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The histopathological growth pattern (HGP) of colorectal cancer liver metastasis (CRLM) is correlated with the prognosis of patients. Patients with desmoplastic HGP have a better prognosis. The latest international scoring guidelines have modified the cut-off value of HGP, and divides it into two types: complete desmoplastic HGP and incomplete desmoplastic HGP. However, the relationship between the HGPs and the treatment response to systemic treatment is still unclear. It is necessary to develop non-invasive methods to evaluate changes in HGP during treatment in the future. This paper reviews the new scoring consensus and clinical applications of HGP in CRLM.
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Objective To evaluate the value of DWI in assessing the biological characteristics of breast invasive ductal carcinoma (IDC).Methods Eighty-seven IDC lesions confirmed by postoperative pathology were involved in this retrospective study.The ADC values of IDC were compared among different lymph node status,grades,and molecular subtype.The correlations of ADC value and lymph node status,grades,and molecular subtype were evaluated.Results The ADC value of IDC with positive lymph node was lower than that with negative lymph node (P=0.035),and the ADC value of the high grade IDC was lower than those of medium grade IDC and low grade IDC (P=0.021,0.002).There was no significant difference of ADC value between different molecular subtypes.There was low negative correlation of ADC value with grades (r.s =-0.357,P 0.001) and week negative correlation of ADC value lymph node status and nolecular subtype (rs =-0.227,P=0.034;rs-0.093,P＜0.001).Conclusion DWI can provide useful information in evaluating the biological characteristics of IDC.
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Objective To investigate the diagnostic values of radiomics model based on ADC map in differentiating benign from malignant lesions in suspicious breast findings with MRI breast imaging reporting and data system (BI-RADS) category 4. Methods Eighty eight patients (36 benign and 52 malignant)with diagnosis of MRI BI-RADS 4 in our hospital from December 2014 to December 2015 were retrospectively enrolled in this study.All the patients were proved by pathology and examined by sequence of T1WI,T2WI,DWI and dynamic contrast enhanced magnetic resonance imaging(DCE-MRI),and then were further sub-categorized into BI-RADS 4A, BI-RADS 4B, or BI-RADS 4C based on DCE-MRI sequence. Thus positive predictive value(PPV)of each sub-category were calculated and ROC were used to describe its efficiency in differential diagnosis.Radiomics features based on ADC map were generated automatically from Analysis-Kinetics(GE Healthcare).Sixty three of the 88 cases randomized-selected by computer were used to establish forecasting models and other 25 cases for validation. Kruskal-Wallis test and Spearman were introduced to reduce radiomics features that were highly correlated with others. Logistic linear regression(LLR)model was constructed based on the selected features by'glm'function in R software and then verified by 10-fold cross validation (repeat 10 times). ROC was curved to determine the diagnostic accuracy of the model.Results The PPV of BI-RADS 4A,4B,4C were 16.7%(2/12),59.6%(28/47),75.9% (22/29)respectively.Area under curve(AUC)of ROC was 0.650,sensitivity and specificity were 76.9% and 45.9% respectively. Three hundred and ninety six radiomics features were extracted automatically by software and 5 features (size zone variability, difference entropy, zone percentage, intensity variability and inverse difference moment)were left after redundancy reduction step.Cross-validation showed the accuracy of Logistic regression model was 80.0%(20/25),AUC was 0.790,sensitivity and specificity were 81.3% and 77.8% when cut-off was 0.45. Conclusion The radiomics model could provide important reference for differentiation between benign and malignant lesions in suspicious BI-RADS 4 findings.
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ObjectiveTo assess the diagnostic value of dual-energy dual-source CT in detecting the enhancement ofhepatocellularcancer( HCC )aftertransarterialchemoembolization( TACE )treatment.Methods Twenty-seven patients with HCC underwent dual-energy dual-source CT including nonenhanced,arterial,portal,and delayed phases scanning after TACE treatment.Arterial phases were acquired with the dual-energy mode for reconstruction of virtual nonenhanced images and color overlay images.DSAs were performed in all these patients.Two blinded and independent readers evaluated the data in 2 reading sessions:standard nonenhanced,arterial phase,portal phase,and delayed phase images were read in session A,and virtual nonenhanced,arterial phase,portal phase,and delayed phase images in session B.Sensitivity and specificity were calculated,with the DSA data set as the reference standard.The sensitivity and specificity were compared with Chi-square test.Results DSA revealed 63 lesions in 27 patients,and 39 of them had blood supply.Overall sensitivity and specificity were 74.4％ (29/39) and 83.3％ (20/24) for session A,and 94.9％ (37/39),95.8％ (23/24) for session B,respectively.The sensitivity of the two reading sessions was significantly different (x2 =6.303,P ＜ 0.05 ),while the specificity was insignificantly different ( x2 =2.009,P ＞ 0.05 ).Conclusion Compared with standard dynamic protocols,an arterial dual-energy dual-source CT scan with reconstruction of virtual nonenhanced and color overlay images enables detection of relapse and intrahepatic metastasis of HCC after TACE treatment with higher accuracy.