Perfluorooctyl bromide nanoemulsions holding MnO2 nanoparticles with dual-modality imaging and glutathione depletion enhanced HIFU-eliciting tumor immunogenic cell death

Tumor-targeted immunotherapy is a remarkable breakthrough, offering the inimitable advantage of specific tumoricidal effects with reduced immune-associated cytotoxicity. However, existing platforms suffer from low efficacy, inability to induce strong immunogenic cell death (ICD), and restrained capacity of transforming immune-deserted tumors into immune-cultivated ones. Here, an innovative platform, perfluorooctyl bromide (PFOB) nanoemulsions holding MnO2 nanoparticles (MBP), was developed to orchestrate cancer immunotherapy, serving as a theranostic nanoagent for MRI/CT dual-modality imaging and advanced ICD. By simultaneously depleting the GSH and eliciting the ICD effect via high-intensity focused ultrasound (HIFU) therapy, the MBP nanomedicine can regulate the tumor immune microenvironment by inducing maturation of dendritic cells (DCs) and facilitating the activation of CD8+ and CD4+ T cells. The synergistic GSH depletion and HIFU ablation also amplify the inhibition of tumor growth and lung metastasis. Together, these findings inaugurate a new strategy of tumor-targeted immunotherapy, realizing a novel therapeutics paradigm with great clinical significance.

Conventional and functional MRI features of parotid Warthin tumor: correlation with clinicopathological findings / 中华口腔医学杂志

Objective@#To assess the conventional and functional MRI features of parotid Warthin tumor (adenolymphoma) and to investigate the correlation between MRI and clinicopathological features which can provide evidence for clinical diagnosis and treatment.@*Methods@#Sixty-seven patients with parotid Warthin tumor who were treated in the Department of Stomatology, The Fifth Clinical Medical College of Yangzhou University, Changshu No. 2 People′s Hospital from June 2008 to April 2017 were included in this study. The retrospective study evaluated preoperative conventional and functional MRI features and clinicopathological findings of this group of patients. Among 67 patients (65 males, 2 females) with 92 lesions, there were 16 patients with multiple lesions and others with single lesion. Their age was (62.1±8.8) years, ranging from 42 to 84 years. According to pathological features, parotid Warthin tumor were classified into two types. Type Ⅰ was predominantly solid component which included completely solid or solid tumor with some cystic components. Type Ⅱ was predominantly cystic component which was characterized by big cyst with some solid components, and could be divided into capsule-like and scum-like cystic type, based on whether its interface of solid and cystic component was clear or not. On contrast-enhanced MRI, according to whether the lesion showed enhancement or not, solid or cystic component was defined.@*Results@#Seventy-two lesions were located in the lower pole of the parotid gland, of which sixty-eight lesions were located in posterior inferior quadrant. In addition, sixteen lesions were located in the upper pole and four lesions in the middle. Because MRI features were consistent with pathological findings, parotid Warthin tumor were classified into solid (73) and cystic types (19). On T2WI, solid components showed isointense (92), whereas on T1WI cystic components demonstrated hyperintense (90). On contrast enhanced T1WI, solid types showed marginal vasculature sign (73), mild (69) or moderate (4) enhancement, whereas its cystic component showed no enhancement. On contrast enhanced T1WI, cystic types showed ring-like enhancement of cycle-wall and intra-cystic septal linear enhancement, whereas its solid components demonstrated mild enhancement (19). On diffusion weighted imaging, these masses demonstrated hyperintensity and lower apparent diffusion coefficient value indicating restricted diffusion (59/59). On dynamic contrast-enhanced-MRI, the masses showed "wash-out" pattern (28/29) or plateau pattern (1/29).@*Conclusions@#Parotid Warthin tumor mainly occur in the posterior inferior quadrant of parotid gland and mostly in mid-aged or elder men. It has certain characteristics on conventional and function MRI. There is correlation between MRI and clinicopathological findings and it is useful for accurate diagnosis and treatment to understand these features.

Diagnostic value diffusion weighted imaging with different b values in the differentiation of malignant from benign orbital masses / 实用放射学杂志

Objective To investigate the changes on apparent diffusion coefficient(ADC)of diffusion weighted imaging with dif-ferent b values and to assess the diagnostic value of ADC for discriminating malignant from benign orbital masses.Methods 81 pa-tients (55 benign orbital masses and 26 malignant orbital masses)were enrolled.These patients underwent serial MR and echo-pla-nar DW imaging examinations of the orbits with b values=0 and/or 400,700,1 000 s/mm2 .The differences of ADC values under different b values between benign and malignant orbital masses were observed and compared,and diagnosis of ADC values was as-sessed by the receiver operating characteristic (ROC)curve.Results In three groups,the ADC values of benign orbital masses [(1.56±0.35)×10 -3 mm2/s,(1.40±0.34)×10 -3 mm2/s and (1.30±0.32)×10 -3 mm2/s,respectively]were significantly differ-ent (P <0.01),while the ADC values of malignant orbital masses were not statistically different (P =0.093)[(1.12 ±0.47)× 10 -3 mm2/s,(0.92±0.42)×10 -3 mm2/s and (0.87±0.40)× 10 -3 mm2/s,respectively].The areas under the ROC curve of ADC values were 0.799,0.866 and 0.867,respectively.The threshold values were 1.05 × 10 -3 mm2/s,0.94 × 10 -3 mm2/s and 0.93 × 10 -3 mm2/s (while sensitivity were 65%,81% and 81%;specificity were 94.5%,91% and 85%;positive predictive values were 85%,80%,72%,negative predictive values were 85%,91%,90%,and accuracy were 85%,87% and 84%,respectively).Conclusion The b value of 700 s/mm2 offered better diagnostic performance.ADC values of diffusion weighted imaging can reflect diffusion characteristics of the orbital masses,as a complementary tool in the differentiation of malignant from benign orbital masses.

The MRI and clinical features of acinic cell carcinoma of the parotid gland / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To analyze the MR imaging findins of acinic cell carcinoma(ACC) in parotid gland and develop the diagnosis of this disease.@*METHOD@#The MR imaging fearures of 11 patients with pathologically proved ACC were retrospectively analyzed. MR imagings were analyzed in relation to the follow:amount, location, size, shape, margin, pseudocapsule, MR signal intensity and enhanced pattern and the cervical lymphadenopathy. The clinical analysis on patients included age, sex, and follow-up.@*RESULT@#There were 11 patients, 7 lesions was located in the right parotid gland and 4 lesions was located in the left parotid gland; the average maximum diameter was (2.66±0.99)cm; 7 lesions showed lobulated,and 4 lesions showed round; 8 lesions had no pseudocapsules and 3 lesions had incomplete pseudocapsule. All lesions showed homogeneous or heterogeneous isointense and slight hyperintense on T1 WI and T2WI. On post contrast images, the tumor parenchyma ingredients showed remarkable enhancement in all lesions.@*CONCLUSION@#The MR imaging of ACC in the parotid gland don't have specific features, but when the tumor of the parotid gland showed no pseudocapsule (or showed incomplete pseudocapsule), lobulate, small cysitc and remarkable enhancement, it may indicate ACC, and the correct diagnosis depends on clinical pathology.

MR diffusion weighted imaging in the differential diagnosis of cystic lesions of the pancreas / 中华胰腺病杂志

Objective To evaluate the value of diffusion-weighted imaging (DWI) in the differential diagnosis of cystic pancreatic lesions.Methods Thirty-four cystic pancreatic lesions confirmed clinically or pathologically were collected,including 11 case of non-neoplastic pseudocyst,5 cases of simple cyst,6 cases of serous cystadenoma,10 cases of mucinous cystadenoma and 2 cases of mucinous cystadenocarcinoma.All the patients underwent routine serial MR and echo-planar DW imaging examination of the pancreas with b values of 0 and 600 s/mm2.The appearances of signal intensity of DWI with all cysts were recorded.ADC maps were reconstructed,and the ratio of the cysts and cyst-to-pancreas ADC (ADCR) were calculated.The receiver operating characteristic (ROC) curves were constructed to evaluate the diagnostic value of ADC and ADCR.Results Among all the 16 non-neoplastic cysts,2 cysts were slightly hyperintense in DWI,and 14 cysts were isointense.Among all the 18 neoplastic cysts,17 cysts appeared slightly hyperintense or hyperintense in DWI,and 1 cyst was isointense.The difference between the two groups was statistically significant (P ＜ 0.001).The ADC values of non-neoplastic and neoplastic cysts were (3.30 ± 0.30) × 10-3,(2.74 ± 0.34) × 10-3 mm2/s ; and the ADCR values of non-neoplastic and neoplastic cysts were 1.85 ± 0.20,1.31 ± 0.21,the difference between the two groups was statistically significant (P ＜ 0.001).The areas under the ROC curves of ADC and ADCR diagnosing neoplastic cysts were 0.94 ± 0.04,0.98 ± 0.02,respectively.An ADC of 3.105 × 10-3 mm2/s showed 81.3％ sensitivity and 94.4％ specificity for predicting neoplastic cysts.An ADCR of 1.525 showed 100％ sensitivity and 88.9％ specificity for predicting neoplastic cysts.Conclusions Diffusion-weighted imaging is of importance in the diagnosis and differential diagnosis of pancreatic cysts,and can be applied as a complementary tool for routine MRI.

CT Features in Differential Diagnosis of Hepatic Angiomyolipoma and Hepatocellular Carcinoma / 中国医学影像学杂志

Purpose To compare the CT features of hepatic angiomyolipoma (HAML) and primary hepatocellular carcinoma (HCC) and improve diagnostic accuracy for HAML. Materials and Methods The CT findings of 9 patients with HAML confirmed pathologically and 20 patients with HCC were retrospectively analyzed in terms of lesion location, appearance, size, margin, CT value at each phase, cirrhosis and vessel presence inside tumor. Results Mean CT value on plain scan and at arterial phase on contrast enhanced scan of HAML was significantly lower than that of HCC (t=-2.885, P0.05). CT value on plain scan and at arterial phase of both HAML and HCC was not significantly different (t=1.289, P>0.05) whilst that at portal vein phase was significantly different (t=2.516, P<0.05). Central vessels were shown in 7 cases of HAML and 3 cases of HCC, pseudocapsule appeared in 1 case of HAML and 13 cases of HCC with statistical difference (χ2=10.828, 7.219;P<0.01). Conclusion CT scan of HAML reveals the component of fat and presentsfast in and slow outpattern, large shadow of vessel and absence of capsule on contrast enhanced scan, which can be helpful in the differential diagnosis from HCCs.

Value of diffusion-weighted imaging in the diagnosis of orbital lymphoma / 中华放射学杂志

Objective To investigate the diagnostic value of apparent diffusion coefficient (ADC)for discriminating orbital lymphomas from other orbital mass lesions.Methods In this prospective study,87 subjects (22 orbital lymphomas and 65 other orbital mass lesions) were enrolled.These patients underwent serial MR and echo-planar DW imaging examination of the orbits with b values of 0 and 700 s/mm2 at 1.5 T MR (GE Signa Excite).ADC maps were reconstructed,and the ADC values of the orbital masses were calculated.Mass ADC was also compared with that of normal-appearing white matter (ADC ratio,ADCR).The receiver operating characteristic curves (ROC) were constructed using optimal cut point of ADC and ADCR to differentiate between orbital lymphomas and other orbital mass lesions.The areas under the ROC curve for ADC and ADCR were also calculated.Results The mean ADC and ADCR of orbital lymphomas were (0.77 ± 0.17) × 10-3 mm2/s and 0.89 ± 0.21,respectively.The mean ADC and ADCR of other orbital mass lesions were (1.36 ± 0.38) × 10-3 mm2/s and 1.51 ± 0.43,respectively.Lymphomas had lower ADCs and ADCRs than other orbital mass lesions (t =-9.620,-9.003,P =0.000).The areas under the ROC curves of ADC and ADCR diagnosing lymphoma were 0.94±0.03 and 0.91 ±0.03,respectively.An ADC of less than 0.804 × 10-3 mm2/sec and ADCR of less than O.956 were optimal for predicting lymphoma (sensitivity,77.3％ for both; specificity,98.4％ and 92.3 ％,respectively ; and accuracy,93.1％ and 88.5 ％,respectively).Compared with pathological results,both ADC and ADCR had high correlations (Kappa values were 0.806 and 0.696,respectively).Conclusion Diffusion-weighted imaging can be applied as a complementary tool in the detection of orbital lymphomas.