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Prediction of pathological nodal stage of locally advanced rectal cancer by collective features of multiple lymph nodes in magnetic resonance images before and after neoadjuvant chemoradiotherapy

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Chinese Journal of Cancer Research 2019年第6期31卷 984-992页

作者： Haitao Zhu Xiaoyan Zhang Xiaoting Li Yanjie Shi Huici Zhu yingshi sun Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing) Department of Radiology Peking University Cancer Hospital & Institute

Objective:To predict pathological nodal stage of locally advanced rectal cancer by a radiomic method that uses collective features of multiple lymph nodes(LNs)in magnetic resonance images before and after neoadjuvant chemoradiotherapy(NCRT).Methods:A total of 215 patients were included in this study and chronologically divided into the discovery cohort(n=143)and validation cohort(n=72).In total,2,931 pre-NCRT LNs and 1,520 post-NCRT LNs were delineated from all visible rectal LNs in magnetic resonance ***,first-order and texture features were extracted from each LN before and after *** features are defined as the maximum,minimum,mean,median value and standard deviation of each feature from all delineated LNs of each ***-model is constructed from collective LN features by logistic regression model with L1 regularization to predict pathological nodal stage(ypN0 or ypN+).Tumor-model is constructed from tumor features for comparison by using DeLong ***:The LN-model selects 7 features from 412 LN features,and the tumor-model selects 7 features from 82 tumor *** area under the receiver operating characteristic curve(AUC)of LN-model in the discovery cohort is 0.818[95%confidence interval(95%CI):0.745-0.878],significantly(Z=2.09,P=0.037)larger than 0.685(95%CI:0.602-0.760)of the *** AUC of LN-model in validation cohort is 0.812(95%CI:0.703-0.895),significantly(Z=3.106,P=0.002)larger than 0.517(95%CI:0.396-0.636)of the ***:The usage of collective features from all visible rectal LNs performs better than the usage of tumor features for the prediction of pathological nodal stage of locally advanced rectal cancer.

关键词： Lymph node neoadjuvant therapy radiomics rectal cancer

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Correlation between imaging features on computed tomography and combined positive score of PD-L1 expression in patients with gastric cancer

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Chinese Journal of Cancer Research 2022年第5期34卷 510-518页

作者： Zhilong Wang Yinkui Wang Xiaoting Li Yanling Li Zhaode Bu Zhongwu Li yingshi sun Jiafu Ji Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education/Beijing) Department of RadiologyBeijing 100142China Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education/Beijing) Center of Gastrointestinal SurgeryBeijing 100142China Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education/Beijing) Department of PathologyPeking University Cancer Hospital&InstituteBeijing 100142China

Objective:To explore the correlation between computed tomography(CT)features and combined positive score(CPS)of programmed cell death ligand 1(PD-L1)expression in patients with gastric cancer(GC).Methods:This study reviewed an institutional database of patients who underwent GC operation without neoadjuvant chemotherapy between December 2019 and September *** CPS results of PD-L1 expression of postoperative histological examination were recorded by *** CT features were measured,and their correlation with CPS 5 or 10 score groups of PD-L1 expression was ***:Data for 153 patients with GC were *** them,124 were advanced GC patients,and 29were early GC *** of the CT features significantly differed between CPS groups with a cutoff score of 5and a score of 10 in patients with early *** advanced GC,the presence of lymph nodes with short diameters>10mm was significantly different(P=0.024)between the CPS10 mm significantly differed between the CPS<10 and CPS≥10 groups in advanced *** sensitivity,specificity and area under receiver operating characteristic(ROC)curve of logistic regression model for predicting CPS≥10 was 71.7%,50.0%and 0.671,*** instability(MSI)status was significantly different in CPS groups with cutoff score of 5 and 10 in advanced GC ***:CT findings of advanced GC patients with CPS≥10 showed greater arterial phase enhancement and larger lymph *** has the potential to help screen patients suitable for immunotherapy.

关键词： Gastric cancer computed tomography combined positive score

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Utility of CT in differentiating liver metastases of well-differentiated gastroenteropancreatic neuroendocrine neoplasms from poorly-differentiated neuroendocrine neoplasms

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Chinese Journal of Cancer Research 2018年第1期30卷 31-39页

作者： Yong Cui Xiaoting Li Shunyu Gao Zhongwu Li Yanling Li Ming Lu yingshi sun Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing) Department of Radiology Beijing 100142 China Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing)Department of Pathology Beijing 100142 China Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing)Department of Gastrointestinal Oneology Peking University Cancer Hospital & Institute Beijing 100142 China

Objective： To determine the capability of dynamic enhanced computed tomography（CT） to differentiate liver metastases（LMs） of well-differentiated from poorly-differentiated gastroenteropancreatic neuroendocrine neoplasms（GEP-NENs）.Methods： Patients with LMs of GEP-NENs who underwent dynamic enhanced CT examination in Peking University Cancer Hospital from January 2009 to October 2015 were included and data were retrospectively analyzed. We assessed the qualitative and quantitative CT features to identify the significant differentiating CT features of LMs of poorly-differentiated GEP-NENs from those of well-differentiated GEP-NENs using univariate analysis and a multivariate logistic regression ***： The study included 22 patients with LMs of well-differentiated GEP-NENs and 32 patients with LMs of poorly-differentiated GEP-NENs. Univariate analysis revealed statistically significant differences between the LMs of well-and poorly-differentiated GEP-NENs in terms of feeding arteries（36.4% vs. 75.0%, χ2=8.061,P=0.005）, intratumoral neovascularity（18.2% vs. 59.4%, χ2=9.047, P=0.003）, lymphadenopathy（27.3% vs. 81.2%,χ2=15.733, P〈0.001）, tumor-to-aortic ratio in the hepatic arterial and portal venous phase（T-A/AP： 0.297±0.080 vs.0.251±0.059, t=2.437, P=0.018; T-A/PVP： 0.639±0.138 vs. 0.529±0.117, t=3.163, P=0.003） and tumor-to-liver ratio in the hepatic arterial phase（T-L/AP： 1.108±0.267 vs. 0.907±0.240, t=2.882, P=0.006）. The LMs of poorlydifferentiated GEP-NENs showed more feeding arteries, more intratumoral neovascularity, more lymphadenopathy and a lower tumor-to-aortic ratio. Multivariate analysis suggested that intratumoral neovascularity [P=0.015, OR=0.108, 95% confidence interval（95% CI）, 0.018–0.646], lymphadenopathy（P=0.001,OR=0.055, 95% CI, 0.009–0.323） and T-A/PVP（P=0.004, OR=5.3 E–5, 95% CI, 0.000–0.044） were independent factors for differentiating LMs of poorly-differentiated from well-differentiated ***： Dynamic enhanced CT features

关键词： Diagnosis gastroenteropancreatic neuroendocrine neoplasm neoplasm grading tomography X-ray computed

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Better prognostic determination of cT3 rectal cancer through measurement of distance to mesorectal fascia:A multicenter study

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Chinese Journal of Cancer Research 2021年第5期33卷 606-615页

作者： Xiaoyan Zhang Qiaoyuan Lu Xiangjie Guo Wuteng Cao Hongmei Zhang Tao Yu Xiaoting Li Zhen Guan Xueping Li Ruijia sun yingshi sun Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education/Beijing) Department of RadiologyPeking University Cancer Hospital&InstituteBeijing 100142China Department of Forensic Medicine Shanxi Medical UniversityTaiyuan 030001China Department of Radiology the Sixth Affiliated HospitalSun Yat-sen UniversityGuangzhou 510655China Department of Radiology National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100021China Department of Medical Imaging Cancer Hospital of China Medical UniversityShenyang 110042China

Objective:To forward the magnetic resonance imaging(MRI)based distance between the deepest tumor invasion and mesorectal fascia(DMRF),and to explore its prognosis differentiation value in cT3 stage rectal cancer with comparison of cT3 ***:This was a retrospective,multicenter cohort study including cT3 rectal cancer patients undergoing neoadjuvant chemoradiotherapy followed by radical surgery from January 2013 to September *** and cT3 substage were evaluated from baseline *** cutoff of DMRF was determined by disease *** cox regression was used to test the prognostic values of baseline ***:A total of 804 patients were included,of which 226(28.1%)developed progression.A DMRF cutoff of7 mm was *** category,the clock position of the deepest position of tumor invasion(CDTI)and extramural venous invasion(EMVI)were independent predictors for disease progression,and hazard ratios(HRs)were 0.26[95%confidence interval(95%CI),0.13-0.56],1.88(95%CI,1.33-2.65)and 1.57(95%CI,1.13-2.18),***3 substage was not a predictor for disease ***:The measurement of DMRF value on baseline MRI can better distinguish cT3 rectal cancer prognosis rather than cT3 substage,and was recommended in clinical evaluation.

关键词： Rectal cancer T3 stage substage distance to mesorectal fascia magnetic resonance imaging

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局部进展期直肠癌新辅助治疗疗效精准影像学评估——从图像到图像背后的隐藏大数据

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中华放射学杂志 2021年第11期55卷 1117-1120页

作者：孙应实北京大学肿瘤医院暨北京市肿瘤防治研究所医学影像科恶性肿瘤发病机制及转化研究教育部重点实验室100142

局部进展期直肠癌新辅助治疗疗效的精准影像学评估,决定了患者后续的临床治疗方式。局部进展期直肠癌新辅助治疗疗效评估目前主要依赖人为主观评价,如何提升肉眼识图和主观诊断的瓶颈问题,是临床面临的重要、疑难问题。人工智能的广泛应... 详细信息

局部进展期直肠癌新辅助治疗疗效的精准影像学评估,决定了患者后续的临床治疗方式。局部进展期直肠癌新辅助治疗疗效评估目前主要依赖人为主观评价,如何提升肉眼识图和主观诊断的瓶颈问题,是临床面临的重要、疑难问题。人工智能的广泛应用,提供了较好的方法学引导,有望提高局部进展期直肠癌新辅助治疗疗效的评估效能,为个性化制定后续治疗策略提供客观量化且精准的影像学依据。本文主要总结了目前临床常用的直肠癌新辅助疗效评估方法,以及人工智能方法在直肠癌研究领域的应用,人工智能方法学的优势使其有潜力作为医师主观评估的有效补充手段,但也必须了解人工智能固有的缺陷。理性面对人工智能,既要“人工”,也要“智能”,积极联合多中心开展扎实的临床研究,大力推进直肠癌人工智能研究的发展和落地。

关键词：直肠肿瘤局部进展期新辅助治疗疗效评估人工智能

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胃肠道肿瘤性病变的影像学评价

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中华胃肠外科杂志 2015年第3期18卷 204-207页

作者：孙应实北京大学肿瘤医院暨北京市肿瘤防治研究所医学影像科恶性肿瘤发病机制及转化研究教育部重点实验室 100142

胃肠道肿瘤一直是我国的高发肿瘤，也是影像领域关注的重要疾病。近年来，随着诊治理念的更新以及治疗技术的进步，使越来越多的患者受益，改善了疾病的预后。影像学在其中发挥了不可或缺的重要作用。对于胃肠道肿瘤患者的诊治，已经由... 详细信息

胃肠道肿瘤一直是我国的高发肿瘤，也是影像领域关注的重要疾病。近年来，随着诊治理念的更新以及治疗技术的进步，使越来越多的患者受益，改善了疾病的预后。影像学在其中发挥了不可或缺的重要作用。对于胃肠道肿瘤患者的诊治，已经由单一手段发展为多元化综合模式，需要多学科协作，提供最优的个体化治疗方案。本文依据此原则，总结近年来发表的研究成果，结合自身临床实践经验，剖析胃肠道肿瘤影像学评价方面的各种热点问题，展望该领域的前景方向。

关键词：胃肠道肿瘤影像学诊断

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Deep learning model improves radiologists'performance in detection and classification of breast lesions

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Chinese Journal of Cancer Research 2021年第6期33卷 682-693页

作者： yingshi sun Yuhong Qu Dong Wang Yi Li Lin Ye Jingbo Du Bing Xu Baoqing Li Xiaoting Li Kexin Zhang Yanjie Shi Ruijia sun Yichuan Wang Rong Long Dengbo Chen Haijiao Li Liwei Wang Min Cao Key Laboratory of Carcinogenesis and Translational Research(Ministry of Educatdon/Beijing) Department of RadiologyPeking University Cancer Hospital&InstituteBeijing 100142China Department of Radiology Beijing Chaoyang HospitalCapital Medical UniversityBeijing 100020China Key Laboratory of Machine Perception MOESchool of EECSPeking UniversityBeijing 100871China Departnient of Radiology Shunyi Women’s&Children’s Hospital of Beijing Children’s HospitalBeijing 101399China Department of Radiology Beijing Chaoyang Maternal and Child Health CenterBeijing 122099China Department of Radiology Beijing Daxing District Peopled HospitalBeijing 102699China Department of Radiology Shunyi District HospitalBeijing 101312China Department of Medical Imaging Beijing Shijingshan HospitalBeijing 100040China Center for Data Science Peking UniversityBeijing 100871China

Objective:Computer-aided diagnosis using deep learning algorithms has been initially applied in the field of mammography,but there is no large-scale clinical ***:This study proposed to develop and verify an artificial intelligence model based on ***,mammograms retrospectively collected from six centers were randomized to a training dataset and a validation dataset for establishing the ***,the model was tested by comparing 12 radiologists’performance with and without ***,prospectively enrolled women with mammograms from six centers were diagnosed by radiologists with the *** detection and diagnostic capabilities were evaluated using the freeresponse receiver operating characteristic(FROC)curve and ROC ***:The sensitivity of model for detecting lesions after matching was 0.908 for false positive rate of 0.25 in unilateral *** area under ROC curve(AUC)to distinguish the benign lesions from malignant lesions was0.855[95%confidence interval(95%CI):0.830,0.880].The performance of 12 radiologists with the model was higher than that of radiologists alone(AUC:0.852 vs.0.805,P=0.005).The mean reading time of with the model was shorter than that of reading alone(80.18 s vs.62.28 s,P=0.032).In prospective application,the sensitivity of detection reached 0.887 at false positive rate of 0.25;the AUC of radiologists with the model was 0.983(95%CI:0.978,0.988),with sensitivity,specificity,positive predictive value(PPV),and negative predictive value(NPV)of94.36%,98.07%,87.76%,and 99.09%,***:The artificial intelligence model exhibits high accuracy for detecting and diagnosing breast lesions,improves diagnostic accuracy and saves time.

关键词： Breast cancer mammography deep learning artificial intelligence

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T1 mapping技术用于心脏疾病危险分层及预后评估研究进展

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中国医学影像技术 2022年第7期38卷 1090-1093页

作者：刘茜王珍孙应实北京大学肿瘤医院暨北京市肿瘤防治研究所医学影像科恶性肿瘤发病机制及转化研究教育部重点实验室北京100142

近年心脏MR(CMR)技术快速发展,在心脏疾病中的应用越来越受到重视。T1 mapping成像技术可量化评价心肌组织T1弛豫时间,在评价心肌组织学特征和定量分析方面具有较大潜力,可为判断多种心脏疾病的预后提供有价值的信息。本文就T1 mapping... 详细信息

近年心脏MR(CMR)技术快速发展,在心脏疾病中的应用越来越受到重视。T1 mapping成像技术可量化评价心肌组织T1弛豫时间,在评价心肌组织学特征和定量分析方面具有较大潜力,可为判断多种心脏疾病的预后提供有价值的信息。本文就T1 mapping技术在心脏疾病危险分层及预后评估中的研究进展进行综述。

关键词：心脏磁共振成像 T1 mapping

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影像学评价局部进展期直肠癌新辅助治疗后病理完全缓解的研究进展

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中国医学影像技术 2016年第3期32卷 453-456页

作者：王莹屏孙应实北京大学肿瘤医院暨北京市肿瘤防治研究所医学影像科恶性肿瘤发病机制及转化研究教育部重点实验室北京100142

局部进展期直肠癌治疗的国际标准为新辅助治疗联合手术。对于局部进展期直肠癌新辅助治疗后能否达到病理完全缓解(pCR),需要通过术后病理得知,但通过组织学评价pCR无法为术前治疗方案的调整提供依据。目前,关于影像学技术评价局部进展... 详细信息

局部进展期直肠癌治疗的国际标准为新辅助治疗联合手术。对于局部进展期直肠癌新辅助治疗后能否达到病理完全缓解(pCR),需要通过术后病理得知,但通过组织学评价pCR无法为术前治疗方案的调整提供依据。目前,关于影像学技术评价局部进展期直肠癌新辅助治疗后的pCR成为研究热点,本文对相关研究进展进行综述。

关键词：直肠肿瘤肿瘤辅助疗法病理完全缓解

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流入饱和技术对多标记后延迟动脉自旋标记图像动脉“流入伪影”的影响

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中国医学影像技术 2021年第10期37卷 1548-1551页

作者：林天烨冯逢孙应实北京大学肿瘤医院暨北京市肿瘤防治研究所医学影像科恶性肿瘤发病机制及转化研究教育部重点实验室北京100142 中国医学科学院北京协和医学院北京协和医院放射科疑难重症及罕见病国家重点实验室北京100730

目的评价流入饱和技术对多标记后延迟动脉自旋标记(multi-PLD ASL)图像中动脉内“流入伪影”的影响。方法针对8名健康志愿者分别行使用/不使用流入饱和技术顺序采集(SASL)及Hadamard编码采集(HASL),观察并比较SASL/HASL图像中出现动脉... 详细信息

目的评价流入饱和技术对多标记后延迟动脉自旋标记(multi-PLD ASL)图像中动脉内“流入伪影”的影响。方法针对8名健康志愿者分别行使用/不使用流入饱和技术顺序采集(SASL)及Hadamard编码采集(HASL),观察并比较SASL/HASL图像中出现动脉内异常信号的频率及其特点。结果不使用流入饱和HASL中,70.00%(28/40)灌注图像动脉内可见异常信号,包括高信号和低信号,常见于血管走行区域;使用流入饱和技术后,仅5.00%(2/40)灌注图像中动脉内出现异常信号,差异有统计学意义(P0.05)。结论流入饱和技术可减轻或消除单次激发multi-PLD ASL中的动脉“流入伪影”。

关键词：动脉通过伪影动脉自旋标记磁共振成像

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