Zishu Zhang

Second Xiangya Hospital of Central South University

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Harrison X. Bai

Johns Hopkins University

Yu‐Dong Xiao

Second Xiangya Hospital of Central South University

Paul J. Zhang

University of Pennsylvania

Cong Ma

Huazhong University of Science and Technology

Paul J. Zhang

Hospital of the University of Pennsylvania

Raymond Y. Huang

Harvard University

Jing Wu

Jilin Province Science and Technology Department

Li Yang

Sun Yat-sen University

Bo Xiao

Shanghai Jiao Tong University

Giorgos C. Karakousis

University of Pennsylvania

Cooperative Institutions

Central South University

119

Second Xiangya Hospital of Central South University

Xiangya Hospital Central South University

University of Pennsylvania

Peking University

Sun Yat-sen University

Hospital of the University of Pennsylvania

Chinese Academy of Sciences

Sichuan University

Capital Medical University

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Differentiation of Low and High Grade Renal Cell Carcinoma on Routine MR with an Externally Validated Automatic Machine Learning Algorithm

SSRN Electronic Journal (2020)

Subhanik Purkayastha Zhao Yi-jun Chengzhang Zhu Jing Wu Rong Hu

Background: Pre-treatment determination of renal cell carcinoma aggressiveness may help guide clinical decision-making. We aimed to differentiate low-grade (Fuhrman I-II) from high-grade (Fuhrman III-IV) renal cell carcinoma using radiomics features extracted from routine MR imaging. Methods: 482 pathologically confirmed renal cell carcinoma lesions from 2008 to 2019 in a multicenter cohort were retrospectively identified. 439 Fuhrman-graded lesions from 4 institutions were divided into training and validation sets with an 8:2 split for model development and internal validation, other 43 lesions from a separate institution were set aside for independent external validation. The performance of TPOT (Tree-Based Pipeline Optimization Tool), an automatic machine learning pipeline optimizer, was compared to hand-optimized machine learning pipelines. Findings: The best-performing hand-optimized pipeline was a Bayesian classifier with Fischer Score feature selection, achieving an external validation ROC AUC of 0.59 (95% CI: 0.49-0.68), accuracy of 0.77 (95% CI: 0.68-0.84), sensitivity of 0.38 (95% CI: 0.29-0.48), and specificity of 0.86 (95% CI: 0.78-0.92). The best-performing TPOT pipeline achieved an external validation ROC AUC of 0.60 (95% CI: 0.50-0.69), accuracy of 0.81 (95% CI: 0.72-0.88), sensitivity of 0.12 (95% CI: 0.14-0.30), and specificity of 0.97 (95% CI: 0.87-0.97). Interpretations: Automated machine learning pipelines can perform equivalent to or better than hand-optimized pipelines on an external validation test non-invasively predicting histological grade of renal cell carcinoma using conventional MR imaging.Funding Statement: This study was supported by RSNA fellow research grant (RF1802), National Institution of Health/National Cancer Institute Grant (R03CA249554) and SIR Foundation Radiology Resident Research Grant to HXB. This project was supported by a training grant from the National Institute of Biomedical Imaging and Bioengineering (NIBIB) of the National Institutes of Health under award number 5T32EB1680 and by the National Cancer Institute (NCI) of the National Institutes of Health under Award Number F30CA239407 to K. Chang.Declaration of Interests: No conflicts of interests exist among all authors.Ethics Approval Statement: The study was approved by the Institutional Review Boards of HUP, MAY, SXH, and PHH. With the agreement to use TCGA/TCIA data, the IRB approval of our study was waived for TCIA.

10.2139/ssrn.3588592

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Citations (0)

Comparison of liver function and safety in hepatocellular cancer patients treated with DEB-TACE and cTACE: a multi-center, retrospective cohort study

Translational Cancer Research (2019)

Hua Xiang Bin Xiong Haiping Li Chang Zhao Zishu Zhang

This study aimed to compare the live function change and adverse events (AEs) between drug-eluting beads (DEB) transarterial chemoembolization (TACE) with CalliSpheres® microspheres (CSM) and conventional TACE (cTACE) in treating hepatocellular carcinoma (HCC) patients.Three hundred and thirty-five HCC patients underwent DEB-TACE with CSM (n=171, DEB-TACE group) or cTACE (n=164, cTACE group) were consecutively enrolled in this multi-center, retrospective cohort study. Liver function indexes were reviewed before treatment (W0), at 1 week (W1) and 1 month (M1) post treatment. Moreover, AEs during operation and hospitalization were retrieved as well.The changes of albumin (ALB) [-3.55 (-6.25 to -0.43) vs. -2.20 (-4.63-0.00), P=0.043] and total protein (TP) [-4.62 (-10.18-0.43) vs. -2.50 (-7.08-1.08), P=0.013] from W1 to W0 were lower in DEB-TACE group compared to cTACE group, while no difference was observed referring to the change of alanine aminotransferase (ALT) (P=0.494), aspartate aminotransferase (AST) (P=0.747), alkaline phosphatase (ALP) (P=0.895), total bilirubin (TBIL) (P=0.059), total bile acid (TBA) (P=0.491) from W1 to W0. And the changes of these seven indexes from M1 to W0 were all similar between DEB-TACE group and cTACE group (all P>0.05). Besides, the occurrence of pain during treatment (19.3% vs. 11.0%, P=0.034) and the occurrence of fever during hospitalization (18.1% vs. 9.1%, P=0.017) were both increased in DEB-TACE group compared to cTACE group.DEB-TACE with CSM is non-inferior to cTACE in terms of liver function change, while DEB-TACE with CSM leads to higher incidences of pain and fever.

Liver Cancer

Center (category theory)

Hepatocellular cancer

Liver function

10.21037/tcr.2019.09.15

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Diameters of left gastric vein and its originating vein on magnetic resonance imaging in liver cirrhosis patients with hepatitis B: Association with endoscopic grades of esophageal varices

Hepatology Research (2013)

Haiying Zhou Tian‐wu Chen Xiao Ming Zhang Nan‐lin Zeng Li Zhou

To determine whether diameters of the left gastric vein (LGV) and its originating vein are associated with endoscopic grades of esophageal varices.Ninety-eight liver cirrhotic patients with hepatitis B undergoing magnetic resonance (MR) portography, and upper gastrointestinal endoscopy for grading esophageal varices were enrolled. Diameters of the LGV and its originating vein - the splenic vein (SV) or portal vein (PV) - were measured on MR imaging. Statistical analyses were performed to identify the association of the diameters with the endoscopic grades.Univariate analysis showed that the SV was predominantly the originating vein of the LGV, and diameters of the LGV and SV were associated with grades of esophageal varices. Diameters of the LGV (P = 0.023, odds ratio [OR] = 1.583) and SV (P = 0.012, OR = 2.126) were independent risk factors of presence of the varices. Cut-off LGV diameters of 5.1 mm, 5.9 mm, 6.6 mm, 7.1 mm, 7.8 mm and 5.8 mm; or cut-off SV diameters of 7.3 mm, 7.9 mm, 8.4 mm, 9.5 mm, 10.7 mm and 8.3 mm, could discriminate grades 0 from 1, 0 from 2, 0 from 3, 1 from 3, 2 from 3, and 0-1 from 2-3, respectively.Diameters of the LGV and SV are associated with endoscopic grades of esophageal varices.

Gastric varices

Splenic vein

Portography

10.1111/hepr.12246

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Citations (13)

[Imaging changes in brain microstructural in long-term abstinent from methamphetamine-dependence].

PubMed (2019)

Lidan Fan Qingqing Zhang Shengxiang Liang Huabing Li Zhong He

To explore the mechanism for changes in brain microstructure in long-term abstinent from methamphetamine-dependence by using the diffusion tensor imaging (DTI). Methods: A total of 26 patients with long-term abstinent methamphetamine-dependence, whose abstinence time more than 14 months, and 26 normal controls all underwent cognitive executive function tests and DTI scans. We used voxel-based analysis to compare the fractional anisotropy (FA) and mean diffusivity (MD) to obtain the abnormal brain regions of DTI parameters between the two groups. Spearman correlation analysis was used to explore the correlation between FA, MD of the brain regions with abnormal parameters and cognitive executive function tests. Results: There were no statistical differences in the cognitive executive function tests between the two groups (P>0.05). Compared with the normal control group, the long-term abstinent from methamphetamine-dependence group showed the decreased FA in the right precuneus, right superior frontal gyrus, right calcarine, left inferior temporal gyrus and the increased MD in the right triangular part of inferior frontal gyrus, right precuneus, right posterior cingulate, right middle temporal gyrus, bilateral middle occipital gyrus, left superior parietal lobule, and lobule VIII of cerebellar hemisphere. The MD values of the right middle temporal gyrus in the long-term abstinent group were negatively correlated with the number of completions within 60 seconds (r=-0.504) and within 120 seconds (r=-0.464) . Conclusion: The DTI parameters in multiple brain regions from the methamphetamine-dependence patients are still abnormal after a long-term abstinence. DTI can provide imaging evidence for brain microstructural abnormalities in long-term abstinent from methamphetamine-dependence.目的：探究长期戒断甲基苯丙胺依赖者大脑微观结构的影像改变机制。方法：对26例长期戒断依赖者(戒断时间长于14个月)和26例对照组进行认知执行功能测试和扩散张量成像(diffusion-tensor imaging，DTI)检查，利用基于体素的分析方法对两组的部分各向异性(fractional anisotropy，FA)和平均扩散率(mean diffusivity， MD)进行比较，获得组间参数差异脑区，将长期戒断甲基苯丙胺组异常脑区参数值与测试结果行Spearman相关分析。结果：长期戒断甲基苯丙胺组和对照组的认知执行功能测试结果差异无统计学意义(P>0.05)；相比对照组，长期戒断甲基苯丙胺依赖组右侧楔前叶、背外侧额上回、距状裂周围皮质及左侧颞下回FA降低；右侧三角部额下回、楔前叶、后扣带回、颞中回、双侧枕中回、左侧顶上回及小脑半球8区MD升高。长期戒断甲基苯丙胺组右侧颞中回MD与数字符号60 s(r=–0.504)和120 s(r=–0.464)内完成个数均呈负相关。结论：甲基苯丙胺依赖者经长期戒断后多个脑区微结构仍存在异常，DTI可为长期戒断甲基苯丙胺依赖者脑微观结构异常提供影像学证据。.

Lingual gyrus

Superior frontal gyrus

Medial frontal gyrus

Middle temporal gyrus

10.11817/j.issn.1672-7347.2019.05.004

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Citations (4)

Carotid artery stenosis: reproducibility of automated 3D CT angiography analysis method

European Radiology (2004)

Zishu Zhang Marja Berg Aki Ikonen Ritva Vanninen Hannu Manninen

Neuroradiology

Computed Tomography Angiography

10.1007/s00330-003-2130-2

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Citations (71)

Comparison of liver function and safety in hepatocellular cancer patients treated with DEB-TACE and cTACE: a multi-center, retrospective cohort study

Translational Cancer Research (2019)

Hua Xiang Bin Xiong Haiping Li Chang Zhao Zishu Zhang

Background: This study aimed to compare the live function change and adverse events (AEs) between drug-eluting beads (DEB) transarterial chemoembolization (TACE) with CalliSpheres ® microspheres (CSM) and conventional TACE (cTACE) in treating hepatocellular carcinoma (HCC) patients. Methods: Three hundred and thirty-five HCC patients underwent DEB-TACE with CSM (n=171, DEB-TACE group) or cTACE (n=164, cTACE group) were consecutively enrolled in this multi-center, retrospective cohort study. Liver function indexes were reviewed before treatment (W0), at 1 week (W1) and 1 month (M1) post treatment. Moreover, AEs during operation and hospitalization were retrieved as well. Results: The changes of albumin (ALB) [–3.55 (–6.25 to –0.43) vs. –2.20 (–4.63–0.00), P=0.043] and total protein (TP) [–4.62 (–10.18–0.43) vs. –2.50 (–7.08–1.08), P=0.013] from W1 to W0 were lower in DEB-TACE group compared to cTACE group, while no difference was observed referring to the change of alanine aminotransferase (ALT) (P=0.494), aspartate aminotransferase (AST) (P=0.747), alkaline phosphatase (ALP) (P=0.895), total bilirubin (TBIL) (P=0.059), total bile acid (TBA) (P=0.491) from W1 to W0. And the changes of these seven indexes from M1 to W0 were all similar between DEB-TACE group and cTACE group (all P>0.05). Besides, the occurrence of pain during treatment (19.3% vs. 11.0%, P=0.034) and the occurrence of fever during hospitalization (18.1% vs. 9.1%, P=0.017) were both increased in DEB-TACE group compared to cTACE group. Conclusions: DEB-TACE with CSM is non-inferior to cTACE in terms of liver function change, while DEB-TACE with CSM leads to higher incidences of pain and fever.

Liver function

Liver Cancer

10.21037/31869

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Citations (1)

Combined transarterial iodized oil injection and computed tomography-guided thermal ablation for hepatocellular carcinoma: utility of the iodized oil retention pattern

Abdominal Radiology (2021)

Jie Tan René Michael Mathy De‐Hua Chang Tian Tang Zishu Zhang

To investigate whether the iodized oil (Lipiodol, Guerbet Group, Villepinte, France) retention pattern influences the treatment efficacy of combined transarterial Lipiodol injection (TLI) and thermal ablation in patients with hepatocellular carcinoma (HCC).Data of 198 patients (280 HCC lesions), who underwent TLI plus computed tomography (CT)-guided thermal ablation at three separate medical institutions between June 2014 and September 2020, were reviewed and analyzed. The Lipiodol retention pattern was classified as complete or incomplete based on non-enhanced CT at the time of ablation. The primary outcome was local recurrence-free survival (LRFS) for lesions; the secondary outcome was overall survival (OS) for patients. Propensity score matching (PSM) was performed using a caliper width of 0.1 between the two groups. Differences in LRFS and OS between the two groups were compared using the log-rank test.A total of 133 lesions exhibited a complete Lipiodol retention pattern, while 147 exhibited an incomplete pattern. After PSM analysis of baseline characteristics of the lesions, 121 pairs of lesions were matched. LRFS was significantly longer for lesions exhibiting complete retention than for those exhibiting incomplete retention (P = 0.030). After PSM analysis of patient baseline characteristics, 74 pairs of patients were matched. There was no significant difference in OS between the two groups (P = 0.456).Lipiodol retention patterns may influence the treatment efficacy of combined TLI and thermal ablation for HCC lesions. However, a survival benefit for the Lipiodol retention pattern among HCC patients was not observed and needs further confirmation.

Iodized oil

10.1007/s00261-021-03305-3

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Citations (5)

Integrated Liver Inflammatory Score Predicts the Therapeutic Outcome of Patients with Hepatocellular Carcinoma after Transarterial Chemoembolization

Journal of Vascular and Interventional Radiology (2021)

Meng-Qi Yu Tian-Zhi An Jun‐Xiang Li De‐Hua Chang Zishu Zhang

10.1016/j.jvir.2021.03.540

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Citations (5)

Comparison of Adjuvant Radiation Therapy Alone and Chemotherapy Alone in Surgically Resected Low-Grade Gliomas: Survival Analyses of 2253 Cases from the National Cancer Data Base

World Neurosurgery (2018)