With the progress of targeted therapy and immunotherapy for lung cancer, the clinical demand for lung biopsy is increasing. An ideal biopsy specimen can be used not only for histopathological diagnosis, but also for biomarker detection. The ideal biopsy specimen should meet two requirements, including more than 60 mm2 of tumor tissue and containing more than 20% of tumor cells. In order to obtain ideal lung cancer biopsy specimens, advanced imaging techniques are needed to help. In this article, we reviewed the requirements for biopsy specimens based on biomarker detection, as well as the current status and research progress of using imaging techniques for preoperative planning and intraoperative real time guidance of lung cancer biopsy. .【中文题目：影像计划和实时引导肺癌穿刺活检 在生物标志物检测中的进展】 【中文摘要：随着肺癌个体化治疗的进展，临床对肺癌穿刺活检样本的要求越来越高。一个理想的肺癌活检样本不仅可以实现组织病理学诊断，还能够用于生物标志物检测。理想的活检样本需符合至少60 mm2的肿瘤组织和其内的瘤细胞占比在20%以上。要想获取理想的肺癌穿刺活检样本，就需要先进的影像技术予以帮助。本文就基于生物标志物检测对活检样本的要求及影像在肺癌穿刺活检术前计划穿刺路径及术中实时引导穿刺活检的现状和研究进展予以综述。 】 【中文关键词：肺肿瘤；活检；生物标志物检测；影像】.
Objective To study the correlation between multi slice spiral CT features and serum tumor markers which include Lung tumor antigen(LTA),Carcino embryonic antigen(CEA),Neuron specific enolase(NSE),and assess the value of both methods in the differential diagnosis of lung cancer.Materials and Methods 64 cases of pathologically confirmed pulmonary malignant lesions and 64 benign lesions received MSCT scanning and serum tumor markers LTA,CEA,NSE detection,MSCT images with post processing reconstruction were used to analyze imaging features of malignant nodules,the relation between MSCT features and serum tumor markers of benign and malignant lesions were compared.Results The relationship between Serum tumor markers LTA,CEA,NSE and the clinical stage,tumor size,spiculation sign,vacuole sign,solid nodules,pleural indentation,signs of bronchial,vascular gathered sign,pleural effusion was no significant difference,there was no statistically significant difference between NSE,CEA and lymph node metastasis(P 0.05),there was significant difference between LTA and lymph node metastasis(P 0.05).Conclusion Combine MSCT morphological characteristics with serum tumor markers are helpful in the differential diagnosis of lung cancer.
Objective To explore the value of MSCT in the differential diagnosis of central pulmonary small cell carcinoma and squamous carcinoma.Methods MSCT appearances of 30 central pulmonary small cell carcinoma and 48 squamous carcinoma confirmed pathologically were analyzed retrospectively.Results(1)Oval or irregular tumor body,conformity between macroaxis of the tumor and bronchus courser,smooth or narrow without obliteration bronchial lumen and extensive metastasis were observed more frequently in central pulmonary small cell carcinoma than that in central pulmonary squamous carcinoma(P=0.026,P=0.005,P=0.001,P=0.004,P=0.041,respectively).While,round tumor body,sudden obliteration of bronchial lumen and obstructive atelectasis or pneumonia appeared more frequently in central pulmonary squamous carcinoma than that in central pulmonary small cell carcinoma(P=0.026,P=0.000,P=0.000,respectively).(2) The signs of Oval or irregular tumor body,smooth or narrow without obliteration bronchial lumen were positive e correlation to the central pulmonary small cell carcinoma and all of them were dangerous factors on Logistic modeling.(3) No significant difference was found in the size of tumor body and the appearance of conoid obstruction of bronchial lumen and tumescent lymph nodes(P 0.05) Conclusion MSCT is of definitive value in differentiating the central pulmonary small cell carcinoma from squamous carcinoma.
Dual source computed tomography (DSCT) plays an important role in the diagnosis of congenital heart diseases (CHD). However, the issue of radiation-related side effects constitutes a wide public concern. The aim of the study was to explore the differences in diagnostic accuracy, radiation dose and image quality between a prospectively ECG - triggered high - pitch spiral acquisition (flash model) and a retrospective ECG-gated protocol of DSCT used for the detection of CHD.The study included 58 patients with CHD who underwent a DSCT examination, including two groups of 29 patients in each protocol. Then, both subjective and objective image quality, diagnostic accuracy and radiation dose were compared between the two protocols.The image quality and the total as well as partial diagnostic accuracy did not differ significantly between the protocols. The radiation dose in the flash model was obviously lower than that in the retrospective model (P<0.05).Compared to the retrospective protocol, the flash model can significantly reduce the dose of radiation, while maintaining both diagnostic accuracy and image quality.
Objective To investigate the clinical safety, effect and feasibility of preventing restenosis after stent with ~(188)Re liquid-filled balloon. Methods Seven patients underwent coronary stenting underwent brachytherapy with ~(188)Re liquid-filled ballon. All patients performed radionuclide gated myocardial perfusion imaging before, (within) one week and six months after brachytherapy respectively for the assessment of restenosis.(Results )The time duration of radiation exposure in brachytherapy was (6.20±1.55) min in average. Non of the patient occurred serve side effect during procedure including balloon rapture,leakege of the ~(188)Re radioactivity into circulation events etc. The incidence of restenosis within the stent was 14.3% (1/7). Conclusion The brachytherapy using ~(188)Re liquid-filled balloon was a safe, effective and feasible method in preventing restenosis within stent and also it has important clinical value.
Objective To explore the effects and the mechanism of radionuclide on smooth muscle cells proliferation and apoptosis, and to investigate the effects of radioactive stents on prevention of restenosis Methods The effects and mechanism of radionuclide on the proliferation, apoptosis, and mutation of HPRT gene exon 7/8 in cultured smooth muscle cells were studied by cellular and molecular technique, and the prevention effects of radioactive stents on restenosis were investigated in animal model Results The proliferation of smooth muscle cells cultured in vitro could be inhibited markedly by β particle radiation from radionuclide 188 Re, proliferation inhibition rate: [(100 0% vs 34 1%, t =2 500, P 0 05), (100 0% vs 27 7%, t =2 744, P 0 05), (100 0% vs 21 8%, t =2 972, P 0 05), (100 0% vs 18 1%, t =3 121, P 0 05)]; DNA synthesis inhibition rate: {[(43 56±2 32)% vs (23 80±2 57)%, t =11 416, P 0 001], [(43 56±2 32)% vs (11 82±2 51)%, t =18 566, P 0 001], [(43 56±2 32)% vs (6 04±1 20)%, t =28 734, P 0 001], [(43 56±2 32)% vs (3 30±0 52)%, t =33 892, P 0 001], [(43 56±2 32)% vs (1 49±0 87)%, t =33 991, P 0 001]} The apoptosis of smooth muscle cells couldn′t be affected significantly by low dose radiation But there was an increase of apoptosis rate only in group 3 70 GBq/L [(2 89±0 56)% vs (17 21±2 56)%, t =9 477, P 0 001] There was a positive relationship between the radiation dose and the mutation of HPRT gene and exon 7/8 ( r =0 993, P 0 001; r =0 947, P 0 05) Radioactive stents could decrease neointimal area [(1 01±0 37) mm 2 vs (0 60±0 29) mm 2, t =2 466, P 0 05], and percent area of stenosis [(16 84±6 61)% vs (10 05±4 27)%, t =2 448, P 0 05] compared with non radioactive stents in animal restenosis model Conclusion Endovascular radiotherapy in low dose and low dose rate was an ideal therapy selection for prevention of restenosis, which could inhibit cell proliferation significantly, but didn′t ruin the vessel structure Radioactive stents could inhibit the restenosis in the animal model, and it is safe and feasible for prevention of restenosis
Objective To evaluate the value of multislice spiral CTA in diagnosis of intracranial aneurysm.Methods CTA data in 32 patients with intracranial aneurysms proved by operation and DSA were retrospectively analysed in comparison with the results of DSA.Results 38 aneurysms in 32 patients were detected by DSA and operation.Six cases of 32 had two aneurysms.36 and 34 aneurysms were detected by DSA and CTA respectively.4 aneurysms located at anterior communicating artery,7 at middle cerebral artery,9 at posterior communicating artery,14 at internal carotid artery and 4 at basilar artery.Conclusion MSCTA can be used as the method in screening intracranial aneurysms for surgery and interventional therapy.
Background and Purpose: To investigate the abnormal pattern of altered functional activity in the brain and the neuroimaging mechanisms underlying the cognitive impairment of patients with colorectal cancer (CRC) via resting-state functional magnetic resonance imaging (rs-fMRI). Materials and Methods: CRC patients (n = 56) and healthy controls (HCs) (n = 50) were studied. The participants underwent rs-fMRI scans and the Montreal Cognitive Assessment (MoCA). The amplitude of low-frequency fluctuations (ALFF), degree centrality (DC), regional homogeneity (ReHo), and MoCA scores, were calculated for participants. Results: The scores of executives, visuospatial, memory, language and attention were lower in CRC patients. ReHo and ALFF values in the left postcentral gyrus, ReHo values in the right postcentral gyrus, ALFF and DC values in the left middle occipital gyrus, ReHo and DC values in the right lingual gyrus, DC values in the right angular gyrus and precuneus, and ALFF values in the left middle temporal gyrus decreased conspicuously in the CRC patients. Conclusion: CRC patients have abnormal resting state function, mainly in the brain areas involved in cognitive function. The overlapping brain regions with abnormal functional indicators are in the middle occipital gyrus, postcentral gyrus, and lingual gyrus. This study reveals the potential biological pathways involved in brain impairment and neurocognitive decline in patients with CRC.
This study was to determine the reliability of age-stratified diagnostic index in differential diagnosis of malignant and benign solitary lesions in the liver using fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography ((18)FDG PET/CT).The enrolled 272 patients with solitary lesions in the liver were divided into three age groups, younger group (under 50 years), middle-aged group (50-69 years), and elderly group (70 years and above). Patients' ages were compared, and the optimal cut-offs of the standard uptake value (SUV) ratio (tumor-to-non-tumor ratio of the SUV), as well as areas under the curves (AUC), were evaluated in terms of malignant and benign lesions in each age group by using receiver operating characteristic (ROC) analysis. Based on optimal cut-offs, the sensitivity, specificity, accuracy were calculated, and the diagnostic accordance rate was compared between each age group and all patients, supported by (18)FDG PET/CT imaging data.There was a significant age difference between the malignant and benign groups (t=3.905 p=0.0001). ROC analysis showed that the optimal cut-off value in all patients, younger group, middle-aged group and elderly group was 1.25, 1.17, 1.45 and 1.25 for SUVratio, and 0.856, 0.962, 0.650, 0.973 for AUC. The chi-square test proved that diagnostic accordance rate of (18)FDG PET/CT in younger group and elderly group were superior to that in all patients (χ(2)=13.352, P=0.0003) and (χ(2)=8.494, P=0.0036). Conversely, overall diagnostic accordance rate in all patient group was higher than that in middle-aged group (χ(2)=9.057, P=0.0026). Representative (18)FDG PET/CT imaging findings are demonstrated.This study indicates that diagnostic optimal cut-offs of SUVratio of liver solitary lesions of (18)FDG PET/CT were different in each age group. In addition, the diagnostic performance of SUVratio was better in younger and elderly groups than that in all patients, and was poorer in middle-aged group than that in all patients. Therefore, age difference appears to be one of the important factors for discriminating malignant liver lesions from benign ones using (18) FDG PET/CT.
Objective To investigate the methods and clinical value of multi-slice CT virtual cholangioscopy in the detection of biliary calculus.Methods Volume scanning was performed in 38 patients with suspected biliary calculi after injection 50% Meglumine adipiodone injection 20 ml through vien.All data sets were transferred to ADV3.1 workstation.MSCTVC reconstruction were done with Navigator soft-ware.All cases were proved by ultrasound,axial CT and MSCT 3 D results or operations.Results MSCTVC could well demonstrate 3D fashion of biliary calculi and it was similar to ultrasound,axial CT and MSCT 3D results.Conclusion MSCTVC combined with CT 2D 3D results has a high diagnosis accuracy and clinical usefulness,thus,improve the diagnosis of biliary calculi.
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