ABSTRACT
Currently, sorafenib is the multi-target inhibitor for the treatment of advanced primary liver cancer, and can effectively prolong the progression-free survival and overall survival in patients with advanced primary liver cancer. The application of sorafenib in the targeted therapy for liver cancer has become a hot topic. Major targets or signaling pathways include Raf/Mek/Erk, Jak/Stat, PI3K/Akt/mTOR, VEGFR and PDGFR, STAT, microRNA, Wnt/β-catenin, autolysosome, and tumor-related proteins, and sorafenib can regulate the proliferation, differentiation, metastasis, and apoptosis of liver cancer cells through these targets. This article reviews the current research on the action of sorafenib on these targets or signaling pathways to provide useful references for further clinical research on sorafenib.
ABSTRACT
Objective To assess the image quality of iterative model reconstruction algorithm (IMR) compared with hybrid iterative reconstruction algorithm (iDose4) for hypovascular hepatic metastases.Methods Medical history and pathological results of 33 cases with primary malignant tumor were retrospective analyzed.Follow-up with enhanced CT or enhanced MRI at more than 3 months confirmed hypovascular metastases in these patients.All patients underwent abdominal CT scanning and dynamic enhanced CT scanning.Portal vein phase of low dose scanning data were taken as the research object.According to the different tube currents and reconstruction algorithm,the images were divided into 4 groups.Group A included images with tube current of 175 mAs and IMR post-processing (17 cases).Group B included images with tube current of 175 mAs and iDose4 post-processing (17 cases).Group C included images with tube current of 125 mAs and IMR post-processing (16 cases).Group D included images with tube current of 125 mAs and iDose4 post-processing (16 cases).In the cases with multiple lesions,the largest lesion was selected to evaluate.For each image of the objective evaluation [including noise,the signal-to-noise ratio (SNR),contrast to noise ratio (CNR)] and subjective evaluation (including lesion sharpness,necrosis interface and diagnostic confidence).The CT dose index of each scanning was recorded.The objective evaluation,subjective evaluation indexes were compared by paired samples t test and Wilcoxon signed rank test.Results The tube current of Group A and Group B were (7.7± 1.8) and (12.8±3.7)HU,while CNR were 10.3 ±2.6 and 5.6± 1.4,SNR were 13.2±3.2 and 8.1 ± 2.2,and the differences were statistically significant (t values were 9.966,12.670,9.203;P＜0.01).The tube current of Group C and Group D were (7.2±1.3) and (9.9±1.8)HU,while CNR were 7.4±2.0 and 3.7±0.9,SNR were 13.9±2.9 and 9.8±1.9,and the differences were statistically significant (t values were 9.209,12.320,9.628;P＜0.01).The lesion sharpness score of Group A and Group B were 4.95±0.24 and 4.29±0.59,while the necrosis interface score were 4.76 ± 0.36 and 3.68 ± 0.30,diagnostic confidence score were 4.94± 0.24 and 4.44 ±0.56,and the differences were statistically significant (P＜0.05).The lesion sharpness score of Group C and Group D were 3.94±0.68 and 3.56±0.63,while the necrosis interface score were 3.91±0.64 and 3.03±0.50,diagnostic confidence score were 4.19±0.40 and 3.94±0.44,and the differences were statistically significant (P＜0.05).CTDIvol of 175 mAs group and 125 m As group were (11.83±0.28) and (8.44±0.24) mGy respectively.Conclusion Compared with iDose4,iterative reconstruction technology IMR significantly reduces the image noise and enhances image quality of hypovascular hepatic metastases.