Résumé
Objective@#To investigate the feasibility of assessing the treatment response using diagnostic-quality CT imaging features during radiotherapy for esophageal cancer.@*Methods@#Thirty-three patients with stage Ⅰ to IV esophageal cancer undergoing intensity-modulated radiotherapy were recruited in this study. CT images were acquired using a CT-on-rail imaging system. Imaging data of CT images including gross tumor volume (GTV), the volume of spinal cord and non-irradiated tissue (NIT), CT mean (MCTN), standard deviation , and skewness were collected and analyzed by using MIM image processing system. Patients were divided into the effective group (complete remission and partial remission, n=24) and ineffective group (no change and progression, n=9) based on the outcomes of 3-month follow-up. The imaging data were statistically compared between two groups using the self-designed Matlab software.@*Results@#The tumor volume and MCTN of 33 patients were gradually decreased with the increase of radiotherapy dose. The tumor volume and MCTN were decreased by 42.46% and 5.76 HU in the effective group, more significant compared with 21.76% and 3.66 HU in the ineffective group (both P<0.005). The skewness in the ineffective group was decreased by 0.503 with the increasing radiation dose, whereas that in the effective group was increased by -0.450(P=0.034). Spinal cord and NIT did not significantly change with the increasing radiation dose.@*Conclusion@#Analysis of the characteristic data of CT images of patients with esophageal cancer during radiotherapy may early predict the clinical efficacy of radiotherapy.
Résumé
Objective To investigate the feasibility of assessing the treatment response using diagnostic-quality CT imaging features during radiotherapy for esophageal cancer.Methods Thirty-three patients with stage Ⅰ to Ⅳ esophageal cancer undergoing intensity-modulated radiotherapy were recruited in this study.CT images were acquired using a CT-on-rail imaging system.Imaging data of CT images including gross tumor volume (GTV),the volume of spinal cord and non-irradiated tissue (NIT),CT mean (MCTN),standard deviation,and skewness were collected and analyzed by using MIM image processing system.Patients were divided into the effective group (complete remission and partial remission,n=24) and ineffective group (no change and progression,n=9) based on the outcomes of 3-month follow-up.The imaging data were statistically compared between two groups using the self-designed Matlab software.Results The tumor volume and MCTN of 33 patients were gradually decreased with the increase of radiotherapy dose.The tumor volume and MCTN were decreased by 42.46％ and 5.76 HU in the effective group,more significant compared with 21.76％ and 3.66 HU in the ineffective group (both P＜0.005).The skewness in the ineffective group was decreased by 0.503 with the increasing radiation dose,whereas that in the effective group was increased by-0.450(P=0.034).Spinal cord and NIT did not significantly change with the increasing radiation dose.Conclusion Analysis of the characteristic data of CT images of patients with esophageal cancer during radiotherapy may early predict the clinical efficacy of radiotherapy.
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Trauma is one of the main reasons for the death and disability in children.Ultrasonic tech-nology has been applied in the early assessment and diagnosis of trauma.it is quick,effective,non-invasive, fast imaging,mobile and suitable for different patients and different parts of the body.It has been used to as-sess the organs in patients with severe trauma widely.
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Objective To investigate the feasibility and value of diffusion-weighted imaging (DWI) in the prediction and early assessment of response to concurrent chemoradiotherapy (CCRT) for esophageal cancer.Methods A total of 40 patients with pathologically confirmed esophageal cancer who received CCRT were included in the study.Routine 3.0 T MRI and DWI were performed at different time points of treatment.The RECIST standard was adopted to evaluate short-term outcomes and divide the patients into remission group (complete remission and partial remission) and non-remission group (stable disease and progressive disease).Group t-test was used for between-group comparison.The receiver operating characteristic (ROC) curve was used to analyze the change rates of apparent diffusion coefficient (ADC) value at different time points of treatment.Results There were 30 patients in the remission group and 10 patients in the non-remission group.The remission group had a significantly higher increase in ADC value than the non-remission group by the end of the first week of treatment (P =0.000).The maximum diameters of tumors for the emission group and non-remission group at the end of the first week of treatment were not significantly different from those before treatment (66.10 mm vs.62.63 mm,P =0.407 ; 70.90 mm vs.68.30 m,P =0.552).The ADC value before treatment had a negative correlation with the reduction rate of the maximum diameter of tumor (r =-0.680,P =0.000).The area under the ROC curve was the largest at the end of the first week of treatment (Az =0.783).If using 15.5 ％ increase in ADC value by the end of the first week as the threshold value for evaluating tumor response,the sensitivity,specificity,positive predictive value,and negative predictive value were 86.7％,70.0％,89.7％,and 63.6％,respectively.Conclusions DWI can be used as a new imaging method for the prediction and early assessment of the response to CCRT for esophageal cancer.The change rate of ADC value by the end of the first week of treatment is sensitive in assessing treatment response,so ADC value can be monitored at this time point.
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Centre for Children Committing Offences (CCCO), at Child Development Institute (CDI) in Toronto, Canada, developed Early Assessment Risk Lists (EARL-20B for boys; EARL-21G for girls), for young children at-risk for future criminality. In this first EARL prospective longitudinal study, 573 boys and 294 girls who participated in SNAP®, a gender-specific evidence-based model for at-risk children (6-11 years), 8.2% of boys and 3.1% of girls had registered criminal offences at follow up (mean age 14.9 and 14.6 respectively). EARL Total, Family, Child, and Responsivity domain scores, including two gender-specific risk items and Overall Clinical Judgment predicted early onset of criminal activity. Findings suggest that gender-sensitive clinical risk assessment and management tools are important for effectively identifying and potentially reducing criminal outcomes.
En el Centro para Niños Infractores (CCCO), del Instituto de Desarrollo Infantil (CDI) en Toronto (Canadá), se desarrollaron las Listas de Evaluación de Riesgos Tempranos (EARL-20B para niños; EARL-21G para niñas), para niños en riesgo de desarrollar criminalidad. En este primer estudio longitudinal de las EARL, 573 niños y 294 niñas que participaron en SNAP un modelo basado en evidencia de género específico para riesgo en niños (6-11 años), 8.2 % de niños y 3.1 % de las niñas registraron delitos criminales durante el seguimiento (M = 14.9 y 14.6, respectivamente). Los puntajes de EARL Total, Familia, Niños y Responsividad, incluyendo dos ítems de riesgo específicos de género, y el Juicio Clínico General predicen el inicio temprano de actividad criminal. Los resultados sugieren que la evaluación del riesgo clínico sensible al género y el manejo de herramientas son importantes para la identificación efectiva y potencialmente reducen los resultados criminales.