ABSTRACT
Objective:To distinguish lung adenocarcinoma (ADC) from squamous cell carcinoma (SCC) using 18F-fluorodeoxyglucose (FDG) PET-based radiomic features. Methods:A retrospective analysis was performed in 182 patients (109 males, 73 females, age (59.0±8.3) years) with non-small cell lung cancer (NSCLC) who underwent 18F-FDG PET/CT scan between January 2018 and December 2019 in Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology. All patients had been diagnosed pathologically with lung ADC or SCC. The patients were divided into a training set ( n=91) and a validation set ( n=91) using simple random sampling method. Radiomic features were extracted from the PET images of segmented tumors using the Python package. The minimum redundancy maximum relevance feature selection algorithm and least absolute shrinkage and selection operator were employed to select informative and non-redundant features, and a radiomics signature score (rad-score) was developed. Differences of rad-score between groups were compared by Mann-Whitney U test. Multivariate logistic regression was applied to select the important factors. A combined model was constructed based on the clinical variable and radiomics signature. The predictive performance of models was analyzed and compared using receiver operating characteristic (ROC) curves and Delong test. Results:Four radiomic features, namely HHL_first order_maximum, LHL_first order_entropy, HHH_ gray level dependence matrix_large dependence high gray level emphasis (GLDM_LDHGLE), HHL_GLDM_LDHGLE (H/L represent the high/low pass filter) were selected to build the rad-score. The rad-score showed a significant ability to discriminate between different histological subtypes in the two sets(training set: -1.30(-1.70, -1.04) vs -0.60 (-1.11, 0.20), z=-4.61, P<0.001); validation set: -1.31(-1.66, -0.96) vs -0.73(-1.02, -0.24), z=-4.76, P<0.001). The area under the curve (AUC) of the rad-score were equal to 0.815 (95% CI: 0.723-0.906) in the training set, and 0.813 (95% CI: 0.726-0.901) in the validation set, respectively, which were larger than those of the clinical variables (smoking had the best prediction performance, training set: 0.721 (95% CI: 0.617-0.810), validation set: 0.726 (95% CI: 0.623-0.814)), however, the difference was not significant ( z values: 1.319, 1.324, both P>0.05). When the clinical variable (smoking) and radiomics signature were combined, the complex model showed a better performance in the classification of histological subtypes, with the AUC increased to 0.862 (95% CI: 0.785-0.940; sensitivity: 88.00%(22/25), specificity: 72.73%(48/66)) in the training set and 0.854 (95% CI: 0.776-0.933; sensitivity: 75.00%(21/28), specificity: 84.13%(53/63)) in the validation set. The AUC values were significantly higher than those of the clinical variable (smoking; training set: z=3.257, P<0.001; validation set: z=3.872, P<0.001). Conclusion:Individualized diagnosis model incorporating with smoking and radiomics signature can help differentiate lung cancer subtypes in a non-invasive, repeatable modality.
ABSTRACT
Objective:To compare the performance of 68Ga-prostate specific membrane antigen (PSMA) PET/CT and MRI in preoperative diagnosis and staging of primary prostate cancer. Methods:Twenty-four patients with prostate cancer, who underwent preoperative 68Ga-PSMA PET/CT and prostate MRI in Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology between April 2018 and December 2019, were retrospectively enrolled. The pathological and follow-up results were considered as the gold standard, and diagnostic efficiencies of the 2 imaging methods were compared per patient and per type of lesions (seminal vesicle invasion, bladder neck invasion, lymph node metastasis and bone metastasis). The χ2 test was used for data analysis. Results:Prostate cancer was confirmed by pathology in 24 patients, including 6 cases with both seminal vesicle and bladder neck invasion, 5 cases with seminal vesicle invasion and 3 cases with invasion of bladder neck. Gleason scores in patients were as follow: 7 in 9 patients, 8-9 in 15 patients. The detection rates of 68Ga-PSMA PET/CT and MRI for primary prostate cancer were both 100%(24/24). The sensitivity, specificity and accuracy of 68Ga-PSMA PET/CT and MRI for detecting seminal vesicle invasion were 10/11, 13/13, 95.8%(23/24) and 9/11, 11/13, 83.3%(20/24), respectively. The specificity and accuracy were significantly different ( χ2 values: 6.231, 13.470, both P<0.05). The sensitivity, specificity and accuracy of 68Ga-PSMA PET/CT and MRI for detecting bladder invasion, which were 7/9, 13/15, 83.3%(20/24) and 3/9, 14/15, 70.8%(17/24), respectively, were not significantly different( χ2 values: 1.285, 0.164, 2.880, all P>0.05). Furthermore, the sensitivity, specificity and accuracy of 68Ga-PSMA PET/CT for detecting pelvic lymph node metastasis were 11/11, 13/13 and 100%(24/24), respectively, and those of MRI for evaluating pelvic lymph node metastasis were 6/11, 11/13 and 70.8%(17/24), and the specificity of the 2 methods were significantly different ( χ2=6.231, P<0.05). All the 5 patients with pelvic bone metastasis were positive on 68Ga-PSMA PET/CT imaging, but only 2 of them were positive on MRI. Information from 68Ga-PSMA PET/CT changed pelvic TNM stage in 41.7%(10/24) patients who underwent MRI for initial staging. Conclusions:68Ga-PSMA PET/CT imaging and MRI can both accurately detect intermediate- to high-risk primary prostate cancer and seminal vesicle invasion. 68Ga-PSMA PET/CT imaging is superior to MRI for evaluating lymph nodes and bone metastasis. 68Ga-PSMA PET/CT provides high accuracy for preoperative diagnosing and staging intermediate- to high-risk prostate cancer.
ABSTRACT
Objective To develop the technique to detect total core antigen of HCV(Total HCV-cAg) by Enzyme-Linked Immu-nosorbent Assay (ELISA) and apply it for clinical diagnosis. Methods 201 serum samples with anti-HCV antibody were detected total HCV-cAg after pre - treating the samples, then the sensitivity of results were compared with HCV RNA tests. Among them, 176 cases was determined by FQ-PCR, and 25 cases by RT-PCR for HCV-RNA. Results HCV RNA was found in sera from 88 of 201 samples (43.8%). Total HCV-cAg was positive in 71 (35.3%) of 201 samples . There was no significant difference between the detection rate of HCV RNA by PCR and total HCV-cAg by ELISA. Conclusion Detection of total core antigen of HCV is suitable to be used as to diagnose HCV in clinic.
ABSTRACT
OBJECTIVE: To observe the clinical effect of Chinese medicine Sansheng Huatan Decoction combined with chemotherapy in treating advanced primary non-small-cell lung cancer and to evaluated the effect of Sansheng Huatan Decoction increasing clinical effect and decreasing toxicity in chemotherapy for non-small-cell lung cancer. METHODS: One hundred and sixty patients of advanced primary non-small-cell lung cancer proved by pathological examination were randomized into two groups. The treatment group was treated with Sansheng Huatan Decoction and chemotherapy, and the control group was treated only with chemotherapy. The clinic effect, life quality, natural killer (NK) activities, liver and kidney functions, and blood routine test of the 2 groups were evaluated. RESULTS: The clinical effective rates of the treatment and control groups were 56.7% and 48.2% respectively, and there was no statistic significance (P>0.10). The life quality, NK activities and blood routine test of the treatment group were better than those of the control group. CONCLUSION: Sansheng Huatan Decoction combined with chemotherapy is a better treatment for non-small-cell lung cancer as compared with chemotherapy.