Abstract
Background
This study was to prospectively investigate the feasibility of four-dimensional computed tomography angiography (4D-CTA) with electrocardiogram-gated (ECG) reconstruction for ...preoperative evaluation of morphological parameters, and compared with digital subtraction angiography (DSA). We also aimed to detect pulsation in unruptured intracranial aneurysms (UIAs) by using 4D-CTA, as a potential predicting factor of growth or rupture.
Materials
64 patients with 64 UIAs underwent ECG-gated dynamic 4D-CTA imaging before treatment, of which 46 patients additionally underwent DSA. Original scanning data were reconstructed to produce 20 data sets of cardiac cycles with 5%-time intervals. The extent of agreement on UIAs morphological features assessed with 4D-CTA and DSA was estimated using the k coefficient of the Kappa test. The radiation doses were also calculated and compared between 4D-CTA and DSA. In the aneurysmal surgically treated in our institution, we were able to compare the surgical findings of the aneurysm wall with 4D-CTA images. We performed long-term follow-up on untreated patients.
Results
The morphological characteristics detected by 4D-CTA and DSA were consistent in aneurysm location (k = 1.0), shape (k = 0.76), maximum diameter (k = 0.94), aneurysm neck (k = 0.79) and proximity to parent and branch vessels (k = 0.85). 4D-CTA required lower radiation doses (0.32 ± 0.11 mSv) than DSA (0.84 ± 0.37 mSv,
P
< 0.001). Pulsation was detected in 26 of the 64 unruptured aneurysms, and all underwent neurosurgical clipping or interventional embolization. In aneurysms surgically treated in our hospital, we observed a significant correlation between 4D-CTA findings and surgical evaluation of the aneurysmal wall, in particular the irregular pulsations detected on 4D-CTA have demonstrated to correspond to dark-reddish thinner wall at surgery.
Conclusions
In this proof-of-concept study, 4D-CTA provided real-time, non-invasive preoperative assessments of UIAs comparable to DSA. Moreover, optimal correlation between the irregular pulsation detected by 4D-CTA and the surgical findings support a possible role of this technique to identify aneurysms with a higher risk of rupture.
c-Met is a receptor tyrosine kinase shown inappropriate expression and actively involved in progression and metastasis in most types of human cancer. Development of c-Met-targeted imaging and ...therapeutic agents would be extremely useful. Previous studies reported that c-Met-binding peptide (Met-pep1, YLFSVHWPPLKA) specifically targets c-Met receptor. Here, we evaluated 18F-labeled Met-pep1 for PET imaging of c-Met positive tumor in human head and neck squamous cell carcinoma (HNSCC) xenografted mice.
c-Met-binding peptide, Met-pep1, was synthesized and labeled with 4-nitrophenyl 18F-2-fluoropropionate (18F-NPFP) (18FFP-Met-pep1). The cell uptake, internalization and efflux of 18FFP-Met-pep1 were assessed in UM-SCC-22B cells. In vivo pharmacokinetics, blocking and biodistribution of the radiotracers were investigated in tumor-bearing nude mice by microPET imaging.
The radiolabeling yield for 18FFP-Met-pep1 was over 55% with 97% purity. 18FFP-Met-pep1 showed high tumor uptake in UM-SCC-22B tumor-bearing mice with clear visualization. The specificity of the imaging tracer was confirmed by significantly decreased tumor uptake after co-administration of unlabeled Met-pep1 peptides. Prominent uptake and rapid excretion of 18FFP-Met-pep1 was also observed in the kidney, suggesting this tracer is mainly excreted through the renal-urinary routes. Ex vivo biodistribution showed similar results that were consistent with microPET imaging data.
These results suggest that 18F-labeled c-Met peptide may potentially be used for imaging c-Met positive HNSCC cancer in vivo and for c-Met-targeted cancer therapy.
Phyllodes tumor (PT) is a special type of breast tumors, including three types: malignant, borderline, and benign. Most of these tumors form unilateral disease and can rapidly increase in size. The ...occurrence of axillary lymph node metastasis is rare. Tumor-associated hypoglycemia can be divided into non-islet cell tumor and insulinoma. In non-islet cell tumor hypoglycemia (NICTH), a considerable high molecular weight form of insulin like growth factor 2 (IGF-2) is formed, which abnormally binds to insulin receptors in the tissues and causes hypoglycemia. Breast phyllodes tumors with NICTH are rare and first reported in 1983. Surgical resection is the main treatment and hypoglycemia symptoms usually resolve after surgery. Nevertheless, prior to surgery, intravenous glucose infusion is used to maintain blood glucose levels. A female patient presented with a rapidly growing breast mass and was diagnosed with a phyllodes tumor with NICTH at our hospital in August 2020; she was successfully treated through surgical resection. We reviewed the relevant literature to investigate and analyze the relationship between NICTH and phyllodes tumors, as well as optimize its diagnosis and treatment.
Background
The aim of this study was to evaluate the clinical usefulness of radiomics signature-derived
18
F-fluorodeoxyglucose (
18
F-FDG) positron emission tomography–computed tomography (PET-CT) ...for the early prediction of neoadjuvant chemotherapy (NAC) outcomes in patients with (BC).
Methods
A total of 124 patients with BC who underwent pretreatment PET-CT scanning and received NAC between December 2016 and August 2019 were studied. The dataset was randomly assigned in a 7:3 ratio to either the training or validation cohort. Primary tumor segmentation was performed, and radiomics signatures were extracted from each PET-derived volume of interest (VOI) and CT-derived VOI. Radiomics signatures associated with pathological treatment response were selected from within a training cohort (
n
= 85), which were then applied to generate different classifiers to predict the probability of pathological complete response (pCR). Different models were then independently tested in the validation cohort (
n
= 39) regarding their accuracy, sensitivity, specificity, and area under the curve (AUC).
Results
Thirty-five patients (28.2%) had pCR to NAC. Twelve features consisting of five PET-derived signatures, four CT-derived signatures, and three clinicopathological variables were candidates for the model’s development. The random forest (RF), k-nearest neighbors (KNN), and decision tree (DT) classifiers were established, which could be utilized to predict pCR to NAC with AUC ranging from 0.819 to 0.849 in the validation cohort.
Conclusions
The PET/CT-based radiomics analysis might provide efficient predictors of pCR in patients with BC, which could potentially be applied in clinical practice for individualized treatment strategy formulation.
Objective: Existing methods for automated coronary artery branch labeling in cardiac CT angiography face two limitations: 1) inability to model overall correlation of branches, since differences ...between branches cannot be captured directly. 2) a serious class imbalance between main and side branches. Methods and procedures: Inspired by the application of Transformer in sequence data, we propose a topological Transformer network (TTN), which solves the vessel branch labeling from a novel perspective of sequence labeling learning. TTN detects differences between branches by establishing their overall correlation. A topological encoding that represents the positions of vessel segments in the artery tree, is proposed to assist the model in classifying branches. Also, a segment-depth loss is introduced to solve the class imbalance between main and side branches. Results: On a dataset with 325 CCTA, our method obtains the best overall result on all branches, the best result on side branches, and a competitive result on main branches. Conclusion: TTN solves two limitations in existing methods perfectly, thus achieving the best result in coronary artery branch labeling task. It is the first Transformer based vessel branch labeling method and is notably different from previous methods. Clinical impact: This Pre-Clinical Research can be integrated into a computer-aided diagnosis system to generate cardiovascular disease diagnosis report, assisting clinicians in locating the atherosclerotic plaques.
Objective: Left ventricular (LV) volume estimation is a critical procedure for cardiac disease diagnosis. The objective of this paper is to address a direct LV volume prediction task. Methods: In ...this paper, we propose a direct volume prediction method based on the end-to-end deep convolutional neural networks. We study the end-to-end LV volume prediction method in items of the data preprocessing, network structure, and multiview fusion strategy. The main contributions of this paper are the following aspects. First, we propose a new data preprocessing method on cardiac magnetic resonance (CMR). Second, we propose a new network structure for end-to-end LV volume estimation. Third, we explore the representational capacity of different slices and propose a fusion strategy to improve the prediction accuracy. Results: The evaluation results show that the proposed method outperforms other state-of-the-art LV volume estimation methods on the open accessible benchmark datasets. The clinical indexes derived from the predicted volumes agree well with the ground truth (EDV:R 2 = 0.974, RMSE = 9.6 ml; ESV:R 2 = 0.976, RMSE = 7.1 ml; EF:R 2 = 0.828, RMSE = 4.71%). Conclusion: Experimental results prove that the proposed method may be useful for the LV volume prediction task. Significance: The proposed method not only has application potential for cardiac diseases screening for large-scale CMR data, but also can be extended to other medical image research fields.
•Citric acid was first proposed as an inhibitor of coal spontaneous combustion.•Citric acid has a good inhibitory effect on different types of coal.•Citric acid can reduce the consumption of ...aliphatic hydrocarbons in coal oxidation.
Transition metals ions in coal can accelerate the coal spontaneous combustion by reducing the activation energy of the coal-oxygen reaction during coal oxidation. The catalytic action of metal ions may be decreased by adding metal chelators to coal. In this article, an environment-friendly metal chelating agent, citric acid, was proposed as an inhibitor of coal spontaneous combustion. Experiments were carried out to investigate the inhibitory effect of citric acid on coal spontaneous combustion. The results showed that the generation of CO, CO2 and the consumption of O2 in the oxidation of inhibited coal samples were much lower than those of raw coal. Compared to raw coal, the crossing point temperature of inhibited samples increased by 9–12 °C, and the advent time of the crossing point temperature was delayed by 30 to 40 min. In addition, the temperature of the characteristic points of the experimental coal samples after inhibition was higher than that of raw coal. The reaction enthalpy of inhibited coal samples was smaller than raw coal when experimental samples entered the rapid combustion stage. Through Fourier Transform infrared spectroscopy (FTIR) experiments, it was found that the amount of -CH3 and -CH2- groups in coal samples increased after inhibition, but the amount of -COOH and C=O groups decreased. Scanning electron microscope (SEM) analysis showed that the surface of the coal sample became smoother and the pore size decreased after citric acid treatment. In conclusion, citric acid has a good inhibitory effect on different types of coal.
Purpose
The radiopharmaceutical
18
FAlF-NOTA-FAPI-04 presents a promising alternative to
68
Ga-FAPI owing to its relatively longer half-life. This study aimed to evaluate the clinical usefulness of ...
18
FAlF-NOTA-FAPI-04 PET/CT for the diagnosis of primary and metastatic lesions in various types of gastrointestinal system cancers, compared with
18
F-FDG PET/CT.
Methods
Patients diagnosed with gastrointestinal system malignancies were prospectively enrolled. All patients underwent both
18
F-FDG and
18
F-FAPI-04 PET/CT scans within one week, with 44 (73.3%) for cancer staging and 16 (26.7%) for tumor restaging. Diagnostic efficacy of the primary tumor, as well as the presence and number of lymph nodes and distant metastases, were assessed. Tumor uptake was quantified by the maximum standard uptake value (SUVmax).
Results
For detection of primary tumor, the diagnostic sensitivity of
18
F-FDG PET/CT was 72.7%, while it was 97.7% for
18
F-FAPI-04 PET/CT. Based on per-lymph node analysis, the sensitivity, specificity, and accuracy of
18
F-FAPI-04 PET/CT in diagnosing metastatic lymph nodes were 91.89%, 92.00%, and 91.96%, respectively. These values were notably higher than those
18
F-FDG PET/CT (79.72%, 81.33% and 80.80%, respectively). The
18
F-FAPI-04 PET/CT surpassed
18
F-FDG PET/CT in detecting suspected metastases in the brain (7 vs. 3), liver (39 vs. 20), bone (79 vs. 51), lung (11 vs. 4), and peritoneal carcinoma (48 vs. 22). Based on per-patient analysis, differential diagnostic accuracies (
18
F-FAPI-04 vs.
18
F-FDG PET/CT) were observed in all patients (91.7% vs. 76.7%), the initial staging group (90.9% vs. 79.5%), and the re-staging group (93.8% vs. 68.7%). Additionally,
18
F-FAPI-04 PET/CT revised final diagnosis in 31.7% of patients, contrasting with
18
F-FDG PET/CT, and prompted changes in clinical management for 21.7% of the patients.
Conclusion
18
F-FAPI-04 PET/CT outperforms
18
F-FDG PET/CT in delineating the primary gastrointestinal tumors and detecting suspected metastatic lesions due to a higher target-to-background ratio (TBR). Moreover,
18
F-FAPI-04 PET/CT could provide valuable guidance for tumor staging, thereby having a potential impact on patient management.
•A deep atlas net explicitly integrated significant atlas prior knowledge into a deep learning framework.•The proposed method converts a traditional on-line atlas optimization problem (which is ...costly) into an off-line optimization problem (which is efficient).•A novel multi-level information consistency constraint to enhance the model’s performance from different levels simultaneously.•A new couple adversarial consistency constraint (i.e., Couple-GAN) was proposed.
Display omitted
We proposed a novel efficient method for 3D left ventricle (LV) segmentation on echocardiography, which is important for cardiac disease diagnosis. The proposed method effectively overcame the 3D echocardiography’s challenges: high dimensional data, complex anatomical environments, and limited annotation data. First, we proposed a deep atlas network, which integrated LV atlas into the deep learning framework to address the 3D LV segmentation problem on echocardiography for the first time, and improved the performance based on limited annotation data. Second, we proposed a novel information consistency constraint to enhance the model’s performance from different levels simultaneously, and finally achieved effective optimization for 3D LV segmentation on complex anatomical environments. Finally, the proposed method was optimized in an end-to-end back propagation manner and it achieved high inference efficiency even with high dimensional data, which satisfies the efficiency requirement of clinical practice. The experiments proved that the proposed method achieved better segmentation results and a higher inference speed compared with state-of-the-art methods. The mean surface distance, mean hausdorff surface distance, and mean dice index were 1.52 mm, 5.6 mm and 0.97 respectively. What’s more, the method is efficient and its inference time is 0.02s. The experimental results proved that the proposed method has a potential clinical application for 3D LV segmentation on echocardiography.
Objectives
This study aimed to evaluate the feasibility and reproducibility of using cardiovascular magnetic resonance feature tracking (CMR-FT) for analysis of bi-ventricular strain and strain rate ...(SR) in hypertrophic cardiomyopathy (HCM) patients as well as to explore the correlation between right ventricular (RV) and left ventricular (LV) deformation.
Methods
A total of 60 HCM patients and 48 controls were studied. Global and segmental peak values of bi-ventricular longitudinal, circumferential, radial strain, and systolic SR were analyzed. Pearson analysis was performed to investigate the correlation of RV and LV deformation. Intra-observer and inter-observer reproducibility were also assessed.
Results
LV mass in the HCM group was significantly higher than that in the control group. LV end-systolic and end-diastolic volume and RV end-systolic and end-diastolic volume in the HCM group were all significantly lower than the correlated parameters in the control group (
p
< 0.001, respectively), whereas no statistical difference was found in ejection fraction (
p
> 0.05). Global longitudinal strain (GLS), global longitudinal strain rate (GLSR), global circumferential strain (GCS), global circumferential strain rate (GCSR), global radial strain (GRS), and global radial strain rate (GRSR) of the LV and RV were all significantly lower than the control group, and segmental strain and SR were also true (
p
< 0.001, respectively). Bi-ventricular strain and SR measurements were highly reproducible at both intra- and inter-observer levels. Additionally, Pearson analysis showed RV GCS, GLS, and GRS positively correlated with LV GCS, GLS, and GRS (
r
= 0.713,
p
< 0.001;
r
= 0.728,
p
< 0.001;
r
= 0.730,
p
< 0.001, respectively).
Conclusions
CMR-FT is a promising approach to analyze impairment of global and segmental myocardium deformation in HCM patients non-invasively and quantitatively.
Key Points
•
CMR-FT allows for advanced myocardial characterization with high reproducibility.
•
As compared with controls, HCM patients have significant differences in CMR-FT strain analysis while ejection fraction was similar.
•
CMR-FT may serve as an early biomarker of HCM in subjects at risk.
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