Objective
To evaluate the value of MRI texture analysis based on gray level co-occurrence matrix to predict cervical lymph node metastasis in patients with tongue carcinoma.
Methods
A total of 70 patients with tongue carcinoma confirmed by pathology were analyzed retrospectively. The patients were divided into cervical lymph node (LN) metastasis group (unilateral LN+,n=18; bilateral LN+,n=22) and no cervical lymph node metastasis(LN-,n=30). T1W, T2W and contrast-enhanced T1W images of the largest section of tumor were selected. ROI of the lesion was manually drew and GLCM texture parameters (energy, contrast, correlation, inverse difference and entropy) were extracted. The tumor length, thickness and para-lingual distance between tumor and tongue midline were also measured. Differences of all parameters were compared between LN+ group and LN- group, unilateral and bilateral cervical lymph node metastasis group, the parameters with statistically significant difference in predicting the efficiency of cervical lymph node metastasis were analyzed. The diagnostic efficiency of lymph node metastasis was calculated.
Results
The correlation, inverse difference and entropy based on T2WI showed significant difference (Zcorrelation=2.97, tinverse difference=5.14, tentropy=2.41; P 0.05). The diagnostic sensitivity of radiologists was 65.0% (26/40), the specificity was 80.0% (24/32) on cervical lymph node metastasis.
Conclusion
Texture analysis based on T2WI can predict cervical lymph node metastasis in patients with tongue carcinoma. Entropy has certain value in predicting bilateral cervical lymph node metastasis.
Key words:
Tongue neoplasms; Lymphatic metastasis; Magnetic resonance imaging; Gray level co-occurrence matrix; Texture analysis
Objective To compare the level of serum vascular epithelial growth factor (VEGF) in patients with fallopian pregnancy and healthy controls with premature intrauterine pregnancy,and to examine the association between magnetic resonance imaging (MRI) features of fallopian pregnancy and the level of VEGF.Methods Thirty-one patients with pathology-diagnosed fallopian pregnancy [menopausal period:(40.5±7.1) days] and 30 healthy controls with premature intrauterine pregnancy pending to receive artificial abortion [menopausal period:(37.9±6.4) days] in the out-patient and in-patient departments of The Third Affiliated Hospital,Guangzhou Medical College between January 2010 and June 2011 were randomly recruited.Fasting venous blood was sampled at day 2 following confirmation of the diagnosis of pregnancy,which entailed assessment of VEGF by enzyme-linked immunosorbent assay (ELISA).The 31 patients with fallopian pregnancy underwent plain and contrast-enhanced pelvic MRI preoperatively for determination of the association between MRI features and VEGF.Results Patients with fallopian pregnancy yielded a significantly higher level of serum VEGF [(289.2±45.3) ng/L vs (19.1±6.3) ng/L,P＜0.05] than those with premature intrauterine pregnancy.Serum VEGF concentration was associated with the size of the ectopic gestational sacs,the volume of hemorrhage,the extent of enhancement and presence of uterine decidual hydrops (all P＜0.05),but not associated with the location of fallopian pregnancy and pelvic hydrops (both P＞0.05).Conclusion The level of serum VEGF in fallopian pregnancy is significantly higher than that in early intrauterine pregnancy and is associated with the size of ectopic gestational sacs,volume of hemorrhage,enhancement and presence of uterine decidual hydrops.
Key words:
Pregnancy, tubal; Vascular endothelial growth factors; Magnetic resonance imaging
Objective
To evaluate the effects of problem-based learning (PBL) teaching model in breast cancer medical imaging education based on multidisciplinary treatment (MDT).
Methods
The PBL teaching practice of breast cancer imaging based on MDT was carried out in the 192 clinical medicine stu-dents in Grade 2014 of Guangzhou Medical University. The students were randomly divided into four groups (group A, B, C and D) and each group was further divided into 1 to 5 teams, with 9 to 11 students in each team. The MDT teaching team consisted of clinical physicians in medical imaging, radiation oncology, surgery (specialized in breast tumor), and other disciplines. The formative assessment method was used to evaluate the teaching effects and the problems involved wereanalyzed.
Results
Firstly, with a full score of 100 points, the quantitative evaluation of each teaching team on the performance of students in PBL were (86.6±7.8), (87.1±8.1), (83.9±6.5), (88.1±4.5), and (85.1±8.2), respectively. No significant difference was found among each tutor team’s quantitative evaluation (F=1.014, P=0.388). Secondly, the whole posi-tive evaluation rate of students for tutors was 96.28%, with the highest and lowest positive rates as 98.36% and 94.08%, respectively. Significant difference was found among parts of the tutors (χ2=10.554, P=0.032), spe-cifically between team 1 and 5 (Z=2.245, P=0.025), 3 and 4 (Z=2.217, P=0.027) and 3 and 5 (Z=2.761, P=0.006) respectively. Lastly, the positive and negative evaluation rates of student's self-assessment were 87.33% and 12.67% respectively.
Conclusion
The effects of PBL based on MDT in breast cancer imaging teaching practice is encouraging, and the formative assessment method can objectively and effectively evalu-ate the effects of this kind of teaching model. However, the standards of evaluation still need to be further per-fected and improved.
Key words:
Problem-based learning; Teaching method; Breast cancer; Multidisciplinary treat-ment; Radiography
By fusing the extracellular domain of the natural killer (NK) cell receptor NKG2D to DAP12, we constructed a chimeric antigen receptor (CAR) to improve NK cell tumor responses. An RNA electroporation approach that provides transient expression of the CAR was adopted as a risk mitigation strategy. Expression of the NKG2D RNA CAR significantly augmented the cytolytic activity of NK cells against several solid tumor cell lines in vitro and provided a clear therapeutic benefit to mice with established solid tumors. Three patients with metastatic colorectal cancer were then treated with local infusion of the CAR-NK cells. Reduction of ascites generation and a marked decrease in number of tumor cells in ascites samples were observed in the first two patients treated with intraperitoneal infusion of low doses of the CAR-NK cells. The third patient with metastatic tumor sites in the liver was treated with ultrasound-guided percutaneous injection, followed by intraperitoneal infusion of the CAR-NK cells. Rapid tumor regression in the liver region was observed with Doppler ultrasound imaging and complete metabolic response in the treated liver lesions was confirmed by positron emission tomography (PET)- computed tomographic (CT) scanning. Our results highlight a promising therapeutic potential of using RNA CAR-modified NK cells to treat metastatic colorectal cancer. By fusing the extracellular domain of the natural killer (NK) cell receptor NKG2D to DAP12, we constructed a chimeric antigen receptor (CAR) to improve NK cell tumor responses. An RNA electroporation approach that provides transient expression of the CAR was adopted as a risk mitigation strategy. Expression of the NKG2D RNA CAR significantly augmented the cytolytic activity of NK cells against several solid tumor cell lines in vitro and provided a clear therapeutic benefit to mice with established solid tumors. Three patients with metastatic colorectal cancer were then treated with local infusion of the CAR-NK cells. Reduction of ascites generation and a marked decrease in number of tumor cells in ascites samples were observed in the first two patients treated with intraperitoneal infusion of low doses of the CAR-NK cells. The third patient with metastatic tumor sites in the liver was treated with ultrasound-guided percutaneous injection, followed by intraperitoneal infusion of the CAR-NK cells. Rapid tumor regression in the liver region was observed with Doppler ultrasound imaging and complete metabolic response in the treated liver lesions was confirmed by positron emission tomography (PET)- computed tomographic (CT) scanning. Our results highlight a promising therapeutic potential of using RNA CAR-modified NK cells to treat metastatic colorectal cancer.
Abstract Background The neuroimaging manifestations of eclampsia and preeclampsia often overlap, mainly presenting as posterior reversible encephalopathy syndrome (PRES). The purpose of this retrospective study was to compare the extent and nature of brain edema in eclampsia and preeclampsia patients with PRES based on MRI characteristics. Methods One hundred fifty women diagnosed with preeclampsia-eclampsia and undergoing cranial MRI were enrolled; 24 of these were diagnosed as having eclampsia. According to clinicoradiologic diagnosis of PRES, eligible patients were classified as having eclampsia with PRES (group E-PRES) and preeclampsia with PRES (group P-PRES). A scale on T2W FLAIR-SPIR images was established to evaluate the extent of brain edema, and the score of brain edema (SBE) of both groups was compared. In patients of the two groups who also underwent DWI sequence, the presence or absence of hyperintensity on DWI and hypointensity on ADC maps were determined to compare the nature of brain edema. Furthermore, clinical and biochemical data of the two groups were compared. Results The incidence of PRES in eclampsia patients was significantly higher than that in preeclampsia patients (87.50% vs. 46.03%, P <0.001). The SBE of all regions and typical regions in group E-PRES patients were significantly higher than those in group P-PRES patients (15.88±8.72 vs. 10.90±10.21, P =0.021; 8.52±3.87 vs. 5.01±4.19, P =0.002; respectively). The presence of hyperintensity on DWI was determined more frequently in group E-PRES patients than group P-PRES patients (71.43% vs. 32.00%, P =0.024). Age, systolic blood pressure, white blood cell count, neutrophil count and percentage of neutrophils were significantly different between the two groups ( P <0.05). Conclusions Certain MRI characteristics that reflect the extent and nature of brain edema were different between eclampsia and preeclampsia patients with PRES. Additional prospective studies are still required to explore whether these MRI characteristics of brain edema may further become a potential predictor for eclamptic seizures in preeclampsia patients with PRES.
Background: The preoperative diagnosis of phyllodes tumors (PTs) of the breast is critical to appropriate surgical treatment. However, reliable differentiation between PT and fibroadenoma (FA) remains difficult in daily clinical practice. The purpose of this study was to investigate the utility of breast MRI texture analysis for differentiating PTs from FAs. Materials and Methods: Forty-two PTs and 42 FAs were enrolled in this retrospective study. Clinical and conventional MRI features (CCMF) and MRI texture analysis were used to distinguish between PT and FA. Texture features were extracted from the axial short TI inversion recovery T2-weighted (T2W-STIR), T1-weighted pre-contrast, and two contrast-enhanced series (first contrast and third contrast). The Mann-Whitney U test was used to select statistically significant features of texture analysis and CCMF. Using a linear discriminant analysis, the most discriminative features were determined from statistically significant features. The K-nearest neighbor classifier and ROC curve were applied to evaluate the diagnostic performance. Results: With a higher classification accuracy (89.3%) and an AUC of 0.89, the texture features on T2W-STIR outperformed the texture features on other MRI sequences and CCMF. The AUC of the combination of CCMF with texture features on T2W-STIR was significantly higher than that of CCMF or texture features on T2W-STIR alone (p < 0.05). Based on the result of the classification accuracy (95.2%) and AUC (0.95), the diagnostic performance of the combination strategy performed better than texture features on T2W-STIR or CCMF separately. Conclusions: Texture features on T2W-STIR showed better diagnostic performance compared to CCMF for the distinction between PTs and FAs. After further validation of multi-institutional large datasets, MRI-based texture features may become a potential biomarker and be a useful medical decision tool in clinical trials having patients with breast fibroepithelial neoplasms.
Preoperative prediction of clinical pathological indicators of cervical cancer (CC) is of great significance to the formulation of personalized treatment plans for CC.To investigate magnetic resonance imaging (MRI) radiomics analysis for the evaluation of pathological types, tumor grade, FIGO stage, and lymph node metastasis (LNM) of CC.A total of 235 patients with CC from three institutes were enrolled in the study. All patients underwent T2/SPAIR and contrast-enhanced T1-weighted (CE-T1WI) imaging scans before radical hysterectomy by pelvic lymph node dissection surgery. Radiomics features extracted from T2/SPAIR and CE-T1WI imaging were selected by the least absolute shrinkage and selection operator (LASSO) methods for further radiomics signature calculation. These radiomic features were used to construct regression and decision tree models to evaluate the performance of radiomic features in distinguishing clinicopathological indicators.The area under the curve (AUC) of T2/SPAIR and CE-T1WI imaging were 0.777 and 0.750, respectively, for differentiating between adenocarcinoma and squamous cell carcinoma. From the two sequences, the AUC of the verification group that distinguished low FIGO stage from high FIGO stage was 0.716 and 0.676, respectively. The AUC for moderately well and poorly differentiated tumors were 0.729 on T2/SPAIR and 0.749 on CE-T1WI imaging. The AUC of the verification groups for LNM was 0.730 and 0.618 on T2/SPAIR and CE-T1WI imaging, respectively.MRI radiomics features can be used as a non-invasive method to evaluate the clinicopathological indexes of CC and provide an important auxiliary examination method for patients to determine individualized treatment plans before operation.
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