Objective To evaluate the effect of low-dose colonic CT scanning in image quality and lesion revealing with different noise idex.Methods Model group:in order to find the optimal scanning parameter range,small simulated polyps in pig colon was prepared and mA was modulated by regulating noise index.Images were reprocessed with CT colonography and Raysum reconstructions.Image quality and the lesion revealing situation were evaluated and scored based on both reconstructive and axial images.The study of patient group was prospective and continuous.All positive cases were comfirmed by biopsy or surgery pathology.Two groups of patients were enrolled.First group(39 cases from January 2007 to June 2007):patients were divided into three sub-groups randomly(15 cages with NI=10,13 cases with NI:13,11 cases with NI=16),while NI was not changed with position.Second group(32 cases from Jury 2007 to January 2008):patients were scanned and NI was changed with different position(NI=10,20).The average X-ray radiation values of two patient groups were compared with standard values.All data were processed with rank sum tesL Results First group:when NI=10,the average scores of axial and constructive images were 4.2 and 2.4 respectively,when NI=13,those were 3.2 and 2.5 respectively,When NI=16.those were 2.9 and 2.7 respectively.and the average CTDlw were 17.51,12.90 and 5.94 mGy respectively.When NI increased,the average scores of axial decreased(H=20.01,P＜0.01),the average scores of constructive images did not changed(H=0.81,P＞0.05).Second group:when NI=10,the average scores of axial and constructive images were respectively 3.6 and 2.3,when NI=20,those were 2.2 and 2.3 respectively,and the average CTDIw was 11.63 mGy.When NI increased from 10 to 20,the average scores of axial decreased(H=20.84,P＜0.01),the average scores of constructive images did not decreased(H=0.29,P＞0.05).In the first group,the average CTDIw wag reduced by 35.0%,52.1%and 77.9%respectively when NI was 10,13 and 16.In the second group,the average CTDIw Was reduced by 56.8%.Conclusions Auto-mA low-dose CT scanning could reduce X-ray radiation obviously,while not affecting image quality.

Objective To evaluate the feasibility of diffusion kurtosis imaging (DKI)in the diagnosis and aggressiveness assessment of prostate cancer.Methods The MR data with multi-b-value diffusion-weighted imaging (DWI)of 30 male patients with prostate cancer were retrospectively analyzed.D maps and K maps were generated from the DKI model and ADC maps were obtained using the conventional monoexponential model.Differences in the D,K and ADC values between prostate cancer and benign peripheral zone (PZ)tissues,among tumors with different Gleason scores were analyzed.P<0.05 was considered statistical significance.Results ADC and D values were significantly lower in the prostate cancers than in the benign PZs (P <0.001).K values were significantly greater in the prostate cancers than in the benign PZs (P <0.001).ADC,D and K values were different significantly among the tumors with Glea-son scores of 6,7 and ≥8 (P <0.001,P =0.01 5 and P <0.001,respectively).Conclusion The DKI model can better describe the signal intensity attenuation with b values increasing,which is helpful for diagnosing and grading prostate cancer.K value may be used to quantitatively evaluate the complicated microstructure of prostate cancer.

Objective:To compare the efficacy and safety of octreotide and somatostatin in the treatment of liver cirrhosis and up-per digestive tract hemorrhage. Methods:The randomized controlled trails ( RCTs) on the comparison between octreotide and soma-tostatin in the treatment of liver cirrhosis and upper digestive tract hemorrhage were searched from Cochrane Library, PubMed, Med-line, Embase, China National Knowledge Infrastructure(CNKI), VIP China Science and Technology Journal Database and Wanfang database (till February 2017). The randomized controlled trails meeting the inclusion criteria were collected and the quality of included RCTs was assessed according to the Cochrane Collaboration system review, and then Meta -analysis was performed using RevMan 5. 3 software after data extraction and bias risk assessment. Results:A total of 11 RCTs were included. Meta-analysis showed the efficacy of octreotide group was similar to that of somatostatin group (OR=1. 10, 95%CI:0. 79-1. 53, P=0. 56). The levels of blood transfu-sion and hemostasis of octreotide group were higher than those of somatostatin group (MD=0. 68, 95%CI:0. 54-0. 82, P<0. 01 and MD=6. 26, 95%CI:4. 89-7. 63, P<0. 01). The risk of abdominal pain in octreotide group was lower than that in somatostatin group (OR=0. 43, 95%CI:0. 22-0. 86, P=0. 02). The other adverse reactions were similar in both groups. Conclusion:The efficacy of octreotide is similar to that of somatostatin in the treatment of liver cirrhosis and upper digestive tract hemorrhage, and the effect of som-atostatin is quicker than that of octreotide with less blood transfusion. The adverse reactions are similar in both groups, except that oct-reotide has a lower risk of abdominal pain. The long-term safety of octreotide still needs to be confirmed by performing higher quality and large-sample RCTs.

Objective To investigate the feasibility of quantitatively evaluating angiogenesis in liver tumors by using flat detector computed tomography (FDCT) in the angiography suite.Methods The VX2 liver tumor model was established in 25 rabbits,and then FDCT examination was performed for each animal.After reconstructing the blood volume (BV) perfusion map,BV values of the hepatic tumor and parenchyma were measured respectively.All experimental rabbits were sacrificed after FDCT,and the corresponding tumor specimens were collected for measuring microvessel density (MVD) and vascular endothelial growth factor (VEGF) expression level.The relationships of BV values with MVD and VEGF expression in liver tumors were analyzed.Results Of the 25 experimental rabbits,FDCT examination was successfully accomplished in 22(88.0％).Both the hepatic parenchyma and tumor lesions could be clearly visualized on BV perfusion map.The hepatic tumor was characterized by a hyperperfusion rim with a hypoperfusion center,known as rim-like enhancement pattern,on BV perfusion map.BV values bore a close relationship to both MVD grade and VEGF grade (P＜0.05 in both),while MVD grade had a parallel relationship with VEGF grade (r=0.504,P＜ 0.001).Conclusion It is feasible to use FDCT in the angiography suite to quantitatively assess the angiogenesis of liver tumors.It may be helpful for interventional treatment of liver tumors.

Objective:To evaluate the diagnostic performance of a radiomics model based on dynamic contrast-enhanced MRI (DCE-MRI) and diffusion weighted imaging (DWI) in small breast cancer (≤ 20 mm in greatest dimension), and to compare the results with those of an experienced radiologist’s interpretation.Methods:A total of 205 small breast lesions in 192 consecutive female patients from June 2016 to January 2018 at Renji Hospital, School of Medicine, Shanghai Jiaotong University, were retrospectively enrolled in the study. All lesions (≤ 20 mm in greatest dimension) were confirmed by surgical pathological results. The lesions were divided into a training set (116 lesions) and an independent test set (89 lesions). Based on preoperative breast DCE-MRI and DWI data, a radiomics model was built using gradient boosting decision tree (GBDT). The GBDT model was applied to the test set for differentiation between malignant and benign small breast lesions. Cases of the test set were also evaluated by an experienced radiologist for benign and malignant diseases differentiation. ROC curve was used to assess the diagnostic performance for the GBDT model and the radiologist evaluation, respectively. Differences in the area under the ROC curve (AUC) were analyzed by the DeLong test. Differences in sensitivity, specificity and accuracy were evaluated by the McNemar test. Kappa values were used to assess the agreement between different evaluation methods.Results:The AUC of the GBDT model (0.950) showed no significant difference from that of the radiologist’s evaluation based on DCE-MRI combing DWI data (0.935) ( Z=0.499, P=0.618). However, it showed the AUC of GBDT model was significantly higher than that of evaluation based on DCE-MRI (0.874) or DWI (0.832) alone ( Z=2.024， P=0.043； Z=2.772， P=0.006). The sensitivity, specificity and accuracy of the best cutoff point of GBDT model were 90.0%, 89.8% and 89.9% respectively. The sensitivity, specificity and accuracy of evaluation based on DCE-MRI combined with DWI were 97.5%, 79.6% and 87.6% respectively. There was no significant difference in diagnostic performance between the two methods (χ 2=0.800,2.286 and 0.083, P>0.05). Conclusions:A radiomics model based on DCE-MRI and DWI images provided good diagnostic performance in small breast cancer. The results of radiomics were favorably comparable with those of experienced radiologist evaluation based on the combination of DCE-MRI and DWI data.

Objective    To evaluate the efficacy of video-assisted thoracoscopic sleeve lobectomy in the treatment of central non-small cell lung cancer. Methods    The clinical data of 105 patients with central non-small cell lung cancer who underwent sleeve lobectomy surgery in the Second Hospital of Shanxi Medical University and Shanxi Cancer Hospital from December 2014 to December 2019 were retrospectively analyzed, including 83 males and 22 females, with an average age of 57.4 (32.6-77.8) years and weight of 62.5 (52.4-79.1) kg. Thirty-five patients received video-assisted thoracoscopic sleeve lobectomy (a group A), and 70 patients received traditional thoracotomy sleeve lobectomy (a group B). The operation time, intraoperative blood loss, number of lymph node dissection, postoperative complication rate, early postoperative mortality, total thoracic drainage volume at 24 hours, time of indwelling chest tube after operation, pain score at 24 hours after operation, postoperative hospital stay, postoperative short-term (1 month, 6 months and 1 year) quality of life score and postoperative 3-year survival rate of two groups were compared. Results    There was statistical difference in the operation time (228.1±24.7 min vs. 175.0±23.7 min, P=0.02), postoperative complication rate (28.6% vs. 34.3%, P=0.04), postoperative pain score at 24 h (3.6±3.5 points vs. 5.9±2.0 points, P=0.03) and postoperative indwelling chest tube time (5.0±2.9 d vs. 8.4±2.1 d, P=0.04) between the two groups. There was no statistical difference in the intraoperative blood loss (182.5±36.9 mL vs. 189.8±27.5 mL, P=0.34), number of lymph node dissections (11.1±2.6 vs. 12.3±1.9, P=0.49), early postoperative mortality (2.9% vs. 4.3%, P=0.31), total thoracic drainage volume at 24 h after surgery (346.8± 91.1 mL vs. 329.8±101.4 mL, P=0.27), postoperative hospital stay (7.9±4.2 d vs. 8.5±3.4 d, P=0.39) and 3-year postoperative survival rate (68.6% vs. 72.9%, P=0.82) between the two groups. Conclusion    Video-assisted thoracoscopic sleeve lobectomy for the treatment of central non-small cell lung cancer is safe and feasible. Compared with traditional thoracotomy for sleeve lobectomy, fewer postoperative complications occur, body recovers faster and the quality of life is higher within the postoperative 6 months. Besides, the 3-year survival rate can achieve similar oncological prognosis results.