Targeted molecular imaging of head and neck squamous cell carcinoma: a window into precision medicine / 中华医学杂志(英文版)

Tumor biomarkers play important roles in tumor growth, invasion, and metastasis. Imaging of specific biomarkers will help to understand different biological activities, thereby achieving precise medicine for each head and neck squamous cell carcinoma (HNSCC) patient. Here, we describe various molecular targets and molecular imaging modalities for HNSCC imaging. An extensive search was undertaken in the PubMed database with the keywords including "HNSCC," "molecular imaging," "biomarker," and "multimodal imaging." Imaging targets in HNSCC consist of the epidermal growth factor receptor, cluster of differentiation 44 variant 6 (CD44v6), and mesenchymal-epithelial transition factor and integrins. Targeted molecular imaging modalities in HNSCC include optical imaging, ultrasound, magnetic resonance imaging, positron emission tomography, and single-photon emission computed tomography. Making the most of each single imaging method, targeted multimodal imaging has a great potential in the accurate diagnosis and therapy of HNSCC. By visualizing tumor biomarkers at cellular and molecular levels in vivo, targeted molecular imaging can be used to identify specific genetic and metabolic aberrations, thereby accelerating personalized treatment development for HNSCC patients.

Coil selection and application during temporomandibular joint MRI imaging / 医疗卫生装备

Objective To evaluate the clinical application of 15-channel phased-array head coil and 6-channel dS Flex M surface coil in MRI imaging of temporomandibular joint.Methods Totally 50 patients were randomly equally assigned into two groups, of whom, one group used a 15-channel phase-array head coil for MRI scanning, and the other applied a 6-channel dS Flex M surface coil. The same regions of interest were set up to measure and analyze the signal to noise ratio (SNR)and contrast to noise ratio (CNR)of each region respectively.SPSS 19.0 software was used for quantitative analysis. Results The head coil had the SNR and the CNR higher than those of the surface coil.The head coil and Flex surface coil had the imaging diagnosis rates being 95.83% and 91.67% respectively,and there was no significant difference between them(P>0.05). Conclusion Both phase-array head coil and dS Flex M surface coil can be used for temporomandibular joint MRI imaging, and it's suggested that conventional imaging be executed with dS Flex M surface coil and functional imaging be implemented with head coil.

Advantage in Bright-blood and Black-blood Magnetic Resonance Imaging with High-resolution for Analysis of Carotid Atherosclerotic Plaques / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>About 50% of the cerebral ischemia events are induced by intracranial and extracranial atherosclerosis. This study aimed to evaluate the feasibility and accuracy for displaying atherosclerotic plaques in carotid arteries and analyzing their ingredients by using high-resolution new magnetic resonance imaging (MRI) techniques.</p><p><b>METHODS</b>Totally, 49 patients suspected of extracranial carotid artery stenosis were subjected to cranial MRI scan and magnetic resonance angiography (MRA) examination on carotid arteries, and high-resolution bright-blood and black-blood MRI analysis was carried out within 1 week. Digital subtraction angiography (DSA) examination was carried out for 16 patients within 1 month.</p><p><b>RESULTS</b>Totally, 103 plaques were detected in the 49 patients, which were characterized by localized or diffusive thickening of the vessel wall, with the intrusion of crescent-shaped abnormal signal into lumens. Fibrous cap was displayed as isointensity in T1-weighted image (T1WI) and hyperintensities in proton density weighted image (PDWI) and T2-weighted image (T2WI), lipid core was displayed as isointensity or slight hyperintensities in T1WI, isointensity, hyperintensities or hypointensity in PDWI, and hypointensity in T2WI. Calcification in plaques was detected in 11 patients. Eight patients were detected with irregular plaque surface or ulcerative plaques, which were characterized by irregular intravascular space surface in the black-blood sequences, black hypointensity band was not detected in three-dimensional time-of-flight, or the hypointensity band was not continuous, and intrusion of hyperintensities into plaques can be detected. Bright-blood and black-blood techniques were highly correlated with the diagnosis of contrast-enhanced MRA in angiostenosis degree, Rs = 0.97, P < 0.001. In comparison to DSA, the sensitivity, specificity, and accuracy of MRI diagnosis of stenosis for ≥50% were 88.9%, 100%, and 97.9%, respectively.</p><p><b>CONCLUSIONS</b>High-resolution bright-blood and black-blood sequential MRI analysis can accurately analyze ingredients in atherosclerotic plaques. Determined by DSA, MRI diagnosis of stenosis can correctly evaluate the serious degree of arteriostenosis.</p>

Dual-energy computed tomography angiography for evaluating the renal vascular variants / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Recognizing renal vascular variants preoperatively is important in order to avoid vascular complications during surgery. This study aimed to investigate the renal vascular variants with dual-energy computed tomography (DECT) angiography to provide valuable information for surgery.</p><p><b>METHODS</b>A total of 378 patients underwent DECT. The number, size, course and relationships of the renal vessels were retrospectively observed from the scans. Anomalies of renal arteries and veins were recorded and classified. Multiplanar reformations (MPR), maximum intensity projections (MIP), and volume renderings (VR) were used for analysis.</p><p><b>RESULTS</b>In 378 patients (756 kidneys), renal artery variations were discovered and recorded in 123 kidneys (16.3%, 123/756) of 106 patients (28.0%, 106/378). Type IB (early branches of the only one main renal artery) and IC (accessory renal artery with only one main renal artery) were found most frequently with an incidence of 11.4% (43/378) and 14.5% (55/378). The incidence of renal artery variations in the left kidney was not statistically different than in the right kidney (12.4% vs. 11.1%). The incidence of renal vein variations was detected in 104 patients (27.5%, 104/378). The incidence of venous variants in the right kidney was higher than in the left kidney (20.1% vs. 7.4%), but left renal vein variations were more complex. Variants of the left renal vein were detected in 28 patients including type 1 (circumaortic left renal vein) in eight cases, type 2 (retroaortic left renal vein) in seven cases, type 3 (abnormal reflux) in six cases, type 4 (late venous confluence of left renal vein) in five cases, and type 5 (rare type) in two cases. The frequency of left renal vein variation associated with the left renal accessory artery was significantly higher than with early branches of the left renal artery (P = 0.037).</p><p><b>CONCLUSIONS</b>The renal vascular variants are rather common and complex. DECT angiography can demonstrate the precise anatomy of the renal vessels, which is a benefit for renal transplantation or other renal operations.</p>

Dynamic MRI study on temporomandibular joint and biomechanical analysis / 医用生物力学

Objective To establish a three-dimensional (3D) dynamic model of temporomandibular joint (TMJ) based on data collected from the TMJ movement with multi-level two-dimensional (2D) dynamic magnetic resonance imaging (MRI) and make biomechanical analysis. Methods GE Signa 1.5T TwinSpeed superconductive magnetic resonance scanner was used. TMJs of 2 asymptomatic male volunteers were chosen to be examined with MRI. All the images were imported to the Mimics software. 3D dynamic model of the TMJ was built, and the relationship between the magnitude of mouth opening and the disc transverse diameter was analyzed using linear fitting. Results The 3D dynamic model of TMJ was successfully established. The disc-condyle relationship and the dynamic morphological change of the TMJ disc were showed clearly in this model. The linear fitting equations were y=-0.03x+14.44 (R2=0.591) and y=-0.061x+13.48 (R2=0.306) from volunteers 1 and 2, respectively. A linear trend was observed regarding the relationship between mouth opening position and articular disc transverse diameter. The contact of the condyle surrounded by the TMJ disc varied inversely with the magnitude of mouth opening; the longitudinal diameter of TMJ disc changed along with the magnitude of mouth opening. In the process of mouth opening, the thickest longitudinal diameter of the joint disc was at the middle part of post-zone. The most remarkable changes of the longitudinal diameter of TMJ disc were found at the outer part of the post-zone and the inner part of the mid-zone. Conclusions The 3D dynamic model of TMJ was built successfully to observe the TMJ movement dynamically with 2D dynamic MRI. The model showed the disc-condyle relationship intuitively and precisely, and could be used as an alternative method to make up for the shortage of the 2D static MRI.

Study of the correlation of papillary thyroid carcinoma's invasion with Ezrin, Moesin and E-Cadherin / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the effects of Ezrin, Moesin and E-Cadherin on the invasion and metastasis of papillary thyroid carcinoma(PTC).</p><p><b>METHODS</b>The 81 paraffin-embedded specimen of PTC treated in The Second Clinical College of Harbin Medical University from 2005 to 2008 were examined immunohistochemically for Ezrin, Moesin, and E-Cadherin. Normal thyroid tissues adjacent to cancer were control. The correlation of Ezrin, Moesin, and E-Cadherin expressions and clinical features of PTC, including gender, age, tumor size, invasion, lymph node metastasis, and TNM stage, was analyzed.</p><p><b>RESULTS</b>Positive staining rates of Ezrin and Moesin in PTC were significantly higher than those in control (χ(2) were 61.691 and 57.949, P < 0.01, respectively). Positive staining rate of E-Cadherin in PTC was significantly lower than that in control (χ(2) = 64.241, P < 0.01). The positive expression rates of Ezrin and Moesin in PTC increased in the subgroups with age ≥ 45 years, local invasion, lymph node metastasis and stage III-IV, with significant difference respectively (P < 0.01), while the positive expression rate of E-Cadherin in PTC significantly decreased (P < 0.01).</p><p><b>CONCLUSIONS</b>The up-regulation expressions of Ezrin and Moesin and the down-regulation expression of E-Cadherin were associated with the invasion and metastasis of PTC. Combined detection of Ezrin, Moesin and E-Cadherin in PTC might served as an important predictor for the invasion, metastasis and prognosis of PTC.</p>

A new study on diffusion tensor imaging of the whole visual pathway fiber bundle and clinical application / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>With conventional imaging methods only the morphous of the visual nerve fiber bundles can be demonstrated, while the earlier period functional changes can not be demonstrated. We hypothesized that diffusion tensor imaging (DTI) would demonstrated the whole optic never fiber bundle and visual pathway and the earlier period functional changes. The purpose of the present study was to evaluate the application of DTI technique in the demonstration of the whole optic never fiber bundle and visual pathway, and the influence of orbital tumors on them.</p><p><b>METHODS</b>GE 1.5 T signa HD MR System, and the software package DTV2 were adopted. The total 45 subjects were enrolled, including 15 volunteers and 30 patients. All patients had ocular proptosis from minor to major. Seven patients had visual acuity decrescence.</p><p><b>RESULTS</b>The nerve fiber bundles, e.g. optic chiasma, optic tract and optic radiation in posterior visual pathway were well demonstrated in all cases. Wherein, the intact whole visual pathway fiber bundles were clearly revealed in 10 volunteers and 17 patients, and optic nerve was not wholly revealed in the rest of the subjects. Shift of optic nerve caused by compression and partial deformation were seen in 7 patients with orbital tumor. In 6 of 7 patients, DTI displayed significant abscise and deformation of visual nerve. Chi-square test indicated significant correlation between visual acuity decrescence and DTI visual nerve non-display.</p><p><b>CONCLUSIONS</b>Visual nerve fiber bundles and the whole visual pathway were visualized in most of patients with DTI. It might be an effective method of providing imaging evidence for visual nerve fiber earlier period functional changes, and laid a foundation for the study in other cranial nerves.</p>

Comparison of MR spectroscopic characteristics between orbital tumor and normal tissues in vitro by super high field MR / 第二军医大学学报

Objective: To study the MR spectroscopic characteristics of orbital tumors and normal tissues in vitro by the super high field MR, so as to provide theoretical basis for clinical application of MR spectroscopy (MRS). Methods: Ten tumor specimens (including 7 benign ones and 3 malignant ones) and 2 normal tissue samples received MR spectroscopic examination by BRUKER AVANCE 400 (SB) super high field MR, and their MR spectroscopic characteristics were compared. Results: 1H-MRS with super high field MR showed that the Cho and Cr peaks of malignant orbital tumors were higher than those of benign tumors. Three consecutive single peaks were noticed around 2 × 106 in the MRS of benign and malignant tumors, but not in that of normal tissues. Conclusion: 1H-MRS can differentiate benign, malignant orbital tumors and normal tissues, making it worth of further study for clinical application.

Value of fast dynamic contrast enhanced MRI in the diagnosis of orbital lesions / 眼科

Objective To study the value of fast dynamic contrast enhanced MRI in the diagnosis of orbital occupying lesions. Design Retrospective ease series.Participants 21 patients with orbital occupying lesions.Methods All the 21 patients were performed on fast dynamic contrast enhanced MRI and were verified by pathology.The raw datum were processed by the software of GE Functool. Parameters such as time-intensity curve(TIC),time to peak(Tpeak),1 minute enhancement ratio(ERlmin)and maximum enhancement ratio(ERmax)were analyzed to study the characteristics of orbital diseases on fast dynamic contrast-enhanced MRI.Main Outcome Measures TIC,ERlmin,and ERmax.Results The characteristics of TIC between benign diseases and malignant tumors were different. Of the 16 cases of benign lesions,12 demonstrated as continuous increasing type,and of 5 cases of malignant lesions,3 cases of lym- phoma were all platform type.The ER1min of the malignant tumors(150.47?42.18)was higher than that of the benign lesions (101.37?43.02)(P=0.021).Cavernous hemangiomas had special progressing enhancing model.Conclusions Fast dynamic contrast enhanced MRI is valuable to distinguish malignant tumors from benign occupying lesions.(Ophthalmol CHN,2007,16:305-308)

Application of functional MRI in breast diseases / 中华放射学杂志

Objective To investigate the value of functional MRI in the diagnosis and differential diagnosis of breast diseases.Methods Sixty-five patients with 68 lesions were enrolled in this study. Conventional T_1 WI and T_2 WI scan,dynamic contrast enhanced MRI,diffusion weighted imaging and ~1H single voxel MR spectroscopy were performed consequently.All lesions were verified by pathology,including 4 cases of breast adenosis,22 fibroadenomas,2 chronic inflammations,3 cysts,33 infitrating ductal carcinomas,1 intraductal carcinoma and 3 cystosarcoma phyllodes tumors.Morphological features,maximum enhancement ratio,time-intensity curve,apparent diffusion coefficient and Choline peak were analyzed. Results The detection rates of T_1 WI and T_2 WI were 14.7%(n=10)and 51.5%(n=35).The sensitivity,specificity,accuracy of dynamic contrast.enhanced MRI for the malignant tumor were 94.6%, 71.4% and 76.5% respectively.Retrospective study showed that diffusion weighted imaging,with the b value from 800 s/mm~2 to 1000 s/mm~2,could be used to differentiate various types of breast lesions.~1H signal voxel spectroscopy had a sensitivity of 51.4%,specificity of 82.6%,and accuracy of 67.6% for the malignent.The sensitivity,specificity and accuracy could reach 97.3%,90.0% and 92.6% respectively by combining conventional scan,dynamic contrast enhanced MRI and MR spectroscopy.Conclusion Functional MRI,with high sensitivity,specificity and accuracy,can be used widely in the diagnosis of malignant breast lesions.

Oxygen-induced brain BOLD-fMRI signal change / 第二军医大学学报

Objective:To observe the signal changes of blood-oxygen-level-dependent functional MRI(BOLD-fMRI)in brain tissue after inhalation of oxygen.Methods:Fifteen volunteers,9 males and 6 females,were included in the present experiment.The fMRI was conducted using 1.5T Singna Double-gradient Super Conducting Magnetic Resonance Imaging system (GE Inc).Bold-fMRI scanning was conducted using GRE-EPI sequence and data analysis was done using SPM2 software. Meanwhile,the BOLD-fMRI T_2 signal changes after 15 s and 6 min inhalation of pure oxygen were observed and compared with those after inhaling normal air.Results:No obvious activation of BOLD-fMRI was observed in the whole brain after inhaling normal air.Fifteen seconds after inhaling pure oxygen,the signal changes in the whole brain mainly manifested as the signal decrease in the gray matter,with average signal change being(-0.041?0.31)% in the gray matter and about(0.056?0.26)% in the white matter;the changes were significantly different from those of the normal air group(P