Value of Real-Time Shear Wave Elastography Versus Acoustic Radiation Force Impulse Imaging in the Diagnosis of Female Bladder Neck Obstruction.

OBJECTIVE: To investigate the application value of shear wave elastography (SWE) and acoustic radiation force impulse imaging (ARFI) in the diagnosis of female bladder neck obstruction (FBNO), we compared the advantages of these 2 methods to provide a more accurate reference for clinical work. METHODS: From April 2016 to February 2018, 27 patients who were diagnosed with FBNO by cystoscopy and/or urine dynamics testing were selected for the study, together with 24 healthy adults in a case-control study at Liaoning Province People's Hospital. We collected general information from 27 patients with FBNO, and using transperineal 2-dimensional ultrasound detection, shear wave elastography (SWE) and ARFI were used, respectively, to detect the Young's modulus and shear wave velocity (SWV) of the bladder necks. Cystoscopy results were considered to be the gold standard, and receiver operating characteristic (ROC) curves were drawn for ARFI, SWE, and the combined diagnosis of the two. The efficacy of the diagnosis was determined by comparing the areas under the ROC curves and calculating the sensitivity, specificity, and accuracy. RESULTS: The areas under the ROC curve for the Q-box mean and max value detected by SWE for FBNO patients were 88.4% and 89.9%, respectively, and the sensitivity, specificity, and accuracy were 81.5%, 79.2%, and 80.4%, respectively. The area under the ROC curve detected by ARFI for FBNO patients was 93.7%, and the sensitivity, specificity, and accuracy were 88.9%, 79.2%, and 84.3%, respectively. The sensitivity, specificity, and accuracy of the combined detection of ARFI and SWE were 92.5%, 87.5%, and 90.2%, respectively. The best diagnostic cutoff point of the SWV or the Q-box mean and max value of SWE in FBNO obtained with the ROC curve was SWV = 2.38 m/s (sensitivity, 71.4%; specificity, 82.5%), Q-box mean = 20.2 kPa, Q-box max = 39.8 kPa (sensitivity, 67.5%; specificity, 76.2%). The average shear wave velocity of ARFI, Q-box mean, and Q-box max value of SWE in the control group were 1.89 ± 0.35 m/s, 15.3 ± 3.6 kPa, and 29.2 ± 8.7 kPa, respectively. In the FBNO group, these values were 2.81 ± 0.63) m/s, 27.2 ± 8.6 kPa, and 51.2 ± 12.3 kPa, respectively. The differences were statistically significant (P < .05). CONCLUSION: The value of the ARFI in the diagnosis of FBNO is a little greater than that of SWE in terms of sensitivity and accuracy, and the combined detection of ARFI and SWE performs better than ARFI or SWE employed separately.

NVP-BKM120 inhibits colon cancer growth via FoxO3a-dependent PUMA induction.

NVP-BKM120, a potent and highly selective PI3K inhibitor, is currently being investigated in phase I/II clinical trials. The mechanisms of action of NVP-BKM120 in colon cancer cells are unclear. In the present study, we investigated how NVP-BKM120 suppresses colon cancer cells growth and potentiates effects of other chemotherapeutic drugs. We found that NVP-BKM120 treatment enhance PUMA induction irrespective of p53 status through the FoxO3a pathway following AKT inhibition. Furthermore, PUMA is required for NVP-BKM120-induced apoptosis in colon cancer cells. In addition, NVP-BKM120 also synergized with 5-Fluorouracil or regorafenib to induce marked apoptosis via PUMA induction. Deficiency of PUMA suppressed apoptosis and antitumor effect of NVP-BKM120 in xenograft model. These results demonstrate a key role of PUMA in mediating the anticancer effects of NVP-BKM120 and suggest that PUMA could be used as an indicator of NVP-BKM120 sensitivity, and also have important implications for it clinical applications.

Application of Acoustic Radiation Force Impulse Imaging for Diagnosis of Female Bladder Neck Obstruction.

OBJECTIVES: To determine the application value of combined transperineal sonography and Virtual Touch tissue quantification (Siemens Medical Solutions, Mountain View, CA) on acoustic radiation force impulse imaging as a scanning method for diagnosis of female bladder neck obstruction. METHODS: Transperineal sonography and Virtual Touch tissue quantification were combined to depict the bladder neck and observe its sonographic characteristics in 36 patients with female bladder neck obstruction and 30 healthy adults in a case-control study. We measured the thickness and shear wave velocity (SWV) of the bladder neck's anterior and posterior lips. RESULTS: There was a statistically significant difference in the thickness and SWV of the bladder neck between the healthy women and those with bladder neck obstruction, whose SWV was higher (P< .05). For the anterior lip, an SWV of 2.11 m/s was the best cutoff point for differentiating bladder neck obstruction from a normal bladder neck; for the posterior lip, an SWV of 2.06 m/s was the best cutoff point. The mean thicknesses of the anterior and posterior lips ± SD were 0.66 ± 0.05 and 0.68 ± 0.05 cm in the group with bladder neck obstruction versus 0.45 ± 0.07 and 0.52 ± 0.09 cm in the normal group. There was a significant difference between them (P < .05). CONCLUSIONS: The bladder neck's anatomic structure can be observed visually by perineal sonography. Virtual Touch tissue quantification on acoustic radiation force impulse imaging can quantitatively reflect the bladder neck stiffness and change in texture. It could provide a quantitative indicator for clinical diagnosis of female bladder neck obstruction and etiology research and display important clinical values.