Comparison of full-field digital mammography and digital breast tomosynthesis on assessment of the lesions in dense breast: a preliminary study / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To compare the performance of full-field digital mammography (FFDM) and digital breast tomosynthesis (DBT) in the assessment of the lesions in dense breast, and to estimate the difference in diagnosis of breast disease by FFDM images alone and FFDM plus DBT images.</p><p><b>METHODS</b>According to the breast imaging reporting and data system (BIRADS), 134 patients were selected. The morphology of the lesions shown on FFDM and DBT were evaluated and compared, and the maximum diameter of the lesions was measured. At first, doctors made the diagnosis of a patient by reading FFDM only. Then they made another diagnosis by combining with DBT images of the same patient. The two diagnoses were compared and analyzed according to the pathology results.</p><p><b>RESULTS</b>One hundred and thirty-four patients were included in this study, and all of them were confirmed by histology (65 benign cases, 69 malignant cases). DBT could show more details about the morphology of the lesions, including the border of the masses, spiculation and vessels. The numbers of those signs detected by DBT were 46, 30 and 3, respectively, while only 33 case with circumscribed masses and 14 cases with spiculation were detected by FFDM. Only the difference of spiculation in heterogeneously dense breast detected by DBT and FFDM was statistically significant (P < 0.05). Of the cases with calcifications, DBT images (reconstructed as a 1-mm-thick slice) showed calcifications superior to FFDM in 2 cases, equal to FFDM in 23 cases, and inferior to FFDM in 11 cases. The difference was statistically significant (P < 0.05). But when thickness was changed into 1 cm, the visibility of calcifications in those cases was equal between FFDM and DBT. The maximum diameter of lesions was 2.46 ± 1.64 cm in DBT image, and 2.58 ± 1.62 cm in FFDM image, with a significant difference (P < 0.05). Comparing with reading FFDM images only, the accuracy of FFDM combining with DBT was increased from 88.8% to 91.8%. For FFDM, the AUC of ROC was 0.887, while for DBT it was increased to 0.912, with a non-significant difference (P > 0.05).</p><p><b>CONCLUSIONS</b>DBT is superior to FFDM in the morphological characterization and small calcification in the lesions in dense breast. Combining FFDM and DBT improves the accuracy of diagnosis, but the difference is not statistically significant.</p>

Feasibility of volume perfusion CT (VPCT) imaging in antiangiogenic treatment of rabbit VX2 soft-tissue tumor / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To explore the feasibility of volume perfusion CT imaging to dynamically monitor and evaluate the response of rabbit VX2 soft-tissue tumor to antiangiogenic treatment.</p><p><b>METHODS</b>To establish an experimental animal model of VX2 soft tissue tumor on 20 New Zealand white rabbits. Twenty rabbits were randomly divided into 2 groups. The therapy group was treated with recombinant human endostatin (3 mg·kg⁻¹·d⁻¹) for 7 days, and the control group received saline in the same dose only. Four times of CT volume perfusion scan were performed before treatment and on the second, forth, seventh days of treatment, respectively. The value of blood flow (BF), blood volume (BV), mean transit time (MTT), and permeability (PMB) in the VX2 tumors were measured after scanning. The microvessel density (MVD) and expression of vascular endothelial growth factor (VEGF) in the tumors were determined using immunohistochemical staining.</p><p><b>RESULTS</b>The tumor volume of the therapy group was (1.36 ± 0.73) cm³ on the forth day of treatment and (1.69 ± 0.68) cm³ on the seventh day of the treatment. The tumor volume of the control group was (2.35 ± 0.62) cm³ on the fourth day of treatment and (3.87 ± 0.93) cm³ on the seventh day of the treatment (P < 0.05). On the seventh day of treatment, tumor necrosis ratio of the therapy group and the control group was (25.58 ± 5.51)% and (42.93 ± 4.34)%, respectively (P < 0.05). Comparing the perfusion parameters between the two groups on the same day, and the second, forth, seventh days of treatment, the value of PMB of the therapy group was (70.36 ± 23.46) ml·100 ml⁻¹·min⁻¹, (79.64 ± 13.68) ml·100 ml⁻¹·min⁻¹ and (84.76 ± 3.55) ml·100 ml⁻¹·min⁻¹, respectively, and that in the control group was (26.61 ± 6.47) ml·100 ml⁻¹·min⁻¹, (33.74 ± 16.47) ml·100 ml⁻¹·min⁻¹ and (30.47 ± 10.64) ml·100 ml⁻¹·min⁻¹, respectively (P < 0.05). The value of BF in the therapy group and control group was (71.19 ± 12.21) ml·100 ml⁻¹·min⁻¹ and (43.56 ± 12.21) ml·100 ml⁻¹·min⁻¹, respectively, on the seventh day of treatment (P < 0.05). The parameters on different days in the same group were compared. In the control group, the value of BF on the seventh day of treatment was significantly lower than that before and on the second and forth days of treatment (P < 0.05). However, in the therapy group, the value of PMB on the second, forth, and seventh days of treatment was significantly higher than that before treatment (P < 0.05). MVD of tumor in the control group was increased gradually, whereas increased on the first day and then decreased more in the therapy group. The VEGF expressions did not differ significantly between the experimental and control groups.</p><p><b>CONCLUSIONS</b>Volume perfusion CT is helpful to quantify the tumor perfusion and evaluate the functional changes of tumor vasculature, and then evaluate the early therapeutic effect of antiangiogenic treatment.</p>

Analysis of cavitation of advanced NSCLC treated by rh-endostatin combined with NP chemotherapy / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To study the significance of intra-tumoral cavitation in the patients with advanced NSCLC treated by rh-endostatin plus NP chemotherapy.</p><p><b>METHODS</b>Fifty-seven patients with advanced NSCLC were randomly assigned to receive chemotherapy with rh-endostatin plus NP or NP alone. The numbers of activated circulating endothelial cells (aCECs) were measured by flow cytometry. Chest computed tomography was performed to evaluate the efficacy after 2 cycles of chemotherapy.</p><p><b>RESULTS</b>Cavitation occurred in 5 of 29 patients in the rh-endostatin plus NP group, but not in any case of the NP group. Of the 5 patients, there were 2 males and 3 females, with pathological types of 3 adenocarcinomas, 1 adenosquamous cell carcinoma and 1 sarcomatoid carcinoma. All of these 5 cases had a peripherally located tumor in the CT scan. There was only one cavity in each case and most of these were roundish. Four cavities were situated in the center of the tumor and another one was eccentric. There were 3 cavities with thin wall and 2 with thick wall. Their average diameter was 2.7 cm. No hemoptysis occurred in these 5 patients. The blood-supply of the tumors showed by perfusion CT images was inhibited in 3 cases after treatment. The average number of aCECs decreased from 323.2/10(5) to 33.0/10(5) after treatment.</p><p><b>CONCLUSION</b>Intratumoral cavitation is a peculiar imaging characteristics after anti-angiogenic therapy, which may be caused by inhibition of blood-supply to the tumor. CT perfusion imaging and measurement of activated circulating endothelial cells may be helpful to predict the efficacy of anti-angiogenic therapy combined with chemotherapy.</p>

Value of imaging in the diagnosis of primary malignant fibrous histiocytoma of bone / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the imaging feature of primary malignant fibrous histiocytoma of the bone (PBMFH) by the conventional radiography, CT and MRI, and to evaluate these different imaging methods in its diagnosis.</p><p><b>METHODS</b>The imaging data of conventional radiography, CT and MRI of 35 patients with pathologically confirmed PBMFH were retrospectively analyzed.</p><p><b>RESULTS</b>Though the imaging appearance of PBMFH varied in different cases, all the imaging findings of malignant bone tumors were revealed. The common imaging appearance on the conventional radiography and CT were eccentric, aggressive, osteolytic destructions of various types located at the ends of extremities with extraosseous soft tissue masses, but periosteal reaction was rare. Heterogeneous signal intensities on T(1)WI and T(2)WI were common MRI changes but not specific.</p><p><b>CONCLUSION</b>Primary malignant bone fibrous histiocytoma, a rare primary malignant bone tumor, is most frequently located in the long bone. Conventional radiography is still the first and main choice and is taken as an essential means of diagnosis. CT and MRI are quite important in demonstrating the details and extent of the disease such as soft tissue, cortical destruction, periosteal reaction, calcification and necrosis. The imaging characteristics may be of value in differentiating MFH from the other malignant bone tumors. Furthermore, MRI may also be valuable in assessing the efficacy of chemotherapy and/or radiation therapy, as well as in distinguishing recurrence from postoperative or post-radiation changes.</p>