BSA modification of bacterial surface: a promising anti-cancer therapeutic strategy.

BACKGROUND: Attenuated live bacterial therapy and medical BSA materials have their own advantages in anti-cancer research, and their combination is expected to overcome some of the disadvantages of conventional anti-cancer therapeutics. METHODS AND OBJECTIVE: Utilizing the high affinity between biotin and streptavidin, BSA modification on the surface of Escherichia coli (E. coli) was achieved. Then, the adhesion and targeting abilities of BSA modified E. coli was explored on different bladder cancer cells, and the underlying mechanism was also investigated. RESULTS: BSA modification on the surface of E. coli enhances its ability to adhere and target cancer cells, and we speculate that these characteristics are related to the expression of SPARC in different bladder cancer cell lines. CONCLUSION: BSA and live bacteria have their own advantages in anti-cancer research. In this study, we found that E. coli surface-modified by BSA had stronger adhesion and targeting effects on bladder cancer cells with high expression of SPARC. These findings pave the way for the future studies exploring the combination of BSA combined with live bacteria for cancer therapy.

Tannins amount determines whether tannase-containing bacteria are probiotic or pathogenic in IBD.

The role of dietary tannin in inflammatory bowel disease (IBD) is still not clear. Therefore, we aim to study the effect of TA in the progression of IBD. Dextran sulphate sodium (DSS)-induced model was used to mimic IBD. Metagenomics and metabolomics were performed to study the alteration of intestinal microbiota and metabolites. NCM460 and THP-1 cells were used for in vitro study. The amount of TA was associated with the outcomes of DSS-induced IBD as evidenced by in vivo and in vitro studies. Metabolomic and metagenomic analyses revealed that TA-induced enrichment of microbial metabolite gallic acid (GA) was responsible for the action of TA. Mechanistically, protective dose of GA promoted colonic mucus secretion to suppress bacterial infection and that it ameliorated DSS-induced epithelial damage by inhibiting p53 signaling, whereas toxic dose of GA directly caused epithelial damage by promoting cell cycle arrest. Therapeutic experiment showed protective dose of GA-promoted recovery of DSS-induced colonic inflammation. The role of tannase-containing bacteria can be transformed under different conditions in IBD progression.

Preoperative Nomogram Incorporating Clinical Factors, Serological Markers and LI-RADS MRI Features to Predict Early Recurrence of Hepatocellular Carcinoma Treated with Transarterial Chemoembolization.

PURPOSE: To develop and validate a preoperative nomogram model that incorporates clinical factors, serological markers and liver imaging reporting and data system (LI-RADS v2018) MRI features for predicting early recurrence (ER) of hepatocellular carcinoma (HCC) treated with transarterial chemoembolization (TACE). METHODS: One hundred and fourteen patients with HCC who underwent MRI scanning before TACE were enrolled retrospectively and divided into a training cohort (n=80) and a test cohort (n=34). The clinical factors, serological markers and LI-RADS v2018 MRI features associated with ER were determined by univariable and multivariable analyses. A nomogram model predicting ER after TACE was developed, and its discriminatory ability, goodness-of-fit and clinical application were evaluated by receiver operating characteristic (ROC) curve, calibration curve and decision curve analysis (DCA), respectively. RESULTS: In total, 74 (64.9%) patients were diagnosed with ER according to the follow-up results. Increased alpha fetoprotein (AFP) levels, larger tumor size, nonsmooth margin, mosaic architecture satellite nodules and corona enhancement were independent predictors associated with ER (p < 0.05). For the established nomogram model that incorporated these six significant predictors, the AUC values were 0.94 (95% CI: 0.89-0.99) and 0.95 (95% CI: 0.88-1.00) for predicting ER after TACE in the training and test cohorts, respectively. The calibration curve and DCA results demonstrate the good goodness-of-fit and clinical benefits of this nomogram. CONCLUSION: A preoperative nomogram model based on serological markers and LI-RADS v2018 MRI features could adequately predict ER in HCC patients after TACE, which may provide personalized guidance for predicting prognosis.

Construction of a machine learning-based artificial neural network for discriminating PANoptosis related subgroups to predict prognosis in low-grade gliomas.

The poor prognosis of gliomas necessitates the search for biomarkers for predicting clinical outcomes. Recent studies have shown that PANoptosis play an important role in tumor progression. However, the role of PANoptosis in in gliomas has not been fully clarified.Low-grade gliomas (LGGs) from TCGA and CGGA database were classified into two PANoptosis patterns based on the expression of PANoptosis related genes (PRGs) using consensus clustering method, followed which the differentially expressed genes (DEGs) between two PANoptosis patterns were defined as PANoptosis related gene signature. Subsequently, LGGs were separated into two PANoptosis related gene clusters with distinct prognosis based on PANoptosis related gene signature. Univariate and multivariate cox regression analysis confirmed the prognostic values of PANoptosis related gene cluster, based on which a nomogram model was constructed to predict the prognosis in LGGs. ESTIMATE algorithm, MCP counter and CIBERSORT algorithm were utilized to explore the distinct characteristics of tumor microenvironment (TME) between two PANoptosis related gene clusters. Furthermore, an artificial neural network (ANN) model based on machine learning methods was developed to discriminate distinct PANoptosis related gene clusters. Two external datasets were used to verify the performance of the ANN model. The Human Protein Atlas website and western blotting were utilized to confirm the expression of the featured genes involved the ANN model. We developed a machine learning based ANN model for discriminating PANoptosis related subgroups with drawing implications in predicting prognosis in gliomas.

[Prokaryotic expression of prostate-specific membrane antigen (PSMA) nanoantibody gene and screening of natural phage nanoantibody library].

Objective To screen nanobodies against prostate specific membrane antigen (PSMA). Methods Based on the naive phage display library, three rounds of screening were performed targeting the PSMA antigen, and positive clones were identified by ELISA and sequencing was performed. The positive cloned gene sequence was inserted into the pET28a prokaryotic expression vector and transformed into E.coli BL21. The expression of the recombinant protein was induced by IPTG and purified using Ni column, with the purified product verified by SDS-PAGE. Results Four PSMA nanobodies VHH1, VHH2, VHH3 and VHH4 were obtained by screening. The VHH1 failed to obtain protein expression, while the VHH2, VHH3 and VHH4 proteins were expressed. The purity of anti-PSMA nanobodies showed high and relative molecular mass (Mr) of about 17 000. Conclusion The sequence of anti-PSMA nanobody was successfully obtained by screening the naive phage nanobody library and were subjected to prokaryotic expression and purified.

Capsaicin regulates dyslipidemia by altering the composition of bile acids in germ-free mice.

The improvement of lipid metabolism by capsaicin (CAP) has been extensively studied, mostly with respect to the vanilloid type 1 (TRPV1) ion channel and intestinal flora. In this study, a model was established in germ-free mice by using resiniferatoxin (RTX) to ablate TRPV1 ion channels. Bile acid composition, blood parameters, and colonic transcriptome analyses revealed that CAP could improve dyslipidemia caused by high-fat diet even in the absence of TRPV1 ion channels and intestinal flora. CAP fed to germ mice decreased the concentrations of low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), fasting blood glucose and fasting insulin, increased the concentration of high-density lipoprotein (HDL-C), and decreased the levels of plasma endotoxin and pro-inflammatory factor interleukin 6 (IL-6). Furthermore, CAP could affect both classical and alternative pathways of cholesterol conversion by changing the composition of bile acids, reducing the concentrations of glycocholic acid (GCA), ursodeoxycholic acid (UDCA) and glycochenodeoxycholic acid (GCDCA). First, changing the composition of bile acids inhibited the expression of colon Fgf15. CAP promoted the expression of Cyp7a1 (Cytochrome p450, family 7, subfamily a, and polypeptide 1) in the liver, and thus reduced TC and TG levels. In addition, it could change the composition of bile acids and increase the expression of Cyp7b1 (Cytochrome p450, family 7, subfamily b, and polypeptide 1) in the colon, increase Cyp7b1 protein in the liver and thus inhibit fat accumulation. In conclusion, CAP could alter the composition of bile acids and promote the conversion of cholesterol to bile acids, thereby improving lipid metabolism abnormalities caused by a high-fat diet.

Characterization of aging cancer-associated fibroblasts draws implications in prognosis and immunotherapy response in low-grade gliomas.

Background: Due to the highly variable prognosis of low-grade gliomas (LGGs), it is important to find robust biomarkers for predicting clinical outcomes. Aging cancer-associated fibroblasts (CAFs) within the senescent stroma of a tumor microenvironment (TME) have been recently reported to play a key role in tumor development. However, there are few studies focusing on this topic in gliomas. Methods and Results: Based on the transcriptome data from TCGA and CGGA databases, we identified aging CAF-related genes (ACAFRGs) in LGGs by the weighted gene co-expression network analysis (WGCNA) method, followed by which LGG samples were classified into two aging CAF-related gene clusters with distinct prognosis and characteristics of the TME. Machine learning algorithms were used to screen out eight featured ACAFRGs to characterize two aging CAF-related gene clusters, and a nomogram model was constructed to predict the probability of gene cluster A for each LGG sample. Then, a powerful aging CAF scoring system was developed to predict the prognosis and response to immune checkpoint blockage therapy. Finally, the ACAFRGs were verified in two glioma-related external datasets. The performance of the aging CAF score in predicting the immunotherapy response was further validated in two independent cohorts. We also confirmed the expression of ACAFRGs at the protein level in glioma tissues through the Human Protein Atlas website and Western blotting analysis. Conclusion: We developed a robust aging CAF scoring system to predict the prognosis and immunotherapy response in LGGs. Our findings may provide new targets for therapeutics and contribute to the exploration focusing on aging CAFs.

Dynamic response of pre-disintegrated carbonaceous mudstone embankment under multi-lane vehicle load.

The purpose of this study is to reveal the response of multi Lane pre disintegrated carbonaceous mudstone embankment under vehicle dynamic load. In this paper, the pre-disintegrated carbonaceous mudstone samples whose fractal dimension meets the requirements are obtained through the indoor disintegration test of carbonaceous mudstone. Geotechnical basic tests such as particle analysis experiments, compaction tests, and direct shear tests were carried out on the pre-disintegrated carbonaceous mudstone samples, and the physical and mechanical parameters of the pre-disintegrated carbonaceous mudstone were obtained. On this basis, a two-way 4-lane pre-disintegration carbonaceous mudstone embankment model of the expressway was established by ABAQUS numerical software. Three different working conditions are set up to study the dynamic response of multi-lane pre-disintegrated carbonaceous mudstone embankment under vehicle load. The results show that the stress change trend on the surface of the pre-disintegrated carbonaceous mudstone embankment without vehicles is the same as that on the side with vehicles. Under this condition, the vertical displacement of the pre-disintegrated carbonaceous mudstone embankment surface can be as high as 4.33mm, and the vertical displacement change of the embankment in the 0-0.6s phase is basically the same as the stress amplitude distribution. When a traffic jam occurs on one side, the maximum increase in vertical stress on the surface of the embankment on the normal driving side is about 170 kPa compared to condition one, and the vertical displacement at each depth of the embankment has been significantly increased. When a traffic jam occurs on one side, it can significantly increase the vertical stress on the surface of the pre-disintegrated carbonaceous mudstone embankment in this lane. The middle part of the stress time curve of monitoring points 3 and 4 in working condition three is more stable and significant than in working condition one, and the maximum vertical displacement is increased by about 1.70mm. The research results can reference the stability analysis of carbonaceous mudstone embankments and engineering practice.

Octreotide-induced acute life-threatening gallstones after vicarious contrast medium excretion: A case report.

BACKGROUND: Octreotide is widely used for the treatment of acromegaly, neuroendocrine tumors, and secretory diarrhea. However, long-term octreotide treatment can increase the incidence of gallstones. Vicarious contrast medium excretion (VCME) through the hepatobiliary system is well known. However, few studies have reported octreotide-induced acute gallstones following VCME. CASE SUMMARY: A 69-year-old man presented with left lower back pain and hematuria caused by a fall. The patient had a history of polycystic kidney disease. VCME occurred following renal artery embolization for a ruptured polycystic kidney. After 5 d of treatment with octreotide, the patient developed acute gallstones and intrahepatic cholestasis which further induced pancreatitis and cholangitis. He was discharged after hemodialysis, antibiotics, and supportive treatments. CONCLUSION: For patients with a high-risk of VCME, octreotide should be cautiously administered and carefully monitored.

Gut microbiota modulates the inflammatory response and cognitive impairment induced by sleep deprivation.

Sleep deprivation (SD) is increasingly common in modern society, which can lead to the dysregulation of inflammatory responses and cognitive impairment, but the mechanisms remain unclear. Emerging evidence suggests that gut microbiota plays a critical role in the pathogenesis and development of inflammatory and psychiatric diseases, possibly via gut microbiota-brain interactions and neuroinflammation. The present study investigated the impact of SD on gut microbiota composition and explored whether alterations of the gut microbiota play a causal role in chronic inflammatory states and cognitive impairment that are induced by SD. We found that SD-induced gut dysbiosis, inflammatory responses, and cognitive impairment in humans. Moreover, the absence of the gut microbiota suppressed inflammatory response and cognitive impairment induced by SD in germ-free (GF) mice. Transplantation of the "SD microbiota" into GF mice activated the Toll-like receptor 4/nuclear factor-κB signaling pathway and impaired cognitive function in the recipient mice. Mice that harbored "SD microbiota" also exhibited increases in neuroinflammation and microglial activity in the hippocampus and medial prefrontal cortex. These findings indicate that gut dysbiosis contributes to both peripheral and central inflammatory processes and cognitive deficits that are induced by SD, which may open avenues for potential interventions that can relieve the detrimental consequences of sleep loss.

Microwave-Assisted Synthesis and Catalytic Performance of Carbon Nanotubes/Flower-Patterned Zinc Oxide Nanostructures.

It is essential for multifunctional asphalt to develop the new nanostructures with high photocatalytic activity in order to endow asphalt with the self-cleaning ability of contamination. Multi-walled carbon nanotubes/ZnO (MWNTs/ZnO) composites were synthesized based on microwave irradiation and their structure and photocatalytic properties were investigated. The experimental results showed that MWNTs/ZnO powder with different morphologies was attained such as cone-shaped, floral-patterned and fusiform structures. The as-obtained MWNTs/ZnO composites were proved to possess quite high catalytic activities for degradation of methyl orange (MO). Especially, the floral-patternedMWNTs/ZnO composites displayed better photocatalytic performance than the other composites indicating that the resultant MWNTs/ZnO composites can be used as photocatalysts without any additional treatment.

The effect of apatinib in the treatment of sorafenib resistant metastatic hepatocellular carcinoma: A case report.

RATIONALE: Most patients with hepatocellular carcinoma (HCC) have lost the chance of radical treatment at the time of their visit, and the prognosis of metastatic HCC is even worse. Sorafenib is currently regarded as a first-line systemic therapy in patients with advanced and metastatic HCC. Apatinib is a new inhibitor of vascular endothelial growth factor receptor 2 tyrosine kinase, which has been reported to be effective in some solid tumors. We herein report a case of apatinib in the treatment of the patient with metastatic HCC who was resistant to sorafenib. PATIENT CONCERNS: A 41-year-old Chinese man with a history of chronic hepatitis B had undergone an emergency partial hepatectomy for tumor ruptured. Despite the treatment with transcatheter arterial chemoembolization and sorafenib, the progression of tumor failed to control. DIAGNOSES: Although the patient had been treated with sorafenib (400 mg, twice daily) for 10 months, computed tomography documented radiological progression. INTERVENTIONS: Due to disease progression, failure of sorafenib and positive expression of vascular endothelial growth factor (VEGF), the drug regimen was changed to apatinib 250 mg once daily. Due to some degree of resistance, the dose was increased up to 425 mg once daily. OUTCOMES: The patient had a disease-free progression of 7 months at 250 mg apatinib. The dosage was adjusted to 425 mg due to drug resistance and the side effects were tolerable. The patient has survived a total of 19 months under apatinib. LESSONS: Apatinib may be a substitute for the HCC patients with sorafenib resistance in the future, especially for those with high expression of VEGF.

Perfused hypertonic-saline-augmented needle enlarges ablation zones in ex vivo porcine livers.

There is a great clinical requirement to improve radiofrequency ablation (RFA) efficacy and create larger coagulation necrotic areas. The aim of the present study was to assess the ability of a hypertonic-saline (HS)-enhanced multipolar RFA technique using a perfused electrode to increase RF-created coagulation necrosis, and to compare that technique with natural saline-augmented needle and conventional multipolar RFA. A total of 18 ablations were performed in explanted porcine livers. A total of 6 thermal ablation zones were created in each of 3 groups treated with the conventional multipolar mode, the multipolar mode with 0.9% NaCl and the multipolar mode with 6% NaCl, respectively. During RFA, the dimensions and volumes of the ablation zones were compared, and gross and microscopic pathological evaluations were performed. Multipolar RFA with 6% NaCl created the largest short-axis diameters and volumes of coagulation necrosis (3.89±0.09 mm and 40.01±2.86 mm3, respectively) among the three groups (conventional group: 2.31±0.04 mm and 8.99±0.52 mm3, respectively; 0.9% NaCl solution group: 3.17±0.05 mm and 21.79±1.05 mm3, respectively). Overall, multipolar RFA with the instillation of 6% NaCl solution through an open perfusion system created a larger ablation zone compared with the conventional and 0.9% NaCl modes. Therefore, HS-enhanced multipolar RFA may be a promising approach for treating large liver tumors.

Accuracy of 320-detector row nonsubtracted and subtracted volume CT angiography in evaluating small cerebral aneurysms.

OBJECTIVE The study aimed to assess the diagnostic accuracy of 320-detector row nonsubtracted and subtracted volume CT angiography (VCTA) in detecting small cerebral aneurysms (< 3 mm) compared with 3D digital subtraction angiography (3D DSA). METHODS Six hundred sixty-two patients underwent 320-detector row VCTA and 3D DSA for suspected cerebral aneurysms. Five neuroradiologists independently reviewed VCTA and 3D DSA images. The 3D DSA was considered the reference standard, and the sensitivity, specificity, and accuracy of nonsubtracted and subtracted VCTA in depicting small aneurysms were analyzed. A p value < 0.05 was considered a significant difference. RESULTS According to 3D DSA images, 98 small cerebral aneurysms were identified in 90 of 662 patients. Nonsubtracted VCTA depicted 90 small aneurysms. Ten small aneurysms were missed, and 2 small aneurysms were misdiagnosed. The missed small aneurysms were located almost in the internal carotid artery, near bone tissue. The sensitivity, specificity, and accuracy of nonsubtracted VCTA in depicting small aneurysms were 89.8%, 99.2%, and 96.5%, respectively, on a per-aneurysm basis. Subtracted VCTA depicted 97 small aneurysms. Three small aneurysms were missed, and 2 small aneurysms were misdiagnosed. The sensitivity, specificity, and accuracy of subtracted VCTA in depicting small aneurysms were 96.9%, 99.2%, and 98.6%, respectively, on a per-aneurysm basis. There was no difference in accuracy between subtracted VCTA and 3D DSA (p = 1.000). However, nonsubtracted VCTA had significantly less sensitivity than 3D DSA and subtracted VCTA (p = 0.039 and 0.016, respectively). CONCLUSIONS Subtracted 320-detector row VCTA is sensitive enough to replace 3D DSA in the diagnosis of small cerebral aneurysms (< 3 mm). The accuracy rate of nonsubtracted VCTA was lower than that of subtracted VCTA and 3D DSA, especially in the assessment of small internal carotid artery aneurysms adjacent to the skull base.

Diagnosis and Treatment of Intracranial Aneurysms with 320-Detector Row Volumetric Computed Tomography Angiography.

OBJECTIVES: The objective of the study was to determine the clinical utility of 320-detector row volume-computed tomographic angiography (VCTA) in the management of intracranial aneurysms. METHODS: Between February 2011 and May 2015, 550 patients successfully underwent 320-detector row VCTA for suspected intracranial aneurysms. Three-dimensional (3D) digital subtraction angiography (DSA) was used as the ultimate reference standard, and the sensitivity, specificity, and accuracy of both nonsubtracted and subtracted VCTA in identifying aneurysms were analyzed. RESULTS: Nonsubtracted VCTA identified 417 aneurysms (2 false-positive readings, 12 false-negative readings). The diagnostic sensitivity, specificity, and accuracy of non-subtracted VCTA, on a per-aneurysm basis, were 97.2%, 99.0%, and 97.6%, respectively. Subtracted VCTA identified 426 aneurysms (2 false-positive readings, 3 false-negative readings). The sensitivity, specificity, and accuracy of subtracted VCTA, on a per-aneurysm basis, were 99.3%, 99.0%, and 99.2%, respectively. No differences in diagnostic accuracy were found between subtracted VCTA and 3D DSA. Nonsubtracted VCTA, however, was observed to be significantly less sensitive than 3D DSA and subtracted VCTA. Twenty-six aneurysm cases were referred for surgical treatment based on VCTA imaging. All aneurysms were deemed completely occluded during surgical clipping. On the basis of VCTA imaging, 299 aneurysms were found suitable for endovascular coiling, of which 293 aneurysms (98%) were treated successfully. CONCLUSIONS: The 320-detector row subtracted VCTA technique is an effective, first-line diagnostic imaging modality for surgical and endovascular treatment of aneurysms. The nonsubtracted VCTA was less accurate than the subtracted VCTA, especially for intracranial aneurysms adjoining bone tissue.

DYNA CT arteriographic evaluation of hepatocellular carcinoma for treatment by trans-catheter arterial chemoembolization.

PURPOSE: The aim of our study was to determine whether using C-arm CT (DYNA CT) during hepatic arteriography imaging assists in TACE treatment. MATERIALS AND METHODS: 138 patients with HCC, 69 patients (Group A) underwent DYNA CT and routine digital subtraction angiography (DSA), while another 69 patients (Group B) underwent only DSA, were prospectively studied at a single facility between May 2011 and September 2012. Liver vessels and tumors were displayed by DYNA CT. The superior mesenteric artery (SMA) and the celiac artery shape and branch anatomy were visualized. The number of tumors and arteries which feed these was compared. RESULTS: In Group A, DYNA CT showed that the hepatic artery originated from the celiac artery in 60 patients, while the right hepatic artery originated from the SMA and the left hepatic artery originated from the common hepatic artery in 9 patients. In 10 patients, the phrenic artery provided blood to the tumor. DYNA CT detected 258 lesions, while routine DSA found 178 lesions (P<0.05). CONCLUSION: DYNA CT has substantial advantages over routine DSA in demonstrating the shape and branches of the target hepatic vessels and the number of tumors. DYNA CT provides important guidance for TACE which simplifies selective catheterization and improves the treatment and quality of TACE.

[Catheter aspiration alone or combined with thrombolysis in the treatment of superior mesenteric artery embolism].

OBJECTIVE: To investigate the efficacy of catheter aspiration or combined with thrombolysis in the treatment of superior mesenteric artery embolism(SMAE). METHODS: Clinical and imaging data of 25 SMAE patients who underwent catheter aspiration or combined with urokinase thrombolysis in the First People's Hospital and the Second People's Hospital of Changzhou from January 2005 to July 2013 were retrospectively analyzed. RESULTS: Twenty patients were confirmed as SMA trunk embolism and 5 as SMA branch artery embolism. The embolic SMA trunks were completely recannulated by catheter aspiration in the above 20 cases, but small emboli embolized distal branch artery in 6 cases. These 6 patients plus above 5 patients with branch artery embolism received catheter aspiration combined with thrombolytic therapy. Among these 11 patients, complete open, partial open and non-open of branch arteries were found in 5, 3, 3 cases respectively, while collateral circulation increased significantly in non-open patients. During the follow-up period of (4.1±2.2) months, clinical symptom relief and digestive function recovery were observed in 24 cases. Only one case underwent bowel resection because of intestinal necrosis 24 hours after treatment and developed short bowel syndrome. CONCLUSION: Catheter aspiration or combined with thrombolysis is a safe and effective method in treating SMAE.

Cerebral aneurysms: accuracy of 320-detector row nonsubtracted and subtracted volumetric CT angiography for diagnosis.

PURPOSE: To assess the accuracy of 320-detector row nonsubtracted and subtracted volumetric computed tomographic (CT) angiography for detection of cerebral aneurysms. MATERIALS AND METHODS: After institutional review board approval and informed written consent were obtained, 282 consecutive patients suspected of having cerebral aneurysms underwent CT angiography with a 320-detector row volumetric CT scanner and three-dimensional (3D) rotational digital subtraction angiography (DSA). The sensitivity, specificity, and accuracy of nonsubtracted and subtracted volumetric CT angiography for depiction of aneurysms were analyzed, with 3D DSA as the reference standard. P values less than .05 were considered to indicate a significant difference. RESULTS: Among the 282 patients, 198 (70.2%) had 239 cerebral aneurysms that were detected on the basis of 3D DSA. Nonsubtracted volumetric CT angiography showed 231 of the 239 (96.7%) aneurysms. The primary reason for missed aneurysms was close proximity to bone tissue. Sensitivity, specificity, and accuracy of nonsubtracted volumetric CT angiography for depicting aneurysms were 96.7%, 100%, and 97.5%, respectively, on a per-aneurysm basis. Subtracted volumetric CT angiography showed 237 of 239 (99.2%) aneurysms. Sensitivity, specificity, and accuracy of subtracted volumetric CT angiography for depicting aneurysms were 99.2%, 100%, and 99.4%, respectively, on a per-aneurysm basis. There was no statistically significant difference in accuracy between subtracted volumetric CT angiography and 3D DSA (P = .500). However, nonsubtracted volumetric CT angiography was significantly less sensitive than 3D DSA and subtracted volumetric CT angiography (P = .031 and .008, respectively). CONCLUSION: Subtracted 320-detector row volumetric CT angiography provides excellent sensitivity for detection of cerebral aneurysms and should be the first-line imaging technique for the noninvasive evaluation of aneurysms. The accuracy of nonsubtracted volumetric CT angiography was lower than that for subtracted volumetric CT angiography, especially for aneurysms adjacent to bone tissue.