Real-Time Detection of Ferulic Acid Effects on Rat Left Ventricle Using Pressure-Volume Conductivity Catheter.

Decreased cardiac function can have a negative impact on other organs. The left ventricular pressure-volume relationship is considered to be a valid method for evaluating cardiac function. Real-time monitoring of cardiac function is important for drug evaluation. Under closed-chest conditions, the miniature transducer, which is an important component of the pressure-volume catheter, enters the left ventricle of the rat through the right carotid artery. The device visualizes the changes in cardiac function during the experiment in the form of a pressure-volume loop. The actual volume of the ventricle is calculated by altering the conductivity of the blood by injecting 50 µL of a 20% sodium chloride solution into the rat's left jugular vein. The actual volume of the rat's ventricular cavity is calculated by measuring the conductivity of the blood in a known volume using a pressure-volume conductance catheter. This protocol allows for continuous observation of the effects of drugs on the heart and will promote the rationale for the use of specialty ethnic drugs in cardiovascular disease.

Intermittent Fasting Alleviates Non-Alcoholic Steatohepatitis by Regulating Bile Acid Metabolism and Promoting Fecal Bile Acid Excretion in High-Fat and High-Cholesterol Diet Fed Mice.

SCOPE: Intermittent fasting (IF) has a protective role across a wide range of chronic disorders, including obesity, diabetes, and cardiovascular disease, but its protection against non-alcoholic steatohepatitis (NASH) is still lacking. This study seeks to investigate how IF alleviates NASH by regulating gut microbiota and bile acids (BAs) composition. METHODS AND RESULTS: Male C57BL/6 mice are fed a high-fat and high-cholesterol (HFHC) diet for 16 weeks to establish a NASH model. Mice then continued HFHC feeding and are treated with or without every other day fasting for 10 weeks. Hepatic pathology is assessed using hematoxylin-eosin staining. Gut microbiota of the cecum are profiled using 16S rDNA gene sequencing and the levels of BAs in serum, colon contents, and feces are measured using ultra-performance liquid chromatography-tandem mass spectrometry. Results indicate that IF significantly decreases murine body weight, insulin resistance, hepatic steatosis, ballooning, and lobular inflammation. IF reshapes the gut microbiota, reduces the accumulation of serum BAs, and increases total colonic and fecal BAs. Moreover, IF increases the expression of cholesterol 7α-hydroxylase 1 in liver, but decreases the expressions of both farnesoid-X-receptor and fibroblast growth factor 15 in the ileum. CONCLUSION: IF alleviates NASH by regulating bile acid metabolism and promoting fecal bile acid excretion.

Establishment of a non-alcoholic fatty liver disease model by high fat diet in adult zebrafish.

BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) has become the most common chronic liver disease in recent years, but the pathogenesis is not fully understood. Therefore, it is important to establish an effective animal model for studying NAFLD. METHODS: Adult zebrafish were fed a normal diet or a high-fat diet combined with egg yolk powder for 30 days. Body mass index (BMI) was measured to determine overall obesity. Serum lipids were measured using triglyceride (TG) and total cholesterol (TC) kits. Liver lipid deposition was detected by Oil Red O staining. Liver injury was assessed by measuring glutathione aminotransferase (AST) and glutamic acid aminotransferase (ALT) levels. Reactive oxygen species (ROS) and malondialdehyde (MDA) were used to evaluate oxidative damage. The level of inflammation was assessed by qRT-PCR for pro-inflammatory factors. H&E staining was used for pathological histology. Caspase-3 immunofluorescence measured apoptosis. Physiological disruption was assessed via RNA-seq analysis of genes at the transcriptional level and validated by qRT-PCR. RESULTS: The high-fat diet led to significant obesity in zebrafish, with elevated BMI, hepatic TC, and TG. Severe lipid deposition in the liver was observed by ORO and H&E staining, accompanied by massive steatosis and ballooning. Serum AST and ALT levels were elevated, and significant liver damage was observed. The antioxidant system in the body was severely imbalanced. Hepatocytes showed massive apoptosis. RNA-seq results indicated that several physiological processes, including endoplasmic reticulum stress, and glucolipid metabolism, were disrupted. CONCLUSION: Additional feeding of egg yolk powder to adult zebrafish for 30 consecutive days can mimic the pathology of human nonalcoholic fatty liver disease.

Development and validation of a 3D-convolutional neural network model based on chest CT for differentiating active pulmonary tuberculosis from community-acquired pneumonia.

PURPOSE: To develop and validate a 3D-convolutional neural network (3D-CNN) model based on chest CT for differentiating active pulmonary tuberculosis (APTB) from community-acquired pneumonia (CAP). MATERIALS AND METHODS: Chest CT images of APTB and CAP patients diagnosed in two imaging centers (n = 432 in center A and n = 61 in center B) were collected retrospectively. The data in center A were divided into training, validation and internal test sets, and the data in center B were used as an external test set. A 3D-CNN was built using Keras deep learning framework. After the training, the 3D-CNN selected the model with the highest accuracy in the validation set as the optimal model, which was applied to the two test sets in centers A and B. In addition, the two test sets were independently diagnosed by two radiologists. The 3D-CNN optimal model was compared with the discrimination, calibration and net benefit of the two radiologists in differentiating APTB from CAP using chest CT images. RESULTS: The accuracy of the 3D-CNN optimal model was 0.989 and 0.934 with the internal and external test set, respectively. The area-under-the-curve values with the 3D-CNN model in the two test sets were statistically higher than that of the two radiologists (all P < 0.05), and there was a high calibration degree. The decision curve analysis showed that the 3D-CNN optimal model had significantly higher net benefit for patients than the two radiologists. CONCLUSIONS: 3D-CNN has high classification performance in differentiating APTB from CAP using chest CT images. The application of 3D-CNN provides a new automatic and rapid diagnosis method for identifying patients with APTB from CAP using chest CT images.

Performance of CT radiomics in predicting the overall survival of patients with stage III clear cell renal carcinoma after radical nephrectomy.

PURPOSE: To investigate the performance of CT radiomics in predicting the overall survival (OS) of patients with stage III clear cell renal carcinoma (ccRCC) after radical nephrectomy. MATERIALS AND METHODS: The 132 patients with stage III ccRCC undergoing radical nephrectomy were collected, and the patients were divided into training set (n = 79) and validation set (n = 53). The ccRCC was segmented and 396 radiomics features were extracted. After dimensionality reduction, radiomics score (RS) was obtained. COX regression was used to construct Model 1 (clinical variables + CT findings) and Model 2 (clinical variables + CT findings + RS) in the training set to predict the OS of patients, and then, the performance of the two models in the two data sets was compared. RESULTS: In the training set, Akaike information criterion, C-index, and corrected C-index were 295.51, 0.744, and 0.728 for Model 1, and 271.78, 0.805, and 0.799 for Model 2, respectively. In the validation set, the corresponding values were 185.68, 0.701, and 0.699 for Model 1, and 175.99, 0.768, and 0.768 for Model 2. The calibration curves showed that both models had good calibration degrees in the validation set. Compared with Model 1, the continuous net reclassification index and integrated discrimination improvement index of Model 2 in the two data sets were positively improved. CONCLUSION: The two prediction models showed high performance in the evaluation of OS of stage III ccRCC patients after radical nephrectomy, among which Model 2 based on ISUP grade and RS was more concise and efficient.

Efficiency of ursodeoxycholic acid for the treatment of nonalcoholic steatohepatitis: A systematic review and meta-analysis.

BACKGROUND: Previous studies have demonstrated that ursodeoxycholic acid (UDCA) possesses anti-inflammatory, antioxidant, and anti-fibrotic properties, and it may reduce the degree of liver damage caused by nonalcoholic steatohepatitis (NASH). However, the effectiveness of UDCA in improving liver function and histology in cases of NASH remains unclear. Therefore, we performed a meta-analysis to assess the efficacy of UDCA in the treatment of NASH. METHODS: PubMed, Web of Science, Embase, Cochrane, and other databases were searched for randomized controlled trials (RCTs) published before 1 January 2022, in which UDCA was used to treat patients with NASH. RESULTS: A total of 8 studies with 655 participantsmet the criteria for inclusion in this meta-analysis. The forest plot displayed that UDCA treatment significantly reduced blood concentrations of alanine aminotransferase (ALT) and γ-glutamyl transferase (GGT). However, the pooled effect size results did not suggest any significant effect of UDCA on anthropometric characteristics or hepatic histology. CONCLUSION: UDCA therapy can effectively reduce serum levels of ALT and GGT in patients with NASH but has no significant effects on physical characteristics or liver histology. Further large-scale and dose-response clinical studies are needed to evaluate the clinical potential of UDCA in treating NASH.

Coenzyme Q10 supplementation improves adipokine profile in dyslipidemic individuals: a randomized controlled trial.

BACKGROUND: In previous study, we found that coenzyme Q10 (CoQ10) improved glucolipid profile in dyslipidemic individuals, but the mechanism is not yet clear. Adipokines have been demonstrated to be vital targets of metabolic diseases. The hypothesis that adipokines mediate the association of CoQ10 on glucolipid metabolism needs to be further studied in human. METHODS: In this randomized, double-blinded, placebo-controlled trial, 101 dyslipidemic individuals were administrated to 120 mg CoQ10 or placebo for 24 weeks. Anthropometric parameters, glucolipid profile, serum total adiponectin, leptin, and resistin were evaluated at baseline, week 12 and week 24. RESULTS: CoQ10 treatment significantly increased serum adiponectin levels at week 12 (165 [0, 362] ng/mL, p < 0.001) and at week 24 (523 [0, 1056] ng/mL, p < 0.001]), which was significant different compared with placebo (p < 0.001). The increase of adiponectin was negative associated with decrease in index of homeostasis model assessment of insulin resistance (HOMA-IR, r = - 0.465, p = 0.001), triglyceride (TG, r = - 0.297, p = 0.047), and low-density lipoprotein cholesterol (LDL-c, r = - 0.440, p = 0.002) at week 24 only in CoQ10-treated group. Resistin was reduced by CoQ10 only at week 24 (- 1.19 [- 4.35, 0.00] ng/mL, p < 0.001), which was significant different compared with placebo (p < 0.001). Reduction of resistin was positively correlated with the change in HOMA-IR (r = 0.343, p = 0.021) and TG (r = 0.323, p = 0.030) at week 24 in CoQ10-treated group but not placebo group. Leptin was not influenced by CoQ10 treatment. Mediation analysis indicated that the improvement of HOMA-IR, TG and LDL-c by CoQ10 was mediated by adiponectin but not resistin. CONCLUSIONS: Our study shows that CoQ10 ameliorates glucolipid profile and adipokines dysfunction in dyslipidemic patients in 24 weeks' intervention. The beneficial effect of CoQ10 on glucolipid profile was mediated by adiponectin. TRIAL REGISTRATION: ClinicalTrials.gov, NCT02407548. Registered on April 3, 2015, https://clinicaltrials.gov/ct2/show/NCT02407548 .

The Bioavailability and Biological Activities of Phytosterols as Modulators of Cholesterol Metabolism.

Phytosterols are natural sterols widely found in plants that have a variety of physiological functions, and their role in reducing cholesterol absorption has garnered much attention. Although the bioavailability of phytosterols is only 0.5-2%, they can still promote cholesterol balance in the body. A mechanism of phytosterols for lowering cholesterol has now been proposed. They not only reduce the uptake of cholesterol in the intestinal lumen and affect its transport, but also regulate the metabolism of cholesterol in the liver. In addition, phytosterols can significantly reduce the plasma concentration of total cholesterol, triglycerides, and low-density lipoprotein cholesterol (LDL-C), with a dose-response relationship. Ingestion of 3 g of phytosterols per day can reach the platform period, and this dose can reduce LDL-C by about 10.7%. On the other hand, phytosterols can also activate the liver X receptor α-CPY7A1 mediated bile acids excretion pathway and accelerate the transformation and metabolism of cholesterol. This article reviews the research progress of phytosterols as a molecular regulator of cholesterol and the mechanism of action for this pharmacological effect.

Diagnosis of Active Pulmonary Tuberculosis and Community Acquired Pneumonia Using Convolution Neural Network Based on Transfer Learning.

RATIONALE AND OBJECTIVES: A convolutional neural network (CNN) model for the diagnosis of active pulmonary tuberculosis (APTB) and community-acquired pneumonia (CAP) using chest radiographs (CRs) was constructed and verified based on transfer learning. MATERIALS AND METHODS: CRs of 1247 APTB cases, 1488 CAP cases and 1247 normal cases were collected. All CRs were randomly divided into training set (1992 cases), validation set (1194 cases) and test set (796 cases) by stratified sampling in 5:3:2 radio. After normalization of CRs, the convolution base of pre-trained CNN (VGG16) model on ImageNet dataset was used to extract features, and the grid search was used to determine the optimal classifier module, which was added to the convolution base for transfer learning. After the training, the model with the highest accuracy of the validation set was selected as the optimal model to verify in the test set and calculate the accuracy of the model. RESULTS: The accuracy of validation set in the 63rd epochs was the highest, which was 0.9430, and the corresponding Categorical crossentropy was 0.1742. The accuracy of the training set was 0.9428, and the Categorical crossentropy was 0.1545. When the optimal model was applied to the test set, the accuracy was 0.9447, and the Categorical crossentropy was 0.1929. CONCLUSION: The transfer learning-based CNN model has good classification performance in the diagnosis of APTB, CAP and normal patients using CRs.

Seropositive Reaction Rates of 9 B-Cell Epitopes of the SARS-CoV-2 Spike Protein and the Relationship between the Epitopes and Neutralizing Antibody.

OBJECTIVE: The aim of the study was to analyze the relationship between serum antibody and neutralizing antibody titers in convalescent coronavirus disease 2019 (COVID-19) patients with different disease severities, and the seropositive reaction rates of 9 reported B-cell epitopes of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). METHODS: Serum IgG and total antibody titers of 165 convalescent COVID-19 patients were determined by chemiluminescence, the serum neutralization antibody titers were determined by microneutralization assay, and the S/CO values of 9 peptides were detected by indirect enzyme-linked immunosorbent assay. Correlations between the aforementioned indexes were statistically analyzed, and differences in patients with different diseases severities were evaluated. RESULTS: IgG, total antibody, and neutralizing antibody titers increased with disease severity. The positive rate of the receptor-binding region (RBD) was 100%, and the average positive rate for all the 9 peptides was above 50% in 165 patients. IDf showed the highest rate of positivity (86.06%), with a rate of 95% for the (IDf + IDa) pattern. Moreover, S/CO values of RBD and mix (IDh) were significantly correlated with IgG, total antibody titers, and neutralizing antibody titers (p < 0.001), whereas the S/CO values for other 8 peptides showed no obvious correlation. CONCLUSION: In this study, a large sample was used to confirm that the peptide IDf had a high positive reaction rate for all patients (86.06%) and also had the highest detection rate in asymptomatic patients (86.67%). Only long peptide and mixed peptide showed correlation with neutralizing antibody titers, suggesting that the ability of SARS-CoV-2 antibody to neutralize virus infectivity may require the interaction of multiple sites.

CoQ10 Promotes Resolution of Necrosis and Liver Regeneration After Acetaminophen-Induced Liver Injury.

Coenzyme Q10 (CoQ10) which acts as an electron transporter in the mitochondrial respiratory chain has many beneficial effects on liver diseases. In our previous research, CoQ10 has been found to attenuate acetaminophen (APAP)-induced acute liver injury (ALI). However, whether CoQ10 administration is still effective at the late stage of APAP overdose is still unknown. In this study, we aimed to test CoQ10 efficacy at the late stage of APAP overdose. C57BL/6J mice were intraperitoneally treated with APAP to induce liver injury. CoQ10 (5 mg/kg) was given to mice at 16 h after APAP treatment. The results showed that while CoQ10 treatment at 16 h post-APAP overdose had no effects on the expression of ROS generated genes or scavenged genes, it still significantly decreased necrosis of hepatocytes following APAP-induced ALI. Moreover, CoQ10 increased MerTK+ macrophages accumulation in the APAP-overdose liver and inhibition of MerTK signaling partly abrogated the protective role of CoQ10 treatment on the hepatic necrosis. CoQ10 treatment also significantly enhanced hepatocytes proliferation as shown in the increased 5-bromodeoxyuridine incorporation in the APAP-intoxicated mice liver section. In addition, CoQ10 treatment increased hepatic Proliferating Cell Nuclear Antigen (PCNA) and Cyclin D1 expression and promoted activation of the ß-catenin signaling in APAP-overdose mice. To conclude, these data provide evidence that CoQ10 treatment is still effective at the late stage of APAP-induced ALI and promotes resolution of necrosis and liver regeneration following ALI.

Computed Tomography Imaging Characteristics: Potential Indicators of Epidermal Growth Factor Receptor Mutation in Lung Adenocarcinoma.

PURPOSE: The purpose of this study was to investigate the correlation between computed tomography imaging characteristics in lung adenocarcinoma and epidermal growth factor receptor (EGFR) mutations. METHODS: A total of 124 patients with lung adenocarcinoma and known EGFR mutation status were collected in this retrospective study. Computed tomography quantitative parameters of each tumor, including total volume, total surface, surface-to-volume ratio (SVR), average diameter, maximum diameter, and average density, were determined using computer-aided detection software. The correlation between the EGFR mutation status and imaging characteristics was assessed. The predictive value of these imaging characteristics for EGFR mutation was calculated using the area under the receiver operating characteristic curve. RESULT: Fifty-eight of 124 patients showed EGFR mutations. Patients who are female (P < 0.001) and nonsmokers (P < 0.001) and those with serum carcinoembryonic antigen (CEA) level of ≥5 (P = 0.035) were likely to have EGFR mutation. Computed tomography features including air bronchogram (P = 0.035), absence of cavitation (P = 0.010), and absence of pulmonary emphysema (P = 0.002) and quantitative parameters, such as smaller total surface (P = 0.002), smaller total volume (P = 0.001), higher SVR (P = 0.003), and smaller average diameter (P = 0.001), were associated with EGFR mutation. Logistic regression analysis revealed that the most significant independent prognostic factors of EGFR mutation for the model were nonsmoking (P = 0.035), CEA level of ≥5 (P = 0.004), presence of air bronchogram (P = 0.040), absence of cavitation (P = 0.021), and high SVR (P = 0.014). The area under the receiver operating characteristic curve, sensitivity, and specificity of the model for predicting EGFR mutation were 0.827, 75.8%, and 82.8%, respectively. CONCLUSIONS: EGFR-mutated adenocarcinoma showed significantly increased CEA level, presence of air bronchogram, absence of cavitation, and higher quantitative parameter SVR than those with wild-type EGFR.

Reducing contrast medium dose with low photon energy images in renal dual-energy spectral CT angiography and adaptive statistical iterative reconstruction (ASIR).

OBJECTIVE: To evaluate the value of using low energy (keV) images in renal dual-energy spectral CT angiography (CTA) and adaptive statistical iterative reconstruction (ASIR) to reduce contrast medium dose. METHODS: 40 patients with renal CTA on a Discovery CT750HD were randomly divided into two groups: 20 cases (Group A) with 600 mgI kg-1 and 20 cases (Group B) with 300 mgI kg-1. The scan protocol for both groups was: dual-energy mode with mA selection for noise index of 10 HU, pitch 1.375:1, rotating speed 0.6 s/r. Images were reconstructed at 0.625 mm thickness with 40%ASIR, Group A used the conventional 70keV monochromatic images, and Group B used monochromatic images from 40 to 70 keV at 5 keV interval for analysis. The CT values and standard deviation (SD) values of the renal artery and erector spine in the plain and arterial phases were measured with the erector spine SD value representing image noise. The enhancement degree of the renal artery (ΔCT = CT(arterial) -CT(plain)), signal-to-noise ratio (SNR=CTrenal-artery/SDrenal-artery) and contrast-to-noise ratio (CNR=(CTrenal-artery-CTerector spine)/SDerector-spine) were calculated. The single factor analysis of variance was used to analyze the difference of ΔCT, SNR and CNR among image groups with p < 0.05 being statistically significant. The subjective image scores of the groups were assessed blindly by two experienced physicians using a 5-point system and the score consistency was compared by the κ test. RESULTS: Contrast medium dose in the 300 mgI kg-1 group was reduced by 50% compared with the 600 mgI kg-1 group, while radiation dose was similar between the two groups. The subjective scores were 4.00 ± 0.65, 4.50 ± 0.60 and 3.70 ± 0.80 for images at 70 keV (600 mgI kg-1 group), 40 keV (300 mgI kg-1 group) and 45 keV (300 mgI kg-1 group), respectively with good consistency between the two reviewers (p > 0.05). The 40 keV images in the 300 mgI kg-1 group had similar ΔCT (469.77 ± 86.95 HU vs 398.54 ± 73.68 HU) and CNR (15.52 ± 3.32 vs 18.78 ± 6.71) values as the 70 keV images in the 600 mgI kg-1) group but higher SNR values (30.19 ± 4.41 vs 16.91 ± 11.12, p < 0,05). CONCLUSION: Contrast dose may be reduced by 50% while maintaining image quality by using lower energy images combined with ASIR in renal dual-energy CTA. ADVANCES IN KNOWLEDGE: Combined with ASIR and energy spectrum, can reduce the amount of contrast dose in renal CTA.

Effect of New Model-Based Iterative Reconstruction on Quantitative Analysis of Airway Tree by Computer-Aided Detection Software in Chest Computed Tomography.

OBJECTIVE: Compared the performance of computer-aided detection (CAD) software for quantitative analysis of airway using computed tomography (CT) images reconstructed with versions of model-based iterative reconstruction (MBIR) that either balances spatial and density resolution (MBIRSTND) or prefers spatial resolution (MBIRRP20), and adaptive statistical iterative reconstruction (ASIR) with lung kernel. METHODS: Thirty patients were included who were scanned for pulmonary disease using a routine dose multidetector CT system. Data were reconstructed with ASIR, MBIRSTND, and MBIRRP20. Airway dimensions from the 3 reconstructions were measured using an automated, quantitative CAD software designed to segment and quantify the bronchial tree automatically using a skeletonization algorithm. For each patient and reconstruction algorithm, the right middle lobe bronchus was selected as a representative for measuring the bronchial length of the matched airways. Two radiologists used a semiquantitative 5-point scale to rate the subjective image quality of MBIRSTND and MBIRRP20 reconstructions on airway trees analysis. RESULTS: Algorithm impacts the measurement variability of bronchus length in chest CT, MBIRRP20 were the best, whereas ASIR were the worst (P < 0.05). In addition, the optimal reconstruction algorithm was found to be MBIRSTND for the airway trees being assessed about subjective noise and MBIRRP20 about bronchial end shows, and there were no significant differences in the continuity and completeness of bronchial wall, whereas ASIR performed inferiorly compared with them (P < 0.05). CONCLUSIONS: Compared with ASIR, MBIRSTND, and MBIRRP20 from MBIRn algorithm potentially allow the desired airway quantification accuracy to be achieved on the performance of CAD, especially for MBIRRP20.

Prediction models for clear cell renal cell carcinoma ISUP/WHO grade: comparison between CT radiomics and conventional contrast-enhanced CT.

OBJECTIVE: Comparing the prediction models for the ISUP/WHO grade of clear cell renal cell carcinoma (ccRCC) based on CT radiomics and conventional contrast-enhanced CT (CECT). METHODS: The corticomedullary phase images of 119 cases of low-grade (I and II) and high-grade (III and IV) ccRCC based on 2016 ISUP/WHO pathological grading criteria were analyzed retrospectively. The patients were randomly divided into training and validation set by stratified sampling according to 7:3 ratio. Prediction models of ccRCC differentiation were constructed using CT radiomics and conventional CECT findings in the training setandwere validated using validation set. The discrimination, calibration, net reclassification index (NRI) and integrated discrimination improvement index (IDI) of the two prediction models were further compared. The decision curve was used to analyze the net benefit of patients under different probability thresholds of the two models. RESULTS: In the training set, the C-statistics of radiomics prediction model was statistically higher than that of CECT (p < 0.05), with NRI of 9.52% and IDI of 21.6%, both with statistical significance (p < 0.01).In the validation set, the C-statistics of radiomics prediction model was also higher but did not show statistical significance (p = 0.07). The NRI and IDI was 14.29 and 33.7%, respectively, both statistically significant (p < 0.01). Validation set decision curve analysis showed the net benefit improvement of CT radiomics prediction model in the range of 3-81% over CECT. CONCLUSION: The prediction model using CT radiomics in corticomedullary phase is more effective for ccRCC ISUP/WHO grade than conventional CECT. ADVANCES IN KNOWLEDGE: As a non-invasive analysis method, radiomics can predict the ISUP/WHO grade of ccRCC more effectively than traditional enhanced CT.

Reducing Radiation Dose and Improving Image Quality in CT Portal Venography Using 80 kV and Adaptive Statistical Iterative Reconstruction-V in Slender Patients.

OBJECTIVE: To explore the feasibility of reducing radiation dose and improving image quality in CT portal venography (CTPV) using 80 kV and adaptive statistical iterative reconstruction-V(ASIR-V) in slender patients in comparison with conventional protocol using 120 kV and ASIR. METHODS: Sixty slender patients for enhanced abdominal CT scanning were randomly divided into group A and group B. Group A used the conventional 120 kV tube voltage, 600 mgI/kg contrast dose and reconstructed with the recommended 40% ASIR. Group B used 80 kV tube voltage, 350 mgI/kg contrast dose and reconstructed with ASIR-V from 40% to 100% with 10% interval. The CT values and standard deviation (SD) values of the main portal vein, left branch, and right branch of portal vein, liver, and erector spinae at the same level were measured to calculate the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR). The image quality was subjectively scored by two experienced radiologists blindly using a 5-point criterion. The contrast dose, volumetric CT dose index, and dose length product were recorded in both groups and the effective dose was calculated. RESULTS: There was no significant difference in general data between the two groups (p > 0.05), the effective dose and contrast dose in group B were reduced by 63.3% (p < 0.001) and 39.7% (p < 0.001), respectively compared with group A. With the percentage of ASIR-V increased in group B, the CT values showed no significant difference, while the SD values gradually decreased and SNR values and CNR values increased accordingly. Compared with group A, group B demonstrated similar CT values (p > 0.05), while the SD values with 80% ASIR-V to 100% ASIR-V were significantly lower than those of 40% ASIR (p < 0.001), and the SNR values and CNR values with 70% ASIR-V to 100% ASIR-V were significantly higher than those of 40% ASIR (p < 0.001). The subjective image quality scores by the two radiologists had excellent consistency (kappa value>0.75, p < 0.001), and the final subjective image quality scores and the subjective scores in each of the 5 scoring categories with 60% ASIR-V to 100% ASIR-V were all significantly higher than those of 40% ASIR, and 80% ASIR-V obtained the highest subjective score among different reconstructions. CONCLUSION: In CTPV, the application of 80 kV and ASIR-V reconstruction in slender patients can significantly reduce radiation dose (by 63.3%) and contrast agent dose (by 39.7%). Compared with the recommended 40% ASIR using 120 kV, ASIR-V with 80% to 100% percentages can further improve image quality and with 80% ASIR-V being the best reconstruction algorithm. ADVANCES IN KNOWLEDGE: CTPV with 80 kV and ASIR-V algorithm in slender patients can significantly reduce radiation dose and contrast agent dose as well as improve image quality, compared with the conventional 120 kV protocol using 40% ASIR.

Clinical value of a new generation adaptive statistical iterative reconstruction (ASIR-V) in the diagnosis of pulmonary nodule in low-dose chest CT.

OBJECTIVE: To evaluate the clinical value of low-dose chest CT combined with the new generation adaptive statistical iterative reconstruction (ASIR-V) algorithm in the diagnosis of pulmonary nodule. METHODS: 30 patients with pulmonary nodules underwent chest CT using Revolution CT. The patients were first scanned with standard-dose at a noise index (NI) of 14, and the images were reconstructed with filtered back projection (FBP) algorithm. If pulmonary nodules were found, a low-dose targeted scan, with NI of 24, was performed localized on the nodules, and the images were reconstructed with 60% ASIR-V. The detection rate of pulmonary nodules in the two scanning modes was recorded. The size of nodules, CT value and standard deviation of nodules were measured. The signal-to-noise ratio and contrast-to-noise ratio were also calculated. Two experienced radiologists used a 5-point method to score the image quality. The volumetric CT dose index, and dose-length product were recorded and the effective dose (ED) was calculated of the two scanning modes. RESULTS: Volumetric CT dose index (ED) of the standard-dose scan covering the entire lungs was 7.29 ± 2.38 mGy (3.52 ± 1.09 mSv), and that of low-dose targeted scan was 2.56 ± 1.87 mGy (0.51 ± 0.32 mSv). However, the ED of the virtual low-dose scan for the entire lungs was 1.44 ± 0.15 mSv, which would mean a dose reduction of 59.1% compared with the standard-dose scan. 85 of the 87 pulmonary nodules were detected in the low-dose targeted scan, with 2 of the ground-glass density nodules with size less than 1 cm missed, resulting in 97.7% overall detection rate. There was no difference between the low-dose ASIR-V images and standard-dose FBP images for the size (1.49 ± 0.74 cm vs 1.48 ± 0.75 cm), CT value [33.02 ± 1.95 Hounsfield unit (HU) vs 34.6 ± 3.07 HU], standard deviation (27.64 ± 14.42 HU vs 30.38 ± 20.04 HU), signal-to-noise ratio (1.44 ± 0.88 vs 1.43 ± 1.31) and contrast-to-noise ratio (38.95 ± 18.43 vs 38.23 ± 14.99) of nodules (all p > 0.05). There was no difference in the subjective scores between the two scanning modes. CONCLUSION: The low-dose CT scan combined with ASIR-V algorithm is of comparable value in the detection and the display of pulmonary nodules when compared with the FBP images obtained by standard-dose scan. ADVANCES IN KNOWLEDGE: This is a clinical study to evaluate the clinical value of pulmonary nodules using ASIR-V algorithm in the same patients in the low-dose chest CT scans. It suggests that ASIR-V provides similar image quality and detection rate for pulmonary nodules at much reduced radiation dose.

Influence of virtual monochromatic spectral image at different energy levels on motion artifact correction in dual-energy spectral coronary CT angiography.

PURPOSE: To investigate the influence of virtual monochromatic spectral (VMS) CT images at different energy levels on the effectiveness of a motion correction technique (SSF) in dual-energy Spectral coronary CT angiography (CCTA). MATERIALS AND METHODS: 29 cases suspected of or diagnosed with coronary artery disease underwent Spectral CCTA using a prospective ECG triggering with 250 ms padding time. SSF was applied to the determined least-motion phase to generate 6 additional sets of VMS images with energy levels from 40 to 100 keV. CT value and standard deviation (SD) in the aortic root and epicardial adipose tissue were measured. Image quality of the RCA, LAD and LCX was evaluated on a per-vessel basis in each patient. Two reviewers evaluated the artery using the score of the segment. RESULTS: The low energy VMS images increased CT value and image noise compared with higher-energy VMS images, except 90 keV and 100 keV. The CNR of 40-70 keV were higher than those of 80-100 keV (P < 0.05). The image quality scores for images at 50-80 keV were higher than those of 40, 90, and 100 keV (P < 0.05), and the VMS image quality at 50 keV and 60 keV with SSF was the highest. CONCLUSION: SSF can effectively reduce the motion artifacts when coronary vessels have suitable contrast enhancement which can be achieved by adjusting energy levels of VMS images.

Astaxanthin inhibits proliferation and induces apoptosis of LX­2 cells by regulating the miR­29b/Bcl­2 pathway.

The aim of the present study was to investigate the role of microRNAs (miRNAs/miRs) in the anti­fibrotic effect of astaxanthin (AST), using the human hepatic stellate cell (HSC) line LX­2 as the research model. LX­2 cells were treated with various concentrations of AST (10, 20 and 40 µM) for 24 or 48 h. miR­29b was selected based on existing literature, and its targeting gene B cell lymphoma (Bcl)­2 was predicted by TargetScan and miRanda databases for further analysis. Interactions between miR­29b and Bcl­2 in the AST treated LX­2 cells were evaluated using reverse transcription­quantitative polymerase chain reaction (RT­qPCR) and western blot analysis. MTT analysis was used to analyze cell viability. Overexpression of miR­29b decreased the expression of Bcl­2 in AST­treated LX­2 cells, and silencing of it had the opposite effect. Additionally, Annexin V­fluorescein isothiocyanate/propidium iodide double staining and flow cytometry were used to evaluate the cell apoptosis, and overexpression of miR­29b increased cell apoptosis rates in AST­treated LX­2 cells; however, silencing of it had the opposite effect. RT­qPCR and western blotting demonstrated that AST induced LX­2 cells apoptosis which may be by regulating miR­29b, as indicated by inhibited Bcl­2 expression levels and elevated Bax and Caspase­3 expression levels. These results highlight an important role of miR­29b in the AST modulating LX­2 cells proliferation and apoptosis and implicate a potential mechanism of miR­29b and AST preventing liver fibrosis.

Comparison of Nongated Chest CT and Dedicated Calcium Scoring CT for Coronary Calcium Quantification Using a 256-Dector Row CT Scanner.

BACKGROUND: Coronary artery calcification (CAC) is a marker of atherosclerosis and an independent risk factor for cardiac-related mortality and frequently detected on noncontrast chest CT. We aimed to investigate the reliability and accuracy of determining CAC using noncontrast, nongated chest CT with 256-detector row. MATERIALS AND METHODS: A total of 1318 patients for chest examination were enrolled to undergo both nongated chest CT and dedicated calcium-scoring CT (CSCT) on a 256-detector row CT scanner. The chest CT was scanned in fast-helical mode with 8 cm collimation, 0.28 second rotation speed and pitch 0.992:1 to cover entire chest. CSCT used single prospective ECG-triggered cardiac axial mode with 0.28 second rotation speed covering only the heart. CAC scores (Agatston, mass, and volume) were determined using both image sets and were statistically compared. RESULTS: Sensitivity and specificity of nongated chest CT for determining positive CAC was 94.8% (182/192) and 100%, respectively. The agreement in assessing the quantitative Agatston, volume, and mass scores between the nongated chest CT and CSCT was almost perfect, with the intraclass correlation coefficient values of 0.998, 0.999, and 0.999, respectively. Additionally, there was a good agreement in CAC quantification between the nongated chest CT and dedicated CSCT with small coefficient of variation: mass score (9.0%), volume score (9.5%), and Agatston score (12.6%). CONCLUSION: Nongated chest CT with 256-detector row is a reliable imaging mode for detecting and quantifying calcifications in coronary arteries compared with dedicated calcium-scoring CT.