Background
Fever of unknown origin (FUO) and inflammation of unknown origin (IUO) are challenging medical problems. Previous studies have shown that 18F-fluorodeoxyglucose positron emission ...tomography/computed tomography (18F-FDG PET/CT) plays an important role in the diagnosis of FUO, but few studies have explored this diagnostic technique in relation to IUO.
Purpose
To systematically review and perform a meta-analysis of published data on the diagnostic performance of PET/CT in the diagnosis of FUO and IUO.
Material and Methods
A comprehensive literature search was performed in accordance with the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) guidelines published in March 2018. Meta-analysis of diagnostic performance was performed using STATA 12.0 software. Subgroup analysis was performed by stratification based on study design, number of patients, geographic area, and final diagnosis based on 18F-FDG PET/CT. Meta-regression analyses were performed to recognize heterogeneity.
Results
Our meta-analysis included 23 studies, comprising a total sample size of 1927 patients. The pooled diagnosis performance was calculated with a per-patient-based analysis: sensitivity = 0.84 (95% confidence interval CI = 0.79–0.89), specificity = 0.63 (95% CI = 0.49–0.75), positive likelihood ratio = 2.3 (95% CI = 1.5–3.4), negative likelihood ratio = 0.25 (95% CI = 0.16–0.38), diagnostic odds ratio = 9 (95% CI = 4.0–20), and AUC = 0.84 (95% CI = 0.81–0.87).
Conclusion
In patients with non-specific symptoms and signs, 18F-FDG PET/CT is very helpful for recognizing and excluding diseases, directing further diagnostic decisions, and avoiding unnecessary invasive examinations. We recommend that 18F-FDG PET/CT should be considered among the first-line diagnostic tools for patients with FUO and IUO.
Background
Tinnitus is considered to be triggered by aberrant neural activity in the brain. Sound therapy is regarded as a reasonable management option for tinnitus treatment and has been applied in ...the clinical setting for decades.
Hypothesis
We hypothesized that sound therapy, a commonly used tinnitus treatment method, would alter the functional connectivity (FC) of brain regions in tinnitus models.
Study Type
Longitudinal.
Population
Resting‐state functional MRI data were collected from 27 tinnitus patients before and after 12 weeks of sound therapy. Twenty‐seven age‐ and sex‐matched healthy controls were also longitudinally scanned at the 12‐week timepoint.
Field Strength
3.0T MRI system and echo planar imaging (EPI) sequence, 3D brain volume imaging (BRAVO) sequence.
Assessment
Functional connectivity strength (FCS), a graph‐theoretical‐based analytic method, was applied to analyze the FC features in the whole brain.
Statistical Tests
Student's t‐test and chi‐square test were used for analyses between two groups. A two‐way analysis of covariance (ANCOVA) followed by post‐hoc analyses was performed to determine differences of FC.
Results
The interaction effect between the two groups and two scans on FCS was observed in the bilateral thalami and left anterior cingulate cortex (ACC). The fitted FCS values in the bilateral thalami were significantly higher in tinnitus patients at baseline and decreased to a relatively normal range after sound therapy compared with healthy controls. Conversely, the fitted FCS values in the left ACC were within the normal range, but increased after treatment (1.08 ± 0.29, P < 0.02); however, there was no change in the control group. Importantly, significant correlations were observed between the FCS changes in the right thalamus (P = 0.028), the FC of the right thalamus‐right inferior frontal gyrus (P = 0.015), and symptomatic improvement.
Data Conclusion
Sound therapy may modulate the brain network by altering the gating function of the thalamus as well as enhancing the tinnitus‐canceling system.
Level of Evidence: 2
Technical Efficacy Stage: 4 J. Magn. Reson. Imaging 2019;50:1731–1741.
Full text
Available for:
BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
This study's purpose was to confirm the observed underexpression of miRNA-410 in glioma tissues and several glioma cells by Quantitative RT-PCR. Our findings suggest that epigenetic alterations ...occurring at the promoter region of miR-410 may be responsible for the reduced expression of miR-410 in glioma. The occurrence of DNA methylation in the miR-410 promoter was verified to be more prevalent through glioma tissues contrasted to adjacent non-tumor brain tissues through the utilization of methylation-specific PCR and CpG bisulfite sequencing sites in the miR-410 promoter region. Accordantly, miR-410 expression in glioma cell lines was observed to be significantly lesser in comparison to that of the human fetal glial cell line. In addition, it was demonstrated through gain- and loss-of-function investigations that miR-410 exerts significant regulation over cell growth, cell cycle development, and glioma cell apoptosis. The findings of the Luciferase reporter assay and western blot analysis indicate that miR-410 has a direct effect on the 3'-UTR of signal transducer and activator of transcription 3 (STAT3), thereby inhibiting its expression within glioma cells. Besides, our clinical investigation indicates a negative association between miR-410 expression and STAT3 within the glioma tissues of humans. In aggregate, the data provided in this investigation indicates that miR-410 is subjected to underexpression via DNA methylation. Furthermore, it has been observed to perform its function as a tumor suppressor in glioma cells through direct targeting of STAT3. The previously mentioned results could potentially have significant implications for the advancement of a new therapeutic approach for treating glioma.
Full text
Available for:
IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
We aim to investigate the feasibility of using diffusion tensor imaging (DTI) to evaluate changes in extraocular muscles (EOMs) and lacrimal gland (LG) in patients with thyroid-associated ...ophthalmopathy (TAO) and to evaluate disease severity.
A total of 74 participants, including 17 healthy controls (HCs), 22 patients with mild TAO, and 35 patients with moderate-severe TAO, underwent 3-Tesla DTI to measure fractional anisotropy (FA) and mean diffusivity (MD) of the EOMs and LG. Ophthalmological examinations, including visual acuity, exophthalmos, intraocular pressure, and fundoscopy, were performed. FA and MD values were compared among patients with different disease severity. Multiple linear regression was adopted to predict the impact of clinical variables on DTI parameters of orbital soft tissue.
TAO patients' EOMs and LG showed significantly lower FA values and higher MD compared to HCs' (
< 0.05). Moderate-severe TAO patients' EOMs and LG had dramatically lower FA and higher MD compared with HCs (
< 0.05). In addition, only the DTI parameters of the medial rectus were considerably different between mild and moderate-severe TAO patients (
= 0.017,
= 0.021). Multiple linear regression showed that disease severity had a significant impact on the DTI parameters of orbital soft tissue.
DTI is a useful tool for detecting microstructural changes in TAO patients' orbital soft tissue. DTI findings, especially medial rectus DTI parameters, can help to indicate the disease severity in TAO patients.
Structural and functional brain alterations have been always observed in end-stage renal disease (ESRD) patients undergoing hemodialysis. The present study aimed to investigate the gray matter volume ...(GMV) changes in hemodialysis patients compared with those noted in healthy subjects, as well as explore the associated functional connectivity alterations based on the abnormal GMV regions. The experiments revealed the effects of regional morphometry aberrance on the brain functional integrity. A total of 46 hemodialysis patients (53.11 ± 1.58 years, 28 males) and 47 healthy subjects (55.57 ± 0.86 years, 22 males) were enrolled in the present study. All subjects underwent high-resolution T1-weighted imaging, resting-state functional MR imaging, and laboratory examinations were performed in hemodialysis patients. The GMV deficits were analyzed using voxel-based morphometry (VBM) and regions with GMV alteration were defined as seeds for functional connectivity analysis. Correlation analyses between significantly different regions and the results of the blood examination were further performed. We found that bilateral thalamus exhibited significantly increased volumes in the hemodialysis patients compared with those of the healthy subjects. However, the bilateral rectus, bilateral caudate, and bilateral temporal gyrus demonstrated significantly decreased volumes. When the regions with GMV alterations were defined as seeds, the hemodialysis patients exhibited decreased integrations in the thalamo-cortical network and within the basal-ganglia connection. The present study revealed the presence of different types of structural and functional brain impairments in hemodialysis patients.
•Gadoxetate disodium-enhanced MRI has a high diagnostic accuracy in staging liver fibrosis.•Gadoxetate disodium-enhanced MRI had the highest sensitivity for staging F4 subset.•A prospective study ...with large sample in patients showed higher diagnostic efficacy.
To evaluate the diagnostic efficacy of gadoxetic acid-enhanced MRI for the staging of liver fibrosis by meta-analysis.
PubMed/Medline, EMBASE, the Web of Science, and the Cochrane Library were searched. Studies were included according to their eligibility and the exclusion criteria. The Quality Assessment of Diagnostic Accuracy Studies 2 tool was used to assess the methodologic quality. The bivariate random-effects model was used to obtain the pooled summary estimates, heterogeneity, and the area under summary receiver operating characteristic curves (AUROC). Meta-regression was performed to discover the source of heterogeneity and compare certain some subsets for their capacity to stage hepatic fibrosis by AUROC comparison.
A total of 20 original articles (1936 patients) were included. Most studies had a low risk of bias and minimal concerns regarding applicability. The summary AUROC values of gadoxetic acid-enhanced MRI in staging the liver fibrosis ≥ F1, ≥ F2, ≥ F3, and F4 subsets were 0.92, 0.87, 0.89, and 0.91, respectively. Studies with populations equal to or more than 100 had a significantly higher sensitivity (84 %) and specificity (91 %) than those with populations less than 100 (70 % and 77 %, respectively, P < 0.01). Studies of a prospective design exhibited a significantly higher sensitivity (94 %) and specificity (94 %) than those of a retrospective design (75 % and 84 %, respectively, P < 0.01).
Our meta-analysis shows the high diagnostic efficacy of gadoxetic acid-enhanced MRI in the staging of liver fibrosis. A prospective study with more than one hundred patients showed higher diagnostic efficacy.
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Background
There have been recent efforts to characterize brain functional activity features in patients with pulsatile tinnitus (PT). These efforts have revealed evidence of aberrant functional ...connectivity (FC) of the right middle temporal gyrus (MTG) in PT patients with prolonged disease duration.
Purpose
To assess the possible predictive effect of aberrant FC of MTG in PT patients with prolonged disease duration.
Study Type
Retrospective.
Population
Thirty‐four patients with recent‐onset PT (RPTIN), 24 patients with long‐term PT (LPTIN), and 35 age‐, gender‐, and education‐matched healthy controls were enrolled.
Field Strength/Sequence
3.0T MRI system and echo‐planar imaging (EPI) sequence, 3D brain volume imaging (BRAVO) sequence.
Assessment
Functional MRI data preprocessing was performed in Data Processing & Analysis for Brain Imaging (DPABI) and Statistical Parametric Mapping (SPM) 8. The FC analyses were conducted using the software REST.
Statistical Tests
One‐way analysis of covariance was conducted between three groups with age and gender as covariates, and post‐hoc analysis was used to identify the sources of group effects. Pearson's correlation analysis was conducted for the z‐values of altered FC strength in the PT group and the clinical data.
Results
Among hubs belonging to the executive control network, the default mode network (DMN), and limbic network, the strength of FC was mainly decreased in the patient groups compared with normal controls (P < 0.05). Relative to RPTIN patients and normal controls, LPTIN patients were further characterized by significantly decreased FC between several short‐range brain regions adjacent to the seed (P < 0.05). Finally, disease duration was negatively correlated with decreased FC between the seed and right fusiform gyrus/parahippocampal gyrus, right inferior frontal gyrus, and right MTG (a brain area adjacent to the seed region).
Data Conclusion
Long‐term reactions to PT mainly involved weakened short‐range FC, especially within a functional network in the right temporal lobe.
Level of Evidence: 4
Technical Efficacy: Stage 2
J. Magn. Reson. Imaging 2018.
Full text
Available for:
BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
We investigated whether leaching fraction (LF) is able to modify the effects of irrigation water salinity (EC
) on evapotranspiration (ET). We conducted an experiment with a completely randomized ...block design using five levels of EC
and two LFs. Results showed that the electrical conductivity of drainage water (EC
) in an LF of 0.29 was considerably higher during the 21-36 days after transplanting (DAT), and considerably lower after 50 DAT than in an LF of 0.17. The hourly, nighttime, daily, cumulative and seasonal ET all decreased considerably as a result of an increase in the EC
. The daily ET started to be considerably higher in the LF of 0.29 than in the LF of 0.17 from 65 DAT. Compared with the LF of 0.17, the seasonal ET in the LF of 0.29 under various EC
levels increased by 4.8%-8.7%. The Maas and Hoffman and van Genuchten and Hoffman models both corresponded well with the measured relative seasonal ET and the LF had no marked effects on these model parameters. Collectively, an increase in the level of EC
always decreased the ET substantially. An increase in the LF increased the ET considerably, but there was a time lag.
Full text
Available for:
IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
The aim of this study was to investigate the relationship between multiple metabolism parameters derived from FDG and tumor TNM stages as well as tumor metastasis-associated protein of GLUT-1 and ...MACC1 in colorectal carcinoma (CRC).
Thirty-eight patients (24 males and 14 females) with primary CRC confirmed by elective surgery pathological, who also accepted
F-FDG PET/CT scans during 2017 to 2019 were included in this study. The tumor classification of T, N and M is explained by the 7th American Joint Committee on Cancer (AJCC).
F-FDG parameters of SUVmax, SUVmean, TLG and MTV were measured by drawing a region of interest on the primary lesions. The expression of GLUT-1 and MACC1 was quantified by immunohistochemical, and the correlation between metabolism parameters and tumor biomarkers were analyzed.
According to our analysis, the
F-FDG parameters of SUVmean was significantly correlated with tumor M status (P = 0.000) of primary CRC. The primary tumor lesion with higher SUVmax, TLG and MTV values prone to a high-T status (P = 0.002, 0.002 and 0.001, respectively). The high expression of GLUT-1/MACC1 weas more frequently involved with T3-4 stage and was poorly differentiated in CRC patients. Multivariate analysis found that the expression of GLUT-1 protein was correlated with SUVmax and MTV (R
= 0.42, P = 0.013 and 0.004, respectively), moreover, the expression of MACC1 protein was correlated with TLG (R
= 0.372, P = 0.000).
Glucose metabolism parameters derived from FDG provides a noninvasive assessment of M status and T status in CRC patients. The expression of GLUT-1 and MACC1 was associated with
F-FDG uptake in CRC patients.
Full text
Available for:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Abstract
BACKGROUND
The relationship between trans-stenotic blood flow velocity differences and the cerebral venous pressure gradient (CVPG) in transverse sinus (TS) stenosis (TSS) has not been ...studied.
OBJECTIVE
To evaluate the hemodynamic manifestations of TSS and the relationship between trans-stenotic blood flow velocity differences and the CVPG.
METHODS
Thirty-three patients with idiopathic intracranial hypertension (IIH) or pulsatile tinnitus (PT) and TSS who had undergone diagnostic venography using venous manometry were included in the patient group. Thirty-three volunteers with no stenosis and symptoms were included in the control group. All the 2 groups underwent prospective venous sinus 4-dimensional (4D) flow magnetic resonance imaging (MRI). The average velocity (Vavg) difference and maximum velocity (Vmax) difference between downstream and upstream of the TS in 2 groups were measured and compared. Correlations between the CVPG and trans-stenotic Vavg difference/Vmax difference/index of transverse sinus stenosis (ITSS) were assessed in the patient group.
RESULTS
The differences in Vavg difference and Vmax difference between the patient and control groups showed a statistical significance (P < .001). The Vavg difference and Vmax difference had a strong correlation with CVPG (R = 0.675 and 0.701, respectively, P < .001) in the patient group. Multivariate linear regression using the stepwise method showed that the Vmax difference and ITSS were correlated with the CVPG (R = 0.752 and R2 = 0.537, respectively; P < .001).
CONCLUSION
The trans-stenotic blood flow velocity difference significantly correlates with the CVPG in TSS. As a noninvasive imaging modality, 4D flow MRI may be a suitable screening or complimentary tool to decide which TSS may benefit from invasive venous manometry.
PDF
