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Tian C, Zhang L. G2NPAN: GAN-guided nuance perceptual attention network for multimodal medical fusion image quality assessment. Front Neurosci 2024; 18:1415679. [PMID: 38803686 PMCID: PMC11128576 DOI: 10.3389/fnins.2024.1415679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Accepted: 04/29/2024] [Indexed: 05/29/2024] Open
Abstract
Multimodal medical fusion images (MMFI) are formed by fusing medical images of two or more modalities with the aim of displaying as much valuable information as possible in a single image. However, due to the different strategies of various fusion algorithms, the quality of the generated fused images is uneven. Thus, an effective blind image quality assessment (BIQA) method is urgently required. The challenge of MMFI quality assessment is to enable the network to perceive the nuances between fused images of different qualities, and the key point for the success of BIQA is the availability of valid reference information. To this end, this work proposes a generative adversarial network (GAN) -guided nuance perceptual attention network (G2NPAN) to implement BIQA for MMFI. Specifically, we achieve the blind evaluation style via the design of a GAN and develop a Unique Feature Warehouse module to learn the effective features of fused images from the pixel level. The redesigned loss function guides the network to perceive the image quality. In the end, the class activation mapping supervised quality assessment network is employed to obtain the MMFI quality score. Extensive experiments and validation have been conducted in a database of medical fusion images, and the proposed method is superior to the state-of-the-art BIQA method.
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Affiliation(s)
| | - Lei Zhang
- School of Information Engineering (School of Big Data), Xuzhou University of Technology, Xuzhou, China
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2
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Tang L, Hui Y, Yang H, Zhao Y, Tian C. Medical image fusion quality assessment based on conditional generative adversarial network. Front Neurosci 2022; 16:986153. [PMID: 36033610 PMCID: PMC9400712 DOI: 10.3389/fnins.2022.986153] [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: 07/04/2022] [Accepted: 07/13/2022] [Indexed: 11/23/2022] Open
Abstract
Multimodal medical image fusion (MMIF) has been proven to effectively improve the efficiency of disease diagnosis and treatment. However, few works have explored dedicated evaluation methods for MMIF. This paper proposes a novel quality assessment method for MMIF based on the conditional generative adversarial networks. First, with the mean opinion scores (MOS) as the guiding condition, the feature information of the two source images is extracted separately through the dual channel encoder-decoder. The features of different levels in the encoder-decoder are hierarchically input into the self-attention feature block, which is a fusion strategy for self-identifying favorable features. Then, the discriminator is used to improve the fusion objective of the generator. Finally, we calculate the structural similarity index between the fake image and the true image, and the MOS corresponding to the maximum result will be used as the final assessment result of the fused image quality. Based on the established MMIF database, the proposed method achieves the state-of-the-art performance among the comparison methods, with excellent agreement with subjective evaluations, indicating that the method is effective in the quality assessment of medical fusion images.
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Affiliation(s)
- Lu Tang
- School of Medical Imaging, Xuzhou Medical University, Xuzhou, China
| | - Yu Hui
- School of Medical Imaging, Xuzhou Medical University, Xuzhou, China
| | - Hang Yang
- School of Medical Imaging, Xuzhou Medical University, Xuzhou, China
| | - Yinghong Zhao
- School of Medical Imaging, Xuzhou Medical University, Xuzhou, China
| | - Chuangeng Tian
- School of Information and Electrical Engineering, Xuzhou University of Technology, Xuzhou, China
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3
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Tian Y, Tang C, Shi G, Wang G, Du Y, Tian J, Zhang H. Novel fluorescent GLUT1 inhibitor for precision detection and fluorescence image-guided surgery in oral squamous cell carcinoma. Int J Cancer 2022; 151:450-462. [PMID: 35478458 DOI: 10.1002/ijc.34049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 03/31/2022] [Accepted: 04/19/2022] [Indexed: 11/10/2022]
Abstract
Early detection and complete resection of oral squamous cell carcinoma (OSCC) are crucial to improving patient survival and prognosis. However, specifically targeted imaging probes for OSCC detection are limited. This study aimed to synthesize a novel near-infrared fluorescence (NIRF) probe for precision detection and fluorescence image-guided surgery in OSCC. Bioinformatics data indicated that glucose transporter 1 (GLUT1) is highly expressed in patients with OSCC. We demonstrated high and specific GLUT1 expression upon immunohistochemical staining of samples from 20 patients with OSCC. The specific expression of GLUT1 was further validated in both human OSCC cell lines and OSCC tumor xenografts. Based on these findings, the GLUT1 inhibitor WZB117 was utilized to synthesize a novel NIRF imaging probe, WZB117-IR820. The fluorescence molecular imaging data revealed that WZB117-IR820 could specifically bind to the tumor areas in an orthotopic OSCC mouse model after intravenous injection and could be further applied for precision fluorescence image-guided surgery with no residual tumor in the orthotopic CAL27-fLUC mouse tumor model. For further clinical translational application in patients with OSCC, precise delineation of OSCC tumor areas was achieved following topical application of the WZB117-IR820 imaging probe and was validated by histopathological and immunohistochemical analyses. In conclusion, we synthesized a novel fluorescent imaging probe, WZB117-IR820, which has potential clinical applications for early detection and fluorescence image-guided surgery in OSCC with no observable toxicity. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Yu Tian
- Medical School of Chinese PLA, Beijing, China.,Department of Stomatology, The First Medical Centre, Chinese PLA General Hospital, Beijing, China.,CAS Key Laboratory of Molecular Imaging, The State Key Laboratory of Management and Control for Complex Systems, Institute of Automation, Chinese Academy of Sciences, Beijing, China
| | - Chu Tang
- Engineering Research Center of Molecular and Neuro Imaging, Ministry of Education, School of Life Science and Technology, Xidian University, Shanxi, China
| | - Guangyuan Shi
- University of Science and Technology of China, Anhui, China
| | - Guorong Wang
- Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Yang Du
- CAS Key Laboratory of Molecular Imaging, The State Key Laboratory of Management and Control for Complex Systems, Institute of Automation, Chinese Academy of Sciences, Beijing, China.,Beijing Key Laboratory of Molecular Imaging, Beijing, China.,University of Chinese Academy of Sciences, Beijing, China
| | - Jie Tian
- CAS Key Laboratory of Molecular Imaging, The State Key Laboratory of Management and Control for Complex Systems, Institute of Automation, Chinese Academy of Sciences, Beijing, China.,Beijing Key Laboratory of Molecular Imaging, Beijing, China.,University of Chinese Academy of Sciences, Beijing, China.,Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, School of Medicine, Beihang University, Beijing, China.,Engineering Research Center of Molecular and Neuro Imaging of Ministry of Education, School of Life Science and Technology, Xidian University, Shaanxi, China
| | - Haizhong Zhang
- Department of Stomatology, The First Medical Centre, Chinese PLA General Hospital, Beijing, China
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4
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Dakua SP, Nayak A. A review on treatments of hepatocellular carcinoma—role of radio wave ablation and possible improvements. EGYPTIAN LIVER JOURNAL 2022. [DOI: 10.1186/s43066-022-00191-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Currently, several treatment options are available for liver cancer depending on various factors such as location, size, shape, and liver function. Image fusion is required for the diagnosis, intervention, and follow-up of certain HCCs. Presently, mental fusion is the only way while diagnosing liver lesions by comparing the ultrasound (US) image with the computed tomography (CT) image. Nevertheless, mental fusion is bound to have errors. The objective of this paper is to study the present treatment options for hepatocellular carcinoma and review the present treatment options, list out their potential limitations, and present a possible alternative solution based on the findings to reduce errors and mistargeting.
Methods
This is a systematic review on the present treatment options for hepatocellular carcinoma, especially radio wave ablation.
Results
It is found that computer fusion is the possible alternative to the present mental registration.
Conclusions
Although computer fusion is the best alternative to use radio wave ablation, there have been a few open-ended questions to further explore.
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Qi S, Zhang Y, Liu G, Chen J, Li X, Zhu Q, Yang Y, Wang F, Shi J, Lee CS, Zhu G, Lai P, Wang L, Fang C. Plasmonic-doped melanin-mimic for CXCR4-targeted NIR-II photoacoustic computed tomography-guided photothermal ablation of orthotopic hepatocellular carcinoma. Acta Biomater 2021; 129:245-257. [PMID: 34082093 DOI: 10.1016/j.actbio.2021.05.034] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 05/12/2021] [Accepted: 05/20/2021] [Indexed: 12/15/2022]
Abstract
Effective and noninvasive diagnosis and prompt treatment of early-stage hepatocellular carcinoma (HCC) are urgently needed to reduce its mortality rate. Herein, the integration of high-resolution diagnostic second near-infrared (NIR-II) photoacoustic computed tomography (PACT) and imaging-guided targeted photothermal ablation of orthotopic small HCC (SHCC) is presented for the first time, which was enabled by a plasmonic platinum (Pt)-doped polydopamine melanin-mimic nanoagent. As designed, an antibody-modified nanoagent (designated Pt@PDA-c) with a plasmonic blackbody-like NIR absorption and superior photothermal conversion efficiency (71.3%) selectively targeted and killed CXCR4-overexpressing HCC (HepG2) cells, which was validated in in vitro experiments. The targeted accumulation properties of Pt@PDA-c in vivo were previously recognized by demonstrating effective NIR-II PA imaging and photothermal ablation in a subcutaneous HCC mouse model. Subsequently, with real-time quantitative guidance by PACT for the accurate diagnosis of intraabdominal SHCC (approximately 4 mm depth), the effective and noninvasive photothermal ablation of SHCCs was successfully demonstrated in an orthotopic tumor-bearing mouse model without damaging adjacent liver tissues. These results show a great potential of NIR-II PACT-guided noninvasive photothermal therapy as an innovative phototheranostic approach and expand the biomedical applications of melanin-mimic materials. STATEMENT OF SIGNIFICANCE: In this paper, we report the first diagnostic NIR-II photoacoustic computed tomography (PACT)-guided noninvasive photothermal ablation of small hepatocellular carcinoma (SHCC) located in deep tissues in orthotopic tumor-bearing mice; this process is empowered by a polydopamine-based melanin-mimic tumor-targeting nanoagent doped with plasmonic platinum that provides superior NIR-II (1064 nm) absorption and photothermal conversion efficiency of 71.3%. Following surface modification with anti-CXCR4 antibodies, the nanoagent (namely Pt@PDA-c) can selectively target CXCR4-overexpressed HepG2 carcinoma cells and tumor lesions, and serve as the theranostic agent for both NIR-II PACT-based diagnosis of orthotopic SHCC (diameter less than 5 mm) and efficient NIR-II PTT in vivo. This study may also extend the potential of melanin-derived blackbody materials for optical-biomedical and water distillation applications.
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Xu B, Li XL, Ye F, Zhu XD, Shen YH, Huang C, Zhou J, Fan J, Chen YJ, Sun HC. Development and Validation of a Nomogram Based on Perioperative Factors to Predict Post-hepatectomy Liver Failure. J Clin Transl Hepatol 2021; 9:291-300. [PMID: 34221915 PMCID: PMC8237151 DOI: 10.14218/jcth.2021.00013] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 02/11/2021] [Accepted: 02/17/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND AND AIMS Post-hepatectomy liver failure (PHLF) is a severe complication and main cause of death in patients undergoing hepatectomy. The aim of this study was to build a predictive model of PHLF in patients undergoing hepatectomy. METHODS We retrospectively analyzed patients undergoing hepatectomy at Zhongshan Hospital, Fudan University from July 2015 to June 2018, and randomly divided them into development and internal validation cohorts. External validation was performed in an independent cohort. Least absolute shrinkage and selection operator (commonly referred to as LASSO) logistic regression was applied to identify predictors of PHLF, and multivariate binary logistic regression analysis was performed to establish the predictive model, which was visualized with a nomogram. RESULTS A total of 492 eligible patients were analyzed. LASSO and multivariate analysis identified three preoperative variables, total bilirubin (p=0.001), international normalized ratio (p<0.001) and platelet count (p=0.004), and two intraoperative variables, extent of resection (p=0.002) and blood loss (p=0.004), as independent predictors of PHLF. The area under receiver operating characteristic curve (referred to as AUROC) of the predictive model was 0.838 and outperformed the model for end-stage liver disease score, albumin-bilirubin score and platelet-albumin-bilirubin score (AUROCs: 0.723, 0.695 and 0.663, respectively; p<0.001 for all). The optimal cut-off value of the predictive model was 14.7. External validation showed the model could predict PHLF accurately and distinguish high-risk patients. CONCLUSIONS PHLF can be accurately predicted by this model in patients undergoing hepatectomy, which may significantly contribute to the postoperative care of these patients.
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Affiliation(s)
- Bin Xu
- Department of Liver Surgery and Transplantation, Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, China
- Key Laboratory of Carcinogenesis and Cancer Invasion of Ministry of Education, Shanghai, China
| | - Xiao-Long Li
- Department of Liver Surgery and Transplantation, Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, China
- Key Laboratory of Carcinogenesis and Cancer Invasion of Ministry of Education, Shanghai, China
| | - Feng Ye
- Department of Hepatobiliary Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiao-Dong Zhu
- Department of Liver Surgery and Transplantation, Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, China
- Key Laboratory of Carcinogenesis and Cancer Invasion of Ministry of Education, Shanghai, China
| | - Ying-Hao Shen
- Department of Liver Surgery and Transplantation, Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, China
- Key Laboratory of Carcinogenesis and Cancer Invasion of Ministry of Education, Shanghai, China
| | - Cheng Huang
- Department of Liver Surgery and Transplantation, Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, China
- Key Laboratory of Carcinogenesis and Cancer Invasion of Ministry of Education, Shanghai, China
| | - Jian Zhou
- Department of Liver Surgery and Transplantation, Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, China
- Key Laboratory of Carcinogenesis and Cancer Invasion of Ministry of Education, Shanghai, China
| | - Jia Fan
- Department of Liver Surgery and Transplantation, Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, China
- Key Laboratory of Carcinogenesis and Cancer Invasion of Ministry of Education, Shanghai, China
| | - Yong-Jun Chen
- Department of Hepatobiliary Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Correspondence to: Hui-Chuan Sun, Liver Cancer Institute and Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai 200032, China. ORCID: https://orcid.org/0000-0003-3761-7058. Tel: +86-21-3115-1990, Fax: +86-21-6403-7181, E-mail: ; Yong-Jun Chen, Department of Hepatobiliary Surgery and Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Second Ruijin Road, Shanghai 200025, China. ORCID: https://orcid.org/0000-0002-6486-2000. Tel: +86-21-6431-4781, Fax: +86-21-6431-4781, E-mail:
| | - Hui-Chuan Sun
- Department of Liver Surgery and Transplantation, Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, China
- Key Laboratory of Carcinogenesis and Cancer Invasion of Ministry of Education, Shanghai, China
- Correspondence to: Hui-Chuan Sun, Liver Cancer Institute and Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai 200032, China. ORCID: https://orcid.org/0000-0003-3761-7058. Tel: +86-21-3115-1990, Fax: +86-21-6403-7181, E-mail: ; Yong-Jun Chen, Department of Hepatobiliary Surgery and Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Second Ruijin Road, Shanghai 200025, China. ORCID: https://orcid.org/0000-0002-6486-2000. Tel: +86-21-6431-4781, Fax: +86-21-6431-4781, E-mail:
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7
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Faragallah OS, El-Hoseny H, El-Shafai W, El-Rahman WA, El-Sayed HS, El-Rabaie ESM, El-Samie FEA, Geweid GGN. A Comprehensive Survey Analysis for Present Solutions of Medical Image Fusion and Future Directions. IEEE ACCESS 2021; 9:11358-11371. [DOI: 10.1109/access.2020.3048315] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Affiliation(s)
- Osama S. Faragallah
- Department of Information Technology, College of Computers and Information Technology, Taif University, Taif, Saudi Arabia
| | - Heba El-Hoseny
- Department of Electronics and Electrical Communication Engineering, Al-Obour High Institute for Engineering and Technology, Al-Obour, Egypt
| | - Walid El-Shafai
- Department of Electronics and Communication Engineering, Faculty of Electronic Engineering, Menofia University, Menouf, Egypt
| | - Wael Abd El-Rahman
- Department of Electrical Engineering, Faculty of Engineering, Benha University, Benha, Egypt
| | - Hala S. El-Sayed
- Department of Electrical Engineering, Faculty of Engineering, Menoufia University, Shebeen El-Kom, Egypt
| | - El-Sayed M. El-Rabaie
- Department of Electronics and Communication Engineering, Faculty of Electronic Engineering, Menofia University, Menouf, Egypt
| | - Fathi E. Abd El-Samie
- Department of Electronics and Communication Engineering, Faculty of Electronic Engineering, Menofia University, Menouf, Egypt
| | - Gamal G. N. Geweid
- Department of Electrical Engineering, Faculty of Engineering, Benha University, Benha, Egypt
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8
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Li GQ, Zhang T, Yang WG, Zhong HL, Xiao P, Liu LW, Wang YW, Chen H, Kong R, Wang G, Tan HT, Bai XW, Li YL, Li L, Sun B. Gut microbiota patterns associated with somatostatin in patients undergoing pancreaticoduodenectomy: a prospective study. Cell Death Discov 2020; 6:94. [PMID: 33083016 PMCID: PMC7522245 DOI: 10.1038/s41420-020-00329-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 08/14/2020] [Accepted: 08/24/2020] [Indexed: 02/07/2023] Open
Abstract
Postoperative pancreatic fistula (POPF) is a common and dreaded complication after pancreaticoduodenectomy (PD). The gut microbiota has been considered as an crucial mediator of postoperative complications, however, the precise roles of gut microbiota in POPF are unclear. A prospective study was developed to explore the effects of somatostatin on gut microbiota and we aim to identify the microbial alterations in the process of POPF. A total of 45 patients were randomly divided into PD group or additional somatostatin therapy group. The fecal sample of each patient was collected preoperatively and postoperatively and the gut microbiota was analyzed by 16S rRNA sequencing. Our study found that somatostatin therapy was independent risk factor for the occurrence of POPF, and it reduced the microbial diversity and richness in patients. At genus level, somatostatin therapy led to a decreased abundance in Bifidobacterium, Subdoligranulum and Dubosiella, whereas the abundance of Akkermansia, Enterococcus and Enterobacter were increased. The abundance levels of certain bacteria in the gut microbiota have significantly shifted in patients with POPF. The LEfSe analysis revealed that Ruminococcaceae could be used as microbial markers for distinguishing patients with high risk of POPF. Furthermore, Verrucomicrobia and Akkermansia could be used as preoperative biomarkers for identifying patients without POPF. Our prospective study highlights the specific communities related with somatostatin therapy and discovers POPF-associated microbial marker, which suggests that gut microbiota may become a diagnostic biomarker and potential therapeutic target for POPF.
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Affiliation(s)
- Guan-Qun Li
- Department of Pancreatic and Biliary Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang China
| | - Tao Zhang
- Department of Pancreatic and Biliary Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang China
| | - Wei-Guang Yang
- Department of Pancreatic and Biliary Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang China
| | - Hao-Liang Zhong
- Department of Pancreatic and Biliary Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang China
| | - Peng Xiao
- Department of Pancreatic and Biliary Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang China
| | - Li-Wei Liu
- Department of Pancreatic and Biliary Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang China
| | - Yong-Wei Wang
- Department of Pancreatic and Biliary Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang China
| | - Hua Chen
- Department of Pancreatic and Biliary Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang China
| | - Rui Kong
- Department of Pancreatic and Biliary Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang China
- Key Laboratory of Hepatosplenic Surgery, Ministry of Education, Harbin, Heilongjiang China
| | - Gang Wang
- Department of Pancreatic and Biliary Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang China
| | - Hong-Tao Tan
- Department of Pancreatic and Biliary Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang China
| | - Xue-Wei Bai
- Department of Pancreatic and Biliary Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang China
| | - Yi-Long Li
- Department of Pancreatic and Biliary Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang China
| | - Le Li
- Department of Pancreatic and Biliary Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang China
| | - Bei Sun
- Department of Pancreatic and Biliary Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang China
- Key Laboratory of Hepatosplenic Surgery, Ministry of Education, Harbin, Heilongjiang China
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Zhang Y, Lv J, Liu P, Zhao X, Chen K, Li Q, Nie L, Fang C. Contrast-Enhanced Multispectral Photoacoustic Imaging for Irregular Hepatectomy Navigation: A Pilot Study. ACS Biomater Sci Eng 2020; 6:5874-5885. [PMID: 33320552 DOI: 10.1021/acsbiomaterials.0c00921] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Irregular hepatectomy plays a prominent role in the treatment of small hepatocellular carcinoma (HCC) patients with severe cirrhosis and localized liver metastasis. In clinical practices, intraoperative tumor boundaries delineation facilitates to accomplish tumor resection with negative margin, remarkably decreasing the recurrence rates. Currently, ultrasound (US) and ICG fluorescence-guided surgery has been used for intraoperative navigation in irregular hepatectomy, but insufficient specificity results in a limited prevalence. Inspired by the high resolution of photoacoustic (PA) imaging and established clinical efficacy of 18F-Alfatide that is specific for integrin αvβ3-overexpressed tumors, we herein developed a fluorescent analogue IR820-E[c(RGDfK)]2, and a proof-of-concept intraoperative multispectral PA imaging navigation for precise irregular hepatectomy using hand-held PA/US imaging system. An integrin αvβ3-targeted fluorescent contrast agent IR820-E[c(RGDfK)]2 was designed, synthesized, and characterized. In vitro studies were performed to determine optical and PA properties, affinity and specificity and biocompatibility. Multispectral PA imaging, the optimal imaging time point and contrast, multispectral PA imaging-guided irregular hepatectomy, pharmacokinetics, and safety profile were evaluated in subcutaneous and orthotopic HCC tumor models. Ex vivo macroscopic three-dimensions (3D) PA imaging with IR820-E[c(RGDfK)]2 staining was also performed in surgical biospecimens from patients with HCC. IR820-E[c(RGDfK)]2 has a simple synthetic method at gram scale, high affinity, and specificity for integrin αvβ3, excellent pharmacokinetic and safety profile can effectively differentiate tumor from normal liver tissues in animal models and surgical biospecimens from HCC patients. Preoperative tumor localization, intraoperative tumor boundaries delineation, and tumor excision, and postoperative negative margin assessment were successfully achieved during irregular hepatectomy. This initial attempt allows one to preoperatively detect tumor lesions, intraoperatively delineate tumor boundaries and guide tumor resection, and postoperatively evaluate tumor margin status during irregular hepatectomy. IR820-E[c(RGDfK)]2 has the potential to be an investigational new drug for clinical use in multispectral photoacoustic imaging-guided irregular hepatectomy.
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Affiliation(s)
- Yueming Zhang
- Department of Hepatobiliary Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou 510515, P. R. China
| | - Jing Lv
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnosis & Center for Molecular Imaging and Translational Medicine, School of Public Health, Xiamen University, Xiamen 361102, P. R. China
| | - Pingguo Liu
- Department of Hepatobiliary Surgery, Zhongshan Hospital Xiamen University, Xiamen 361004, P. R. China
| | - Xingyang Zhao
- Department of Hepatobiliary Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou 510515, P. R. China
| | - Kang Chen
- Department of Hepatobiliary Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou 510515, P. R. China
| | - Qiaolin Li
- Department of Hepatobiliary Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou 510515, P. R. China
| | - Liming Nie
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnosis & Center for Molecular Imaging and Translational Medicine, School of Public Health, Xiamen University, Xiamen 361102, P. R. China
| | - Chihua Fang
- Department of Hepatobiliary Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou 510515, P. R. China
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10
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Huang X, Tang T, Wang X, Bai X, Liang T. Calreticulin couples with immune checkpoints in pancreatic cancer. Clin Transl Med 2020; 10:36-44. [PMID: 32508042 PMCID: PMC7239268 DOI: 10.1002/ctm2.10] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Revised: 03/04/2020] [Accepted: 03/04/2020] [Indexed: 12/27/2022] Open
Abstract
Although immune checkpoint blockade is considered to be the dominant approach in future cancer immunotherapy, whether it will apply to pancreatic cancer remains largely unknown. To address this issue, pancreatic cancer-associated datasets were individually collected by Gene Expression Profiling Interactive Analysis 2 (GEPIA2), cBioPortal, and Tumor and Immune System Interaction Database (TISIDB), and subsequently subjected to prognostic, genomic, and immunologic analyses of all well-established immune checkpoints. The results indicate that immune checkpoints might not be ideal targets for pancreatic cancer therapy. Intriguingly, the genomic alteration of calreticulin, the key mediator of chemotherapy-induced cancer immunogenic cell death, was found to couple with immune checkpoints in pancreatic cancer. Moreover, calreticulin was observed to be highly expressed in pancreatic adenocarcinoma, and high calreticulin expression significantly favors both overall survival and disease-free survival of patients with pancreatic adenocarcinoma. Importantly, calreticulin was further revealed to be closely related to anti-tumor immunity in pancreatic adenocarcinoma, including multiple immune effector molecules and T-cell signatures. Taken together, calreticulin-based therapy may represent a more promising prospect for pancreatic cancer immunotherapy than immune checkpoint blockade therapy.
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Affiliation(s)
- Xing Huang
- Zhejiang Provincial Key Laboratory of Pancreatic DiseaseThe First Affiliated HospitalSchool of MedicineZhejiang UniversityZhejiangChina
- Department of Hepatobiliary and Pancreatic SurgeryThe First Affiliated HospitalSchool of MedicineZhejiang UniversityZhejiangChina
- Innovation Center for the Study of Pancreatic DiseasesZhejiangChina
| | - Tianyu Tang
- Zhejiang Provincial Key Laboratory of Pancreatic DiseaseThe First Affiliated HospitalSchool of MedicineZhejiang UniversityZhejiangChina
- Department of Hepatobiliary and Pancreatic SurgeryThe First Affiliated HospitalSchool of MedicineZhejiang UniversityZhejiangChina
- Innovation Center for the Study of Pancreatic DiseasesZhejiangChina
| | - Xun Wang
- Zhejiang Provincial Key Laboratory of Pancreatic DiseaseThe First Affiliated HospitalSchool of MedicineZhejiang UniversityZhejiangChina
- Department of Hepatobiliary and Pancreatic SurgeryThe First Affiliated HospitalSchool of MedicineZhejiang UniversityZhejiangChina
- Innovation Center for the Study of Pancreatic DiseasesZhejiangChina
| | - Xueli Bai
- Zhejiang Provincial Key Laboratory of Pancreatic DiseaseThe First Affiliated HospitalSchool of MedicineZhejiang UniversityZhejiangChina
- Department of Hepatobiliary and Pancreatic SurgeryThe First Affiliated HospitalSchool of MedicineZhejiang UniversityZhejiangChina
- Innovation Center for the Study of Pancreatic DiseasesZhejiangChina
| | - Tingbo Liang
- Zhejiang Provincial Key Laboratory of Pancreatic DiseaseThe First Affiliated HospitalSchool of MedicineZhejiang UniversityZhejiangChina
- Department of Hepatobiliary and Pancreatic SurgeryThe First Affiliated HospitalSchool of MedicineZhejiang UniversityZhejiangChina
- Innovation Center for the Study of Pancreatic DiseasesZhejiangChina
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