Objective: To develop a classification tree algorithm to improve diagnostic performances of 99mTc-MIBI SPECT/CT fusion imaging in differentiating solitary pulmonary nodules (SPNs). Methods: Forty-four SPNs, including 30 malignant cases and 14 benign ones that were eventually pathologically identified, were included in this prospective study. All patients received 99Tcm-MIBI SPECT/CT scanning at an early stage and a delayed stage before operation. Thirty predictor variables, including 11 clinical variables, 4 variables of emission and 15 variables of transmission information from SPECT/CT scanning, were analyzed independently by the classification tree algorithm and radiological residents. Diagnostic rules were demonstrated in tree-topology, and diagnostic performances were compared with Area under Curve (AUC) of Receiver Operating Characteristic Curve (ROC). Results: A classification decision tree with lowest relative cost of 0.340 was developed for 99Tcm-MIBI SPECT/CT scanning in which the value of Target/Normal region of 99Tcm-MIBI uptake in the delayed stage and in the early stage, age, cough and specula sign were five most important contributors. The sensitivity and specificity were 93.33% and 78.57%, respectively, a little higher than those of the expert. The sensitivity and specificity by residents of Grade one were 76.67% and 28.57%, respectively, and AUC of CART and expert was 0.886±0.055 and 0.829±0.062, respectively, and the corresponding AUC of residents was 0.566±0.092. Comparisons of AUCs suggest that performance of CART was similar to that of expert (P = 0.204), but greater than that of residents (P<0.001). Conclusion: Our data mining technique using classification decision tree has a much higher accuracy than residents. It suggests that the application of this algorithm will significantly improve the diagnostic performance of residents.

Objective: To develop a classification tree algorithm to improve diagnostic performances of 99mTc-MIBI SPECT/CT fusion imaging in differentiating solitary pulmonary nodules (SPNs). Methods: Forty-four SPNs, including 30 malignant cases and 14 benign ones that were eventually pathologically identified, were included in this prospective study. All patients received 99Tcm-MIBI SPECT/CT scanning at an early stage and a delayed stage before operation. Thirty predictor variables, including 11 clinical variables, 4 variables of emission and 15 variables of transmission information from SPECT/CT scanning, were analyzed independently by the classification tree algorithm and radiological residents. Diagnostic rules were demonstrated in tree-topology, and diagnostic performances were compared with Area under Curve (AUC) of Receiver Operating Characteristic Curve (ROC). Results: A classification decision tree with lowest relative cost of 0.340 was developed for 99Tcm-MIBI SPECT/CT scanning in which the value of Target/Normal region of 99Tcm-MIBI uptake in the delayed stage and in the early stage, age, cough and specula sign were five most important contributors. The sensitivity and specificity were 93.33% and 78.57%, respectively, a little higher than those of the expert. The sensitivity and specificity by residents of Grade one were 76.67% and 28.57%, respectively, and AUC of CART and expert was 0.886±0.055 and 0.829±0.062, respectively, and the corresponding AUC of residents was 0.566±0.092. Comparisons of AUCs suggest that performance of CART was similar to that of expert (P = 0.204), but greater than that of residents (P<0.001). Conclusion: Our data mining technique using classification decision tree has a much higher accuracy than residents. It suggests that the application of this algorithm will significantly improve the diagnostic performance of residents.

Objective To explore CT diagnostic values of cardiac carcinoma.Methods CT findings of cardiac cancer comfired pathologically in 50 cases were analysed.All case were examined with spiral CT.Results The thickness of gastric cardia wall was found in all 50 cases,soft tissue masses was found in 25 cases,adjacent tissue invasion was found in 18 cases and metastasis of lymph nodes was found in 33 cases.Conclusion CT is a valuable method in demonstrating the size of cardiac carcinoma,its adjacent tissue infiltration and lymph node metastasis.It plays important role in the planning of treatment in clinical practice.

Objective To explore the characteristics and applied value of diffusion-weighted MR imaging of kidney in healthy people.Methods Using Philips Gyroscan Intera 1.5T MR System,DWI of kidney was performed in 40 healthy adult volunteers,the ADCs of renal cortex and medulla were measured.Results The cortex and medulla of the normal kidney could be clearly showed by DWI.The ADCs of the cortex medulla and average were 3.08?0.52,2.74?0.68 and 2.91?0.58;2.79?0.51,2.53?0.65 and 2.63?0.62;2.64?0.43,2.32?0.47 and 2.48?0.44 when the b values were 300,500 and 800 s/mm2,respectively.The ADC was higher in the cortex than that in the medulla.Conclusion DWI can be used in kidney,it may be helpful for the diagnosis of renal diseases.

Objective To investigate the imaging manifestations, clinical features and treatment of primary aggressive osteoblastoma (PAO)of the calcaneus.Methods The clinical data,imaging findings and treatment of PAO of the calcaneus in a young man retrospectively analyzed with literature review.The lesion was confirmed by pathology one and half years ago,and recurred after operation 10 months follow-up.Results X-ray and CT revealed expansive destruction of right calcaneus with little calcification or ossification,the bone destruction in the medial part of the calcaneus was obvious,the bone cortex was thin and incontinuous,there was no soft tissue mass or periosteal reaction.The talocalcaneal joint was not involved by the tumor.Neither other bones nor the root of Achilles' tendon showed direct tumor invasion or metastasis but neighboring swelling existed.Conclusion There are no significant differences about imaging manifestations, clinical features and laboratory analyses between primary aggressive and benign osteoblastoma of the calcaneus.The accurate diagnosis of PAO is only depending on pathology.The therapeutic effect with pure curettage and bone grafting for the lesion is not fine and tends to recur and malignant change.

Objective To study feasibility in extraction of calcific sign within pulmonary nodules with pattern classification.Meth-ods 49 cases with pulmonary nodules (benign in 16 and malignant in 33)confirmed by pathology or clinical follow-up were included in this study and all cases underwent chest CT examinations.CT images were interpreted double-blind by two associate chief radiolo-gists to draw a conclusion that there were any calcification within pulmonary nodules.Meanwhile,the calcifications in the regions of interest(ROI)on CT images were estimated with extraction of the sign of gray value,geometric and lung markings in ROI,and based on pattern classification algorithm at supporting vector machine(SVM).Results According to the results assessed by senior radiologists for classification within pulmonary nodules,the area under ROC curve was 0.95 which was extracted by automatic pat-tern classification algorithm,the extraction performance was stable(k=1),and was goodness fit with visual observation by doctors (k=0.939).Conclusion The ability of automatic pattern classification in detecting calcification within pulmonary nodules is about the same as that of visual assessment by senior doctors.

Objective To investigate the value of mammography (MAM),ultrasound (US)and MRI in the diagnosis of breast tumors using a Meta-analysis.Methods A systematic search of relevant literatures was done from CNKI,CBM,VIP,EMBASE OvidSP,PubMed and The Cochrane Library databases.Some related literatures about MAM,US and MRI in the diagnosis of breast tumors and the quality was evaluated,and the available information was extracted.The Meta-analysis was then performed by a Meta-disc 1.4 software,and a Review Manager 5.3 software was used to calculate the summary receiver operating characteristic curves and the area under the curve.Results The diagnostic effect of the MAM+US+MRI was significantly higher than that of mammography or ultrasound (P <0.05).The MAM study heterogeneity among sources was affected by whether it based on BI-RADS diagnostic criteria,and US study heterogeneity was affected by average age of patients.However,the MRI heterogeneity between studies displayed by regression analysis was not affected by each covariate.The diagnostic sensitivity and specificity were 76% (95%CI:0.73-0.79)and 72% (95%CI:0.69-0.75)for MAM,85% (95%CI:0.82-0.87)and 70% (95%CI:0.67-0.73)for US,and 95% (95%CI:0.93-0.96)and 72% (95%CI:0.69-0.75)for MRI,respectively.And the area under curve (AUC)of summary receiver operating characteristic (SROC)curve was 82.0%,88.5% or 97.4%, respectively.Moreover,the AUC of combined three methods together was 98.3%.Conclusion The value of MAM,US and MRI in diagnosis of breast tumor is higher,and the highest one exists when the combined three methods together are used.

Objective To analyze CT morphologic features and pathologic changes of pulmonary sclerosing pneumocytoma (PSP) and to improve preoperative diagnostic accuracy of PSP.Methods The clinical and CT data of 12 cases with PSP (with total 13 lesions)confirmed by surgery and pathology were collected and analyzed retrospectively.All cases performed CT plain scan,9 cases had contrast CT scan.Results 1 1 cases had isolated lesions,and 1 case multiple lesions.The long-axis diameter ranged from 1.10 cm to 8.03 cm, with an average of (3.53±0.78)cm.Of 13 lesions,3 located in left lung (23.1%,1 in the upper lobes,2 in lower lobe),and 10 in right lung (76.9%,2 in upper lobe,2 in the middle lobe and 6 in lower lobe);8 lesions located in the lower lobe (61.5%),and 5 in upper and middle lobe (38.5%).There were center type of 4 lesions (30.8%),and peripheral type of 9 lesions (69.2%);The shapes of 8 lesions wereovoid or similar round (61.5%),irregular type of 1 case (7.7%),shallow lobe of 4 cases (30.8%);Smooth edge of 10 cases (76.9%), burr edge in 3 cases (23.1%).With contrast CT scan,7 cases (53.8%)had vascular welt sign,6 cases (46.2%)had air crescent sign,6 cases (46.2%)had halo sign,and 6 cases (46.2%)had tail sign.3 lesions (23.1%)had scattered spot calcification,and the other lesions had uniform density.The CT value ranged from 28 HU to 47 HU,with the average of 35 HU;Of 9 cases (with 10 lesions)with contrast CT scan,2 lesions had mild enhancement,5 cases had obvious enhancement,and 3 case had non-uniform enhancement.Enhanced CT value was 60-1 10 HU,with the average of 77.2 HU,and with the maximum of 75 HU.Conclusion If the pulmonary nodules or masses in middle-aged females had single round or ovoid shape,with about 3 cm diameters,soft-tissue density,smooth edge,and with obvious enhancement after contrast CT scan,and accompanied by vascular welt sign,air crescent sign,halo sign,or tail sign, the diagnosis of PSP should be considered.

Objective To improve recognition and diagnosis of primary non-obstructive megaureter.Methods The authors analyzed the X-ray findings of intravenous urography and B-ultrasonographic manifestations of 28 cases with primary non-obstructive megaureter proved by varied examinations and operations.Results The X-ray and B-ultrasonographic manifestations as follows:in the terminal ureter,there was a short segment,less than 3 cm in length,with normal caliber but adynamic to micturition and the ureter proximal to the adynamic segment was secondarily dilated remarkably.The terminal end of the dilated ureter appeared as drumstick shaped,spindle-shaped,snakehead shaped or rattail shaped.On right time fluoroscopy and B-ultrasonographic observation,a decrease of peristalsis frequency,increase of peristalsis range,interrupted downward convey of peristalsis wave could be noted.Conclusion The contrast urography is the main method,B-ultrasonography and cyctocopy are helpful for the diagnosis of primary non-obstructive megaureter.

Objective To study the clinical and X-ray manifestations of primary non-Hodgkin's lymphoma(PNHL)of bone so that to suppy the valuable informations for clinical diagnosis and treatment of this disease.Methods 14 cases with PNHL of bone confirmed by clinic and pathology were analyzed retrospectively.There were 9 male and 5 femal,age ranged from 20 to 60 years with average of 35 years,and average history of disease was 11 months in all cases.Results Of all cases single bone involved in 11 cases,multiple bone involved in 3 cases,most of them the flat bone and the distal end of long bone were involved.The appearances of the lesion on X-ray were bony destruction with slight sclerosis at the margin of destructive area,there were periosteal reaction,soft tissue masses and destruction of joint manifestations,PNHL of bone can be classified as four typers:osteolytic(n=8),sclerotic(n=2),mixed(n=3)and cystic(n=1)lesions by the form and feature of bone destruction.Conclusion PNHL of bone has characteristic X-ray manifestations comparatively.The correct diagnostic rate can be improved if we concern about clinical data.