The Cancer Incidence and Trends From 2011 to 2018 in Ma'anshan, China: A Registry-Based Observational Study.

BACKGROUND: The cancer burden in China has been increasing over the decades. However, the cancer incidence remains unknown in Ma'anshan, which is one of the central cities in the Yangtze River Delta in Eastern China. The study was designed to describe the cancer incidence and trends in Ma'anshan from 2011 to 2018, providing information about cancer etiology that is useful for prevention programs. METHODS: The cancer incidence rate and age-standardized incidence rate (ASIR) were calculated using the cancer registry data in Ma'anshan during 2011-2018. The average annual percentage change (AAPC) of the ASIR was analyzed by the Joinpoint regression analysis. Age, period, and cohort effects on cancer incidence were estimated through the age-period-cohort model. RESULTS: There were 13,508 newly diagnosed cancer cases in males and 9558 in females in Ma'anshan during 2011-2018. The ASIR maintained a steady trend in both males and females. Age effects showed that cancer risk increased with age in both genders; no visible period effects were detected during this study period. Cohort effects changed slowly until the end of the 1950s, then started decreasing in males while increasing in females after 1960. Lung, gastric, female breast, colorectal, cervical, esophageal, liver, thyroid, lymphoma, and pancreatic cancer were the most common cancers in Ma'anshan during the study period. The ASIR of gastric cancer (AAPC: -3.72%), esophageal cancer (AAPC: -8.30%), and liver cancer (AAPC: -5.55%) declined, while that of female breast cancer (AAPC: 3.91%), colorectal cancer (AAPC: 3.23%), and thyroid cancer (AAPC: 22.38%) rose. CONCLUSION: During 2011-2018, the cancer incidence in Ma'anshan was lower than that in China, nation-wide. The incidence of upper gastrointestinal cancer decreased gradually while female breast, colorectal, and thyroid cancers showed an upward trend, consistent with the changes in the cancer spectrum in China. Further studies should be designed to discover the underlying causes of these findings.

Healthy lifestyles are associated with alleviating the single-nucleotide polymorphism-based genetic risks of ischaemic stroke, intracerebral haemorrhage and myocardial infarction.

BACKGROUND: Both genetic and lifestyle factors contribute to myocardial infarction (MI) and stroke, including ischaemic stroke (IS) and intracerebral haemorrhage (ICH). We explored how and the extent to which a healthy lifestyle, by considering a comprehensive list, could counteract the genetic risk of those diseases, respectively. METHODS: 315 044 participants free of stroke and MI at baseline were identified from the UK Biobank. Genetic risk scores (GRS) for those diseases were constructed separately and categorised as low, intermediate and high by tertile. Lifestyle risk scores (LRS) were constructed separately using smoking, alcohol intake, physical activity, dietary patterns and sleep patterns. Similarly, participants were categorised into low, intermediate and high LRS. The data were analysed using Cox proportional hazard models. RESULTS: Over a median follow-up of 12.8 years, 4642, 1046 and 9485 participants developed IS, ICH and MI, respectively. Compared with participants with low levels of GRS and LRS, the HRs of those with high levels of GRS and LRS were 3.45 (95% CI 2.71 to 4.41), 2.32 (95% CI 1.40 to 3.85) and 4.89 (95% CI 4.16 to 5.75) for IS, ICH and MI, respectively. Moreover, among participants with high GRS, the standardised 14-year rates of IS events were 4.40% (95% CI 3.45% to 5.36%) among those with high LRS. In contrast, it is only 1.78% (95% CI 1.63% to 1.94%) among those with low LRS. Similarly for MI, the high LRS group had standardised rates of 8.60% (95% CI 7.38% to 9.81%), compared with 3.34% (95% CI 3.12% to 3.56%) in low LRS. Among the high genetic risk group of ICH, the rate is reduced by about half compared low LRS to high LRS, although the rate was low for both (0.36% (95% CI 0.31% to 0.42%) and 0.71% (95% CI 0.36% to 1.05%), respectively). CONCLUSION: Healthy lifestyles were substantially associated with a reduction in the risk of IS, ICH and MI and attenuated the genetic risk of IS, ICH and MI by at least half, respectively.

Whole-lesion iodine map histogram analysis in the risk classification of gastrointestinal stromal tumors: comparison with single-slice iodine concentration measurements.

PURPOSE: To evaluate and compare the diagnostic performances of whole-lesion iodine map (IM) histogram analysis and single-slice IM measurement in the risk classification of gastrointestinal stromal tumors (GISTs). METHODS: Thirty-seven patients with GISTs, including 19 with low malignant underlying GISTs (LG-GISTs) and 18 with high malignant underlying GISTs (HG-GISTs), were evaluated with dual-energy computed tomography (DECT). Whole-lesion IM histogram parameters (mean; median; minimum; maximum; standard deviation; variance; 1st, 10th, 25th, 50th, 75th, 90th, and 99th percentile; kurtosis, skewness, and entropy) were computed for each lesion. In other sessions, iodine concentrations (ICs) were derived from the IM by placing regions of interest (ROIs) on the tumor slices and normalizing them to the iodine concentration in the aorta. Both quantitative analyses were performed on the venous phase images. The diagnostic accuracies of the two methods were assessed and compared. RESULTS: The minimum, maximum, 1st, 10th, and 25th percentile of the whole-lesion IM histogram and the IC and normalized IC (NIC) of the single-slice IC measurement significantly differed between LG- and HG-GISTs (p < 0.001 - p = 0.042). The minimum value in the histogram analysis (AUC = 0.844) and the NIC in the single-slice measurement analysis (AUC = 0.886) showed the best diagnostic performances. The NIC of single-slice measurements had a diagnostic performance similar to that of the whole-lesion IM histogram analysis (p = 0.618). CONCLUSIONS: Both whole-lesion IM histogram analysis and single-slice IC measurement can differentiate LG-GISTs and HG-GISTs with similar diagnostic performances.

Nutrient availability regulates the secretion and function of immune cell-derived extracellular vesicles through metabolic rewiring.

Extracellular vesicle (EV)-based immunotherapeutics have emerged as promising strategy for treating diseases, and thus, a better understanding of the factors that regulate EV secretion and function can provide insights into developing advanced therapies. Here, we report that nutrient availability, even changes in individual nutrient components, may affect EV biogenesis and composition of immune cells [e.g., macrophages (Mφs)]. As a proof of concept, EVs from M1-Mφ under glutamine-depleted conditions (EVGLN-) had higher yields, functional compositions, and immunostimulatory potential than EVs from conventional GLN-present medium (EVGLN+). Mechanistically, the systemic metabolic rewiring (e.g., altered energy and redox metabolism) induced by GLN depletion resulted in up-regulated pathways related to EV biogenesis/cargo sorting (e.g., ESCRT) and immunostimulatory molecule production (e.g., NF-κB and STAT) in Mφs. This study highlights the importance of nutrient status in EV secretion and function, and optimizing metabolic states and/or integrating them with other engineering methods may advance the development of EV therapeutics.

Synthetic white balancing for intra-operative hyperspectral imaging.

Purpose: Hyperspectral imaging shows promise for surgical applications to non-invasively provide spatially resolved, spectral information. For calibration purposes, a white reference image of a highly reflective Lambertian surface should be obtained under the same imaging conditions. Standard white references are not sterilizable and so are unsuitable for surgical environments. We demonstrate the necessity for in situ white references and address this by proposing a novel, sterile, synthetic reference construction algorithm. Approach: The use of references obtained at different distances and lighting conditions to the subject were examined. Spectral and color reconstructions were compared with standard measurements qualitatively and quantitatively, using ΔE and normalized RMSE, respectively. The algorithm forms a composite image from a video of a standard sterile ruler, whose imperfect reflectivity is compensated for. The reference is modeled as the product of independent spatial and spectral components, and a scalar factor accounting for gain, exposure, and light intensity. Evaluation of synthetic references against ideal but non-sterile references is performed using the same metrics alongside pixel-by-pixel errors. Finally, intraoperative integration is assessed though cadaveric experiments. Results: Improper white balancing leads to increases in all quantitative and qualitative errors. Synthetic references achieve median pixel-by-pixel errors lower than 6.5% and produce similar reconstructions and errors to an ideal reference. The algorithm integrated well into surgical workflow, achieving median pixel-by-pixel errors of 4.77% while maintaining good spectral and color reconstruction. Conclusions: We demonstrate the importance of in situ white referencing and present a novel synthetic referencing algorithm. This algorithm is suitable for surgery while maintaining the quality of classical data reconstruction.

Differential diagnosis of lung cancer and tuberculosis based on 18 F-fluorodeoxyglucose PET/CT multi-time points imaging.

OBJECTIVE: To investigate the value of 18 F-fluorodeoxyglucose(FDG) PET/CT multi-time points imaging (MTPI) on the differential diagnosis between lung cancer (LC) and tuberculosis (TB). METHODS: Sixty-four patients underwent 18 F-FDG PET/CT MTPI. The stdSUVmax, stdSUVavg, retention index, metabolic tumor volume, total lesion glycolysis at four-time points and slope of metabolic curve were measured and calculated, and the sex, age, and uniformity of FDG uptake were recorded. The difference in each index between LC and TB was analyzed, and dynamic metabolic curves (DMCs) of LC and TB were fitted by significance indexes. Artificial neural network (ANN) prediction models were established between squamous cell carcinoma (SCC) and TB, as well as between adenocarcinomas and TB. RESULTS: Differences between SCC and TB, stdSUVmax/avg at four-time points, total lesion glycolysis, stdSUVmax/avg slope (1-2 h,1-3 h and 1-4 h), uniformity of FDG uptake and age were significant. stdSUVavg has the largest area under the 4 h curve; age was only significant between adenocarcinomas and TB. DMCs at 1-4 h fitted by stdSUVavg were more helpful in differentiating LC and TB than stdSUVmax. stdSUVavg(1 h and 4 h), stdSUVavg slope 1-4 h, age, and uniformity of FDG uptake were selected to establish an ANN prediction model between SCC and TB; the area under the curve (AUC) was 100.0%. The same indices were used to establish the prediction model between adenocarcinomas and TB; the AUC was up to 83.5, and after adding stdSUVavg (2 and 4 h) to adenocarcinomas and TB models, the AUC was 87.7%. CONCLUSION: 18 F-FDG PET/CT MTPI fitting DMCs and establishing an ANN prediction model would distinguish SCC from TB relatively accurately and provide certain help in the differentiation between adenocarcinomas and TB.

Radiomics-based prediction of response to immune checkpoint inhibitor treatment for solid cancers using computed tomography: a real-world study of two centers.

BACKGROUND: Immune checkpoint inhibitors (ICIs) represent an approved treatment for various cancers; however, only a small proportion of the population is responsive to such treatment. We aimed to develop and validate a plain CT-based tool for predicting the response to ICI treatment among cancer patients. METHODS: Data for patients with solid cancers treated with ICIs at two centers from October 2019 to October 2021 were randomly divided into training and validation sets. Radiomic features were extracted from pretreatment CT images of the tumor of interest. After feature selection, a radiomics signature was constructed based on the least absolute shrinkage and selection operator regression model, and the signature and clinical factors were incorporated into a radiomics nomogram. Model performance was evaluated using the training and validation sets. The Kaplan-Meier method was used to visualize associations with survival. RESULTS: Data for 122 and 30 patients were included in the training and validation sets, respectively. Both the radiomics signature (radscore) and nomogram exhibited good discrimination of response status, with areas under the curve (AUC) of 0.790 and 0.814 for the training set and 0.831 and 0.847 for the validation set, respectively. The calibration evaluation indicated goodness-of-fit for both models, while the decision curves indicated that clinical application was favorable. Both models were associated with the overall survival of patients in the validation set. CONCLUSIONS: We developed a radiomics model for early prediction of the response to ICI treatment. This model may aid in identifying the patients most likely to benefit from immunotherapy.

Flagellin C decreases the expression of the Gossypium hirsutum cation/proton exchanger 3 gene to promote calcium ion, hydrogen peroxide, and nitric oxide and synergistically regulate the resistance of cotton to Verticillium wilt.

To date, no ideal effective method for controlling Verticillium wilt in upland cotton (Gossypium hirsutum) has been defined. The purpose of this study was to determine the effects and mechanism through which flagellin C (FLiC) regulates the Gossypium hirsutum cation/proton exchanger 3 gene (GhCAX3), induces plant immunity, and increases resistance to Verticillium wilt. The FLiC gene was cloned from an endophytic bacterium (Pseudomonas) isolated from roots of the upland cotton cultivar Zhongmiansuo 41. The biocontrol effects of FLiC purified in vitro on resistant and susceptible upland cotton cultivars were 47.50 and 32.42%, respectively. FLiC induced a hypersensitive response (HR) in leaves of tobacco and immune responses in upland cotton. Transcriptome data showed that treatment with FLiC significantly enriched the calcium antiporter activity-associated disease-resistant metabolic pathway in seedlings. Moreover, FLiC downregulated GhCAX3 expression to increase intracellular calcium ion (Ca2+) content and stimulate increases in the intracellular hydrogen peroxide (H2O2) and nitric oxide (NO) contents. The coordinated regulation of Ca2+, H2O2, and NO enhanced cotton resistance to Verticillium wilt. Furthermore, transgenic Arabidopsis plants overexpressing FLiC showed significantly improved resistance to Verticillium wilt. FLiC may be used as a resistance gene and a regulator to improve resistance to Verticillium dahliae (VD) in upland cotton.

Identification of Candidate Therapeutic Genes for More Precise Treatment of Esophageal Squamous Cell Carcinoma and Adenocarcinoma.

The standard therapy administered to patients with advanced esophageal cancer remains uniform, despite its two main histological subtypes, namely esophageal squamous cell carcinoma (SCC) and esophageal adenocarcinoma (AC), are being increasingly considered to be different. The identification of potential drug target genes between SCC and AC is crucial for more effective treatment of these diseases, given the high toxicity of chemotherapy and resistance to administered medications. Herein we attempted to identify and rank differentially expressed genes (DEGs) in SCC vs. AC using ensemble feature selection methods. RNA-seq data from The Cancer Genome Atlas and the Fudan-Taizhou Institute of Health Sciences (China). Six feature filters algorithms were used to identify DEGs. We built robust predictive models for histological subtypes with the random forest (RF) classification algorithm. Pathway analysis also be performed to investigate the functional role of genes. 294 informative DEGs (87 of them are newly discovered) have been identified. The areas under receiver operator curve (AUC) were higher than 99.5% for all feature selection (FS) methods. Nine genes (i.e., ERBB3, ATP7B, ABCC3, GALNT14, CLDN18, GUCY2C, FGFR4, KCNQ5, and CACNA1B) may play a key role in the development of more directed anticancer therapy for SCC and AC patients. The first four of them are drug targets for chemotherapy and immunotherapy of esophageal cancer and involved in pharmacokinetics and pharmacodynamics pathways. Research identified novel DEGs in SCC and AC, and detected four potential drug targeted genes (ERBB3, ATP7B, ABCC3, and GALNT14) and five drug-related genes.

Hepatic perivascular epithelioid cell tumor: A case report.

BACKGROUND: Perivascular epithelioid cell tumor (PEComa) is a mesenchymal tumor with histologic and immunophenotypic characteristics of perivascular epithelioid cells, has a low incidence, and can involve multiple organs. PEComa originating in the liver is extremely rare, with most cases being benign, and only a few cases are malignant. Good outcomes are achieved with radical surgical resection, but there is no effective treatment for some large tumors and specific locations that are contraindicated for surgery. CASE SUMMARY: A 32-year-old woman was admitted to our hospital with a palpable abdominal mass and progressive deterioration since the previous month. An ultrasound-guided percutaneous liver aspiration biopsy was performed. Postoperative pathological immunohistochemical staining was HMB45, Melan-A, and smooth muscle actin positive. Perivascular epithelioid tumor was diagnosed. The tumor was large and could not be completely resected by surgery. Further digital subtraction angiography revealed a rich tumor blood supply, and interventional embolization followed by surgery was recommended. Finally, the patient underwent transarterial embolization (TAE) combined with sorafenib for four cycles. Angiography reexamination indicated no clear vascular staining of the tumor, and the tumor had shrunk. The patient was followed up for a short period of time, achieved a stable condition, and surgery was recommended. CONCLUSION: Adjuvant combination treatment with TAE and sorafenib is safe and feasible as it shrinks the tumor preoperatively and facilitates surgery.

Minimal apparent diffusion coefficient in predicting the Ki-67 proliferation index of pancreatic neuroendocrine tumors.

PURPOSE: To investigate the diagnostic performance of the minimal apparent diffusion coefficient (ADCmin) to distinguish between pancreatic neuroendocrine tumors (Pan-NETs) with low and high Ki-67 proliferation index values and to evaluate the relationship between ADCmin and the Ki-67 proliferation index. METHODS: Pre-operative magnetic resonance imaging data and postoperative Ki-67 proliferation index data of 42 patients with primary neuroendocrine tumor of the pancreas from November 2014 to March 2021 were included in this retrospective study. According to the Ki-67 proliferation index value, Pan-NETs were divided into a high-expression group (Ki-67 ≥ 10%, n = 17) and low-expression group (Ki-67 < 10%, n = 25), and mean ADC (ADCmean) and ADCmin values were compared between groups using receiver operating characteristic (ROC) curves to evaluate the performance of ADCmean and ADCmin in judging the expression level of Ki-67 proliferation index. The relationship between ADCmin and the Ki-67 proliferation index was also evaluated. RESULTS: The ADCmin was significantly higher in the low-expression group (Z = - 3.537, p < 0.01). The area under the ROC curve (AUC) for ADCmin was 0.825, which was higher than that for ADCmean (0.781). Using 1.32 × 10-3 mm2/s as the optimal discriminating threshold, the sensitivity, specificity, accuracy, and positive and negative predictive values of the two groups were 80%, 88.2%, 83.3%, 90%, and 75%, respectively. The ADCmin of Pan-NETs showed a significant negative correlation with the Ki-67 proliferation index (rs = - 0.634, p < 0.001). CONCLUSION: The ADCmin is a potential imaging biomarker, which may be helpful for non-invasive preoperative prediction of the Ki-67 proliferation index of Pan-NETs and the subsequent planning of appropriate treatment.

Optical properties of human brain and tumour tissue: An ex vivo study spanning the visible range to beyond the second near-infrared window.

Neuro-oncology surgery would benefit from detailed intraoperative tissue characterization provided by noncontact, contrast-agent-free, noninvasive optical imaging methods. In-depth knowledge of target tissue optical properties across a wide-wavelength spectrum could inform the design of optical imaging and computational methods to enable robust tissue analysis during surgery. We adapted a dual-beam integrating sphere to analyse small tissue samples and investigated ex vivo optical properties of five types of human brain tumour (meningioma, pituitary adenoma, schwannoma, low- and high-grade glioma) and nine different types of healthy brain tissue across a wavelength spectrum of 400 to 1800 nm. Fresh and frozen tissue samples were analysed. All tissue types demonstrated similar absorption spectra, but the reduced scattering coefficients of tumours show visible differences in the obtained optical spectrum compared to those of surrounding normal tissue. These results underline the potential of optical imaging technologies for intraoperative tissue characterization.

Intraoperative hyperspectral label-free imaging: from system design to first-in-patient translation.

Despite advances in intraoperative surgical imaging, reliable discrimination of critical tissue during surgery remains challenging. As a result, decisions with potentially life-changing consequences for patients are still based on the surgeon's subjective visual assessment. Hyperspectral imaging (HSI) provides a promising solution for objective intraoperative tissue characterisation, with the advantages of being non-contact, non-ionising and non-invasive. However, while its potential to aid surgical decision-making has been investigated for a range of applications, to date no real-time intraoperative HSI (iHSI) system has been presented that follows critical design considerations to ensure a satisfactory integration into the surgical workflow. By establishing functional and technical requirements of an intraoperative system for surgery, we present an iHSI system design that allows for real-time wide-field HSI and responsive surgical guidance in a highly constrained operating theatre. Two systems exploiting state-of-the-art industrial HSI cameras, respectively using linescan and snapshot imaging technology, were designed and investigated by performing assessments against established design criteria and ex vivo tissue experiments. Finally, we report the use of our real-time iHSI system in a clinical feasibility case study as part of a spinal fusion surgery. Our results demonstrate seamless integration into existing surgical workflows.

Clinical value of spectral CT imaging combined with AFP in identifying liver cancer and hepatic focal nodular hyperplasia.

PURPOSE: To investigate the clinical value of spectral computed tomography (CT) imaging combined with alpha-fetoprotein (AFP) in identifying liver cancer and hepatic focal nodular hyperplasia (FNH). METHODS: A total of 132 patients with local liver space-occupying lesions, including 68 patients with liver cancer, were randomly enrolled. All the patients underwent spectral CT imaging and AFP examinations. The corresponding specificity, sensitivity, accuracy rate, positive predictive value and negative predictive value of spectral CT imaging, AFP and combined detection were recorded, respectively, with pathological findings as the gold standards. SPSS 17.0 software was used for statistical analysis. P<0.05 suggested that the difference was statistically significant. RESULTS: The diagnostic rate of spectral CT imaging was 79.5% for liver cancer and 81.3% for hepatic FNH. In arterial phase and portal venous phase, the contrast-to-noise ratio (CNR) of liver cancer was remarkably lower than that of FNH, showing a statistically significant difference, and the difference was the greatest at 70-100 keV between the two kinds of lesions. The detection rate of AFP for liver cancer was 86.8%, and the exclusive diagnostic rate of AFP for hepatic FNH was 96.9%. AFP had the highest specificity (73.2%) in identifying liver cancer and hepatic FNH. The spectral CT imaging possessed the highest sensitivity (91.7%) in identifying liver cancer and hepatic FNH. Both the sensitivity (98.1%) and accuracy (89.1%) of spectral CT imaging combined with AFP were the highest in identifying liver cancer and hepatic FNH. CONCLUSION: The spectral CT imaging combined with AFP is conducive to improving the efficiency of differential diagnosis of liver cancer and hepatic FNH.

Intraoperative multispectral and hyperspectral label-free imaging: A systematic review of in vivo clinical studies.

Multispectral and hyperspectral imaging (HSI) are emerging optical imaging techniques with the potential to transform the way surgery is performed but it is not clear whether current systems are capable of delivering real-time tissue characterization and surgical guidance. We conducted a systematic review of surgical in vivo label-free multispectral and HSI systems that have been assessed intraoperatively in adult patients, published over a 10-year period to May 2018. We analysed 14 studies including 8 different HSI systems. Current in-vivo HSI systems generate an intraoperative tissue oxygenation map or enable tumour detection. Intraoperative tissue oxygenation measurements may help to predict those patients at risk of postoperative complications and in-vivo intraoperative tissue characterization may be performed with high specificity and sensitivity. All systems utilized a line-scanning or wavelength-scanning method but the spectral range and number of spectral bands employed varied significantly between studies and according to the system's clinical aim. The time to acquire a hyperspectral cube dataset ranged between 5 and 30 seconds. No safety concerns were reported in any studies. A small number of studies have demonstrated the capabilities of intraoperative in-vivo label-free HSI but further work is needed to fully integrate it into the current surgical workflow.

Value of CT spectral imaging in the differential diagnosis of thymoma and mediastinal lymphoma.

OBJECTIVE:: To investigate the imaging characteristics of thymoma and mediastinal lymphoma using spectral CT and evaluate whether the quantitative information can improve the differential diagnosis of these diseases. METHODS:: This retrospective study was approved by the institutional review board, and written informed consent was obtained from all patients. Overall, 39 patients with mediastinal tumors (24 thymomas and 15 mediastinal lymphomas) were examined with CT spectral imaging during the arterial phase (AP) and venous phase (VP). Iodine concentrations were derived from iodine-based material-decomposition CT images and normalized to the iodine concentration in the aorta. The difference in normalized iodine concentrations (NICs), HU curve slop(λHU), and the differences between AP and VP for CT values of lesions in 70 Kev were calculated. The two-sample t-test was performed to compare quantitative parameters, and non-quantitative parameters were compared with the Chi-square test (Fisher exact). Receiver operating characteristic (ROC) curves were generated to help establish threshold values for the parameters required for the significant differentiation of thymomas from mediastinal lymphomas. Two readers qualitatively assessed the lesion types according to the imaging features. The sensitivity and specificity of the qualitative and quantitative studies were compared. RESULTS:: NICs during the VP and λHU during the AP in patients with mediastinal lymphomas differed significantly from those in patients with thymomas. The mean NICs during the VP were 0.28 ± 0.08 mg ml-1 (±standard deviation) vs 0.49 ± 0.15 mg ml-1, respectively. The λHU during the AP was 0.69 ± 0.17 vs 1.26 ± 0.74, respectively. The NICs during the VP and λHU during the AP had high sensitivity and specificity in differentiating mediastinal lymphomas from thymomas. The tumor location, margin, necrosis, presence of swollen mediastinal lymph nodes, relationship with adjacent vessels, and enhancement pattern differed significantly between the groups (p < 0.05). The combination of NICs and λHU had higher sensitivity and specificity than did those of conventional qualitative CT image analysis during the combined phases. CONCLUSION:: CT spectral imaging has promising potential for the diagnostic differentiation of mediastinal lymphomas and thymomas. The iodine content and λHU could be valuable parameters for differentiating thymomas and mediastinal lymphomas. ADVANCES IN KNOWLEDGE:: The iodine content and λHU, provided by spectral CT, could be used as new parameters to distinguish mediastinal lymphomas from thymomas.

Wide-field spectrally resolved quantitative fluorescence imaging system: toward neurosurgical guidance in glioma resection.

In high-grade glioma surgery, tumor resection is often guided by intraoperative fluorescence imaging. 5-aminolevulinic acid-induced protoporphyrin IX (PpIX) provides fluorescent contrast between normal brain tissue and glioma tissue, thus achieving improved tumor delineation and prolonged patient survival compared with conventional white-light-guided resection. However, commercially available fluorescence imaging systems rely solely on visual assessment of fluorescence patterns by the surgeon, which makes the resection more subjective than necessary. We developed a wide-field spectrally resolved fluorescence imaging system utilizing a Generation II scientific CMOS camera and an improved computational model for the precise reconstruction of the PpIX concentration map. In our model, the tissue's optical properties and illumination geometry, which distort the fluorescent emission spectra, are considered. We demonstrate that the CMOS-based system can detect low PpIX concentration at short camera exposure times, while providing high-pixel resolution wide-field images. We show that total variation regularization improves the contrast-to-noise ratio of the reconstructed quantitative concentration map by approximately twofold. Quantitative comparison between the estimated PpIX concentration and tumor histopathology was also investigated to further evaluate the system.

Coronal in vivo forward-imaging of rat brain morphology with an ultra-small optical coherence tomography fiber probe.

A well-established navigation method is one of the key conditions for successful brain surgery: it should be accurate, safe and online operable. Recent research shows that optical coherence tomography (OCT) is a potential solution for this application by providing a high resolution and small probe dimension. In this study a fiber-based spectral-domain OCT system utilizing a super-luminescent-diode with the center wavelength of 840 nm providing 14.5 µm axial resolution was used. A composite 125 µm diameter detecting probe with a gradient index (GRIN) fiber fused to a single mode fiber was employed. Signals were reconstructed into grayscale images by horizontally aligning A-scans from the same trajectory with different depths. The reconstructed images can display brain morphology along the entire trajectory. For scans of typical white matter, the signals showed a higher reflection of light intensity with lower penetration depth as well as a steeper attenuation rate compared to the scans typical for gray matter. Micro-structures such as axon bundles (70 µm) in the caudate nucleus are visible in the reconstructed images. This study explores the potential of OCT to be a navigation modality in brain surgery.