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Radiomics approach for preoperative identification of stages Ⅰ-Ⅱand Ⅲ-Ⅳ of esophageal cancer

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Chinese Journal of Cancer Research 2018年第4期30卷 396-405页

作者： Lei WU Cong Wang Xianzheng Tan Zixuan Cheng Ke Zhao Lifen Yan Yanli Liang Zaiyi Liu Changhong Liang School of Medicine South China University of Technology Guangzhou 510006 China Department of Radiology Guangdong General HospitalGuangdong Academy of Medical Sciences Guangzhou 510080 China School of Automation Science and Engineering South China University of Technology Guangzhou 510641 China

Objective： To predict preoperative staging using a radiomics approach based on computed tomography （CT）images of patients with esophageal squamous cell carcinoma （ESCC）.Methods： This retrospective study included 154 patients （primary cohort： n： t 14; validation cohort： n：40） withpathologically confirmed ESCC. All patients underwent a preoperative CT scan from the neck to abdomen. Highthroughput and quantitative radiomics features were extracted from the CT images for each patient. A radiomicssignature was constructed using the least absolute shrinkage and selection operator （Lasso）. Associations betweenradiomics signature, tumor volume and ESCC staging were explored. diagnostic performance of radiomicsapproach and tumor volume for discriminating between stages Ⅰ-Ⅱand Ⅲ-Ⅳ was evaluated and compared usingthe receiver operating characteristics （ROC） curves and net reclassification improvement （NRI）.Results= A total of 9,790 radiomics features were extracted. Ten features were selected to build a radiomicssignature after feature dimension reduction. The radiomics signature was significantly associated with ESCCstaging （P〈0.001）, and yielded a better performance for discrimination of early and advanced stage ESCC comparedto tumor volume in both the primary [area under the receiver operating characteristic curve （AUC）： 0.795 vs. 0.694,P=0.003; NRI=0.424）] and validation cohorts （AUC： 0.762 vs. 0.624, P=0.035; NRI=0.834）.Conclusions： The quantitative approach has the potential to identify stage Ⅰ-Ⅱand Ⅲ-Ⅳ ESCC beforetreatment.

关键词： Esophageal cancer tumor staging diagnostic imaging tumor volume

Low-grade mucinous appendiceal neoplasm mimicking an ovarian lesion: A case report and review of literature

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World Journal of Clinical Cases 2021年第10期9卷 2334-2343页

作者： André Luís Borges Catarina Reis-de-Carvalho Martinha Chorão Helena Pereira Dusan Djokovic Department of Obstetrics and Gynecology Hospital de São Francisco Xavier-Centro Hospitalar Lisboa OcidentalLisbon 1449-005Portugal Faculdade de Ciências da Saúde Universidade da Beira InteriorCovilhã6201-001Portugal Department of Obstetrics Gynecology and Reproductive MedicineHospital de Santa Maria-Centro Hospitalar Universitário Lisboa NorteLisbon 1649-028Portugal Department of Pathology Hospital Egas MonizCentro Hospitalar Lisboa OcidentalLisbon 1349-019Portugal Department of Obstetrics and Gynecology Maternidade Dr.Alfredo da Costa-Centro Hospitalar Universitário de Lisboa CentralLisbon 2890-495Portugal Faculdade de Ciências Médicas Nova Medical SchoolLisbon 1169-056Portugal

BACKGROUND Appendiceal tumors are rare lesions that may not be easily differentiated from primary ovarian lesions preoperatively,despite the use of advanced diagnostic methods by experienced clinicians.CASE SUMMARY A 59-year-old G2P2 woman,with chronic pelvic pain,underwent a pelvic ultrasound that revealed an adnexal mass measuring 58 mm×34 mm×36 mm,with irregular borders,heterogeneous echogenicity,no color Doppler vascularization and without acoustic shadowing.Normal ovarian tissue was visualized in contact with the lesion,and it was impossible to separate the lesion from the ovary by applying pressure with the ultrasound probe.Ascites,peritoneal metastases or other alterations were not observed.With the international ovarian tumor analysis ADNEX model,the lesion was classified as a malignant tumor(the risk of malignancy was 27.1%,corresponding to Ovarian-Adnexal Reporting Data System category 4).Magnetic resonance imaging confirmed the presence of a right adnexal mass,apparently an ovarian tumor measuring 65 mm×35 mm,without signs of invasive or metastatic disease.During explorative laparotomy,normal morphology of the internal reproductive organs was noted.A solid mobile lesion involved the entire appendix.Appendectomy was performed.Inspection of the abdominal cavity revealed no signs of malignant dissemination.Histopathologically,the appendiceal lesion corresponded to a completely resected low-grade mucinous appendiceal neoplasm(LAMN).CONCLUSION The appropriate treatment and team of specialists who should provide health care to patients with seemingly adnexal lesions depend on the nature(benign vs malignant)and origin(gynecological vs nongynecological)of the lesion.Radiologists,gynecologists and other pelvic surgeons should be familiar with the imaging signs of LAMN whose clinical presentation is silent or nonspecific.The assistance of a consultant specializing in intestinal tumors is important support that gynecological surgeons can receive during the operation to offer the patient with intestinal pathology

关键词： Adnexal mass Appendiceal neoplasm diagnostic imaging Pelvic neoplasm Adnexal diseases Pelvic neoplasm Case report

Radiological prognosticators of hepatocellular carcinoma treated by hepatectomy

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Hepatobiliary & Pancreatic Diseases International 2012年第6期11卷 612-617页

作者： Kevin KW Chu See Ching Chan Sheung Tat Fan Kenneth SH Chok Tan To Cheung William W Sharr Albert CY Chan Chung Mau Lo Department of Surgery The University of Hong Kong102 Pokfulam Road Hong Kong China State Key Laboratory for Liver Research The University of Hong Kong 102 Pokfulam Road Hong Kong China

BACKGROUND: Hepatectomy is the main curative treatment for hepatocellular carcinoma (HCC), but postoperative long- term survival is poor. Preoperative radiological features of HCC displayed by computed tomography or magnetic resonance imaging could serve as additional prognostic factors. This study aimed to identify preoperative radiological features of HCC that may be of prognostic significance in hepatectomy. METHODS: Ninety-two patients who underwent hepatectomy for HCC were included in this study. Preoperative radiological features including tumor number, size, location (peripheral, middle, central), portal vein invasion, hepatic vein invasion, and presence of pseudo-capsule were analyzed in relation to survival. RESULTS: With a median follow-up period of 41.7 months, the 1-, 3- and 5-year overall survival rates were 85%, 65% and 58%, respectively. Univariate analysis showed that portal vein invasion and absence of pseudo-capsule were significant prognostic factors for overall survival, while all the examined radiological features were prognostic factors for disease-free survival. Multivariate analysis for overall survival found no significant factor. On multivariate analysis for disease-free survival, patients who had tumors with portal vein invasion had poorer survival with a hazard ratio of 2.26 (95% CI, 1.05-4.91; P=0.038) and patients with single nodular HCC or pseudo-capsulated HCC had better survival with a hazard ratio of 0.50 (95% CI, 0.27-0.94; P=0.032) and 0.38 (95% CI, 0.14-0.99; P=0.048), respectively. CONCLUSIONS: Demonstrable pseudo-capsule of HCC and solitary HCC on imaging and absence of portal vein invasionare features associated with better disease-free survival after hepatectomy. These features may guide treatment planning for HCC.

关键词： hepatocellular carcinoma hepatectomy diagnostic imaging prognosis survival analysis

Current update on molecular cytogenetics, diagnosis and management of gastrointestinal stromal tumors

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World Journal of Gastroenterology 2021年第41期27卷 7125-7133页

作者： Mindy X Wang Catherine Devine Nicole Segaran Dhakshinamoorthy Ganeshan Department of diagnostic imaging University of Texas MD Anderson Cancer CenterHoustonTX 77030United States Department of Radiology Mayo Clinic ArizonaPhoenixAZ 85259United States

Gastrointestinal stromal tumors(GISTs)are the most common mesenchymal tumors of the gastrointestinal(GI)tract and are thought to arise from precursors of the interstitial cells of Cajal.GISTs can arise anywhere in the GI tract,but most commonly originate from the stomach and small intestine.The majority of GISTs occur as a result of activating mutations in two receptor protein tyrosine kinases:KIT and/or platelet-derived growth factor receptor-α.Mutational analyses allow for predicting patient prognosis and treatment response.Clinical presentations can vary from no symptoms,typical in the case of small incidentally found tumors,to GI bleeding,abdominal discomfort,and ulcer-related symptoms when the tumor is enlarged.imaging plays a critical role in the diagnosis and management of these tumors with multiphasic computed tomography serving as the imaging modality of choice.Magnetic resonance imaging and positron emission tomography-computed tomography can serve as imaging adjuncts in lesion characterization,especially with liver metastases,and subsequent staging and assessment for treatment response or recurrence.Surgical resection is the preferred management for small GISTs,while tyrosine kinase inhibitors−imatinib mesylate and sunitinib malate−serve as crucial molecular-targeted therapies for locally advanced and metastatic GISTs.This review article highlights the clinical presentation,pathology and molecular cytogenetics,imaging features,and current management of GISTs.

关键词： Gastrointestinal stromal tumors Cytogenetics diagnostic imaging Computed tomography Magnetic resonance imaging Imatinib mesylate

Systematic Training of Liver imaging Reporting and Data System Magnetic Resonance imaging v2018 can Improve the Diagnosis of Hepatocellular Carcinoma for Different Radiologists

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Journal of Clinical and Translational Hepatology 2021年第4期9卷 537-544页

作者： A-Hong Ren Hui Xu Da-Wei Yang Nan Zhang Te Ba Zhen-Chang Wang Zheng-Han Yang Department of Radiology Beijing Friendship HospitalCapital Medical UniversityBeijingChina Department of Radiology The First Hospital of Beijing Fangshan DistrictBeijingChina

Background and Aims:Liver imaging reporting and data system(LI-RADS)provides standardized lexicon and categorization for diagnosing hepatocellular carcinoma(HCC).However,there is limited knowledge about the effect of LI-RADS training.We prospectively explored whether the systematic training of LI-RADS v2018 on magnetic resonance imaging(MRI)can effectively improve the diagnostic performances of different radiologists for HCC.Methods:A total of 20 visiting radiologists and the multiparametric MRI of 70 hepatic observations in 61 patients with high risk of HCC were included in this study.The LI-RADS v2018 training procedure included three times of thematic lectures(each lasting for 2.5 h)given by a professor specialized in imaging diagnosis of liver,with an interval of a month.After each seminar,the radiologists had a month to adopt the algorithm into their daily work.The diagnostic performances and interobserver agreements of these radiologists adopting the algorithm for HCC diagnosis before and after training were compared.Results:A total of 20 radiologists(male/female,12/8;with an average age of 36.75±4.99 years)were enrolled.After training,the interobserver agreements for the LI-RADS category for all radiologists(p=0.005)were increased.The sensitivity,specificity,positive predictive value,negative predictive value,and coincidence rate of all radiologists for HCC diagnosis before and after training were 43%vs.54%,86%vs.88%,74%vs.81%,62%vs.67%,and 65%vs.71%,respectively.The diagnostic performances of all radiologists(pdiagnostic performances of radiologists with different experiences for HCC.

关键词： Magnetic resonance imaging Liver neoplasm diagnostic imaging Training program Liver imaging Reporting and Data System

Primary breast cancer patient with poliomyelitis:A case report

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World Journal of Clinical Cases 2020年第23期8卷 6190-6196页

作者： Xing-Miao Wang Yi-Zi Cong Guang-Dong Qiao Song Zhang Li-Juan Wang Department of Breast Surgery The Affiliated Yantai Yuhuangding Hospital of Qingdao UniversityYantai 264400Shandong ProvinceChina Department of Radiology The Affiliated Yantai Yuhuangding Hospital of Qingdao UniversityYantai 264400Shandong ProvinceChina

BACKGROUND Poliomyelitis is an acute infection caused by an enterovirus,which primarily infects the human gastrointestinal tract.In general,patients with polio have no association with the occurrence of cancer.The present case study presents a rare case of poliomyelitis combined with primary breast cancer.CASE SUMMARY A 61-year-old woman who was diagnosed with poliomyelitis at 5 years old and confirmed invasive breast cancer by core needle biopsy(CNB)after hospitalization.The patient received a modified radical mastectomy and four cycles of chemotherapy with the TC(docetaxel and cyclophosphamide)regimen.The patient was also prescribed endocrine therapy without radiotherapy after chemotherapy.The patient had no evidence of lymphedema in the right upper extremities and no evidence of either regression or distant metastasis at the 1-year follow-up.CONCLUSION The pectoral muscles of patients with polio are easily damaged in traumatic procedures,such as CNB,local anesthesia for tumor excision,and general anesthesia for surgery.A CNB,modified radical mastectomy,and four cycles of TC chemotherapy were successfully completed for the present case and the adverse reactions were found to be tolerable.This case may indicate the relationship between breast cancer and polio,and the examination and treatment methods used could be used as a guide for similar cases in the future.

关键词： Breast cancer diagnostic imaging Follow-up Poliomyelitis Surgery Case report

imaging of paraduodenal pancreatitis:A systematic review

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World Journal of Radiology 2023年第2期15卷 42-55页

作者： Matteo Bonatti NicolòDe Pretis Giulia A Zamboni Alessandro Brillo Stefano Francesco Crinò Riccardo Valletta Fabio Lombardo Giancarlo Mansueto Luca Frulloni Department of Radiology Ospedale Centrale di BolzanoBolzano 39100Italy Gastroenterology and Digestive Endoscopy Unit The Pancreas InstituteG.B.Rossi University Hospital of VeronaVerona 37134Italy Department of diagnostics and Public Health Radiology SectionPoliclinico GB RossiUniversity of VeronaVerona 37134VeronaItaly Department of Medicine University of VeronaVerona 37134Italy Department of Radiology IRCCS Sacro Cuore Don Calabria HospitalNegrar 37024Italy

BACKGROUND Paraduodenal pancreatitis(PP)represents a diagnostic challenge,especially in non-referral centers,given its potential imaging overlap with pancreatic cancer.There are two main histological variants of PP,the cystic and the solid,with slightly different imaging appearances.Moreover,imaging findings in PP may change over time because of disease progression and/or as an effect of its risk factors exposition,namely alcohol intake and smoking.AIM To describe multimodality imaging findings in patients affected by PP to help clinicians in the differential diagnosis with pancreatic cancer.METHODS The systematic review was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-analyses 2009 guidelines.A Literature search was performed on PubMed,Embase and Cochrane Library using(groove pancreatitis[Title/Abstract])OR(PP[Title/Abstract])as key words.A total of 593 articles were considered for inclusion.After eliminating duplicates,and title and abstract screening,53 full-text articles were assessed for eligibility.Eligibility criteria were:Original studies including 8 or more patients,fully written in English,describing imaging findings in PP,with pathological confirmation or clinical-radiological follow-up as the gold standard.Finally,14 studies were included in our systematic review.RESULTS Computed tomography(CT)findings were described in 292 patients,magnetic resonance imaging(MRI)findings in 231 and endoscopic ultrasound(EUS)findings in 115.Duodenal wall thickening was observed in 88.8%of the cases:Detection rate was 96.5%at EUS,91.0%at MRI and 84.1%at CT.Second duodenal portion increased enhancement was recognizable in 76.3%of the cases:Detection rate was 84.4%at MRI and 72.1%at CT.Cysts within the duodenal wall were detected in 82.6%of the cases:Detection rate was 94.4%at EUS,81.9%at MRI and 75.7%at CT.A solid mass in the groove region was described in 40.9%of the cases;in 78.3%of the cases,it showed patchy enhancement in the portal venous phase,and in 100%appeared iso/hyperin

关键词： Pancreatitis Paraduodenal pancreatitis diagnostic imaging Computed tomography Magnetic resonance imaging Endoscopic ultrasound

Isolated interrupted aortic arch in an adult:A case report

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World Journal of Clinical Cases 2021年第4期9卷 992-998页

作者： Shu-Wen Dong Duo-Duo Di Guan-Xun Cheng Medical imaging Department Peking University Shenzhen HospitalShenzhen 518000Guangdong ProvinceChina Medical imaging Department Anhui Medical UniversityHefei 230000Anhui ProvinceChina

BACKGROUND Interrupted aortic arch(IAA)is a rare congenital heart disease defined by an interruption of the lumen and anatomical continuity between the ascending and descending major arteries.It is usually found within a few hours or days of birth.Without surgery,the chances of survival are low.If IAA patients have an effective collateral circulation established,they can survive into adulthood.However,IAA in adults is extremely rare,with few reported cases.CASE SUMMARY A 27-year-old woman presented with a 6-year history of progressively worsening shortness of breath and chest tightness on exertion.She had cyanotic lips and clubbing of the fingers.A transthoracic echocardiogram revealed an enlarged heart and dilation of the main pulmonary artery.There was an abnormal 9 mm passage between the descending aorta and pulmonary artery.The ventricular septal outflow tract had a 14 mm defect.Doppler ultrasound suggested a patent ductus arteriosus and computed tomographic angiography showed the absence of the aortic arch.The diagnoses were ventricular septal defect,patent ductus arteriosus,and definite interruption of the aortic arch.Although surgical correction was recommended,the patient declined due to the surgical risks and was treated with medications to reduce pulmonary artery pressure and treat heart failure.Her condition has been stable for 12 mo of follow-up.CONCLUSION Although rare,IAA should be considered in adults with refractory hypertension or unexplained congestive heart failure.

关键词： Interrupted aortic arch diagnostic imaging Multimodal imaging Patent ductus arteriosus Ventricular septal defect Case report

Enhancement parameters of contrast-enhanced computed tomography for pancreatic ductal adenocarcinoma: Correlation with pathologic grading

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World Journal of Gastroenterology 2020年第28期26卷 4151-4158页

作者： Woorim Seo Young Chul Kim Seon Jeong Min Sang Min Lee Department of Radiology Hallym University Dongtan Sacred Heart HospitalGyeonggi-do 18450South Korea Department of Radiology Hallym University Sacred Heart HospitalGyeonggido 14068South Korea

BACKGROUND Pancreatic ductal adenocarcinoma(PDA)is a malignancy with a high mortality rate and short survival time.The conventional computed tomography(CT)has been worldwide used as a modality for diagnosis of PDA,as CT enhancement pattern has been thought to be related to tumor angiogenesis and pathologic grade of PDA.AIM To evaluate the relationship between the pathologic grade of pancreatic ductal adenocarcinoma and the enhancement parameters of contrast-enhanced CT.METHODS In this retrospective study,42 patients(Age,mean±SD:62.43±11.42 years)with PDA who underwent surgery after preoperative CT were selected.Two radiologists evaluated the CT images and calculated the value of attenuation at the aorta in the arterial phase and the pancreatic phase(VAarterial and VApancreatic)and of the tumor(VTarterial and VTpancreatic)by finding out four regions of interest.Ratio between the tumor and the aorta enhancement on the arterial phase and the pancreatic phase(TARarterial and TARpancreatic)was figured out through dividing VT arterial by VAarterial and VTpancreatic by VApancreatic.Tumor-to-aortic enhancement fraction(TAF)was expressed as the ratio of the difference between attenuation of the tumor on arterial and parenchymal images to that between attenuation of the aorta on arterial and pancreatic images.The Kruskal-Wallis analysis of variance and Mann-Whitney U test for statistical analysis were used.RESULTS Forty-two PDAs(23 men and 19 women)were divided into three groups:Welldifferentiated(n=13),moderately differentiated(n=21),and poorly differentiated(n=8).TAF differed significantly between the three groups(P=0.034)but TARarterial(P=0.164)and TARpancreatic(P=0.339)did not.The median value of TAF for poorly differentiated PDAs(0.1011;95%CI:0.01100-0.1796)was significantly higher than that for well-differentiated PDAs(0.1941;95%CI:0.1463-0.3194).CONCLUSION Calculation of TAF might be useful in predicting the pathologic grade of PDA.

关键词： Computed tomography Pancreatic ductal carcinoma diagnostic imaging Clinical pathology Neoplasm grading Prognosis