Personalized radiomics signature to screen for KIT-11 mutation genotypes among patients with gastrointestinal stromal tumors: a retrospective multicenter study.

OBJECTIVES: Gastrointestinal stromal tumors (GISTs) carrying different KIT exon 11 (KIT-11) mutations exhibit varying prognoses and responses to Imatinib. Herein, we aimed to determine whether computed tomography (CT) radiomics can accurately stratify KIT-11 mutation genotypes to benefit Imatinib therapy and GISTs monitoring. METHODS: Overall, 1143 GISTs from 3 independent centers were separated into a training cohort (TC) or validation cohort (VC). In addition, the KIT-11 mutation genotype was classified into 4 categories: no KIT-11 mutation (K11-NM), point mutations or duplications (K11-PM/D), KIT-11 557/558 deletions (K11-557/558D), and KIT-11 deletion without codons 557/558 involvement (K11-D). Subsequently, radiomic signatures (RS) were generated based on the arterial phase of contrast CT, which were then developed as KIT-11 mutation predictors using 1408 quantitative image features and LASSO regression analysis, with further evaluation of its predictive capability. RESULTS: The TC AUCs for K11-NM, K11-PM/D, K11-557/558D, and K11-D ranged from 0.848 (95% CI 0.812-0.884), 0.759 (95% CI 0.722-0.797), 0.956 (95% CI 0.938-0.974), and 0.876 (95% CI 0.844-0.908), whereas the VC AUCs ranged from 0.723 (95% CI 0.660-0.786), 0.688 (95% CI 0.643-0.732), 0.870 (95% CI 0.824-0.918), and 0.830 (95% CI 0.780-0.878). Macro-weighted AUCs for the KIT-11 mutant genotype ranged from 0.838 (95% CI 0.820-0.855) in the TC to 0.758 (95% CI 0.758-0.784) in VC. TC had an overall accuracy of 0.694 (95%CI 0.660-0.729) for RS-based predictions of the KIT-11 mutant genotype, whereas VC had an accuracy of 0.637 (95%CI 0.595-0.679). CONCLUSIONS: CT radiomics signature exhibited good predictive performance in estimating the KIT-11 mutation genotype, especially in prediction of K11-557/558D genotype. RS-based classification of K11-NM, K11-557/558D, and K11-D patients may be an indication for choice of Imatinib therapy.

Effect of Suo Quan Wan on the bladder function of aging rats based on the ß-adrenoceptor.

Suo Quan Wan (SQW) has been used to treat lower urinary tract symptoms (LUTS) in elderly patients for hundreds of years in China. ß-adrenoceptors (ß-ARs), particularly ß3-adrenoceptor (ß3-AR), was reported to be important in the bladder dysfunction of the elderly. The present study was conducted to explore the effect of ß-AR, and particularly the ß3-adrenoceptor, in aging rat bladder function in vitro and to test the therapeutic effect of SQW on LUTS in an aging rat model based on the ß3-adrenoceptor. Briefly, the bladder detrusor muscles of young (age, 3 months) and aging (age, 15 months) female rats were separated. A ß-AR non-selective agonist, isoprenaline (ISO), subtype ß3-AR agonist (BRL37344A) and ß3-AR antagonist (SR59230A) were used to define the tension change of detrusor muscles between young and aging rats in vitro. For blank controls, 12 young rats were marked, and 48 aging female rats were randomly divided into four groups as follows: Model, SQW high, SQW middle and SQW low. Following oral administration of SQW for 6 weeks in aging rats, urodynamic and bladder detrusor tests were used to evaluate the therapeutic effect of SQW. The expression of ß3-AR mRNA was investigated using reverse transcription-quantitative polymerase chain reaction. Using ISO and BRL37344A in vitro, maximum relaxation (Emax), intrinsic activity (IA), and log (50% effective concentration) (PD2) were significantly decreased in aging rats compared with that in young rats (P<0.05). Significant changes were also observed in the ß3-AR antagonist experiment, which blocked ISO-induced relaxation, with significant decreases observed in Emax, IA and PD2, and a significant increase observed in PA2 for the aging rats compared with the young controls (P<0.05). SQW was demonstrated to enhance bladder control, storage and contraction ability. Furthermore, SQW was able to increase the sensitivity and expression of ß3-AR in an aging rat. In conclusion, the decrease in ß3-AR sensitivity in aging rats and the expression resulted in bladder detrusor dysfunction. In addition, the therapeutic effect of SQW against LUTS relies on the former's effect on the urethral sphincter, bladder detrusor and ß3-AR.

Objective assessment of transcatheter arterial chemoembolization angiographic endpoints: preliminary study of quantitative digital subtraction angiography.

PURPOSE: To explore the significance of quantitative digital subtraction angiography (DSA; Q-DSA) in the assessment of chemoembolization endpoints. MATERIALS AND METHODS: Twenty patients with hepatocellular carcinoma treated with chemoembolization were included in the study. All DSA series before and after chemoembolization were postprocessed with Q-DSA. The maximal enhancement and time to peak (TTP) were measured for several homologous anatomic landmarks, including the origin and embolized site of the tumor-feeding artery, parenchyma of the tumor, and ostia of the pre- and postprocedure catheter. The TTP, tumor blood supply time, and maximal enhancement of the time density curve (TDC) were analyzed. RESULTS: Of the 20 DSA series collected, 18 were successfully postprocessed. The TTPs of the landmarks before and after treatment were 3.60 seconds±1.02 and 3.57 seconds±0.78 at the ostia of the catheter, 3.91 seconds±1.01 and 4.09 seconds±1.14 at the origin site of the tumor-feeding artery, and 4.07 seconds±1.02 and 5.60 seconds±1.56 s the embolized site of the main tumor-feeding artery, respectively. Statistical differences were detected between pre- and postprocedural TTP of the embolized site of the feeding artery (P<.01), as well as between pre- and postprocedural tumor blood supply time (P<.01). The mean maximal TDC enhancements of selected tumor spots were 3.01 units±1.04 and 0.81 units±0.35 before and after the procedure (P<.01), respectively. CONCLUSIONS: Q-DSA may provide a feasible quantitative measurement in the assessment of chemoembolization endpoints.

Pulmonary CT findings in relapsing polychondritis.

BACKGROUND: Relapsing polychondritis (RPC) is a rare rheumatic disease characterized by recurrent inflammation of cartilaginous structures, with airway involvement a major cause of morbidity and mortality. PURPOSE: To retrospectively evaluate airway and lung abnormalities in RPC with computed tomography (CT). MATERIAL AND METHODS: From January 2004 to May 2009, 21 patients with RPC (12 men, 9 women; 13-65 years old) underwent chest CT examinations. Two chest radiologists evaluated the CT images retrospectively. Abnormal findings, including airway stenosis, airway malacia, air trapping, and airway wall thickening with or without calcifications, were observed and noted. RESULTS: Major abnormal CT findings were observed in eight patients (38.1%), which included airway wall thickening (n=7), airway stenosis (n=6), airway malacia (n=6), airway wall calcification (n=8), and air trapping (n=3). Mediastinal lymph nodes were found in 12 patients. Lung infection was identified in four patients and interstitial lung disease in six patients. CONCLUSION: The CT findings in patients with RPC consisted mainly of airway wall thickening, airway stenosis, airway malacia, airway wall calcification, and air trapping.

Nonalcoholic fatty liver disease: quantitative assessment of liver fat content by computed tomography, magnetic resonance imaging and proton magnetic resonance spectroscopy.

OBJECTIVE: The purpose of this study was to evaluate the clinical application of imaging technology in the quantitative assessment of fatty liver with magnetic resonance imaging (MRI) and proton MR spectroscopy. METHODS: Overall 36 patients with diffuse fatty liver who had undertaken the computed tomography (CT) scan, MRI and proton MR spectroscopy (1H MRS) were analyzed. Their body mass index (BMI) was measured and their liver to spleen CT ratio (L/S) calculated on the plain CT scan. MR T1-weighted imaging (T1WI) was obtained with in-phase (IP) and out-of-phase (OP) images. T2-weighted imaging (T2WI) was acquired with or without the fat-suppression technique. The liver fat content (LFC) was quantified as the percentage of relative signal intensity loss on T1WI or T2WI images. The intrahepatic content of lipid (IHCL) was expressed as the percentage of peak value ratio of lipid to water by 1H MRS. RESULTS: The results of BMI measurement, CT L/S ratio, LFC calculated from MR T1WI and T2WI images, as well as IHCL measured by 1H MRS were 27.26 +/- 3.01 kg/m2, 0.88 +/- 0.26, 13.80 +/- 9.92%, 40.67 +/- 16.04% and 30.98 +/- 20.43%, respectively. The LFC calculated from MR T1WI, T2WI images and IHCL measured by 1H MRS correlated significantly with the CT L/S ratio (r = -0.830, P = 0.000; r = -0.736, P = 0.000; r = -0.461, P = 0.005, respectively). BMI correlated significantly only with the liver fat contents measured by T1WI IP/OP and 1H MRS (r = -0.347, P = 0.038; r = -0.374, P = 0.025, respectively). CONCLUSION: CT, MR imaging and 1H MRS were effective methods for the quantitative assessment of LFC. The MR imaging, especially 1H MRS, would be used more frequently in the clinical evaluation of fatty liver and (1)H MRS could more accurately reflect the severity of fatty liver.