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1.
FEBS Open Bio ; 11(3): 911-920, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33455075

RESUMO

Multiple clinical trials have shown that monoclonal antibodies (mAbs) against programmed death-ligand 1 (PD-1/PD-L1) can benefit patients with lung cancer by increasing their progression-free survival and overall survival. However, a significant proportion of patients do not respond to anti-PD-1/PD-L1 mAbs. In the present study, we investigated whether galectin (Gal)-3 inhibitors can enhance the antitumor effect of PD-L1 blockade. Using the NSCLC-derived cell line A549, we examined the expression of Gal-3 in lung cancer cells under hypoxic conditions and investigated the regulatory effect of Gal-3 on PD-L1 expression, which is mediated by the STAT3 pathway. We also explored whether Gal-3 inhibition can facilitate the cytotoxic effect of T cells induced by PD-L1 blockade. The effects of combined use of a Gal-3 inhibitor and PD-L1 blockade on tumor growth and T-cell function were also investigated, and we found that hypoxia increased the expression and secretion of Gal-3 by lung cancer cells. Gal-3 increased PD-L1 expression via the upregulation of STAT3 phosphorylation, and administration of a Gal-3 inhibitor enhanced the effect of PD-L1 blockade on the cytotoxic activity of T cells against cancer cells in vitro. In a mouse xenograft model, the combination of a Gal-3 inhibitor and PD-L1 blockade synergistically suppressed tumor growth. Furthermore, the administration of a Gal-3 inhibitor enhanced T-cell infiltration and granzyme B release in tumors. Collectively, our results show that Gal-3 increases PD-L1 expression in lung cancer cells and that the administration of a Gal-3 inhibitor as an adjuvant enhanced the antitumor activity of PD-L1 blockade.

2.
Artigo em Inglês | MEDLINE | ID: mdl-33420610

RESUMO

PURPOSE: This study aimed to establish an effective nomogram to predict primary distant metastasis (DM) in patients with nasopharyngeal carcinoma (NPC) to guide the application of PET/CT. METHODS: In total, 3591 patients with pathologically confirmed NPC were consecutively enrolled. The nomogram was constructed based on 1922 patients treated between 2007 and 2014. Multivariate logistical regression was applied to identify the independent risk factors of DM. The predictive value of the nomogram was evaluated using the concordance index (C-index), calibration curve, probability density functions (PDFs), and clinical utility curve (CUC). The results were validated in 1669 patients enrolled from 2015 to 2016. Net reclassification improvement (NRI) was applied to compare performances of the nomogram with other clinical factors. The best cut-off value of the nomogram chosen for clinical application was analyzed. RESULTS: A total of 355 patients showed primary DM among 3591 patients, yielding an incidence rate of 9.9%. Sex, N stage, EBV DNA level, lactate dehydrogenase level, and hemoglobin level were independent predictive factors for primary DM. C-indices in the training and validation cohort were 0.796 (95% CI, 0.76-0.83) and 0.779 (95% CI, 0.74-0.81), respectively. The NRI indices demonstrated that this model had better predictive performance than plasma EBV DNA level and N stage. We advocate for a threshold probability of 3.5% for guiding the application of PET/CT depending on the clinical utility analyses. CONCLUSION: This nomogram is a useful tool to predict primary DM of NPC and guide the clinical application of PET/CT individually at the initial staging.

3.
Eur Radiol ; 2021 Jan 06.
Artigo em Inglês | MEDLINE | ID: mdl-33409777

RESUMO

OBJECTIVES: The study aimed to compare the ability of morphological and texture features derived from contrast-enhanced CT in histological subtyping of epithelial ovarian carcinoma (EOC). METHODS: Consecutive 205 patients with newly diagnosed EOC who underwent contrast-enhanced CT were included and dichotomised into high-grade serous carcinoma (HGSC) and non-HGSC. Clinical information including age and cancer antigen 125 (CA-125) was documented. The pre-treatment images were analysed using commercial software, TexRAD, by two independent radiologists. Eight qualitative CT morphological features were evaluated, and 36 CT texture features at 6 spatial scale factors (SSFs) were extracted per patient. Features' reduction was based on kappa score, intra-class correlation coefficient (ICC), univariate ROC analysis and Pearson's correlation test. Texture features with ICC ≥ 0.8 were compared by histological subtypes. Patients were randomly divided into training and testing sets by 8:2. Two random forest classifiers were determined and compared: model 1 incorporating selected morphological and clinical features and model 2 incorporating selected texture and clinical features. RESULTS: HGSC showed specifically higher texture features than non-HGSC (p < 0.05). Both models performed highly in predicting histological subtypes of EOC (model 1: AUC 0.891 and model 2: AUC 0.937), and no statistical significance was found between the two models (p = 0.464). CONCLUSION: CT texture analysis provides objective and quantitative metrics on tumour characteristics with HGSC demonstrating specifically high texture features. The model incorporating texture analysis could classify histology subtypes of EOC with high accuracy and performed as well as morphological features. KEY POINTS: • A number of CT morphological and texture features showed good inter- and intra-observer agreements. • High-grade serous ovarian carcinoma showed specifically higher CT texture features than non-high-grade serous ovarian carcinoma. • CT texture analysis could differentiate histological subtypes of epithelial ovarian carcinoma with high accuracy.

4.
Eur Radiol ; 2021 Jan 08.
Artigo em Inglês | MEDLINE | ID: mdl-33416977

RESUMO

OBJECTIVES: The value of using PET/CT for staging of stage I-II NPC remains unclear. Hence, we aimed to investigate the survival benefit of PET/CT for staging of early-stage NPC before radical therapy. METHODS: A total of 1003 patients with pathologically confirmed NPC of stages I-II were consecutively enrolled. Among them, 218 patients underwent both PET/CT and conventional workup ([CWU], head-and-neck MRI, chest radiograph, liver ultrasound, bone scintigraphy) before treatment. The remaining 785 patients only underwent CWU. The standard of truth (SOT) for lymph node metastasis was defined by the change of size according to follow-up MRI. The diagnostic efficacies were compared in 218 patients who underwent both PET/CT and CWU. After covariate adjustment using propensity scoring, a cohort of 872 patients (218 with and 654 without pre-treatment PET/CT) was included. The primary outcome was overall survival based on intention to treat. RESULTS: Retropharyngeal lymph nodes were metastatic based on follow-up MRI in 79 cases. PET/CT was significantly less sensitive than MRI in detecting retropharyngeal lymph node lesions (72.2% [62.3-82.1] vs. 91.1% [84.8-97.4], p = 0.004). Neck lymph nodes were metastatic in 89 cases and PET/CT was more sensitive than MRI (96.6% [92.8-100.0] vs. 76.4% [67.6-85.2], p < 0.001). In the survival analyses, there was no association between pre-treatment PET/CT use and improved overall survival, progression-free survival, local relapse-free survival, regional relapse-free survival, and distant metastasis-free survival. CONCLUSIONS: This study showed PET/CT is of little value for staging of stage I-II NPC patients at initial imaging. KEY POINTS: • PET/CT was more sensitive than MRI in detecting neck lymph node lesions whereas it was significantly less sensitive than MRI in detecting retropharyngeal lymph node lesions. • No association existed between pre-treatment PET/CT use and improved survival in stage I-II NPC patients.

5.
Eur J Radiol ; 134: 109466, 2020 Dec 03.
Artigo em Inglês | MEDLINE | ID: mdl-33307459

RESUMO

PURPOSE: Accurate glioma grading and IDH mutation status prediction are critically essential for individualized preoperative treatment decisions. This study aims to compare the diagnostic performance of magnetic resonance (MR) amide proton transfer (APT) and diffusion kurtosis imaging (DKI) in glioma grading and IDH mutation status prediction. METHOD: Fifty-one glioma patients without treatment were retrospectively included. APT-weighted (APTw) effect and DKI indices, including mean diffusivity (MD), fractional anisotropy (FA), mean kurtosis (MK), and kurtosis FA (KFA) were obtained from APT and diffusion-weighted images, respectively. DKI indices in tumors were normalized to that in contralateral normal appearing white matter (CNAWM) and the APTw difference (ΔAPTw) between the two regions was calculated. Student's t-test, one-way ANOVA and ROC analyses were conducted. RESULTS: Among the enrolled 51 patients, 13 had glioma-II, 17 had glioma-III and 21 had glioma-IV. 25 patients were diagnosed as IDH-mutant, and 26 as IDH-wild type. MD and MK differed significantly between glioma-IV and glioma II/III (P < 0.05), but not between glioma-II and glioma-III. FA and KFA showed no significant difference among the three groups (P > 0.05). IDH-mutant group exhibited significantly higher MD and lower FA, MK and ΔAPTw than IDH-wild type (P < 0.05), whereas the two groups showed comparable KFA values. In contrast, ΔAPTw differed significantly across tumor grades and IDH mutation status (P < 0.05), with consistently better discriminatory performance than DKI indices in glioma grading and IDH mutation status prediction. CONCLUSIONS: APT imaging was superior to DKI in glioma grading and IDH mutation status prediction, benefiting accurate diagnoses and treatment decisions.

6.
Radiother Oncol ; 154: 6-13, 2020 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-32941954

RESUMO

BACKGROUND: Deep learning is promising to predict treatment response. We aimed to evaluate and validate the predictive performance of the CT-based model using deep learning features for predicting pathologic complete response to neoadjuvant chemoradiotherapy (nCRT) in esophageal squamous cell carcinoma (ESCC). MATERIALS AND METHODS: Patients were retrospectively enrolled between April 2007 and December 2018 from two institutions. We extracted deep learning features of six pre-trained convolutional neural networks, respectively, from pretreatment CT images in the training cohort (n = 161). Support vector machine was adopted as the classifier. Validation was performed in an external testing cohort (n = 70). We assessed the performance using the area under the receiver operating characteristics curve (AUC) and selected an optimal model, which was compared with a radiomics model developed from the training cohort. A clinical model consisting of clinical factors only was also built for baseline comparison. We further conducted a radiogenomics analysis using gene expression profiles to reveal underlying biology associated with radiological prediction. RESULTS: The optimal model with features extracted from ResNet50 achieved an AUC and accuracy of 0.805 (95% CI, 0.696-0.913) and 77.1% (65.6%-86.3%) in the testing cohort, compared with 0.725 (0.605-0.846)) and 67.1% (54.9%-77.9%) for the radiomics model. All the radiological models showed better predictive performance than the clinical model. Radiogenomics analysis suggested a potential association mainly with WNT signaling pathway and tumor microenvironment. CONCLUSIONS: The novel and noninvasive deep learning approach could provide efficient and accurate prediction of treatment response to nCRT in ESCC, and benefit clinical decision making of therapeutic strategy.

7.
JAMA Netw Open ; 3(9): e2015927, 2020 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-32910196

RESUMO

Importance: For patients with locally advanced esophageal squamous cell carcinoma, neoadjuvant chemoradiation has been shown to improve long-term outcomes, but the treatment response varies among patients. Accurate pretreatment prediction of response remains an urgent need. Objective: To determine whether peritumoral radiomics features derived from baseline computed tomography images could provide valuable information about neoadjuvant chemoradiation response and enhance the ability of intratumoral radiomics to estimate pathological complete response. Design, Setting, and Participants: A total of 231 patients with esophageal squamous cell carcinoma, who underwent baseline contrast-enhanced computed tomography and received neoadjuvant chemoradiation followed by surgery at 2 institutions in China, were consecutively included. This diagnostic study used single-institution data between April 2007 and December 2018 to extract radiomics features from intratumoral and peritumoral regions and established intratumoral, peritumoral, and combined radiomics models using different classifiers. External validation was conducted using independent data collected from another hospital during the same period. Radiogenomics analysis using gene expression profile was done in a subgroup of the training set for pathophysiological explanation. Data were analyzed from June to December 2019. Exposures: Computed tomography-based radiomics. Main Outcomes and Measures: The discriminative performances of radiomics models were measured by area under the receiver operating characteristic curve. Results: Among the 231 patients included (192 men [83.1%]; mean [SD] age, 59.8 [8.7] years), the optimal intratumoral and peritumoral radiomics models yielded similar areas under the receiver operating characteristic curve of 0.730 (95% CI, 0.609-0.850) and 0.734 (0.613-0.854), respectively. The combined model was composed of 7 intratumoral and 6 peritumoral features and achieved better discriminative performance, with an area under the receiver operating characteristic curve of 0.852 (95% CI, 0.753-0.951), accuracy of 84.3%, sensitivity of 90.3%, and specificity of 79.5% in the test set. Gene sets associated with the combined model mainly involved lymphocyte-mediated immunity. The association of peritumoral area with response identification might be partially attributed to type I interferon-related biological process. Conclusions and Relevance: A combination of peritumoral radiomics features appears to improve the predictive performance of intratumoral radiomics to estimate pathological complete response after neoadjuvant chemoradiation in patients with esophageal squamous cell carcinoma. This study underlines the significant application of peritumoral radiomics to assess treatment response in clinical practice.

8.
BMC Med Imaging ; 20(1): 5, 2020 01 16.
Artigo em Inglês | MEDLINE | ID: mdl-31948400

RESUMO

BACKGROUND: Differentiating glioma recurrence from treatment-related changes can be challenging on conventional imaging. We evaluated the efficacy of quantitative parameters measured by dual-energy spectral computed tomographic (CT) for this differentiation. METHODS: Twenty-eight patients were examined by dual-energy spectral CT. The effective and normalized atomic number (Zeff and Zeff-N, respectively); spectral Hounsfield unit curve (λHU) slope; and iodine and normalized iodine concentration (IC and ICN, respectively) in the post-treatment enhanced areas were calculated. Pathological results or clinicoradiologic follow-up of ≥2 months were used for final diagnosis. Nonparametric and t-tests were used to compare quantitative parameters between glioma recurrence and treatment-related changes. Sensitivity, specificity, positive and negative predictive values (PPV and NPV, respectively), and accuracy were calculated using receiver operating characteristic (ROC) curves. Predictive probabilities were used to generate ROC curves to determine the diagnostic value. RESULTS: Examination of pre-contrast λHU, Zeff, Zeff-N, IC, ICN, and venous phase ICN showed no significant differences in quantitative parameters (P > 0.05). Venous phase λHU, Zeff, Zeff-N, and IC in glioma recurrence were higher than in treatment-related changes (P < 0.001). The optimal venous phase threshold was 1.03, 7.75, 1.04, and 2.85 mg/cm3, achieving 66.7, 91.7, 83.3, and 91.7% sensitivity; 100.0, 77.8, 88.9, and 77.8% specificity; 100.0, 73.3, 83.3, and 73.3% PPV; 81.8, 93.3, 88.9, and 93.3% NPV; and 86.7, 83.3, 86.7, and 83.3% accuracy, respectively. The respective areas under the curve (AUCs) were 0.912, 0.912, 0.931, and 0.910 in glioma recurrence and treatment-related changes. CONCLUSIONS: Glioma recurrence could be potentially differentiated from treatment-related changes based on quantitative values measured by dual-energy spectral CT imaging.


Assuntos
Neoplasias Encefálicas/diagnóstico por imagem , Glioma/diagnóstico por imagem , Recidiva Local de Neoplasia/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Adulto , Neoplasias Encefálicas/patologia , Diagnóstico Diferencial , Feminino , Glioma/patologia , Glioma/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/patologia , Recidiva Local de Neoplasia/terapia , Estadiamento de Neoplasias , Curva ROC , Interpretação de Imagem Radiográfica Assistida por Computador , Sensibilidade e Especificidade , Resultado do Tratamento
9.
Neuroimage Clin ; 25: 102175, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31954985

RESUMO

Patients with hepatitis B virus (HBV)-related cirrhosis (HBV-RC) and minimal hepatic encephalopathy (MHE) exhibit alterations in homotopic inter-hemispheric functional connectivity (FC) and corpus callosum (CC) degeneration. However, the progression of inter-hemispheric dysconnectivity in cirrhotic patients from no MHE (NMHE) to MHE and its association with the progression of diseased-related cognitive impairment remain uncharacterized. We hypothesized that inter-hemispheric dysconnectivity exists in NMHE patients and further deteriorates at the MHE stage, which is associated with performance measured by psychometric hepatic encephalopathy scores (PHES) that can characterize cirrhotic patients with NMHE and MHE. Using inter-hemispheric homotopic FC and CC (and its subfields) volumetric measurements in 31 patients with HBV-RC (17 with NMHE and 14 with MHE) and 37 healthy controls, we verified that MHE patients had significant attenuated inter-hemispheric homotopic FC in the bilateral cuneus, post-central gyrus, inferior parietal lobule, and superior temporal gyms, as well as CC degeneration in total CC, CC2, CC3, and CC4 (each comparison had a corrected P < 0.05). In contrast, NMHE patients had relatively less severe inter-hemispheric homotopic FC and no CC degeneration. In addition, the degeneration of the CC and inter-hemispheric homotopic functional disconnections correlated with poor PHES performances in all cirrhotic patients (NMHE and MHE). Furthermore, impairment of inter-hemispheric homotopic FC partially mediated the association between CC degeneration and worse PHES performance. Notably, a combination of inter-hemispheric homotopic FC and CC volumes had higher discriminative values according to the area under the curve (AUC) score (AUC = 0.908, P < 0.001) to classify patients into MHE or NMHE groups when compared with either alone. Our findings shed light on the progression of inter-hemispheric dysconnectivity in relation to the progression of disease-related cognitive impairment in patients with HBV-RC.

10.
Front Neurol ; 10: 752, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31379710

RESUMO

Background: Increasing evidence indicates that early radiation-induced subtle cerebral changes may be the precursors to permanent brain dysfunction at the late-delayed (LDS) post-radiotherapy (RT) stage. In this study, we aim to track the RT-related longitudinal brain activity in nasopharyngeal carcinoma (NPC) patients and to determine whether early abnormal brain activity can predict late neurocognitive dysfunction after RT. Methods: Thirty-three NPC patients were finally included and longitudinally followed up at the following time points: prior to treatment initiation, early-delayed stage (EDS, 1-3 months), and LDS (six months) after RT. Fifteen comparable healthy controls (HCs) were finally included and followed up in parallel. Montreal Cognitive Assessment (MoCA) was used to assess the general cognitive function. Brain activity was recorded via resting-state fMRI and regional homogeneity (ReHo). A whole-brain voxel-wise-based one-way repeated-measure analysis of variance (ANOVA) was conducted to evaluate the longitudinal ReHo changes among the three time points for NPC patients and HCs, respectively. Results were reported at the significant level of a threshold of two-tailed voxel-wise P < 0.01 and cluster level P < 0.05 with Gaussian Random Field (GRF) correction. Finally, the efficacies of the aberrant ReHo at EDS for predicting the cognitive impairment at LDS in NPC patients were evaluated. Results: Significant differences were detected in ReHo among the three time points in NPC patients but not in HCs. Aberrant ReHo was distributed in the bilateral cerebellum, the right temporal lobe, and the left insular areas, which showed different dynamic changes patterns over time. Logistic regression model combining the mean ReHo, age, and irradiation dose on the bilateral temporal lobe had the highest diagnostic efficiency according to the area under the curve (AUC) score (AUC = 0.752, P = 0.023). Conclusions: The post-RT brain activity revealed by ReHo in NPC patients was dynamic, complex, and multifactorial. Furthermore, the combination of the aberrant ReHo at EDS, age, and irradiation dose may serve as a potential biomarker of the RT-induced cognitive impairments at LDS.

11.
Brain Imaging Behav ; 13(4): 1160-1171, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30054872

RESUMO

Increasing evidence indicates that radiation-induced injury to the hippocampus may play a critical role in neurocognitive dysfunction in patients with nasopharyngeal carcinoma (NPC). However, few studies have assessed RT-induced hippocampal structural alterations in these patients early after radiotherapy (RT). In this study, 58 NPC patients were longitudinally followed up prior to treatment initiation as well as 3 and 6 months after RT, respectively. Twenty comparable normal controls were recruited and followed up in parallel. A novel magnetic resonance imaging (MRI)-based automated method was used to label hippocampal subfields. The linear mixed model was employed to evaluate longitudinal changes in the volumes of the whole hippocampus and seven hippocampal subfields. Time-dependent volume reduction was observed in the bilateral hippocampus, as well as in the bilateral granule cell layer (GCL), bilateral cornu ammonis 1 (CA1), bilateral molecular layer (ML), and bilateral subiculum (SUB) in NPC patients, but not in controls. Moreover, volume deficits in the bilateral hippocampus, bilateral GCL, and right ML showed dose-dependent patterns, and high volume losses in the bilateral hippocampus, bilateral GCL, left SUB, and right ML were associated with a rapid decline in cognitive function. Our findings demonstrated that the hippocampal subfields were selectively injured by irradiation-related early neurotoxic effects, which might account for cognitive impairment in NPC patients at an early stage after RT. Further, structural MRI could serve as a potential noninvasive imaging biomarker for the early detection of radiation effects on the hippocampus in NPC patients after RT.


Assuntos
Cognição/efeitos da radiação , Hipocampo/efeitos da radiação , Radioterapia/efeitos adversos , Adulto , Atrofia/patologia , Encéfalo/patologia , Disfunção Cognitiva/fisiopatologia , Feminino , Hipocampo/patologia , Humanos , Estudos Longitudinais , Imagem por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Carcinoma Nasofaríngeo/fisiopatologia , Neoplasias Nasofaríngeas , Radiação , Lobo Temporal/patologia
12.
Neuroimage Clin ; 19: 252-259, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30035019

RESUMO

Background and purpose: To investigate effects of radiotherapy on normal brain tissue using in vivo neuroimaging in patients with nasopharyngeal carcinoma (NPC). Methods and materials: We used longitudinal MRI to monitor structural brain changes during standard radiotherapy in patients newly diagnosed with NPC. We assessed volumetric measures in 63 patients at 2-3 time points before and after radiotherapy, with 20 NPC-free participants as normal controls. Images were processed using validated software (FreeSurfer). Automated results were inspected visually for accuracy. We examined changes in volume of the whole brain, gray matter, white matter, and ventricles, as well as in cerebral volumes partitioned into temporal, frontal, parietal, and occipital lobes. A linear mixed model was used to evaluate longitudinal changes in these measurements. Statistical significance was evaluated at p < 0.05, which was corrected for multiple comparisons. Results: Volumes of the gray matter, and bilateral temporal lobes decreased in a time-dependent manner, whereas ventricle volume showed a time-dependent increase after radiotherapy. No volume changes were detected in NPC patients before radiotherapy when compared normal controls. No volume changes were detected in the subcohort of patients after completion of induction chemotherapy but prior to initiation of radiotherapy. Changes of bilateral temporal lobe volume correlated with irradiation dose in this region. Expansion of the ventricles correlated with a reduction in cognition assessment. Conclusions: We detected significant and progressive radiotherapy-associated structural changes in the brains of patients with NPC who were treated with standard radiotherapy, especially in the bilateral temporal lobe in which the effect was dose-dependent. Expansion of the ventricles can serve as an imaging marker for treatment-related reduction in cognitive function. Future studies with longer follow-ups are needed to evaluate morphometric changes long-term after radiotherapy.


Assuntos
Encéfalo/diagnóstico por imagem , Carcinoma Nasofaríngeo/diagnóstico por imagem , Neoplasias Nasofaríngeas/diagnóstico por imagem , Adulto , Feminino , Humanos , Estudos Longitudinais , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Carcinoma Nasofaríngeo/patologia , Carcinoma Nasofaríngeo/radioterapia , Neoplasias Nasofaríngeas/patologia , Neoplasias Nasofaríngeas/radioterapia , Neuroimagem , Tamanho do Órgão , Adulto Jovem
13.
Brain Imaging Behav ; 12(5): 1279-1289, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-29164505

RESUMO

In this study, we seek to longitudinally investigate the network-level functional connectivity (FC) alternations and its association with irradiation dose and cognition changes in the early stage post radiotherapy (RT) in nasopharyngeal carcinoma (NPC) patients. We performed independent component analysis (ICA) of resting state blood oxygen level-dependent functional magnetic resonance imaging (BOLD-fMRI) from 39 newly diagnosed NPC patients before receiving treatment (baseline), and 3 months post-RT. the default mode network (DMN), salience network (SN), and executive control network (ECN) were extracted with well-validated software (GIFT). Inter-network connectivity was assessed using the functional network connectivity (FNC) toolbox. The inter- and intra-network FC was compared between time points, and the z value of FC alternation was correlated with the RT dose value and cognitive changes. Compared with baseline, the FC of the left anterior cingulate cortex (ACC) within the DMN, and the right insular within the SN, significantly reduced 3 months post-RT, with greater effects at higher doses in the right insular. Bilateral ECN FC was also significantly lower 3 months post-RT compared to the baseline. Chemotherapy was not associated with inter- and intra- network FC change. We found intra- and inter-network FC disruption in NPC patients 3 months post-RT, with the right insular showing a dose-dependent effect. Thus, this network-level FC may serve as a potential biomarker of the RT-induced brain functional impairments, and provide valuable targets for further functional recovery treatment.


Assuntos
Encéfalo/fisiopatologia , Encéfalo/efeitos da radiação , Carcinoma Nasofaríngeo/fisiopatologia , Carcinoma Nasofaríngeo/radioterapia , Neoplasias Nasofaríngeas/fisiopatologia , Neoplasias Nasofaríngeas/radioterapia , Adulto , Antineoplásicos/uso terapêutico , Encéfalo/diagnóstico por imagem , Mapeamento Encefálico , Circulação Cerebrovascular , Cognição/efeitos da radiação , Feminino , Humanos , Estudos Longitudinais , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Carcinoma Nasofaríngeo/diagnóstico por imagem , Carcinoma Nasofaríngeo/psicologia , Neoplasias Nasofaríngeas/diagnóstico por imagem , Neoplasias Nasofaríngeas/psicologia , Vias Neurais/diagnóstico por imagem , Vias Neurais/fisiopatologia , Vias Neurais/efeitos da radiação , Oxigênio/sangue , Estudos Prospectivos , Doses de Radiação , Descanso , Resultado do Tratamento , Adulto Jovem
14.
Oncol Lett ; 14(5): 6224-6230, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-29113271

RESUMO

The aim of the present study was to analyze the differences in imaging and clinical features between primary pulmonary lymphoma (PPL) and secondary pulmonary lymphoma (SPL) to provide insight into pulmonary lymphoma for an improved clinical diagnosis. A retrospective study of 38 patients with pulmonary lymphoma (19 PPL and 19 SPL) treated between September 1, 2006, and December 31, 2015, was performed. The clinical manifestations, and computed tomography (CT) and positron emission tomography-CT images of each case were collected. χ2 and Fisher's exact tests were applied to assess statistically significant differences between PPL and SPL in terms of clinical and imaging features. The significant variables were further applied to canonical discriminate analysis. The CT results revealed that the occurrence of a >3-cm mass (P=0.007), peripheral location (lower than the segmental bronchi) (P=0.027), cavitation (P=0.008) and consolidation (P=0.027) were associated with PPL, while peripheral and hilar location (P=0.003) or mediastinal and hilar lymph node engagement (P=0.044) were predominantly observed in SPL. However, no significant differences between clinical manifestations and the maximum standard uptake value of pulmonary lesions in PPL and SPL were identified (all P>0.05). A function derived from discriminate analysis was generated that may predict the affiliation to PPL or SPL radiographically, with an overall accuracy of ≤92.1%. The results of the present study revealed that PPL and SPL exhibit distinctive features on CT images due to distinct molecular mechanisms and growth patterns. Careful observation of CT features may be useful in the diagnosis of PPL and SPL regarding the tumor morphology, location and lymph node involvement.

15.
Biomed Res Int ; 2016: 4168512, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27403426

RESUMO

There is increasing evidence that cirrhosis may affect functional connectivity among various brain regions in patients prior to onset of overt hepatic encephalopathy (HE). However, most investigators have focused mainly on alterations in functional connectivity strengths, and the changes in functional connectivity density (FCD) are largely unknown. Here, we investigated alterations in resting-state FCD in patients with hepatitis B virus-related cirrhosis (HBV-RC) without overt HE. Totally, 31 patients with HBV-RC without overt HE and 30 age- and sex-matched healthy controls underwent resting-state functional MRI examinations. FCD mapping was employed to compute local and global FCD maps. Then, short-range and long-range FCD values were calculated and voxel-based comparisons were performed between the two groups. The HBV-RC group showed significant decreases in FCD, including decreased short-range FCDs in the bilateral middle cingulum gyrus/precuneus, the bilateral cuneus, and the left lingual gyrus/inferior occipital gyrus and decreased long-range FCD in the bilateral cuneus/precuneus. In addition, the decreased long-range FCD in the bilateral cuneus/precuneus in the HBV-RC group was related to performance on the psychometric hepatic encephalopathy score (PHES) test. These findings suggest aberrant functional connectivity density in cirrhotic patients prior to overt HE onset, which may provide better insight into understanding the pathophysiological mechanisms underlying the cirrhotic-related cognitive impairment.


Assuntos
Encéfalo/fisiopatologia , Encefalopatia Hepática/diagnóstico por imagem , Cirrose Hepática/diagnóstico por imagem , Cirrose Hepática/fisiopatologia , Adulto , Encéfalo/diagnóstico por imagem , Mapeamento Encefálico , Feminino , Encefalopatia Hepática/complicações , Encefalopatia Hepática/fisiopatologia , Encefalopatia Hepática/virologia , Vírus da Hepatite B/patogenicidade , Humanos , Cirrose Hepática/complicações , Cirrose Hepática/virologia , Imagem por Ressonância Magnética , Masculino , Potenciais da Membrana/fisiologia , Pessoa de Meia-Idade
16.
Clin Breast Cancer ; 15(2): e147-54, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-25523373

RESUMO

BACKGROUND: The purpose of the study was to explore the relationship between the mammographic features, MR features, and pathological manifestations of PMBCs and MMBCs. PATIENTS AND METHODS: Twenty-seven cases of mucinous breast carcinoma confirmed in surgical biopsy, including 18 cases of PMBC and 9 cases of MMBC, were included (mean age, 51.2 and 53.3 years, respectively). All patients underwent preoperative mammography, and 13 of 27 patients underwent preoperative MR imaging (MRI), 4 of whom underwent diffusion-weighted imaging. All mammographic and MRI information, such as the size, shape, borders of the mass, and evidence of calcification were classified according to the American Collage of Radiology (ACR) Breast Imaging-Reporting And Data System (BI-RADS) mammography/MR lexicon. The signal intensity of the mass was visually classified as low, iso, high, strongly high, or mixed in accordance with surrounding mammary gland tissues. The pattern of internal enhancement of the mass included homogeneity, rim enhancement, central enhancement, dark internal septation, and enhancing internal septation. The kinetic curve pattern was categorized into 3 types: persistent, plateau, or washout. RESULTS: There was no significant difference PMBC and MMBC in the shape of tumor, calcifications, T2 signal intensity, internal mass enhancement, kinetic curve assessment, and positivity for estrogen receptor (ER), progesterone receptor (PR), and human epidermalgrowth factor receptor-2 (HER-2). The PMBC tumors were larger than MMBC tumors (P < .001), and MMBC tended to present as an ill-circumscribed mass (P = .043). The ADC values of the 5 lesions of 4 mucinous breast carcinoma (MBCs) ranged from 0.771 to 2.252 × 10(3) mm(2)/s, markedly greater than that of conventional infiltrating ductal carcinoma (IDC). The ADC values of MMBC were visibly less than those of PMBC for the former mixed with massive tumor cells of IDC. CONCLUSION: MBC commonly presented as masses with well circumscribed, round, or lobular shapes. The remaining cases presented with focal symmetry. The rate of regional nodal involvement of MBC was less than that of IDC. The MR features of PMBC included benign (homogenous intensity on T1-weighted imaging [WI] and T2-WI, persistent enhancement pattern) and malignant characteristics (rim or heterogeneous enhancement). The ADC values of MBC were greater than those of benign lesions and other malignant tumors. We believe that the combination of mammography and Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) may help to improve the diagnostic accuracy of MBC.


Assuntos
Adenocarcinoma Mucinoso/patologia , Neoplasias da Mama/patologia , Feminino , Humanos , Interpretação de Imagem Assistida por Computador , Imagem por Ressonância Magnética/métodos , Mamografia , Pessoa de Meia-Idade
17.
Acta Radiol ; 56(4): 493-9, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-24682407

RESUMO

BACKGROUND: A synovial sarcoma arising from the kidney is extremely rare. To date, few data are available on their radiological features. PURPOSE: To identify the computer tomography (CT) imaging findings of primary renal synovial sarcomas (PRSSs). MATERIAL AND METHODS: Five cases of PRSS confirmed by histopathological and cytogenetic studies were retrospectively analyzed. All patients had undergone unenhanced and multiphase enhanced CT examinations (one patient underwent CT twice). The CT characteristics, including shape, size, margin, attenuation, and enhancement pattern after intravenous contrast medium injection, were analyzed. RESULTS: The study involved two female and three male patients (mean age, 27.4 years; range, 15-43 years). Unenhanced CT showed completely or partly well-defined masses, with heterogeneous (n = 5) or homogeneous (n = 1) patchy low density. On multiphase contrast-enhanced CT, in five of the six CT examinations, the tumors appeared as solid-cystic masses with cyst walls or pseudo-capsules, and demonstrated moderately heterogeneous (n = 5) and/or septate enhancement (n = 2), with a "rapid wash-in and slow wash-out" pattern of enhancement in the solid component. Only one tumor showed a simple cyst appearance and developed an irregular, intratumoral, septate soft density 8 months later. A renal vein and inferior vena cava thrombus was noticed in one patient, while lymphadenopathy was not observed in any patient. CONCLUSION: PRSS should be included in the differential diagnosis when an adolescent or young adult presents with a renal neoplasm appearing as a solid-cystic mass with well-defined borders, a cystic wall or pseudo-capsule, heterogeneous or septate enhancement, a "rapid wash-in and slow wash-out" pattern of enhancement in the solid component, and no sign of lymphadenopathy.


Assuntos
Neoplasias Renais/diagnóstico por imagem , Sarcoma Sinovial/diagnóstico por imagem , Adolescente , Adulto , Meios de Contraste , Diagnóstico Diferencial , Feminino , Humanos , Processamento de Imagem Assistida por Computador/métodos , Iohexol/análogos & derivados , Rim/diagnóstico por imagem , Masculino , Variações Dependentes do Observador , Intensificação de Imagem Radiográfica/métodos , Estudos Retrospectivos , Tomografia Computadorizada por Raios X , Adulto Jovem
18.
PLoS One ; 8(11): e78738, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-24223847

RESUMO

BACKGROUND: In the past twenty years, codeine-containing cough syrups (CCS) was recognized as a new type of addictive drugs. However, the exact neurobiologic mechanisms underlying CCS-dependence are still ill-defined. The aims of this study are to identify CCS-related modulations of neural activity during the resting-state in CCS-dependent individuals and to investigate whether these changes of neural activity can be related to duration of CCS use, the first age of CCS use and impulse control deficits in CCS-dependent individuals. We also want to observe the impact of gray matter deficits on these functional results. METHODOLOGY/PRINCIPAL FINDINGS: Thirty CCS-dependent individuals and 30 control subjects participated. Resting-state functional MRI was performed by using gradient-echo echo-planar imaging sequence. Regional homogeneity (ReHo) was calculated by using REST software. Voxel-based analysis of the ReHo maps between controls and CCS-dependent groups was performed using two-sample t tests (p<0.05, corrected for multiple comparisons). The Barratt Impulsiveness Scale 11 (BIS.11) was surveyed to assess participants' impulsivity trait soon after MR examination. Abnormal clusters revealed by group comparison were extracted and correlated with impulsivity, duration of CCS use, and age of first CCS use. ReHo was diminished in the bilateral medial orbitofrontal cortex (mOFC) and left dorsal striatum in CCS-dependent individuals. There were negative correlations between mean ReHo in the bilateral medial OFC, left dorsal striatum and duration of CCS use, BIS.11 total scores, and the subscale of attentional impulsivity in CCS-dependent individuals. There was a significantly positive correlation between mean ReHo in the left dorsal striatum and age of first CCS use in CCS-dependent individuals. Importantly, these results still remain significant after statistically controlling for the regional gray matter deficits. CONCLUSION: Resting-state abnormalities in CCS-dependent individuals revealed in the present study may further improve our understanding about the neural substrates of impulse control dysfunction in CCS-dependent individuals.


Assuntos
Codeína/uso terapêutico , Corpo Estriado/fisiopatologia , Tosse/tratamento farmacológico , Lobo Frontal/fisiopatologia , Comportamento Impulsivo/fisiopatologia , Transtornos Relacionados ao Uso de Substâncias/fisiopatologia , Adulto , Antitussígenos/efeitos adversos , Antitussígenos/uso terapêutico , Mapeamento Encefálico , Codeína/efeitos adversos , Corpo Estriado/efeitos dos fármacos , Corpo Estriado/patologia , Feminino , Lobo Frontal/efeitos dos fármacos , Lobo Frontal/patologia , Humanos , Imagem por Ressonância Magnética/métodos , Masculino , Medicamentos sem Prescrição/efeitos adversos , Medicamentos sem Prescrição/uso terapêutico , Estudos Prospectivos , Adulto Jovem
19.
Metab Brain Dis ; 28(3): 485-92, 2013 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-23836055

RESUMO

Neurocognitive dysfunction of varying degrees is common in patients with hepatitis B virus-related cirrhosis (HBV-RC) without overt hepatic encephalopathy (OHE). However, the neurobiological mechanisms underlying these dysfunctions are not well understood. We sought to identify changes in the neural activity of patients with HBV-RC without OHE in the resting state by using the amplitude of low-frequency fluctuation (ALFF) method and to determine whether these changes were related to impaired cognition. Resting-state functional MRI data from 30 patients with HBV-RC and 30 healthy controls matched for age, sex, and years of education were compared to determine any differences in the ALFF between the two groups. Cognition was measured with the psychometric hepatic encephalopathy score (PHES), and the relationship between these scores and ALFF variation was assessed. Compared with controls, patients showed widespread lower standardized ALFF (mALFF) values in visual association areas (bilateral lingual gyrus, middle occipital gyrus, and left inferior temporal gyrus), motor-related areas (bilateral precentral gyrus, paracentral lobule, and right postcentral gyrus), and the default mode network (bilateral cuneus/precuneus and inferior parietal lobule). Higher mALFF values were found in the bilateral orbital gyrus/rectal gyrus. In patients, mALFF values were significantly positive correlated with the PHES in the right middle occipital gyrus and bilateral precentral gyrus. Our findings of resting-state abnormalities in patients with HBV-RC without OHE suggest that neurocognitive dysfunction in patients with HBV-RC without OHE may be caused by abnormal neural activity in multiple brain regions.


Assuntos
Encéfalo/fisiopatologia , Hepatite B/fisiopatologia , Hepatite B/psicologia , Cirrose Hepática/fisiopatologia , Cirrose Hepática/psicologia , Adulto , Idoso , Feminino , Encefalopatia Hepática/fisiopatologia , Hepatite B/complicações , Humanos , Processamento de Imagem Assistida por Computador , Cirrose Hepática/complicações , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Oxigênio/sangue , Psicometria
20.
Liver Int ; 33(3): 375-83, 2013 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-23402608

RESUMO

BACKGROUND: Many studies have reported that cognitive deficits exist in cirrhotic patients without overt hepatic encephalopathy (OHE). However, the neurobiological mechanisms underlying these deficits are still not fully understood. AIM: To investigate regional activity abnormalities in patients with hepatitis B virus-related cirrhosis (HBV-RC) without OHE using resting-state functional MRI (Rs-fMRI), and to examine the relationship between regional activity abnormalities and impaired cognition. METHODS: A newly reported regional homogeneity (ReHo) approach was used to compare the local synchronization of Rs-fMRI signals in 32 patients with HBV-RC without OHE and 32 well-matched healthy controls. Cognition was measured in all patients using psychometric hepatic encephalopathy score (PHES) tests, and the relationship between ReHo variation and PHES was analysed. RESULTS: Relative to healthy controls, the cirrhosis group showed high ReHo in the prefrontal cortex, and widespread low ReHo in visual association areas (left lingual gyrus, middle temporal gyrus and right middle occipital gyrus), motor association areas (bilateral precentral gyrus and paracentral lobule) and the bilateral precuneus. Correlation analysis of the mean ReHo values in different brain areas and PHES in cirrhotic patients revealed a significantly positive correlation in the left lingual gyrus (r = 0.352; P = 0.048), right middle occipital gyrus (r = 0.453; P = 0.009) and bilateral precentral gyrus (left: r = 0.436, P = 0.013; right: r = 0.582, P < 0.001), paracentral lobule (r = 0.485; P = 0.005) and precuneus (r = 0.468; P = 0.007). CONCLUSIONS: Our results provide information on the pathophysiological mechanisms underlying cognitive alterations in cirrhotic patients and demonstrate the feasibility of using Rs-fMRI with ReHo analysis as a noninvasive modality with which to detect the progression of cognitive changes in cirrhotic patients.


Assuntos
Encéfalo/fisiopatologia , Transtornos Cognitivos/fisiopatologia , Hepatite B/complicações , Cirrose Hepática/etiologia , Cirrose Hepática/fisiopatologia , Adulto , China , Transtornos Cognitivos/etiologia , Feminino , Humanos , Cirrose Hepática/complicações , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Estudos Prospectivos
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