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Evaluation of recurrence in gastric carcinoma: Comparison of contrast-enhanced computed tomography and positron emission tomography/computed tomography

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World Journal of Gastroenterology 2017年第35期23卷 6448-6456页

作者： Jong Hyeon Kim Suk Hee Heo Jin Woong Kim Sang Soo Shin Jung Jun Min Seong Young Kwon Yong Yeon Jeong Heoung Keun Kang Department of Radiology Chonnam National University Medical SchoolChonnam National University Hwasun Hospital Department of Radiology Chonnam National University Medical SchoolChonnam National University Hospital Department of Nuclear Medicine Chonnam National University Medical SchoolChonnam National University Hwasun Hostpital

AIM To compare the value of contrast-enhanced abdominal computed tomography(CT) and fluorodeoxyglucose(FDG) positron emission tomography/computed tomography(PET/CT) for detecting gastric carcinoma recurrence.METHODS We retrospectively examined data from 2475 patients who underwent both contrast-enhanced abdominal CT and FDG PET/CT for the surveillance of gastric carcinoma curative resection. Patients had an interval of less than 1 mo between their CT and PET/CT scans. Sixty patients who had recurrence were enrolled. Among 1896 patients who did not have recurrence, 60 were selected by simple random sampling. All CT and PET/CT images were reviewed retrospectively by two reviewers blinded to all clinical and pathologic information except curative resection due to gastric carcinoma. RESULTS The pathological stage of the recurrence group was statistically significantly higher than that of the control group(P < 0.001). In the 60 patients who had recurrence, there were 79 recurrent lesions. Fortyfour patients had only one location of recurrence, 13 patients had two locations, and 3 patients had three. In the detection of patient-based overall recurrence, no statistically significant differences existed between the two modalities(P = 0.096). However, for peritoneal carcinomatosis, CT had a statistically significantly higher sensitivity compared to PET/CT(96% vs 50%, P = 0.001). Adenocarcinoma was the most common type of gastric carcinoma. On the pathology-based analysis, CT also had a statistically significantly higher sensitivity compared to PET/CT(98% vs 80%, P = 0.035).CONCLUSION Contrast-enhanced CT was superior to PET/CT in the detection of peritoneal carcinomatosis and pathologic type of adenocarcinoma.

关键词： Gastric carcinoma Surgery contrastenhanced abdominal computed tomography Fluorodeoxyglucose positron emission tomograph/computed tomography Surveillance Recurrence

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Diagnostic imaging advances in murine models of colitis

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World Journal of Gastroenterology 2016年第3期22卷 996-1007页

作者： Markus Brückner Philipp Lenz Marcus M Mücke Faekah Gohar Peter Willeke Dirk Domagk Dominik Bettenworth Department of Medicine B University Hospital of MünsterAlbert-Schweitzer-Campus 1D-48149 MünsterGermany Department of Paediatric Rheumatology and Immunology University Hospital of MünsterAlbert-Schweitzer-Campus 1D-48149 MünsterGermany Department of Medicine D University Hospital of MünsterAlbert-Schweitzer-Campus 1D-48149 MünsterGermany Department of Medicine I Josephs-Hospital WarendorfAcademic Teaching HospitalUniversity of MünsterAm Krankenhaus 2D-48231 WarendorfGermany

Inflammatory bowel diseases(IBD) such as Crohn's disease and ulcerative colitis are chronic-remittent inflammatory disorders of the gastrointestinal tract still evoking challenging clinical diagnostic and therapeutic situations. Murine models of experimental colitis are a vital component of research into human IBD concerning questions of its complex pathogenesis or the evaluation of potential new drugs. To monitor the course of colitis, to the present day, classical parameters like histological tissue alterations or analysis of mucosal cytokine/chemokine expression often require euthanasia of animals. Recent advances mean revolutionary noninvasive imaging techniques for in vivo murine colitis diagnostics are increasingly available. These novel and emerging imaging techniques not only allow direct visualization of intestinal inflammation, but also enable molecular imaging and targeting of specific alterations of the inflamed murine mucosa. For the first time, in vivo imaging techniques allow for longitudinal examinations and evaluation of intra-individual therapeutic response. This review discusses the latest developments in the different fields of ultrasound, molecularly targeted contrast agent ultrasound, fluorescence endoscopy, confocal laser endomicroscopy as well as tomographic imaging with magnetic resonance imaging, computed tomography and fluorescence-mediated tomography,discussing their individual limitations and potential future diagnostic applications in the management of human patients with IBD.

关键词： confocal laser endomicroscopy contrastenhanced ultrasound Dextran Sodium Sulphate colitis experimental colitis fluorescence imaging endoscopy Imaging Inflammatory bowel disease Tomography

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Dual-input two-compartment pharmacokinetic model of dynamic contrast-enhanced magnetic resonance imaging in hepatocellular carcinoma

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World Journal of Gastroenterology 2016年第13期22卷 3652-3662页

作者： Jian-Feng Yang Zhen-Hua Zhao Yu Zhang Li Zhao Li-Ming Yang Min-Ming Zhang Bo-Yin Wang Ting Wang Bao-Chun Lu Department of Radiology Second Affliated Hospital College of Medicine Zhejiang University Hangzhou 310009 Zhejiang Province China Shaoxing People's Hospital (Shaoxing Hospital of Zhejiang University) Shaoxing 312000 Zhejiang Province China Department of Radiology Shaoxing People's Hospital (Shaoxing Hospital of Zhejiang University) Shaoxing 312000 Zhejiang Province China Department of Hepatobiliary Surgery Shaoxing People's Hospital (Shaoxing Hospital of Zhejiang University) Shaoxing 312000 Zhejiang Province China

AIM: To investigate the feasibility of a dual-input two-compartment tracer kinetic model for evaluating tumorous microvascular properties in advanced hepatocellular carcinoma(HCC). METHODS: From January 2014 to April 2015, we prospectively measured and analyzed pharmacokinetic parameters [transfer constant(K_(trans)), plasma flow(F_p), permeability surface area product(PS), efflux rate constant(k_(ep)), extravascular extracellular space volume ratio(V_e), blood plasma volume ratio(V_p), and hepatic perfusion index(HPI)] using dual-input two-compartment tracer kinetic models [a dual-input extended Tofts model and a dual-input 2-compartment exchange model(2CXM)] in 28 consecutive HCC patients. A well-known consensus that HCC is a hypervascular tumor supplied by the hepatic artery and the portal vein was used as a reference standard. A paired Student's t-test and a nonparametric paired Wilcoxon rank sum test were used to compare the equivalent pharmacokinetic parameters derived from the two models, and Pearson correlation analysis was also applied to observe the correlations among all equivalent parameters. The tumor size and pharmacokinetic parameters were tested by Pearson correlation analysis, while correlations among stage, tumor size and all pharmacokinetic parameters were assessed by Spearman correlation analysis. RESULTS: The F_p value was greater than the PS value(F_P = 1.07 m L/m L per minute, PS = 0.19 m L/m L per minute) in the dual-input 2CXM; HPI was 0.66 and 0.63 in the dual-input extended Tofts model and the dualinput 2CXM, respectively. There were no significant differences in the K_(ep), V_p, or HPI between the dual-input extended Tofts model and the dual-input 2CXM(P = 0.524, 0.569, and 0.622, respectively). All equivalent pharmacokinetic parameters, except for V_e, were correlated in the two dual-input two-compartment pharmacokinetic models; both Fp and PS in the dualinput 2CXM were correlated with K_(trans) derived from the dual-input extended Tofts model(P = 0.002, r = 0.566; P = 0.002, r = 0.57

关键词： Hepatocellular carcinoma Dynamic contrastenhanced magnetic resonance imaging Pharmacokinetics

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Contrast-enhanced ultrasonographic findings of hepatic paragonimiasis

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World Journal of Gastroenterology 2013年第13期19卷 2087-2091页

作者： Qiang Lu Wen-Wu Ling Lin Ma Zi-Xing Huang Chang-Li Lu Yan Luo Department of Ultrasound Chinese Evidence-Based Medicine CenterWest China Hospital of Sichuan University Department of Ultrasound West China Hospital of Sichuan University Sichuan University Department of Radiology West China Hospital of Sichuan University Department of Pathology West China Hospital of Sichuan University

AIM: To investigate the features of hepatic paragonimiasis on contrast-enhanced ultrasound (CEUS) imag- ing. METHODS: Fifteen patients with hepatic paragonimiasis who were admitted to our hospital between March 2008 and August 2012 were enrolled to this study. The conventional ultrasound and CEUS examinations were performed with a Philips IU22 scanner with a 1-5-MHz convex transducer. After conventional ultrasound scanning was completed, the CEUS study was performed. Pulse inversion harmonic imaging was used for CEUS. A bolus injection of 2.4 mL of a sulfur hexafluoride-filled microbubble contrast agent (SonoVue) was administered. CEUS features were retrospectively reviewed and correlated with pathological findings. RESULTS: In total, 16 lesions were detected on CEUS. The mean size of the lesions was 4.4 ± 1.6 cm (range, 1.7-6.6 cm). Subcapsular location was found in 12 lesions (75%). All the lesions were hypoechoic. Six lesions (37.5%) were of mixed content, seven (43.8%) were solid with small cystic areas, and the other three (18.8%) were completely solid. Ten lesions (62.5%) were rim enhanced with irregular tract-like nonenhanced internal areas. Transient wedge-shaped hyperenhancement of the surrounding liver parenchyma was seen in seven lesions (43.8%). Areas with hyperor iso-enhancement in the arterial phase showed contrast wash-out and appeared hypoenhanced in the late phase. The main pathological findings included: (1) coagulative or liquefactive necrosis within the lesion, infiltration of a large number of eosinophils with the formation of chronic eosinophilic abscesses and sporadic distribution of Charcot-Leyden crystals; and (2) hyperplasia of granulomatous and fibrous tissue around the lesion. CONCLUSION: Subcapsular location, hypoechogenicity, rim enhancement and tract-like nonenhanced areas could be seen as the main CEUS features of hepatic paragonimiasis.

关键词： Paragonimiasis Liver Infection contrastenhanced ultrasonography

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Role of contrast-enhanced ultrasound in follow-up assessment after ablation for hepatocellular carcinoma

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World Journal of Gastroenterology 2013年第6期19卷 855-865页

作者： Shu-Guang Zheng Hui-Xiong Xu Ming-De Lu Xiao-Yan Xie Zuo-Feng Xu Guang-Jian Liu Lin-Na Liu Department of Medical Ultrasound Tenth People's Hospital of Tongji University Department of Medical Ultrasonics the First Affiliated HospitalSun Yat-Sen University

AIM:To assess the usefulness of contrast-enhanced ultrasound (CEUS) during follow-up after percutaneous ablation therapy for hepatocellular carcinoma (HCC).METHODS:A total of 141 patients with HCCs who received percutaneous ablation therapy were assessed by paired follow-up CEUS and contrast-enhanced computed tomography (CECT).The follow-up scheme was designed prospectively and the intervals between CEUS and CECT examinations were less than 14 d.Both im-ages of follow-up CEUS and CECT were reviewed by radiologists.The ablated lesions were evaluated and classified as local tumor progression (LTP) and LTPfree.LTP was defined as regrowth of tumor inside or adjacent to the successfully treated nodule.The detected new intrahepatic recurrences were also evaluated and defined as presence of intrahepatic new foci.On CEUS and CECT,LTP and new intrahepatic recurrence both were displayed as typical enhancement pattern of HCC (i.e.,hyper-enhancing during the arterial phase and washout in the late phase).With CECT as the reference standard,the ability of CEUS in detecting LTP or new intrahepatic recurrence during follow-up was evaluated.RESULTS:During a follow-up period of 1-31 mo (median,4 mo),169 paired CEUS and CECT examinations were carried out for the 141 patients.For a total of 221 ablated lesions,266 comparisons between CEUS and CECT findings were performed.Thirty-three LTPs were detected on CEUS whereas 40 LTPs were detected on CECT,there was significant difference (P < 0.001).In comparison with CECT,the numbers of false positive and false negative LTPs detected on CEUS were 6 and 13,respectively;the sensitivity,specificity,positive predictive value (PPV),negative predictive value (NPV) and overall accuracy of CEUS in detecting LTPs were 67.5%,97.4%,81.8%,94.4% and 92.3%,respectively.Meanwhile,131 new intrahepatic recurrent foci were detected on CEUS whereas 183 were detected on CECT,there was also significant difference (P < 0.05).In comparison with CECT,the numbers of false positive and false negative intrahepatic r

关键词： Contrast-enhanced ultrasound contrastenhanced computed tomography Hepatocellular carcinoma Radiofrequency ablation Microwave ablation

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Evaluation of tumor response to antiangiogenic therapy in patients with recurrent gliomas using contrast-enhanced perfusion-weighted magnetic resonance imaging techniques:A meta-analysis

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World Journal of Meta-Analysis 2019年第2期7卷 51-65页

作者： Akanganyira Kasenene Aju Baidya Salman Shams Hai-Bo Xu Department of Radiology and Nuclear Medicine Zhongnan Hospital of Wuhan UniversityWuhan University

BACKGROUND It is of vital importance to find radiologic biomarkers that can accurately predict treatment response. Usually, the initiation of antiangiogenic therapy causes a rapid decrease in the contrast enhancing tumor. However, the treatment response is observed only in a fraction of patients due to the partial radiological response secondary to stabilization of abnormal vessels which does not essentially indicate a true antitumor effect. Perfusion-weighted magnetic resonance imaging(PWMRI) techniques have shown implicitness as a strong imaging biomarker for gliomas since they give hemodynamic information of blood vessels. Hence, there is a rapid expansion of PW-MRI related studies and clinical applications.AIM To determine the diagnostic performance of PW-MRI techniques including:(A)dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI); and(B)dynamic susceptibility contrast magnetic resonance imaging(DSC-MRI) for evaluating response to antiangiogenic therapy in patients with recurrent gliomas.METHODS Databases such as PubMed(MEDLINE included), EMBASE, and Google Scholar were searched for relevant original articles. The included studies were assessed for methodological quality with the Quality Assessment of Diagnostic Accuracy Studies 2 tool. Medical imaging follow-up or histopathological analysis was used as the reference standard. The data were extracted by two reviewers independently, and then the sensitivity, specificity, summary receiver operating characteristic curve, area under the curve(AUC), and heterogeneity were calculated using Meta-Disc 1.4 software.RESULTS This study analyzed a total of six articles. The overall sensitivity for DCE-MRI and DSC-MRI was 0.69 [95% confidence interval(CI): 0.53-0.82], and the specificity was 0.99(95%CI: 0.93-1) by a random effects model(DerSimonianeeLaird model). The likelihood ratio(LR) +, LR-, and diagnostic odds ratio(DOR)were 12.84(4.54-36.28), 0.35(0.22-0.53), and 24.44(7.19-83.06), respectively. The AUC(± SE) was 0.9921(± 0.0120), and the Q* index(± SE)

关键词： Glioma Perfusion-weighted magnetic resonance imaging Dynamic contrastenhanced magnetic resonance imaging Dynamic susceptibility contrast magnetic resonance imaging Anti-vascular endothelial growth factor Antiangiogenic Metaanalysis

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Texture analysis on parametric maps derived from dynamic contrast-enhanced magnetic resonance imaging in head and neck cancer

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World Journal of Radiology 2016年第1期8卷 90-97页

作者： Jacobus FA Jansen Yonggang Lu Gaorav Gupta Nancy Y Lee Hilda E Stambuk Yousef Mazaheri Joseph O Deasy Amita Shukla-Dave Department of Radiology Maastricht University Medical Center Department of Medical Physics Memorial SloanKettering Cancer Center Departments of Radiation Oncology Memorial Sloan-Kettering Cancer Center Department of Radiology Memorial Sloan-Kettering Cancer Center

AIM: To investigate the merits of texture analysis on parametric maps derived from pharmacokinetic modeling with dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI) as imaging biomarkers for the prediction of treatment response in patients with head and neck squamous cell carcinoma(HNSCC). METHODS: In this retrospective study,19 HNSCC patients underwent pre- and intra-treatment DCEMRI scans at a 1.5T MRI scanner. All patients had chemo-radiation treatment. Pharmacokinetic modeling was performed on the acquired DCE-MRI images,generating maps of volume transfer rate(Ktrans) and volume fraction of the extravascular extracellular space(ve). Image texture analysis was then employed on maps of Ktrans and ve,generating two texture measures: Energy(E) and homogeneity.RESULTS: No significant changes were found for the mean and standard deviation for Ktrans and ve between pre- and intra-treatment(P > 0.09). Texture analysis revealed that the imaging biomarker E of ve was significantly higher in intra-treatment scans,relative to pretreatment scans(P < 0.04). CONCLUSION: Chemo-radiation treatment in HNSCC significantly reduces the heterogeneity of tumors.

关键词： Tumor heterogeneity Dynamic contrastenhanced magnetic resonance imaging Image texture analysis Head and neck squamous cell carcinomas

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Current status and future applications of contrast-enhanced endoscopic ultrasonography

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World Journal of Gastrointestinal Endoscopy 2014年第4期6卷 121-127页

作者： Hon Chi Yip Anthony Yuen Bun Teoh Charing Ching Ning Chong James Yun Wong Lau Department of Surgery Princeof Wales Hospitalthe Chinese University of Hong Kong Institute of Digestive Disease Chinese University of Hong Kong

Endoscopic ultrasonography(EUS) is currently an in-tegral investigation of many gastrointestinal disorders.It has been shown to have a higher efficacy thanconventional computed tomography in detection andcharacterization of small lesions especially in the pan-creas. Much effort has been put to further improvethe sensitivity, specificity and overall accuracy of EUS.One of the major advances is the utilization of contrastagents for better delineation of the vascularity and tis-sue perfusion of the target lesion. This article describesthe basic principles of ultrasound contrast agents andthe different modalities used in contrast-enhanced EUS(CE-EUS) including contrast-enhanced Doppler EUS(CED-EUS) and contrast-enhanced harmonic EUS(CEH-EUS). In addition, the current applications of contrastenhanced EUS in different gastrointestinal conditionswere discussed. Furthermore, the future developmentof hybrid approaches combining CE-EUS with other im-aging modalities and the potential therapeutic aspectof using it as a vector for drug delivery were also dis-cussed.

关键词： Endoscopic ultrasonography contrastenhanced endoscopic ultrasonography Advanced endoscopic ultrasonographic imaging

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