Comparison of setup errors in supraclavicular regions of lung and esophageal cancer treated with radiotherapy / 中华放射肿瘤学杂志

Objective:To compare the setup errors in the supraclavicular regions of two different postures (arms placed on each side of the body, namely the body side group; arms crossed and elbows placed above forehead, namely the uplifted group) using the chest and abdomen flat frame fixation device in lung and esophageal cancer.Methods:Clinical data of patients with stage Ⅰ to Ⅳ lung or esophageal cancer who received three-dimensional radiotherapy with chest and abdomen flat frame fixation device in our institution from November 2020 to April 2021 were retrospectively analyzed. The setup errors of two postures were compared.Results:A total of 56 patients were included, including 31 patients (55%) in the body side group and 25 patients (45%) in the uplifted group. A total of 424 CBCTs were performed in the whole group. The overall setup errors in the X, Y and Z directions were similar in both groups ( P>0.05). The setup errors of sternoclavicular joint in the X and RZ directions in the body side group were significantly smaller than those in the uplifted group [(0.163±0.120) cm vs. (0.209 ±0.152) cm, P=0.033; 0.715°±0.628° vs. 0.910°±0.753°, P=0.011]. The setup errors of acromioclavicular joint in the Y, Z and RZ directions in the body side group were significantly smaller than those in the uplifted group [(0.233±0.135) cm vs. (0.284±0.193) cm, P=0.033; (0.202±0.140) cm vs. (0.252±0.173) cm, P=0.005; 0.671°±0.639° vs. 0.885°±0.822°, P=0.023]. The margins of target volume for setup errors were smaller in the X (0.45 cm vs. 0.54 cm) and Y (0.54 cm vs. 0.65 cm) directions of the sternoclavicular joint, as well as in the Y (0.59 cm vs. 0.78 cm) and Z directions (0.53 cm vs. 0.72 cm) of the acromioclavicular joint in the body side group. Conclusions:For lung and esophageal cancer patients requiring supraclavicular irradiation, the body side group yields smaller setup errors and corresponding margins of target volume than the uplifted group. In clinical practice, it is necessary to take comprehensive consideration of the accuracy of radiotherapy and additional radiation of the limbs to select appropriate posture.

Application of MR fingerprinting technology in medical imaging / 中国介入影像与治疗学

MR fingerprinting (MRF) is a technology which can be used to quickly get quantitative images and post processing.The program of signal acquisitions,post-processing and virtualization of MRF are innovatively designed,being able to obtain a highly repeatable and multi-parametric quantification map in one scanning.MRF has shown various advantages,such as short scanning time,high fault tolerance and easy recognition of image data with computer,therefore having broad prospect in clinical application.The research progresses of MRF were reviewed in this article.

Value of conventional and functional MRI in the diagnosis of orbit solitary fibrous tumor / 实用放射学杂志

Objective To evaluate the value of conventional and functional MRI in the diagnosis of orbital solitary fibrous tumor (SFT).Methods MR images of 8 patients with pathologically confirmed orbital SFT were analyzed retrospectively.The lesion shape, size,location and signal features on conventional MRI were evaluated.Apparent diffusion coefficient(ADC)values and DCE-MRI parameters(time-signal intensity curve pattern,maximum ratio of enhancement and washout ratio)were calculated.Results The majority of tumors(6/8)showed regular shape with maximum diameters varying from 2.5 cm to 3.7 cm.Of 8 cases,there was 1 case in intraconal space,2 cases involved with intra and extraconal space,5 cases in extraconal space.On T1WI,all lesions demonstrated isointense to gray matter.On T2WI,5 lesions showed isointensity and 3 lesions showed slight hypointensity,of which 6 cases showed heterogeneous signal.After contrast enhancement,8 lesions showed marked enhancement.Plateau pattern of time-signal intensity curve was observed in 6 cases with maximum ratio of enhancement of 1.37 ± 0.54 and washout ratio of 6.58% ± 3.66%.Mean ADC value was(1.28 ± 0.25)×10-3mm2/s.Conclusion Combination of conventional MRI,DWI and DCE-MRI can assist the diagnosis of orbital SFT.

Predictive value of lipoprotein-associated phospholipase A2 on risk of cerebral infarction occurrence after transient ischemic attack / 国际检验医学杂志

Objective To investigate the predictive value of plasma lipoprotein associated phospholipase A 2 (Lp-PLA2 ) in cere-bral infarction(CI) after transient cerebral ischemia attack (TIA).Methods Plasma Lp-PLA2 level was detected in 112 TIA pa-tients ,and the incidence rate of CI was observed on 7 ,30 ,90 d after TIA.Then the grouping was performed according to the Lp-PLA2 level ,and the predictive value of Lp-PLA2 in the risk of CI occurrence after TIA was evaluated.Results Among 112 patients with TIA ,27 cases (24.1% ) developed CI within 90 d;there were 17 cases(63.0% ) of CI after TIA in the Lp-PLA2 >207 μg/L group ,which were significantly higher than that in the 175-207 μg/L group and <175 μg/L group (P<0.05);moreover the CI occurrence in TIA patients was mainly concentrated within 7 d after onset ;the patients of Lp-PLA2 ≥175μg/L were mainly distrib-uted in the moderate and high risk groups of ABCD2 score system ;in ROC curve of Lp-PLA2 for predicting CI after TIA ,with Lp-PLA2 ≥194 μg/L as the diagnostic critical point ,the sensitivity was 0.730 and specificity was 0.680.Conclusion Lp-PLA2 may be an effective risk predictive indicator of CI occurrence after TIA ,and can improve the adverse outcome of TIA patients.

Analysis on correlation between lipoprotein associated phospholipase A2,D-dimer and antithrombin Ⅲ with acute cerebral infarction / 国际检验医学杂志

Objective To investigate the levels of lipoprotein associated phospholipase A2(Lp-PLA2),D-dimer(D-D),antithrombin Ⅲ (AT Ⅲ) in acute cerebral infarction (ACI)patients,and to analyzed their correlation with ACI.Methods Sixty-nine patients with ACI(ACI group) and 40 individuals undergoing healthy physical examination(control group) were selected in this study.The levels of Lp-PLA2,D-D and ATⅢ were compared between the two groups and their positive rates were statistically analyzed.Then the correlation between Lp-PLA2,D-D and ATⅢ with ACI was analyzed.Results The levels of Lp-PLA2 and D-D in the ACI group were higher than those in the control group,while the ATⅢ level was lower than that in the control group(P<0.05).Their positive rates in the ACI group were higher than those in the control group (P<0.05).Lp-PLA2,D-D and ATⅢ were correlated with ACI occurrence and had mutual correlation (all P<0.05).Conclusion Lp-PLA2,D-D and AT Ⅲ participate in the occurrence process of ACI,and their detection can be applied to screen out ACI high-risk groups,and may guide early prevention and early diagnosis of ACI.

Analysis on value of combined detection of Hcy,hs-CRP and Lp-PLA2 in diagnosis of ischemic cerebral stroke / 国际检验医学杂志

Objective To analyze the significance of levels and combined detection of plasma homocysteine(Hcy),high-sensitivity C reactive protein(hs-CRP) and lipoprotein-associated phospholipase A2(Lp-PLA2) in patients with ischemic cerebral stroke(ICS).Methods A total of 140 patients with ICS were selected into ICS group,and 100 healthy individuals were recruited in the control group.The plasma levels of Hcy,hs-CRP,Lp-PLA2 were examined,then the positive rates of them were statistically analyzed.Analyzed the value of the levels and joint detection of Hcy,hs-CRP and Lp-PLA2.Results The plasma levels and the positive rates of Hcy,hs-CRP and Lp-PLA2 in ICS group were statistically higher than those in the control group(P<0.05).The area under the receiver-operating characteristic curve of combined detection of Hcy,hs-CRP and Lp-PLA2 in diagnosis of ICS was 0.949,the sensitivity was 0.850,and the specificity was 0.807,which were higher than Hcy,hs-CRP and Lp-PLA2 alone.Conclusion The plasma levels of Hcy,hs-CRP and Lp-PLA2 increase in ICS patients,and the combined detection of the three indicators might improve the early diagnostic value of ICS.

MRI texture analysis in differential diagnosis of orbital lymphoma and inflammatory pseudotumor / 中国医学影像技术

Objective To discuss the application value of texture analysis of conventional MRI in differential diagnosis of orbital lymphoma from inflammatory pseudotumor.Methods The conventional MRI data of 15 patients with lymphoma and 17 patients with inflammatory pseudotumor proven by pathology or clinical follow-up were retrospectively reviewed.The texture features of lesions based on axial T1WI,fat-saturated T2WI and contrast enhanced fat-saturated T1WI were extracted by manually drawn ROIs with software MaZda.The subsets of optimized texture parameters were chosen by four different methods:Fisher coefficient,probability of classification error and average correlation coefficient (POE+ ACC),mutual information measure (MI) and the combination of the above three methods (FPM),respectively.Linear discriminant analysis (LDA) and nonlinear discriminant analysis (NDA) were performed for texture classification.The texture features from the sequence with the best classification result of orbital lymphoma and inflammatory pseudotumor were compared.Results The optimal texture parameters were mainly derived from co occurrence matrix and run-length matrix on T1WI and T2WI.The optimal texture parameters were mainly derived from co-occurrence matrix and histogram on contrast enhanced T1WI.The best classification of MRI texture was obtained within T2WI with lowest classification error of 1.56％ achieved by FPM in combination with NDA.Comparing the texture parameters of orbital lymphoma and inflammatory pseudotumor on T2WI,the angular second moment and long length emphasis were significantly higher in orbital lymphoma (both P＜0.005),while the entropy and short length emphasis were significantly lower in orbital lymphoma (both P＜0.005).Conclusion It is feasible to use texture analysis on conventional MRI for the differentiation of orbital lymphoma and inflammatory pseudotumor.