Establishment and Verification of Benign and Malignant Prediction Model of Subcentimeter Pulmonary Ground Glass Nodules Based on HRCT / 中国肺癌杂志

BACKGROUND@#Pre-operative accuracy of subcentimeter ground glass nodules (SGGNs) is a difficult problem in clinical practice, but there are few clinical studies on the benign and malignant prediction model of SGGNs. The aim of this study was to help identify benign and malignant lesions of SGGNs based on the imaging features of high resolution computed tomography (HRCT) and the general clinical data of patients, and to build a risk prediction model.@*METHODS@#This study retrospectively analyzed the clinical data of 483 patients with SGGNs who underwent surgical resection and were confirmed by histology from the First Affiliated Hospital of University of Science and Technology of China from August 2020 to December 2021. The patients were divided into the training set (n=338) and the validation set (n=145) according to 7:3 random assignment. According to the postoperative histology, they were divided into adenocarcinoma group and benign lesion group. The independent risk factors and models were analyzed by univariate analysis and multivariate Logistic regression. The receiver operator characteristic (ROC) curve was constructed to evaluate the model differentiation, and the calibration curve was used to evaluate the model consistency. The clinical application value of the decision curve analysis (DCA) evaluation model was drawn, and the validation set data was substituted for external verification.@*RESULTS@#Multivariate Logistic analysis screened out patients' age, vascular sign, lobular sign, nodule volume and mean-CT value as independent risk factors for SGGNs. Based on the results of multivariate analysis, Nomogram prediction model was constructed, and the area under ROC curve was 0.836 (95%CI: 0.794-0.879). The critical value corresponding to the maximum approximate entry index was 0.483. The sensitivity was 76.6%, and the specificity was 80.1%. The positive predictive value was 86.5%, and the negative predictive value was 68.7%. The benign and malignant risk of SGGNs predicted by the calibration curve was highly consistent with the actual occurrence risk after sampling 1,000 times using Bootstrap method. DCA showed that patients showed a positive net benefit when the predictive probability of the predicted model probability was 0.2 to 0.9.@*CONCLUSIONS@#Based on preoperative medical history and preoperative HRCT examination indicators, the benign and malignant risk prediction model of SGGNs was established to have good predictive efficacy and clinical application value. The visualization of Nomogram can help to screen out high-risk groups of SGGNs, providing support for clinical decision-making.

Evaluation of Serum Prostate Specific Antigen in Benign and Malignant Enlargements of Prostate

Prostatic enlargement is a common cause of bladder outlet obstruction among men in India. The enlargement usually leads to lower urinary tract symptoms, irrespective of whether it is benign or malignant. Methods: Forty six patients attending surgical outpatient department of Hi-Tech Medical College, Rourkela with symptoms of bladder outflow obstruction and prostate enlargement were studied. Results: The maximum numbers of patient recruited in the study were in the age range of 56–65 years and 66–75 years, having 14 (30.4%) and 11 (23.9%) cases, respectively. Out of 31 cases which were categorized as malignant on the basis of the serum PSA levels, 27 were confirmed by histopathology & 4 cases which were diagnosed as malignant by serum PSA levels were confirmed as benign by histopathology. Categorization of the Prostatic lesions on the basis of the Sr P.S.A. levels, which were confirmed by CytoHPE the accuracy for BPH was 50% and 67.4 % for malignant lesions. Conclusion: Patients with symptomatic prostate enlargement, serum PSA should be seen as a continuum with increasing risk of prostate malignancy.

The analysis of chest,abdominal and pelvic primary occupying lesions by whole-body PET-like imaging / 实用放射学杂志

Objective To study the application value of 1.5T MRI whole-body PET-like imaging in the chest,abdominal and pelvic primary occupying lesions.Methods Whole-body PET-like imaging were performed in 5 7 patients with chest,abdominal and pelvic primary occupying lesions.The detection rate of whole-body PET-like in chest,abdominal and pelvis primary occupying lesions were compared.Apparent diffusion coefficient (ADC)values for benign and malignant lesions were compared and analyzed.Results (1) All of 71 cases of chest,abdominal and pelvic primary occupying lesions,67 lesions (94.4%)were diagnosed by whole-body PET-like imaging. Among them,31(93.9%)of malignant lesions were detected and 36(94.7%)benign lesions were detected.There was not statistically significant of detection rate between benign and malignant lesions(P>0.05).(2)The range of ADC value:malignant tumor was (0.83-1.57)× 10-3mm2/s,among which 27 lesions ADC value less than 1.1×10-3mm2/s,accounting for 87.1%;The benign lesion was (1.41-3.16)× 10-3mm2/s,among which the total 32 lesion ADC values of liver cyst(13),hepatic hemangioma(9)and renal cyst(10)were greater than 2.0×10-3mm2/s,accounting for 88.9%.There was significantly different of ADC values between benign and malignant lesions (P<0.05).Conclusion There is higher detection rate on primary chest,abdominal and pelvic space occupying lesions for whole-body PET-like imaging,which is suitable for tumor screening in healthy population.It is helpful to differentiate benign and malignant tumors by quantitative analysis of ADC value.

The correlation of pulmonary ground-glass opacity imaging features and benign,malignant lesions / 实用放射学杂志

Objective To analyze the imaging features of ground-glass opacity (GGO) and provide advice for early diagnosis and treatment of malignant lung lesions.Methods The imaging findings of 56 GGOs scanned by MSCT on thin layer scanning were analyzed by χ2 test.Multivariate Logistic regression analysis was performed of the statistically significant variables for univariate analysis.Results Smoothness of the boundary, uniformity of the internal density, and spiculated margin of the GGO lesions were closely related to the diagnosis of malignant lesions.However,size,shape and distribution of the lesions were limited.Conclusion The distribution of GGO(internal, middle and outer band), border, internal density and spiculation are playing important role in early diagnosis of benign and malignant GGO.

The value of DCE-MRI quantitative parameters in the differential diagnosis of hepatocellular carcinoma from benign liver tumors / 实用放射学杂志

Objective To study the values of quantitative parameters of DCE-MRI in diagnosis of benign and malignant liver tumors and to explore its diagnostic efficacy.Methods Consecutive 25 patients with benign or malignant liver tumors underwent plain scanning and dynamic contrast-enhanced MRI,and total 28 lesions were confirmed by pathology or follow-up.The DCE-MRI quantitative parameters (Ktrans ,Kep ,Ve and iAUC)of the lesions and the surrounding normal liver tissue were acquired.The inde-pendent sample t test was used to compare the quantitative parameters between different tumors.The optimal parameters values of benign and malignant liver tumors were determined by plotting ROC curves.Results The mean quantitative parameters of HCC and benign lesions were larger than those of the surrounding normal liver tissue.Ktrans ,Kep and iAUC between HCC and surrounding nor-mal liver tissue had significant differences (P <0.05),Ktrans and iAUC between benign lesions and surrounding normal liver tissue had a significant difference (P <0.05).Ktrans ,Kep and iAUC between HCC and benign lesions had significant differences (P <0.05). The diagnostic effectiveness of Ktrans = 0.21 5 min-1 ,with sensitivity of 81.3% and specificity of 66.7%,was greater than that of Kep =0.477 and iAUC=24.706.Conclusion The DCE-MRI quantitative analysis can provide a reference for the differential diagnosis of HCC from benign liver tumors.

FNAC of Head and Neck Swellings.

Background : Fine Needle Aspiration Cytology is simple, quick, inexpensive, majority are on OPD basis and minimally invasive technique used to diagnose different types of swellings located in the head and neck commonly originate from cervical lymph node, thyroid, salivary glands and soft tissues. Aim : To assess the frequency of incidences at different sites of head and neck region, and amongst the sex group. To assess distribution amongst inflammatory and neoplastic lesions. Methodology: A retrospective study was conducted at a tertiary care hospital, Ahmedabad from October 2013 to January 2014. Patients between the ages of 1 to 80 years were enrolled into the study. A total of 146 patients with a head and neck swelling underwent FNAC. Fine needle aspiration diagnosis was correlated with detail of relevant clinical findings and investigations. Results : Out of 146 fine needle aspiration procedures, 107 (73.29%) were of lymph nodes, 25 (17.12%) were of thyroid gland, 08 (5.48%) from soft tissue and 06 (4.11%) from salivary glands. Amongst lymph node swellings (73.29%), tuberculous involvement was seen in 73 cases (68.22%) with a female preponderance. Out of total 146 lesions, 109 (74.66%) were inflammatory, 29 (19.86%) were benign and 08 (5.48%) were malignant. Conclusions : The head and neck swellings are very common conditions encountered, with most of them being on OPD basis. Our study found that FNAC is simple, quick, inexpensive and minimally invasive technique to diagnose different types of head and neck swellings. It could differentiate the infective process from neoplastic one and avoids unnecessary surgeries. In case of neoplastic conditions, patient may be referred to Regional Cancer Centre.