Spectral imaging is an important tool for a wide variety of applications. We present a technique for spectral imaging using computational imaging pattern based on compressive sensing （CS）. The spectral and spatial i...Spectral imaging is an important tool for a wide variety of applications. We present a technique for spectral imaging using computational imaging pattern based on compressive sensing （CS）. The spectral and spatial infor- mation is simultaneously obtained using a fiber spectrometer and the spatial light modulation without mechanical scanning. The method allows high-speed, stable, and sub sampling acquisition of spectral data from specimens. The relationship between sampling rate and image quality is discussed and two CS algorithms are compared.展开更多
BACKGROUND Tumor deposits(TDs)are an independent predictor of poor prognosis in colorec-tal cancer(CRC)patients.Enhanced follow-up and treatment monitoring for TD+patients may improve survival rates and quality of lif...BACKGROUND Tumor deposits(TDs)are an independent predictor of poor prognosis in colorec-tal cancer(CRC)patients.Enhanced follow-up and treatment monitoring for TD+patients may improve survival rates and quality of life.However,the detection of TDs relies primarily on postoperative pathological examination,which may have a low detection rate due to sampling limitations.AIM To evaluate the spectral computed tomography(CT)parameters of primary tu-mors and the largest regional lymph nodes(LNs),to determine their value in predicting TDs in CRC.METHODS A retrospective analysis was conducted which included 121 patients with CRC whose complete spectral CT data were available.Patients were divided into the TDs+group and the TDs-group on the basis of their pathological results.Spectral CT parameters of the primary CRC lesion and the largest regional LNs were measured,including the normalized iodine concentration(NIC)in both the arte-rial and venous phases,and the LN-to-primary tumor ratio was calculated.Stati-stical methods were used to evaluate the diagnostic efficacy of each spectral para-meter.RESULTS Among the 121 CRC patients,33(27.2%)were confirmed to be TDs+.The risk of TDs positivity was greater in patients with positive LN metastasis,higher N stage and elevated carcinoembryonic antigen and cancer antigen 19-9 levels.The NIC(LNs in both the arterial and venous phases),NIC(primary tumors in the venous phase),and the LN-to-primary tumor ratio in both the arterial and venous phases were associated with TDs(P<0.05).In mul-tivariate logistic regression analysis,the arterial phase LN-to-primary tumor ratio was identified as an independent predictor of TDs,demonstrating the highest diagnostic performance(area under the curve:0.812,sensitivity:0.879,specificity:0.648,cutoff value:1.145).CONCLUSION The spectral CT parameters of the primary colorectal tumor and the largest regional LNs,especially the LN-to-primary tumor ratio,have significant clinical value in predicting TDs in CRC.展开更多
BACKGROUND The diagnostic accuracy for detecting metastatic lymph nodes in colorectal cancer(CRC)remains suboptimal.To address this limitation,our study investigates the potential of gemstone spectral computed tomogra...BACKGROUND The diagnostic accuracy for detecting metastatic lymph nodes in colorectal cancer(CRC)remains suboptimal.To address this limitation,our study investigates the potential of gemstone spectral computed tomography imaging(GSI)to improve diagnostic accuracy in lymph node metastasis(LNM)assessment.AIM To extensively investigate the clinical utility of GSI in the preoperative assessment of CRC.METHODS The subject population included 200 patients with CRC who were admitted to Zibo Central Hospital from January 2022 to December 2023.All patients underwent dual-phase contrast-enhanced scans in the arterial and venous phases using GSI before surgical intervention.During the research,meticulous quantification was conducted regarding the number of patients with CRC with LNM as well as the exact count of metastatic lymph nodes.Moreover,for both metastatic and non-metastatic lymph nodes,the short diameter at the maximum crosssectional area(covering the axial,sagittal,and coronal planes),morphological features(including manifestations such as margin blurring,aggregation,and enhancement),and spectral parameters in the arterial and venous phases[specifically iodine concentration(IC),normalized IC(NIC),and the slope of the spectral curve(λHU)]were measured and recorded,and a comparative analysis was conducted.The diagnostic efficacy of each index with differences was systematically assessed using the receiver operating characteristic(ROC)curve.Concurrently,receiver operating characteristic curves were constructed for LNM screening based on the short diameter at the maximum cross-sectional area of lymph nodes and each spectral parameter in the arterial and venous phases.RESULTS The area under the curve of GSI for diagnosing LNM in patients with CRC can reach 0.897,with sensitivity,specificity,and accuracy of 92.59%,85.87%,and 89.50%,respectively.A total of 265 lymph nodes were analyzed from the 200 participants with CRC,with metastatic lymph nodes accounting for 56.60%.Compared with nonmetastatic lymph nodes,the short diameters of metastatic lymph nodes in the axial,sagittal,and coronal planes were significantly increased,whereas the IC values in the arterial and venous phases,the NIC value in the arterial phase,and theλHU values in the arterial and venous phases were significantly decreased.The short axial,sagittal,and coronal diameters,arterial-phase IC,venous-phase IC,arterial-phase NIC,arterial-phaseλHU,and venousphaseλHU for diagnosing metastatic lymph nodes demonstrated area under the curve values of 0.631,0.681,0.659,0.862,0.808,0.831,0.801,and 0.706,respectively.CONCLUSION GSI exhibits substantial clinical significance in the preoperative assessment of CRC.Among the parameters assessed,the arterial-phase IC demonstrates the most outstanding diagnostic performance,effectively improving the diagnostic efficacy for preoperative LNM in CRC.展开更多
BACKGROUND Accurate preoperative T staging is essential for determining optimal treatment strategies in colorectal cancer(CRC).Low-keV virtual monoenergetic images(VMIs)have been shown to enhance lesion conspicuity.Th...BACKGROUND Accurate preoperative T staging is essential for determining optimal treatment strategies in colorectal cancer(CRC).Low-keV virtual monoenergetic images(VMIs)have been shown to enhance lesion conspicuity.This study aimed to assess the diagnostic value of dual-layer spectral computed tomography(CT)-derived VMIs,in combination with multiplanar reformation(MPR)and evaluation of peritumoral fat stranding(PFS),for improving the accuracy of T staging in CRC.AIM To assess the diagnostic performance of dual-layer spectral CT(DLSCT)VMIs,particularly at low energy levels,and their integration with personalized MPR for preoperative T staging of CRC.METHODS In this retrospective study,157 patients with pathologically confirmed CRC(mean age:63.5±12.1 years)underwent DLSCT within 1 week before surgery.VMIs ranging from 40 keV to 70 keV(at 10 keV intervals)and conventional polyenergetic images(PEIs)were reconstructed.Objective image quality parameters,including image noise,signal-to-noise ratio(SNR),and contrast-to-noise ratio(CNR),were quantified,alongside subjective image quality scores using a 5-point Likert scale.Interobserver agreement was evaluated usingκstatistics.Taking histopathology as the reference standard,the diagnostic accuracy of T staging(T1-2 vs T3-4)was compared across PEIs and VMIs,both with and without MPR and PFS.RESULTS Low-keV VMIs(40-70 keV)demonstrated significantly higher SNR and CNR than PEIs(all P<0.001).Notably,40-keV VMIs achieved noise levels comparable to PEIs(8.17±3.63 vs 8.53±2.90;P=0.673).Subjective image quality peaked at 40-50 keV VMIs(Likert scores 4.85-4.88 vs 3.97 for PEIs;P<0.001),supported by excellent interobserver agreement(κ=0.812-0.913).The combination of 40-50 keV VMIs with MPR yielded the highest T staging accuracy(94.27%)compared to axial PEIs(70.7%),with a sensitivity and specificity of 83.87%and 96.83%,respectively(Youden index=0.81;P<0.05).While PFS enhanced staging accuracy on PEIs(up to 77.07%with MPR),it provided no significant additional benefit for VMIs.CONCLUSION DLSCT VMIs at 40-50 keV significantly enhanced image quality and improved preoperative T staging accuracy of CRC when combined with MPR.These findings underscored the clinical value of low-keV spectral imaging in tailoring individualized treatment strategies.展开更多
Background:Prostate cancer is one of the most common diagnosed cancers globally,with early detection crucial for reducing mortality and morbidity.However existing screening methods have limitations,such as invasivenes...Background:Prostate cancer is one of the most common diagnosed cancers globally,with early detection crucial for reducing mortality and morbidity.However existing screening methods have limitations,such as invasiveness and patient discomfort.Spectral detector computed tomography(SDCT)could be an alternative or complementary test for prostate cancer diagnosis because of its material decomposition capabilities.The purpose of this experimental study was to explore the capability of SDCT to accurately measure zinc(Zn)and magnesium(Mg)levels in solutions that simulate clinically relevant concentrations of these elements.Methods:Solutions of zinc and magnesium chloride(50-1200μg/g)were prepared in 10 mL test tubes and scanned using SDCT.A region of interest was selected,and average effective atomic numbers(Z‐effective[Z‐eff])were obtained using IntelliSpace Discovery.Linear regression assessed the relationship between concentration and Z‐eff,with p<0.05.Regression lines,R2 values,and 95%prediction intervals evaluated measurement variability and precision.Results:A strong positive correlation was observed between Zn concentration and Z‐eff(R2=0.99),with the regression equation Z‐eff=7.17þ0.0010�concentration.Similarly,Mg concentration demonstrated a positive correlation with Z‐eff(R2=0.97),with the regression equation Z‐eff=7.14þ0.0002�concentration.The 95%prediction interval showed minimal variability in the data.Conclusions:SDCT effectively differentiates between Zn and Mg within clinically relevant concentration ranges,providing a foundation for further research into its clinical application for prostate cancer diagnosis.展开更多
AIM To investigate the correlation of iodine concentration(IC) generated by spectral computed tomography(CT) with micro-vessel density(MVD) and vascular endothelial growth factor(VEGF) expression in patients with adva...AIM To investigate the correlation of iodine concentration(IC) generated by spectral computed tomography(CT) with micro-vessel density(MVD) and vascular endothelial growth factor(VEGF) expression in patients with advanced gastric carcinoma(GC).METHODS Thirty-four advanced GC patients underwent abdominal enhanced CT in the gemstone spectral imaging mode. The IC of the primary lesion in the arterial phase(AP) and venous phase(VP) were measured, and were then normalized against that in the aorta to provide the normalized IC(nI C). MVD and VEGF were detected by immunohistochemical assays, using CD34 and VEGF-A antibodies, respectively. Correlations of nI C with MVD, VEGF, and clinical-pathological features were analyzed.RESULTS Both nI Cs correlated linearly with MVD and were higher in the primary lesion site than in the normal control site, but were not correlated with VEGF expression. After stratification by clinical-pathological subtypes, nI C-AP showed a statistically significant correlation with MVD, particularly in the group with tumors at stage T4, without nodular involvement, of a mixed Lauren type, where the tumor was located at the antrum site, and occurred in female individuals. nI C-VP showed a positive correlation with MVD in the group with the tumor at stage T4 and above, had nodular involvement, was poorly differentiated, was located at the pylorus site, of a mixed and diffused Lauren subtype, and occurred in male individuals. nI C-AP and nI C-VP showed significant differences in terms of histological differentiation and Lauren subtype.CONCLUSION The IC detected by spectral CT correlated with the MVD. n IC-AP and n IC-VP can reflect angiogenesis in different pathological subgroups of advanced GC.展开更多
BACKGROUND Lymphovascular invasion(LVI)and perineural invasion(PNI)are important prognostic factors for gastric cancer(GC)that indicate an increased risk of metastasis and poor outcomes.Accurate preoperative predictio...BACKGROUND Lymphovascular invasion(LVI)and perineural invasion(PNI)are important prognostic factors for gastric cancer(GC)that indicate an increased risk of metastasis and poor outcomes.Accurate preoperative prediction of LVI/PNI status could help clinicians identify high-risk patients and guide treatment deci-sions.However,prior models using conventional computed tomography(CT)images to predict LVI or PNI separately have had limited accuracy.Spectral CT provides quantitative enhancement parameters that may better capture tumor invasion.We hypothesized that a predictive model combining clinical and spectral CT parameters would accurately preoperatively predict LVI/PNI status in GC patients.AIM To develop and test a machine learning model that fuses spectral CT parameters and clinical indicators to predict LVI/PNI status accurately.METHODS This study used a retrospective dataset involving 257 GC patients(training cohort,n=172;validation cohort,n=85).First,several clinical indicators,including serum tumor markers,CT-TN stages and CT-detected extramural vein invasion(CT-EMVI),were extracted,as were quantitative spectral CT parameters from the delineated tumor regions.Next,a two-step feature selection approach using correlation-based methods and information gain ranking inside a 10-fold cross-validation loop was utilized to select informative clinical and spectral CT parameters.A logistic regression(LR)-based nomogram model was subsequently constructed to predict LVI/PNI status,and its performance was evaluated using the area under the receiver operating characteristic curve(AUC).RESULTS In both the training and validation cohorts,CT T3-4 stage,CT-N positive status,and CT-EMVI positive status are more prevalent in the LVI/PNI-positive group and these differences are statistically significant(P<0.05).LR analysis of the training group showed preoperative CT-T stage,CT-EMVI,single-energy CT values of 70 keV of venous phase(VP-70 keV),and the ratio of standardized iodine concentration of equilibrium phase(EP-NIC)were independent influencing factors.The AUCs of VP-70 keV and EP-NIC were 0.888 and 0.824,respectively,which were slightly greater than those of CT-T and CT-EMVI(AUC=0.793,0.762).The nomogram combining CT-T stage,CT-EMVI,VP-70 keV and EP-NIC yielded AUCs of 0.918(0.866-0.954)and 0.874(0.784-0.936)in the training and validation cohorts,which are significantly higher than using each of single independent factors(P<0.05).CONCLUSION The study found that using portal venous and EP spectral CT parameters allows effective preoperative detection of LVI/PNI in GC,with accuracy boosted by integrating clinical markers.展开更多
This letter comments on the article that developed and tested a machine learning model that predicts lymphovascular invasion/perineural invasion status by combining clinical indications and spectral computed tomograph...This letter comments on the article that developed and tested a machine learning model that predicts lymphovascular invasion/perineural invasion status by combining clinical indications and spectral computed tomography characteristics accurately.We review the research content,methodology,conclusions,strengths and weaknesses of the study,and introduce follow-up research to this work.展开更多
BACKGROUND Although surgery remains the primary treatment for gastric cancer(GC),the identification of effective alternative treatments for individuals for whom surgery is unsuitable holds significance.HER2 overexpres...BACKGROUND Although surgery remains the primary treatment for gastric cancer(GC),the identification of effective alternative treatments for individuals for whom surgery is unsuitable holds significance.HER2 overexpression occurs in approximately 15%-20%of advanced GC cases,directly affecting treatment-related decisions.Spectral-computed tomography(sCT)enables the quantification of material compositions,and sCT iodine concentration parameters have been demonstrated to be useful for the diagnosis of GC and prediction of its invasion depth,angioge-nesis,and response to systemic chemotherapy.No existing report describes the prediction of GC HER2 status through histogram analysis based on sCT iodine maps(IMs).AIM To investigate whether whole-volume histogram analysis of sCT IMs enables the prediction of the GC HER2 status.METHODS This study was performed with data from 101 patients with pathologically confirmed GC who underwent preoperative sCT examinations.Nineteen parameters were extracted via sCT IM histogram analysis:The minimum,maximum,mean,standard deviation,variance,coefficient of variation,skewness,kurtosis,entropy,percentiles(1st,5th,10th,25th,50th,75th,90th,95th,and 99th),and lesion volume.Spearman correlations of the parameters with the HER2 status and clinicopathological parameters were assessed.Receiver operating characteristic curves were used to evaluate the parameters’diagnostic performance.RESULTS Values for the histogram parameters of the maximum,mean,standard deviation,variance,entropy,and percentiles were significantly lower in the HER2+group than in the HER2–group(all P<0.05).The GC differentiation and Lauren classification correlated significantly with the HER2 status of tumor tissue(P=0.001 and 0.023,respectively).The 99th percentile had the largest area under the curve for GC HER2 status identification(0.740),with 76.2%,sensitivity,65.0%specificity,and 67.3%accuracy.All sCT IM histogram parameters correlated positively with the GC HER2 status(r=0.237-0.337,P=0.001-0.017).CONCLUSION Whole-lesion histogram parameters derived from sCT IM analysis,and especially the 99th percentile,can serve as imaging biomarkers of HER2 overexpression in GC.展开更多
BACKGROUND Primary pancreatic paraganglioma is exceedingly rare.Most patients with pancreatic paraganglioma lack a typical clinical presentation,and the tumor is difficult to accurately differentiate from other pancre...BACKGROUND Primary pancreatic paraganglioma is exceedingly rare.Most patients with pancreatic paraganglioma lack a typical clinical presentation,and the tumor is difficult to accurately differentiate from other pancreatic neuroendocrine tumors,making the misdiagnosis rate extremely high.Surgical excision is the primary treatment modality but is considered high risk.Because of its rich vascularity,the tumor easily bleeds during surgery,especially malignant paragangliomas invading large blood vessels.Thus,a thorough preoperative evaluation of the tumor is necessary.Here,we report a primary malignant pancreatic paraganglioma,the second such case in a young patient that was successfully resected surgically.CASE SUMMARY A 26-year-old female patient was admitted to the hospital with unexplained abdominal pain.Dual-layer spectral-detector computed tomography(DLCT)revealed a mixed density mass in the pancreatic body and tail.The patient was transferred to our hospital after previous failed surgical resection at other hospitals.The patient and her family strongly desired surgery.After a thorough preoperative evaluation and adequate preparation,a large mass with the greatest dimension of 8.0 cm was successfully resected.The final pathological diagnosis was malignant paraganglioma.The patient was discharged in good condition 2 wk postoperatively.CONCLUSION The rare malignant pancreatic paraganglioma reported here was difficult to diagnose preoperatively.Early filling of the draining vein may be a crucial diagnostic imaging feature.DLCT can provide more precise information for surgical resection through dual-energy imaging.展开更多
Tissue texture reflects the spatial distribution of contrasts of image voxel gray levels,i.e.,the tissue heterogeneity,and has been recognized as important biomarkers in various clinical tasks.Spectral computed tomogr...Tissue texture reflects the spatial distribution of contrasts of image voxel gray levels,i.e.,the tissue heterogeneity,and has been recognized as important biomarkers in various clinical tasks.Spectral computed tomography(CT)is believed to be able to enrich tissue texture by providing different voxel contrast images using different X-ray energies.Therefore,this paper aims to address two related issues for clinical usage of spectral CT,especially the photon counting CT(PCCT):(1)texture enhancement by spectral CT image reconstruction,and(2)spectral energy enriched tissue texture for improved lesion classification.For issue(1),we recently proposed a tissue-specific texture prior in addition to low rank prior for the individual energy-channel low-count image reconstruction problems in PCCT under the Bayesian theory.Reconstruction results showed the proposed method outperforms existing methods of total variation(TV),low-rank TV and tensor dictionary learning in terms of not only preserving texture features but also suppressing image noise.For issue(2),this paper will investigate three models to incorporate the enriched texture by PCCT in accordance with three types of inputs:one is the spectral images,another is the cooccurrence matrices(CMs)extracted from the spectral images,and the third one is the Haralick features(HF)extracted from the CMs.Studies were performed on simulated photon counting data by introducing attenuationenergy response curve to the traditional CT images from energy integration detectors.Classification results showed the spectral CT enriched texture model can improve the area under the receiver operating characteristic curve(AUC)score by 7.3%,0.42%and 3.0%for the spectral images,CMs and HFs respectively on the five-energy spectral data over the original single energy data only.The CM-and HF-inputs can achieve the best AUC of 0.934 and 0.927.This texture themed study shows the insight that incorporating clinical important prior information,e.g.,tissue texture in this paper,into the medical imaging,such as the upstream image reconstruction,the downstream diagnosis,and so on,can benefit the clinical tasks.展开更多
Objective Ureteral lesions caused by impacted ureteral stones are likely to result in postoperative ureteral stricture.On this basis,the study aimed to investigate if dual-energy spectral computed tomography can predi...Objective Ureteral lesions caused by impacted ureteral stones are likely to result in postoperative ureteral stricture.On this basis,the study aimed to investigate if dual-energy spectral computed tomography can predict ureteral hardening caused by impacted stones and to explore the relationship between different types of ureteral lesions and the risk of ureteral stricture.Methods This prospective study collected data of 93 patients with impacted stones from hospital automation system during January 2018 to October 2019.They underwent an abdominal scan on a dual-energy spectral computed tomography.During surgery,the operator used ureteroscopy to identify ureteral lesions,which were classified into four categories:edema,polyps,pallor,and hardening.Seven months later,90 patients were reviewed for the degree of hydronephrosis.Results Endoscopic observations revealed 38(41%)cases of ureteral edema,20(22%)cases of polyps,13(14%)cases of pallor,and 22(24%)cases of hardening.There were significant differences in hydronephrosis,the period of impaction,the calcium concentration of the ureter,and the slope of the spectral Hounsfield unit curve between the four groups.After that,we evaluated the factors associated with ureteral hardening and found that the calcium concentration of the ureter and hydronephrosis remained independent predictors of ureteral hardening.Receiver operating characteristic curve analysis showed that 5.3 mg/cm^(3)calcium concentration of the ureter is an optimal cut-off value to predict ureteral hardening.The result of follow-up showed that 80 patients had complete remission of hydronephrosis,with a complete remission rate of 61.9%(13/21)in the hardening group and 97.1%(67/69)in the non-hardening group(p<0.001).Conclusion Calcium concentration of the ureter is an independent predictor of ureteral hardening.Patients with ureteral hardening have more severe hydronephrosis after ureteroscopic lithotripsy.When the calcium concentration of the ureter is less than 5.3 mg/cm^(3),ureteral lesions should be actively treated.展开更多
Soft Computing denotes a set of paradigma related to cognitive modelling, which in the last years have been intensively studied, since important synergy effects among members of this set have been disclosed. Because o...Soft Computing denotes a set of paradigma related to cognitive modelling, which in the last years have been intensively studied, since important synergy effects among members of this set have been disclosed. Because of this, Soft Computing has emerged as an environment to effectively work with red world complex problems. Fuzzy Logic, Genetic Algorithms and Neural Networks are possibly the best known representatives of Soft Computing. In this paper we show how Spectral Techniques may help to further study these subjects or to improve their performance. The name Spectral Techniques comprises Methods and Applications based on Abstract Harmonic Analysis.展开更多
BACKGROUND Bronchogenic cysts(BCs)are benign congenital foregut malformations that are mostly present in the mediastinum and pulmonary parenchyma but rarely seen in the retroperitoneum.CASE SUMMARY We report the case ...BACKGROUND Bronchogenic cysts(BCs)are benign congenital foregut malformations that are mostly present in the mediastinum and pulmonary parenchyma but rarely seen in the retroperitoneum.CASE SUMMARY We report the case of 17-year-old girl who complained of epigastric pain.A cystic lesion was found in the left suprarenal region on spectral computed tomography.The ovoid,well-defined,and homogeneous cystic lesion revealed slightly enhancement on conventional imaging but no enhancement on 40 KeV virtual mono-energetic images.The iodine density value of the lesion was 0.001 mg/mL and the Z-effective value was 7.25,which were close to those of fluid material in in vitro experiments.Magnetic resonance imaging revealed a cystic mass of intermediate signal intensity on T1-weighted imaging and high signal intensity on T2-weighted imaging.A laparoscopic surgery was carried out.Intraoperatively,a cystic lesion with a smooth surface was found in the left retroperitoneum.And the cystic wall was completely resected after intracystic fluid was suctioned.The histopathological examination findings of the lesion were compatible with BC.The patient recovered uneventfully without sighs of recurrence during a 10-mo follow-up period.CONCLUSION Radiological examinations play a significant role in the diagnosis of suprarenal BCs and spectral images offer additional spectral parameters.Accurate preoperative diagnoses of retroperitoneal BCs based on thorough imaging examinations are beneficial to the operation of laparoscopic resection.展开更多
Background and Aims:Hepatocellular carcinoma(HCC)is the most common primary hepatic malignancy.This study was designed to investigate the value of computed tomography(CT)spectral imaging in differentiating HCC from he...Background and Aims:Hepatocellular carcinoma(HCC)is the most common primary hepatic malignancy.This study was designed to investigate the value of computed tomography(CT)spectral imaging in differentiating HCC from hepatic hemangioma(HH)and focal nodular hyperplasia(FNH).Methods:This was a retrospective study of 51 patients who underwent spectral multiple-phase CT at 40–140 keV during the arterial phase(AP)and portal venous phase(PP).Slopes of the spectral curves,iodine density,water density derived from iodine-and water-based material decomposition images,iodine uptake ratio(IUR),normalized iodine concentration,and the ratio of iodine concentration in liver lesions between AP and PP were measured or calculated.Results:As energy level decreased,the CT values of HCC(n=31),HH(n=17),and FNH(n=7)increased in both AP and PP.There were significant differences in IUR in the AP,IUR in the PP,normalized iodine concentration in the AP,slope in the AP,and slope in the PP among HCC,HH,and FNH.The CT values in AP,IUR in the AP and PP,normalized iodine concentration in the AP,slope in the AP and PP had high sensitivity and specificity in differentiating HH and HCC from FNH.Quantitative CT spectral data had higher sensitivity and specificity than conventional qualitative CT image analysis during the combined phases.Conclusions:Mean CT values at low energy(40–90 keV)and quantitative analysis of CT spectral data(IUR in the AP)could be helpful in the differentiation of HCC,HH,and FNH.展开更多
Radiotherapy(RT)mediated tumor immunogenicity offers an opportunity for simultaneous RT and immunotherapy via immunogenic cell death(ICD),which releases damaged-associated molecular patterns and generates“eat me”sig...Radiotherapy(RT)mediated tumor immunogenicity offers an opportunity for simultaneous RT and immunotherapy via immunogenic cell death(ICD),which releases damaged-associated molecular patterns and generates“eat me”signals for the innate immune system to modulate the immunogenicity.However,tumor hypoxia significantly reduces the therapeutic efficacy of RT and hampers its mediation of ICD induction.Herein,Au@Bi_(2)Te_(3)-polyethylene glycol(PEG)was rationally constructed as theranostic nanozymes for mild photothermal therapy,tumor hypoxia modulation,and RT adjuvant cancer immunotherapy.The tumor-specific production of oxygen could not only augment the effects of RT by enhanced reactive oxygen species(ROS)generation,but also reduce hypoxia-related cytokines and downregulate programmed cell death-ligand 1(PD-L1)to unleash immune-enhancing T cells.Moreover,Au@Bi_(2)Te_(3)-PEG could act as an immune-blocking inhibitor by efficient ICD induction with the combination of mild-photothermal therapy+RT to inhibit the tumor immune escape and improve antitumor immune response.Increased amounts of CD^(4+)and CD^(8+)Tcells and elevated levels of cytokines could be observed that eventually led to effective post-medication inhibition of primary and abscopal tumors.Spectral computed tomography/photoacoustic imaging allowed noninvasive and real-time tracking of nanoparticle(NP)accumulation and oxygenation status at tumor sites.Collectively,Au@Bi_(2)Te_(3)-PEG NPs could serve as effective theranostic nanoregulators with remarkable synergistic mildphotothermal/RT/immunotherapy effects that helped reshape the immune microenvironment and had remarkable molecular imaging properties.展开更多
基金Supported by the National Major Scientific Instruments Development Project of China under Grant No 2013YQ030595the National Natural Science Foundation of China under Grant Nos 11675014,61601442,61605218,61474123 and 61575207+2 种基金the Science and Technology Innovation Foundation of Chinese Academy of Sciences under Grant No CXJJ-16S047,the National Defense Science and Technology Innovation Foundation of Chinese Academy of Sciencesthe Program of International S&T Cooperation under Grant No 2016YFE0131500the Advance Research Project under Grant No 30102070101
文摘Spectral imaging is an important tool for a wide variety of applications. We present a technique for spectral imaging using computational imaging pattern based on compressive sensing （CS）. The spectral and spatial infor- mation is simultaneously obtained using a fiber spectrometer and the spatial light modulation without mechanical scanning. The method allows high-speed, stable, and sub sampling acquisition of spectral data from specimens. The relationship between sampling rate and image quality is discussed and two CS algorithms are compared.
文摘BACKGROUND Tumor deposits(TDs)are an independent predictor of poor prognosis in colorec-tal cancer(CRC)patients.Enhanced follow-up and treatment monitoring for TD+patients may improve survival rates and quality of life.However,the detection of TDs relies primarily on postoperative pathological examination,which may have a low detection rate due to sampling limitations.AIM To evaluate the spectral computed tomography(CT)parameters of primary tu-mors and the largest regional lymph nodes(LNs),to determine their value in predicting TDs in CRC.METHODS A retrospective analysis was conducted which included 121 patients with CRC whose complete spectral CT data were available.Patients were divided into the TDs+group and the TDs-group on the basis of their pathological results.Spectral CT parameters of the primary CRC lesion and the largest regional LNs were measured,including the normalized iodine concentration(NIC)in both the arte-rial and venous phases,and the LN-to-primary tumor ratio was calculated.Stati-stical methods were used to evaluate the diagnostic efficacy of each spectral para-meter.RESULTS Among the 121 CRC patients,33(27.2%)were confirmed to be TDs+.The risk of TDs positivity was greater in patients with positive LN metastasis,higher N stage and elevated carcinoembryonic antigen and cancer antigen 19-9 levels.The NIC(LNs in both the arterial and venous phases),NIC(primary tumors in the venous phase),and the LN-to-primary tumor ratio in both the arterial and venous phases were associated with TDs(P<0.05).In mul-tivariate logistic regression analysis,the arterial phase LN-to-primary tumor ratio was identified as an independent predictor of TDs,demonstrating the highest diagnostic performance(area under the curve:0.812,sensitivity:0.879,specificity:0.648,cutoff value:1.145).CONCLUSION The spectral CT parameters of the primary colorectal tumor and the largest regional LNs,especially the LN-to-primary tumor ratio,have significant clinical value in predicting TDs in CRC.
文摘BACKGROUND The diagnostic accuracy for detecting metastatic lymph nodes in colorectal cancer(CRC)remains suboptimal.To address this limitation,our study investigates the potential of gemstone spectral computed tomography imaging(GSI)to improve diagnostic accuracy in lymph node metastasis(LNM)assessment.AIM To extensively investigate the clinical utility of GSI in the preoperative assessment of CRC.METHODS The subject population included 200 patients with CRC who were admitted to Zibo Central Hospital from January 2022 to December 2023.All patients underwent dual-phase contrast-enhanced scans in the arterial and venous phases using GSI before surgical intervention.During the research,meticulous quantification was conducted regarding the number of patients with CRC with LNM as well as the exact count of metastatic lymph nodes.Moreover,for both metastatic and non-metastatic lymph nodes,the short diameter at the maximum crosssectional area(covering the axial,sagittal,and coronal planes),morphological features(including manifestations such as margin blurring,aggregation,and enhancement),and spectral parameters in the arterial and venous phases[specifically iodine concentration(IC),normalized IC(NIC),and the slope of the spectral curve(λHU)]were measured and recorded,and a comparative analysis was conducted.The diagnostic efficacy of each index with differences was systematically assessed using the receiver operating characteristic(ROC)curve.Concurrently,receiver operating characteristic curves were constructed for LNM screening based on the short diameter at the maximum cross-sectional area of lymph nodes and each spectral parameter in the arterial and venous phases.RESULTS The area under the curve of GSI for diagnosing LNM in patients with CRC can reach 0.897,with sensitivity,specificity,and accuracy of 92.59%,85.87%,and 89.50%,respectively.A total of 265 lymph nodes were analyzed from the 200 participants with CRC,with metastatic lymph nodes accounting for 56.60%.Compared with nonmetastatic lymph nodes,the short diameters of metastatic lymph nodes in the axial,sagittal,and coronal planes were significantly increased,whereas the IC values in the arterial and venous phases,the NIC value in the arterial phase,and theλHU values in the arterial and venous phases were significantly decreased.The short axial,sagittal,and coronal diameters,arterial-phase IC,venous-phase IC,arterial-phase NIC,arterial-phaseλHU,and venousphaseλHU for diagnosing metastatic lymph nodes demonstrated area under the curve values of 0.631,0.681,0.659,0.862,0.808,0.831,0.801,and 0.706,respectively.CONCLUSION GSI exhibits substantial clinical significance in the preoperative assessment of CRC.Among the parameters assessed,the arterial-phase IC demonstrates the most outstanding diagnostic performance,effectively improving the diagnostic efficacy for preoperative LNM in CRC.
基金Supported by Jiangsu Province 333 Talent Key Industry Field Talent Project,No.[2022]21Key Scientific Research Program of Jiangsu Provincial Health Committee,No.ZD2021059+2 种基金Nantong Key Laboratory Project,No.[2020]163The Project of Nantong City Health Committee,No.MS2023027Young Medical Talents Fund of Health and Family Planning Commission of Nantong,No.QA2019006 and No.QNZ2023027.
文摘BACKGROUND Accurate preoperative T staging is essential for determining optimal treatment strategies in colorectal cancer(CRC).Low-keV virtual monoenergetic images(VMIs)have been shown to enhance lesion conspicuity.This study aimed to assess the diagnostic value of dual-layer spectral computed tomography(CT)-derived VMIs,in combination with multiplanar reformation(MPR)and evaluation of peritumoral fat stranding(PFS),for improving the accuracy of T staging in CRC.AIM To assess the diagnostic performance of dual-layer spectral CT(DLSCT)VMIs,particularly at low energy levels,and their integration with personalized MPR for preoperative T staging of CRC.METHODS In this retrospective study,157 patients with pathologically confirmed CRC(mean age:63.5±12.1 years)underwent DLSCT within 1 week before surgery.VMIs ranging from 40 keV to 70 keV(at 10 keV intervals)and conventional polyenergetic images(PEIs)were reconstructed.Objective image quality parameters,including image noise,signal-to-noise ratio(SNR),and contrast-to-noise ratio(CNR),were quantified,alongside subjective image quality scores using a 5-point Likert scale.Interobserver agreement was evaluated usingκstatistics.Taking histopathology as the reference standard,the diagnostic accuracy of T staging(T1-2 vs T3-4)was compared across PEIs and VMIs,both with and without MPR and PFS.RESULTS Low-keV VMIs(40-70 keV)demonstrated significantly higher SNR and CNR than PEIs(all P<0.001).Notably,40-keV VMIs achieved noise levels comparable to PEIs(8.17±3.63 vs 8.53±2.90;P=0.673).Subjective image quality peaked at 40-50 keV VMIs(Likert scores 4.85-4.88 vs 3.97 for PEIs;P<0.001),supported by excellent interobserver agreement(κ=0.812-0.913).The combination of 40-50 keV VMIs with MPR yielded the highest T staging accuracy(94.27%)compared to axial PEIs(70.7%),with a sensitivity and specificity of 83.87%and 96.83%,respectively(Youden index=0.81;P<0.05).While PFS enhanced staging accuracy on PEIs(up to 77.07%with MPR),it provided no significant additional benefit for VMIs.CONCLUSION DLSCT VMIs at 40-50 keV significantly enhanced image quality and improved preoperative T staging accuracy of CRC when combined with MPR.These findings underscored the clinical value of low-keV spectral imaging in tailoring individualized treatment strategies.
基金This PhD research project titled Mapping Zinc and Magnesium to Better Evaluate Prostate Health was supported by funding from the School of Medicine at Deakin University.
文摘Background:Prostate cancer is one of the most common diagnosed cancers globally,with early detection crucial for reducing mortality and morbidity.However existing screening methods have limitations,such as invasiveness and patient discomfort.Spectral detector computed tomography(SDCT)could be an alternative or complementary test for prostate cancer diagnosis because of its material decomposition capabilities.The purpose of this experimental study was to explore the capability of SDCT to accurately measure zinc(Zn)and magnesium(Mg)levels in solutions that simulate clinically relevant concentrations of these elements.Methods:Solutions of zinc and magnesium chloride(50-1200μg/g)were prepared in 10 mL test tubes and scanned using SDCT.A region of interest was selected,and average effective atomic numbers(Z‐effective[Z‐eff])were obtained using IntelliSpace Discovery.Linear regression assessed the relationship between concentration and Z‐eff,with p<0.05.Regression lines,R2 values,and 95%prediction intervals evaluated measurement variability and precision.Results:A strong positive correlation was observed between Zn concentration and Z‐eff(R2=0.99),with the regression equation Z‐eff=7.17þ0.0010�concentration.Similarly,Mg concentration demonstrated a positive correlation with Z‐eff(R2=0.97),with the regression equation Z‐eff=7.14þ0.0002�concentration.The 95%prediction interval showed minimal variability in the data.Conclusions:SDCT effectively differentiates between Zn and Mg within clinically relevant concentration ranges,providing a foundation for further research into its clinical application for prostate cancer diagnosis.
基金Supported by the National Natural Science Foundation of China,No.81271573
文摘AIM To investigate the correlation of iodine concentration(IC) generated by spectral computed tomography(CT) with micro-vessel density(MVD) and vascular endothelial growth factor(VEGF) expression in patients with advanced gastric carcinoma(GC).METHODS Thirty-four advanced GC patients underwent abdominal enhanced CT in the gemstone spectral imaging mode. The IC of the primary lesion in the arterial phase(AP) and venous phase(VP) were measured, and were then normalized against that in the aorta to provide the normalized IC(nI C). MVD and VEGF were detected by immunohistochemical assays, using CD34 and VEGF-A antibodies, respectively. Correlations of nI C with MVD, VEGF, and clinical-pathological features were analyzed.RESULTS Both nI Cs correlated linearly with MVD and were higher in the primary lesion site than in the normal control site, but were not correlated with VEGF expression. After stratification by clinical-pathological subtypes, nI C-AP showed a statistically significant correlation with MVD, particularly in the group with tumors at stage T4, without nodular involvement, of a mixed Lauren type, where the tumor was located at the antrum site, and occurred in female individuals. nI C-VP showed a positive correlation with MVD in the group with the tumor at stage T4 and above, had nodular involvement, was poorly differentiated, was located at the pylorus site, of a mixed and diffused Lauren subtype, and occurred in male individuals. nI C-AP and nI C-VP showed significant differences in terms of histological differentiation and Lauren subtype.CONCLUSION The IC detected by spectral CT correlated with the MVD. n IC-AP and n IC-VP can reflect angiogenesis in different pathological subgroups of advanced GC.
基金Supported by Science and Technology Project of Fujian Province,No.2022Y0025.
文摘BACKGROUND Lymphovascular invasion(LVI)and perineural invasion(PNI)are important prognostic factors for gastric cancer(GC)that indicate an increased risk of metastasis and poor outcomes.Accurate preoperative prediction of LVI/PNI status could help clinicians identify high-risk patients and guide treatment deci-sions.However,prior models using conventional computed tomography(CT)images to predict LVI or PNI separately have had limited accuracy.Spectral CT provides quantitative enhancement parameters that may better capture tumor invasion.We hypothesized that a predictive model combining clinical and spectral CT parameters would accurately preoperatively predict LVI/PNI status in GC patients.AIM To develop and test a machine learning model that fuses spectral CT parameters and clinical indicators to predict LVI/PNI status accurately.METHODS This study used a retrospective dataset involving 257 GC patients(training cohort,n=172;validation cohort,n=85).First,several clinical indicators,including serum tumor markers,CT-TN stages and CT-detected extramural vein invasion(CT-EMVI),were extracted,as were quantitative spectral CT parameters from the delineated tumor regions.Next,a two-step feature selection approach using correlation-based methods and information gain ranking inside a 10-fold cross-validation loop was utilized to select informative clinical and spectral CT parameters.A logistic regression(LR)-based nomogram model was subsequently constructed to predict LVI/PNI status,and its performance was evaluated using the area under the receiver operating characteristic curve(AUC).RESULTS In both the training and validation cohorts,CT T3-4 stage,CT-N positive status,and CT-EMVI positive status are more prevalent in the LVI/PNI-positive group and these differences are statistically significant(P<0.05).LR analysis of the training group showed preoperative CT-T stage,CT-EMVI,single-energy CT values of 70 keV of venous phase(VP-70 keV),and the ratio of standardized iodine concentration of equilibrium phase(EP-NIC)were independent influencing factors.The AUCs of VP-70 keV and EP-NIC were 0.888 and 0.824,respectively,which were slightly greater than those of CT-T and CT-EMVI(AUC=0.793,0.762).The nomogram combining CT-T stage,CT-EMVI,VP-70 keV and EP-NIC yielded AUCs of 0.918(0.866-0.954)and 0.874(0.784-0.936)in the training and validation cohorts,which are significantly higher than using each of single independent factors(P<0.05).CONCLUSION The study found that using portal venous and EP spectral CT parameters allows effective preoperative detection of LVI/PNI in GC,with accuracy boosted by integrating clinical markers.
文摘This letter comments on the article that developed and tested a machine learning model that predicts lymphovascular invasion/perineural invasion status by combining clinical indications and spectral computed tomography characteristics accurately.We review the research content,methodology,conclusions,strengths and weaknesses of the study,and introduce follow-up research to this work.
基金Supported by Science and Technology Program of Fujian Province,No.2021J01430Joint Funds for the Innovation of Science and Technology of Fujian Province,No.2021Y9229.
文摘BACKGROUND Although surgery remains the primary treatment for gastric cancer(GC),the identification of effective alternative treatments for individuals for whom surgery is unsuitable holds significance.HER2 overexpression occurs in approximately 15%-20%of advanced GC cases,directly affecting treatment-related decisions.Spectral-computed tomography(sCT)enables the quantification of material compositions,and sCT iodine concentration parameters have been demonstrated to be useful for the diagnosis of GC and prediction of its invasion depth,angioge-nesis,and response to systemic chemotherapy.No existing report describes the prediction of GC HER2 status through histogram analysis based on sCT iodine maps(IMs).AIM To investigate whether whole-volume histogram analysis of sCT IMs enables the prediction of the GC HER2 status.METHODS This study was performed with data from 101 patients with pathologically confirmed GC who underwent preoperative sCT examinations.Nineteen parameters were extracted via sCT IM histogram analysis:The minimum,maximum,mean,standard deviation,variance,coefficient of variation,skewness,kurtosis,entropy,percentiles(1st,5th,10th,25th,50th,75th,90th,95th,and 99th),and lesion volume.Spearman correlations of the parameters with the HER2 status and clinicopathological parameters were assessed.Receiver operating characteristic curves were used to evaluate the parameters’diagnostic performance.RESULTS Values for the histogram parameters of the maximum,mean,standard deviation,variance,entropy,and percentiles were significantly lower in the HER2+group than in the HER2–group(all P<0.05).The GC differentiation and Lauren classification correlated significantly with the HER2 status of tumor tissue(P=0.001 and 0.023,respectively).The 99th percentile had the largest area under the curve for GC HER2 status identification(0.740),with 76.2%,sensitivity,65.0%specificity,and 67.3%accuracy.All sCT IM histogram parameters correlated positively with the GC HER2 status(r=0.237-0.337,P=0.001-0.017).CONCLUSION Whole-lesion histogram parameters derived from sCT IM analysis,and especially the 99th percentile,can serve as imaging biomarkers of HER2 overexpression in GC.
文摘BACKGROUND Primary pancreatic paraganglioma is exceedingly rare.Most patients with pancreatic paraganglioma lack a typical clinical presentation,and the tumor is difficult to accurately differentiate from other pancreatic neuroendocrine tumors,making the misdiagnosis rate extremely high.Surgical excision is the primary treatment modality but is considered high risk.Because of its rich vascularity,the tumor easily bleeds during surgery,especially malignant paragangliomas invading large blood vessels.Thus,a thorough preoperative evaluation of the tumor is necessary.Here,we report a primary malignant pancreatic paraganglioma,the second such case in a young patient that was successfully resected surgically.CASE SUMMARY A 26-year-old female patient was admitted to the hospital with unexplained abdominal pain.Dual-layer spectral-detector computed tomography(DLCT)revealed a mixed density mass in the pancreatic body and tail.The patient was transferred to our hospital after previous failed surgical resection at other hospitals.The patient and her family strongly desired surgery.After a thorough preoperative evaluation and adequate preparation,a large mass with the greatest dimension of 8.0 cm was successfully resected.The final pathological diagnosis was malignant paraganglioma.The patient was discharged in good condition 2 wk postoperatively.CONCLUSION The rare malignant pancreatic paraganglioma reported here was difficult to diagnose preoperatively.Early filling of the draining vein may be a crucial diagnostic imaging feature.DLCT can provide more precise information for surgical resection through dual-energy imaging.
基金This work was partially supported by the NIH/NCI,No.CA206171.
文摘Tissue texture reflects the spatial distribution of contrasts of image voxel gray levels,i.e.,the tissue heterogeneity,and has been recognized as important biomarkers in various clinical tasks.Spectral computed tomography(CT)is believed to be able to enrich tissue texture by providing different voxel contrast images using different X-ray energies.Therefore,this paper aims to address two related issues for clinical usage of spectral CT,especially the photon counting CT(PCCT):(1)texture enhancement by spectral CT image reconstruction,and(2)spectral energy enriched tissue texture for improved lesion classification.For issue(1),we recently proposed a tissue-specific texture prior in addition to low rank prior for the individual energy-channel low-count image reconstruction problems in PCCT under the Bayesian theory.Reconstruction results showed the proposed method outperforms existing methods of total variation(TV),low-rank TV and tensor dictionary learning in terms of not only preserving texture features but also suppressing image noise.For issue(2),this paper will investigate three models to incorporate the enriched texture by PCCT in accordance with three types of inputs:one is the spectral images,another is the cooccurrence matrices(CMs)extracted from the spectral images,and the third one is the Haralick features(HF)extracted from the CMs.Studies were performed on simulated photon counting data by introducing attenuationenergy response curve to the traditional CT images from energy integration detectors.Classification results showed the spectral CT enriched texture model can improve the area under the receiver operating characteristic curve(AUC)score by 7.3%,0.42%and 3.0%for the spectral images,CMs and HFs respectively on the five-energy spectral data over the original single energy data only.The CM-and HF-inputs can achieve the best AUC of 0.934 and 0.927.This texture themed study shows the insight that incorporating clinical important prior information,e.g.,tissue texture in this paper,into the medical imaging,such as the upstream image reconstruction,the downstream diagnosis,and so on,can benefit the clinical tasks.
文摘Objective Ureteral lesions caused by impacted ureteral stones are likely to result in postoperative ureteral stricture.On this basis,the study aimed to investigate if dual-energy spectral computed tomography can predict ureteral hardening caused by impacted stones and to explore the relationship between different types of ureteral lesions and the risk of ureteral stricture.Methods This prospective study collected data of 93 patients with impacted stones from hospital automation system during January 2018 to October 2019.They underwent an abdominal scan on a dual-energy spectral computed tomography.During surgery,the operator used ureteroscopy to identify ureteral lesions,which were classified into four categories:edema,polyps,pallor,and hardening.Seven months later,90 patients were reviewed for the degree of hydronephrosis.Results Endoscopic observations revealed 38(41%)cases of ureteral edema,20(22%)cases of polyps,13(14%)cases of pallor,and 22(24%)cases of hardening.There were significant differences in hydronephrosis,the period of impaction,the calcium concentration of the ureter,and the slope of the spectral Hounsfield unit curve between the four groups.After that,we evaluated the factors associated with ureteral hardening and found that the calcium concentration of the ureter and hydronephrosis remained independent predictors of ureteral hardening.Receiver operating characteristic curve analysis showed that 5.3 mg/cm^(3)calcium concentration of the ureter is an optimal cut-off value to predict ureteral hardening.The result of follow-up showed that 80 patients had complete remission of hydronephrosis,with a complete remission rate of 61.9%(13/21)in the hardening group and 97.1%(67/69)in the non-hardening group(p<0.001).Conclusion Calcium concentration of the ureter is an independent predictor of ureteral hardening.Patients with ureteral hardening have more severe hydronephrosis after ureteroscopic lithotripsy.When the calcium concentration of the ureter is less than 5.3 mg/cm^(3),ureteral lesions should be actively treated.
文摘Soft Computing denotes a set of paradigma related to cognitive modelling, which in the last years have been intensively studied, since important synergy effects among members of this set have been disclosed. Because of this, Soft Computing has emerged as an environment to effectively work with red world complex problems. Fuzzy Logic, Genetic Algorithms and Neural Networks are possibly the best known representatives of Soft Computing. In this paper we show how Spectral Techniques may help to further study these subjects or to improve their performance. The name Spectral Techniques comprises Methods and Applications based on Abstract Harmonic Analysis.
文摘BACKGROUND Bronchogenic cysts(BCs)are benign congenital foregut malformations that are mostly present in the mediastinum and pulmonary parenchyma but rarely seen in the retroperitoneum.CASE SUMMARY We report the case of 17-year-old girl who complained of epigastric pain.A cystic lesion was found in the left suprarenal region on spectral computed tomography.The ovoid,well-defined,and homogeneous cystic lesion revealed slightly enhancement on conventional imaging but no enhancement on 40 KeV virtual mono-energetic images.The iodine density value of the lesion was 0.001 mg/mL and the Z-effective value was 7.25,which were close to those of fluid material in in vitro experiments.Magnetic resonance imaging revealed a cystic mass of intermediate signal intensity on T1-weighted imaging and high signal intensity on T2-weighted imaging.A laparoscopic surgery was carried out.Intraoperatively,a cystic lesion with a smooth surface was found in the left retroperitoneum.And the cystic wall was completely resected after intracystic fluid was suctioned.The histopathological examination findings of the lesion were compatible with BC.The patient recovered uneventfully without sighs of recurrence during a 10-mo follow-up period.CONCLUSION Radiological examinations play a significant role in the diagnosis of suprarenal BCs and spectral images offer additional spectral parameters.Accurate preoperative diagnoses of retroperitoneal BCs based on thorough imaging examinations are beneficial to the operation of laparoscopic resection.
基金This work was supported by the National Natural Science Foundation of China(Grant number 81401406)the Innovative Research Team of High-Level Local Universities in Shanghai.
文摘Background and Aims:Hepatocellular carcinoma(HCC)is the most common primary hepatic malignancy.This study was designed to investigate the value of computed tomography(CT)spectral imaging in differentiating HCC from hepatic hemangioma(HH)and focal nodular hyperplasia(FNH).Methods:This was a retrospective study of 51 patients who underwent spectral multiple-phase CT at 40–140 keV during the arterial phase(AP)and portal venous phase(PP).Slopes of the spectral curves,iodine density,water density derived from iodine-and water-based material decomposition images,iodine uptake ratio(IUR),normalized iodine concentration,and the ratio of iodine concentration in liver lesions between AP and PP were measured or calculated.Results:As energy level decreased,the CT values of HCC(n=31),HH(n=17),and FNH(n=7)increased in both AP and PP.There were significant differences in IUR in the AP,IUR in the PP,normalized iodine concentration in the AP,slope in the AP,and slope in the PP among HCC,HH,and FNH.The CT values in AP,IUR in the AP and PP,normalized iodine concentration in the AP,slope in the AP and PP had high sensitivity and specificity in differentiating HH and HCC from FNH.Quantitative CT spectral data had higher sensitivity and specificity than conventional qualitative CT image analysis during the combined phases.Conclusions:Mean CT values at low energy(40–90 keV)and quantitative analysis of CT spectral data(IUR in the AP)could be helpful in the differentiation of HCC,HH,and FNH.
基金supported by the National Natural Science Foundation of China(Nos.81871334,81801764,82072056,and 51937010)the Guangdong Basic and Applied Basic Research Foundation(Nos.2017A050506011,2018030310343,2020B1515020008,2021A1515012542,and 2021A1515011882)+1 种基金the Medical Scientific Research Foundation of Guangdong Province(No.A2018014)the Pearl River Talented Young Scholar Program(No.2017GC010282).
文摘Radiotherapy(RT)mediated tumor immunogenicity offers an opportunity for simultaneous RT and immunotherapy via immunogenic cell death(ICD),which releases damaged-associated molecular patterns and generates“eat me”signals for the innate immune system to modulate the immunogenicity.However,tumor hypoxia significantly reduces the therapeutic efficacy of RT and hampers its mediation of ICD induction.Herein,Au@Bi_(2)Te_(3)-polyethylene glycol(PEG)was rationally constructed as theranostic nanozymes for mild photothermal therapy,tumor hypoxia modulation,and RT adjuvant cancer immunotherapy.The tumor-specific production of oxygen could not only augment the effects of RT by enhanced reactive oxygen species(ROS)generation,but also reduce hypoxia-related cytokines and downregulate programmed cell death-ligand 1(PD-L1)to unleash immune-enhancing T cells.Moreover,Au@Bi_(2)Te_(3)-PEG could act as an immune-blocking inhibitor by efficient ICD induction with the combination of mild-photothermal therapy+RT to inhibit the tumor immune escape and improve antitumor immune response.Increased amounts of CD^(4+)and CD^(8+)Tcells and elevated levels of cytokines could be observed that eventually led to effective post-medication inhibition of primary and abscopal tumors.Spectral computed tomography/photoacoustic imaging allowed noninvasive and real-time tracking of nanoparticle(NP)accumulation and oxygenation status at tumor sites.Collectively,Au@Bi_(2)Te_(3)-PEG NPs could serve as effective theranostic nanoregulators with remarkable synergistic mildphotothermal/RT/immunotherapy effects that helped reshape the immune microenvironment and had remarkable molecular imaging properties.
