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Objective:The purpose of this study was to investigate the clinical value of CT-guided localization of pulmonary nodules with soft wire hook-wire by trailing technique.Methods:The clinical data of 211 pulmonary nodules of 185 patients from November 2020 to March 2022 in Beijing Aerospace General Hospital were retrospectively analyzed. The pulmonary nodules were localized with soft wire hook-wire by trailing technique before video-assisted thoracic surgery (VATS). The success rate, complications, pathological results and localization operations related data were statistically analyzed.Results:The success rate of localization was 97.63% (206/211), and the success rate of VATS removal was 99.53% (210/211). The average operation time was (7.19 ± 2.62) min, and the average time required for resection of lesions was 27 min (10 to 126 min). During the surgery, the soft wire hook-wire of two patient was found to be dislocated and retracted into the chest wall. The pulmonary nodules were successfully located and removed according traces left by puncture points on the lung surface. It was found that the hook-wire was located in the interlobar fissure in 3 patients. The pulmonary nodules were successfully removed by the hook-wire position and appropriately expanding the resection range. A minor pneumothorax occurred in 49 patients, but no closed drainage was needed; 12 patients developed intrapulmonary hematoma; 15 patients with chest pain were treated with analgesia.Conclusions:For small pulmonary nodules requiring thoracoscopic surgery, the computed tomography-guided pulmonary nodule localization with soft wire hook-wire by trailing technique is more convenient, safe and effective, and is worthy of promotion to use.
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Acute carbon monoxide poisoning and its delayed encephalopathy have obvious damage to the central nervous system. There are different neuroimaging changes in different stages of the disease, and they are relatively specific. This article reviews the clinical research progress on the imaging changes of carbon monoxide poisoning and delayed encephalopathy, including computed tomography (CT) , conventional magnetic resonance imaging (MRI) , diffusion weighted imaging (DWI) , diffusion tensor imaging (DTI) , diffusion kurtosis imaging (DKI) , magnetic resonance spectroscopy (MRS) and other imaging changes reflecting the function and metabolic state of the brain tissue.
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Humans , Brain Diseases/etiology , Carbon Monoxide Poisoning/diagnostic imaging , Diffusion Magnetic Resonance Imaging , Diffusion Tensor Imaging , Magnetic Resonance Imaging , Tomography, X-Ray Computed , Magnetic Resonance SpectroscopyABSTRACT
Background: Diagnosis of intrathoracic masses is a difficult challenge for clinicians. The compact anatomical arrangement of the medias?num with diverse pathologies is usually encountered. The present study was done to determine the efficiency of computed tomography (CT) guided Fine-Needle Aspira?on Cytology (FNAC) in the evalua?on of various thoracic mass lesions Methods : A total of n=46 pa?ents presen?ng as intrathoracic mass lesions, confirmed on contrast-enhanced CT, were included in the study. A commercially available CT (Ingenuity 128 slices, Philips) was used for biopsy. All pa?ents were subjected to detailed clinical history and physical examina?on. Inves?ga?ons: Complete blood count, Erythrocyte sedimenta?on rate, bleeding ?me, clo?ng ?me, Prothrombin ?me, Ac?vated par?al thromboplas?n ?me, HIV and HbsAg, Chest X-ray postero Anterior view, and Lateral view done in all cases. Chest X-ray AP view and Ultrasound was done wherever needed. Plain and contrast CT was done in all cases before FNAC. Results: The posi?ve diagnos?c yield in our study is noted in 45 of the 46 pa?ents(97.82%); the posi?ve yield for malignancy was 89.13% (41 of 46 pa?ents), benign in8.69 % (4/46), and undiagnosed in 1/46 (2.17%). Out of 46, 40(86.96%) were parenchymal lesions and 6(13.04%) were medias?nal lesions. Out of 40 parenchymal lesions, 38/40(95%) were malignant, which consisted of 55.3% Squamous cell carcinoma, 28.9% Adenocarcinoma. Conclusion: FNAC is useful for obtaining samples for the diagnosis of focal pulmonary infec?ons, even in immunocompromised pa?ents, and planning appropriate chemotherapy op?ons in lung cancer and metasta?c lesions.CT-guided FNAC is an ini?al approach for the diagnosis of small pulmonary nodules of less than 20mm, aiding in early diagnosis and treatment interven?ons improving prognosis.
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OBJECTIVES@#To study the correlation between CT imaging features of acceleration and deceleration brain injury and injury degree.@*METHODS@#A total of 299 cases with acceleration and deceleration brain injury were collected and divided into acceleration brain injury group and deceleration brain injury group according to the injury mechanism. Subarachnoid hemorrhage (SAH) and Glasgow coma scale (GCS), combined with skull fracture, epidural hematoma (EDH), subdural hematoma (SDH) and brain contusion on the same and opposite sides of the stress point were selected as the screening indexes. χ2 test was used for primary screening, and binary logistic regression analysis was used for secondary screening. The indexes with the strongest correlation in acceleration and deceleration injury mechanism were selected.@*RESULTS@#χ2 test showed that skull fracture and EDH on the same side of the stress point; EDH, SDH and brain contusion on the opposite of the stress point; SAH, GCS were correlated with acceleration and deceleration injury (P<0.05). According to binary logistic regression analysis, the odds ratio (OR) of EDH on the same side of the stress point was 2.697, the OR of brain contusion on the opposite of the stress point was 0.043 and the OR of GCS was 0.238, suggesting there was statistically significant (P<0.05).@*CONCLUSIONS@#EDH on the same side of the stress point, brain contusion on the opposite of the stress point and GCS can be used as key indicators to distinguish acceleration and deceleration injury mechanism. In addition, skull fracture on the same side of the stress point, EDH and SDH on the opposite of the stress point and SAH were relatively weak indicators in distinguishing acceleration and deceleration injury mechanism.
Subject(s)
Humans , Brain Contusion , Brain Injuries/diagnostic imaging , Hematoma, Epidural, Cranial , Hematoma, Subdural/etiology , Logistic Models , Skull Fractures/diagnostic imaging , Tomography, X-Ray Computed , Wounds, Nonpenetrating/diagnostic imagingABSTRACT
@#Imaging diagnosis is one of the main bases for the diagnosis of occupational pneumoconiosis. At present the - diagnosis of occupational pneumoconiosis is mainly based on high kV X ray chest radiography or chest digital radiography. With （ ） ， （ ） the wide application of computed tomography CT in occupational lung diseases high resolution CT HRCT is increasingly Update： Standardized CT/HRCT Classification of Occupational valuable in the diagnosis of occupational pneumoconiosis. The and Environmental Thoracic Diseases in Germany， ， published in 2014 is the latest and highly reliable standard. The standard - - - recommends the use of low dose HRCT scanning regimens and whole lung thin layer volumetric scanning with a thickness of - ， ， 1.0 mm and high resolution reconstruction which classify CT image quality into four levels and describes methods for （ ， classification and quantitative recording of CT manifestations of lung lesions including round opacities irregular and/or linear ， ， ， ， ） opacities ground glass opacity honeycombing emphysema and large opacities and pleural lesions. It is beneficial for ， ， ， epidemiological research early screening diagnosis and differential diagnosis treatment and prognosis of occupational ， pneumoconiosis as well as the comparison of international data related to occupational pneumoconiosis.
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@#Imaging diagnosis is one of the main bases for the diagnosis of occupational pneumoconiosis. At present the - diagnosis of occupational pneumoconiosis is mainly based on high kV X ray chest radiography or chest digital radiography. With （ ） ， （ ） the wide application of computed tomography CT in occupational lung diseases high resolution CT HRCT is increasingly Update： Standardized CT/HRCT Classification of Occupational valuable in the diagnosis of occupational pneumoconiosis. The and Environmental Thoracic Diseases in Germany， ， published in 2014 is the latest and highly reliable standard. The standard - - - recommends the use of low dose HRCT scanning regimens and whole lung thin layer volumetric scanning with a thickness of - ， ， 1.0 mm and high resolution reconstruction which classify CT image quality into four levels and describes methods for （ ， classification and quantitative recording of CT manifestations of lung lesions including round opacities irregular and/or linear ， ， ， ， ） opacities ground glass opacity honeycombing emphysema and large opacities and pleural lesions. It is beneficial for ， ， ， epidemiological research early screening diagnosis and differential diagnosis treatment and prognosis of occupational ， pneumoconiosis as well as the comparison of international data related to occupational pneumoconiosis.
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Objective To study the imaging characteristics of maxillary sinus effusion in drowned bodies, to explore its morphological characteristics and value in the diagnosis of the cause of death, and to provide objective evidence to support the study of virtual anatomy of drowning. Methods The 154 postmortem CT examination cases （31 cases of drowning, 123 cases of non-drowning） of Beijing Public Security Bureau Forensic Center in 2019 were collected. The bodies of all cases were scanned by multi-layer spiral CT before double-blind reading by clinical imaging experts. Maxillary sinus of corpses with maxillary sinus effusion in imaging findings was punctured. The detection rate of maxillary sinus effusion was calculated. The CT value and volume of maxillary sinus effusion were measured on 3D DICOM workstation. Results The detection rate of maxillary sinus effusion in the drowning was 100%, the shape was horizontal liquid level, the volume was 1.2-11.2 mL, the CT value was 6.08-19.02 Hu, with an average value of 12.85 Hu. The detection rate of maxillary sinus effusion in non-drowning was 19.51% （24/123）, the shape was wavy or irregular, and there were bubbles inside, the volume was 0.4-13.4 mL, the CT value was 23.68-77.75 Hu, with an average value of 42.08 Hu. The differences in CT value between the two groups had statistical significance. Conclusion The postmortem CT examination method can be used to observe the shape and measure the CT value of the maxillary sinus effusion in the bodies in water, which can be an auxiliary examination method for identification of drowning.
Subject(s)
Humans , Autopsy , Beijing , Drowning/diagnostic imaging , Maxillary Sinus/diagnostic imaging , Tomography, X-Ray ComputedABSTRACT
To investigate the predictive value of [ 18F]fluorodeoxyglucose-positron emission computed tomography(PET)/CT for disease progression in patients with dermatomyositis (DM) and interstitial lung diseases (ILD). Sixty-seven DM patients who underwent [ 18F] FDG-PET/CT imaging were retrospectively analyzed from January 2012 to September 2017 at PLA General Hospital. Their clinical manifestations and imaging characteristics were recorded. Compared with those chronically progressed (C-ILD), patients with rapid progression (RP-ILD) had significantly higher erythrocyte sedimentation rate (ESR) and standardized uptake value (SUV) in lungs ( P<0.05). In patients with RP-ILD, SUV in lungs was positively correlated with age, disease course, and ESR. Receiver operating characteristic curve analysis suggested that when lung SUV cut off value was 2.25, the sensitivity and specificity to predict disease progression was 77.8% and 72.8%, respectively. Old age, longer disease course, low creatine kinase level, higher ESR, and high SUV are prognostic factors for DM-associated ILD.
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Tuberculosis is one of the leading causes of mortality in a developing country like India among the infectious diseases. Early diagnosis of tuberculosis is by chest X-Ray, sputum examination, culture and nucleic acid amplification. Chest X-Ray findings are not very specific, sputum examination and culture take many days thus delaying the diagnosis. CT scan is very fast, non-invasive and accurate. It can diagnose the cause of unexplained cough, chest pain, fever and other chest symptoms. Because of accuracy, high speed and better resolution, CT scan is the modality of choice for early detection of pulmonary TB. The aim of the study is to evaluate the role of CT and HRCT in pulmonary TB.METHODSIt is a cross sectional study conducted at Jawaharlal Nehru Institute of Medical Sciences from January 2016 to June 2016 in a series of cases sent for CT or HRCT using AQUILION, Toshiba 64 slice multi detector CT. All the data were entered in excel sheet and transferred to SPSS Version 2 and then analysed by using descriptive statistics like mean, standard deviation and percentage. Chi square test was used. p Value of <0.05 was taken as statistically significant.RESULTSAmong 358 cases, 49.7% (178 cases) were diagnosed as pulmonary tuberculosis. In cases diagnosed as pulmonary TB, 104 (58.4%) were male and 74 (41.7%) were female. Over 60 yrs. of age, 56.1% of the cases had TB with cavitary and parenchymal lesion, followed by TB with lung destruction & cicatrisation in 17.3% of the cases. In younger age group, 20 years and below, had TB with cavitary & parenchymal lesions in 75% of cases and TB with chronic empyema & fibrothorax in 25% cases. Incidence of TB in higher age groups was statistically significant (p<0.05).CONCLUSIONSCT and HRCT can diagnose different stages of pulmonary TB and any associated diseases. It helps in taking treatment decisions and preventing disease spread which is an important health issue. For early detection of pulmonary TB, CT and HRCT is a must for diagnosis.
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Objective:To explore the potential regularity and cause of the differences between magnetic resonance imaging (MRI) and computed tomography (CT) presenting electrodes after deep brain stimulation (DBS) for Parkinson's disease (PD), in order to provide reference for optimizing clinical decision. Methods:Forty-nine PD patients who underwent DBS treatment in Department of Functional Neurosurgery of Ruijin Hospital, Shanghai Jiao Tong University School of Medicine from Jan. 2016 to Dec. 2017 were selected. CT images were acquired 3-5 days after surgery and MRI images were acquired during 3-6 months by the follow-up of regular programming. The fused images of short-term CT combined with preoperative MRI and long-term MRI respectively were compared to show the difference by the tip contact positions of electrodes. Results:A total of 50 groups of postoperative CT fused images and MRI images were obtained. The space differences of the two types of images were 1.36 (0.98, 1.70) mm (P=0.021) and 1.28 (0.99, 1.88) mm (P=0.006), on the right and left electrodes, respectively. Bilateral electrodes in both short-term and long-term images had a tendency to move to the medial, rear, and bottom part of the brain. Conclusion:The potential tendency in shifts of DBS electrodes can provide reference for establishing the brain drift model and optimizing the position of the implanted electrode.
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Introduction: The sinonasal region is often imaged because of infectious and allergic diseases of the nasal cavityand paranasal sinuses. Improved knowledge of normal pneumatization and development of paranasal sinusesis important to allow sinus diseases to be evaluated and an adequate treatment to be proposed.Materials and methods: 100 patients (72 males and 28 females) undergoing coronal and axial sections of computedtomography scan of maxillary sinus of head and neck aged between 1year to 90 years at the Radiology Department,Vydehi Institute of Medical Science & Research Centre Bangalore for reasons other than due to craniofacialabnormalities or sinus problem were taken for the study. Volume and dimensions of the maxillary sinuses withits anatomical variations were obtained. Mean, SD, significant difference between age & gender was calculated.Results: Maxillary sinuses in Males on both sides have higher values in mean height, depth and volume thanfemales except right side width which was lesser in value than females. All the mean parameters were more onleft sinus both in male and females, except mean height of right sinus in males, on side comparison all the meanparameters were more on right side in females. There is a significant difference in mean height of right and leftmaxillary sinus in between male and female. There is a significant difference on right and left side widthbetween male and female in the age group 51-60 yrs and 61-70 yrs. The maximum age growth in males was during11-20 yrs and 41-50 yrs in height, width and volume, in 21-30 yrs and 31-40 yrs in depth, later dimensions weredecreasing in growth by 61-70 yrs in height and 81-90 yrs both in depth, width and volume. In females maximumgrowth was in 21-30 yrs and 51-70 yrs for height, depth, volume, 11-20 yrs and 51-60 yrs for width dimensions, laterdecreases by 61-70 yrs onwards in height, width and 11-20 yrs in depth and volume.Conclusion: These results will be helpful in understanding normal and pathological conditions of the maxillarysinuses and useful in clinical planning of medical or surgical interventions of the maxillary sinuses
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Objective: To evaluate the use of computed tomography (CT) as an osteoporosis screening tool, evaluating the relation between the bone mineral density (BMD) from maxilla and mandible with the cervical vertebrae, using the Hounsfield units (HU). Material and Methods: It was included in this study a convenience sample of 118 multislice CT examinations from patients who underwent maxilla, mandible and cervical vertebrae (C1 and C2) simultaneously scans. For each patient, the following regions on both sides of head CT scans were assessed in sagittal slice: above maxillary central and lateral incisors apexes; maxillary tuberosity; mandible head; mandible body endosteum; mandible body trabeculae and vertebrae C1 and C2. HU were measured in each area using a 0.5 cm region of interest (ROI) positioned in the center of the slice. Results: It was verified that there is a correlation between the BMD of the C1 and C2 vertebrae and the anterior region of the maxilla. It was not found correlation between the vertebrae, C1 and C2, and the other structures analyzed. Conclusions: This study showed that this method can be a good screening tool to diagnosis of osteoporosis, when evaluated the correlation between C1 and C2 vertebrae and anterior region of maxilla. More studies are necessary to evaluate the possibility of using CT as an osteoporosis screening tool. (AU)
Objetivos: Avaliar o uso da tomografia computadorizada como ferramenta de rastreamento da osteoporose, avaliando a relação entre a densidade mineral óssea da maxila e mandíbula com as vértebras cervicais, utilizando as unidades de Hounsfield. Material e métodos: Neste estudo foram incluidos uma amostra de 118 pacientes submetidos à exames de tomografia computadorizada multislice que apresentavam as estruturas anatomicas da maxila, mandibula e as vértebras cervicais (C1 e C2) simultaneamente. Para cada paciente, as seguintes regiões dos dois lados da tomografia computadorizada da cabeça foram avaliadas em corte sagital: acima dos ápices dos incisivos centrais e laterais superiores; tuberosidade maxilar; cabeça da mandíbula; endósteo do corpo da mandíbula; trabéculas do corpo da mandíbula e vértebras C1 e C2. As unidades de Hounsfield foram medidas em cada área usando uma região de interesse de 0,5 cm (ROI) posicionada no centro do corte. Resultados: Verificou-se uma correlação positiva entre a densidade mineral óssea das vértebras C1 e C2 e a região anterior da maxila. Não foram encontradas correlação entre as vértebras C1 e C2 e as demais estruturas analisadas. Conclusão: Este estudo mostrou que esse método pode ser uma ferramenta de triagem para o diagnóstico de osteoporose, quando avaliada a correlação entre as vértebras C1 e C2 e a região anterior da maxila. Mais estudos são necessários para avaliar a possibilidade do uso da tomografia computadorizada como ferramenta de rastreamento da osteoporose. (AU)
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Humans , Osteoporosis , Tomography, X-Ray Computed , Bone DensityABSTRACT
Objective: To determine the clinical, imaging, and histological features, and surgical resection modalities and outcomes of adult sacrococcygeal teratoma (SCT). Methods: Adult patients with histopathologically diagnosed SCT were enrolled in our hospital between August 2010 and August 2018. Each patient’s characteristics and clinical information were reviewed. Results: There were 8 patients in the study (2 males, 6 females) with a median age of 34 years (range, 18–67 years). The time to clinical symptoms was 14 d to 35 years, with a median time of 4 years. Six patients presented with symptoms of sacrococcygeal pain, and four with signs of sacrococcygeal mass and ulceration in the sacrococcygeal region. Six patients were evaluated using a combination of computed tomography (CT) and magnetic resonance imaging (MRI). All patients showed a presacral tumor with heterogeneous intensity on CT images. All patients underwent surgical treatment, including 6 parasacral, 1 transabdominal, and 1 combined anterior-posterior surgery cases. Seven patients were histopathologically diagnosed with benign mature SCT, and have shown no recurrence. One patient had malignant SCT, with recurrence at 84 months after surgery. After a second surgery, the patient had no recurrence within 6 months follow-up after re-resection. Conclusions: Our retrospective study demonstrated: (1) adult SCT is difficult to diagnose because of a lack of typical clinical symptoms and signs; (2) a combination of CT and MRI examination is beneficial for preoperative diagnosis; (3) the choice of surgical approach and surgical resection modality depends on the size, location, and components of the tumor, which can be defined from preoperative CT and MRI evaluation; (4) most adult SCTs are benign; the surgical outcome for the malignant SCT patient was good after complete resection. Even for the patient with recurrent malignant SCT, the surgical outcome was good after re-resection.
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Objective@#To explore the possibility that the neck extension in chest CT scanning would make thyroid move upward and reduce thyroid radiation exposure.@*Methods@#The images of 1 994 patients who underwent chest CT examination in Beijing Chaoyang Hospital from March to June in 2017 were compared and analyzed retrospectively. According to different cervical positions, patients were divided into extension group and routine group with 997 cases in each group. In the extension group, the head and neck bended back to the maxillary top position while in the regular group with normal position. The length of thyroid glands exposed to the scanning range and the number of cases of all glands moved out of the scanning range were observed with the first rib head as the baseline counting mark. The differences in exposed length of thyroid gland in primary radiation area between the two groups were compared.@*Results@#The length of exposed thyroid gland by primary radiation in the extension group (4.69±5.68) mm was significantly shorter (U=91 073.5, P<0.05) than that in the routine group (17.16±6.68) mm. In addition, the number of thyroid glands out of scanning range completely in the extension group (n=519, with ratio of 52.1%) was significantly more (U=594.8, P<0.05) than those in the routine group (n=32, with ratio of 3.2%).@*Conclusions@#During chest CT scan, the length of thyroid gland in the scanning field can be shortened with neck backbend position and the radioation protection for thyroid gland can be effectively improved.
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Objective@#To estimate the effective dose burden to the public in Suzhoui induced by medical exposure from computed tomography (CT) and digital radiography (DR).@*Methods@#Twenty-seven hospitals were selected by stratified random sampling. The application information was colleted from picture archiving and communication system (PACS) and radiology information system (RIS). For DR, DAP was measured by the dose-area product meter in different body parts, then the effective dose values were calculated by the DAP. For CT, effective dose was estimated by measuring CT dose index weighted (CTDIw) and scanning parameters in different parts of the body. The public dose burden caused by DR and CT medical exposure in Suzhou was estimated according to the scanning time and effective dose to each part.@*Results@#The effective dose due to DR examination was abdomen AP 0.565 mSv, pelvis AP 0.280 mSv, skull LAT 0.016 mSv, skull AP 0.012 mSv, chest LAT 0.111 mSv, chest AP 0.060 mSv, thoracic spine LAT 0.100 mSv, thoracic spine AP 0.102 mSv, lumbar spine LAT 0.307 mSv and lumbar spine AP 0.152 mSv, respectively. The effective doses from CT scanning were 1.33 mSv for head, 5.75 mSv for thorax and 7.31 mSv for abdomen, respectively. The annual collective effective dose in Suzhou in 2017 from DR exposures and CT scans was 9 593.07 man·Sv, and the average annual effective dose was 0.898 mSv.@*Conclusions@#The contribution of CT medical radiation to the public dose is much greater than that of DR. Controlling the frequency of medical exposure and single scan dose is an effective way to reduce the public dose burden. The public dose burden from DR and CT medical exposure in Suzhou is at a high level and attention needs to be paid by relevant health administrative departments.
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Objective To explore the possibility that the neck extension in chest CT scanning would make thyroid move upward and reduce thyroid radiation exposure.Methods The images of 1 994 patients who underwent chest CT examination in Beijing Chaoyang Hospital from March to June in 2017 were compared and analyzed retrospectively.According to different cervical positions,patients were divided into extension group and routine group with 997 cases in each group.In the extension group,the head and neck bended back to the maxillary top position while in the regular group with normal position.The length of thyroid glands exposed to the scanning range and the number of cases of all glands moved out of the scanning range were observed with the first rib head as the baseline counting mark.The differences in exposed length of thyroid gland in primary radiation area between the two groups were compared.Results The length of exposed thyroid gland by primary radiation in the extension group (4.69± 5.68) mm was significantly shorter (U=91 073.5,P＜0.05) than that in the routine group (17.16±6.68) mm.In addition,the number of thyroid glands out of scanning range completely in the extension group (n =519,with ratio of 52.1％) was significantly more (U=594.8,P＜0.05) than those in the routine group (n=32,with ratio of 3.2％).Conclusions During chest CT scan,the length of thyroid gland in the scanning field can be shortened with neck backbend position and the radioation protection for thyroid gland can be effectively improved.
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Objective To estimate the effective dose burden to the public in Suzhoui induced by medical exposure from computed tomography (CT) and digital radiography (DR).Methods Twenty-seven hospitals were selected by stratified random sampling.The application information was colleted from picture archiving and communication system (PACS) and radiology information system (RIS).For DR,DAP was measured by the dose-area product meter in different body parts,then the effective dose values were calculated by the DAP.For CT,effective dose was estimated by measuring CT dose index weighted (CTDIw) and scanning parameters in different parts of the body.The public dose burden caused by DR and CT medical exposure in Suzhou was estimated according to the scanning time and effective dose to each part.Results The effective dose due to DR examination was abdomen AP 0.565 mSv,pelvis AP 0.280 mSv,skull LAT 0.016 mSv,skull AP 0.012 mSy,chest LAT 0.111 mSv,chest AP 0.060 mSv,thoracic spine LAT 0.100 mSv,thoracic spine AP 0.102 mSv,lumbar spine LAT 0.307 mSv and lumbar spine AP 0.152 mSv,respectively.The effective doses from CT scanning were 1.33 mSv for head,5.75 mSv for thorax and 7.31 mSv for abdomen,respectively.The annual collective effective dose in Suzhou in 2017 from DR exposures and CT scans was 9 593.07 man · Sv,and the average annual effective dose was 0.898 mSv.Conclusions The contribution of CT medical radiation to the public dose is much greater than that of DR.Controlling the frequency of medical exposure and single scan dose is an effective way to reduce the public dose burden.The public dose burden from DR and CT medical exposure in Suzhou is at a high level and attention needs to be paid by relevant health administrative departments.
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Objective: To investigate the prognostic value of chest computed tomography (CT) characteristics in crizotinib-treated pa-tients with advanced non-small cell lung cancer (NSCLC). Methods: Forty-seven patients with advanced ALK-rearranged NSCLC who re-ceived crizotinib treatment from January 2014 to March 2017 were enrolled in this retrospective study. Pre-treatment CT characteris-tics were evaluated. Patients were followed up after crizotinib treatment, and the best overall response and progression-free survival (PFS) were assessed according to the Response Evaluation Criteria in Solid Tumors (RECIST version 1.1). Results: The median PFS of all patients was 10 months. There was no association between CT characteristics and response. In univariate analysis, large tumor size (P=0.009), central type (P=0.002), consolidation of surrounding lung tissue (P=0.002), pleural effusion (P=0.001), and lymphangitic carcino-matosis (P=0.019) suggested a poor prognosis. Multivariate Cox regression analysis showed that location (hazard ratio, 3.219; 95% con-fidence interval: 1.517-6.833; P=0.002) was an independent prognostic predictor. Conclusions: Pre-treatment CT characteristics are useful in predicting the PFS of crizotinib-treated patients with advanced NSCLC harboring ALK rearrangement.
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We demonstrate a novel inorganic-organic crystalline nanoconstruct, where gold atoms were imbedded in the crystal lattices as defects of camptothecin nanocrystals, suggesting its potential use as simultaneous agents for cancer therapy and bioimaging. The incorporation of gold, a potential computed tomography (CT) contrast agent, in the nanocrystals of camptothecin was detected by transmission electron microscope (TEM) and further quantified by energy dispersive X-ray spectrometry (EDS) and inductively coupled plasma-optical emission spectrometers (ICP-OES). Due to gold's high attenuation coefficient, only a relatively small amount needs to be present in order to create a good noise-to-contrast ratio in CT imaging. The imbedded gold atoms and clusters are expected to share the same biological fate as the camptothecin nanocrystals, reaching and accumulating in tumor site due to the enhanced permeation and retention (EPR) effect.
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Objective • To explore the clinical value of the ratio of low attenuation areas (LAA%) and lung volume calculated according to chest CT in evaluating the severity of spirometric abnormality. Methods • The patients who underwent chest CT scan and lung function test at the same time from January 2010 to July 2014 in Ruijin Hospital, Shanghai Jiao Tong University School of Medicine were retrospectively enrolled. LAA% and lung volume were calculated by Myrian software. The correlation analysis was performed between post-bronchodiation forced expiratory volume in 1 second (FEV1) or its percentage of predicted value (FEV1%pred) and LAA% or lung volume. Multi-variable models for post-bronchodiation FEV1 and FEV1%pred were developed based on LAA%, lung volume, gender, height, and weight. The ROC curves were depicted and the diagnostic values of LAA%, lung volume, and models were compared. The cut points were chosen according to Younden indexes and specificity. Results • A total of 1 150 patients were included in summarization group. LAA% was negatively correlated with post-bronchodiation FEV1 and FEV1%pred. Lung volume was positively correlated with post-bronchodiation FEV1. The regression models of post-bronchodiation FEV1 and FEV1%pred were FEV1=-2.700+0.111×lung volume-0.216×ln (LAA%+0.1)-0.025×age+0.154×gender+0.034×height and FEV1%pred=65.582+4.014×lung volume-7.508×ln (LAA%+0.1)-10.264×gender, respectively. The regression model performed better than LAA% and lung volume in estimating the degree of post-bronchodiation FEV1 decrease. LAA% and the regression model performed better than lung volume in estimating the degree of post-bronchodiation FEV1%pred decrease. The sensitivity was 75.6% and the specificity was 90.6% in estimating post-bronchodiation FEV1%pred1.61% as the criteria. The sensitivity was 58.9% and the specificity was 81.4% in estimating post-bronchodiation FEV1<1 L by using the value of regression model<1.76. Conclusion • The regression models of post-bronchodiation FEV1 and FEV1%pred were obtained based on lung volume and LAA% on chest CT. LAA% and lung volume can roughly estimate the severity of spirometric abnormality.