Use of hepatobiliary phase images in Gd-EOB-DTPA-enhanced MRI of breast cancer hepatic metastasis to predict response to chemotherapy

Liver Metastases: Correlation between Imaging Features and Pathomolecular Environments

A wide range of imaging manifestations of liver metastases can be encountered, as various primary cancers preferably metastasize to the liver (organ-specific metastases), with the imaging characteristics largely depending on various primary tumor-specific factors such as histopathologic category, degree of tumor differentiation, histologic behavior, and intratumor alterations. Characteristic imaging features potentially can help provide a more precise diagnosis in some clinical settings. These settings include those of (a) primary cancers of hollow organs such as gastrointestinal organs, the lungs, and the bladder, owing to the appearance of metastases that cannot be applied to the liver, which is a parenchymal organ; (b) unknown primary tumors; (c) more than one primary tumor; (d) another emergent malignancy; and (e) transformation to a different histopathologic tumor subtype. The characteristic features include the target sign on T2-weighted MR images or during the hepatobiliary phase of hypovascular metastasis, the peripheral rim washout sign on delayed phase images, peritumor hyperintensity during the hepatobiliary phase, hypervascular metastasis, a cystic appearance with marked hyperintensity on T2-weighted images, marked hyperintensity on T1-weighted images, calcification, capsular retraction, absence of the vessel-penetrating sign, distribution of liver metastases, and rare intraductal forms of metastases. In addition to various factors associated with the primary cancer, desmoplastic reactions around the tumor-which can be observed in adenocarcinomas with peripheral and peritumor enhancement, distinct arterioportal shunts with metastases from pancreatic ductal carcinoma, and pseudocirrhosis-also can affect these findings. The authors review the characteristic imaging findings of liver metastases from various primary cancers, with a focus on the mechanisms that underlie organ-specific liver metastases. Online supplemental material is available for this article. ^©RSNA, 2022.

Pattern recognition of breast tumor based on image dynamic enhancement technique

At present, the diagnosis of breast tumors is affected by many factors, which leads to certain errors in the diagnosis results. Therefore, it is necessary to improve the diagnosis in combination with the actual situation. This study used the whole tumor ADC histogram to identify the heterogeneous features of benign and malignant breast lesions and used the diffusion characteristics of the whole tumor to construct a diagnostic model suitable for breast tumor image feature recognition. Simultaneously, this study combined the actual situation to construct a system framework of image enhancement algorithm based on Retinex theory, and combined image processing algorithms to improve the model. In addition, this study converted the pixel data type of the grayscale image of each color channel into a double type and converted each color channel image into a logarithmic domain. Finally, in order to study the performance of the algorithm, this study designed a comparative test for performance analysis. The research shows that the algorithm has certain clinical effects and can provide theoretical reference for subsequent related research.

Hepatobiliary contrast uptake patterns on gadoxetic acid-enhanced MRI in liver metastases from pancreatic ductal adenocarcinoma: can it predict prognosis?

OBJECTIVES

To evaluate the relationship between the patterns of hepatobiliary phase (HBP) contrast uptake in liver metastases on gadoxetic acid-enhanced MR imaging and overall survival (OS) in patients with pancreatic ductal adenocarcinoma (PDAC).

METHODS

This retrospective study was approved by our institutional review board and written informed consent was waived. A total of 57 patients (30 men and 27 women; age range, 46-92 years; mean age, 64.9 ± 9.2 years) with PDAC and liver metastasis who had undergone gadoxetic acid-enhanced MR imaging were included. The internal morphologies of the nodules were classified as heterogeneous or homogeneous on HBP images (20 min). During patient-by-patient analysis, patients with both patterns of nodules were classified as belonging to the heterogeneous group. Kaplan-Meier analysis and log-rank test were conducted for univariate analysis and Cox proportional hazards regression was conducted for multivariate analysis to evaluate prognostic factors for OS in patients with PDAC and liver metastasis.

RESULTS

A total of 199 liver metastases were analyzed, among which 138 nodules (69%) demonstrated heterogeneous hypointensity, while 61 nodules (31%) demonstrated homogeneous hypointensity. Homogeneous hypointense nodules were encountered in 18 patients (32%; homogeneous group), heterogeneous in 29 patients (51%), and both patterns co-existed in 10 patients (17%; heterogeneous group). The heterogeneous group exhibited lower OS rates than the homogeneous group (mean OS, 48.5 months vs 23.9 months; p = 0.032).

CONCLUSIONS

Hepatobiliary contrast uptake pattern in liver metastasis on HBP images can be a potential imaging biomarker to predict OS in patients with PDAC and liver metastasis.

KEY POINTS

• Majority of the liver metastases were heterogeneous (69%) after gadoxetic acid-enhanced MR imaging. • Patients with heterogeneous hypointense nodules demonstrated lower overall survival rate. • Hepatobiliary contrast uptake pattern in liver metastasis is possibly associated with patients' prognosis.

Long Non-Coding RNA (LncRNA) HOXA11-AS Promotes Breast Cancer Invasion and Metastasis by Regulating Epithelial-Mesenchymal Transition

BACKGROUND To detect the expression of lncRNA HOXA11-AS and its biological effect in breast cancer. MATERIAL AND METHODS In this study, fluorescent quantitative real-time PCR (qRT-PCR), MTT assay and clone formation assay, flow cytometry, Transwell assay and wound healing assay, immunofluorescence, and Western blot analysis were conducted to detect the expression of lncRNA HOXA11-AS, cell proliferation activity, cell apoptosis rate and cell cycle distribution, the changes of cell invasion and metastasis capacity, and the expressions of molecular markers of epithelial-mesenchymal transition (EMT), respectively. Additionally, a nude mouse metastatic tumor model was established to study the influence of lncRNA HOXA11-AS on invasion and metastasis capacity of breast cancer cells. RESULTS The qRT-PCR experiment results showed that HOXA11-AS expression in breast cancer tissue of 50 patients was relatively higher than that in tissue adjacent to cancer. MTT assay suggested that tumor cell proliferation capacity was suppressed followed by the knockdown of lncRNA HOXA11-AS expression in MDA-MB-231 and MCF-7 cells; flow cytometry results demonstrated that interfering in lncRNA HOXA11-AS could induce tumor cell apoptosis and promote cell cycle progression to be arrested in G1/G0 stage; experiments in vivo/vitro manifested that interfering in lncRNA HOXA11-AS could inhibit tumor cell invasion and migration capacity by affecting the expressions of EMT-related molecular markers (E-cadherin, N-cadherin, Vimentin). CONCLUSIONS High expression of lncRNA HOXA11-AS promotes breast cancer invasion and metastasis by affecting EMT, and interfering in lncRAN HOXA11-AS expression provides a theoretical basis and important molecular target for inhibiting the distant metastasis of breast cancer in clinical practice.