Histogram analysis of diffusion-weighted magnetic resonance imaging as a biomarker to predict LNM in T3 stage rectal carcinoma.

BACKGROUND: Preoperative identification of rectal cancer lymph node status is crucial for patient prognosis and treatment decisions. Rectal magnetic resonance imaging (MRI) plays an essential role in the preoperative staging of rectal cancer, but its ability to predict lymph node metastasis (LNM) is insufficient. This study explored the value of histogram features of primary lesions on multi-parametric MRI for predicting LNM of stage T3 rectal carcinoma. METHODS: We retrospectively analyzed 175 patients with stage T3 rectal cancer who underwent preoperative MRI, including diffusion-weighted imaging (DWI) before surgery. 62 patients were included in the LNM group, and 113 patients were included in the non-LNM group. Texture features were calculated from histograms derived from T2 weighted imaging (T2WI), DWI, ADC, and T2 maps. Stepwise logistic regression analysis was used to screen independent predictors of LNM from clinical features, imaging features, and histogram features. Predictive performance was evaluated by receiver operating characteristic (ROC) curve analysis. Finally, a nomogram was established for predicting the risk of LNM. RESULTS: The clinical, imaging and histogram features were analyzed by stepwise logistic regression. Preoperative carbohydrate antigen 199 level (p = 0.009), MRN stage (p < 0.001), T2WIKurtosis (p = 0.010), DWIMode (p = 0.038), DWICV (p = 0.038), and T2-mapP5 (p = 0.007) were independent predictors of LNM. These factors were combined to form the best predictive model. The model reached an area under the ROC curve (AUC) of 0.860, with a sensitivity of 72.8% and a specificity of 85.5%. CONCLUSION: The histogram features on multi-parametric MRI of the primary tumor in rectal cancer were related to LN status, which is helpful for improving the ability to predict LNM of stage T3 rectal cancer.

Histogram peritumoral enhanced features on MRI arterial phase with extracellular contrast agent can improve prediction of microvascular invasion of hepatocellular carcinoma.

BACKGROUND: Preoperative microvascular invasion (MVI) prediction plays an important role in therapeutic decision-making of hepatocellular carcinoma (HCC). This study aimed to investigate the value of histogram based on the arterial phase (AP) of magnetic resonance imaging (MRI) with extracellular contrast agent compared with radiological features for predicting MVI of solitary HCC. METHODS: In total, 113 patients with pathologically proven solitary HCC were retrospectively enrolled who received surgical resection and underwent preoperative abdominal MRI. The patients were divided into the ≤3 cm [small HCC (sHCC)] cohort and the >3 cm cohort. Based on pathological analysis of surgical specimens, the patients were classified into MVI negative (MVI-) and MVI positive (MVI+) groups. Peritumoral and intratumoral histogram features [mean, median, standard deviation (Std), coefficient of variation (CV), skewness, kurtosis] were acquired on AP subtraction images and radiological features [size, capsule, corona enhancement, corona enhancement thickness (CET), CET group]. Receiver operating characteristic (ROC) curve was constructed to assess predictive capability. Subgroup analysis of patients with a visible corona enhancement based on the CET cut-off value was performed. RESULTS: None of the features extracted from the intratumor area were significantly different between the MVI+ and MVI- groups in both cohorts. Histogram defined peritumoral (peri-) mean, median, kurtosis, and radiological features including CET and CET group were associated with MVI in sHCCs. Peri-mean, median, Std and radiological features including incomplete capsule, CET, and CET group were associated with MVI in HCC >3 cm. In multivariate logistic regression analysis, the CET group and peri-mean were independent predictors for HCC >3 cm with an area under the curve (AUC) of 0.741. Peri-mean was an independent predictor for sHCC (AUC =0.798). Subgroup analysis of the corona enhancement using 8 mm as a cut-off value showed 100% sensitivity and negative predictive value (NPV). CONCLUSIONS: Peritumoral AP enhanced degree on MRI showed an encouraging predictive performance for preoperative prediction of MVI, especially in sHCCs. CET ≤8 mm could be used as a negative predictive marker for MVI.

Rim enhancement on hepatobiliary phase of pre-treatment 3.0 T MRI: A potential marker for early chemotherapy response in colorectal liver metastases treated with XELOX.

PURPOSE: To assess the value of the enhanced features on the hepatobiliary phase (HBP) of pre-treatment Gd-EOB-DTPA MRI in evaluating response to chemotherapy in colorectal liver metastases (CRLMs). METHODS: We retrospectively studied 65 patients with CRLMs who underwent Gd-EOB-DTPA enhanced MRI before chemotherapy from October 2015 to November 2017. The diagnosis of liver metastasis was established on the basis of imaging findings. Two radiologists evaluated the size, contrast-enhanced (CE) patterns of the maximum lesion on the HBP. According to the different CE patterns, we quantified area signal intensity (SI) by applying SI ratio (such as SIcenter/outer and SIrim/center). All of the above parameters were analyzed in terms of chemotherapy response. RESULTS: Rim enhancement on the HBP was more frequent in the responding group of 28 patients (72%) than in the non-responding group of eight patients (31%). Additionally, there was a significant association between chemotherapy response and quantitative parameters: including diameter (P = 0.04), SIcenter/outer (P = 0.047) and SIrim/center (P = 0.012). The HBP CE pattern (P = 0.007) and SIcenter/outer (P = 0.022) were independent factors for chemotherapy response. The areas under the curve (AUCs) of the above-mentioned parameters were significant associated with response to chemotherapy, in which diameter, HBP CE patterns, SIcenter/outer, and SIrim/center were 0.638, 0.706, 0.712, and 0.673, respectively. Moreover, the combination of these parameters obtained the largest AUC of 0.821. CONCLUSION: The CE patterns, in particular with rim enhancement, and SI ratio parameters on the HBP are useful indicators for early evaluation of therapeutic response after chemotherapy in patients with CRLMs.

Effect of cold adaptation on activities of relevant enzymes and antioxidant system in rats.

Exercise in cold environments can cause significant metabolic regulation and antioxidant behavior. For discussing enzymatic responses towards cold adaptation, we investigated enzyme activities of adenylate cyclase (AC) and phosphodiesterase (PDE) in liver, skeletal muscle, and brown adipose tissue (BAT), as well as Na(+)·K(+) ATPase and Na(+)/K(+) ratio in blood. Malondialdehyde (MDA) and superoxide dismutase (SOD) activity in blood were also studied to address the effect of cold adaptation on oxidative damage and antioxidant system. Experimental results indicated that enzyme activities in liver, skeletal muscle and BAT maintained relatively constant for the control group. For the cold adaptation group, enzyme activities in liver and skeletal muscle were in high levels at the beginning, and then gradually decreased to similar values with the control group. However, enzyme activities in BAT performed an increasing trend and significantly higher than the control at the end. In addition, decreased oxidative damage and activated antioxidant system was observed along with the cold adaptation process.

The effect of pre-competition training on biochemical indices and immune function of volleyball players.

OBJECTIVE: Pre-competition sports training can have varying effects on an athlete's immune function, including causing reduced resistance. The aim of this study was to explore effects of pre-competition training on some biochemical indices and immunologic functions in top-level volleyball athletes to determine whether training should be modified for optimal health. METHODS: Biochemical indices (Hb, BUN, CK, LDH) and immunologic function (IgA, IgG, IgM, CD3(+), CD4(+), CD8(+)) were detected by semiautomatic biochemistry analyzer, light scattering photometer, or flow cytometry in sera from 24 top-level volleyball athletes and compared before and after pre-competition training. RESULTS: After training, the levels of Hb, IgA, IgG, IgM, and CD4(+) and the CD4(+)/CD8(+) ratio decreased significantly, while BUN, CK, LDH, and CD8(+) increased significantly (P < 0.05). Further, the decrease in Hb levels in female athletes was more significant than that in male athletes (P < 0.05). CONCLUSIONS: These results indicate that pre-competition training affects biochemical indices and immunologic function in this group of athletes. Additionally, more dramatic changes in Hb in female athletes may indicate a need for adapted training loads and rest periods for females.