Prognostic value of computed tomography derived skeletal muscle mass index in lung cancer: A meta-analysis.

BACKGROUND: The prognostic role of the skeletal muscle mass index (SMI) derived from computed tomography (CT) imaging been well verified in several types of cancers. However, whether the SMI could serve as a reliable and valuable predictor of long-term survival in lung cancer patients remains unclear. AIM: To identify the prognostic value of the CT-derived SMI in lung cancer patients. METHODS: The PubMed, Web of Science, and Embase electronic databases were searched up to November 5, 2021 for relevant studies. The Reference Citation Analysis databases were used during the literature searching and selection. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated to assess the association of the SMI with the overall survival (OS) of lung cancer patients. All statistical analyses were performed with STATA 12.0 software. RESULTS: A total of 12 studies involving 3002 patients were included. The pooled results demonstrated that a lower SMI was significantly related to poorer OS (HR = 1.23, 95%CI: 1.11-1.37, P < 0.001). In addition, the subgroup analyses stratified by treatment (nonsurgery vs surgery), tumor stage (advanced stage vs early stage), and tumor type (non-small cell lung cancer vs lung cancer) showed similar results. CONCLUSION: The CT-derived SMI is a novel and valuable prognostic indicator in lung cancer and might contribute to the clinical management and treatment of lung cancer patients.

Prognostic value of ground glass opacity on computed tomography in pathological stage I pulmonary adenocarcinoma: A meta-analysis.

BACKGROUND: The clinical role of ground glass opacity (GGO) on computed tomography (CT) in stage I pulmonary adenocarcinoma patients currently remains unclear. AIM: To explore the prognostic value of GGO on CT in lung adenocarcinoma patients who were pathologically diagnosed with tumor-node-metastasis stage I. METHODS: A comprehensive and systematic search was conducted through the PubMed, EMBASE and Web of Science databases up to April 3, 2021. The hazard ratio (HR) and corresponding 95% confidence interval (CI) were combined to assess the association between the presence of GGO and prognosis, representing overall survival and disease-free survival. Subgroup analysis based on the ratio of GGO was also conducted. STATA 12.0 software was used for statistical analysis. RESULTS: A total of 12 studies involving 4467 patients were included. The pooled results indicated that the GGO predicted favorable overall survival (HR = 0.44, 95%CI: 0.34-0.59, P < 0.001) and disease-free survival (HR = 0.35, 95%CI: 0.18-0.70, P = 0.003). Subgroup analysis based on the ratio of GGO further demonstrated that the proportion of GGO was a good prognostic indicator in pathological stage I pulmonary adenocarcinoma patients, and patients with a higher ratio of GGO showed better prognosis than patients with a lower GGO ratio did. CONCLUSION: This meta-analysis manifested that the presence of GGO on CT predicted favorable prognosis in tumor-node-metastasis stage I lung adenocarcinoma. Patients with a higher GGO ratio were more likely to have a better prognosis than patients with a lower GGO ratio.

[Application Value of CT Metal Artifact Correction Technology (MAC TM) in CT Review after Total Hip Replacement].

OBJECTIVE: To evaluate the application value of CT metal artifact correction technology (MAC TM) in CT review after total hip replacement. METHODS: A total of 72 patients who underwent CT re-examination after total hip replacement from December 2018 to March 2020 were enrolled, and the original data were reconstructed by filter backup projection （FBP） and MAC. Select three identical levels in the two sets of reconstructed images and place the same ROI. The selected levels were the initial level, central level, and lower edge of acetabulum. Measure the CT and noise (SD) of metal high and low density artifacts of the three levels area, as well as metal hip joint space, metal para-bone tissue, muscle, bladder and subcutaneous fat, and calculate the average value. Subcutaneous fat value was used as a reference to calculate the SNR and CNR of metal implant para-bone tissue, muscle and bladder. Two radiologists scored the two groups of reconstructed images using blinded method, Kappa's test was used to compare the homogeneity. RESULTS: There were differences between the two groups of reconstructed images in high- and low-density artifact areas, joint gap CT values, and image noise. Compared with the FBP group, the CT value of the high-density area and the joint space of the MAC group decreased, the CT value of the low-density area increased, and the noise value of each area decreased. The SNR and CNR of metal adjacent bone tissue, muscle and bladder were higher in the MAC group than those in the FBP group, and the difference was statistically significant ( P<0.05). The difference in subjective scores between the two groups was statistically significant ( Z=-6.564, P<0.05). 2 radiologists had moderate consistency with Kappa value of 0.72 on FBP group, and good consistency with Kappa value of 0.85 on MAC group. CONCLUSION: MAC TM in CT review after total hip replacement can reduce metal artifacts, make the joint space more clear, and improve the quality of CT images.

[Application Value of Motion-correction Phase Sensitive Inversion Recovery (MOCO-PSIR) to Evaluate Myocardial Fibrosis in Patients with Heart Failure Caused by Dilated Cardiomyopathy].

OBJECTIVE: To study the application value of motion-correction phase sensitive inversion recovery (MOCO-PSIR) to evaluate myocardial fibrosis in the patients with heart failure caused by dilated cardiomyopathy (DCM). METHODS: A prospective study included 60 patients who underwent cardiac MRI enhanced scan from June 2017 to November 2018, including 38 patients who were clinically diagnosed with DCM and 22 patients in the normal control group. All patients were scanned with three late gadolinium enhancement (LGE) sequences: segmented-PSIR, single-shot-PSIR, MOCO-PSIR at the same time. The subjective quality score (level 4) and image signal-to-noise ratio (objective evaluation) of normal and abnormal myocardium were analyzed and compared in three scanning technique groups. The detection rate of myocardial fibrosis and image acquisition time of the three scanning techniques were recorded. RESULTS: In the normal control group (sinus rhythm), subjective score showed no statistical significance. Subjective scoring results in the patients with DCM: MOCO-PSIR>single-shot-PSIR> segmented-PSIR (P < 0.05). SNR results PSIR-LGE images in DCM patients as well as control group: segmented-PSIR>MOCO-PSIR> single-shot-PSIR (P < 0.05). In the whole 646 segments analysis of DCM patients, the ratio unable to judge in segmented-PSIR was up to 25.5%, but only 1.4% in MOCO-PSIR. Significant difference was found in the three groups. While in the 374 segments of control group, no statistical difference was found in comparison of incapability to judge. Acquisition time covered left ventricular: (5.6±1.7) min in segmented-PSIR, (0.4±0.2) min in single-shot-PSIR and (4.5±1.1) min in MOCO-PSIR. Pairwise comparison of acquisition time among three scanning techniques was statistically significant (P < 0.001). CONCLUSION: MOCO-PSIR-LGE has better clinical significance than conventional delayed enhanced scan sequences in the diagnosis of myocardial fibrosis in the patients with heart failure caused by dilated cardiomyopathy.

[Image quality adapted thoracic diameters in CT coronary artery imaging].

OBJECTIVE: To evaluate the correlation between image quality and thoracic diameters, anteroposterior diameter (AP) and right-left diameter (RL) for the optimization of reducing radiation dose in coronary artery imaging with Dual-source CT. METHODS: 118 patients underwent CT coronary artery imaging (CTCA) were divided into two groups (A and B) according to body mass index (BMI). There were 58 patients in group A with BMI values > or = 25 kg/m2 and < 30 kg/m2; and 60 patients in group B with BMI values < 25 kg/m2. Scan parameters: collimation 64 X 0.6 mm, reconstruction slice thickness 0.75 mm, reconstructin interval 0.7 mm, FOV 150-180 mm, the pitch adjusted according to heart rate automatically. CT imagings were obtained with tube voltage 100 kV, tube current 330 mAs (group A) and 100 kV, tube current 220 mAs (group B). The contrast-noise ratio (CNR), signal to noise ratio (SNR), as well as blind correlation test score values were calculated to establish the relationship among BMI, AP, RL and CNR, SNR. RESULTS: RL of five levels in groups of A, B were correlated to CNRa (P < 0.05). In group A and B (except iii, iv level of Group A), AP were associated with CNRa (P < 0.05). In addition to ii, iv level of group A, v level of group B, BMI were associated with CNRa (P < 0.05). The correlation coefficient of CNRa and RL of group A except ii level was greater than that of CNRa and AP. The correlation coefficient of CNRa, SNRa and RL of group B was greater than that of CNRa, SNRa and AP. Except iii level, the correlation coefficient of CNRa, SNRa and AP of group A was greater than that of CNRa, SNRa and BMI. Except ii level, the correlation coefficient of CNRa and AP of group B was greater than that of CNRa and BMI. CONCLUSION: Thoracic diameter of RL can be used as a guider to select the appropriate scan protocol in the coronary imaging acqusition with dual-source CT.

[The value of split-bolus 2-phase with virtual non-enhanced scan in CT urography].

OBJECTIVE: To investigate the value of split-bolus 2-phase with virtual non-enhanced scan in CT urography. METHODS: Eighty (80) patients with urinary obstruction were divided into two groups, group A was traditional CT urography scan, group B was split-bolus 2-phase with virtual non-enhanced scan. The scan sequence of group A included conventional scan first, then enhanced scan in arterial phase, parenchyma phase and excretion delayed phase after the injection of 100 mL contrast agent. The scan sequence of group B included conventional scan and enhanced scan following two bolus injection of contrast; the first injection of contrast was 40 mL, the second injection was 60 mL with 15-30 minutes delay, then enhanced scan was conducted in arterial and parenchymal phase, the parenchymal phase scan was performed with dual energy scanning sequence. The image quality of urinary collecting system, the detection of urinary obstructive lesion, and radiation dose were compared between the two groups. RESULTS: Between the two imaging methods, the imaging quality of urinary system did not show significant difference, but radiation dose was statistically significant difference. The radiation dose of split-bolus 2-phase with virtual non-enhanced scan was only 55% of traditional CTU scan. CONCLUSION: Split-bolus2 phase with virtual non-enhanced scan could obtain the same image quality as tranditional CTU, while reducing the approximately half the radiation dose.