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Current interventional options for palliative care for patients with advanced-stage cholangiocarcinoma

World Journal of Clinical Oncology 2024年第3期15卷 381-390页

作者： Maryam Makki Malak Bentaleb Mohammed Abdulrahman Amal Abdulla Suhool Salem Al Harthi Marcelo AF Ribeiro Jr department of surgery Division of TraumaCritical Care and Acute Care SurgerySheikh Shakhbout Medical CityAbu Dhabi 11001United Arab Emirates department of surgery College of Medicine and Health SciencesKhalifa UniversityAbu Dhabi 11001United Arab Emirates department of surgery Division of Hepato-Pancreato-Biliary(HPB)SurgerySheikh Shakhbout Medical CityAbu Dhabi 91888United Arab Emirates

Primary biliary tract tumors are malignancies that originate in the liver,bile ducts,or gallbladder.These tumors often present with jaundice of unknown etiology,leading to delayed diagnosis and advanced disease.Currently,several palliative treatment options are available for primary biliary tract tumors.They include percutaneous transhepatic biliary drainage(PTBD),biliary stenting,and surgical interventions such as biliary diversion.Systemic therapy is also commonly used for the palliative treatment of primary biliary tract tumors.It involves the administration of chemotherapy drugs,such as gemcitabine and cisplatin,which have shown promising results in improving overall survival in patients with advanced biliary tract tumors.PTBD is another palliative treatment option for patients with unresectable or inoperable malignant biliary obstruction.Biliary stenting can also be used as a palliative treatment option to alleviate symptoms in patients with unresectable or inoperable malignant biliary obstruction.Surgical interventions,such as biliary diversion,have traditionally been used as palliative options for primary biliary tract tumors.However,biliary diversion only provides temporary relief and does not remove the tumor.Primary biliary tract tumors often present in advanced stages,making palliative treatment the primary option for improving the quality of life of patients.

关键词： Cholangiocarcinoma Palliative care Endoscopic treatment surgery Complications Interventional radiology

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Transperineal laser ablation of the prostate as a treatment for benign prostatic hyperplasia and prostate cancer: The results of a Delphi consensus project

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Asian Journal of Urology 2024年第2期11卷 271-279页

作者： Andrea Cocci Marta Pezzoli Fernando Bianco Franco Blefari Pierluigi Bove Francois Cornud Gaetano De Rienzo Paolo Destefanis Danilo Di Trapani Alessandro Giacobbe Luca Giovanessi Antonino Laganà Giovanni Lughezzani Guglielmo Manenti Gianluca Muto Gianluigi Patelli Novello Pinzi Stefano Regusci Giorgio I.Russo Juan I.M.Salamanca Matteo Salvi Luigi Silvestri Fabrizio Verweij Eric Walser Riccardo GBertolo Valerio Iacovelli Alessandro Bertaccini Debora Marchiori Hugo Davila Pasquale Ditonno Paolo Gontero Gennaro Iapicca Theo M De Reijke Vito Ricapito Pierluca Pellegrini Andrea Minervini Sergio Serni Francesco Sessa department of Urology Careggi HospitalUniversity of FlorenceFlorenceItaly Urology Section University of FlorenceFlorenceItaly Urological Research Network MiamiFLUSA Urology Section Prato HospitalPratoItaly Torvergata Oncoscience Research Centre of Excellence TORDepartment of Experimental MedicineUniversity of Rome Tor VergataRomeItaly department of Urology San Carlo di Nancy HospitalRomeItaly department of radiology Hôpital CochinParis Descartes UniversityParisFrance Urology and Andrology Unit II Department of Emergency and Organ TransplantationUniversity of BariBariItaly Unit of Urology Cittàdella Salute e della Scienza HospitalUniversity of TurinTurinItaly Urology Unit Buccheri La Ferla Fatebenefratelli HospitalPalermoItaly department of Urology Humanitas Gradenigo HospitalTurinItaly Urology Unit Surgical DepartmentFondazione Poliambulanza Istituto OspedalieroBresciaItaly Departement of Urology “S.Giovanni Evangelista”HospitalTivoliItaly Humanitas Clinical and Research CentereIRCCS Department of UrologyRozzanoItaly department of Biomedical Sciences Humanitas UniversityPieve EmanueleItaly department of Biomedicine and Prevention University of Rome“Tor Vergata”RomeItaly department of Diagnostic Imaging and Interventional radiology University of Rome“Tor Vergata”RomeItaly department of Interventional radiology Pesenti-Fenaroli Hospital-ASST Bergamo EstAlzano LombardoItaly department of Urology University of SienaSienaItaly Swiss International Prostate Center GenevaSwitzerland Clinique Générale Beaulieu GenevaSwitzerland department of Urology University of CataniaItaly department of Urology Puerta de Hierro-Majadahonda University HospitalMadridSpain Lyx Institute of Urology Universidad Francisco de VitoriaMadridSpain department of Medico-Surgical Sciences and Biotechnologies Sapienza University of RomeFaculty of Pharmacy and MedicineUrology Unit ICOTLatinaItaly department of Urology European Institute of Oncology(IEO)IRCCSMilanItaly department of radiology D

Objective: To evaluate transperineal laser ablation (TPLA) with Echolaser® (Echolaser® TPLA, Elesta S.p.A., Calenzano, Italy) as a treatment for benign prostatic hyperplasia (BPH) and prostate cancer (PCa) using the Delphi consensus method.Methods: Italian and international experts on BPH and PCa participated in a collaborative consensus project. During two rounds, they expressed their opinions on Echolaser® TPLA for the treatment of BPH and PCa answering online questionnaires on indications, methodology, and potential complications of this technology. Level of agreement or disagreement to reach consensus was set at 75%. If the consensus was not achieved, questions were modified after each round. A final round was performed during an online meeting, in which results were discussed and finalized.Results: Thirty-two out of forty invited experts participated and consensus was reached on all topics. Agreement was achieved on recommending Echolaser® TPLA as a treatment of BPH in patients with ample range of prostate volume, from 80 mL (80%), comorbidities (100%), antiplatelet or anticoagulant treatment (96%), indwelling catheter (77%), and strong will of preserving ejaculatory function (100%). Majority of respondents agreed that Echolaser® TPLA is a potential option for the treatment of localized PCa (78%) and recommended it for low-risk PCa (90%). During the final round, experts concluded that it can be used for intermediate-risk PCa and it should be proposed as an effective alternative to radical prostatectomy for patients with strong will of avoiding urinary incontinence and sexual dysfunction. Almost all participants agreed that the transperineal approach of this organ-sparing technique is safer than transrectal and transurethral approaches typical of other techniques (97% of agreement among experts). Pre-procedural assessment, technical aspects, post-procedural catheterization, pharmacological therapy, and expected outcomes were discussed, leading to statements and recommendations.Conclusion: Ech

关键词： Transperineal laser ablation Prostatecancer Benignprostatic hyperplasia Delphi consensus

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Effect of an Airbag-selective Portal Vein Blood Arrester on the Liver after Hepatectomy:A New Technique for Selective Clamping of the Portal Vein

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Current Medical Science 2024年第2期44卷 380-390页

作者： Ce-xiong FU Xiao-ri QIN Jin-song CHEN Jie ZHONG Yu-xu XIE Bi-dan LI Qing-qing FU Fang LI Jin-fang ZHENG department of Hepatobiliary and Pancreatic surgery Hainan General HospitalHainan Affiliated Hospital of Hainan Medical UniversityHaikou 57031lChina University of South China Hengyang 421001China department of Gastroenterology Gastroenterology Endoscopy CenterHainan General HospitalHainan Affiliated Hospital of Hainan Medical UniversityHaikou 57031lChina Center of Clinical Laboratory Hainan General HospitalHainan Afiliated Hospital of Hainan Medical UniversityHaikou 570311China department of radiology Hainan General HospitalHainan Afiliated Hospital of Hainan Medical UniversityHaikou 570311China

Objective:A novel technique was explored using an airbag-selective portal vein blood arrester that circumvents the need for an intraoperative assessment of anatomical variations in patients with complex intrahepatic space-occupying lesions.Methods:Rabbits undergoing hepatectomy were randomly assigned to 4 groups:intermittent portal triad clamping(PTC),intermittent portal vein clamping(PVC),intermittent portal vein blocker with an airbag-selective portal vein blood arrester(APC),and without portal blood occlusion(control).Hepatic ischemia and reperfusion injury were assessed by measuring the 7-day survival rate,blood loss,liver function,hepatic pathology,hepatic inflammatory cytokine infiltration,hepatic malondialdehyde levels,and proliferating cell nuclear antigen levels.Results:Liver damage was substantially reduced in the APC and PVC groups.The APC animals exhibited transaminase levels similar to or less oxidative stress damage and inflammatory hepatocellular injury compared to those exhibited by the PVC animals.Bleeding was significantly higher in the control group than in the other groups.The APC group had less bleeding than the PVC group because of the avoidance of portal vein skeletonization during hepatectomy.Thus,more operative time was saved in the APC group than in the PVC group.Moreover,the total 7-day survival rate in the APC group was higher than that in the PTC group.Conclusion:Airbag-selective portal vein blood arresters may help protect against hepatic ischemia and reperfusion injury in rabbits undergoing partial hepatectomy.This technique may also help prevent liver damage in patients requiring hepatectomy.

关键词： hepatectomy portal vein hepatic damage selective clamping

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Value of multiple models of diffusion-weighted imaging to predict hepatic lymph node metastases in colorectal liver metastases patients

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World Journal of Gastroenterology 2024年第4期30卷 308-317页

作者： Hai-Bin Zhu Bo Zhao Xiao-Ting Li Xiao-Yan Zhang Qian Yao Ying-Shi Sun Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education/Beijing) Department of RadiologyPeking University Cancer Hospital and InstituteBeijing 100142China Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education/Beijing) Department of PathologyPeking University Cancer Hospital and InstituteBeijing 100142China

BACKGROUND About 10%-31% of colorectal liver metastases(CRLM)patients would concomitantly show hepatic lymph node metastases(LNM),which was considered as sign of poor biological behavior and a relative contraindication for liver resection.Up to now,there’s still lack of reliable preoperative methods to assess the status of hepatic lymph nodes in patients with CRLM,except for pathology examination of lymph node after resection.AIM To compare the ability of mono-exponential,bi-exponential,and stretchedexponential diffusion-weighted imaging(DWI)models in distinguishing between benign and malignant hepatic lymph nodes in patients with CRLM who received neoadjuvant chemotherapy prior to surgery.METHODS In this retrospective study,97 CRLM patients with pathologically confirmed hepatic lymph node status underwent magnetic resonance imaging,including DWI with ten b values before and after chemotherapy.Various parameters,such as the apparent diffusion coefficient from the mono-exponential model,and the true diffusion coefficient,the pseudo-diffusion coefficient,and the perfusion fraction derived from the intravoxel incoherent motion model,along with distributed diffusion coefficient(DDC)andαfrom the stretched-exponential model(SEM),were measured.The parameters before and after chemotherapy were compared between positive and negative hepatic lymph node groups.A nomogram was constructed to predict the hepatic lymph node status.The reliability and agreement of the measurements were assessed using the coefficient of variation and intraclass correlation coefficient.RESULTS Multivariate analysis revealed that the pre-treatment DDC value and the short diameter of the largest lymph node after treatment were independent predictors of metastatic hepatic lymph nodes.A nomogram combining these two factors demonstrated excellent performance in distinguishing between benign and malignant lymph nodes in CRLM patients,with an area under the curve of 0.873.Furthermore,parameters from SEM showed substantial repeatability.CONCLUSION The dev

关键词： Colorectal cancer Individualized treatment Diffusion magnetic resonance imaging Intravoxel incoherent motion Liver

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In Situ Deposition of Drug and Gene Nanoparticles on a Patterned Supramolecular Hydrogel to Construct a Directionally Osteochondral Plug

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Nano-Micro Letters 2024年第1期16卷 341-359页

作者： Jiawei Kang Yaping Li Yating Qin Zhongming Huang Yifan Wu Long Sun Cong Wang Wei Wang Gang Feng Yiying Qi department of Orthopaedic surgery The Second Affiliated HospitalZhejiang University School of MedicineHangzhou City 310009Zhejiang ProvincePeople’s Republic of China College of Chemical and Biological Engineering Zhejiang UniversityHangzhou 310027People’s Republic of China ZJU-Hangzhou Global Scientific and Technological Innovation Center Hangzhou 311215ZhejiangPeople’s Republic of China The Affiliated Nanhua Hospital Orthopedic Research CentreHengyang Medical SchoolUniversity of South ChinaHengyang 421001HunanPeople’s Republic of China department of radiology Jining No.1 People’s HospitalJining Medical UniversityJining 272000ShandongPeople’s Republic of China

The integrated repair of bone and cartilage boasts advantages for osteochondral restoration such as a long-term repair effect and less deterioration compared to repairing cartilage alone.Constructing multifactorial,spatially oriented scaffolds to stimulate osteochondral regeneration,has immense significance.Herein,targeted drugs,namely kartogenin@polydopamine(KGN@PDA)nanoparticles for cartilage repair and miRNA@calcium phosphate(miRNA@CaP)NPs for bone regeneration,were in situ deposited on a patterned supramolecular-assembled 2-ureido-4[lH]-pyrimidinone(UPy)modified gelation hydrogel film,facilitated by the dynamic and responsive coordination and complexation of metal ions and their ligands.This hydrogel film can be rolled into a cylindrical plug,mimicking the Haversian canal structure of natural bone.The resultant hydrogel demonstrates stable mechanical properties,a self-healing ability,a high capability for reactive oxygen species capture,and controlled release of KGN and miR-26a.In vitro,KGN@PDA and miRNA@CaP promote chondrogenic and osteogenic differentiation of mesenchymal stem cells via the JNK/RUNX1 and GSK-3β/β-catenin pathways,respectively.In vivo,the osteochondral plug exhibits optimal subchondral bone and cartilage regeneration,evidenced by a significant increase in glycosaminoglycan and collagen accumulation in specific zones,along with the successful integration of neocartilage with subchondral bone.This biomaterial delivery approach represents a significant toward improved osteochondral repair.

关键词： Osteochondral regeneration Oriented hydrogel Kartogenin miRNA-26a

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Treatment and Clinical Management of Chronic Thromboembolic Pulmonary Hypertension:An Update of Literature Review

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Congenital Heart Disease 2024年第2期19卷 157-176页

作者： Yuan Ren Yingxian Sun Zhiguang Yang Yanli Chen The department of Cardiology The First Afﬁliated Hospital of China Medical UniversityShenyang110000China The radiology department Shengjing Hospital of China Medical UniversityShenyang110020China

Chronic thromboembolic pulmonary hypertension(CTEPH)is a chronic,progressive,debilitating,and life-threa-tening complication of pulmonary embolism(PE).Recent technological advances have permitted various treat-ment options for the treatment of CTEPH,including surgery,angioplasty,and medical treatment,depending on the location and characteristics of lesions.Pulmonary endarterectomy(PEA)is the treatment of choice for CTEPH,as it offers excellent long-term outcomes and a high probability of recovery.Moreover,various medical and interventional therapies are currently being developed for patients with inoperable CTEPH.This review mainly summarizes the current treatment approaches of CTEPH,offering more options for specialist physicians to,thus,better manage chronic thromboembolic syndromes.

关键词： Chronic thromboembolic pulmonary hypertension(CTEPH) chronic thromboembolic pulmonary disease(CTEPD) pulmonary endarterectomy(PEA) balloon pulmonary angioplasty(BPA) COVID-19

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Survival benefit of concurrent chemoradiotherapy for advanced ampulla of Vater cancer

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World Journal of Clinical Cases 2024年第2期12卷 267-275页

作者： Chae Hwa Kwon Hyung Il Seo Dong Uk Kim Sung Yong Han Suk Kim Nam Kyung Lee Seung Baek Hong Ji Hyun Ahn Young Mok Park Byeong Gwan Noh BioMedical Research Institute Pusan National University HospitalBusan 49241South Korea department of surgery Pusan National University School of Medicine and Biomedical Research InstitutePusan National University HospitalBusan 49241South Korea department of Internal Medicine Pusan National University School of Medicine and Biomedical Research InstitutePusan National University HospitalBusan 49241South Korea department of radiology Pusan National University School of Medicine and Biomedical Research InstitutePusan National University HospitalBusan 49241South Korea department of Pathology and Biomedical Research Institute Pusan National University HospitalBusan 49241South Korea

BACKGROUND Currently,there is no standard adjuvant therapy for patients with resected ampulla of Vater(AoV)cancer.AIM To evaluate the effectiveness of adjuvant concurrent chemoradiotherapy(CCRT)in patients with advanced AoV cancer who underwent curative resection.METHODS This single-centered,retrospective study included 29 patients with advanced AoV cancer who underwent pancreaticoduodenectomy between 2006 and 2018.The impact of CCRT on advanced AoV cancer was analyzed.RESULTS The 1-,3-,and 5-yr recurrence-free survival(RFS)rates for patients with advanced AoV cancer were 82.8%,48.3%,and 40.8%,respectively,and the overall survival(OS)rates were 89.7%,62.1%,and 51.7%,respectively.Lymphovas-cular invasion was found to be a significant risk factor for RFS and OS in patients with advanced AoV cancer in the univariate analysis,whereas T stage and lymph node metastasis were significantly associated with OS in the multivariate analysis.Compared to the patients who did not receive adjuvant CCRT,those who received adjuvant CCRT did not show statistically significant improvements in the RFS and OS,although they had a significantly lower average age and significantly higher platelet-to-lymphocyte ratio.CONCLUSION Adjuvant CCRT did not improve survival outcomes in patients with advanced AoV cancer.These findings contribute to existing knowledge on the effectiveness of CCRT in this patient population and provide important insights for clinical decision-making.

关键词： Advanced ampulla of Vater cancer Adjuvant concurrent chemoradiotherapy Recurrence Survival Vater cancer

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Risk factors and predictive model of cerebral edema after road traffic accidents-related traumatic brain injury

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Chinese Journal of Traumatology 2024年第3期27卷 153-162页

作者： Di-You Chen Peng-Fei Wu Xi-Yan Zhu Wen-Bing Zhao Shi-Feng Shao Jing-Ru Xie Dan-Feng Yuan Liang Zhang Kui Li Shu-Nan Wang Hui Zhao Institute for Traffc Medicine aping HospitalArmy Medical UniverstyChongqing400042China department of radiology Daping HospitalArmy Medical UniversityChongqing400042China Chongqing Key Laboratory of Traffic Injury and Vehicle Ergonomics Chongqing400042China Wound Trauma Medical Center State Key Laboratory of TraumnaBurns and Combined lnjuryInstitute of Surgery ResearchDaping HospialArmy Medical UniversityChongqing.400042China

Purpose:Cerebral edema(CE)is the main secondary injury following traumatic brain injury(TBI)caused by road traffic accidents(RTAs).It is challenging to be predicted timely.In this study,we aimed to develop a prediction model for CE by identifying its risk factors and comparing the timing of edema occurrence in TBI patients with varying levels of injuries.Methods:This case-control study included 218 patients with TBI caused by RTAs.The cohort was divided into CE and non-CE groups,according to CT results within 7 days.Demographic data,imaging data,and clinical data were collected and analyzed.Quantitative variables that follow normal distribution were presented as mean±standard deviation,those that do not follow normal distribution were presented as median(Q1,Q3).Categorical variables were expressed as percentages.The Chi-square test and logistic regression analysis were used to identify risk factors for CE.Logistic curve fitting was performed to predict the time to secondary CE in TBI patients with different levels of injuries.The efficacy of the model was evaluated using the receiver operator characteristic curve.Results:According to the study,almost half(47.3%)of the patients were found to have CE.The risk factors associated with CE were bilateral frontal lobe contusion,unilateral frontal lobe contusion,cerebral contusion,subarachnoid hemorrhage,and abbreviated injury scale(AIS).The odds ratio values for these factors were 7.27(95%confidence interval(CI):2.08-25.42,p=0.002),2.85(95%CI:1.11-7.31,p=0.030),2.62(95%CI:1.12-6.13,p=0.027),2.44(95%CI:1.25-4.76,p=0.009),and 1.5(95%CI:1.10-2.04,p=0.009),respectively.We also observed that patients with mild/moderate TBI(AIS≤3)had a 50%probability of developing CE 19.7 h after injury(χ^(2)=13.82,adjusted R2=0.51),while patients with severe TBI(AIS>3)developed CE after 12.5 h(χ^(2)=18.48,adjusted R2=0.54).Finally,we conducted a receiver operator characteristic curve analysis of CE time,which showed an area under the curve of 0.744 and 0.672 for severe and mild/moderate TBI,

关键词： Road traffic accident Traumatic brain injury Cerebral edema Risk factors Time window

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First-line camrelizumab(a PD-1 inhibitor)plus apatinib(an VEGFR-2 inhibitor)and chemotherapy for advanced gastric cancer(SPACE):a phase 1 study

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Signal Transduction and Targeted Therapy 2024年第4期9卷 1760-1767页

作者： Xiaofeng Chen Hao Xu Xiaobing Chen Tongpeng Xu Yitong Tian Deqiang Wang Fen Guo Kangxin Wang Guangfu Jin Xiao Li Rong Wang Fengyuan Li Yongbin Ding Jie Tang Yueyu Fang Jing Zhao Liang Liu Ling Ma Lijuan Meng Zhiguo Hou Rongrong Zheng Yang Liu Ni Guan Bei Zhang Shuang Tong Shiqing Chen Xing Li Yongqian Shu department of Oncology The First Affiliated Hospital with Nanjing Medical UniversityNanjingChina Gusu School Nanjing medical UniversitySuzhouChina Jiangsu Key Lab of Cancer Biomarkers Prevention and TreatmentCollaborative Innovation Center for Cancer Personalized MedicineNanjing Medical UniversityNanjingChina department of General surgery The First Affiliated Hospital with Nanjing Medical UniversityNanjingChina department of Oncology Henan Cancer Hospital Affiliated Cancer Hospital of Zhengzhou UniversityZhengzhouChina Henan Engineering Research Center of Precision Therapy of Gastrointestinal Cancer&Zhengzhou Key Laboratory for Precision Therapy of Gastrointestinal Cancer ZhengzhouChina department of Oncology Digestive Disease Institute&Cancer Institute of Jiangsu UniversityAffiliated Hospital of Jiangsu UniversityZhenjiangChina department of Oncology Suzhou Hospital of Nanjing Medical UniversitySuzhouChina department of Oncology Nanjing PuKou People’s HospitalNanjingChina department of Epidemiology School of Public HealthNanjing Medical UniversityNanjingChina department of Pathology The First Affiliated Hospital with Nanjing Medical UniversityNanjingChina department of general surgery Jurong Branch hospital of Jiangsu Province People HospitalJurongChina department of Medical Oncology Liyang People’s HospitalLiyangChina department of radiology Nanjing PuKou People’s HospitalNanjingChina Jiangsu Hengrui Pharmaceuticals ShanghaiChina department of Medical Affairs 3D Medicines Inc.ShanghaiChina Shanghai OrigiMed Co. Ltd.ShanghaiChina

Patients with advanced gastric cancer typically face a grim prognosis.This phase 1a(dose escalation)and phase 1b(dose expansion)study investigated safety and efficacy of first-line camrelizumab plus apatinib and chemotherapyfor advanced gastric or gastroesophageal junction adenocarcinoma.The primary endpoints included maximum tolerated dose(MTD)in phase 1a and objective response rate(ORR)across phase 1a and 1b.Phase 1a tested three dose regimens of camrelizumab,apatinib,oxaliplatin,and S-1.Dose regimen 1:camrelizumab 200 mg on day 1,apatinib 250 mg every other day,oxaliplatin 100 mg/m^(2) on day 1,and S-140 mg twice a day on days 1-14.Dose regimen 2:same as dose regimen 1,but oxaliplatin 130mg/m.Dose regimen3:same as dose regimen 2,but apatinib 250 mg daily.Thirty-four patients were included(9 in phase 1a,25 in phase 1b).No dose-limiting toxicities occurred so no MTD was identified.Dose 3 was set for the recommended phase 2 doses and administered in phase 1b.The confrmed ORR was 76.5%(95%CI 58.8-89.3).The median progression-free survival was 8.4 months(95%CI 5.9-not evaluable[NE]),and the median overall survival(OS)was not mature(11.6-NE).Ten patients underwent surgery after treatment and the multidisciplinary team evaluation.Among 24 patients without surgery,the median OS was 19.6 months(7.8-NE).Eighteen patients(52.9%)developed grade≥3 treatment-emergent adverse events.Camrelizumab plus apatinib and chemotherapy showed favorable clinical outcomes and manageable safety for untreated advanced gastric cancer(ChiCTR2000034109).

关键词： regimen cancer doses

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Characterization of tumors of jaw:Additive value of contrast enhancement and dual-energy computed tomography

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World Journal of radiology 2024年第4期16卷 82-93页

作者： Deepak Justine Viswanathan Ashu Seith Bhalla Smita Manchanda Ajoy Roychoudhury Deepika Mishra Asit Ranjan Mridha department of Radiodiagnosis and Interventional radiology All India Institute of Medical SciencesNew Delhi 110029India department of Oral and Maxillofacial surgery All India Institute of Medical SciencesNew Delhi 110029India department of Oral Pathology and Microbiology All India Institute of Medical SciencesNew Delhi 110029India department of Pathology All India Institute of Medical SciencesAnsari NagarNew Delhi 110029India

BACKGROUND Currently,the differentiation of jaw tumors is mainly based on the lesion’s morphology rather than the enhancement characteristics,which are important in the differentiation of neoplasms across the body.There is a paucity of literature on the enhancement characteristics of jaw tumors.This is mainly because,even though computed tomography(CT)is used to evaluate these lesions,they are often imaged without intravenous contrast.This study hypothesised that the enhancement characteristics of the solid component of jaw tumors can aid in the differentiation of these lesions in addition to their morphology by dual-energy CT,therefore improving the ability to differentiate between various pathologies.AIM To evaluate the role of contrast enhancement and dual-energy quantitative parameters in CT in the differentiation of jaw tumors.METHODS Fifty-seven patients with jaw tumors underwent contrast-enhanced dual-energy CT.Morphological analysis of the tumor,including the enhancing solid component,was done,followed by quantitative analysis of iodine concentration(IC),water concentration(WC),HU,and normalized IC.The study population was divided into four subgroups based on histopathological analysis-central giant cell granuloma(CGCG),ameloblastoma,odontogenic keratocyst(OKC),and other jaw tumors.A one-way ANOVA test for parametric variables and the Kruskal-Wallis test for nonparametric variables were used.If significant differences were found,a series of independent t-tests or Mann-Whitney U tests were used.RESULTS Ameloblastoma was the most common pathology(n=20),followed by CGCG(n=11)and OKC.CGCG showed a higher mean concentration of all quantitative parameters than ameloblastomas(P<0.05).An IC threshold of 31.35×100μg/cm^(3) had the maximum sensitivity(81.8%)and specificity(65%).Between ameloblastomas and OKC,the former showed a higher mean concentration of all quantitative parameters(P<0.001),however when comparing unilocular ameloblastomas with OKCs,the latter showed significantly higher WC.Also,ameloblastoma had

关键词： Jaw neoplasms Ameloblastomas Dual-energy computed tomography Iodine quantification Mandibular neoplasms Maxillary neoplasms

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