1.Basic principles and clinical applications of dynamic contrast-enhanced MRI in prostate cancer
Shengjian ZHANG ; Weijun PENG ; Liangping ZHOU
Chinese Journal of Medical Imaging Technology 2010;26(2):378-380
Dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) enables non-invasive imaging characterization of tissue vascularity with small molecular weight gadolinium chelates. Depending on this technique, tissue blood perfusion, microvessel permeability and extracellular leakage space can be obtained. The basic principles of two dynamic MRI techniques (T2*W and T1W DCE-MRI) and their applications in prostate cancer of DCE-MRI including diagnosis, differential diagnosis, formulation of treatment plan, evaluation of therapeutic reaction, detection of lesion recurrent were reviewed in this article.
2.MRI features of lymphoma in spinal area
Liangping ZHOU ; Weijun PENG ; Wentao YANG ; Feng TANG
Chinese Journal of Radiology 2008;42(7):683-687
Objective To analyze MR imaging manifestations of spinal area lymphoma in order to improve the recognition and understanding of the disease. Methods A group of 45 patients with pathologically or clinically proven spinal area lymphoma were reviewed. Five cases were primary NHL,40 cases were secondary with 9 HL and 31 NHL (27 B-cell type NHL and 4 T-cell type NHL). MR Imaging findings were analyzed and correlated with clinical and pathologic findings. Results (1) Location of lesions: 13 cases were focal type and 32 cases were multifocal type. All of the 5 patients with primary lymphoma were focal type, while 32 of 40 cases of secondary lymphoma were multifocal type. (2) Type oflesions: ①Vertebral destruction: 27 cases manifested as bone destruction with 23 of them had soft tissuemass and the extent of soft tissue masses were larger than that of bone destruction in 18 cases.②Soft tissuemasses: 6 cases manifested as soft masses without obvious bone destruction, of which 5 cases had soft tissuemasses imbedded vertebrae and communicated paravertebral and epidural spaces through intervertebralforamen.③Bone marrow infiltration: 9 cases of secondary spinal lympboma had signal intensity changes ofbone marrow without obvious cortical bone destruction and soft tissue mass. ④ Spinal cord infiltration:3 cases of secondary spinal lymphoma had spinal cord swelling and signal intensity changes. (3) MRIfindings: all lesions of bone destruction and marrow infiltration manifested as hypointense on T1-weightedimages, hypointense, isointense or hyperintense on T2-weighted images and hyperintense on T2-weightedimages with fat-suppression technique. All soft tissue masses were homogeneous hypointense on T1-weightedimages and hyperintense on T2-weighted images. After intravenous injection of contrast media, the lesions ofthe bone and the soft tissue showed mild or moderate enhancement without remarkable cystic degenerationand necrosis. Conclusions Most of the spinal area lymphoma is the secondary B type NHL with complexMRI manifestation. Osteolytic lesion with contiguous paravertebral soft tissue mass imbedded vertebrae whichcommunicated paravertebral and epidural spaces through intervertebral foramen with a mild or moderateenhancement may suggest the diagnosis of this rare disease.
3.The diagnostic ability of biexponential diffusion-weighted imaging (DWI) for organ-conifned prostate cancer in peripheral zone:compared to monoexponential DWI
Lei YUE ; Xiaohang LIU ; Liangping ZHOU ; Jian MAO ; Weijun PENG
China Oncology 2016;26(7):616-622
Background and purpose:With the widespread use of screening of prostate-specific antigen (PSA) levels, prostate cancers at organ-conifned stage are increasing in newly diagnosed cases. However, some defects remain in conventional monoexponential diffusion-weighted imaging (DWI) for differentiating organ-conifned prostate cancer from benign lesions. Therefore, the aim of this study was to obtain biexponential apparent diffusion parameters of prostate organ-conifned cancer, chronic prostatitis in peripheral zone (PZ) and normal PZ tissue, and to compare with monoexponential apparent diffusion coeffcient (ADC) for differentiating prostate cancer from prostatitis lesions. Methods:Sixteen patients with pathologically confirmed prostate organ-confined cancer in PZ, 14 with prostatitis underwent conventional (b-factors 0, 1 000 s/mm2) and 10b-factors (0-3 000 s/mm2) diffusion-weighted imaging (DWI).The monoexponential ADC value and biexponential parameters fast ADC (ADCf), fraction of ADCf (f), slow ADC (ADCs) value for prostate cancer, prostatitis and normal tissues were calculated and compared. Receiver operating characteristic analysis was performed for those parameters.Results:Biexponential and monoexponential parameters were obtained for 18 prostate cancers, 18 prostatitis and 37 normal PZ tissues. The ADC value of prostate cancer tissues was remarkably lower [(0.83±0.11)×10-3 mm2/s] than that of other tissues (P<0.01), while the ADC value of prostatitis [(1.45±0.19)×10-3 mm2/s] was lower than that of PZ [(1.67±0.31)×10-3 mm2/s] (P<0.01). Prostate cancer tissues had low-er ADCf [(1.54±0.23)×10-3 mm2/s],f [(45.8±5.4)%] and ADCs [(0.52±0.15)×10-3mm2/s] than the other tissues (P<0.01). The ADCf,f and ADCs were higher in PZ [(3.90±0.40)×10-3, (67.3±8.2)% and (1.51±0.36)×10-3 mm2/s] than prostatitis [(3.06±0.49)×10-3, (47.9±3.9)% and (0.91±0.29)×10-3 mm2/s) (P<0.01). The area under the curve (AUC) of ADCf and ADC were similar in differentiating cancer and prostatitis (0.96vs 0.94) (P>0.01), but the AUC off and ADCs in differ-entiating cancer from prostatitis (0.83 and 0.80) were signiifcantly lower than that of ADC (P<0.01).Conclusion:The biexponential DWI provided additional tissue characterization parameters for different prostate tissues. ADCf yielded comparable accuracy with ADC in identiifcation of prostate organ-conifned cancer. The biexponential parameter could further improve the diagnostic effcacy.
4.Primary non-Hodgkin lymphoma of skeletal muscle:imaging findings
Liangping ZHOU ; Weijun PENG ; Wentao YANG ; Feng TANG ; Jian MAO
Chinese Journal of Radiology 2000;0(12):-
Objective To analyze the imaging manifestations of primary non-Hodgkin lymphoma of skeletal muscle and improve the recognition of this rare disease.Methods Five cases of primary non-Hodgkin lymphoma of skeletal muscle proved pathologically underwent imaging exam,including MRI and CT in 3 cases,only MRI in 1 case,only CT in 1 case,X-ray in 2 cases and bone scintigraphy in 2 cases.Results Diffuse enlargements of involved muscle with presentation of overall configuration were observed in all five cases.All 4 cases manifested as homogeneous soft masses,which is isoattenuating to normal muscle on unenhanced CT images.After intravenous injection of contrast media,the masses enhanced homogeneously and slightly(2 cases)or moderately(1 case)on CT images.The lesions were homogenous and had isointense or slightly low signal intensity compared with that of uninvolved muscle on T1-weighted images and high signal intensity on T2-weighted images.After intravenous injection of contrast media,all 2 cases enhanced homogeneously and moderately with the enhanced signal intensity of involved muscle greatly higher than that of uninvolved muscle on MR images.Two cases of X-ray plain showed no destruction of bone and 2 cases of bone scintigraphy exams showed increased radiotracer uptake of involved muscle with no infiltration of bone marrow.Conclusion There are several characteristics on the imaging of primary non-Hodgkin lymphoma of skeletal muscle.MRI is the optimal imaging method for the diagnosis of this disease.
5.Application of DWI with various b values in diagnosis of clear cell renal cell carcinoma Fuhrman grades SHEN
Liangping ZHOU ; Weijun PENG ; Xiaoqun YANG ; Lei YUE
China Oncology 2015;(3):205-210
Background and purpose:Renal cell carcinoma is the most common type of adult renal cancer, and the Fuhrman grading system is the most widely accepted independent indicator for the prognosis of kidney tumors. This study aimed to explore the correlation between the conventional diffusion weighted imaging (DWI) with various b values and Fuhrman grade of clear cell renal cancer, and assess the diagnostic efifciency of ADC values at different b values in differentiating Fuhrman low- and high-grade tumor. Methods:Thirty-three patients with pathologically proved clear cell renal cell cancer (CCRCC) and qualiifed images were included for the research. The diagnostic efif-ciency of ADC values at different b values for differentiating Fuhrman low-(1 and 2) and high-grade (3 and 4) tumor were also assessed and compared by receiver operator characteristic curve (ROC), and the optimum sensitivity, speciifc-ity and accuracy were selected using Youden index. Results:The 33 patients consist one tumor of Fuhrman grade 1, 14 of grade 2, 16 of grade 3 and 2 of grade 4. A negative correlation was found between the ADC0-800, ADC0-400-800, ADC0-600-1 200, ADC0-400-800-1 200 and ADCtotal with Fuhrman grade (r:-0.553,-0.511,-0.603,-0.645,-0.610, respectively), among these the ADC0-400-800-1200 showed the strongest correlation. The AUCs [area under the (receiver operator characteristic curve) ROC curve] of those parameters for differentiating the low-and high-grade tumor were 0.789, 0.757, 0.813, 0.844 and 0.835, among which the ADC0-400-800-1 200 reveal the best result, but the difference was not statistically signif-icant (P>0.05). The sensitivity of the ADC values were 86.7%, 73.3%, 60.0%, 86.7%and 86.7%;The speciifcity were 66.7%, 77.8, 72.2%, 77.8%and 72.2%. Conclusion:ADC0-800, ADC0-400-800, ADC0-600-1 200, ADC0-400-800-1 200 and ADCtotal re-vealed signiifcant correlation with the Fuhrman grade of clear cell renal cancer, and providing high diagnostic efifciency in differentiating Fuhrman low-and high-grade tumor.
6.CT and MRI features of primary adrenal lymphoma
Liangping ZHOU ; Weijun PENG ; Jianhui DING ; Xiaohang LIU ; Chaofu WANG ; Xigang SHEN ; Min QIAN ; Jian MAO
Chinese Journal of Radiology 2009;43(9):969-972
dneys, renal hilars and adjacent blood vessels. Conclusions Most of the adrenal lymphoma manifested as large soft tissue masses with shght contrast enhancement. The larger lesions were likely to invade the ipsilateral kidney and adjacent blood vessels.
7.MRI findings and correlation with pathological features in breast phyllodes tumor
Xigang SHEN ; Hongna TAN ; Weijun PENG ; Ruimin LI ; Yajia GU ; Da HUANG ; Juan MAO ; Liangping ZHOU
Chinese Journal of Radiology 2011;45(12):1108-1112
ObjectiveTo study the MR Imaging features of breast phyllodes tumor (PT),and to correlate it with pathological results.MethodClinical and MRI findings were retrospectively reviewed in twenty-seven women with 28 PTs lesions confirmed by surgical pathology.Statistical analyses were one-way ANOVA for size analysis,Fisher exact test for analysis of MR appearances and Spearman correlation to study the relationship between MRI findings and BI-RADS categories.Results( 1 ) The histologic findings were benign,borderline and malignant PTs in 14.3% (4/28),53.6% (15/28) and 32.1% (9/28) of lesions,respectively.(2) The mean maximum-diameter were (6.4 ± 3.9) cm,(5.7 ± 2.2) cm in borderline type and (4.8 ± 1.8)cm in benign type respectively.The results showed differences in lesion's size among the three type (F = 287.541,P =0.000),especially between malignant and benign type (P = 0.033 ).(3)Internal non-enhanced septations and silt-like changes on enhanced images,as well as time-signal curve on MRI correlated significantly with the histological grade ( P < 0.05 ).( 4 ) If the category BI-RADS ≥ 4a was considered to be a suspicious sign for malignant lesion,the diagnostic accuracy of MRI would be 96.4% (27/28),and the BI-RADS category of the MRI could reflect the PT's histological grade with a low correlation coefficient ( r = 0.382,P = 0.045 ).Conclusion The findings of PT on MRI have some characteristics,with tumor size and several MRI features correlating with the histological grade of breast PT.
8.Analysis of the expression of MAGE-1 gene in human esophageal carcinoma and cloning of MAGE-1 cDNA from the carcinoma
Liangping PENG ; Guiqi WANG ; Yuliang RAN ; Haiyan LIU ; Lixin SUN ; Long YU ; Zhihua YANG
Immunological Journal 2001;(2):97-99
Objective To evaluate the expression of MAGE-1 gene in esophageal carcinoma and determine whether esophageal carcinoma patients should be eligible for MAGE-1 antigen-based vaccine therapies. Methods MAGE-1 mRNA expression in esophageal carcinoma was assessed by reverse transcription and polymerase chain reaction amplification. The PCR products were then digested by restriction endonucleases and inserted into the pET-30a(+) vector. The sequence of the inserted gene fragment was confirmed by DNA sequence analysis. Results Out of the 30 esophageal carcinomas studied, 43% of the esophageal carcinomas tissues expressed MAGE-1 gene and no expression was found in matched adjacent normal esophageal mucosae. The entire cDNA of the gene was cloned. Conclusion Owing to the high frequency of MAGE-1 gene expression in esophageal carcinoma and MAGE-1 antigen can be recognized by cytolytic T lymphocytes when presented by class-I HLA molecular, a large proportion of these patients might be suitable candidates for immune therapy involving tumor specific antigens encoded by MAGE-1 gene.
9.Clinical application study on malignant metastatic diseases between DWIBS and PET/CT
Xigang SHEN ; Liangping ZHOU ; Weijun PENG ; Jian MAO ; Ling ZHANG ; Yajia GU ; Zhifeng YAO ; Jingyi CHENG
China Oncology 2015;(6):456-466
Background and purpose: Diffusion-weighted whole-body imaging with background body signal suppression (DWIBS) can be used for magnetic resonance imaging systemic examination, especially in examing the metastatic lesions, lymph node and bone diseases, and the imaging result is similar with PET. This study aimed to evaluate the application value of magnetic resonance DWIBS and positron emission tomography with computed tomography (PET/CT) on malignant metastatic diseases. Methods: Thirty-six patients confirmed with malignant tumors accompanying metastasis by the pathology of operation or biopsy underwent both DWIBS imaging and PET/CT, chi-square test and Kappa test were used for comparing the detection results of metastasis by these 2 imaging methods. Results:Among the 36 malignant tumor patients with 238 metastatic lesions, 218 (91.6%, 218/238) lesions in DWIBS and 209 (87.8%, 209/238) lesions in PET/CT were detected, with 200 lesions detected by the two methods simultaneously, and the concordance rate was 88.7%(211/238);but there was no statistical signiifcance between this two methods (χ2=1.843, P=0.157). Kappa test showed a fair concordance rate between DWIBS and PET/CT (P=0.000).There were different significance between DWIBS and PET/CT in detecting metastatic lesions of brain and bone (P=0.005 and 0.031);But there was no signiifcant differences (P=0.309 and 1.000) in detecting metastatic lesions of lymph nodes and liver. Conclusion:DWIBS could detect metastatic lesions effectively, and there is ifne consistency with PET/CT. DWIBS is more sensitive than PET/CT in detecting metastatic lesions of brain and bone, so DWIBS could be chosed for screening metastatic lesions according to the characteristics of different primary tumors.
10.Acute Toxicity Study on Intragastric Administration of Different ProcessedRadix Aconiti Lateralis PraeparataProducts to Beagle Dogs
Yuqin SONG ; Xue ZHANG ; Yanhong DONG ; Liangping DAI ; Cheng PENG ; Xiaofang XIE
World Science and Technology-Modernization of Traditional Chinese Medicine 2015;(7):1432-1437
This article was aimed to study the acute toxicities on intragastric administration of differentRadix Aconiti Lateralis Praeparataprocessed products to Beagle dogs. A total of 16 healthy and qualified Beagle dogs were randomly divided into the blank group,Pao-Fu-Pian(PFP) group,Pao-Tian-Xiong(PTX) group andHei-Shun-Pian(HSP) group according to the body weight. The intragastric administration of 4 g crude herb per kg was given. Before medication, 1 h, 24 h, and 3, 7, 14 days after medication, the body weight, food consumption, rectal temperature, electrocardiogram, blood routine and blood biochemistry were measured. The results showed that after medication, all dogs in three experimental groups were depressed. And there were significant differences in the electrolytes of blood. Among them, the HSP group was the most obvious one. The red blood cells, blood sugar and triglycerides of dogs in the PFP group had significant difference. The lymphocytes and blood sugar had significant difference of dogs in the PTX group. However, after the medication of HSP, the lymphocytes of the dogs were decreased significantly. It was concluded that the toxicity of three processed products followed the order of HSP > PFP > PTX.