Is arterial spin labelling necessarily low perfusion for cavernous sinus venous malformation? A case of hyperperfusion cavernous sinus venous malformation.

Generally, due to the complexity of the skull base structures, it is difficult to differentiate cavernous vascular malformation and meningioma in the cavernous sinus area using conventional imaging studies. Cavernous sinus venous malformation are characterized by increased capillary masses without a direct arterial supply, typically leading to low perfusion. On the other hand, meningiomas receive arterial blood supply to the tumour and often exhibit high perfusion. So, arterial spin labelling (ASL) can be helpful in distinguishing between the 2 tumour types. However, in our specific case of a cavernous sinus venous malformation, the ASL imaging showed hyperperfusion. Further analysis revealed that this hyperperfusion on ASL can occur when cavernous sinus venous malformation is associated with arteriovenous fistula malformation.

Does Regular Physical Activity Improve Personal Income? Empirical Evidence from China.

A lack of adequate exercise threatens human health, weakening human capital accumulation. The relationship between exercise and income has become the focus of attention in health economics. In terms of reducing body weight and improving physical fitness, diet and physical exercise are intertwined and become effective ways to shape a healthy state. Based on individual-level survey data from China, this study quantified the economic returns of habitual exercise behavior by using an endogenous switching regression model (ESRM) to eliminate selection bias. The study shows that (1) participants in the group with regular exercise behavior increased their income by 3.79% compared with those not exercising regularly; (2) for the group with no regular exercise behavior, regular exercise increased their income by 13.36% compared with those not exercising regularly. Additionally, empirical evidence shows that both drinking and smoking can significantly increase individual income, despite unhealthy habits. These results suggest that the habit of regular physical activity plays a vital role in increasing individual income and improving overall national health, and the effect of individual behavior on income is affected by national culture. The outcomes are empirical evidence for the Chinese government to promote Healthy China Action and support developing countries worldwide to enable habitual exercise, stimulating a policy of exercise behavior.

Radiomics features based on T2-weighted fluid-attenuated inversion recovery MRI predict the expression levels of CD44 and CD133 in lower grade gliomas.

Objective: To verify the association between CD44 and CD133 expression levels and the prognosis of patients with lower grade gliomas (LGGs) and constructing radiomic models to predict those two genes' expression levels before surgery. Materials & methods: Genomic data of patients with LGG and the corresponding T2-weighted fluid-attenuated inversion recovery images were downloaded from The Cancer Genome Atlas and The Cancer Imaging Archive, which were utilized for prognosis analysis, radiomic feature extraction and model construction, respectively. Results & conclusion: CD44 and CD133 expression levels in LGG can significantly affect the prognosis of patients with LGG. Based on the T2-weighted fluid-attenuated inversion recovery images, the radiomic features can effectively predict the expression levels of CD44 and CD133 before surgery.

Multiparametric MRI Radiomics for the Early Prediction of Response to Chemoradiotherapy in Patients With Postoperative Residual Gliomas: An Initial Study.

PURPOSE: To evaluate whether multiparametric magnetic resonance imaging (MRI)-based logistic regression models can facilitate the early prediction of chemoradiotherapy response in patients with residual brain gliomas after surgery. PATIENTS AND METHODS: A total of 84 patients with residual gliomas after surgery from January 2015 to September 2020 who were treated with chemoradiotherapy were retrospectively enrolled and classified as treatment-sensitive or treatment-insensitive. These patients were divided into a training group (from institution 1, 57 patients) and a validation group (from institutions 2 and 3, 27 patients). All preoperative and postoperative MR images were obtained, including T1-weighted (T1-w), T2-weighted (T2-w), and contrast-enhanced T1-weighted (CET1-w) images. A total of 851 radiomics features were extracted from every imaging series. Feature selection was performed with univariate analysis or in combination with multivariate analysis. Then, four multivariable logistic regression models derived from T1-w, T2-w, CET1-w and Joint series (T1+T2+CET1-w) were constructed to predict the response of postoperative residual gliomas to chemoradiotherapy (sensitive or insensitive). These models were validated in the validation group. Calibration curves, receiver operating characteristic (ROC) curves, and decision curve analysis (DCA) were applied to compare the predictive performances of these models. RESULTS: Four models were created and showed the following areas under the ROC curves (AUCs) in the training and validation groups: Model-Joint series (AUC, 0.923 and 0.852), Model-T1 (AUC, 0.835 and 0.809), Model-T2 (AUC, 0.784 and 0.605), and Model-CET1 (AUC, 0.805 and 0.537). These results indicated that the Model-Joint series had the best performance in the validation group, followed by Model-T1, Model-T2 and finally Model-CET1. The calibration curves indicated good agreement between the Model-Joint series predictions and actual probabilities. Additionally, the DCA curves demonstrated that the Model-Joint series was clinically useful. CONCLUSION: Multiparametric MRI-based radiomics models can potentially predict tumor response after chemoradiotherapy in patients with postoperative residual gliomas, which may aid clinical decision making, especially to help patients initially predicted to be treatment-insensitive avoid the toxicity of chemoradiotherapy.

A Radiomics Model for Predicting Early Recurrence in Grade II Gliomas Based on Preoperative Multiparametric Magnetic Resonance Imaging.

OBJECTIVE: This study aimed to develop a radiomics model to predict early recurrence (<1 year) in grade II glioma after the first resection. METHODS: The pathological, clinical, and magnetic resonance imaging (MRI) data of patients diagnosed with grade II glioma who underwent surgery and had a recurrence between 2017 and 2020 in our hospital were retrospectively analyzed. After a rigorous selection, 64 patients were eligible and enrolled in the study. Twenty-two cases had a pathologically confirmed recurrent glioma. The cases were randomly assigned using a ratio of 7:3 to either the training set or validation set. T1-weighted image (T1WI), T2-weighted image (T2WI), and contrast-enhanced T1-weighted image (T1CE) were acquired. The minimum-redundancy-maximum-relevancy (mRMR) method alone or in combination with univariate logistic analysis were used to identify the most optimal predictive feature from the three image sequences. Multivariate logistic regression analysis was then used to develop a predictive model using the screened features. The performance of each model in both training and validation datasets was assessed using a receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA). RESULTS: A total of 396 radiomics features were initially extracted from each image sequence. After running the mRMR and univariate logistic analysis, nine predictive features were identified and used to build the multiparametric radiomics model. The model had a higher AUC when compared with the univariate models in both training and validation data sets with an AUC of 0.966 (95% confidence interval: 0.949-0.99) and 0.930 (95% confidence interval: 0.905-0.973), respectively. The calibration curves indicated a good agreement between the predictable and the actual probability of developing recurrence. The DCA demonstrated that the predictive value of the model improved when combining the three MRI sequences. CONCLUSION: Our multiparametric radiomics model could be used as an efficient and accurate tool for predicting the recurrence of grade II glioma.

A Clinical-Radiomic Nomogram Based on Unenhanced Computed Tomography for Predicting the Risk of Aldosterone-Producing Adenoma.

PURPOSE: To develop and validate a clinical-radiomic nomogram for the preoperative prediction of the aldosterone-producing adenoma (APA) risk in patients with unilateral adrenal adenoma. PATIENTS AND METHODS: Ninety consecutive primary aldosteronism (PA) patients with unilateral adrenal adenoma who underwent adrenal venous sampling (AVS) were randomly separated into training (n = 62) and validation cohorts (n = 28) (7:3 ratio) by a computer algorithm. Data were collected from October 2017 to June 2020. The prediction model was developed in the training cohort. Radiomic features were extracted from unenhanced computed tomography (CT) images of unilateral adrenal adenoma. The least absolute shrinkage and selection operator (LASSO) regression model was used to reduce data dimensions, select features, and establish a radiomic signature. Multivariable logistic regression analysis was used for the predictive model development, the radiomic signature and clinical risk factors integration, and the model was displayed as a clinical-radiomic nomogram. The nomogram performance was evaluated by its calibration, discrimination, and clinical practicability. Internal validation was performed. RESULTS: Six potential predictors were selected from 358 texture features by using the LASSO regression model. These features were included in the Radscore. The predictors included in the individualized prediction nomogram were the Radscore, age, sex, serum potassium level, and aldosterone-to-renin ratio (ARR). The model showed good discrimination, with an area under the receiver operating characteristic curve (AUC) of 0.900 [95% confidence interval (CI), 0.807 to 0.993], and good calibration. The nomogram still showed good discrimination [AUC, 0.912 (95% CI, 0.761 to 1.000)] and good calibration in the validation cohort. Decision curve analysis presented that the nomogram was useful in clinical practice. CONCLUSIONS: A clinical-radiomic nomogram was constructed by integrating a radiomic signature and clinical factors. The nomogram facilitated accurate prediction of the probability of APA in patients with unilateral adrenal nodules and could be helpful for clinical decision making.

Evaluation of gliomas peritumoral diffusion and prediction of IDH1 mutation by IVIM-DWI.

Glioma characterized by high morbidity and mortality, is one of the most common brain tumors. The application of intravoxel incoherent motion diffusion weighted imaging (IVIM-DWI) in differentiating glioma grading and IDH1 mutation status were poorly investigated. 78 glioma patients confirmed by pathological and imaging methods were enrolled. Glioma patients were measured using IVIM-DWI, then related parameters such as cerebral blood flow (CBF), perfusion fraction (f), pseudo diffusivity (D*), and true diffusivity (D), were derived. Receiver operating characteristic (ROC) curves were made to calculate specificity and sensitivity. The values of CBF1, CBF3, D*1, rCBF1-2, rCBF3-2, and age in group high-grade gliomas (HGG) were significantly higher than that of in group low-grade gliomas (LGG). The values of CBF1, CBF3, rCBF1-2, rCBF3-2, D*1, and age in group IDH1mut were significantly lower than that of in group IDH1wt. The levels of D1 and f1 were remarkably higher in the group IDH1mut than group IDH1wt. rCBF1-2 had a remarkably positive correlation with CBF1 (r=0.852, p<0.001). f1 showed a markedly negative correlation with CBF1 (r= -0.306, p=0.007). IVIM-DWI presented efficacy in differentiating glioma grading and IDH1 mutation status.

An Assessment of the Relationship between Structural and Functional Imaging of Cerebrovascular Disease and Cognition-Related Fibers.

In order to assess the relationship between structural and functional imaging of cerebrovascular disease and cognition-related fibers, this paper chooses a total of 120 patients who underwent cerebral small vessel disease (CSVD) treatment at a designated hospital by this study from June 2013 to June 2018 and divides them into 3 groups according to the random number table method: vascular dementia (VaD) group, vascular cognitive impairment no dementia (VCIND) group, and noncognition impairment (NCI) group with 40 cases of patients in each group. Cognitive function measurement and imaging examination were performed for these 3 groups of patients, and the observation indicators of cognitive state examination (CSE), mental assessment scale (MAS), clock drawing test (CDT), adult intelligence scale (AIS), frontal assessment battery (FAB), verbal fluency test (VFT), trail making test (TMT), cognitive index (CI), white matter lesions (WML), third ventricle width (TVW), and frontal horn index (FHI) were tested, respectively. The results shows that the average scores of CSE, MAS, AIS, and VFT in the VaD and VCIND group are lower than those of the NCI group and the differences are statistically significant (P < 0.05); the average scores of FAB, TMT, and CI in the VaD group are higher than those of the VCIND group and the differences are also statistically significant (P < 0.05); the average scores of FHI and TVW in the VaD group are lower than those of the VCIND and NCI group with statistically significant differences (P < 0.05); the average scores of WML, CDT, and AIS in the VaD group are higher than those of the VCIND and NCI group with statistically significant differences (P < 0.05). Therefore, it is believed that the structural and functional imaging features of cerebrovascular disease are closely related to cognition-related fibers, and the incidence of white matter lesions is closely related to the degree of lesions and cognitive dysfunction of cerebral small vessel disease, in which a major risk factor for cognitive dysfunction in patients with small blood vessels is the severity of white matter lesions; brain imaging and neuropsychiatric function assessment can better understand the relationship between cerebrovascular disease and cognitive impairment. The results of this study provide a reference for the further research studies on the relationship between structural and functional imaging of cerebrovascular disease and cognition-related fibers.

Preclinical evaluation of severely defective manganese-based nanocrystal as a liver-specific contrast media for MR imaging: comparison with Gd-EOB-DTPA and MnDPDP.

Manganese-based (chemically formulated of KMnF3) nanocrystal was evaluated as a liver-specific contrast agent for MR imaging and its imaging performance was also compared with those of two commercial hepatobiliary contrast media (Gd-EOB-DTPA and MnDPDP). KMnF3 nanocrystal was post-treated using a plasma technique to cause severe defects, leading to appropriate water dispersibility and high relaxivity. Severely defective KMnF3 nanocrystal (SD-KMnF3) has characteristic high tolerance, as evidenced by cytotoxicity on the macrophage cell, and acute and subchronic toxicity on the healthy mouse. SD-KMnF3 showed better hepatic MR imaging as the T 1 relaxation time of the liver decreased to only 17% of the control group, compared to 22% of the control group for Gd-EOB-DTPA (P < 0.01) and 42% of the control group for MnDPDP (P < 0.001). As applied to MR imaging of the allograft orthotopic model of liver cancer, statistical studies demonstrated that SD-KMnF3 significantly improved the tumor's contrast-to-noise ratio, compared with Gd-EOB-DTPA (P < 0.01) and MnDPDP (P < 0.01) by spin-echo pulse sequence, and even better performance (P < 0.001) by gradient-echo sequence. Our findings indicate that SD-KMnF3 could serve as a hepatic contrast agent for imaging liver cancer such as hepatocarcinoma or metastatic lesions.

Non-coding RNA 886 promotes renal cell carcinoma growth and metastasis through the Janus kinase 2/signal transducer and activator of transcription 3 signaling pathway.

Non-coding RNA 886 (nc886) has been suggested to serve tumor-suppressing roles in several cancer cells. However, the expression pattern of nc886 and its function in renal cell carcinoma (RCC) has not been reported until now. The present study aimed to examine the expression of nc886 in human RCC tissues and to investigate the role of nc886 in RCC cell proliferation, apoptosis and invasion in vitro. Furthermore, whether nc886 exerts its function on RCC via Janus kinase 2/signal transducer and activator of transcription 3 (JAK2/STAT3) signaling was investigated. It was demonstrated that nc886 is overexpressed in human RCC tissues compared with normal tissues, as determined by reverse transcription-quantitative polymerase chain reaction analysis. The nc886 mimic and inhibitor were transfected into the A­498 cells to overexpress or knock down nc886 expression. Cell proliferation, cell apoptosis rate and cell invasion ability were determined by MTT, flow cytometry and Transwell­Matrigel invasion assays. The results demonstrated that nc886 overexpression promotes A­498 cell proliferation and invasion, and inhibits cell apoptosis, while nc886 knockdown resulted in the opposite effects. Furthermore, nc886 could activate the JAK2/STAT3 signaling pathway in A­498 cells. AG490, an inhibitor of JAK2, could attenuate the effects of nc886 on cell proliferation, apoptosis and invasion. In conclusion, to the best of our knowledge, the present study for the first time revealed the expression profile and the tumor­promoting role of nc886 in RCC. nc886 affects RCC cell proliferation, apoptosis and invasion at least partially via the activation of JAK2/STAT3 signaling. This study may provide a useful therapeutic target for RCC.

Downregulation of USP18 inhibits growth and induces apoptosis in hepatitis B virus-related hepatocellular carcinoma cells by suppressing BCL2L1.

Ubiquitin-specific peptidase 18 (USP18) is closely related with hepatitis B virus (HBV), which has been involved in tumourigenesis. However, there has been little research into the role of USP18 on the progression of hepatocellular carcinoma (HCC), especially in HBV-related HCC. In present study, we found that USP18 expression was aberrantly elevated in HCC tissues than adjacent non-tumour tissues. Importantly, USP18 expression was higher in HBV-related HCC cell lines (HepG2.2.15 and Hep3B) than HBV-unrelated HCC cell lines. Furthermore, knockdown of USP18 significantly suppressed tumour cell proliferation in vitro and tumour growth in vivo, whereas overexpression of USP18 promoted HCC cells growth. Moreover, our experimental data revealed that USP18 silencing obviously blocked cell cycle at G1 phase and increased cell apoptosis. Finally, BCL2L1, a member of BCL2 family protein, was identified as a downstream gene of USP18. Mechanistically, we found that USP18 directly bind to BCL2L1 and positively regulated its expression in HCC cells. Overall, our results suggested that USP18 has a crucial role in regulating diverse aspects of the pathogenesis of HCC, indicating that it might be a potential therapeutic target.

[Effect of lead exposure on brain iron in aged rats based on the MRI].

OBJECTIVE: To explore the effect of long-term lead exposure on brain iron in aged rats. METHODS: SPF female and male Sprague-Dawley rats were respectively randomly divided into three groups: control, low lead-exposed, high lead-exposed. Lead-exposed female rats drank 0.8g/L or 1.5g/L lead acetate solutions through pregnancy until weaning and then the pups received 0.3g/L or 0.9g/L lead acetate solution depending on their group. Control group rats drank deionized water throughout the experiment. At the postnatal 18 months, one pup for per group was given an ultra structural detection of hippocampus, and the other male pups were measured the lead and iron concentration of blood and brain by GE MR 3.0T MR scanner and ICP-AES. RESULTS: In comparing with control group, the lead concentrations of blood and brain in lead-exposed groups were significantly higher, and the iron contents of brain and cortex, hippocampus, thalamus were significantly higher in 0.9g/L lead-exposed group. Also, it was highly positively correlated between blood lead and iron of blood, cortex, hippocampus, thalamus, respectively. With the dose of lead-exposed increased, cytoplasm, nucleus, mitochondrial structure and synaptic structure had suffered vary degrees of damage from ultra structural detection of hippocampus, it could be observed early neuronal apoptosis. CONCLUSION: Lead induced neurodegenerative diseases might be related to iron overload which caused by lead exposure.

The effect of lead exposure on brain iron homeostasis and the expression of DMT1/FP1 in the brain in developing and aged rats.

The relation between lead (Pb) and iron (Fe) becomes increasingly concerned because they are both divalent metals that are absorbed by the same intestinal mechanism, and Pb exposure and Fe deficiency in the developmental brain, as well as Fe overload in the aged brain, can cause cognitive deficits. However, the interaction between Pb exposure and Fe status in the brain has not been established. Therefore, in the current study, we examined the effects of maternal ingestion of Pb in drinking water during gestation and lactation on the Fe status and the expression of divalent metal transporter 1 (DMT1) and ferroportin 1 (FP1) in the brain of offspring. The offspring were followed through old age, with measurements taken at postnatal week 3 (PNW3), 41 (PNW41) and 70 (PNW70). Pb exposure increases the Fe content in the old-aged rats' brain, which might be not subjected to DMT1 mediating, but may be associated with the decrease expression of FP1. Furthermore, the effect of Pb on FP1 expression is regulated at transcriptional and posttranscriptional levels. The perturbation in Fe homeostasis may contribute to the neurotoxicology consequences induced by Pb exposure, and FP1 may play a role in Pb-induced Fe cumulation in the brain.

Diagnostic value of whole body diffusion weighted imaging for screening primary tumors of patients with metastases.

OBJECTIVE: To evaluate the values of whole body diffusion weighted imaging (DWI) in screening primary unknown tumor in patients with metastases. METHODS: Totally, 34 patients with metastases of primary unknown tumors were scanned with whole body DWI, and conventional magnetic resonance (MR) imaging was performed if suspected lesions were detected. All the metastases including 27 cases of osseous metastases, 2 brain metastases, 2 liver metastases, 1 pulmonary multiple metastasis, 1 neck metastasis and 1 malignant ascites, were diagnosed by computed tomography, single photon emission computed tomography, or MR imaging. For the proven primary tumors diagnosed by biopsy or pathology of surgical specimens, apparent diffusion coefficient (ADC) values of the primary and metastatic lesions were measured respectively. The sensitivity and specificity of this technique for screening primary tumors were evaluated. RESULTS: We found 24 cases with suspected primary lesions, in which 23 lesions were proved to be primary tumors, and 1 was proved to be benign lesion. And no definite primary lesion was found in 10 cases on whole body DWI, but in which 1 case was diagnosed with primary tumor by biopsy later, and the other 9 cases remained unknown within follow-up of over half a year. The difference was not significant in ADC values between primary and metastatic lesions (P>0.05). The sensitivity and specificity of whole body DWI for searching primary tumors was 95.8% and 90.0%, respectively. CONCLUSION: Combined with conventional MR scanning, whole body DWI can help to search primary lesions of patients with metastases.

[Optic radiation in normal adults: a study using magnetic resonance diffusion tensor imaging and diffusion tensor tractography].

OBJECTIVE: To study the fractional anisotropy (FA) and the architecture of the optic radiation fiber tracts of normal adults with magnetic resonance (MR) diffusion tensor imaging (DTI). METHODS: Diffusion tensor images were obtained from 30 healthy volunteers without any cerebral abnormalities on conventional MRI. FA and the mean diffusivity (MD) of the optic radiation were measured in the directional encoded color (DEC) maps. The architecture of the optic radiation fiber tracts were displayed with the software of diffusion tensor fiber tracking. RESULTS: In all subjects, the optic radiation could be readily identified in the DEC maps. The FA value was 0.509-/+0.029 in the left and 0.502-/+0.026 in the right, with the MD value of (0.763-/+0.050) x10(-3) and 0.748-/+0.052)x10(-3) mm2/s, respectively. No significant differences were found in the FA or MD value of the bilateral optic radiation (P>0.05). Diffusion tensor tractography (DTT) demonstrated that the 3 bundles of the optic radiation fibers were located in the lateral sagittal stratum, passing from the lateral geniculate body of the thalamus to the primary visual cortex. The dorsal and lateral bundles passed posteriorly to the superior bank of the calcarine cortex, while the ventral bundle passed anteriorly before making a sharp turn, known as the Meyer loop, and subsequently coursed posteriorly to terminate in the inferior margin of the calcarine cortex, which was consistent with the results of classic anatomical studies. CONCLUSION: As a novel method to study the relationship between visual function and optic pathway, DTI and DTT can show the FA and architecture of the optic radiation.