Focus on the inconsistency of the shape, location and size of brain glioma, a dual-channel 3-dimensional (3D) densely connected network is proposed to automatically segment brain glioma tumor on magnetic resonance images. Our method is based on a 3D convolutional neural network frame, and two convolution kernel sizes are adopted in each channel to extract multi-scale features in different scales of receptive fields. Then we construct two densely connected blocks in each pathway for feature learning and transmission. Finally, the concatenation of two pathway features was sent to classification layer to classify central region voxels to segment brain tumor automatically. We train and test our model on open brain tumor segmentation challenge dataset, and we also compared our results with other models. Experimental results show that our algorithm can segment different tumor lesions more accurately. It has important application value in the clinical diagnosis and treatment of brain tumor diseases.
Acute aortic dissection is featured as sudden onset and high mortality. Regardless early optimal surgical intervention and strict medical therapy, incidence of late complications is still high. Thus, specific imaging techniques and precise measurement of biomarkers to predict complications are needed. In the present study, we reviewed related papers to compare traditional imaging techniques (computed tomography, echocardiography) and magnetic resonance imaging (MRI) in the diagnosis of chronic aortic dissection. In addition, we discussed how to further evaluate aortic dissection by MRI.
Objective To analyze and summarize advantages, disadvantages, and limitations of present imaging techniques in assessing efficacy of immunotherapy for patient with hepatocellular carcinoma in order to provide strong evidence for drug therapy evaluation and clinical decision-making for it. Method The relevant literatures about imaging evaluation of immunotherapy for hepatocellular carcinoma were collected to make a review, then analyze and summarize the value of different imaging techniques. Results The immunotherapy, characterized by the noninvasive, high specificity and good curative effect, had been playing an important role in the treatment of hepatocellular carcinoma in recent years. The imaging techniques currently used to assess the immunotherapy results of hepatocellular carinoma mainly included the CT, MRI, ultrasound, and nuclear medicine, which could be used to better evaluate the effectiveness of immunotherapy. It was very important for screening of the patients’ treatment options and judging of the survival and prognosis. The most of the evaluation indicators were based on the anatomic evaluation criteria and it had some certain limitations in evaluating the immunotherapy efficacy of patient with hepatocellular carcinoma. Conclusions As an emerging biological therapy, immunotherapy has gradually become a hotspot in diagnosis and treatment of hepatocellular carcinoma in future. Present imaging techniques and evaluation criteria have certain limitations. More multifunctional imaging indicators need to be improved and developed so as to provide strong evidence for drug therapy evaluation and clinical decision of patient with hepatocellular carcinoma.
Objective To evaluate the clinical value of cardiac MRI for the diagnosis of viral myocarditis (VMC). Methods Such databases as PubMed (1950 to 2009), EMbase (1974 to 2009), and The Cochrane Library (December 2009) were searched to include clinical research reports of diagnosing viral myocarditis with MRI. QUADAS items were used to evaluate the quality of the included studies. The Meta-disc software was used to conduct merger analyses on sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio. The Heterogeneity test was performed and summary receiver operating characteristic curve (SROC) was completed. Results Five trials were included. The value of merger sensitivity, specificity, and diagnostic odds ratio (DOR) were 0.94, 0.69, 2.76, and 28.11, respectively. The area under of SROC curve (AUC) was 0.871 9. Conclusion The current evidence shows that cardiac MRI has high sensitivity (94%) and moderate specificity (69%) in the diagnosis of viral myocarditis. The positive rate in the viral myocarditis group is 28.11 times as high as that in the non-viral myocarditis group, so Cardiac MRI has good diagnostic values for viral myocarditis.
Urokinase plasminogen activator receptor (uPAR) is a membrane protein which is attached to the cellular external membrane. The uPAR expression can be observed both in tumor cells and in tumor-associated stromal cells. Thus, in the present study, the human amino-terminal fragment (hATF), as a targeting element to uPAR, is used to conjugate to the surface of superparamagnetic iron nanoparticle (SPIO). Flowcytometry was used to examine the uPAR expression in different tumor cell lines. The specificity of hATF-SPIO was verified by Prussian blue stain and cell phantom test. The imaging properties of hATF-SPIO were confirmed in vivo magnetic resonance imaging (MRI) of uPAR-elevated colon tumor. Finally, the distribution of hATF-SPIO in tumor tissue was confirmed by pathological staining. Results showed that the three cells in which we screened, presented different expression characteristics, i.e., Hela cells strongly expressed uPAR, HT29 cells moderately expressed uPAR, but Lovo cells didn't express uPAR. In vitro, after incubating with Hela cells, hATF-SPIO could specifically combined to and be subsequently internalized by uPAR positive cells, which could be observed via Prussian blue staining. Meanwhile T2WI signal intensity of Hela cells, after incubation with targeted probe, significantly decreased, and otherwise no obvious changes in Lovo cells both by Prussian blue staining and MRI scans. In vivo, hATF-SPIO could be systematically delivered to HT29 xenograft and accumulated in the tumor tissue which was confirmed by Prussian Blue stain compared to Lovo xenografts. Twenty-four hours after injection of targeting probe, the signal intensity of HT29 xenografts was lower than Lovo ones which was statistically significant. This targeting nanoparticles enabled not only in vitro specifically combining to uPAR positive cells but also in vivo imaging of uPAR moderately elevated colon cancer lesions.
ObjectiveTo investigate the CT and MR imaging manifestation of solid-pseudopapillary neoplasm of pancreas (SPNP), deepen the understanding of imaging and clinical pathological characteristics of SPNP and improve the level of diagnosis. MethodsBetween Jan 2010 and Dec 2015, the CT and MR imaging data of seven patients with SPTP proved by surgery and histopathologically were analyzed retrospectively. The following imaging features were reviewed: tumor size, location, shape, margin, encapsulation, calcification, hemorrhage, solid-cystic ratio, pancreatic and bile duct dilatation, the manifestation of plain scan and dynamic pattern of enhancement. ResultsThe population comprised 7 women, the average age was 28.3 years oldwith a median tumor size of 5.7 cm. Tumors were located at body tail of pancreas in 5 cases, at the head in 1 case, and at the tail in 1 case. The tumor were exogenous in 5 cases, endogenous in 2 cases. Five tumors showed the regular margin, inregular in 2 cases. Four cases of plain and enhanced CT scan showed cystic-solid tumors, the solid and encapsulation part ofSPNP presented as hipo-, iso-density, and gradually enhancement after injecting contrast medium. Three cases were examined by MRI, 2 cases appeared hemorrhage, tumor located in the head of pancreas leaded to the secondary ducts dilatations in 1 case. Conciusions There are some characteristics in CT and MRI manifestation of SPNP. Accurate diagnosis meybe created by the imaging study combined with the clinical feature.
ObjectiveTo investigate the clinical value of magnetic resonance imaging (MRI) combined with ultrasound (US) contrasting with MRI in evaluating the pathological complete response (pCR) of breast cancer after neoadjuvant chemotherapy (NAC).MethodsThe imaging data of patients with primary invasive breast cancer who completed the surgical resection after NAC and met the inclusion criteria in the Breast Disease Diagnosis and Treatment Center of Affiliated Hospital of Qingdao University from December 2016 to December 2019 were collected retrospectively. These patients were evaluated by MRI and MRI combined with US examination respectively. The results of MRI alone and MRI combined with US were designed into imaging of complete remission (rCR) and imaging of non-complete remission (non-rCR). With results of postoperative pathology as the gold standard, the sensitivity, specificity, and positive predictive value (PPV) of MRI alone and MRI combined with US in predicting pCR of patients with rCR or non-rCR were calculated and which were further analyzed in the 4 subtypes of breast cancer (HR+/HER2+, HR+/HER2–, HR–/HER2+, and HR–/HER2– subtype).Results① According to the inclusion and exclusion criteria, a total of 146 patients with primary invasive breast cancer were included, including 34 cases of HR+/HER2+subtype, 63 cases of HR+/HER2– subtype, 23 cases of HR–/HER2+ subtype, and 26 cases of HR–/HER2– subtype. ② After NAC, 36 cases had a pCR, among which 9 cases (26.5%) were in HR+/HER2+ subtype, 10 cases (15.9%) were in HR+/HER2– subtype, 8 cases (34.8%) were in HR–/HER2+ subtype, and 9 cases (34.6%) were in HR–/HER2– subtype. ③ After NAC, 22 (78.6%) of the 28 patients evaluated by MRI alone achieved pCR, 17 (81.0%) of the 21 patients evaluated by MRI combined with US achieved pCR, and the PPV value of pCR evaluated by MRI alone and MRI combined with US was 78.6% and 81.0%, respectively. ④ Both MRI alone and MRI combined with US predicted NAC showed the highest PPV values in patients with HR–/HER2– subtype breast cancer (85.7% and 100%, respectively), and the lowest values in HR+/ HER2– subtype breast cancer (71.4% and 60.0%, respectively).ConclusionFor the overall patients with primary invasive breast cancer, MRI combined with US is superior to MRI alone in the evaluation of efficacy after NAC, and among the patients with different subtypes of breast cancer, except HR+/HER2– subtype, MRI combined with US is still more effective in predicting efficacy after NAC than MRI alone.