Objective To study the value of CT perfusion in differential diagnosis of local recur and local radiofibrosis of nasopharyngeal carcinoma(NPC) at pre-and post-radiotherapy.Methods Dynamic CT scan was performed in 71 objectives: 14 in local recur group,22 in radiofibrosis group,15 in pre-radiotherapy NPC group and 20 in control group,the time-density curve(TDC) and the data of perfusion parameters were recorded and analyzed statistically.Results The TDC feature between local recur group,pre-radiotherapy NPC group and radiofibrosis group,control group had difference.The average of blood flow(BF) had significant differences by two by two comparison in four groups(P

Endothelial leukocyte adhesion molecule -1 ( ELAM -1 ) is a member of the cell adhesion molecules,which plays a great role in the distant metastasis of tumor in ligand interactions between sLe (x)and sLe(a).Recently,it becomes a new research hotspot on applying ELAM -1 in targeted cancer therapy.Many studies results show that by regulation of ELAM -1 in biological effects ,such as ELAM-1 and ligand inhibitors , monoclonal antibody ,targeting gene ,and other mediates of the path of blocking therapy ,thereby inhibiting or bloc-king tumor distant metastasis ,so as to achieve the purpose of tumor therapy and improve the prognosis .Therefore , ELAM-1 is expected to exert a critical role in the tumor targeted therapy .In this paper ,the application value of ELAM-1 in tumor related targeted therapy is reviewed .

ObjectiveTo investigate the effect of different reference vessel groups on CT perfusion in patients with nasopharyngeal carcinoma (NPC) after radiation therapy,and explore the feasibility of substitution of reference vessel.MethodsThirty patients with NPC after radiation therapy were divide into two groups,recurrence group ( n =19) and fibrosis group ( n =11 ).All patients underwent CT perfusion scans,and the CT parameters were calculated with different arterial input and vein output in order to study their differences.The vessels were internal carotid artery-internal jugular vein( ICA-IJV group),external carotid artery-retomandibular vein (ECA-RTV group)and external carotid artery-internal jugular vein( ECAIJV group) respectively.The differences of the CT parameters between local recurrence group and fibrosis group were compared among the various vessel groups by rank sum test.With the help of receiver operating characteristic curve (ROC),the diagnostic efficiencies were compared by the area under the ROC curve (AUC).ResultsIn ICA-IJV group,ECA-RTV group and ECA-IJV group,bloood flow(BF) of local recurrence group were 201.88,439.59,252.23 ml · min-1 · 100 g-1,while BF of fibrosis group were 98.96,180.50,106.55 ml · min-1 · 100 g-1.Blood volume (BV) of local recurrence group were 6.71,12.39,6.70 ml/l00 g,while BV of fibrosis group were 2.35,4.76,2.95 ml/100 g.Mean transit time (MTT) of local recurrence group were 1.66,1.50,1.56 s,while MTT of fibrosis group were 2.13,1.96,1.79 s.Permeability surface (PS) of local recurrence group were 19.31,36.39,15.22 ml · min- 1 ·100 g-1,while they were 16.58,29.08 ,16.63 ml · min-1 · 100 g-1 in the fibrosis group.The differencesof BF and BV between the local recurrence group and fibrosis group were statistically significant in each vessel group (P ＜ 0.05 ) but MTT and PS showed no significant difference( P ＞ 0.05 ).In ICA-IJV group,the AUC of BF,BV,MTT,PS were 0.909,0.947,0.677,0.703,respectively.BF,BV,MTT,PS in ECA-RTV group were 0.938,0.967,0.648,0.679 respectively,and those in ECA-IJV group were 0.861,0.890,0.641,0.656 respectively.However,AUC of BF and BV of three groups all had significant difference ( P ＜ 0.01 ).ConclusionsBoth BF and BV values calculated by three pairs of reference vessels had enough diagnosis efficiency for local recurrence and fibrosis,so all of the three groups of vessels may substitute each other in CT perfusion.

0.05).Conclusion The parameters of CT perfusion can be regarded as a surrogate index of tumor angiogenic activity pre-and post-radiotherapy in nasopharyngeal carcinoma.

PurposeTo evaluate the significance of ultrasonic elastography strain ratio, MRI and the combination of both in diagnosis of breast tumor.Materials and MethodsFifty-four cases with single breast tumor underwent preoperative ultrasound elasticity imaging and MRI. Accuracy of ultrasound elastography strain rate ratio (SRR) of the tumor and surrounding normal breast tissue was measured by quantitative ultrasound elastography, and its combination with MRI were analyzed. ResultsThere was signiifcant differences on SRR between the benign group and the malignant group (2.24±1.28vs 4.96±1.73, t=2.648,P<0.05). Optimal threshold of ultrasonic elastography SRR in differential diagnosis of breast benign from malignant tumor was 2.41 determined by ROC curve. The accuracy of SRR, MRI and the combination of both in differentiating benign from malignant breast tumor was 81.48% (44/54), 85.19% (46/54) and 96.30%(52/54), respectively. There was no statistic difference between SRR and MRI in diagnostic accuracy (χ2=0.267,P>0.05). Combined both had higher diagnosis accuracy when compared with SR and MRI separately (χ2=6.000 and 3.967,P<0.05).Conclusion Ultrasonic elastography strain ratio is accurate and objective in differentiating benign from malignant breast tumors. It is a valuable quantitative index in clinical practice. Moreover, SRR combined with MRI can reduce the misdiagnosis rate.

Objective To explore the diagnostic performance of susceptibility weighted imaging (SWI) in distinguishing malignant from benign parotid lesions.Methods We prospectively evaluated preoperative SWI findings of 41 patients with 12 malignant and 29 benign parotid lesions by surgical pathology, and explore the intravenous distribution, the largest diameter of veins (dv-max), the number of veins per unit area (N/Svein) and the graduation of intratumoral susceptibility signal intensity (ITSS).The parameters was analyzed by Chi-square test, Independent t-test, Mann-Whitney U rank test and receiver operating characteristics (ROC) curves with SPSS 16.0 software.Results (1) For intravenous distribution, the benign ones mainly distributed around peripheral areas, accounting for 89.7％ (26/29), while the malignant ones were centrally distributed, making up 10/12.There were significant difference (x2=20.882, P=0.000) between benign and malignant ones.(2) The largest diameter of veins (dv-max) of benign and malignant lesions were (1.1±0.5) mm and (2.5 ± 1.0)mm respectively.There were significant difference (t=4.633, P=0.000) between benign and malignant ones.(3) The N/Svein of benign lesions were (0.80±0.92) per cm2, while that of malignant ones are (1.07±0.69) per cm2.The N/Svein (t=0.9143, P=0.367) was statistically insignificant.(4) For the graduation of ITSS,among benign lesions, there were 3 cases of grade 0, 22 cases of grade 1, 2 cases of grade 2 and 2 cases of grade 3.Meanwhile, there were 2 cases of grade 1, 5 cases of grade 2 and 5 cases of grade 3 among malignant lesions.When the Youden index reached the highest point, the optimal diagnostic threshold of dv-max and ITSS values were 1.75 mm and 1.5 mm, the corresponding area under the ROC curve (AUC) were 0.924 and 0.856 respectively.The sensitivity of d and ITSS ondiagnosis were 10/12 and 10/12, and the specificity of that were 96.6％ and 86.2％ respectively.The table shows that the sensitivity and specificity of intravenous distribution in diagnosis of malignant lesions are 10/12 and 89.7％.Conclusions The results provided evidence that SWI may be helpful in distinguishing malignant from benign parotid lesions, and it is worth to be generalized in clinical medicine.

Objective To evaluate the value of differential diagnosis between benign and malignant thyroid lesions by susceptibility weighted imaging(SWI).Methods 53 patients with 20 malignant thyroid lesions and 71 benign thyroid lesions confirmed by surgery and pathology were analyzed retrospectively.All cases received conventional MRI and SWI preoperatively.Location,volume,SWI parameters including signal to noise ratio(SNR),contrast noise ratio(CNR)and intratumor susceptibility hypointensity (ITSHIA)datas in benign and malignant lesions were compared and analyzed.Results There was no statistical significance between benign and malignant thyroid lesions in the location,volume,SNR and CNR(χ2 or t =0.014,0.286,0.927,1.169;P =0.907,0.778,0.368,0.259 respectively).The maximum diameter (1.90 mm±0.32 mm),degree of maximum diameter(1.33±0.47),frequence(1.40±0.20)and area ratio(1.09±0.28)for benign thyroid lesions were less than those for malignant lesions(3.39 mm±0.79 mm,2.25±0.44,1.40±0.68,1.70±0.47)respectively (t or Z =12.629,5.788,3.41 5,5.795;P =0.000,0.000,0.001,0.000).Conclusion SWI semiquantitative assessment of pathlogical vascularity is useful in differential diagnosis of benign and malignant thyroid lesions.

Objective To evaluate the diagnostic performance of enhancement value and morphological features by using mul-tiphasic MDCT on differentiating untypical T4a from T3 gastric cancer.Methods Fifty-one histopathologically proven T3 and T4a gastric cancer patients with smooth serosa were collected retrospectively.Three radiologists read all images regarding morphological features,while the CT value and enhancement value of regions of interest (ROIs)located in the outer of lesion were calculated.Cut-off analysis was performed to determine optimal threshold levels of enhancement value to discriminate T4a and T3 gastric cancer.Di-agnostic performance of enhancement value and combination of enhancement value and morphologic assessment were compared with morphologic assessment by means of receiver operating characteristic (ROC)curve analysis.Results The sensitivity and specificity of morphological features was 66.67% and 33.33% respectively;the area under the ROC of enhancement value (between venous phase and plain scan)for differentiating T4a from T3 gastric cancer was 0.82,with a cut-off at 43.6 HU,sensitivity of 74.07% and specificity of 70.83%.Combined conventional standard and enhancement value,sensitivity of 100.00% and specificity 26.31%. Conclusion For differentiation of T4a and T3 gastric cancer by means of MDCT,enhancement value is found to be superior to con-ventional standard.

Objective To investigate the correlation between apparent diffusion coefficient (ADC)value of MR diffusion weighted imaging (DWI)and Ki-67 expression in rectal cancer.Methods The data of 47 patients with rectal cancer confirmed by pathology were retrospectively analyzed.Pelvic MRI,rectum DWI and enhanced examination were performed preoperatively.According to the Ki-67 index,the patients were divided into A-D four Groups:Group A with Ki-67 <10% (-),Group B with Ki-67 10%-25%(+),Group C with Ki-67 26%-50%(++);and Group D Ki-67 > 50%(+++).ADC values were calculated in each group to analyze the correlation with the Ki-67 expression levels.Results The mean ADC value were (1.280 ± 0.200 )× 10 -3 mm2/s in Group A (13 cases),(1.044±0.046)×10 -3 mm2/s in Group B (14 cases),(0.987 ±0.256)×10 -3 mm2/s in Group C (9 cases), and (0.85 1±0.099)×10 -3 mm2/s in Group D (1 1 cases).The mean ADC values were significantly different in the different groups with different levels of Ki-67 expression (P =0.001).ADC value and Ki-67 expression were moderate negatively correlated (r = -0.577, P=0.000).Conclusion DWI and ADC measurement can evaluate indirectly the cell proliferation and prognosis of rectal tumor to some extent.

Objective To investigate the value of diffusion weighted imaging (DWI)in identification of different molecular sub-types for breast cancer classifications.Methods All patients with breast cancer were divided into four subtypes groups by immuno-histochemistry results including Luminal A subtype,Luminal B subtype,HER2-over expressing (HER2-OE)subtype,and triple negative breast cancer (TNBC),respectively.The means of maximum,average,and minimum ADC of the lesions in all patients were recorded.The analysis of ANOVA and least significant difference test (LSD-t )were used for the statistical evaluation.Results There were significant differences in maximum ADC,average ADC,and minimum ADC among Luminal A subtype (n=21),Lu-minal B subtype (n=22),HER2-OE subtype (n=1 7)and TNBC subtype (n=12)groups (P =0.025,0.039 and 0.041,respec-tively).However,paired comparison in mean of maximum ADC,average ADC and minimum ADC by LSD-t multiple comparisons among Luminal A,Luminal B,HER2-OE and TNBC respectively were not significantly different.Conclusion DWI may be difficult to discriminate the molecular subtypes of breast cancer classification before surgery or biopsy.