Y0025.
文摘BACKGROUND Lymphovascular invasion(LVI)and perineural invasion(PNI)are important prognostic factors for gastric cancer(GC)that indicate an increased risk of metastasis and poor outcomes.Accurate preoperative prediction of LVI/PNI status could help clinicians identify high-risk patients and guide treatment deci-sions.However,prior models using conventional computed tomography(CT)images to predict LVI or PNI separately have had limited accuracy.Spectral CT provides quantitative enhancement parameters that may better capture tumor invasion.We hypothesized that a predictive model combining clinical and spectral CT parameters would accurately preoperatively predict LVI/PNI status in GC patients.AIM To develop and test a machine learning model that fuses spectral CT parameters and clinical indicators to predict LVI/PNI status accurately.METHODS This study used a retrospective dataset involving 257 GC patients(training cohort,n=172;validation cohort,n=85).First,several clinical indicators,including serum tumor markers,CT-TN stages and CT-detected extramural vein invasion(CT-EMVI),were extracted,as were quantitative spectral CT parameters from the delineated tumor regions.Next,a two-step feature selection approach using correlation-based methods and information gain ranking inside a 10-fold cross-validation loop was utilized to select informative clinical and spectral CT parameters.A logistic regression(LR)-based nomogram model was subsequently constructed to predict LVI/PNI status,and its performance was evaluated using the area under the receiver operating characteristic curve(AUC).RESULTS In both the training and validation cohorts,CT T3-4 stage,CT-N positive status,and CT-EMVI positive status are more prevalent in the LVI/PNI-positive group and these differences are statistically significant(P<0.05).LR analysis of the training group showed preoperative CT-T stage,CT-EMVI,single-energy CT values of 70 keV of venous phase(VP-70 keV),and the ratio of standardized iodine concentration of equilibrium phase(EP-NIC)were independent influencing factors.The AUCs of VP-70 keV and EP-NIC were 0.888 and 0.824,respectively,which were slightly greater than those of CT-T and CT-EMVI(AUC=0.793,0.762).The nomogram combining CT-T stage,CT-EMVI,VP-70 keV and EP-NIC yielded AUCs of 0.918(0.866-0.954)and 0.874(0.784-0.936)in the training and validation cohorts,which are significantly higher than using each of single independent factors(P<0.05).CONCLUSION The study found that using portal venous and EP spectral CT parameters allows effective preoperative detection of LVI/PNI in GC,with accuracy boosted by integrating clinical markers.
文摘AIM: To assess the diagnostic accuracy of multidetectorrow computed tomography(MDCT) as compared with conventional magnetic resonance imaging(MRI), in identifying mesorectal fascia(MRF) invasion in rectal cancer patients.METHODS: Ninety-one patients with biopsy proven rectal adenocarcinoma referred for thoracic and abdominal CT staging were enrolled in this study. The contrast-enhanced MDCT scans were performed on a 256 row scanner(ICT, Philips) with the following acquisition parameters: tube voltage 120 KV, tube current 150-300 m As. Imaging data were reviewed as axial and as multiplanar reconstructions(MPRs) images along the rectal tumor axis. MRI study, performed on 1.5 T with dedicated phased array multicoil, included multiplanar T2 and axial T1 sequences and diffusion weighted images(DWI). Axial and MPR CT images independently were compared to MRI and MRF involvement was determined. Diagnostic accuracy of both modalities was compared and statistically analyzed.RESULTS: According to MRI, the MRF was involved in 51 patients and not involved in 40 patients. DWI allowed to recognize the tumor as a focal mass with high signal intensity on high b-value images, compared with the signal of the normal adjacent rectal wall or with the lower tissue signal intensity background. The number of patients correctly staged by the native axial CT images was 71 out of 91(41 with involved MRF; 30 with not involved MRF), while by using the MPR 80 patients were correctly staged(45 with involved MRF; 35 with not involved MRF). Local tumor staging suggested by MDCT agreed with those of MRI, obtaining for CT axial images sensitivity and specificity of 80.4% and 75%, positive predictive value(PPV) 80.4%, negative predictive value(NPV) 75% and accuracy 78%; while performing MPR the sensitivity and specificity increased to 88% and 87.5%, PPV was 90%, NPV 85.36% and accuracy 88%. MPR images showed higher diagnostic accuracy, in terms of MRF involvement, than native axial images, as compared to the reference magnetic resonance images. The difference in accuracy was statistically significant(P = 0.02). CONCLUSION: New generation CT scanner, using high resolution MPR images, represents a reliable diagnostic tool in assessment of loco-regional and whole body staging of advanced rectal cancer, especially in patients with MRI contraindications.
基金National Natural Science Foundation of China(81403502)General Research Fund ofResearch Grants Council of Hong Kong (17124418).
文摘OBJECTIVE Major depressive disorder(MDD) is a highly heterogeneous mental illness.Further classification may help characterize its heterogeneity.The purpose of this study was to examine metabolomic and brain connectomic associations with traditional Chinese medicine(TCM) diagnostic classification of MDD.METHODS Fifty unmedicated depressed patients were classified into Liver Qi Stagnation(LQS,n=30) and Heart and Spleen Deficiency(HSD,n=20) subtypes according to TCM diagnosis.Healthy volunteers(n=28) were included as controls.Gas chromatography-mass spectrometry(GC-MS) and diffusion tensor imaging were used to detect serum and urinary metabolomic profiles and whole-brain white matter connectivity,respectively.RESULTS In metabolomic analysis,28 metabolites were identified for good separations between TCM subtypes and healthy controls in serum and urine samples.While both TCM subtypes had similar profiles in proteinogenic branched-chain amino acids and energy metabolism-related metabolites that were differentiated from healthy controls,the LQS subtype additionally differed from healthy controls in multiple amino acid metabolites that are involved in the biosynthesis of monoamine and amino acid neurotransmitters.Several metabolites are differentially associated with the two subtypes.In connectomic analysis,The LQS subtype showed significant differences in multiple network metrics of the angular gyrus,middle occipital gyrus,calcarine sulcus,and Heschl′ s gyrus when compared to the other two groups.The HSD subtype had markedly greater regional connectivity of the insula,parahippocampal gyrus,and posterior cingulate gyrus than the other two groups,and microstructural abnormalities of the frontal medial orbital gyrus and middle temporal pole.The insular betweenness centrality was strongly inversely correlated with the severity of depression and dichotomized the two subtypes at the optimal cutoff value with acceptable sensitivity and specificity.CONCLUSION The LQS subtype may represent an MDD subpopulation mainly characterized by abnormalities in the biosynthesis of monoamine and amino acid neurotransmitters,closer associations with stress-related pathophysiology,and aberrant connectivity of the audiovisual perception-related temporal-occipital network,whereas the HSD subtype is more closely associated with hyperconnectivity and microstructural abnormalities of the limbicparalimbic network.Certain metabolomic and connectomic variables are potential biomarkers for TCM diagnostic subtypes which is perhaps an alternative classification for depressive disorders.
文摘BACKGROUND:Closed loop bowel obstruction is a specific type of mechanical obstruction with a high risk of strangulation and bowel infarction,especially in the small bowel.It is associated with a high mortality rate.Hence,it is important for emergency physicians to identify the presence of strangulation,while making the diagnosis of closed loop small bowel obstruction.METHODS:We reported three patients with strangulated closed loop small bowel obstruction associated with severe abdominal pain,who had been treated at the emergency department.Urgent computerized tomography was performed in the patients.RESULTS:Two patients were discharged with stable conditions,and one patient died after hemodialysis.CONCLUSION:Urgent computerized tomography of the abdomen serves as an important diagnostic tool in view of its ability to detect the site,level and cause of obstruction along with the distinctive CT appearance of closed loop small bowel obstruction and signs of ischemia.Early definitive diagnosis will guide subsequent management and improve outcomes.
文摘Retrospective study was done at KAUH to determine the sonographic characteristics in predicting the malignancy of thyroid nodules. The sample was 120 patients consisting of 70 benign nodules and 50 malignant nodules. Out of 120 patients, 106 (88.3%) female and 14 (11.7%) male patients. Out of 106 female patients, 64 (91.45) had benign and 42 had malignant thyroid nodules. Out of 14 (11.7) male patients, 6 had benign and 8 had malignant thyroid nodules. The youngest patient in our study was 31 years and the oldest patient was 76 years. The common range of patients age was ≥ 60 years and consisting of twenty (28.6%) benign thyroid nodules and fourteen (28%) malignant thyroid nodules. The majority of patients’ age group with malignant thyroid nodules were between 50 - 60 years and consisting of twenty (40%) malignant nodules. In our study, according to the result of gray scale and color Doppler ultrasonography, hypo-echogenicity, solid echo structure, micro-calcification and intra-nodular vascularity were the significant characteristics of malignancy in nodules with sensitivity (72%, 74%, 48% and 88% respectively), specificity (66%, 63%, 94% and 69% respectively), PPV (60%, 59%, 86% and 67% respectively) and NPV (77%, 77%, 72% and 89% respectively).
基金Supported by the National Key Research and Development Program of China,No.2020AAA0109503.
文摘The post-hepatectomy recurrence rate of hepatocellular carcinoma(HCC)is persistently high,affecting the prognosis of patients.An effective therapeutic option is crucial for achieving long-term survival in patients with postoperative recurrences.Local ablative therapy has been established as a treatment option for resectable and unresectable HCCs,and it is also a feasible approach for recurrent HCC(RHCC)due to less trauma,shorter operation times,fewer complications,and faster recovery.This review focused on ablation techniques,description of potential candidates,and therapeutic and prognostic implications of ablation for guiding its application in treating intrahepatic RHCC.
文摘The present letter to the editor corresponds to the article entitled“Comprehensive literature review on the radiographic findings,imaging modalities,and the role of radiology in the coronavirus disease 2019(COVID-19)pandemic”by Pal et al,published in World J Radiol.2021;13(9):258-282.With zero to unknown prevalence,COVID-19 has created a heterogeneous and unforeseen situation across the world.Healthcare providers encountered new challenges in image interpretation,characterization,and prognostication of the disease.Pal et al delineated the radiological findings,which would guide the radiologists to identify the early signs of severe infection.
文摘AIM: To analyze the 5-year disease-free survival(DFS) of primary orbital lymphoma(POL) by clinical characteristics and imaging features.METHODS: A total of 72 patients, 43 males and 29 females, with histologically confirmed POL, were retrospectively recruited between January 2012 and May 2017. The information on clinical characteristics, imaging features, and 5-year DFS was obtained. Univariate and multivariate forward logistic regression analyses were used to identify the variables significantly associated with 5-year DFS. Kaplan-Meier was applied for survival analysis. RESULTS: Univariate analysis revealed that uni-or bilateral orbital involvement, single or multiple lesions, treatment methods, and contrast enhancement pattern on images were significant for 5-year DFS(P=0.022, 0.042, <0.001, and 0.028, respectively), while in multivariate logistic regression analysis, only uni-or bilateral orbital involvement, treatment methods and contrast enhancement pattern on images were significant(r=0.453, 0.897, and 0.556, P=0.038, <0.001 and 0.022, respectively). The survival curves for DFS were obtained. CONCLUSION: The majority of POL are B-cell lymphomas. Unilateral orbital involvement, homogeneous contrast enhancement on images, and the appropriate treatment schemes result to be significant factors for a good prognosis for POL.
文摘Irreversible electroporation(IRE) employs the use of an electric field to cause irreversible permeability of the cell membrane, inducing apoptosis. The use of IRE for locally advanced pancreatic cancer(LAPC) was first described in 2012. The crucial advantage of IRE compared with other devices employing thermal ablation is the safety around vital structures such as vessels and ducts. This makes it an attractive option for use in the pancreas due to the close proximity of multiple major vascular structures, biliary ducts, and adjacent gastrointestinal organs. Over the past decade, IRE has established itself as a useful treatment adjunct and may soon become the standard of care, particularly for LAPC. This article will explore the current evidence and provide a concise summary of pertinent issues, including patient selection, preoperative management, clinical outcomes, radiological response and future prospects of IRE in pancreatic cancer.
文摘The medical sector values time when it determines life in its totality. Any waste of time, especially in critical conditions, compromises patients and puts lives at stake. From a diagnosis and treatment perspective, efficient use of time determines the success of procedures. Whether it be the inclusion of computing technologies or it be the implementation of informatics, the benefits of medical technology have been tremendous to the healthcare sector. This research has looked at the impact of the Radiology Information System (RIS) on CT reporting time in the King Khalid Hospital (KKH) in the Kingdom of Saudi Arabia. The approach of the study has been quasi-experimental, using the power calculation of a pair of 381 CT scan reports of 40,000 after which the data was collected and analyzed by using SPSS to deduce the impact that RIS has on CT reporting time. The comparison of CT reporting time is done between two distinct timeframes Pre- and Post-installation of RIS. The patients in the current study were organized into three primary categories: emergency patients, inpatients, and outpatients. The results show that the turnaround time was impacted positively with the incorporation of RIS and related technologies in CT scan patients. The outpatient department saw the most improvement among the three categories indicating the highest average percentage of reduction in Turnaround Time. Thus, it was concluded that the RIS has an overall positive impact on CT reporting time.
基金Supported by Colonel Robert R McCormick Professorship of Diagnostic Imaging Fund at Rush University Medical Center(The Activity Number is 1233-161-84),No.8410152-03.
文摘Central nervous system abnormalities in fetuses are fairly common,happening in 0.1%to 0.2%of live births and in 3%to 6%of stillbirths.So initial detection and categorization of fetal Brain abnormalities are critical.Manually detecting and segmenting fetal brain magnetic resonance imaging(MRI)could be timeconsuming,and susceptible to interpreter experience.Artificial intelligence(AI)algorithms and machine learning approaches have a high potential for assisting in the early detection of these problems,improving the diagnosis process and follow-up procedures.The use of AI and machine learning techniques in fetal brain MRI was the subject of this narrative review paper.Using AI,anatomic fetal brain MRI processing has investigated models to predict specific landmarks and segmentation automatically.All gestation age weeks(17-38 wk)and different AI models(mainly Convolutional Neural Network and U-Net)have been used.Some models'accuracy achieved 95%and more.AI could help preprocess and postprocess fetal images and reconstruct images.Also,AI can be used for gestational age prediction(with one-week accuracy),fetal brain extraction,fetal brain segmentation,and placenta detection.Some fetal brain linear measurements,such as Cerebral and Bone Biparietal Diameter,have been suggested.Classification of brain pathology was studied using diagonal quadratic discriminates analysis,Knearest neighbor,random forest,naive Bayes,and radial basis function neural network classifiers.Deep learning methods will become more powerful as more large-scale,labeled datasets become available.Having shared fetal brain MRI datasets is crucial because there aren not many fetal brain pictures available.Also,physicians should be aware of AI's function in fetal brain MRI,particularly neuroradiologists,general radiologists,and perinatologists.
文摘The embolization of gastric varices is an established technique for acute bleeding in patients with portal hypertension. Here, we report an attempt to embolize a gastrorenal shunt to facilitate esophagectomy in a patient with an esophageal malignancy. To our knowledge, this is the first case in the literature to highlight the role of interventional medicine in the treatment of patients with esophageal malignancy.
文摘Cardioembolic stroke is a potentially devastating condition and tends to have a poor prognosis compared with other ischemic stroke subtypes.Therefore,it is important for proper therapeutic management to identify a cardiac source of embolism in stroke patients.Cardiac computed tomography(CCT)can detect the detailed visualization of various cardiac pathologies in the cardiac chambers,interatrial and interventricular septum,valves,and myocardium with few motion artifacts and few dead angles.Multiphase reconstruction images of the entire cardiac cycle make it possible to demonstrate cardiac structures in a dynamic manner.Consequently,CCT has the ability to provide high-quality information about causal heart disease in cardioembolic stroke.In addition,CCT can simultaneously evaluate obstructive coronary artery disease,which may be helpful in surgical planning in patients who need urgent surgery,such as cardiac tumors or infective endocarditis.This review will introduce the potential clinical applications of CCT in an ischemic stroke population,with a focus on diagnosing cardioembolic sources using CCT.
基金supported by the National University of Singapore(Grant Nos.:NUHSRO/2021/097/Startup/13,NUHSRO/2020/133/Startup/08,NUHSRO/2023/008/NUSMed/TCE/LOA,NUHSRO/2021/034/TRP/09/Nanomedicine,and NUHSRO/2021/044/Kickstart/09/LOA)National Medical Research Council(Grant Nos.:OFYIRG23jan-0025,OFYIRG23jan-0017,MOH-001254-01,and CG21APR1005)+2 种基金Singapore Ministry of Education Academic Research Fund(Grant Nos.:NUHSRO/2022/093/T1/Seed-Sep/06 and MOE-000387-01)National Research Foundation(Grant No.:CRP28-2022RS-0001),National Natural Science Foundation of China(Grant No.:82202206)Beijing Natural Science Foundation(Grant No.:7224365).
文摘In the ever-evolving landscape of cancer research and treatment,the quest for novel and non-invasive imaging techniques has become crucial for accurate diagnosis and effective therapy.This study[1]successfully developed a good manufacturing practices(GMP)grade ^(89)Zr-labeled anti-Claudin18.2(CLDN18.2)recombinant humanized antibody TST001.^(89)Zr-DFO-TST001 exhibited high radiochemical purity(>99%)and specific activity(24.15±1.34 GBq/mmol).It demonstrated good specificity and rapid tumor accumulation in vivo and in vivo.Through immuno-PET imaging,it enables non-invasive visualization and quantification of CLDN18.2 expression level in CLDN18.2-positive gastrointestinal tumor models.
文摘Introduction: Polycystic ovary syndrome (PCOS) is one of the most common endocrine and metabolic disorders in premenopausal women affecting 5% - 10% women in reproductive age. Many studies show that good dietary habits and balanced diet in addition to regular exercise can significantly improve the symptoms of the syndrome. The prevalence rate in the Kingdom of Saudi Arabia reached 42.8%. This study aimed to measure the awareness of Jazan females about the nutrition related effects of polycystic ovary syndrome and investigate the association between age and awareness of nutrition related effect on PCOS. Method: Cross sectional study was conducted during a period from January 9<sup>th</sup> to February 5<sup>th</sup> 2023, by a questionnaire used to measure the awareness of female in Jazan region about the nutrition related effects of poly cystic ovary syndrome. Data was collected using Google questionnaire survey and it was randomly distributed to Jazan women from 18 to 50 years old. The questionnaire was about general information about PCOS, nutrition-related effects of PCOS, the effects of eating patterns on PCOS, physical activity, and sleeping. The sample size was 384 women. Results: The total response was about 363 women. The results showed that women in the Jazan region did not have sufficient knowledge about PCOS 51.5% and 63.4% had no knowledge about diet recommendations for PCOS. However, there was awareness about healthy eating patterns that reduce the symptoms of PCOS. The level of awareness of PCOS and its association with age among Jazan women was higher in young adult groups (21 to 29 years old). Conclusion: Based on the results of this study, the level of knowledge about PCOS among Jazan women is insufficient. Also, their awareness about diet and lifestyle interventions was low. There is a relationship between age and awareness of the nutrition-related effects of PCOS. Promoting the role of balanced nutrition and nutritional knowledge is an important requirement for all women, especially those with PCOS. The role of health, educational, and governmental institutions is important in spreading the link between nutrition and PCOS.
文摘Background: Non-uniformity in signal intensity occurs commonly in magnetic resonance (MR) imaging, which may pose substantial problems when using a 3T scanner. Therefore, image non-uniformity correction is usually applied. Purpose: To compare the correction effects of the phased-array uniformity enhancement (PURE), a calibration-based image non-uniformity correction method, among three different software versions in 3T Gd-EOB-DTPA-enhanced MR imaging. Material and Methods: Hepatobiliary-phase images of a total of 120 patients who underwent Gd-EOB-DTPA-enhanced MR imaging on the same 3T scanner were analyzed retrospectively. Forty patients each were examined using three software versions (DV25, DV25.1, and DV26). The effects of PURE were compared by visual assessment, histogram analysis of liver signal intensity, evaluation of the spatial distribution of correction effects, and evaluation of quantitative indices of liver parenchymal enhancement. Results: The visual assessment indicated the highest uniformity of PURE-corrected images for DV26, followed by DV25 and DV25.1. Histogram analysis of corrected images demonstrated significantly larger variations in liver signal for DV25.1 than for the other two versions. Although PURE caused a relative increase in pixel values for central and lateral regions, such effects were weaker for DV25.1 than for the other two versions. In the evaluation of quantitative indices of liver parenchymal enhancement, the liver-to-muscle ratio (LMR) was significantly higher for the corrected images than for the uncorrected images, but the liver-to-spleen ratio (LSR) showed no significant differences. For corrected images, the LMR was significantly higher for DV25 and DV26 than for DV25.1, but the LSR showed no significant differences among the three versions. Conclusion: There were differences in the effects of PURE among the three software versions in 3T Gd-EOB-DTPA-enhanced MR imaging. Even if the non-uniformity correction method has the same brand name, correction effects may differ depending on the software version, and these differences may affect visual and quantitative evaluations.
文摘Objective:Response Evaluation Criteria in Solid Tumors(RECIST)guideline version 1.0(RECIST 1.0)was proposed as a new guideline for evaluating tumor response and has been widely accepted as a standardized measure.With a number of issues being raised on RECIST 1.0,however,a revised RECIST guideline version 1.1(RECIST 1.1)was proposed by the RECIST Working Group in 2009.This study was conducted to compare CT tumor response based on RECIST 1.1 vs.RECIST 1.0 in patients with advanced gastric cancer(AGC).Methods:We reviewed 61 AGC patients with measurable diseases by RECIST 1.0 who were enrolled in other clinical trials between 2008 and 2010.These patients were retrospectively re-analyzed to determine the concordance between the two response criteria using theκstatistic.Results:The number and sum of tumor diameters of the target lesions by RECIST 1.1 were significantly lower than those by RECIST 1.0(P<0.0001).However,there was excellent agreement in tumor response between RECIST 1.1 and RECIST 1.0(κ=0.844).The overall response rates(ORRs)according to RECIST1.0 and RECIST 1.1 were 32.7%(20/61)and 34.5%(20/58),respectively.One patient with partial response(PR)based on RECIST 1.0 was reclassified as stable disease(SD)by RECIST 1.1.Of two patients with SD by RECIST 1.0,one was downgraded to progressive disease and the other was upgraded to PR by RECIST 1.1.Conclusions:RECIST 1.1 provided almost perfect agreement with RECIST 1.0 in the CT assessment of tumor response of AGC.
文摘AIM: To investigate the effect of partial splenic embolization (PSE) on platelet values in liver cirrhosis patients with thrombocytopenia and to determine the effective embolization area for platelet values improvement. METHODS: Blood parameters and liver function indicators were measured on 10 liver cirrhosis patients (6 in Child-Pugh grade A and 4 in grade B) with thrombocytopenia (platelet values < 80 × 103/μL) before embolization. Computed tomography scan was also needed in advance to acquire the splenic baseline. After 2 to 3 d, angiography and splenic embolization were performed. A second computed tomography scan was made to confirm the embolization area after 2 to 3 wk of embolization. The blood parameters of patients were also examined biweekly during the 1 year follow-up period. RESULTS: According to the computed tomography images after partial splenic embolization, we divided all patients into two groups: low (< 30%), and high (≥ 30%) embolization area groups. The platelet values were increased by 3 times compared to baseline levels after 2 wk of embolization in high embolization area group. In addition, there were significant differences in platelet values between low and high embolization area groups. GPT values decreased significantly in all patients after 2 wk of embolization. The improvement in platelet and GPT values still persisted until 1 year after PSE. In addition, 3 of 4 (75%) Child-Pugh grade B patients progressed to grade A after 2 mo of PSE. The complicationrate in < 30% and ≥ 30% embolization area groups was 50% and 100%, respectively. CONCLUSION: Partial splenic embolization is an effective method to improve platelet values and GPT values in liver cirrhosis patients with thrombocytopenia and the ≥ 30% embolization area is meaningful for platelet values improvement. The relationship between the complication rate and embolization area needs further studies.
基金Bundesministerium fuer Bildung,Wissenschaft, Forschung und Technologie(Germany),No.01KS9602
文摘AIM:To introduce an animal model of hepatocellular carcinoma (HCC) in ACI-rats, and to evaluate the therapeutic effects of Poly-lactide-co-glycolide(PIcg)-microspheres in the transarterial chemoembolization (TACE) in this model, as well the value of this model in the experiments of interventional therapy.
