1.Assessment of Breast Cancer Response to Neoadjuvant Chemotherapy with Tumor's Size at MR Imaging
Chunxue WU ; Xiaoying WANG ; Naishan QIN ; Li GUO ; Xuexiang JIANG
Journal of Practical Radiology 2010;26(1):77-83
Objective To investigate the clinical value of tumor's longest diameter and volume in assessing pathologic response in locally advanced breast cancer treated with neoadjuvant chemotherapy(NAC).Methods A prospective study was undertaken in women undergoing NAC for locally advanced breast cancer in order to determine the ability of quantitative MRI to assess the final pathologic response. 36 cases with pathologically confirmed locally advanced breast cancer who had been undergone four courses of NAC underwent preoperative breast MRI three times during the NAC. Pathologic response was assessed according Miller & Payne grading system, of which grade 4 and 5 defined as major histological response (MHR), and grade 1 to 3 as non-major histological response (NMHR). The tumor's longest diameters and volumes in MHR were compared with those in NMHR by Mann-Whitney U test before, after the second and fourth cycle of NAC. Concordance correlation coefficient (CCC) were assessed to evaluate the agreement between the two method. Receiver operating characteristic curve (ROC) analysis was carried out to assess the clinical value of tumor size and the change rate.Results Before,after the second and the fourth cycle of NAC, the difference of tumor's longest diameters and their first change rate between MHR [(2.75±1.16) cm,(2.19±1.07) cm ,(1.58±0.75) cm and (21.70±15.09)%]respectively,and NMHR [(2.71±1.10) cm,(2.33±0.90) cm,(2.01±0.94) cm and (11.68±10.27)%] respectively were not significant(P>0.05). The second change rate of tumor's longest diameter in MHR [(39.00±15.38)% ] was significantly higher than that in NMHR[ (25.83±21.77)% ](P=0.04). Before, after the second and the fourth cycly of NAC, the differences of tumor volumes and their first change rate between MHR [ median 14.00 cm~3 ( range 2.96~83.41 cm~3 ) , median 7.31 cm~3 (range 0.05~55.35 cm~3), median 2.69 cm~3 (range 0~33.40 cm~3 ) , median 48.65% (range 33.64%~98.48%) ] and NMHR [median 4.25 cm~3 (range 4.78~106.55 cm~3), median 10.53 cm~3 (range 1.72~42.85 cm~3), median 7.56 cm~3 (range 0.68~156.58 cm~3), median 52.04% (range-35.79%~78.31%) ] were not significant. The second changing rate of tumor's volume in MHR [median 85.37% (ranged 27.52%~100%)] was significantly higher than that in NMHR [median 68.80% (ranged -289.60%~94.24%)](P=0.01). CCC was computed before and (0.82), after the second cycle (0.67) and after the fourth cycle (0.55), in all examinations pooled together (0.78).The second change rates of tumor's longest diameter and volume were equal to predict the final pathologic response, and the area under curve were 0.75 and 0.80, respectively (P=0.61). Conclusion The agreement between the tumor's longest diameters and tumor's volumes is good in all in breast carcinoma. The assessment efficacy of the change rate of tumor's longest diameter and that of volume were low.
2.Assessment of breast cancer response to neoadjuvant chemotherapy with time-intensity curve parameters in MRI
Chunxue WU ; Xiaoying WANG ; Naishan QIN ; Xuexiang JIANG
Chinese Journal of Radiology 2010;44(5):465-469
Objective To investigate the clinical value of the type and the steepest slope of tumor's time-intensity curve (TIC) in assessing the pathologic response of locally advanced breast cancer treated with neoadjuvant chemotherapy (NAC). Methods Thirty-six patients with pathologically confirmed locally advanced breast cancer who finished four courses of neoadjuvant chemotherapy underwent preoperative breast MRI three times during the NAC. Pathologic response was assessed according Miller-Payne grading system, grade 4 and 5 were defined as major histological response ( MHR, n = 16) group, and grade 1 to 3 as nonmajor histological response( NMHR,n = 20)group. The type and the steepest slope of tumor's TIC were compared between two groups before NAC, after the second cycle and after the fourth cycle of NAC. ROC analysis was carried out to assess the clinical value of the TIC parameters. Results After the second cycle of NAC, the steepest slope of TIC and its first change rate were different between the MHR group [ ( 1.93 ±0.88) %/s, median 35.6%] and NMHR group [(2.73 ± 1.22) %/s, median - 11.4%] (P =0.045 and 0. 01,t=1. 09,Z= -3.64). After the fourth cycle, the proportion of type Ⅰ in MHR group (62.5% ,10/16) was significantly higher than that in NMHR group (10.0%, 2/20, P = 0.01, Z=-2. 02), and the proportion of type Ⅲ in MHR group (6. 2% ,1/16)was significantly lower than that in NMHR group (60. 0% ,12/20,P =0. 01 ,Z = -1.48). The steepest slope and its second change rate were different between the MHR group [ ( 1.33 ± 0. 52) %/s, median 56. 8% ] and NMHR group [ (2. 33 ±0. 94) %/s, median 15. 8% ] ( P < 0. 01, t = 1.82, Z = - 3. 58 ). After the second cycle, the area under curve of the steepest slope of TIC and its first change rate were 0. 70 ( P = 0. 04 ), 0. 80 ( P = 0. 01 ),respectively. After the fourth cycle, the area under curve of the type Ⅰ, the type Ⅰ + Ⅱ, the steepest slope and its second change were 0. 78 ( P = 0. 03 ), 0. 69 ( P = 0. 06), 0. 82 ( P = 0. 01 ), 0. 92 ( P = 0. 01 ),respectively. Conclusion The steepest slope of TIC and its first change rate could assess the NAC response after the second cycle, and the type Ⅰ, the steepest slope and its second change could assess the NAC response after the fourth cycle.
3.The Value of Measurement of Fractional Anisotropy on the Splenium of the Corpus Callosum in Diagnosis of Patients with Mild Alzheimer’s Disease
Sheng XIE ; Hongkun WU ; Jiangxi XIAO ; Yinhua WANG ; Xuexiang JIANG
Journal of Practical Radiology 2001;0(09):-
Objective To detect abnormal anisotropy on the splenium of the corpus callosum in patients with mild Alzheimer’s disease (AD).Methods Normalized hippocampal volume and fractional anisotropy on the splenium of the corpus callosum were measured in 13 patients with mild Alzheimer’s disease and 19 normally aging volunteers. Non-dependent samples t-tests were conducted to compare them between the two groups. In addition, the sensitivity in the diagnosis of mild Alzheimer’s disease was calculated.Results The splenium of the corpus callosum showed reduced anisotropy in mild Alzheimer’s disease. The normalized hippocampal volume also decreased in patients. The FA of the splenium of the corpus callosum was more sensitive in the diagnosis of mild Alzheimer’s disease. Conclusion The decreased anisotropy on the splenium of the corpus callosum reflects the degeneration of the fibers, and it is promising in the early diagnosis of Alzheimer’s disease.
4.The relevance between the level of thyroid hormone and TPOAb during gestation period
Caixia LI ; Xuefeng SHI ; Xuexiang WU ; Xiaomin ZHENG
Chongqing Medicine 2015;(29):4089-4091
Objective To study the relevance between the level of thyroid hormone and anti‐thyroid peroxidase antibody (TPOAb) during gestation period .Methods From November 2011 to May 2014 ,150 gravidas were chosen as objectives ,and were divided into 2 groups according TPOAb .The clinical feature ,level of thyroid hormone ,pregnancy outcome ,and complication of neo‐phyte between 2 groups were compared .Results In 150 gravidas ,44 were positive in TPOAb and 106 were negative .The age ,ges‐tational weeks and BMI between two groups had no statistical difference(P>0 .05) .At the early and middle pregnancy as well as at the late pregnancy ,the level of thyroid hormone between two groups had statistical difference(P<0 .05);In study group ,the level of thyroid hormone of early and middle pregnancy and that of late pregnancy had statistical difference(P<0 .05) .The rate of unde‐sirable gestational outcome and that of neophyte complication between two groups had statistical difference(P<0 .05) .Conclusion During gestation period ,the TPOAb was significant for the diagnosis of the sub‐clinical hypothyroidism ,as well for prognosis of gravidas .
5.Diagnostic criterion of diffusion-weighted imaging for prostatic peripheral zone cancer
Xuemei GUO ; Xiaoying WANG ; Bing WU ; Xuexiang JIANG
Chinese Journal of Medical Imaging Technology 2009;25(7):1235-1238
Objective To evaluate and testify the diagnostic efficacy of the ADC value of the diffusion-weighted imaging (DWI) in prostatic peripheral zone cancer. Methods There were 40 patients with prostatic diseases proved by ultrasound guided systemic biopsy. DWI scans were performed with 1.5T MR scanner using TOSORPA coil and b value of 800 s/mm2. The peripheral zones of prostate were divided in six areas and were attributed to noncancerous and cancerous areas according to the results of biopsy. The minimal ADC values of each peripheral zone were recorded and analyzed. Results There were 240 areas, in which 89 areas were cancerous and the others were noncancerous. The mean ADC value of cancerous areas was (0.98±0.30)×10-3 mm2/s, while the noncancerous areas was (1.59±0.29)×10-3 mm2/s. The diagnostic sensitivity, specificity and accuracy were 80.58%, 92.42% and 86.73% respectively with cutoff point ≤1.24×10-3 mm2/s, whereas 66.56%, 96.95% and 86.26% respectively with cutoff point ≤1.04×10-3 mm2/s. The diagnostic sensitivity was 98.63%, the specificity was 37.07%, the accuracy was 58.82% with cutoff point <1.69×10-3 mm2/s. Conclusion The ADC value ≤1.24×10-3 mm2/s should be regarded as the diagnostic standard of prostate cancer. When ADC value is between (1.04-1.24)×10-3 mm2/s, some cancer might be missed.
6.Voxel-based comparison of whole brain gray matter of patients with mild Alzheimer's disease with normal aging volunteers
Sheng XIE ; Hongkun WU ; Jiangxi XIAO ; Yinhua WANG ; Xuexiang JIANG
Chinese Journal of Radiology 2000;0(11):-
Objective To detect gray matter abnormalities of whole brain in patients with mild Alzheimer's disease(AD)by voxel-based morphometry(VBM).Methods Thirteen patients with mild Alzheimer's disease and sixteen normal aging volunteers underwent 3D SPGR scanning.For every subject,data was transferred to PC to be normalized,segmented and smoothed using SPM99.Non-dependent samples T-tests were conducted to compare gray matter density voxel to voxel between the two groups.Results Significant reductions in gray matter density were found in the bilateral hippocampi and nucleus amygdalae,bilateral insulae,bilateral medial thalami,bilateral rectus gyri,right superior temporal gyrus,right caudate nucleus,right prefrontal lobe,right basal forebrain and portions of right occipital lobe.Conclusion VBM reveals significant gray matter reductions of numeral cortices in mild Alzheimer's disease.It can be a useful method to evaluate the anatomical changes in the progress of the disease.
7.Evaluation of semi-quantitative parameters of prostate MR spectroscopy: comparison with biopsy
Cuiyan WANG ; Xiaoying WANG ; Xinmin LI ; Xuemei GUO ; Lebin WU ; Xuexiang JIANG
Chinese Journal of Radiology 2010;44(3):282-287
Objective To explore convenient and practical semi-quantitative MRS indicators in diagnosis of prostate cancer.Methods One hundred patients with completer MRS data and clinical data were enrolled in the study.The following parameters were assessed to evaluate their efficacy in diagnosis of prostate cancer, (Cho + Cr)/Cit of single voxel, mean (Cho + Cr)/Cit of the whole area and (Cho + Cr)/ Cit positive voxel ratio at the sextant level.Similarly, all the parameters mentioned above and mean (Cho +Cr)/Cit positive voxel ratios of the whole gland were assessed at the whole gland level.Pearson test and Kappa test were used in the research.Results Two thousand nine hundred and forty-five voxels were assessed including 1203 in cancer positive region and 1742 in cancer negative regioa The range of the (Cho + Cr) /Cit ratio in cancer positive region was from 0.22 to 8.00 (median, 1.87), and that in cancer negative region was from 0.11 to 8.00 (median, 0.53).The (Cho + Cr)/Cit ratio in cancer positive region was higher than that in cancer negative region (Z =28.48, P<0.01) with partial overlap.On the level of sextant, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of (Cho + Cr)/Cit ratio> 0.911 to diagnose prostate cancer were 81.4% (179/220),64.2% (194/302), 62.4% (179/287) 、82.6% (194/235) 、71.5% (373/522) respectively; those of mean (Cho + Cr)/Cit ratio>0.911 were 77.3% (170/220),77.2% (233/302),71.1% (170/239),82.3% (233/283),77.2% (403/522) respectively; those of positive voxel ratio>0.519 were 73.2% (161/220),80.8% (244/302)、 73.5% (161/219),80.8% (244/302), 77.6% (405/522) respectively; the consistency between mean (Cho + Cr) /Cit ratio and positive voxel ratio was high (Kappa=0.907).On the level of the whole prostate, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of (Cho + Cr)/ Cit ratio>0.911 to diagnose prostate cancer were 94.3% (50/53),40.4% (19/47),64.1% (50/78), 86.4% (19/22),69.0% (69/100) respectively; those of mean (Cho + Cr)/Cit ratio>0.911 were73.6% (39/53),83.0% (39/47), 83.0% (39/47), 73.6% (39/53), 78.0% (78/100) respectively; those of maximum positive voxel ratio> 0.519 were 88.7% (47/53),61.7% (29/47),72.3% (47/65),82.9% (29/35),76.0% (76/100) respectively; those of mean positive voxel ratio>0.519 were 62.3% (33/53), 85.1% (40/47), 82.5% (33/40), 66.7% (40/60), 73.0% (73/100) respectively; the consistency between mean (Cho + Cr)/Cit ratio and mean positive voxel ratio was fairly high (Kappa =0.818).Conclusion Single voxel criteria were suggested to diagnose clinically suspected prostate cancer.Maximum positive voxel ratio criteria were suggested to guide localization in biopsy.
8.Cerebral collateral magnetic resonance imaging
Bing WU ; Xiaoying WANG ; Jia GUO ; Dapeng MO ; Sheng XIE ; C.wong ERIC ; Jue ZHANG ; Shengde BAO ; Yining HUANG ; Xuexiang JIANG
Chinese Journal of Neurology 2009;42(3):179-182
Objective To evaluate collateral flows using vessel encoded arterial spin labeling (VE-ASL) perfusion imaging. MethodsVE-ASL was achieved to assess the presence and function of collateral flow on patients with internal carotid artery (ICA) stenosis. The presence of the anterior and posterior collateral flow was demonstrated by flow patterns of the A1 segment and posterior communicating artery (PCoA).Distal function of collateral flow of stenotic hemisphere was categorized as adequate ( cerebral blood flow ≥10 ml · min-1·100 g-1 ) or deficient (cerebral blood flow < 10 ml · min-1· 100 g-1 ). The results were compared with magnetic resonance angiography (MRA) and intraarterial digital subtraction angiography (DSA) in crosstable by using Kappa values. The VE-ASL before and after ICA stent therapy were compared. ResultsThe Kappa values of the flow patterns of AI segment and PCoA between VE-ASL and MRA were 0. 746 and 0. 700. The Kappa value of the function of collaterals using VE-ASL and DSA was914. VE-ASL showed collateral flow via leptomeningeal anastomoses. VE-ASL changed significantly after ICA steat therapy. ConclusionVE-ASL reveals the presence and distal function of collateral flow, which helps to evaluate the efficacy of ICA steat therapy.
9.Current status of knowledge and attitude of schistosomiasis control among human population in schistosomiasis transmission-controlled area of Changqiu mountainous areas
Chunli CAO ; Lin CHEN ; Xuexiang WAN ; Qing LIU ; Xingping CAI ; Bo ZHONG ; Dongchuan QIU ; Xiaohua WU ; Xiaonong ZHOU ; Jiagang GUO
Chinese Journal of Schistosomiasis Control 2010;22(1):74-77
Objective To understand the status of knowledge and attitude of schistosomiasis control among the human populafion in schistosomiasis transmission-controlled area of Changqiu mountainous areas.Methods The subjects were selected by the random cluster sampling method among residents and students in these alias,then they were investigated by questionnaire.Resuits A total of 150 residents and 209 students were selected.There were 60% of the residents whose awareness rates of the knowledge on schistosomiasis control were above 90%.The correction rates of the questions in residents were between 99.30% and 100%.and the awareness rates about the questionswhether re-infection would occure after schistosomiasis was cured and the remedy for schistosomiasisof female adults were both 75.40%.The correction rates of the two question8 on attitude and behaviour of schistosomiasis control in adults were above 80.00%.In students'questionnaires.the awareness rates of knowledge on schistosomiasis control were above 90%.except the two questions on the shape of the snailand the infection-risk months of schistosomiasis.The correction rates of attitude and behaviour of schistosomiasis control were aslo above 80%.Conclusion The correction rates of knowledge,attitude and behaviour of schistosomiasis control of adults and students have reached the national goal of schistosomiasis control in 2008.
10.Indirect fluorescent antibody test for the diagnosis and therapeutic evaluation of trichinosis
Jing CUI ; Zhongquan WANG ; Feng WU ; Xuexiang JIN ; Pengyuan ZHANG ; Ruiqin YANG ; Jun LIU
Chinese Medical Journal 1998;111(5):0-0
Objective To evaluate the values of indirect fluorescent antibody test for the diagnosis and therapeutic evaluation of trichinosis.Methods Indirect fluorescent antibody test using frozen section of the purified Trichinella larvae as antigen was employed on the detection of anti-Trichinella antibodies in sera from the mice infected with T. spiralis and the patients with trichinosis. Sera from patients with trichinosis were collected at different time intervals after the onset of disease and after treatment with albendazole (20 mg/kg per day). Sera from the patients with other parasitic diseases and from healthy individuals were used as control.Results The anti-Trichinella antibodies were detected in the mice as early as 2 weeks after infection. The specific antibodies were observed in 86.38% of the of the patients with trichinosis. All sera from patients with filariasis, schistosomiasis and echinococcosis and from healthy controls were negative. The antibody positive rate of patients with trichinosis was only 70.59% one week after the onset of disease, and increased to 91.30%, 95.83% and 100% in 2, 3 and 4 weeks after the onset respectively. The frozen section antigens could be stored at -20℃ for at least 5 years without the loss of activity. After therapy, the detection time of antibodies was 1 to 2 weeks ahead of time. The antibody positive rate increased from 87.5% before therapy to 100% one week after therapy. Serum antibody titers one week after therapy were also obviously higher than those before therapy. The distinct elevation of serum antibody levels in a short term after therapy could be considered as an objective criterion of effective therapy. The antibody negative conversion rate of the patients was 24% one month after therapy, and increased to 75% four months after therapy.Conclusions Indirect fluorescent antibody test using frozen section of the purified Trichinella larvae as antigens is a higher sensitive, specific and stable technique and can be used to diagnose and evaluate the therapeutic effect of trichinosis.