ObjectiveTo summarize the research progress of ultrasmall superparamagnetic iron oxide (USPIO) enhanced magnetic resonance imaging (MRI) in normal-sized lymph node metastasis of colorectal cancer.MethodThe relevant literatures published recently at domestic and abroad about USPIO enhanced MRI in normal-sized lymph node metastasis of colorectal cancer were collected and reviewed.ResultsUSPIO, a kind of lymph node targeted magnetic resonance contrast agent, could be used to evaluate lymph node metastasis of malignant tumors. USPIO enhanced MRI could detect normal-sized lymph node metastasis in colorectal cancer effectively compared with normal MRI. It provided a higher diagnostic performance than normal enhanced MRI. In addition, USPIO enhanced MRI could also distinguish inflammatory and metastatic lymph nodes better that were difficult to be distinguished by normal enhanced MRI.ConclusionUSPIO enhanced MRI shows a certain potential for clinical application in detecting normal-sized lymph node metastasis of colorectal cancer, but it has not been widely used in China.
Objective To review study of various imaging examination methods for evaluating of gastric cancer. Method The recent and relevant literatures about the imaging examination methods for evaluating of gastric cancer were scrutinized and analyzed retrospectively. Results The imaging examination methods such as the barium meal, endoscopic ultrasonography, computed tomography (CT), magnetic resonance imaging, positron emission tomography-CT, were used to evaluate the gastric cancer, but with certain limitations. The new methods such as the dual-energy CT, radiomics, and so on, had become the focus of the clinical research. The imaging methods are of great significances in the evaluation of the gastric cancer before the surgery, peritoneal metastasis, chemoradiotherapy and neoadjuvant chemotherapy later. Conclusions Various imaging examination methods, used in evaluating of gastric cancer, play some important roles in clinical application. New methods such as dual-energy CT, radiomics, and so on, are with bright potentiality for clinical application.
To analyze the CT features of solid pseudopapillary tumor of pancreas (SPTP), and correlation with the pathological findings of the disease so as to improve the diagnostic abilities, the CT images and the clinical manifestations, we retrospectively analyzed the pathological materials of 23 cases with surgery and pathology proved SPTP. In the 23 patients, 21 cases were female (91.3%) and 2 were male (8.7%). The most common symptom was abdominal discomfort with dull pain in 12 patients (52.2%). Others included the pancreatic mass that was detected incidentally during physical examination in 9 patients (39.1%), nausea/vomiting in 2 patients (8.7%). And 1 case of female patients had 2 lesions. In the 24 tumors, 6 cases were located at the head (25.0%), 3 were at neck (12.5%), 8 cases were at body (33.3%), and 7 cases were at tail of pancreas respectively (29.2%). The long-axis diameter ranged from 2.1cm to 20.1cm (mean 6.4cm). 9 tumors were mostly solid component (37.5%), 10 tumors were contained similar proportion of solid and cystic part (41.7%), and mainly cystic components in 5 tumors (20.8%). In 9 of the 23 patients, calcification was found in the tumor (39.1%). In 2 of the 23 patients, bleeding was seen in the mass (8.7%). The dilation of intrahepatic bile duct was found in 1 patient (8.7%). Liver metastasis was showed in one patient (8.7%). On post-contrast CT scan, solid parts demonstrated mild enhancement at the arterial phase. At the portal phase, solid parts were enhanced continuously in all cases, and the enhancement degrees were lower than normal pancreatic tissue. The cystic parts of all lesions showed no enhancement. Pseudo papillary structure, hemorrhage, necrosis, or cystic degeneration were found in all patients by histological study. In a word, SPTP has comparatively characteristic CT imaging features consistent with histological features, when combined with clinical manifestations, could be correctly diagnosed and differentially diagnosed.
Gastric cancer remains one of the most prevalent and fatal malignancies in China. Peritoneal metastasis represents a frequent mode of dissemination or recurrence in patients with advanced disease and confers an extremely poor prognosis. In recent years, considerable progress has been made in imaging techniques, with modalities including CT, ultrasound, MRI and PET-CT being implemented to evaluate peritoneal metastasis. However, adequate detection remains challenging, particularly for occult peritoneal metastasis. With the advent of precision medicine, radiomics and artificial intelligence have undergone rapid development and show considerable promise for the early prediction of peritoneal metastasis in gastric cancer, providing a new means of diagnosis and treatment for patients with peritoneal metastasis.
The patients with rectal cancer account for 50% or more of patients with colorectal cancer. The rectal magnetic resonance imaging (MRI) plays a pivotal role in clinical practice for evaluating the treatment baseline of tumors. The structured report of MRI serves as the foundation so as to promote homogenized, standardized, and normalized diagnosis and treatment of rectal cancer. We presented the MRI-based baseline evaluation structured reporting system for rectal cancer developed by West China Hospital of Sichuan University, aiming to advance the standardization and normalization of imaging reports for treatment baseline assessment in rectal cancer.
This study reported a case of intrahepatic splenosis with CT and MR findings mimicking hepatocellular carcinoma. The patient had two risk factors for hepatocellular carcinoma, including elevated alpha-fetoprotein and a history of hepatitis B virus infection, and had previously splenectomy due to spleen trauma. This paper briefly described the etiology and pathogenesis of intrahepatic splenosis and reviewed the radiological findings of this disease reported in previous literature, in order to strengthen readers’ understanding of intrahepatic splenosis and reduce the misdiagnosis rate.
Objective To determine feasibility of texture analysis of CT images for the discrimination of hepatic epithelioid hemangioendothelioma (HEHE) and liver metastases of colon cancer. Methods CT images of 9 patients with 19 pathologically proved HEHEs and 18 patients with 38 liver metastases of colon cancer who received treatment in West China Hospital of Sichuan University from July 2012 to August 2016 were retrospectively analyzed. Results Thirty best texture parameters were automatically selected by the combination of Fisher coefficient (Fisher)+classification error probability combined with average correlation coefficients (PA)+mutual information (MI). The 30 texture parameters of arterial phase (AP) CT images were distributed in co-occurrence matrix (22 parameters), run-length matrix (1 parameter), histogram (4 parameters), gradient (1 parameter), and autoregressive model (2 parameters). The distribution of parameters in portal venous phase (PVP) were co-occurrence matrix (18 parameters), run-length matrix (2 parameters), histogram (7 parameters), gradient (2 parameters), and autoregressive model (1 parameter). In AP, the misclassification rates of raw data analysis (RDA)/K nearest neighbor classification (KNN), principal component analysis (PCA)/KNN, linear discriminant analysis (LDA)/KNN, and nonlinear discriminant analysis, and nonlinear discriminant analysis (NDA)/artificial neural network (ANN) was 38.60% (22/57), 42.11% (24/57), 8.77% (5/57), and 7.02% (4/57), respectively. In PVP, the misclassification rates of RDA/KNN, PCA/KNN, LDA/KNN, and NDA/ANN was 26.32% (15/57), 28.07% (16/57), 15.79% (9/57), and 10.53% (6/57), respectively. The misclassification rates of AP and PVP images had no statistical significance on the misclassification rates of RDA/KNN, PCA/KNN, LDA/KNN, and NDA/ANN between AP and PVP (P>0.05). Conclusion The texture analysis of CT images is feasible to identify HEHE and liver metastases of colon cancer.