Value of third-generation of VNCa dual-energy CT for differentiating diffuse marrow infiltration of multiple myeloma from red bone marrow.

This study aims to investigate the ability of bone marrow imaging using third-generation dual-energy computed tomography (CT) virtual noncalcium (VNCa) to differentiate between multiple myeloma (MM) with diffuse bone marrow infiltration and red bone marrow (RBM). Bone marrow aspiration or follow-up results were used as reference. We retrospectively reviewed 188 regions of interests (ROIs) from 21 patients with confirmed MM and diffuse bone marrow infiltrations who underwent VNCa bone marrow imaging between May 2019 and September 2022. At the same time, we obtained 98 ROIs from 11 subjects with RBM for comparative study, and 189 ROIs from 20 subjects with normal yellow bone marrow for the control group. The ROIs were delineated by 2 radiologists independently, the interobservers reproducibility was evaluated by interclass correlation coefficients. The correlation with MRI grade results was analyzed by Spearman correlation coefficient. Receiver operating characteristic (ROC) curve analysis was used to determine the optimal threshold for differentiating between these groups and to assess diagnostic performance. There were statistically significant differences in VNCa CT values of bone marrow among the MM, RBM, and control groups (all P < .001), with values decreasing sequentially. A strong positive rank correlation was observed between normal bone marrow, subgroup MM with moderately and severe bone marrow infiltration divided by MRI and their corresponding CT values (ρ = 0.897, 95%CI: 0.822 to 0.942, P < .001). When the CT value of VNCa bone marrow was 7.15 HU, the area under the curve (AUC) value for differentiating RBM and MM was 0.723, with a sensitivity of 50.5% and a specificity of 89.8%. When distinguishing severe bone marrow infiltration of MM from RBM, the AUC value was 0.80 with a sensitivity 70.9% and a specificity 78.9%. The AUC values for MM, RBM, and the combined group compared to the control group were all >0.99, with all diagnostic sensitivity and specificity exceeding 95%. VNCa bone marrow imaging using third-generation dual-energy CT accurately differentiates MM lesions from normal bone marrow or RBM. It demonstrates superior diagnostic performance in distinguishing RBM from MM with diffuse bone marrow infiltration.

Quantitative evaluation of bone marrow characteristics in occult and subtle rib fractures by spectral CT.

PURPOSE: The present study aimed to determine whether the water content change in the medullary cavity of occult rib fractures by spectral computed tomography (CT). METHODS: The material decomposition (MD) images were reconstructed using the water-hydroxyapatite basis material pairs from spectral CT. The water contents of the medullary cavity in subtle or occult rib fractures and the symmetrical sites of the contralateral ribs were measured, and their difference was calculated. The absolute value of the water content difference was compared to patients without trauma. An independent samples t-test was adopted to compare the consistency of the water content in the medullary cavity of the normal ribs. Intergroup and pairwise comparisons were applied to the difference in water content among the subtle/occult fractures and normal ribs, followed by receiver operating characteristic curve calculations. p < 0.05 was considered to have a statistically significant difference. RESULTS: A total of 100 subtle fractures, 47 occult fractures, and 96 pairs of normal ribs were included in this study. The water content of the medullary cavity in the subtle and occult fractures was both higher than that in their symmetrical sites with the difference value of 31.06 ± 15.03 mg/cm3 and 27.83 ± 11.40 mg/cm3, respectively. These difference values between the subtle and occult fractures were not statistically significant (p = 0.497). For the normal ribs, the bilateral water contents were not statistically different (p > 0.05) with a difference value of 8.05 ± 6.13 mg/cm3. The increased water content of fractured ribs was higher than that of normal ribs (p < 0.001). According to the classification based on whether the ribs were fractured, the area under the curve was 0.94. CONCLUSIONS: The water content measured on MD images in spectral CT in the medullary cavity increased as a response to subtle/occult rib fractures.

Correlation Between Doppler Ultrasound Blood Flow Parameters and Angiogenesis and Proliferation Activity in Breast Cancer.

BACKGROUND The aim of this study was to assess the correlation between Doppler ultrasound blood flow parameters and angiogenesis and proliferation activity in breast cancer. MATERIAL AND METHODS We enrolled breast cancer patients (n=55) and benign tumor patients (n=40) from Tengzhou Central People's Hospital from Mar 2014 to Dec 2016. Doppler ultrasound examination was conducted to determine blood flow parameters, and immunohistochemistry (IHC) experiments were performed to determine the protein expression of angiogenesis genes, cell proliferation genes, and tumor-suppressor genes. RESULTS Compared with benign tumors, the maximum velocity (Vmax) and resistance index (RI) were significantly different in I-II stage and III-IV stage breast cancer (P<0.01 and P<0.001, respectively). IHC assay showed that VEDGF165, NRP-1, SphK1, CD31, YAP, CTGF, and Gli2 proteins expressions were significantly higher in breast cancer patients (P<0.01 and P<0.001, respectively). PTEN and MFN2 protein expressions of breast cancer patients were significantly lower (P<0.01 or P<0.001, respectively) compared with those of benign tumor patients. VEDGF165, NRP-1, SphK1, CD31, YAP, CTGF, and Gli2 proteins expressions were positively correlated with Vmax and negatively correlated with RI in breast cancer. PTEN and MFN2 protein expressions were negative correlated with Vmax and positively correlated with RI in breast cancer patients. CONCLUSIONS Decreased RI and increased Vmax are correlated with angiogenesis, proliferation, and tumor suppression in breast cancer.