Methods for Identifying Seeds of Chinese Medicinal Materials： A Review / 中国实验方剂学杂志

Seeds are the source for the production of Chinese medicinal materials. The seed authenticity and quality of directly affect the effectiveness and safety of Chinese medicinal materials. The seed quality is faced with the problems such as mixed sources， existence of adulterants and seeds stocked for years， low maturity， and low purity. To ensure the high-quality and sustainable development of the Chinese medicinal material industry， it is urgent to standardize the seed market and identify and evaluate the quality of the seeds circulating in the market. Seed identification methods include visual inspection， microscopic observation， micro-character identification， chemical fingerprinting， molecular identification， electronic nose， X-ray diffraction， electrochemical fingerprinting， spectral imaging， and artificial intelligence. These methods have different application scopes and unique advantages and disadvantages. According to the different species of Chinese herbal medicines and different requirements of testing sites， suitable methods can be selected to achieve rapid and accurate identification with low costs. In the future， the seed identification methods should be developed based on emerging technologies with interdisciplinary knowledge， and intelligent， nondestructive， and single-grain detection methods are needed for the modern Chinese medicinal material industry. This paper introduces the seed identification technologies currently applied in research and production， compares the principles， applicability， advantages， and disadvantages of different technologies， and provides an outlook on the future development of seed identification technologies， aiming to provide a reference for the identification and quality evaluation of seeds of Chinese medicinal material.

Progress of single-cell protein imaging methods / 中国药科大学学报

@#Abstract: The differential expression and subcellular localization of single-cell proteins are closely related to the physiological state and pathological mechanisms of the body. The development of single-cell protein in situ imaging methods provides powerful tools for spatial single-cell proteomics research and single-cell protein profiling. This article summarizes the single-cell protein imaging methods developed in recent years, including the circulating immunofluorescence imaging methods based on ordered multi-round antibody incubation, mass spectrometry imaging based on metal element labeled antibodies, fluorescence imaging based on DNA-barcoded antibody, gene encoded fluorescence protein imaging and spectral imaging based on Raman spectroscopy or X-ray spectroscopy, with brief explanation of the imaging principles of these methods. It focuses on the multiple performance, imaging resolution and signal amplification performance of these methods, and analyzes their application characteristics in practical scientific research and clinical work, in the hope of providing some reference for the development of more revolutionary single-cell imaging methods, and promoting the development of biomedical and precision medicine.

Correlation study of carotid artery plaque components and CT cerebral perfusion by the analysis of CT energy spectrum imaging / 中国医学装备

Objective:To quantitatively analyze the plaque components of carotid artery through energy spectrum computed tomography angiography(CTA),and to measure the blood flow perfusion in the blood-supply area of carotid artery through CT perfusion(CTP),so as to explore the relationship among plaque component,the degree of luminal stenosis and cerebral blood flow perfusion.Methods:A total of 68 patients with unilateral plaques of carotid artery and severe vascular stenosis who were screened and diagnosed by ultrasound and CTA in Xiyuan Hospital from December 2017 to July 2019 were selected,and all patients underwent CTA examination and CTP examination.North American symptomatic carotid endarterectomy test(NASCET)method was used to measure the degree of carotid stenosis.The GE AW 4.7 post-process workstation was used to conduct analyses of energy spectrum and cerebral perfusion for the plaque component.And then,the slope of energy spectrum curve and the effective atomic number were obtained.At the same time,the cerebral blood volume(CBV),cerebral blood flow(CBF),time to peak(TTP)and mean transit time(MTT)of contrast agent in blood-supplying area of anterior cerebral artery(ACA)and middle cerebral artery(MCA)at the side of lesion were measured.Results:A total of 68 measured plaques of 68 patients met the condition,including 44 vulnerable plaques(including lipid plaques and mixed plaques)and 24 stable plaques(fibrous plaques).The average slopes of the energy spectrum curves of vulnerable plaque and stable plaque were respectively 0.45±0.45 and 1.15±0.39,and the differences were significant(t=2.413,P<0.05).The averagely effective atomic numbers of vulnerable plaques and stable plaques were respectively 7.21±1.06 and 8.01±0.63,and the difference were significant(t=2.548,P<0.05).The average TTP values of the ACA at the side of lesion of vulnerable plaques and stable plaques were respectively(12.20±1.61)S and(13.59±2.79)S,and the difference was significant(t=-2.607,P<0.05).The mean MTT values of the ACA at the side of lesion of vulnerable plaques and stable plaques were respectively(5.07±1.66)S and(6.09±2.19)S,and the difference was significant(t=-2.177,P<0.05).The degree of vascular stenosis at the side of lesion was positively correlated with TTP and MTT in blood-supplying area of middle cerebral artery(MCA)at the side of lesion(r=0.537,0.465,P<0.05),and that was negatively correlated with CBF values in blood-supplying areas of ACA and MCA at the side of lesion(r=-0.281,-0.569,P<0.05),respectively.The slope of the energy spectrum curve of carotid plaque was positively correlated with the TTP values in blood-supplying areas of ACA and MCA at the side of lesion(r=0.242,0.246,P<0.05),respectively.Conclusion:CT spectral imaging can quantitatively analyze the displayed components of carotid atherosclerotic plaque,and the degree of vascular stenosis can affect the blood flow perfusion of cerebral tissue,and the delays of TTP and MTT are more easily caused by vulnerable plaque,and the TTP of them is more sensitivity.

Value of nomogram based on quantitative parameters of dual-layer detector spectral CT and conventional CT features in preoperative prediction of tumor deposits in colorectal cancer / 中华放射学杂志

Objective:To investigate the value of the nomogram based on quantitative parameters of dual-layer detector spectral CT and conventional CT features in preoperatively predicting tumor deposits (TDs) in colorectal cancer.Methods:This study was a case-control study. A total of 126 patients with pathologically confirmed colorectal cancer who underwent preoperative spectral CT scan from January 2022 to March 2023 in the First Affiliated Hospital of Soochow University were enrolled retrospectively. Patients were divided into TDs-positive group ( n=38) and TDs-negative group ( n=88) based on pathological results. The following conventional CT features were assessed: cT stage, cN status, uniformity of enhancement in the venous phase, pericolorectal fat invasion (PFI), maximum tumor diameter, and tumor location. The following quantitative parameters were also measured and calculated: the normalized iodine concentration (NIC) of lesions, the normalized effective atomic number (NZ eff), and the slope of the 40-100 keV spectral curve (K) in the arterial and venous phases, and the difference in NIC between the arterial and venous phases. Multivariate logistic regression analysis was used to select independent predictors of TDs and the nomogram based on spectral CT quantitative parameters and conventional CT features was constructed. The receiver operating characteristic curve was performed to evaluate the diagnostic performance of each parameter and model. DeLong test was used to compare the differences of area under the curve (AUC). Results:Statistically significant differences were found between the TDs-positive and TDs-negative groups for the cT stage, cN status, uniformity of enhancement in the venous phase, PFI, NIC, NZ eff, K in the venous phase and the difference in NIC between the arterial and venous phases ( P<0.05). After multivariate logistic regression analysis, the conventional CT feature model incorporated two features: uniformity of enhancement in the venous phase (OR=9.602, 95% CI 3.728-24.734, P=0.001) and PFI ( OR=2.881, 95% CI 1.177-7.049, P=0.020). The combined model of conventional CT features and spectral CT quantitative parameters incorporated three features: the difference in NIC between the arterial and venous phases ( OR=37.599, 95% CI 8.320-169.912, P=0.001), uniformity of enhancement in the venous phase ( OR=14.978, 95% CI 3.848-58.295, P=0.001), and PFI ( OR=4.013, 95% CI 1.320-12.760, P=0.015), and the nomogram was constructed. The AUC, sensitivity, and specificity of the nomogram for predicting TDs were 0.919 (95% CI 0.865-0.973), 84.2%, and 86.5%, respectively. The AUC of the conventional CT feature model was 0.796 (95% CI 0.707-0.885), which was lower than that of the nomogram, and the difference was statistically significant ( Z=3.87, P=0.001). Conclusion:Dual-layer spectral detector CT can be used to predict TDs in colorectal cancer preoperatively, and the nomogram based on quantitative parameters of dual-layer detector spectral CT and conventional CT features shows good diagnostic performance.

Dual-energy CT quantitative parameters combined with CT features for predicting perineural invasion of colorectal adenocarcinoma / 中国医学影像技术

Objective To investigate the value of dual-energy CT quantitative parameters combined with CT features for predicting perineural invasion(PNI)of colorectal adenocarcinoma.Methods Preoperative whole-abdominal CT data of 79 patients with colorectal adenocarcinoma confirmed by postoperative pathology were retrospectively analyzed.The patients were divided into PNI group(n=31)or no PNI group(n=48).Univariate analysis was used to compare CT features and dual-energy CT quantitative parameters between groups,and the variables with significant differences were included in binary logistic regression analysis to construct a combined model.Receiver operating characteristic(ROC)curves were drawn and area under the curve(AUC)were calculated,the efficacy of single CT parameters and combined model for predicting PNI of colorectal adenocarcinoma were evaluated.Results There were significant differences of the location of the primary lesion,the maximum thickness of the diseased intestinal wall,the presence or absence of peritumoral lymph node metastases,peritumoral mesenteric streak shadow and tumor deposits shown on CT between groups(all P＜0.05).Significant differences of the arterial phase slope of energy spectrum curve(λHU),iodine concentration(IC),normalized IC(NIC),dual energy index and the venous phase NIC of dual energy index were found between groups(all P＜0.05).AUC of the above single parameters for predicting PNI of colorectal adenocarcinoma ranged from 0.615 to 0.698,while of the combined model was 0.864.Conclusion Dual-energy CT quantitative parameters combined with CT features could be used to effectively predict PNI of colorectal adenocarcinoma.

Value of spectral CT based iodine concentration for the preoperative prediction of vascular invasion in gastric cancer / 中华放射学杂志

Objective:To investigate the value of spectral CT based iodine concentration (IC) parameters for preoperative prediction of lymphovascular invasion (LVI) in gastric cancer.Methods:Between January 2021 and November 2021, 266 patients diagnosed as gastric adenocarcinomas by endoscopy and undergoing gastrectomy at the Affiliated Cancer Hospital of Zhengzhou University were recruited prospectively. They were divided into LVI and non-LVI groups according to pathological reports. Triple phase contrasted enhanced CT scans, including arterial phase (AP), venous phase (VP) and delayed phase (DP) were performed on a spectral CT platform within one week before surgery. The IC of gastric cancer lesions at three enhanced phases were measured based on iodine maps, and the normalized IC (nIC) was calculated. The thickness of the tumor was measured. Clinicopathological features were collected, including ulceration, pathological tumor staging (pT), pathological node staging (pN), histodifferentiation, Lauren subtype, perineural invasion (PNI), positive node numbers and positive node ratio. Student′s t tes t or Mann-Whitney U test were used to compare the differences of continuous variables between the two groups, while Chi-square test or Fisher′s exact test was used for categorical data. Multivariable logistic regression analysis was used to screen independent risk factors of LVI, and to build a combined parameter based on risk factors. The receiver operating characteristic curve analysis was performed to determine the predictive efficacy of IC parameters and the combined parameter for LVI. DeLong′s test was used to compare the differences among different area under the curve (AUC). Results:There were statistical differences in tumor thickness, ulceration, pT, pN, histodifferentiation, positive node numbers, positive node ratio, Lauren subtype and PNI between LVI and non-LVI groups ( P<0.05). The values of IC VP, IC DP, nIC VP, nIC DP in LVI group were statistically higher than those in non-LVI group ( t=3.77, 4.23, 4.25, 6.12, all P<0.001), with the AUC (95%CI) of 0.674 (0.610-0.738), 0.677 (0.614-0.741), 0.731 (0.671-0.792), 0.700 (0.636-0.764) for predicting LVI, respectively. Multivariable logistic regression analysis revealed that tumor thickness (OR=1.148, 95%CI 1.085-1.237, P<0.001) and nIC VP (OR=209.904, 95%CI 14.874-644.362, P<0.001) were independent predictors for LVI, the combined parameter incorporating these two factors yielded an AUC (95%CI) of 0.790 (0.736-0.937), which was statistically higher than any single parameter of IC VP, IC DP, nIC VP and nIC DP ( Z=3.07, 3.29, 2.10, 2.60, P=0.002, 0.001, 0.036, 0.009). Conclusion:The IC and nIC values of gastric cancer lesions derived from the VP and DP on spectral CT can effectively predict LVI status in gastric adenocarcinomas, and the combination of nIC VP and tumor thickness can further improve the predictive efficacy.

Predicting the invasiveness of lung adenocarcinoma manifesting as ground-glass opacity using spectral CT multi-parameter functional imaging / 中华放射学杂志

Objective:To explore the clinical value of quantitative parameters on spectral CT in predicting the invasiveness of lung adenocarcinoma manifesting as ground-glass nodules (GGN).Methods:The clinical and imaging data of 129 patients with pathologically confirmed lung adenocarcinoma who were surgically resected in the First Affiliated Hospital of Zhengzhou University from March to October 2022 were retrospectively analyzed, including 45 males and 84 females, aged from 33 to 81. According to the pathological results, they were divided into the minimally invasive adenocarcinoma (MIA) group ( n=64) and the invasive adenocarcinoma (IAC) group ( n=65). All patients underwent enhanced spectral CT within two weeks before surgery. The iodine density map, Z-Effective (Z eff) map, and electron density (ED) map were reconstructed on the post-processing workstation, and the spectral parameters, including normalized iodine concentration (NIC), arterial enhancement fraction (AEF), Z eff, and ED were measured and calculated. Conventional CT features were analyzed, including maximum diameter, CT value, nodule types, margin, lobulation sign, spiculation sign, bubble sign, pleural retraction sign, abnormal vascular sign, and air bronchial sign. The clinical features, conventional CT characteristics and spectral CT parameters of two groups were compared using the independent sample t test, the Mann-Whitney U test, and the χ 2 test. Multivariate logistic regression analysis was used to evaluate the independent risk factors of lung adenocarcinoma invasiveness, and the model was constructed. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the performance of parameters and models in predicting the invasiveness of lung adenocarcinoma. Results:There were significant differences between the MIA group and IAC group in maximum diameter, CT value, nodule type, margin, spiculation sign, pleural retraction sign, air bronchial sign, venous phase NIC, AEF, venous phase Z eff, arterial phase ED, venous phase ED ( P<0.05). Multivariate logistic regression analysis showed that the maximum diameter (OR=1.183, 95%CI 1.062-1.318), CT value (OR=1.004, 95%CI 1.001-1.007), venous phase NIC (OR=1.185, 95%CI 1.083-1.298), AEF(OR=0.975, 95%CI 0.957-0.994), venous phase Z eff (OR=0.031, 95%CI 0.005-0.196) were independent influence factors for the invasiveness of lung adenocarcinoma. The conventional CT model was established with the maximum diameter and CT value, and the spectral CT model was established with venous phase NIC, AEF, and venous phase Z eff. The combined model was established with all the parameters above. Areas under the ROC curve of the conventional CT model, the spectral CT model, and the combined model for predicting the invasiveness of lung adenocarcinoma were 0.828, 0.854, and 0.902, respectively. Conclusion:The quantitative parameters of double-layer detector spectral CT can be used as an indicator to predict the invasiveness of lung adenocarcinoma manifesting as GGN, and AEF has the highest diagnostic efficacy. Spectral CT combined with conventional CT features can further improve the diagnostic efficiency.

Development status of novel spectral imaging techniques and application to traditional Chinese medicine / 药物分析学报

Traditional Chinese medicine(TCM)is a treasure of the Chinese nation,providing effective solutions to current medical requisites.Various spectral techniques are undergoing continuous development and provide new and reliable means for evaluating the efficacy and quality of TCM.Because spectral tech-niques are noninvasive,convenient,and sensitive,they have been widely applied to in vitro and in vivo TCM evaluation systems.In this paper,previous achievements and current progress in the research on spectral technologies(including fluorescence spectroscopy,photoacoustic imaging,infrared thermal imaging,laser-induced breakdown spectroscopy,hyperspectral imaging,and surface enhanced Raman spectroscopy)are discussed.The advantages and disadvantages of each technology are also presented.Moreover,the future applications of spectral imaging to identify the origins,components,and pesticide residues of TCM in vitro are elucidated.Subsequently,the evaluation of the efficacy of TCM in vivo is presented.Identifying future applications of spectral imaging is anticipated to promote medical research as well as scientific and technological explorations.

Diagnostic efficiency of CT enterography comprehensive score combined with spectral imaging for Crohn's disease in active phase / 中国医师杂志

Objective:To explore the diagnostic efficiency of CT enterography (CTE) comprehensive score combined with spectral imaging for Crohn's disease (CD) in active phase.Methods:A retrospective analysis was performed on the case data of 87 CD patients who were admitted to the First People's Hospital of Chenzhou from October 2018 to October 2020. According to CD activity index (CDAI), they were divided into active phase group ( n=58) and remission phase group ( n=29). The results of CTE and spectral imaging in both groups were collected. The diagnostic value of CTE comprehensive score combined with spectral imaging for CD in active phase was analyzed. Multiple linear stepwise regression analysis was used to analyze the independent related factors affecting the active phase of CD. Receiver operating characteristic (ROC) curve was used to predict the area under curve (AUC), sensitivity, specificity and cutoff value of CTE comprehensive score combined with energy spectrum imaging (intestinal wall thickness, intestinal wall uniform enhancement and iodine concentration in portal phase) in active phase of CD. Results:The probability of comb sign, intestinal stenosis or expansion and target sign in CTE of patients with active CD was significantly higher than that in patients with remission CD, the probability of fat sign was significantly lower than that in patients with remission CD, and the CTE comprehensive score was significantly higher than that in patients with remission CD ( P<0.05). Multiple linear stepwise regression analysis showed that the thickness of intestinal wall, uniform enhancement of intestinal wall and iodine concentration in portal phase were independent related factors affecting the active phase of CD ( P<0.05). ROC curve analysis showed that AUC of CTE comprehensive score combined with intestinal wall thickness, intestinal wall uniform enhancement and iodine concentration in portal phase for predicting CD in active phase was 0.953, higher than 0.869, 0.907, 0.914 and 0.913 of single index. The cut-off values of CTE comprehensive score, intestinal wall thickness and iodine concentration in portal phase were 6.0 points, 0.89 cm and 2.68 mg/ml, respectively. There was no homogeneous enhancement of intestinal wall in spectral imaging. Conclusions:CTE comprehensive score combined with intestinal wall thickness, intestinal wall enhancement and iodine concentration in portal phase can more accurately determine CD in active phase, which provide a new quantitative diagnostic reference.

The value of dual-layer detector spectral CT in evaluation of immunohistochemical expression in breast cancer patients / 中华放射学杂志

Objective:To investigate the value of dual-layer detector spectral CT in preoperative evaluation of immunohistochemical expression levels in breast cancer patients.Methods:The clinical, pathological and imaging data of breast cancer patients who received preoperative spectral CT chest scan in Affiliated Hospital of Southwest Medical University from October 2020 to January 2021 were retrospectively analyzed. A total of 70 patients were divided into positive or negative estrogen receptor (ER) group, positive or negative progesterone receptor (PR) group, positive or negative human epithelial growth factor receptor 2 (HER2) group, and positive or negative Ki-67 group according to the immunohistochemistry. Philips workstation and Special Diagnostic Suite software were used for processing and analysis. The CT value and iodine concentration value (IC) of the lesion and the effective atomic number (Z eff) of the lesion in the arterial and venous phases were measured, and the standardized CT value (NCT), standardized iodine concentration value (NIC), slope (K) of the keV-CT value curve in the arterial and venous phases as well as the CT difference and the IC difference in the arteriovenous phase were calculated. Independent sample t test was used to compare the differences in spectral parameters between patients with positive and negative immunohistochemical parameters, and ROC curve was used to analyze the efficacy of spectral parameters in the differential diagnosis of positive and negative different immunohistochemical parameters. Results:Z eff, NIC, K value, CT value, IC value of arterial and venous phase and NCT value of venous phase in negative ER group were higher than those in positive ER group, the difference was statistically significant ( P<0.05). Z eff, NIC, K value, IC, CT difference in arteriovenous phase and IC difference in arteriovenous phase in positive HER2 group were higher than those in negative HER2 patients, the difference was statistically significant (P<0.05). The arterial K value in positive Ki-67 group was higher than that in negative Ki-67 group, the difference was statistically significant ( P<0.05). Taking arterial phase K value of 1.22 as the diagnostic threshold, it had the highest diagnostic efficiency in differential diagnosis of ER positivity versus negativity (area under curve of 0.791, sensitivity of 84.00%, specificity of 65.00%). Taking the arteriovenous phase IC difference of 0.47 mg/ml as the diagnostic threshold, it had the highest performance in differential diagnosis of HER2 positivity versus negativity (area under curve of 0.736, sensitivity of 76.32%, specificity of 65.62%). Conclusion:Dual-layer detector spectral CT has certain diagnostic value for the immunohistochemical expression of breast cancer patients, which can provide reference for clinical diagnosis and treatment.

Spectral CT findings of focal organizing pneumonia and peripheral lung cancer / 中国医学影像技术

Objective: To observe the energy spectral CT manifestations of focal organizing pneumonia (FOP) and peripheral lung cancer (PLC). Methods: Data of 40 patients with FOP (FOP group) and 60 patients with PLC (PLC group) confirmed by pathology who underwent chest dual-phase energy spectral CT were retrospectively analyzed. CT40~100 keV values on single energy images, iodine concentration, water concentration and effective atomic number at arterial and venous phase of lesions were measured and recorded, respectively. The corresponding energy spectral curve was drawn, and the slope of the curve was calculated. The quantitative parameters were compared between 2 groups. Results: There was no statistically differences of patients' age, gender, clinical symptoms nor lesions' size or location between 2 groups (all P>0.05). CT40 keV, CT50 keV, CT60 keV and CT 70 keV values, λ70 keV, iodine concentration, effective atomic number at arterial phase in PLC group were all higher than those in FOP group (t=3.46, 3.08, 3.08, 2.03, 2.32, 2.69, 2.73, all P0.05). Conclusion: Energy spectral CT findings of FOP and PLC had certain difference, providing references for differential diagnosis of FOP and PLC.

Evaluation of terminal ileitis with energy spectrum CT / 中国医学影像技术

Objective: To observe the manifestations of terminal ileitis on gemstone energy spectrum CT imaging (GSI) and its diagnostic efficacy compared conventional CT enterography (CTE), so as to evaluate the diagnosis value of GSI for terminal ileitis. Methods: Data of 120 patients with suspected terminal ileum diseases were retrospectively analyzed, including 115 cases of pathologically proved diseases (72 cases of terminal ileum enteritis, 6 cases of ileum polyps or tumorlike lesions, 30 cases of ileum Crohn's disease and 7 cases of ileum tuberculosis) and 5 cases without obvious abnormality. Among them 70 patients received conventional CTE (CTE group) and 50 received GSI (GSI group). Imaging characteristics of terminal ileitis were observed and compared between 2 groups. The consistency of the results of 2 methods for detecting terminal ileitis with pathological results were analyzed, and their sensitivities and specificities were compared. ROC curves of 2 methods for detecting terminal ileitis were drawn, and their relative diagnostic efficacy were analyzed. Results: Compared with conventional CTE, the lesions were clearer on low keV single energy imaging. The energy spectrum curve and iodide maps clearly identified the lesion's wall, normal wall, the fluid in intestinal cavity and the adjacent fat tissue. The iodine concentration of terminal ileitis at the arterial and venous phase was (10.90±0.55)μg/cm3 and (14.33±0.75)μg/cm3, respectively. Conventional CTE showed poor, while GSI showed high consistency with the pathological results for detecting terminal ileitis (Kappa=0.35, 0.72, P=0.16, <0.01). The sensitivity and specificity of GSI (86.21%, 85.71%) were bith higher than those of conventional CTE (65.12%, 51.85%, χ2=3.97, 6.10, both P<0.05). The AUC of GSI (0.86) was higher than that of conventional CTE (0.57, Z=2.42, P=0.02). Conclusion: GSI could clearly show lesions of terminal ileitis, therefore having high diagnostic efficacy for detecting terminal ileitis.

Specific spectral CT in evaluating antiangiogenic efficacy of Axitinib in rabbit VX2 liver tumors / 中国医学影像技术

Objective: To explore the value of specific spectral CT in evaluating antiangiogenic efficacy of Axitinib in rabbit VX2 liver tumors. Methods: Forty VX2 liver tumor-bearing rabbits were randomly assigned into study group (n=25, given Axitinib through intragastric administration for 14 days) and control group (n=15, given equal volume of normal saline through intragastric administration for 14 days). Rabbits in study group were scanned with one-stop perfusion and spectral CT mode, while in control group underwent arterial-phase spectral CT scan and perfusion CT scan, sequentially. The optimal scan time for control group was the maximum tumor contrast time based on the time-intensity curve of perfusion CT data of study group. The correlation coefficients of tumor perfusion parameters and the normalized iodine concentration (NIC) at different phases in study group were compared. Correlations between imaging features and vascular endothelial growth factor receptor-2 (VEGFR-2), and the differences among correlation coefficients were analyzed. Results: In control group, 73.33% (11/15) tumors achieved maximum contrast by using the optimal arterial scan time ([18±4]s) acquired from study group. The tumor blood flow (BF), blood volume (BV) and hepatic arterial fraction (HAF) had positive correlations with NIC. No statistical difference of correlation coefficients acquired in the optimal scan time and in the maximum correlation was found except for tumor BV. The tumor BF (r=0.828, P=0.008) and NIC (r=0.820, P=0.010) were positively correlated with VEGFR-2,while PS was negatively correlated with VEGFR-2 (r=-0.782, P=0.010), no statistical difference was found among the above three correlation coefficients (P>0.05). Conclusion: Single-phase contrast-enhanced spectral CT scan at tumor-specific and individual-specific acquisition time might be able to replace perfusion CT in evaluating antiangiogenic efficacy of Axitinib in rabbit VX2 liver tumors.

Dual-source CT energy parameters in qualitative diagnosis of metastatic cervical lymph nodes after surgical resection of papillary thyroid carcinoma / 中国医学影像技术

Objective: To explore the diagnostic value of dual-source CT energy parameters in qualitative diagnosis of metastatic cervical lymph nodes after surgical resection of thyroid papillary carcinoma (PTC). Methods Totally 30 postoperative PTC patients with 74 enlarged cervical lymph nodes were enrolled, including 49 metastatic lymph nodes (metastatic group) and 25 non metastasis lymph nodes (non-metastatic group). In addition, 30 cases with benign enlarged cervical lymph nodes were taken as benign group. All subjects underwent dual-source CT scanning. The iodine concentration value of nonenhanced phase (ICNP), arterial phase (ICAP) and venous phase (ICVP), normalized iodine concentration (NIC) and slope of energy spectrum curve (K) were detected and compared among 3 groups. Results: There were significant differences in ICNP, ICAP, ICVP, NIC and K among 3 groups (all P0.05). Conclusion: Dual-source CT energy parameters can be used to qualitatively diagnose cervical enlarged lymph nodes after surgical resection of PTC.

Clinical application and progresses of contrast-enhanced spectral mammography / 中国医学影像技术

Breast cancer is the most common cancer in female population. Early detection of breast lesions and proper differentiation will directly impact on clinical treatment strategy and is related with prognosis. Breast tumors are usually rich in vascularity. Contrast-enhanced spectral mammography (CESM), based on K-edge effect of iodine, can acquire images of iodine contrast distribution in breasts through special computing and subtraction of images with both low- and high-energy X-ray exposures after intravenous induction of iodinated contrast media. It can eliminate the disturbance caused by overlapping breast tissues and demonstrate blood supply of the lesions, thus is sensitive to small lesion, more accurate in tumor delineating and able to help diagnosing. The current clinical applications and progresses of CESM were reviewed in this article.

One-stop CT gemstone spectral and perfusion imaging for prediction in rabbit axillary lymph nodes / 中国医学影像技术

Objective: To explore the application value of one-stop CT gemstone spectral and perfusion imaging quantitative parameters in predicting the properties of axillary lymph nodes. Methods Totally 60 purebred female New Zealand white rabbits were randomly divided into two groups, and rabbit models of axillary metastatic lymph nodes with VX2 implanted breast cancer (metastasis group) and inflammatory lymph nodes (inflammation group) were established, respectively. One-stop CT gemstone spectral and perfusion imaging scan was performed at the end of the fourth week after modeling. Then the axillary lymph nodes were taken for pathological examination and compared with CT images. Two independent samples t-test were used to compare the energy parameters and perfusion parameters between metastatic and inflammatory lymph nodes. Logistic regression and ROC curves were used to analyze the efficacy of single parameters and combined parameters in diagnosis of rabbit axillary lymph nodes. Results The blood flow (BF), blood volume (BV), arteriovenous iodine concentration (IC), standardized iodine value (NIC) and the slope (λ) of the energy spectrum curve from 40 keV to 70 keV in the metastasis group were higher than those in inflammation group (all P0.05). Taken 0.65 as the threshold, AUC of combined parameters (BF+arterial phase λ+venous phase λ) was 0.942, the sensitivity, specificity, positive predictive value and negative predictive value in diagnosis of axillary lympy nodes were 79.68%, 95.92%, 92.91% and 82.70%, respectively. Conclusion: The quantitative parameters of one-stop CT gemstone spectral and perfusion imaging show good diagnostic efficacy in identifying rabbit axillary breast cancer metastatic lymph nodes and inflammatory lymph nodes, while combined parameters (BF+arterial phase λ+venous phase λ) have higher diagnostic value.

An interpretation of the Second consensus on the assessment of sublingual microcirculation in critically ill patients issued by the European Society of Intensive Care Medicine in 2018 / 中华危重病急救医学

The European Society of Intensive Care Medicine (ESICM) issued the second consensus on the assessment of sublingual microcirculation in critically ill patients. This paper interprets the consensus for clinicians about: what is microcirculation, how to observe microcirculation, and the details of microcirculation images collection and parameters analysis. Besides, this paper illustrates the relationship between microcirculation alternation and shock, it also evaluates the present situation and future development of microcirculation monitoring.

Comparison of gemstone spectral curve and CT value of gastric cancer with different pathological types and differentiation degrees / 中华肿瘤杂志

Objective@#To investigate the differences of gemstone spectral curve and CT value of gastric cancer with different pathological types and differentiation degrees.@*Methods@#91 cases of preoperative gemstone CT images with gastric cancer were collected, including 24 cases of mucinous carcinoma, 67 cases of non-mucinous carcinoma, 16 cases of signet ring cell carcinoma, 8 cases of mucinous adenocarcinoma, 32 cases of moderately differentiated adenocarcinoma and 35 cases of poorly differentiated adenocarcinoma. Gemstone CT spectral imaging was performed preoperatively, and the spectral curve of the lesion in venous phase was obtained by using GSI Viewer software, the slope of the curve was calculated, and 11 monoenergetic CT values of 40~140 keV (10 keV interval) were measured. The gemstone spectral curves and CT values of gastric cancer with different pathological types and differentiation degrees are compared.@*Results@#The curve slopes of non-mucinous carcinoma, signet ring cell carcinoma and poorly differentiated adenocarcinoma were -1.92±0.53, -1.73±0.37 and -2.14±0.54, respectively. The absolute values were higher than those of mucinous carcinoma (-1.45±0.54), mucinous adenocarcinoma (-0.90±0.34) and moderately differentiated adenocarcinoma (-1.67±0.41), and the differences were all statistically significant (P<0.05). There were significant differences in monoenergetic CT values between mucinous and non-mucinous carcinomas at 40-140 keV (all P<0.05). The former was lower than the latter in different degrees, and the lower the energy, the greater the difference was. There were significant differences in monoenergetic CT values between signet ring cell carcinoma and mucinous adenocarcinoma at 40-100 keV (all P<0.05); monoenergetic CT values between poorly differentiated adenocarcinoma and moderately differentiated adenocarcinoma at 40-90 keV showed statistically significant differences (P<0.05).@*Conclusions@#Gastric cancer with different pathological types and differentiation degrees have their characteristic spectral curves in venous phase, and the monoenergetic CT values are significantly different at low energy. The spectral curve of gemstone CT may be helpful to evaluate the pathological type and differentiation degree of gastric cancer before operation.

Feasibility study of automatic spectral imaging protocol selection combined with double low technique in CT portal vein imaging / 中华放射医学与防护杂志

Objective To explore the application value of virtual monochromatic imaging combined with adaptive statistical iterative reconstruction (ASIR) and automatic spectral imageing mode selection(ASIS) in reducing the radiation dose and contrast dose of CT portal venography.Methods We retrospectively collected 120 cases (80 males and 40 females) who underwent upper abdominal enhancement CT from January 2017 to April 2017.Patients were divided into 3 groups (40 cases in each group) according to the scanning program.Group A used conventional 120 kVp scan,NI =10,contrast agent dosage was 450 mgI/kg of body weight,image was reconstructed with 50％ ASIR technique;Groups B and C used spectral CT mode,NI =10 (Group B),NI =13 (Group C),the amount of contrast agent was 300 mgI/kg of body weight,and the image was reconstructed with 60 keV +50％ ASIR.One-way analysis of variance was used to compare the mean CT values and their differences,image noise,SNR and CNR of portal vein and liver parenchyma in three groups of images.Subjective image quality scores were performed on three groups of images by two senior radiologists.The patient's CTDIvol,DLP were recorded and the E was calculated.Results The amount of contrast agent in group B and C was reduced by about 30％ compared with group A.The portal vein CT values of groups A,B,and C were 168.22± 17.82,209.06±20.07,and 211.03±25.60.The portal vein CT values of group B and C were significantly higher than those of group A,respectively (t =-9.625,-8.680,P ＜ 0.05).The CT value difference between portal vein and liver parenchyma was 60.01± 17.01,106.63±25.83,107.72±25.39,respectively.SNRs were 8.48±1.41,12.64±2.94,10.77±1.94,and CNR were 5.16±1.80,8.13±2.54,7.32±1.84,respectively.The image quality scores were 3.53±0.68,4.75±0.54 and 4.53±0.64,respectively.The CT value difference,SNR,CNR and image quality scores of group B and group C were significantly higher than those in group A(t=-9.536,-9.857,-8.082,-6.064,-6.050,-5.308,-8.912,-6.779,P＜0.05).The CTDIvolof groups A,B and C were (12.15±5.02) mGy,(12.34±4.18) mGy,(10.03±3.13) mGy,DLP were (348.62± 155.99) mGy· cm,(355.56± 131.07) mGy·cm,(287.10±92.25) mGy·cm,respectively,E were (5.23±2.34) mSv,(5.33±1.97) mSv,(4.31±.1.38) mSv,compared with the A and B groups,the CTDI,ol,DLP and E of the C group were significantly lower(t=2.274,2.147,2.147,2.812,2.702,2.702,P＜0.05),and CTDIvol,DLP and E were decreased by 19％.Conclusions In CT portal venography,NI =13,60 keV combined with 50％ ASIR reconstruction and ASIS can be used to personalize the contrast dose and radiation dose of the patient and provide images that meet the diagnostic requirements.

Imaging and Spectral Characteristics of Amyloid Plaque Autofluorescence in Brain Slices from the APP/PS1 Mouse Model of Alzheimer's Disease / 神经科学通报·英文版

Amyloid deposits are one of the hallmark pathological lesions of Alzheimer's disease (AD). They can be visualized by thioflavin-S, silver impregnation, Congo red staining, and immunohistochemical reactions. However, that amyloid deposits generate blue autofluorescence (auto-F) has been ignored. Here, we report that visible light-induced auto-F of senile plaques (SPs) was detected and validated with conventional methods. Brain slices from APP/PS1 (amyloid precursor protein/presenilin 1) transgenic mice were mounted on slides, rinsed, coverslipped and observed for details of the imaging and spectral characteristics of the auto-F of SPs. Then the slices were treated with the above classic methods for comparative validation. We found that the SP auto-F was greatest under blue-violet excitation with a specific emission spectrum, and was much easier, more sensitive, and reliable than the classic methods. Because it does not damage slices, observation of auto-F can be combined with all post-staining techniques in slices and for brain-wide imaging in AD.