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Triazole fungicides, such as difenoconazole (DFZ), are frequently used to control fungus in crops that pollute water. The common carp (Cyprinus carpio) (hereafter referred to as "carp") is an excellent bio-indicator of water quality. The seeds of the silymarin plant contain a flavonolignan called silybin (SYB), which is used to treat liver disease. To explore SYB's involvement in DFZ-triggered kidney damage in carps, an H&E assay was conducted, and ROS level was also examined. The results demonstrated that SYB alleviated DFZ-induced destruction of kidney tissue structure in carps, as well as alleviating the elevation of kidney ROS level in carps. RT-qPCR and Western blot were used to detect inflammation-, oxidative stress- and apoptosis-related factors at mRNA level and protein level. The experimental findings indicated that relative to the DFZ group, SYB + DFZ co-treatment reduced inflammation-related mRNA level of il-6, il-1ß and tnf-α, elevated mRNA level of il-10. It also reduced protein expression levels of NF-κB and iNOS. In addition, SYB + DFZ co-treatment reduced DFZ-induced increase in the oxidative stress-related mRNA indicators sod and cat, and decreased the protein expression levels of Nrf2 and NQO1. SYB reduced the DFZ-induced increase in pro-apoptotic gene Bax mRNA and protein expression levels and the DFZ-induced decrease in anti-apoptotic gene Bcl-2 mRNA and protein expression levels. In summary, SYB potentially mitigates DFZ-induced kidney damage in carp by addressing inflammation, oxidative stress, and apoptosis. Our results establish a theoretical foundation for the clinical advancement of freshwater carp feeds.
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Apoptosis , Carpas , Inflamación , Estrés Oxidativo , Silibina , Triazoles , Animales , Carpas/inmunología , Estrés Oxidativo/efectos de los fármacos , Apoptosis/efectos de los fármacos , Triazoles/farmacología , Inflamación/veterinaria , Inflamación/tratamiento farmacológico , Inflamación/inducido químicamente , Silibina/farmacología , Silibina/administración & dosificación , Fungicidas Industriales/farmacología , Enfermedades de los Peces/inmunología , Enfermedades de los Peces/inducido químicamente , Dioxolanos/farmacología , Riñón/efectos de los fármacos , Riñón/inmunología , Riñón/patología , Enfermedades Renales/veterinaria , Enfermedades Renales/inducido químicamente , Enfermedades Renales/inmunología , Enfermedades Renales/tratamiento farmacológicoRESUMEN
The development of high-throughput technologies has enhanced our understanding of small non-coding RNAs (sncRNAs) and their crucial roles in various diseases, including atrial fibrillation (AF). This study aimed to systematically delineate sncRNA profiles in AF patients. PANDORA-sequencing was used to examine the sncRNA profiles of atrial appendage tissues from AF and non-AF patients. Differentially expressed sncRNAs were identified using the R package DEGseq 2 with a fold change >2 and p < 0.05. The target genes of the differentially expressed sncRNAs were predicted using MiRanda and RNAhybrid. Gene Ontology (GO) categories and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses were performed. In AF patients, the most abundant sncRNAs were ribosomal RNA-derived small RNAs (rsRNAs), followed by transfer RNA-derived small RNAs (tsRNAs), and microRNAs (miRNAs). Compared with non-AF patients, 656 rsRNAs, 45 miRNAs, 191 tsRNAs and 51 small nucleolar RNAs (snoRNAs) were differentially expressed in AF patients, whereas no significantly differentially expressed piwi-interacting RNAs were identified. Two out of three tsRNAs were confirmed to be upregulated in AF patients by quantitative reverse transcriptase polymerase chain reaction, and higher plasma levels of tsRNA 5006c-LysCTT were associated with a 2.55-fold increased risk of all-cause death in AF patients (hazard ratio: 2.55; 95% confidence interval, 1.56-4.17; p < 0.001). Combined with our previous transcriptome sequencing results, 32 miRNA, 31 snoRNA, 110 nucleus-encoded tsRNA, and 33 mitochondria-encoded tsRNA target genes were dysregulated in AF patients. GO and KEGG analyses revealed enrichment of differentially expressed sncRNA target genes in AF-related pathways, including the 'calcium signaling pathway' and 'adrenergic signaling in cardiomyocytes.' The dysregulated sncRNA profiles in AF patients suggest their potential regulatory roles in AF pathogenesis. Further research is needed to investigate the specific mechanisms of sncRNAs in the development of AF and to explore potential biomarkers for AF treatment and prognosis.
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Apéndice Atrial , Fibrilación Atrial , Perfilación de la Expresión Génica , ARN Pequeño no Traducido , Humanos , Fibrilación Atrial/genética , ARN Pequeño no Traducido/genética , Apéndice Atrial/metabolismo , Masculino , Femenino , MicroARNs/genética , Ontología de Genes , Anciano , Persona de Mediana Edad , ARN Nucleolar Pequeño/genética , ARN Nucleolar Pequeño/metabolismo , Regulación de la Expresión Génica , Transcriptoma/genética , Biología Computacional/métodos , PronósticoRESUMEN
Autonomic dysfunction (AutD) is common and debilitating in Parkinson's disease (PD). Predictors of AutD are unclear, and data are limited on the biological relevance of AutD in PD. Here, we evaluated the baseline prevalence and 2-year longitudinal assessment of AutD in patients with de novo PD compared with healthy controls (HC). Moreover, we also assessed various variables that could predict longitudinal changes in AutD in early PD. Parkinson's Progression Markers Initiative (PPMI) was utilized to evaluate untreated PD participants at baseline and HC. Autonomic function was assessed using the 25-item Scale for Outcomes in Parkinson's Disease-Autonomic (SCOPA-AUT) score at baseline and 2 years. Clinical and biological variables were measured for their correlations with AuD for up to 2 years. Two hundred and ninety PD subjects and 170 HC were enrolled and followed for 2 years. SCOPA-AUT mean (SD) scores increased from baseline 8.49 ± 5.23 to 10.12 ± 5.77 at year 2 in PD subjects (p < 0.001) versus from 4.98 ± 3.34 to 5.03 ± 374 in HC (p = 0.496), with a significant difference between the groups (p < 0.001). Among them, 242 PD participants and 151 HC completed the SCOPA-AUT assessment, including sexual function. In the multivariate analysis, a higher baseline SCOPA-AUT score was associated with higher baseline MDS-UPDRS Part I scores (p < 0.001). Moreover, a longitudinal increase in autonomic function severity was associated with the white race (p = 0.010) at baseline. In contrast, there was no association with the CSF biomarkers. MDS-UPDRS Part I score may predict AuD in patients with early PD, which is correlated with nonmotor symptoms and race.
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Enfermedades del Sistema Nervioso Autónomo , Enfermedad de Parkinson , Humanos , Enfermedad de Parkinson/complicaciones , Enfermedad de Parkinson/diagnóstico , Enfermedad de Parkinson/epidemiología , Prevalencia , Enfermedades del Sistema Nervioso Autónomo/diagnóstico , Enfermedades del Sistema Nervioso Autónomo/epidemiología , Enfermedades del Sistema Nervioso Autónomo/etiología , Sistema Nervioso Autónomo , BiomarcadoresRESUMEN
BACKGROUND: Eosinophilic granulomatosis with polyangiitis (EGPA), formerly known as Churg-Strauss syndrome, is a rare form of anti-neutrophil cytoplasmic antibody-associated vasculitis characterized by asthma, vasculitis, and eosinophilia. CASE SUMMARY: We report an atypical case of EGPA in a 20-year-old female patient. Unlike previously reported cases of EGPA, this patient's initial symptom was asthma associated with a respiratory infection. This was followed by Loeffler endocarditis and cardiac insufficiency. She received treatment with methylprednisolone sodium succinate, low molecular weight heparin, recombinant human brain natriuretic peptide, furosemide, cefoperazone sodium/sulbactam sodium, and acyclovir. Despite prophylactic anticoagulation, she developed a large right ventricular thrombus. EGPA diagnosis was confirmed based on ancillary test results and specialty consultations. Subsequent treatment included mycophenolate mofetil. Her overall condition improved significantly after treatment, as evidenced by decreased peripheral blood eosinophils and cardiac markers. She was discharged after 17 d. Her most recent follow-up showed normal peripheral blood eosinophil levels, restored cardiac function, and a reduced cardiac mural thrombus size. CONCLUSION: This case illustrates the swift progression of EGPA and underscores the significance of early detection and immediate intervention to ensure a favorable prognosis.
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Objective: Post-stroke cognitive impairment (PSCI) is secondary to stroke, and is a significant burden for patients, their families and society as a whole. Our study aimed to investigate the predictive value of ß-amyloid 42 (Aß42) and hemoglobin (Hb) in the diagnosis of PSCI. Methods: 120 patients were selected and then assigned to either the PSCI group, Alzheimer's disease (AD) group or post-stroke cognitive normal (PSCN) group. Baseline data were recorded. Correlation between Aß42 and Hb and cognitive scores was evaluated. Then, the ability of these indicators to predict PSCI was compared based on logistic regression analysis and ROC curve. Results: Aß42 and Hb in the PSCI group were lower than in the AD and PSCN groups (P < .05). Compared with AD, hypertension (HTN) and Hb were independent risk factors for PSCI (P < .05), and Aß42 was a relevant risk factor for PSCI (P = .063). Compared with PSCN, age and Hb posed a threat to the occurrence of PSCI (P < .05). Under the ROC curve, the area under the curve (AUC) of the joint diagnosis of Aß42 and Hb was 0.7169, specificity was 0.625 and sensitivity reached 0.800. Conclusion: Aß42 and Hb in patients with PSCI were significantly lower than in the AD and PSCN groups, and were risk factors for PSCI. When the two are combined, the differential diagnosis performance may be improved.
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Disfunción Cognitiva , Accidente Cerebrovascular , Humanos , Disfunción Cognitiva/diagnóstico , Disfunción Cognitiva/etiología , Accidente Cerebrovascular/complicaciones , Accidente Cerebrovascular/diagnóstico , Accidente Cerebrovascular/epidemiología , Factores de RiesgoRESUMEN
PURPOSE: To investigate the effectiveness of simultaneous multislice (SMS) accelerated readout-segmented echo planar imaging (RESOLVE) DWI for assessing rectal cancer in the clinic. METHOD: Sixty consecutive histologically proven rectal cancer patients were enrolled. They all received MRI examinations, including both SMS-RESOLVE and RESOLVE sequences. Two readers visually assessed the overall image quality, distinction of anatomical structures, lesion conspicuity, and artifacts of two sequences by using a qualitative 4-point Likert scale. The quantitative ADC value, lesion contrast, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) and temporal SNR (tSNR) were independently calculated in rectal cancer on the largest slice of the tumor. RESULTS: The scan time was shortened from 3 min and 50 s to 1 min and 47 s. The interobserver agreement of visual and quantitative assessments between the two readers was good overall. There were no differences in overall image quality, lesion conspicuity or artifact scores between the two sequences in both readers (all p > 0.05). The lesion contrast (p = 0.013) was significantly higher in SMS-RESOLVE, and the CNR was similar in the two DWIs. The scores of distinctions of anatomical structures in SMS-RESOLVE were lower (all p < 0.05) in both readers. The SNR of SMS-RESOLVE was lower than that of RESOLVE (p = 0.004), and the tSNR of SMS-RESOLVE was significantly higher (p < 0.001). The ADC value of the tumor was lower in SMS-RESOLVE (p = 0.001), but the ADC values of the normal rectal wall showed no difference between the two DWIs. CONCLUSION: SMS-RESOLVE allowed a substantial reduction in acquisition time while maintaining overall image quality and lesion conspicuity in rectal cancer. It also had a higher contrast of the lesion and a higher temporal SNR.
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Imagen Eco-Planar , Neoplasias del Recto , Humanos , Imagen Eco-Planar/métodos , Reproducibilidad de los Resultados , Relación Señal-Ruido , Neoplasias del Recto/diagnóstico por imagen , Imagen de Difusión por Resonancia Magnética/métodosRESUMEN
A novel label-free point-of-care quartz crystal microbalance (QCM) aptasensing platform based on metal-organic frameworks (MOFs) and gold nanoparticles (AuNPs) was fabricated for tetracycline (TC) detection. MOFs (HKUST-1) and AuNPs were modified onto the sensing interface of QCM sensor to enhance the sensing performance of the QCM aptasensor. TC aptamer with sulfhydryl group was fixed through Au-S bond. The recognition performance of the aptasensor was predicted and verified by the computer simulation. At the optimal conditions, the frequency change of the sensor was adopted for quantitative detection of TC. The prepared QCM aptasensor exhibited a wide linear range from 1 × 10-10 g mL-1 to 1 × 10-5 g mL-1 with low limit of detection (0.8 × 10-11 g mL-1). High sensitivity, good selectivity, acceptable recoveries (87.6-91.4%) in real samples were obtained. For the first time, MOFs were utilized in the construction of QCM aptasensing platform, providing a promising application way of MOFs in the QCM sensing.
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Técnicas Biosensibles , Nanopartículas del Metal , Estructuras Metalorgánicas , Simulación por Computador , Oro/química , Límite de Detección , Nanopartículas del Metal/química , Sistemas de Atención de Punto , Tecnicas de Microbalanza del Cristal de Cuarzo , TetraciclinaRESUMEN
PURPOSE: To develop a bounding box (BBOX)-based radiomics model for the preoperative diagnosis of occult peritoneal metastasis (OPM) in advanced gastric cancer (AGC) patients. MATERIALS AND METHODS: 599 AGC patients from 3 centers were retrospectively enrolled and were divided into training, validation, and testing cohorts. The minimum circumscribed rectangle of the ROIs for the largest tumor area (R_BBOX), the nonoverlapping area between the tumor and R_BBOX (peritumoral area; PERI) and the smallest rectangle that could completely contain the tumor determined by a radiologist (M_BBOX) were used as inputs to extract radiomic features. Multivariate logistic regression was used to construct a radiomics model to estimate the preoperative probability of OPM in AGC patients. RESULTS: The M_BBOX model was not significantly different from R_BBOX in the validation cohort [AUC: M_BBOX model 0.871 (95% CI, 0.814-0.940) vs. R_BBOX model 0.873 (95% CI, 0.820-0.940); p = 0.937]. M_BBOX was selected as the final radiomics model because of its extremely low annotation cost and superior OPM discrimination performance (sensitivity of 85.7% and specificity of 82.8%) over the clinical model, and this radiomics model showed comparable diagnostic efficacy in the testing cohort. CONCLUSIONS: The BBOX-based radiomics could serve as a simpler reliable and powerful tool for the preoperative diagnosis of OPM in AGC patients. And M_BBOX-based radiomics is simpler and less time consuming.
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Gut microbiota is closely related to the Parkinson's disease (PD) pathogenesis. Additionally, aggregation of α-synuclein (α-syn) is central to PD pathogenesis. Here we identified the further mechanisms of gut microbiota in PD. A mouse model with PD was established via injection of MPTP. Normal or MPTP-induced PD like animals were treated with FMT from healthy normal mice. Pole test and traction test were performed to examine the effects of FMT on motor function of PD mice. Fecal SCFAs were assessed by gas chromatography-mass spectrometry. The α-syn level in the substantia nigra pars compacta (SN) of mice was measured using western blot. Dopaminergic neurons and microglial activation in the SN were analyzed by immunohistochemistry (IHC) and immunofluorescence (IF) staining. FMT alleviated physical impairment, decreased fecal SCFAs in a mouse model of PD. Additionally, FMT decreased the expression of α-syn, as well as inhibited the activation of microglia in the SN, and blocked the TLR4/PI3K/AKT/NF-κB signaling in the SN and striatum. FMT could protect mice against PD via suppressing α-syn expression and inactivating the TLR4/PI3K/AKT/NF-κB signaling.
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Trasplante de Microbiota Fecal/métodos , FN-kappa B/antagonistas & inhibidores , Trastornos Parkinsonianos/prevención & control , Proteínas Proto-Oncogénicas c-akt/antagonistas & inhibidores , Receptor Toll-Like 4/antagonistas & inhibidores , alfa-Sinucleína/antagonistas & inhibidores , Animales , Masculino , Ratones , Ratones Endogámicos C57BL , FN-kappa B/metabolismo , Neuroprotección/fisiología , Trastornos Parkinsonianos/inducido químicamente , Trastornos Parkinsonianos/metabolismo , Fosfatidilinositol 3-Quinasas/metabolismo , Proteínas Proto-Oncogénicas c-akt/metabolismo , Receptor Toll-Like 4/metabolismo , alfa-Sinucleína/metabolismoRESUMEN
OBJECTIVE: This study assessed the association between body composition and prognosis of patients with upper urinary tract urothelial carcinoma (UTUC) patients treated by radical nephroureterectomy. METHODS: We retrospectively collected baseline data on age, sex, body mass index (BMI), hypertension, diabetes, and tumor-related factors. Computed tomography (CT) scans were performed to measure body composition parameters such as muscle attenuation (MA), total abdominal muscle area (TAMA), visceral fat area (VFA), intermuscular fat area (IMF), and lateral/posterior perirenal fat thickness (L/P PNF), visceral fat density (VD), and subcutaneous fat density (SD). Patient follow-up was conducted via telephone or in the clinic. The endpoints of follow-up were all-cause death, local progression or distant metastasis. Survival analysis was analyzed using the Kaplan-Meier method, and risk factors associated with prognosis were identified using univariate and multivariate Cox proportional hazard analyses. RESULTS: Among the 273 UTUC patients (median age, 68 years) enrolled in our study, 102 had a BMI > 24.0, 100 suffered from diabetes, and 120 had hypertension. A large proportion of patients (189) had high grade tumors. Across all patients, 1- and 3-year rates for overall survival were 86.45% and 75.55%; local progression-free survival, 92.11% and 89.67%; and distant metastasis-free survival, 85.23% and 80.17%. Based on the Cox regression analysis, MA, IMF, TAMA, TPA, TPT, APT, SMI and PMI significantly reduced the risk of local progression (p < 0.05), while PPNF = 1 point reduced the risk of distant metastasis (p < 0.05). Overall survival was significantly associated with MA, TAMA, and SMI (p < 0.05). CONCLUSION: Our findings illustrate that body composition parameters can act as independent predictors of prognosis in UTUC patients who underwent RNU. These results can help improve stratification of patients and optimize postoperative treatment.
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PURPOSE: To evaluate the role of IVIM and diffusion kurtosis imaging (DKI) in identifying pathologic complete response (pCR) and T stages after neoadjuvant chemoradiotherapy (nCRT) in locally advanced rectal cancer (LARC). METHOD: Forty-two patients with biopsy-proven rectal adenocarcinoma, who underwent both pre-and post-CRT MRI with IVIM and DKI sequences on a 3â¯T scanner, were enrolled prospectively. According to the pathologic ypTNM stages and tumor regression grade (TRG), patients were grouped into pCR (TRG0) and non-pCR (TRG1-3) groups and low T stage (ypT0-2) and high T stage (ypT3-4) groups. IVIM parameters (the slow diffusion coefficient [D], fast diffusion coefficient [D*], perfusion fraction [f]), DKI parameters (mean diffusivity [MD] and mean kurtosis [MK]), and mono-exponential ADC were calculated and analyzed between groups. RESULTS: The pCR group had significantly higher post-CRT ADC, D*, f, and MD values than non-pCR group, and higher percent changes in the ADC, f, and MD values (all Pâ¯<â¯0.05). The post-CRT MD values yielded the highest AUC (0.788) with higher sensitivity than post-ADC values (82.9 % vs. 77.1 %, respectively). Post-CRT ADC and MD values and the percent changes in the ADC and MD values were also negatively correlated with TRG (all Pâ¯<â¯0.05). Besides, negative correlations were found among the pre-CRT MD, post-CRT ADC, D, f, and MD values and the ypT stages (all Pâ¯<â¯0.05). CONCLUSIONS: Both IVIM and DKI parameters could provide more information when evaluating pCR and T stages after nCRT. In particular, the diagnostic performance of the MD values was more valuable than ADC values in being able to determine pCR.
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Terapia Neoadyuvante , Neoplasias del Recto , Quimioradioterapia , Imagen de Difusión por Resonancia Magnética , Imagen de Difusión Tensora , Humanos , Neoplasias del Recto/tratamiento farmacológico , Neoplasias del Recto/terapia , RectoRESUMEN
OBJECTIVE: The chest CT findings of the pneumonia patients with coronavirus disease 19 (COVID-19) were summarized to provide an auxiliary diagnostic basis for the early detection of infected patients. METHODS: Clinical data and CT images of 23 patients diagnosed with COVID-19 in West China Hospital of Sichuan University were retrospectively collected, and the chest CT findings were summarized and analyzed. RESULT: Of the 23 patients, 56.5% (13/23) had bilateral disease, 69.6% (16/23) had lesions distributed along the bronchovascular bundle, 65.2% (15/23) had lesions distributed periphery, 82.6% (19/23) involved in the basal segment of lower lobe, 82.6% (19/23) had ground-glass opacities, 30.4% (7/23) had ground-glass opacities with consolidation, 26.1% (6/23) had reticular changes. In the stage of disease progression, 54.6% (6/11) had an increased number of lesions, and 63.6% (7/11) had the scope of lesions enlarged and density increased. In the remission stage, 25.0% (4/16) had reduced number of lesions, 81.3% (13/16) had scope of lesions reduced, 62.5% (10/16) had density of lesions decreased, and 37.5% (6/16) had fibrosis. CONCLUSIONS: As an important diagnostic examination method for COVID-19, CT is conducive to the rapid diagnosis of the disease in patients with epidemiological history.
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Infecciones por Coronavirus , Pandemias , Neumonía Viral , Tomografía Computarizada por Rayos X , Betacoronavirus , COVID-19 , China , Infecciones por Coronavirus/diagnóstico por imagen , Humanos , Neumonía Viral/diagnóstico por imagen , Estudios Retrospectivos , SARS-CoV-2RESUMEN
BACKGROUND: Accurate assessment of tumor response in rectal cancer could help individualize treatment. PURPOSE: To evaluate the role of diffusion-weighted imaging (DWI) based on readout-segmented echo-planar imaging (rs-EPI) in assessing tumor response after neoadjuvant chemoradiotherapy (CRT) in locally advanced rectal cancer (LARC). MATERIAL AND METHODS: Sixty-three patients with LARC who received neoadjuvant CRT and surgery were enrolled retrospectively. They all underwent pre- and post-CRT magnetic resonance examinations, including DWI using rs-EPI. According to pathological results, patients were grouped as pathological complete responder (pCR, n = 16) and non-pCR (n = 47). Visual assessment of residual tumor and whole-tumor histogram analysis of pre- and post-CRT apparent diffusion coefficient (ADC) map was performed by two radiologists; tumor volume on ADC map was also recorded. RESULTS: Overall inter-observer agreement was good for histogram analysis (ICC = 0.543-0.999). Tumor volume reduction rate on ADC map showed no significant difference between the two groups (P = 0.468). Post-CRT mean, quantile values, and their percentage changes were higher in the pCR group (all P < 0.001). Post-CRT mean value had a good diagnostic power in selecting pCR (AUC = 0.855), with a cut-off value of 1.345 × 10-3 mm2/s, yielding a sensitivity of 83%, specificity of 81.3%. Post-CRT 95% quantile value had the highest AUC (AUC = 0.868) among quantile values, and a higher specificity (87.5% vs. 81.3%) than mean value with comparable overall diagnostic performance (P = 0.563). Visual assessment showed a sensitivity of 85.1%, specificity of 68.8% in selecting pCR. CONCLUSION: Quantitative ADC value of rs-EPI DWI could reliably evaluate tumor response in patients with LARC. Post-CRT 95% quantile ADC value could help mean value to more accurately identify pCR.
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Imagen de Difusión por Resonancia Magnética , Imagen Eco-Planar , Neoplasias del Recto/diagnóstico por imagen , Neoplasias del Recto/terapia , Adulto , Anciano , Quimioradioterapia , China , Femenino , Humanos , Interpretación de Imagen Asistida por Computador , Masculino , Persona de Mediana Edad , Terapia Neoadyuvante , Estadificación de Neoplasias , Neoplasia Residual/diagnóstico por imagen , Neoplasias del Recto/patología , Estudios Retrospectivos , Sensibilidad y Especificidad , Carga TumoralRESUMEN
OBJECTIVES: To explore if there is a correlation between T2WI histogram features of the primary tumor and the existence of regional lymph node (LN) metastasis in rectal cancer. METHODS: Eighty-eight patients with pathologically proven rectal adenocarcinoma, who received direct surgical resection and underwent preoperative rectal MRIs, were enrolled retrospectively. Based on pathological analysis of surgical specimen, patients were classified into negative LN (LN-) and positive LN (LN+) groups. The degree of differentiation and pathological T stage were recorded. Clinical T stage, tumor location, and maximum diameter of tumor were evaluated of each patient. Whole-tumor texture analysis was independently performed by two radiologists on axial T2WI, including skewness, kurtosis, energy, and entropy. RESULTS: The interobserver agreement was overall good for texture analysis between two radiologists, with intraclass correlation coefficients (ICCs) ranging from 0.626 to 0.826. The LN- group had a significantly higher skewness (p < 0.001), kurtosis (p < 0.001), and energy (p = 0.004) than the LN+ group, and a lower entropy (p = 0.028). These four parameters showed moderate to good diagnostic power in predicting LN metastasis with respective AUC of 0.750, 0.733, 0.669, and 0.648. In addition, they were both correlated with LN metastasis (rs = - 0.413, - 0.385, - 0.28, and 0.245, respectively). The multivariate analysis showed that lower skewness was an independent risk factor of LN metastasis (odds ratio, OR = 9.832; 95%CI, 1.171-56.295; p = 0.01). CONCLUSIONS: Signal intensity histogram parameters of primary tumor on T2WI were associated with regional LN status in rectal cancer, which may help improve the prediction of nodal stage. KEY POINTS: ⢠Histogram parameters of tumor on T2WI may help to reduce uncertainty when assessing LN status in rectal cancer. ⢠Histogram parameters of tumor on T2WI showed a significant difference between different regional LN status groups in rectal cancer. ⢠Skewness was an independent risk factor of regional LN metastasis in rectal cancer.
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Adenocarcinoma/diagnóstico por imagen , Adenocarcinoma/patología , Metástasis Linfática/diagnóstico por imagen , Imagen por Resonancia Magnética/métodos , Neoplasias del Recto/diagnóstico por imagen , Neoplasias del Recto/patología , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Ganglios Linfáticos/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Reproducibilidad de los Resultados , Estudios RetrospectivosRESUMEN
OBJECTIVE. The purpose of this study is to determine the performance of the apparent diffusion coefficient (ADC) value calculated from high-resolution DWI using readout-segmented echo-planar imaging (rs-EPI) and to assess the texture parameters of T2-weighted MR images in identifying pathologic complete response (pCR) after patients with locally advanced rectal cancer (LARC) undergo preoperative chemoradiotherapy (CRT). MATERIALS AND METHODS. A total of 76 patients with LARC who underwent preoperative CRT and subsequent surgery were enrolled in the study retrospectively. All patients underwent post-CRT MRI, which included acquisition of a DWI sequence with use of the rs-EPI technique. The histopathologic tumor regression grade was the reference standard. Patients were subdivided into pCR and non-pCR groups. Two radiologists independently drew whole-tumor ROIs on DW images and T2-weighted MR images to calculate the mean ADC value and first-order texture parameters. RESULTS. Interobserver agreement was good to excellent (intraclass correlation coefficient [ICC], 0.79-0.993) for imaging analysis. Calculated from high-resolution DWI, the mean post-CRT ADC value was significantly higher in the pCR group (p < 0.001). The pCR group also showed lower uniformity (p < 0.001) of the T2-weighted image. The mean ADC value and uniformity were significantly correlated with the tumor regression grade. The mean ADC value was a good indicator for differentiating pCR from absence of pCR (ROC AUC value, 0.912). Uniformity (ROC AUC value, 0.776) showed a moderate ability to identify pCR. Combining the mean ADC value and uniformity yielded an ROC AUC value comparable to that of the mean ADC value (p = 0.125). CONCLUSION. Mean post-CRT ADC values calculated from high-resolution DWI using rs-EPI could effectively select for patients with LARC who have a pCR after preoperative CRT. First-order texture parameters of T2-weighted MR images could also identify patients with pCR by reflecting tumor heterogeneity, even though they could not significantly improve the diagnostic performance.