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Objective:To construct radiomics models of micro-calcification in carotid plaques, and compare their diagnostic values.Methods:Fifty-two patients with large atherosclerotic cerebral infarction admitted to Department of Neurology, Third Affiliated Hospital of Soochow University from May 2017 to November 2019 were enrolled. All patients underwent conventional carotid artery Doppler ultrasound to detect carotid plaques and Micropure? ultrasound to detect micro-calcifications in the plaques. A cross-section image with maximum numbers of micro-calcifications was chosen when there were micro-calcifications in carotid plaques; otherwise, a cross-section image with the largest area of the plaque was chosen. After all images were normalized by Photoshop software, the plaques were delineated as regions of interest using MaZda 4.6 software and 283 texture features of the plaques were automatically extracted. The texture features with the strongest predictive value were selected through consistency analysis (intrclass correlation coefficient [ICC]>0.75), two-sample t-test, Least absolute shrinkage and selection operator (Lasso) regression. The predictive models were constructed by RandomForest (RF) and Support vector machine (SVM) classifiers. The training set and test set were divided by 7: 3 to analyze the classification accuracy. Receiver operating characteristic (ROC) curves were used to calculate the area under the curve (AUC) to evaluate the diagnostic values of the models. Delong test was used to compare the difference between the diagnostic values of the 2 classifiers in test set. Results:A total of 148 plaque images from 52 patients were enrolled, including 104 plaques with micro-calcification and 44 plaques without micro-calcification. Nine texture features were finally selected after ICC analysis, T test and Lasso regression: 5 image gray histogram features were mean, variance, skewness, kurtosis and 99 th percentile (Perc. 99%); 1 autoregressive model feature was Teta3, and 3 wavelet transform features were WavEnLH_s-3, WavEnLH_s-4, and WavEnLH_s-6. With RF classifier, accuracy of the diagnostic model was 0.93, enjoying AUC of 0.92; with SVM classifier, that was 0.91, enjoying AUC of 0.90; Delong test showed that the diagnostic values of the 2 classifiers in test set were significantly different ( Z=1.000, P=0.320). Conclusion:Radiomic models constructed by RF and SVM classifiers can identify micro-calcification in carotid plaques, and the 2 classifiers share equivalent diagnostic values.
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Objective:To explore the correlations of micro-calcification load in carotid plaques and plaque vulnerability scores detected by Micropure? ultrasonic technology with 18F-sodium fluoride ( 18F-NaF) uptake ratio (tissue-background ratio [TBR]) in positron emission tomography-computed tomography (PET-CT). Methods:Baseline data of patients with carotid atherosclerotic plaques admitted to our hospital from March 2017 to November 2020 were collected. Carotid arteries of these patients simultaneously positive on Micropure? ultrasound examination and 18F-NaF PET-CT were included. The number of spots in carotid plaques detected by Micropure? ultrasonic technology was defined as load of micro-calcification: they were divided into large number of micro-calcifications group (≥5 spots) and small number of micro-calcifications group (1-4 spots). The scores of carotid plaque vulnerability were evaluated according to carotid atherosclerosis scores in Diagnostic Value of Carotid Atherosclerosis Score for Ischemic Stroke. Correlations of TBR with micro-calcification load and plaque vulnerability scores in these 39 carotid arteries were analyzed. Results:Thirty-nine carotid arteries from 28 patients were enrolled: 24 carotid arteries were classified into the large number of micro-calcifications group and 15 carotid arteries were classified into the small number of micro-calcifications group. TBR of the large number of micro-calcifications group (2.61±0.73) was significantly increased as cpmpared with that of the small number of micro-calcifications group (1.93±0.43, t=-3.657, P=0.001). In the 39 carotid arteries, micro-calcification load was 5(3, 5), while the carotid plaque vulnerability scores were 2 (2, 3); micro-calcification load was positively correlated with TBR (2.35±0.71, r s=0.519, P=0.001), but no correlation was noted between TBR and carotid plaque vulnerability scores ( r s=0.086, P=0.602). Conclusion:Carotid plaque micro-calcification load detected by Micropure? ultrasound examination is associated with 18F-NaF uptake ratio; the larger the micro-calcification load, the more obvious the uptake of 18F-NaF.
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Background: Thyroid nodules are a common entity encountered in clinical practice and the prevalence by palpation is only 3-7%, but on ultrasonographic evaluation it is 20-76% with wide variability. Accurate prediction of malignancy with minimal diagnostic modalities and assessing the risk factors in malignancy may help in reducing extensive procedures. The objective of the study is to assess the risk factors associated with development of malignancy in solitary thyroid nodules and to find out the percentage of malignancy among the cases of solitary nodules.Methods: A three year prospective study was conducted at ACSR medical college and all cases diagnosed as solitary thyroid nodules were enrolled and institutional ethical approval was obtained. Socio demographic data, clinical history and ultrasonogram findings were collected and entered in a separate data sheet for analysis. Fine needle aspiration cytology, histopathological examination was done and reported findings were noted. Statistical analysis was done in SPPS version 20 and ‘p’ value <0.05 was considered significant.Results: 128 cases of solitary thyroid nodules (STN) with 41 male and 87 female cases and F:M ratio of 2.13:1 with mean age of 46.6±10.8 years was enrolled. 43.75% were euthyroid, 47.66% were hypothyroid and 8.59% were hyperthyroid on hormonal evaluation. Micro calcification was observed in 50.78%, increased vascularity in 38.28% and irregular margins in 34.38% of cases. Colloid goitre was predominant observation on fine needle aspiration cytology (40.6%) and follicular adenoma (32%) on histopathology.Conclusions: Features of micro calcification, solid echogenicity, and associated lymphadenopathy are associated features with increased risk of malignancy among STN.
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Objective: To investigate the correlation between the prognosis of breast cancer patients and mammographic calcification. Methods: A total of 1 035 breast cancer patients with complete clin ical information were in cluded in this study. According to mammographic calcification before operation, the patients were divided into calcification group and non-calcification group, and then the expressions of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor-2 (HER-2) were compared between two groups. The influence of calcification on the positive expression rates of ER, PR and HER-2 and the relationship between calcification and tumor size, axillary lymph node status, histological grade, molecular classification and prognosis were analyzed. Results: The rate of calcification in the patients with axillary node metastasis was significantly higher than that in the patients without lymphatic metastasis [53.6% (199/371) vs 47.1% (312/663)] (P 0.05). In survival analysis, there was no obvious difference between the calcification group and non-calcification group. Conclusion: The breast cancer with micro-calcification shown on mammographic X-ray images was associated with the expression of HER-2, molecular typing and axillary lymph node status. The calcification is likely to have no effect on the survival of patients.
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Objective To compare the accuracy and clinical effect between X-ray stereotactic vacuum-assisted biopsy (SVAB) and metal wire guided lumpectony.Methods From January 2010 to June 2014,681 cases of breast micro-calcification biopsy were performed.Among them,78 cases were performed with SVAB and 603 eases were performed with the method of stereotaetic metal wire guided lumpectomy.All cases were non-palpable breast lesions (NPBLs) and breast imaging-reporting and data system (BI-RADS) assessment categories 4.The diagnostic accuracy and clinical effect were compared.Results The sensitivity of both methods was 100 ％ with no misdiagnosis.The underestimation rate of SVAB was 12.5 ％.Compared with the method of metal wire guided lumpectomy,SVAB had many advantages,such as easy to use,quickly performed,low rate of local deformation and lower rate of operative complications.77.5 ％ patients benefited from SVAB by avoiding open surgery of benign disease.Conclusions SVAB is an accurate,safe and convenient method of biopsy.It can be recommended as the preferred method of micro-calcification (BI-RADS 4).Additional operation should be performed on patients with the pathological diagnosis of middle and high grade of dysplasia and any kind of carcinoma.
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Objective To evaluate the ability of micropure system on calcifications detection of thyroid nodules. Methods A total of 63 patients with thyroid nodules that prepared for surgery were detected by micropure system and gray?scale ultrasound imaging,respectively. Results Among the 87 lesions removed with surgery,there were 72 benign lesions and 15 malignant ones. For the coarse calcifications,3 calcifications in the benign lesions were found both by micropure system and gray?scale ultrasound imaging;while in these malignant lesions,11 and 9 calcifications were visual?ized by micropure system and gray?scale ultrasound imaging,respectively. There was no significant difference between the two methods(P>0.05). For the micro?calcifications,8 and 2 calcifications were found in the benign lesions by micropure system and gray?scale ultrasound imaging,respec?tively;while 12 and 5 calcifications were visualized in the malignant lesions by micropure system and gray?scale ultrasound imaging,respectively. The micropure system method is more sensitive in micro?calcification detection compare to the traditional gray?scale ultrasound imaging method(P<0.05). Conclusion Micropure system can detect micro?calcifications and has a better visibility for micro?calcifications within the thyroid lesions, which can be applied in early thyroid cancer diagnosis.