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Dong J, Zhang Y, Wu YF, Yue ZD, Fan ZH, Zhang CY, Liu FQ, Wang L. Computed tomography perfusion in differentiating portal hypertension: A correlation study with hepatic venous pressure gradient. World J Gastrointest Surg 2023; 15:664-673. [PMID: 37206083 PMCID: PMC10190718 DOI: 10.4240/wjgs.v15.i4.664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/11/2023] [Accepted: 03/23/2023] [Indexed: 04/22/2023] Open
Abstract
BACKGROUND Hepatic venous pressure gradient (HVPG) is the gold standard for diagnosis of portal hypertension (PH), invasiveness and potential risks in the process of measurement limited its widespread use.
AIM To investigate the correlation of computed tomography (CT) perfusion parameters with HVPG in PH, and quantitatively assess the blood supply changes in liver and spleen parenchyma before and after transjugular intrahepatic portosystemic shunt (TIPS).
METHODS Twenty-four PH related gastrointestinal bleeding patients were recruited in this study, and all patients were performed perfusion CT before and after TIPS surgery within 2 wk. Quantitative parameters of CT perfusion, including liver blood volume (LBV), liver blood flow (LBF), hepatic arterial fraction (HAF), spleen blood volume (SBV) and spleen blood flow (SBF), were measured and compared before and after TIPS, and the quantitative parameters between clinically significant PH (CSPH) and non-CSPH (NCSPH) group were also compared. Then the correlation of CT perfusion parameters with HVPG were analyzed, with statistical significance as P < 0.05.
RESULTS For all 24 PH patients after TIPS, CT perfusion parameters demonstrated decreased LBV, increased HAF, SBV and SBF, with no statistical difference in LBF. Compared with NCSPH, CSPH showed higher HAF, with no difference in other CT perfusion parameters. HAF before TIPS showed positive correlation with HVPG (r = 0.530, P = 0.008), while no correlation was found in other CT perfusion parameters with HVPG and Child-Pugh scores.
CONCLUSION HAF, an index of CT perfusion, was positive correlation with HVPG, and higher in CSPH than NCSPH before TIPS. While increased HAF, SBF and SBV, and decreased LBV, were found after TIPS, which accommodates a potential non-invasive imaging tool for evaluation of PH.
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Affiliation(s)
- Jian Dong
- Department of Radiology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Yu Zhang
- Department of Interventional Radiology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Yi-Fan Wu
- Department of Interventional Radiology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Zhen-Dong Yue
- Department of Interventional Radiology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Zhen-Hua Fan
- Department of Interventional Radiology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Chun-Yan Zhang
- Department of Radiology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Fu-Quan Liu
- Department of Interventional Radiology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Lei Wang
- Department of Interventional Radiology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
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Quantification of Liver Fat Content after Radiofrequency Ablation for Liver Cancer: Correlation with Hepatic Perfusion Disorders. Diagnostics (Basel) 2021; 11:diagnostics11112137. [PMID: 34829484 PMCID: PMC8625447 DOI: 10.3390/diagnostics11112137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 11/12/2021] [Accepted: 11/14/2021] [Indexed: 11/16/2022] Open
Abstract
PURPOSE To quantitatively investigate the correlation between liver fat content and hepatic perfusion disorders (HPD) after radiofrequency ablation (RFA) for liver cancer using magnetic resonance imaging (MRI)-determined proton density fat fraction (PDFF). MATERIALS AND METHODS A total of 150 liver cancer patients underwent liver MRI examination within one month after RFA and at four months after RFA. According to the liver fat content, they were divided into non-, mild, moderate, and severe fatty liver groups. The liver fat content and hepatic perfusion disorders were determined using PDFF images and dynamic contrast-enhanced MRI images. The relationship between the liver fat content and HPD was investigated. RESULTS At the first postoperative MRI examination, the proportion of patients in the nonfatty liver group with hyperperfused foci (11.11%) was significantly lower than that in the mild (30.00%), moderate (42.86%), and severe fatty liver (56.67%) groups (p < 0.05), whereas the proportions of patients with hypoperfused foci (6.67%, 7.5%, 5.71%, and 6.67%, respectively) were not significantly different among the four groups (p > 0.05). In the nonfatty liver group, the liver fat content was not correlated with hyperperfusion abnormalities or hypoperfusion abnormalities. By contrast, in the three fatty liver groups, the liver fat content was correlated with hyperperfusion abnormalities but was not correlated with hypoperfusion abnormalities. At the second postoperative MRI examination, six patients in the nonfatty liver group were diagnosed with fatty liver, including two patients with newly developed hyperperfusion abnormalities and one patient whose hypoperfusion abnormality remained the same as it was in the first postoperative MRI examination. CONCLUSION There was a high correlation between the liver fat content and hyperperfusion abnormalities after RFA for liver cancer. The higher the liver fat content was, the higher the was risk of hyperperfusion abnormalities. However, there was little correlation between liver fat content and hypoperfusion abnormalities, and the increase in postoperative liver fat content did not induce or alter the presence of hypoperfused foci.
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Tang Y, Zhang T, Zhou X, Zhao Y, Xu H, Liu Y, Wang H, Chen Z, Ma X. The preoperative prognostic value of the radiomics nomogram based on CT combined with machine learning in patients with intrahepatic cholangiocarcinoma. World J Surg Oncol 2021; 19:45. [PMID: 34334138 PMCID: PMC8327418 DOI: 10.1186/s12957-021-02162-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 02/02/2021] [Indexed: 02/08/2023] Open
Abstract
Background Intrahepatic cholangiocarcinoma is an aggressive liver carcinoma with increasing incidence and mortality. A good auxiliary prognostic prediction tool is desperately needed for the development of treatment strategies. The purpose of this study was to explore the prognostic value of the radiomics nomogram based on enhanced CT in intrahepatic cholangiocarcinoma. Methods In this retrospective study, 101 patients with pathological confirmation of intrahepatic cholangiocarcinoma were recruited. A radiomics nomogram was developed by radiomics score and independent clinical risk factors selecting from multivariate Cox regression. All patients were stratified as high risk and low risk by a nomogram. Model performance and clinical usefulness were assessed by calibration curve, ROC curve, and survival curve. Results A total of 101patients (mean age, 58.2 years old; range 36–79 years old) were included in the study. The 1-year, 3-year, and 5-year overall survival rates were 49.5%, 26.6%, and 14.4%, respectively, with a median survival time of 12.2 months in the whole set. The least absolute shrinkage and selection operator (LASSO) method selected 3 features. Multivariate Cox analysis found three independent prognostic factors. The radiomics nomogram showed a significant prognosis value with overall survival. There was a significant difference in the 1-year and 3-year survival rates of stratified high-risk and low-risk patients in the whole set (30.4% vs. 56.4% and 13.0% vs. 30.6%, respectively, p = 0.018). Conclusions This radiomics nomogram has potential application value in the preoperative prognostic prediction of intrahepatic cholangiocarcinoma and may facilitate in clinical decision-making. Supplementary Information The online version contains supplementary material available at 10.1186/s12957-021-02162-0.
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Affiliation(s)
- Youyin Tang
- Department of Liver Surgery, Liver Transplantation Center, West China Hospital of Sichuan University, No. 37 GuoXue Alley, Chengdu, 610041, People's Republic of China
| | - Tao Zhang
- West China School of Medicine, West China Hospital, Sichuan University, No. 37 GuoXue Alley, Chengdu, 610041, People's Republic of China
| | - Xianghong Zhou
- Department of Biotherapy, West China Hospital, Sichuan University, No. 37 GuoXue Alley, Chengdu, 610041, People's Republic of China
| | - Yunuo Zhao
- West China School of Medicine, West China Hospital, Sichuan University, No. 37 GuoXue Alley, Chengdu, 610041, People's Republic of China
| | - Hanyue Xu
- West China School of Medicine, West China Hospital, Sichuan University, No. 37 GuoXue Alley, Chengdu, 610041, People's Republic of China
| | - Yichun Liu
- West China School of Public Health, NO.4 West China Teaching Hospital, Sichuan University, No. 18, three section of people south road, Chengdu, 610041, People's Republic of China
| | - Hang Wang
- West China School of Medicine, West China Hospital, Sichuan University, No.14, 3Rd Section Of Ren Min Nan Rd., Chengdu, Sichuan, 610041, People's Republic of China
| | - Zheyu Chen
- Department of Liver Surgery, Division of Liver Transplantation Center, West China Hospital, Sichuan University, No. 37 GuoXue Alley, Chengdu, 610041, People's Republic of China.
| | - Xuelei Ma
- Department of Biotherapy, West China Hospital and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, No. 37 GuoXue Alley, Chengdu, 610041, People's Republic of China.
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Zhang T, Zhang Y, Liu X, Xu H, Chen C, Zhou X, Liu Y, Ma X. Application of Radiomics Analysis Based on CT Combined With Machine Learning in Diagnostic of Pancreatic Neuroendocrine Tumors Patient's Pathological Grades. Front Oncol 2021; 10:521831. [PMID: 33643890 PMCID: PMC7905094 DOI: 10.3389/fonc.2020.521831] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 12/11/2020] [Indexed: 02/05/2023] Open
Abstract
Purpose To evaluate the value of multiple machine learning methods in classifying pathological grades (G1,G2, and G3), and to provide the best machine learning method for the identification of pathological grades of pancreatic neuroendocrine tumors (PNETs) based on radiomics. Materials and Methods A retrospective study was conducted on 82 patients with Pancreatic Neuroendocrine tumors. All patients had definite pathological diagnosis and grading results. Using Lifex software to extract the radiomics features from CT images manually. The sensitivity, specificity, area under the curve (AUC) and accuracy were used to evaluate the performance of the classification model. Result Our analysis shows that the CT based radiomics features combined with multi algorithm machine learning method has a strong ability to identify the pathological grades of pancreatic neuroendocrine tumors. DC + AdaBoost, DC + GBDT, and Xgboost+RF were very valuable for the differential diagnosis of three pathological grades of PNET. They showed a strong ability to identify the pathological grade of pancreatic neuroendocrine tumors. The validation set AUC of DC + AdaBoost is 0.82 (G1 vs G2), 0.70 (G2 vs G3), and 0.85 (G1 vs G3), respectively. Conclusion In conclusion, based on enhanced CT radiomics features could differentiate between different pathological grades of pancreatic neuroendocrine tumors. Feature selection method Distance Correlation + classifier method Adaptive Boosting show a good application prospect.
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Affiliation(s)
- Tao Zhang
- Department of Biotherapy, Cancer Center, West China Hospital, Sichuan University, Chengdu, China.,State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - YueHua Zhang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Xinglong Liu
- West China School of Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Hanyue Xu
- West China School of Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Chaoyue Chen
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China
| | - Xuan Zhou
- West China School of Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Yichun Liu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Xuelei Ma
- Department of Biotherapy, Cancer Center, West China Hospital, Sichuan University, Chengdu, China.,State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
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Tang Y, Zhang T, Zhao Y, Chen Z, Ma X. Development and validation of a comprehensive radiomics nomogram for prognostic prediction of primary hepatic sarcomatoid carcinoma after surgical resection. Int J Med Sci 2021; 18:1711-1720. [PMID: 33746587 PMCID: PMC7976557 DOI: 10.7150/ijms.53602] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 01/06/2021] [Indexed: 02/05/2023] Open
Abstract
Objective: This study aimed to establish and validate a radiomics nomogram comprised of clinical factors and radiomics signatures to predict prognosis of primary hepatic sarcomatoid carcinoma (PHSC) patients after surgical resection. Methods: In this retrospective study, 79 patients with pathological confirmation of PHSC and underwent surgical resection were recruited. A radiomics nomogram was developed by radiomics signatures and independent clinical risk factors selecting from multivariate Cox regression. All patients were stratified as high risk and low risk by nomogram. Model performance and clinical usefulness were assessed by C-index, calibration curve, decision curve analysis (DCA) and survival curve. Results: A total of 79 PHSC were included with 1-year and 3-year overall survival rates of 63.3% and 35.4%, respectively. The least absolute shrinkage and selection operator (LASSO) method selected 3 features. Multivariate Cox analysis found six independent prognostic factors. The radiomics nomogram showed a significant prediction value with overall survival (HR: 7.111, 95%CI: 3.933-12.858, P<0.001). C-index of nomogram was 0.855 and 0.829 in training and validation set, respectively. Decision curve analysis validated the clinical utility of this nomogram. There was a significant difference in the 1-year and 3-year survival rates of stratified high-risk and low-risk patients in the whole cohort (30.6% vs. 90.1% and 5.6% vs. 62.4%, respectively, P < 0.001). Conclusion: This radiomics nomogram serve as a potential tool for predicting prognosis of PHSC after surgical resection, and help to identify high risk patients who may obtain feeble survival benefit from surgical resection.
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Affiliation(s)
- Youyin Tang
- Department of Liver Surgery, Liver Transplantation Center, West China Hospital of Sichuan University, No. 37 GuoXue Alley, Chengdu 610041, China
| | - Tao Zhang
- West China School of Medicine, West China Hospital, Sichuan University, No. 37 GuoXue Alley, Chengdu 610041, China
| | - Yunuo Zhao
- Department of Biotherapy, West China Hospital and State Key Laboratory of Biotherapy, Sichuan University, No. 37 GuoXue Alley, Chengdu 610041, China
| | - Zheyu Chen
- Department of Liver Surgery, Liver Transplantation Center, West China Hospital of Sichuan University, No. 37 GuoXue Alley, Chengdu 610041, China
| | - Xuelei Ma
- Department of Biotherapy, West China Hospital and State Key Laboratory of Biotherapy, Sichuan University, No. 37 GuoXue Alley, Chengdu 610041, China
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Yang B, Si G, He Q, Liu S, Wang S, Xian R, Zhang J, Yu F, Guan J. Multislice Computed Tomographic Manifestation of Transient Hepatic Attenuation Difference in the Left Lobe of the Liver: A Retrospective Study. Adv Ther 2020; 37:3954-3966. [PMID: 32715380 DOI: 10.1007/s12325-020-01428-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Transient hepatic attenuation differences (THAD) are areas of high parenchymal enhancement observed during the hepatic arterial phase on computed tomography (CT). THAD in the left lobe of the liver can lead to surgical complications. METHODS A retrospective study was conducted on patients who underwent multislice computed tomography (MSCT) examination of the upper abdomen to understand the morphology, distribution, and causes of THAD and their correlation with hepatic artery variation. RESULTS Among 179 cases, 65 and 114 belonged to diseased and normal groups, respectively. THAD as observed in MSCT demonstrated various shapes: lobe/segment (127 cases; 70.9%), irregular sheet (31; 17.3%), strip shape (9; 5.02%), arc/semicircle (7; 3.9%), and segment + flaky (5; 2.79%). THAD were found to be caused by liver tumor (32.3%), hepatic inflammatory lesions (6.15%), biliary tract diseases (13.8%), perihepatic disease compression (9.23%), portal vein obstructive disease (1.53%), and lesion in left hepatic lobe with hepatic artery variation (29.2%). THAD exhibited variation in distribution in the left lobe of the liver. Among 114 cases, THAD in 18 (15.7%) cases were observed in the S2 segment, six (5.26%) in the S3 segment, and 90 (78.9%) in multiple segments of the liver, that is, 50 cases in S2 and S3 segments and 40 cases in S2, S3, and S4 segments. The hepatic artery of 179 cases was of various types based on Hiatt classification: 57 cases of Hiatt I (31%), 65 cases of Hiatt II (37%), 11 cases of Hiatt III (6%), 17 cases of Hiatt IV (10%), 7 cases of Hiatt V (4%), 12 cases of large left hepatic artery (7%), 6 cases of right hepatic artery originating from the celiac trunk (3%), and 4 cases (2%) of superior mesenteric artery originating from the celiac trunk. CONCLUSION THAD can occur as a result of specific pathological causes and hence should be considered as a diagnostic sign in liver pathologies.
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Affiliation(s)
- Bin Yang
- Department of Radiology, Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Lu Zhou, 646000, Sichuan, People's Republic of China
| | - Guangyan Si
- Department of Radiology, Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Lu Zhou, 646000, Sichuan, People's Republic of China.
| | - Qizhou He
- Department of Radiology, Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Lu Zhou, 646000, Sichuan, People's Republic of China
| | - Shulan Liu
- Department of Radiology, Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Lu Zhou, 646000, Sichuan, People's Republic of China
| | - Sikai Wang
- Department of Radiology, Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Lu Zhou, 646000, Sichuan, People's Republic of China
| | - Rong Xian
- Department of Radiology, Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Lu Zhou, 646000, Sichuan, People's Republic of China
| | - Jie Zhang
- Department of Radiology, Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Lu Zhou, 646000, Sichuan, People's Republic of China
| | - Fei Yu
- Department of Radiology, Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Lu Zhou, 646000, Sichuan, People's Republic of China
| | - Jian Guan
- Department of Radiology, The First Affiliated Hospital of Zhongshan University, Guang Zhou, 510080, Guangdong, People's Republic of China
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Predicting Clinical Efficacy of Vascular Disrupting Agents in Rodent Models of Primary and Secondary Liver Cancers: An Overview with Imaging-Histopathology Correlation. Diagnostics (Basel) 2020; 10:diagnostics10020078. [PMID: 32024029 PMCID: PMC7168934 DOI: 10.3390/diagnostics10020078] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 01/24/2020] [Accepted: 01/28/2020] [Indexed: 12/16/2022] Open
Abstract
Vascular disrupting agents (VDAs) have entered clinical trials for over 15 years. As the leading VDA, combretastatin A4 phosphate (CA4P) has been evaluated in combination with chemotherapy and molecular targeting agents among patients with ovarian cancer, lung cancer and thyroid cancer, but still remains rarely explored in human liver cancers. To overcome tumor residues and regrowth after CA4P monotherapy, a novel dual targeting pan-anticancer theragnostic strategy, i.e., OncoCiDia, has been developed and shown promise previously in secondary liver tumor models. Animal model of primary liver cancer is time consuming to induce, but of value for more closely mimicking human liver cancers in terms of tumor angiogenesis, histopathological heterogeneity, cellular differentiation, tumor components, cancer progression and therapeutic response. Being increasingly adopted in VDA researches, multiparametric magnetic resonance imaging (MRI) provides imaging biomarkers to reflect in vivo tumor responses to drugs. In this article as a chapter of a doctoral thesis, we overview the construction and clinical relevance of primary and secondary liver cancer models in rodents. Target selection for CA4P therapy assisted by enhanced MRI using hepatobiliary contrast agents (CAs), and therapeutic efficacy evaluated by using MRI with a non-specific contrast agent, dynamic contrast enhanced (DCE) imaging, diffusion weighted imaging (DWI) are also described. We then summarize diverse responses among primary hepatocellular carcinomas (HCCs), secondary liver and pancreatic tumors to CA4P, which appeared to be related to tumor size, vascularity, and cellular differentiation. In general, imaging-histopathology correlation studies allow to conclude that CA4P tends to be more effective in secondary liver tumors and in more differentiated HCCs, but less effective in less differentiated HCCs and implanted pancreatic tumor. Notably, cirrhotic liver may be responsive to CA4P as well. All these could be instructive for future clinical trials of VDAs.
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Chen XP, Liu J, Zhou J, Zhou PC, Shu J, Xu LL, Li B, Su S. Combination of CEUS and MRI for the diagnosis of periampullary space-occupying lesions: a retrospective analysis. BMC Med Imaging 2019; 19:77. [PMID: 31477041 PMCID: PMC6719361 DOI: 10.1186/s12880-019-0376-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 08/23/2019] [Indexed: 12/18/2022] Open
Abstract
Background The value of magnetic resonance imaging (MRI), contrast-enhanced ultrasound (CEUS), and the combination of CEUS and MRI (CCWM) for the diagnosis of periampullary space-occupying lesions (PSOL) was investigated. Methods A total of 102 patients diagnosed with PSOLs by surgery or biopsy were recruited retrospectively. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of MRI, CEUS, and CCWM were analyzed. Results MRI, CEUS, and CCWM allowed for the accurate detection of 91.17, 92.15, and 99.01% of PSOLs, respectively. The specificity, PPV, and accuracy of CCWM were significantly different from MRI and CEUS (p < 0.05). However, there the sensitivity and NPV were not significantly different among the three diagnostic technologies. In addition, the specificity, PPV, and accuracy were not significantly different between MRI and CEUS (all p > 0.05). Conclusions CCWM is valuable for differentiating benign and malignant PSOL, which provides important guiding significances for the clinic.
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Affiliation(s)
- Xin-Pei Chen
- Department of Hepatobiliary Surgery, The Affiliated Hospital of Southwest Medical University, No. 25 Taiping Street, Jiangyang District, Luzhou, 646000, Sichuan Province, China
| | - Jiang Liu
- Department of Nephrology, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan Province, China
| | - Jing Zhou
- Department of Ultrasonics, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan Province, China
| | - Peng-Cheng Zhou
- Department of Hepatobiliary Surgery, The Affiliated Hospital of Southwest Medical University, No. 25 Taiping Street, Jiangyang District, Luzhou, 646000, Sichuan Province, China
| | - Jian Shu
- Department of Radiology, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan Province, China
| | - Lu-Lu Xu
- Department of Radiology, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan Province, China
| | - Bo Li
- Department of Hepatobiliary Surgery, The Affiliated Hospital of Southwest Medical University, No. 25 Taiping Street, Jiangyang District, Luzhou, 646000, Sichuan Province, China
| | - Song Su
- Department of Hepatobiliary Surgery, The Affiliated Hospital of Southwest Medical University, No. 25 Taiping Street, Jiangyang District, Luzhou, 646000, Sichuan Province, China.
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Zhu W, Mai G, Zhou X, Song B. Double contrast-enhanced ultrasound improves the detection and localization of occult lesions in the pancreatic tail: a initial experience report. Abdom Radiol (NY) 2019; 44:559-567. [PMID: 30121778 DOI: 10.1007/s00261-018-1746-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
PURPOSE The aim of this study is to review our initial experience of Double contrast-enhanced ultrasonography (DCEUS) in the preoperative detection of pancreatic tail occult tumors. METHODS Thirty-five patients were recruited to undergo DCEUS of the pancreas suspected by occult lesions of pancreatic with MRI or clinical evidence. The radiologists assessed the images (conventional US, DCEUS, and MRI) for enhancement phases, tumor presence, location, enhancement characteristics, and tumor conspicuity. The differences in the onset times of the phases between DCEUS and MRI were noted. Tumor conspicuity was graded on a four-point scale for conspicuity comparison among three imaging modalities. RESULTS Pancreatic tail tumors were missed on conventional transabdominal US in 11 of 35 patients. DCEUS revealed 12 lesions of 35 patients. Pancreatic tail tumors were identified on MRI in 10 of 35 patients. The sensitivity and specificity of DCEUS for depicting occult lesions of ≤ 2.2 cm were 92% and 95%, respectively. In contrast, the sensitivity and specificity of conventional US were 67% and 66%, respectively. The sensitivity and specificity of MRI were 91% and 88%, respectively. The conspicuity ratings of the three phases did not significantly differ between the DCEUS and MRI groups (P > 0.05). The DCEUS phases started much earlier than the corresponding MRI phases. CONCLUSION DCEUS is a promising technique in the detection of occult pancreatic tail tumors and is possibly superior to dynamic enhanced MRI in the case of some peripheral lesions.
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Affiliation(s)
- Wei Zhu
- Echo Lab of Cardiology, Department/Department of Ultrasound, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Gang Mai
- Department of Hepatobiliopancreatic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xiang Zhou
- Department of Interventional Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.
| | - Bin Song
- Radiology Department, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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Chen J, Si Y, Zhao K, Shi X, Bi W, Liu SE, Hua H. Evaluation of quantitative parameters of dynamic contrast-enhanced magnetic resonance imaging in qualitative diagnosis of hepatic masses. BMC Med Imaging 2018; 18:56. [PMID: 30587152 PMCID: PMC6307244 DOI: 10.1186/s12880-018-0299-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Accepted: 12/13/2018] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND To explore the value of parameters of multiphase dynamic contrast-enhanced magnetic resonance imaging (MDCE-MRI) in the qualitative diagnosis of hepatic masses. METHODS Eighty patients with hepatic masses were retrospectively analyzed. All the patients underwent MDCE-MRI at 3.0 T MR before treatment. Mean enhancement time (MET), positive enhancement integral (PEI), a maximum slope of increase (MSI), and a maximum slope of decrease (MSD) were measured. RESULTS There were significant differences between benign and malignant hepatic masses with respect to MET, PEI, and MSI values. The PEI and MSI values between hemangiomas, hepatocellular carcinomas (HCCs), cholangiocarcinomas, and metastatic tumors had significant differences. The MSD value between metastatic tumors, HCCs, and hemangiomas were significantly different. The area under the curve (AUC) values of the receiver operator characteristic curves for MET, PEI, and MSI were 0.70, 0.72, and 0.80, respectively. The specificity of MET, PEI, and MSI were all 77%, and the sensitivities of MSI was the highest, of which was 82.40%. Logistic regression analysis showed the regression equation to be P = 1/[1 + e0.008 × 1 + 0.007 × 2-6.707], and taking the Youden index maximum points as a diagnostic point was 0.2946. CONCLUSION Some parameters of MDCE-MRI have significant roles in differentiating hepatic masses.
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Affiliation(s)
- Jingjing Chen
- Department of Radiology, The Affiliated Hospital of Qingdao University, Qingdao, 266000, Shandong Province, China
| | - Youjiao Si
- Department of Radiology, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, 264100, Shandong Province, China
| | - Kaikai Zhao
- Department of Oncology, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, 264100, Shandong Province, China
| | - Xianglong Shi
- Department of Radiology, The Affiliated Hospital of Qingdao University, Qingdao, 266000, Shandong Province, China
| | - Weiqun Bi
- Department of Radiology, The Affiliated Hospital of Qingdao University, Qingdao, 266000, Shandong Province, China
| | - Shi-En Liu
- Department of Radiology, The Affiliated Hospital of Qingdao University, Qingdao, 266000, Shandong Province, China
| | - Hui Hua
- Department of Thyroid Surgery, The Affiliated Hospital of Qingdao University, No. 16 Jiangsu Road, Qingdao, 266000, Shandong Province, China.
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Cao QY, Zou ZM, Wang Q, He CN, Zou Q, Wang B. MRI manifestations of hepatic perfusion disorders. Exp Ther Med 2018; 15:5199-5204. [PMID: 29805544 PMCID: PMC5958701 DOI: 10.3892/etm.2018.6090] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Accepted: 01/06/2017] [Indexed: 12/25/2022] Open
Abstract
The present study aimed to analyze the magnetic resonance imaging (MRI) results from patients with hepatic perfusion disorders (HPD) and liver diseases, in order to assess the pathogenetic mechanisms. This was completed byanalyzing the causes of HPD in 35 patients to assess if they were associated with arterioportal shunt, and classify the patients according to results from the MRI scans. Of the 35 patients, 26 (74.3%) with HPD presented with hepatocellular carcinoma, a major cause of HPD. The HPD phenomenon in 35 patients was not identified as obvious abnormal lesions on T2WI and T1WI according to the isointensity on diffusion weighted images. Enhanced scanning showed hyperintense signals on the arterial phase images, isointense or hyperintense signals on portal phase and delayed phase images. According to their MRI findings, hepatic perfusion disorders may be divided into different types, as follows: Diffuse, lobe or segment type, wedge type and platy. The HPD phenomenon may herald an underlying abnormality of liver disease and MRI may accurately diagnose HPDs in liver diseases.
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Affiliation(s)
- Qing-Yong Cao
- Department of Radiology, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, Shandong 264100, P.R. China
| | - Zhi-Meng Zou
- Department of Radiology, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, Shandong 264100, P.R. China
| | - Qi Wang
- Department of Radiology, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, Shandong 264100, P.R. China
| | - Chun-Ni He
- Department of Radiology, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, Shandong 264100, P.R. China
| | - Qing Zou
- Department of Radiology, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, Shandong 264100, P.R. China
| | - Bin Wang
- Department of Radiology, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, Shandong 264100, P.R. China.,Medical Imaging Center, Binzhou Medical University, Yantai, Shandong 264100, P.R. China
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Feng Y, Qin XC, Luo Y, Li YZ, Zhou X. Efficacy of contrast-enhanced ultrasound washout rate in predicting hepatocellular carcinoma differentiation. ULTRASOUND IN MEDICINE & BIOLOGY 2015; 41:1553-1560. [PMID: 25747937 DOI: 10.1016/j.ultrasmedbio.2015.01.026] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Revised: 01/18/2015] [Accepted: 01/26/2015] [Indexed: 06/04/2023]
Abstract
The aim of this retrospective study was to evaluate the efficacy of contrast-enhanced ultrasound (CEUS) washout rate in predicting hepatocellular carcinoma (HCC) differentiation. Two hundred seventy-one patients underwent liver resection for HCC between April 2008 and December 2012 after being examined by CEUS using the contrast agent SonoVue with a low mechanical index (<0.1) in a routine procedure. Contrast agent washout rates obtained from video images were divided into four categories from slow to fast: WR1 = no washout in all phases (slowest); WR2 = washout after 120 s from contrast injection (late-phase washout); WR3 = washout between 41 and 120 s from contrast injection (portal venous washout); WR4 = washout before 40 s from contrast injection (fastest washout rate). HCC nodules were graded as well, moderately and poorly differentiated. Spearman rank correlation and χ(2)-tests were used to assess group relationships and differences. Receiver operating characteristic curve analysis was used to determine the diagnostic predictive value of CEUS. Among the 271 patients, 18 (6.6%) had well differentiated, 150 (55.4%) had moderately differentiated and 103 (38.0%) had poorly differentiated HCC. Statistical tests indicated that washout rate was significantly correlated with tumor differentiation (p < 0.05), and the poorly differentiated HCCs had earlier washout. At the cutoff point of WR4, CEUS based on washout rate performed poorly in distinguishing poorly differentiated from moderately and well-differentiated HCCs, with a sensitivity, specificity and accuracy (area under the curve) of 24%, 97% and 0.68, respectively. However, at the cutoff point of WR2, the sensitivity, specificity and accuracy of CEUS in differentiating well-differentiated HCC from other HCCs were significantly better: 98%, 78% and 0.96, respectively. Thus, CEUS washout rate may have a role in identifying patients with well-differentiated HCC.
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Affiliation(s)
- Yan Feng
- Ultrasound Department, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China; Medical Imaging Pharmaceutical Lab, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Xia-Chuan Qin
- Ultrasound Department, Nanchong Central Hospital, Nanchong, Sichuan Province, China
| | - Yan Luo
- Ultrasound Department, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Yong-Zhong Li
- Ultrasound Department, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Xiang Zhou
- Ultrasound Department, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China; Medical Imaging Pharmaceutical Lab, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
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Catalano O. Transient hepatic echogenicity differences at contrast-enhanced US. Radiology 2011; 261:1002; author reply 1002-3. [PMID: 22096005 DOI: 10.1148/radiol.11111388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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