Imaging research progress on complete pathological remission after neoadjuvant therapy for rectal cancer / 中国医师杂志

Rectal cancer is a common malignant tumor in China, with a high mortality rate ranking fifth. Neoadjuvant therapy for rectal cancer can improve patient prognosis and even achieve pathological complete remission (pCR) in some patients, thereby avoiding complications and functional damage caused by radical surgery. Therefore, how to accurately evaluate pCR before surgery is currently a research hotspot. In recent years, new imaging technologies such as endorectal ultrasound, magnetic resonance imaging (MRI), and positron emission computed tomography (PET-CT) have developed rapidly, and imaging evaluation of pCR after neoadjuvant therapy for rectal cancer has achieved good results. This article provides a review of this field, aiming to provide a basis for personalized treatment of rectal cancer patients.

Strengthening management of latent tuberculosis infection and accelerating the elimination of the tuberculosis epidemic / 上海预防医学

Screening and preventive treatment for latent tuberculosis infection （LTBI） are important measures to reduce the incidence of active tuberculosis （TB） and its global burden. This paper discusses the current status of LTBI prevalence and preventive treatment， risk of incidence in high-risk groups， screening methods， and other interventions， emphasizing the importance of prevention and control as early as possible in a scientific strategy， so as to lay a solid foundation for eliminating TB by 2030.

Advances in preoperative imaging evaluation of extramural vascular invasion of rectal cancer / 中国医师杂志

Rectal cancer is a common malignancy of the gastrointestinal tract. Extramural vascular invasion (EMVI) is a key indicator of risk stratification for rectal cancer and an important reference factor in determining individualised treatment options, so it is important to accurately assess whether extramural vessels are infiltrated by the tumour before surgery. The main imaging methods for rectal cancer include magnetic resonance imaging (MRI), computed tomography (CT) and transrectal ultrasound (TRUS). This article focuses on the performance and diagnostic efficacy of these imaging methods in the diagnosis of EMVI in rectal cancer, and provides clinical reference.

Research progress and clinical significance of the correlation between breast cancer heterogeneity and contrast-enhanced ultrasound / 中国医师杂志

Breast cancer is a highly heterogeneous tumor originating from genetic basis, with significant differences in morphology, immunophenotype and therapeutic response, which poses great challenges to the treatment of breast cancer patients. Therefore, it is very important to understand the diversity of different molecular biological states and expressions in tumor cells to obtain good therapeutic effects for breast cancer. Contrast-enhanced ultrasound (CEUS) is widely used as a non-invasive real-time diagnostic technique for breast tumors. At present, many domestic and foreign literatures have reported that there is a certain correlation between molecular biological indicators related to breast cancer and the characteristics of CEUS, which is expected to provide a reference for preoperative treatment through non-invasive and convenient ultrasound examination. The combination of ultrasound contrast agent and ultrasound can mediate the drug therapy of breast cancer, which makes the targeted delivery and targeted regulation of drugs possible, thus improving the efficiency of chemotherapy drugs. In this review, we reviewed the relationship between molecular markers related to breast cancer and CEUS and the application of ultrasound contrast agents in targeted therapy of breast cancer.

Application of contrast-enhanced ultrasonography in differentiating benign and malignant breast BI-RADS 4 nodules / 中国医师杂志

Objective:To explore the application value of contrast-enhanced ultrasound (CEUS) in differentiating benign and malignant breast imaging reporting and data system (BI-RADS) type 4 nodules.Methods:The clinical data of 81 patients (82 nodules) with breast tumors admitted to the People′s Hospital of Inner Mongolia from February 2018 to January 2022 were retrospectively analyzed, all of whom were classified as BI-RADS. All patients underwent preoperative CEUS examination and underwent puncture biopsy or surgical treatment. Quantitative analysis software was used to draw a time intensity curve (TIC), quantitatively analyzing peak intensity (PI), area under the curve (AUC), baseline intensity (BI), time to peak (TTP), arrival time of contrast agent (AT), slope up (AS), half peak time (DT/2), and slope down (DS). We analyzed the differences in imaging parameters of the tumor edge zone in patients with benign and malignant breast tumors, and plotted the subject operating characteristic (ROC) curve for predicting benign and malignant breast tumors using statistically significant quantitative parameters. Area under the curve and cutoff values were calculated. The differences in imaging parameters between different regions of the tumor in the malignant breast group were analyzed.Results:PI and AUC at the margin of breast malignant tumor were higher than those of breast benign tumor (all P<0.001); There was no significant difference in PI, AUC in the central and surrounding tissues of breast malignant tumor, and BI, TTP, AT, DT/2, DS, AS in the central, marginal and surrounding tissues of breast malignant tumor compared with benign tumor of breast (all P>0.05). After drawing the receiver operating characteristic of PI and AUC at the edge of breast tumor, it was concluded that the area under the curve of PI in predicting benign and malignant breast tumors was 0.740 ( P<0.001), the sensitivity was 67.6%, the specificity was 77.8%, and the Youden′s J statistic was 0.453; The area under the curve of AUC was 0.743 ( P<0.001), the sensitivity was 67.6%, the specificity was 73.3%, and the Youden′s J statistic was 0.409. There was no statistically significant difference in PI and AUC at the edge of breast malignant tumors compared to the center of the tumor ( P=0.471, P=0.988); The PI and AUC of the center and edge of breast malignant tumors were higher than those of the surrounding breast tissue (all P<0.001). Conclusions:The blood flow perfusion characteristics of the marginal zone of breast tumors have certain diagnostic value in distinguishing between benign and malignant tumors, and can be used as a non-invasive indicator for distinguishing between benign and malignant breast tumors.

Progress in the application of transrectal ultrasound in preoperative evaluation of anal preservation in low and middle rectal cancer surgery / 中国医师杂志

Rectal cancer is one of the most common malignant tumors in the digestive system, and mid to low rectal cancer has attracted great attention due to its unique anatomy, examination, and treatment. Accurate diagnosis and appropriate treatment are key to improving the prognosis of rectal cancer patients. One of the long-standing technical challenges in colorectal surgery is how to make a more accurate evaluation of the surgical plan for rectal cancer before surgery. Transrectal intracavitary ultrasound can provide some effective objective basis for the selection of surgical plans for middle and low rectal cancer. This article reviews the application value and progress of preoperative evaluation of preoperative staging and anal preservation of middle and low rectal cancer using transrectal intracavitary ultrasound.

Progress in the application of new ultrasound technology in evaluation the efficacy of neoadjuvant chemotherapy for breast cancer / 中国医师杂志

In recent years, the incidence rate of breast cancer has increased rapidly and is tending to be younger. The application of neoadjuvant chemotherapy (NAC) can reduce the tumor stage, which is conducive to surgical resection or breast conserving surgery. Therefore, it is very important to evaluate the curative effect of NAC in breast cancer by imaging for the choice of operation timing. In recent years, with the rapid development of new ultrasound technologies such as contrast-enhanced ultrasound and elastography, these new technologies can provide more abundant imaging information and basis for individualized treatment of breast cancer, which has become a research hotspot of the curative effect of breast cancer NAC. This article reviews the research progress of new ultrasound technology in evaluating the curative effect of NAC in breast cancer in recent years.

Research progress of artificial intelligence in ultrasound diagnosis of breast cancer / 中国医师杂志

Breast cancer is the cancer with the largest number of new cases in the world, and ranks first in the incidence spectrum and cause of death among women in most countries. In recent years, artificial intelligence (AI), especially deep learning and computer-aided diagnosis, has shown remarkable performance in image analysis and processing, computer vision and other aspects, and has great development potential in the field of medical and health lesions identification, disease diagnosis and other aspects. This paper mainly discusses the application and progress of AI in ultrasound diagnosis of breast cancers.

Application value of transrectal multimodal ultrasound in evaluating the efficacy of endocrine therapy for prostate cancer / 中华超声影像学杂志

Objective:To explore the value of transrectal multimodal ultrasound parameters in monitoring and evaluating the efficacy of endocrine therapy for prostate cancer.Methods:Thirty patients with prostate cancer confirmed by pathology and treated with endocrine therapy in Inner Mongolia Autonomous Region People′s Hospital from November 2019 to May 2021 were selected. The levels of serum prostate specific antigen (PSA), prostate volume, color Doppler parameters, elasticity index and contrast-enhanced ultrasound parameters were measured and recorded before treatment, 1 month and 3 months after treatment. The parameters before and after treatment were statistically analyzed. The correlation between the changes of each index and PSA was analyzed by Spearman correlation analysis.Results:Total prostate specific antigen, free prostate specific antigen, and prostate volume were significantly different before treatment, and 1 month and 3 months after treatment( P<0.05), and the values showed a downward trend with increase of treatment time. There was no significant difference in resistance index before and 1 month after treatment( P>0.05), but decreased significantly 3 months after treatment( P<0.05). The values of elasticity index, peak intensity, area under curve and gradient at 1 month and 3 months after treatment were lower than those before treatment, while the arrival time and rising time at 1 month and 3 months after treatment were significantly higher than those before treatment( P<0.05). Spearman correlation analysis showed that there was no correlation between the changes of quantitative parameters and PSA value before and after treatment( P>0.05). Conclusions:Prostate volume, color Doppler parameters, elasticity index, and contrast-enhanced ultrasound parameters change in the early stage of endocrine therapy for prostate cancer, which can be used as a useful supplement to PSA for prostate cancer, and can be used to evaluate the efficacy of clinical prostate cancer endocrine therapy.

Diagnosis of extramural venous invasion of rectal cancer by transrectal ultrasound / 中华超声影像学杂志

Objective:To evaluate the value of transrectal ultrasound(TRUS)in diagnosing extramural venous invasion(EMVI) of rectal cancer.Methods:Clinical data of 81 rectal cancer patients were retrospectively analyzed in the People′s Hospital of Inner Mongolia Autonomous Region from January 2015 to December 2021. The extramural vascular sonographic features in these patients were summarized. Based on the postoperative pathology and compared with MRI examination, the efficacy of TRUS for the diagnosis of EMVI in rectal cancer was investigated.Results:①According to the sonographic presentation, extramural vessels of rectal cancer can be divided into the following four types: typeⅠshowed that the mass broke through the muscularis propria of the intestinal wall, and no peripheral vascular shadow was observed; typeⅡshowed that the mass broke through the muscularis propria, surrounded by extraneous vessels with normal diameter, running and blood flow; type Ⅲ showed that the mass broke through the intrinsic muscle layer of the intestinal wall and was surrounded by extramural vessels with abnormally thickened diameters, and blood flow filling defects; type Ⅳ showed a mass that broke through the intrinsic muscular layer, with irregularly dilated vessels outside the peritumoral wall and no blood flow signal in the lumen. ②With type Ⅲ and type Ⅳ as positive signs of EMVI, the diagnosis compliance rate of TRUS was 90.1% (Kappa=0.580, P<0.001), sensitivity was 58.3%, specificity was 95.7%, positive predictive value was 70.0%, negative predictive value was 93.0%, and area under the ROC curve(AUC) was 0.770. The diagnosis compliance rate of MRI was 86.4% (Kappa=0.541, P<0.001), sensitivity was 75.0%, specificity was 88.4%, positive predictive value was 52.9%, negative predictive value was 95.3%, and the AUC was 0.817. The differences in sensitivity and specificity between TRUS and MRI for the diagnosis of rectal cancer EMVI were not statistically significant ( P>0.05), and the differences in the AUC were not statistically significant ( Z=0.447, P=0.655). Conclusions:TRUS is valuable in assessing the extramural vascular status of rectal cancer and is expected to be an effective imaging method for preoperative diagnosis of EMVI.

The role of coupler perfusion in transrectal ultrasound in the diagnosis of T-stage rectal cancer / 中华超声影像学杂志

Objective:To investigate the role of coupler perfusion in transrectal ultrasound in the diagnosis of preoperative T staging of rectal cancer.Methods:A retrospective analysis of the preoperative clinical data of 132 patients with rectal cancer in the People′s Hospital of Inner Mongolia Autonomous Region from June 2015 to November 2020. According to whether or not the patients agreed to coupler perfusion before ultrasound examination, they were divided into 2 groups, namely the perfusion group 69 cases and the non-perfusion group of 63 cases, with postoperative pathology as the gold standard, and compared with magnetic resonance imaging(MRI) to evaluate the accuracy of the 2 groups and MRI in the T staging of rectal cancer.Results:The total coincidence rates of the coupling agent perfusion group, non-perfusion group and MRI group for the diagnosis of rectal cancer T staging were 89.9%, 76.2% and 87.9%, respectively, and the difference among the three methods was statistically significant (χ 2=6.096, P=0.047). The diagnostic sensitivity of the coupling agent perfusion group for T1 stage was 96.0%, which was higher than 61.5% of the non-perfusion group and 92.3% of the MRI ( P=0.010). The specificity of the perfusion group for the diagnosis of T2 stage was 95.7%, higher than the non-perfusion group and MRI ( P=0.037), the positive predictive value of the perfusion group for T2 stage was 90.9%, which was higher than the non-perfusion group and MRI ( P=0.035). The diagnostic accuracy of the perfusion group for T2 stage was 94.2%, higher than the non-perfusion group and MRI (χ 2=7.070, P=0.029). There were no statistically significant differences in diagnostic sensitivity, specificity, positive predictive value, negative predictive value and accuracy among the perfusion group and the non-perfusion group and the MRI for T3 and T4 (all P>0.05). Conclusions:Coupled-agent perfusion makes it convenient and fast for intracavity ultrasound to diagnose T staging of rectal cancer, and the diagnostic efficiency is comparable to MRI. In particular, it can be used as a highly reliable imaging method for T1 and T2 rectal cancer.

Multivariate analysis of prediction prostate cancer based on the contrast-enhanced transrectal ultrasonography and clinical data / 中华超声影像学杂志

Objective To explore the value of transrectal contrast-enhanced ultrasonography(TR-CEUS) and clinical data in prediction prostate cancer (PCa).Methods The clinical and images data of 152 patients who highly suspected with PCa were analyzed retrospectively.All patients were not treated before operation,in addition,TR-CEUS and prostate biopsy were taken.To analyze images with time intensity curves(TIC) analysis software,6 parameters including arrival time(RT),time-to-peak(TTP),peak intensity (PI) and so on were measured.According to the results of pathological findings and images,the patients were classified into PCa and benign prostatic hyperplasia(BPH) group.The pathological result was used as the dependent variable,the P ＜0.30 variables as independent variables,multivariate analysis was performed using Logistic regression,the statistically significant factors were used to establish a diagnosis model,construct ROC curve and calculate the area under the curve (AUC).Results Of total 152 patients,BPH accounted for 54.6 ％ (83/152),PCa accounted for 45.4 ％ (69/152).In the single factor analysis,the RT of TR-CEUS parameter in PCa group was lower than that in BPH group (P =0.021),and the PI was higher than that in BPH group (P =0.005).The single factor analysis of P ＜ 0.30 variables including age,volume,PSA,RT,PI,MTT,AUC and TTP eight variables were used in Logistic regression,the results showed that PSA,PI and AUC were independent risk factors in prediction PCa (P ＜0.05),established a diagnosis model.The area under ROC curve was 0.797 (P ＜0.001),the diagnosis model of boundary value was 0.383,the PCa forecast sensitivity was 77.9 ％,specificity was 79.5％,Youden index was 57.5 ％,the positive predictive value was 65.1％,and the negative predictive value was 81.5 ％.Conclusions In the TR-CEUS parameter,PI and AUC are independent predictors in prediction PCa,and the establishment of a diagnostic model combined with serum PSA has a certain clinical value in predicting PCa.

Correlation between peripheral nutrient artery and expression of C-erbB-2 in breast invasive ductal carcinoma / 中华超声影像学杂志

Objective To evaluate the relation between peripheral nutrient artery and expression of C-erbB-2 in breast invasive ductal carcinoma(IDC) . Methods The peak systolic velocity(PSV) and resistive index ( RI ) of peripheral nutrient artery of tumor in 122 cases with breast IDC and 138 cases with fibroadenoma which proved by operation and pathology were analyzed retrospectively . The C-erbB-2 was measured by immunohistochemical test ,according to the results of immunohistochemical examination ,the masses were divided into negative group( -) ,weakly positive group( + ) ,positive group( + + ) and strong positive group( + + + ) . The relationship between the classification of C-erbB-2 expression and the two factors of peripheral nutrient artery in breast tumor mass were analysed . Results The PSV of trophoblastic artery in IDC group was ( 20 .99 ± 8 .14 ) cm/s , RI 0 .66 ± 0 .07 , the PSV of trophoblastic artery in fibroadenoma group was (15 .56 ± 3 .68)cm/s ,RI 0 .66 ± 0 .07 ,there was significant statistically difference in peripheral nutrient artery of tumor between the breast IDC and fibroadenoma( P < 0 .001) . The RI and PSV of the peripheral nutrient artery in IDC were correlated to the classification of C-erbB-2 expression ( r=0 .323 ,0 .360 ,respectively) ,there was no correlation between the RI and PSV of peripheral nutrient artery in fibroadenoma and the classification of C-erbB-2 expression ( r = 0 .001 ) . Conclusions The spectrum form of peripheral nutrient artery in IDC is high speed and high resistance . The RI and PSV of the peripheral nutrient artery in IDC are correlated to the classification of C-erbB-2 expression .

Diagnostic value of virtual tough tissues quantification in discriminating breast benign and malignant solid tumor / 中华超声影像学杂志

Objective To evaluate the feasibility and the diagnostic value of virtual touch tissues quantification(VTQ) in discriminating breast benign and malignant solid tumors.Methods A total of 72 patients with 76 breast solid tumors and the normal glandular tissues were examined by means of VTQ technique.The reproducibility of VTQ values was analyzed with intraclass correlation coefficient (ICC).Compared with the pathologic diagnosis,the cut-off point of VTQ value was determined by receiver operating characteristic curve.Results All VTQ values measured in normal glandular tissue and solid tumors of patients were with good reproducibility.The cut off point of VTQ value was determined as 6.37 m/s,sensitivity was 96.3 ％,specificity was 91.8 ％ and accuracy was 93.4 ％.Conclusions It was stable for VTQ technique appling in breast,,which is a new quantitative and helpful method in discriminating breast benign and malignant solid tumors.

Dual plane ultrasonography study of anal canal / 中华超声影像学杂志

Objective To identify anal canal structures by dual plane transrectal ultrasound. Methods One anorectal specimen was observed by ultrasonography when needles were placed in different anal muscle layers respectively. Fifty patients with no anorectal or perianal diseases were examined by transrectal ultrasound to verify the sonographic features of anal canal, meanwhile the inner and outer sphincters and longitudinal combination muscle were measured. The ultrasound images of anal canal were compared with MR images. Fifty patients were divided into three groups according to the age: 25- 40 years old, 41 -55 years old,and ＞55 years old. Results The sonographic features of anal canal structures by transrectal ultrasound were identified. Anal canal sonographic images and MR images had consistency. The thickness of inner sphincter in each group was (0.19 ± 0.03)cm, (0.22 ± 0.02)cm, (0.24 ± 0.03)cm respectively,while outer sphincter (0.44 ± 0.03)cm, (0.49 ± 0.04)cm, (0.52 ± 0.04)cm, and longitudinal combination muscle (0.10±0.02)cm,(0.11 ± 0.02)cm,(0.11 ± 0.02)cm. Conclusions Transrectal ultrasound is a simple,efficient and non-invasive method to examine anal canal which can identify anal canal structures clearly.