Inactivation of EGFR/ERK/NF-κB signalling associates with radiosensitizing effect of 18ß-glycyrrhetinic acid on progression of hepatocellular carcinoma.

Hepatocellular carcinoma (HCC) is recognized as the fifth most common cancer and the third most common cause of death in Asian population. Studies reported that HCC is relatively insensitive to radiotherapy (RT); thus, considering how to sensitize HCC to RT is worth to be elucidated. Epidermal growth factor receptor (EGFR)-mediated signalling transduction plays the important role in regulating treatment efficacy of HCC. An active compound, 18beta-glycyrrhetinic acid (18ß-GA), has been reported to own anti-tumour effect. However, whether 18ß-GA possess RT sensitization ability in HCC remains unclear. Here, we used RNA data from TCGA-LIHC (Liver hepatocellular carcinoma) to identify the role between EGFR/ERK/nuclear factor kappa B (NF-κB) signalling and RT by radiosensitivity index (RSI) analysis. We suggested that patients with activated NF-κB signalling may show resistance to RT treatment, whereas combining 18ß-GA may reinforce RT efficacy in a Hep3B-bearing animal model. 18ß-GA combined with RT showed superior tumour inhibition capacity as compared to monotherapy and even reached similar efficacy as erlotinib combined with RT. Treatment promotion of RT by 18ß-GA in HCC is not only through diminishing RT-induced EGFR/ERK/NF-κB signalling but also promoting RT-induced apoptosis pathways. 18ß-GA may act as radiosensitizer through inactivating EGFR-mediated HCC progression and inducing caspase-dependent apoptosis signalling.

Amentoflavone induces caspase-dependent/-independent apoptosis and dysregulates cyclin-dependent kinase-mediated cell cycle in colorectal cancer in vitro and in vivo.

Colorectal cancer (CRC) is recognized as the third most common malignancy and the second most deadly in highly developed countries. Although the treatment of CRC has improved in the past decade, the mortality rate of CRC is still increasing. Amentoflavone, one of the flavonoids detected in medical plants, is reported to possess potential anticancer properties in various cancers. However, its role in CRC has not been studied. This study aimed to investigate the role and underlying mechanism of amentoflavone on CRC in vitro and in vivo. We identified the cytotoxicity, apoptosis effect, cell cycle alteration, DNA damage induction and tumor progression inhibition of amentoflavone in HT-29 model by using MTT assay, flow cytometry, immunofluorescence (IF) staining, Western blotting and animal experiments. Amentoflavone induced cytotoxicity is caused by triggering G1 arrest, DNA damage and apoptosis in HT-29 cells. The expression of cyclin D1, CDK4 and CDK6 was decreased by amentoflavone; in contrast, the phosphorylation of ATM and CHK2 and the expression of p21 and p27 were increased. The apoptosis induction of amentoflavone in CRC is not only caspase-dependent but also increases EndoG and AIF nuclear translocation in a caspase-independent manner. Importantly, the apoptosis induction of amentoflavone is not affected by the activity of p53 in CRC. Amentoflavone suppressed the progression of CRC by initiating G1 arrest and ATM/CHK2-mediated DNA damage-responsive, caspase-dependent/independent apoptotic effects. We uncovered a novel tumor-inhibitory role of amentoflavone in CRC that is not associated with p53 activity, which may serve as a potential treatment for CRC.

Comparison of quantitative measurements of four manufacturer's metal artifact reduction techniques for CT imaging with a self-made acrylic phantom.

BACKGROUND: Metal artifact reduction (MAR) techniques can improve metal artifacts of computed tomography (CT) images. OBJECTIVE: This work focused on conducting a quantitative analysis to compare the effectiveness of four commercial MAR techniques on three types of metal implants (hip implant, spinal implant, and dental filling) with a self-made acrylic phantom. METHODS: A cylindrical phantom was made from acrylic with a groove in the middle, and then three types of metal implants were placed in the groove. The phantom was scanned by four CT scanners and four commercialized MAR techniques were used to analyze the images. The techniques used were single-energy metal artifact reduction (SEMAR, Canon), smart metal artifact reduction software (Smart-MAR, GE), iterative metal artifact reduction (IMAR, Siemens), and metal artifact reduction for orthopedic implants (OMAR, Philips). Quantitative analysis methods included objective and subjective analysis. RESULTS: The expected value of SEMAR, Smart-MAR, IMAR, and OMAR were 36.6, 37.8, 5.0, and 2.3, respectively. SEMAR and Smart-MAR achieved optimal results. CONCLUSION: This study successfully evaluated the effects of four commercial MAR techniques on three types of metal implants in a phantom. All MAR techniques effectively reduced metal artifacts, but the effect was not significant with dental fillings due to high-density material.

Quantitative assessment of three vendor's metal artifact reduction techniques for CT imaging using a customized phantom.

A metal implant was placed in an acrylic phantom to enable quantitative analysis of the metal artifact reduction techniques used in computed tomography (CT) scanners from three manufacturers. Two titanium rods were placed in a groove in a cylindrical phantom made by acrylic, after which the groove was filled with water. The phantom was scanned using three CT scanners (Toshiba, GE, Siemens) under the abdomen CT setting. CT number accuracy, contrast-to-noise ratio, area of the metal rods in the images, and fraction of affected pixel area of water were measured using ImageJ. Different iterative reconstruction, dual energy, and metal artifact reduction techniques were compared within three vendors. The highest contrast-to-noise ratio of three scanners were 85.7 ± 8.4 (Toshiba), 85.9 ± 11.7 (GE), and 55.0 ± 14.8 (Siemens); and the most correct results of metal area were 157.1 ± 1.4 mm2 (Toshiba), 155.0 ± 1.0 (GE), and 170.6 ± 5.3 (Siemens). The fraction of affected pixel area obtained using single-energy metal artifact reduction of Toshiba scanner was 2.2% ± 0.7%, which is more favorable than 4.1% ± 0.7% obtained using metal artifact reduction software of GE scanner (p = 0.002). Among all quantitative results, the estimations with fraction of affected pixel areas matched the effect of metal artifact reduction in the actual images. Therefore, the single-energy metal artifact reduction technique of Toshiba scanner had a desirable effect. The metal artifact reduction software of GE scanner effectively reduced the effect of metal artifacts; however, it underestimated the size of the metal rods. The monoenergetic and dual energy composition techniques of Siemens scanner could not effectively reduce metal artifacts.

Evaluating doses of multi-slice CT in brain examinations using various methods.

PURPOSE: The effective dose (HE) and organ or tissue equivalent dose (HT) of a Rando phantom undergoing two brain computed tomography (CT) examination protocols were evaluated using thermoluminescent dosimeters (TLD-100H) and dose length product (DLP) methods. MATERIALS AND METHODS: TLDs were inserted into the correlated positions of an organ or tissue of Rando phantom, such as thyroid, brain, and salivary gland, using (A) axial scan: scanning the maxillae ranging from external auditory meatus to the parietal bone, and (B) helical scan: scanning from the mandible to the parietal bone. CT examinations were performed on a Philips computer tomography (Brilliance CT) at Lukang Christian Hospital. TLDs were measured using a Harshaw 3500 TLD reader. The HT of organ and tissue during the two protocols was discussed. RESULTS AND CONCLUSION: HE were calculated using ICRP 60 and 103 at 2.67 ± 0.18 and 1.89 ± 0.23 mSv based on an axial scan, and 4.70 ± 0.38 and 4.39 ± 0.37 mSv based on a helical scan, respectively. In the DLP method, HE was estimated from CTDIvol that was recorded directly from the console display of the CT unit and then calculated using AAPM 96. Finally, experimental results are compared with those in literature. Radiologists should choose and adjust protocols to prevent unnecessary radiation to patients and satisfying the as low as reasonably achievable (ALARA) principle. These findings will be valuable to patients, physicians, radiologists, and the public.

Evaluation of the occupational X-rays dose of the medical staff in a cardiac catheterization laboratory using an acrylic phantom and semiconductor dosimeter.

OBJECTIVE: The occupational X-rays doses of medical staff in a cardiac catheterization laboratory were evaluated. METHODS: Four customized acrylic phantoms were used to simulate a patient, medical doctor, assistant, and radiologist to evaluate the in-situ X-rays exposure dose using semiconductor dosimeters. The exposure dose was measured under three scenarios that were preset to imply: no shielding, moderate shielding and complete shielding for the medical staff in the laboratory. The doses were applied by changing the dose area product (DAP) from 11,000 to 500,000mGy·cm(2) in 14 increments. RESULTS: The estimated annual occupational doses for doctors, assistants and radiologists in scenarios I, II, and III were: I) 35.03, 7.78, 1.95; II) 1.95, 0.78, 0.06; and III) 0.19, 0.10, 0.05cSv, respectively. The derived linear regression line of the exposure dose with respect to the DAP were extrapolated to obtain the minimum detectable level (MDL) of DAP for triggering the staff dosimeters. Accordingly, the minimum annual dose was estimated as 0.05cSv. Additional shielding provided measurable protection to the staff. The protective clothing used in scenarios II and III can reduce the original dose from scenario I to ∼3% (scenario II) and ∼0.5% (scenario III). The annual occupational dose also changed with the various X-rays energy settings. The annual dose increased to 126% when the preset X-rays energy was changed from 70 to 100kVp. CONCLUSION: The semiconductor dosimeter proved to be an adequate tool for measuring low doses and low dose rates under these circumstances. The dose can be reduce of I) 35.03, 7.78, 1.95; to II) 1.95, 0.78, 0.06 (∼3%); or III) 0.19, 0.10, 0.05 (∼0.5%)cSv, respectively according to different protective scenarios.

Quantification of the In Vitro Radiosensitivity of Mung Bean Sprout Elongation to 6MV X-Ray: A Revised Target Model Study.

In this study, a revised target model for quantifying the in vitro radiosensitivity of mung bean sprout elongation to 6-MV X-rays was developed. The revised target model, which incorporated the Poisson prediction for a low probability of success, provided theoretical estimates that were highly consistent with the actual data measured in this study. The revised target model correlated different in vitro radiosensitivities to various effective target volumes and was successfully confirmed by exposing mung beans in various elongation states to various doses of 6-MV X-rays. For the experiment, 5,000 fresh mung beans were randomly distributed into 100 petri dishes, which were randomly divided into ten groups. Each group received an initial watering at a different time point prior to X-ray exposure, resulting in different effective target volumes. The bean sprouts were measured 70 hr after X-ray exposure, and the average length of the bean sprouts in each group was recorded as an index of the mung bean in vitro radiosensitivity. Mung beans that received an initial watering either six or sixteen hours before X-ray exposure had the shortest sprout length, indicating that the maximum effective target volume was formed within that specific time period. The revised target model could be also expanded to interpret the "two-hit" model of target theory, although the experimental data supported the "one-hit" model. If the "two-hit" model was sustained, theoretically, the target size would be 2.14 times larger than its original size to produce the same results.

Multi-detector row CT angiography in the assessment of coronary in-stent restenosis: a systematic review.

PURPOSE: The aim of this study was to perform a systematic review of the diagnostic accuracy of multi-detector row computed tomography angiography (MDCT) for detection of coronary in-stent restenosis in patients treated with coronary stenting when compared to invasive catheter angiography. MATERIALS AND METHODS: A search of PUBMED and MEDLINE databases for English literature was performed. Only studies with at least 10 patients comparing 16- or more detector rows MDCT angiography with invasive catheter angiography in the detection of coronary in-stent restenosis (more than 50% stenosis) were included for analysis. Sensitivity and specificity estimates pooled across studies were tested using a fixed effects model. RESULTS: 15 studies met selection criteria for inclusion in the analysis. There were eight studies performed with 16-detector row CT scanners, and five studies with 64-detector row scanners and one study with a 40-detector scanner. The remaining study was performed with a mixture of 16-and 64-detector row scanners. Prevalence of in-stent restenosis following coronary stenting was 18% (95% CI: 13, 24%). Pooled estimates of the sensitivity and specificity of overall MDCT angiography for the detection of coronary in-stent restenosis was 85% (95% CI: 78, 90%) and 97% (95% CI: 95, 98%), respectively. No significant difference was found between 16- and 64-detector row scanners regarding the sensitivity and specificity of MDCT for assessment of in-stent restenosis (p>0.05). CONCLUSION: The results showed that MDCT angiography (with 16 or more detector rows) has moderate sensitivity and high specificity for the detection of coronary in-stent restenosis when compared to invasive catheter angiography. A high specificity value of MDCT may be most valuable as a non-invasive technique of excluding coronary stent restenosis or occlusion. The main factors affecting visualization are stent diameters and stent materials.

Quality of compressed medical images.

Previous studies have shown that Joint Photographic Experts Group (JPEG) 2000 compression is better than JPEG at higher compression ratio levels. However, some findings revealed that this is not valid at lower levels. In this study, the qualities of compressed medical images in these ratio areas ( approximately 20), including computed radiography, computed tomography head and body, mammographic, and magnetic resonance T1 and T2 images, were estimated using both a pixel-based (peak signal to noise ratio) and two 8 x 8 window-based [Q index and Moran peak ratio (MPR)] metrics. To diminish the effects of blocking artifacts from JPEG, jump windows were used in both window-based metrics. Comparing the image quality indices between jump and sliding windows, the results showed that blocking artifacts were produced from JPEG compression, even at low compression ratios. However, even after the blocking artifacts were omitted in JPEG compressed images, JPEG2000 outperformed JPEG at low compression levels. We found in this study that the image contrast and the average gray level play important roles in image compression and quality evaluation. There were drawbacks in all metrics that we used. In the future, the image gray level and contrast effect should be considered in developing new objective metrics.