Long-term Brain Tissue Monitoring after Semi-brain Irradiation in Rats Using Proton Magnetic Resonance Spectroscopy: A Preliminary Study / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>In head and neck neoplasm survivors treated with brain irradiation, metabolic alterations would occur in the radiation-induced injury area. The mechanism of these metabolic alterations has not been fully understood, while the alternations could be sensitively detected by proton (1H) nuclear magnetic resonance spectroscopy (MRS). In this study, we investigated the metabolic characteristics of radiation-induced brain injury through a long-term follow-up after radiation treatment using MRS in vivo.</p><p><b>METHODS</b>A total of 12 adult Sprague-Dawley rats received a single dose of 30 Gy radiation treatment to semi-brain (field size: 1.0 cm × 2.0 cm; anterior limit: binocular posterior inner canthus connection; posterior limit: external acoustic meatus connection; internal limit: sagittal suture). Conventional magnetic resonance imaging and single-voxel 1H-MRS were performed at different time points (in month 0 before irradiation as well as in the 1st, 3rd, 5th, 7th, and 9th months after irradiation) to investigate the alternations in irradiation field. N-acetylaspartate/choline (NAA/Cho), NAA/creatinine (Cr), and Cho/Cr ratios were measured in the bilateral hippocampus and quantitatively analyzed with a repeated-measures mixed-effects model and multiple comparison test.</p><p><b>RESULTS</b>Significant changes in the ratios of NAA/Cho (F = 57.37, P<sub>g < 0.001), NAA/Cr (F = 54.49, P<sub>g < 0.001), and Cho/Cr (F = 9.78, P<sub>g = 0.005) between the hippocampus region of the irradiated semi-brain and the contralateral semi-brain were observed. There were significant differences in NAA/Cho (F = 9.17, P<sub>t < 0.001) and NAA/Cr (F = 13.04, P<sub>t < 0.001) ratios over time. The tendency of NAA/Cr to change with time showed no significant difference between the irradiated and contralateral sides. Nevertheless, there were significant differences in the Cho/Cr ratio between these two sides.</p><p><b>CONCLUSIONS</b>MRS can sensitively detect metabolic alternations. Significant changes of metabolites ratio in the first few months after radiation treatment reflect the metabolic disturbance in the acute and early-delayed stages of radiation-induced brain injuries.</p>

Neuroendocrine carcinoma of the breast: mammographic features correlated with sonography and histopathological findings / 中华肿瘤杂志

<p><b>OBJECTIVE</b>The purpose of this study was to describe the X-ray features of the neuroendocrine carcinoma (NEC) of breast to raise the awareness for the disease.</p><p><b>METHODS</b>The mammography, sonography and clinicopathologic features in a total of 16 cases of pathologically proven breast neuroendocrine carcinoma in Fudan University Cancer Hospital were analyzed retrospectively.</p><p><b>RESULTS</b>All the 16 patients were women with a mean age of 67.3 years old (ranged from 45 to 75 years old). Twelve patients had palpable masses and the other four patients had outflow from the nipple. Pathological diagnosis included endocrine ductal carcinoma in situ (E-DCIS) in 4 cases, E-DCIS with microinvasion in 5, and invasive solid neuroendocrine carcinoma in 7. On mammography, 9 of 16 cases exhibited round or slightly lobulated masses. Five of the 16 cases exhibited irregular or asymmetric opacities. Two of the 16 cases had negative findings. The borders of the 14 masses detected on mammography were vague in 7, partly unclear in 3 and clear-cut in 4 cases. Malignant microcalcification was not found in all cases. The accuracy rates of preoperative qualitative diagnosis for NEC with mammography and sonography were 68.8% (11/16) and 81.3% (13/16), respectively. Given the application of combined mammography and sonography, the accuracy rates could be improved to 87.5% (14/16).</p><p><b>CONCLUSIONS</b>A round mass and irregular or asymmetric opacities without malignant calcification are the most frequent appearances of mammography in neuroendocrine carcinoma of the breast. Combination of mammography and sonography may be useful to improve the accuracy of diagnosis and early detection of neuroendocrine carcinoma of the breast.</p>