As a non-invasive functional radiographic imaging method, perfusion computed tomography (PCT) permits the evalu-ation of non-small-cell lung cancer (NSCLC) angiogenesis and response to therapy by demonstrating alterations in NSCLC vascularity. PCT performed shortly after initiating therapy may provide a better evaluation of physiological changes rather than conventional size as-sessment obtained by response evaluation criteria in solid tumors. Based on the angiogenesis principle of NSCLC, the main evaluation indexes of PCT are blood flow, blood volume, mean transit time, permeability surface, and peak enhancement index. The relationship between PCT and the indexes of vascular normalization may have implications for exploring the predictive model of efficacy and prognostic factors of NSCLC. The cavity of microvessel in NSCLC and expression of VEGF factors are closely related to PCT imag-ing. According to PCT assessment, pathological classification and histological type of NSCLC play significant roles. However, techni-cal limitations, reproducibility of blood flow parameters, radiation dose, and volume of contrast medium delivered to the patient are some issues in this type of investigation. With the development of PCT technology and anti-angiogenesis drugs for NSCLC, more mo-lecular imaging markers and standardized targeted therapies will be available. Such advancements will provide a wider space for the as-sessment of NSCLC treated with anti-angiogenic therapy using PCT.

Objective To analyze the correlation between renal blood flow (BF)of CT perfusion and effective renal plasma flow (ERPF)of radionuclide labeled microspheres.Methods CT perfusion was applied to 26 cases of renal cell carcinoma (RCC)in order to obtain the average unit BF of the target layer of the uninjured lateral kidney.For the renal image of the uninjured lateral kidney in the nephrographic phase (NP),we used the value of maximal renal cross-sectional area times the value of renal maximal height as the standardized volume.The product of this standardized volume and average unit BF could be used as an approximation of total re-nal blood flow,which was a standardized renal BF value.Meanwhile,we took radionuclide labeled microspheres into practice to ob-tain an ERPF value of the corresponding uninjured lateral kidney.The correlation between standard renal BF and ERPF was obtained by using Pearson chi-square test.Results The standard renal BF values of the uninjured lateral kidney for the group of 26 cases of RCC ranged from 620.59 to 820.76 mL·min-1 ·g-1 ·cm3 (mean=718.87 ±58.40 mL·min-1 ·g-1 ·cm3 ),and the values of ERPF tested by radionuclide labeled microspheres ranged from 244 to 41 1 mL/min (mean= 320.54 ± 55.71 mL/min).The two groups were positively correlated (r=0.754,P <0.01).Conclusion CT perfusion imaging of the kidney,to some extent,has the potential to replace renal functional examination of radionuclide labeled microspheres.

Objective To explore the correlation between epidermal growth factor receptor (EGFR) gene mutations and computed tomography (CT) characteristics in lung adenocarcinoma.Methods Chest CT scan results of 200 postoperative lung adenocarcinoma patients were retrospectively studied,the EGFR gene mutations detection results were statistically analyzed,and the correlation between EGFR gene mutations status and CT characteristics was investigated.Results Single factor analysis results showed that non smoking,female patients,air bronchogram sign and small tumor diameter were significantly associated with EGFR gene mutations (P＜0.05),and the incidence of GGO in the EGFR gene mutation group was higher than that in the wild group,but no statistical significance was found (P＞0.05),while other clinical and CT signs,such as age,lobulation,spicule,calcification,cavity and pleural indentation were not associated with EGFR gene mutations (P＞0.05).Logistics regression analysis results showed that non smoking and air bronchogram sign were significantly associated with EGFR gene mutations (P＜0.05),but gender and tumor size were not associated with EGFR gene mutations(P＞0.05).Conclusions Non smoking and air bronchogram sign may be used as predictive factors for EGFR gene mutations in lung adenocarcinoma.

Objective To investigate the role of CT in the diagnois of superior vena cava syndrome secondary to pulmonary carcinoma. Method Fifty patients with pulmonary carcinoma resulting in SVCS were confirmed by pathological examinations. Relationship between anatomical distribution and gross type of pulmonary carcinoma and modes of pulmonary carcinoma resulting in SVCS were analyzed retrospectively and statistically. Correlation among obstructive degree of SVC, opening of collateral pathway and swelling of chest wall was analyzed retrospectively and statistically. Results For modes of pulmonary carcinoma resulting in SVCS, direct invasion of pulmonary carcinoma was 7 patients, metastasis of lymph node was 16 patients and both of the two was 27 patients.Modes of pulmonary carcinoma resulting in SVCS were different for different gross types of pulmonary carcinoma in different pulmonary lobes ( x2 = 30.012,P ＜ 0.05). On CT appearances of secondary lesions, cases of simple constitution and opening of collateral pathway, simple swelling of chest wall, both of the two and neither of the two were 14 patients, 12 cases, 15 patients and 9 patients in order on CT. With SVC obstruction at different extent,constitution and opening of collateral pathway and swelling of chest wall were different ( x2= 12.881, P ＜ 0.05).Conclusions SVCS resulted from pulmonary carcinoma can be diagnosed by contrast enhanced CT.

Objective:To examine the features of multislice spiral computed tomography (MSCT) in micropapillary-predominant lung adenocarcinomas to improve the understanding of this type of lung cancer. Methods:The MSCT features of 18 cases with micro-papillary-predominant lung adenocarcinoma (micropapillary component>50%) confirmed by histopathology were analyzed retrospec-tively. Results:Among the 18 cases of lung cancer, 1 was diffuse, 3 were central, and 14 were peripheral lung cancer (PLC). The size of the adenocarcinomas in the 14 PLC cases ranged from 1.3 cm to 8.5 cm, with an average of 3.56 cm, including the size of 8 cases greater than or equal to 3 cm. Among the 18 cases, 13 were lobulated, 9 showed spicule signs, 7 showed pleural indentation signs, 5 had pleural adhesions, 1 had bronchial truncation (i.e., cut-off sign), and 4 were surrounded by obstructive inflammation. In addition, calcifi-cation was observed in one case, uneven density in two large lesions, air bronchus sign in four, and solid and ground-glass mixed densi-ty in two. Among the total number of cases, a variety of the measurable enhanced CT values (ΔCT) of lesions were found in 16, ranging from 13 HU to 80 HU, with an average of 47.5 HU, of which 15 were cases ofΔCT≥15 HU and 15 were cases ofΔCT≥20 HU. Pleu-ral thickening was observed in two cases with pleural effusion, and pleural metastasis in one case was confirmed by histopathology. One case with pleural effusion suffering pleural metastasis was confirmed. Ground-glass density nodules in both lungs were observed in one case, with a few bilateral pleural and pericardial effusions. Eight cases had mediastinal or hilar enlarged lymph nodes with uneven density enhancement, and lymph node metastasis was pathologically confirmed in six cases. Lymph node metastasis was found in four cases, but no apparent enlargement of lymph nodes in MSCT was observed. Conclusion:Micropapillary-predominant lung adenocarci-nomas were common in non-smoking elderly female patients, whose lung cancer cases were mostly PLC. The typical features of PLC include lobulation, spicule, and pleural indentation signs. Solid density ranked first in the PLC cases, with evident enhancement and high rate of lymph node metastasis.

Objective To assess the CT perfusion characteristics of breast diseases. Methods Twenty-two patients with fibroadenoma accompanied with cyst (n=1), other benign diseases (n=5), and carcinomas (n=16) underwent breast CT scan. CT perfusion was performed for breast with cine mode (0.5 s per rotation ) on a multislice CT scanner ,120 kV, 60 mA, 4?5 mm collimation. Contrast injection was done by using 50 ml nonionic contrast agent ( 300 mg I/ml ), at a flow rate of 4 ml/s with a power injector, 5 seconds delay, and data acquisition lasted for 50 seconds. These data were processed on a GE AW 4.1 workstation using perfusion 3 software package, and the mean BF, BV, MTT and PS were measured and statistically analyzed. Results The mean BF, BV, MTT and PS in carcinoma were (33.55? 28.40) ml?min -1 ? 100 g -1 , (5.60?3.08) ml/100 g, (15.37?6.41) s, (18.71?10.42) ml?min -1 ?100 g -1 . The mean BF, BV, MTT and PS in contralateral normal breast of carcinoma were (10.36?9.44) ml?min -1 ? 100 g -1 , (0.70?0.22) ml/100 g, (13.55?7.27) s, (1.54?1.74) ml?min -1 ?100 g -1 . The mean BF, BV, and PS between carcinoma and normal breast were statistically significant (P0.05). The mean BF, BV, MTT and PS in fibroadenoma were (62.57?19.62) ml?min -1 ?100 g -1 , (7.37?1.30) ml/100 g, (11.24?3.34) s, (27.63?3.87) ml?min -1 ?100 g -1 . The mean PS between carcinoma and fibroadenoma was statistically significant (P0.05). The mean BF, BV, MTT and PS in benign lesion were (7.65?10.24) ml?min -1 ?100 g -1 , (1.23?0.97) ml/100 g, (14.94?10.68) s, (1.81?1.72) ml?min -1 ?100 g -1 . The mean BF, BV, and PS between carcinoma and benign lesion were statistically significant (P0.05). Conclusion MSCT perfusion may reflect the features of breast diseases, and provide valuable hemodynamic message. These parameters have a value in diagnosis of breast diseases and are helpful for differential diagnosis.

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Objective:To study the predictive value of combining alpha-feto protein (AFP) with contrast-enhanced MRI imaging features in predicting incidence of microvascular invasion (MVI) in patients with hepatocellular carcinoma.Methods:The data of 206 patients with hepatocellular carcinoma treated at Tianjin Medical University Cancer Institute and Hospital from January 2017 to April 2019 were retrospectively analyzed. There were 179 males and 27 females, with an average age of 58.7 years. The roles of preoperative MRI imaging features and clinical data on predicting the incidence of MVI in patients with hepatocellular carcinoma were evaluated by univariate and multivariate logistic regression analyses. Multivariable regression analysis was then used to plot a nomogram.Results:There were 86 patients (41.7%) with MVI positivity and 120 patients (58.3%) with MVI negativity. Multivariate logistic regression analysis showed that AFP >400 μg/L ( OR=3.318, 95% CI: 1.243-8.855, P=0.017), two-trait predictor of venous invasion (TTPVI) ( OR=13.111, 95% CI: 6.797-28.119, P<0.001), diffusion weighted imaging/T 2 weighted imaging (DWI/T 2WI) mismatch ( OR=17.233, 95% CI: 4.731-44.490, P<0.001), and rim enhancement( OR=5.665, 95% CI: 2.579-18.152, P=0.013) predicted increased risks of MVI in patients with hepatocellular carcinoma. The constructed nomogram directly predicted the risk of MVI in these patients. Conclusions:AFP>400 μg/L, TTPVI, DWI/T 2WI mismatch and rim enhancement were independent risk factors in predicting MVI in patients with hepatocellular carcinoma. This predictive model of MVI which was based on multivariate logistic regression analysis was helpful to clinicians in making individualized treatment plans for patients with hepatocellular carcinoma.

Objective To study the value of breast imaging reporting and data system (BI-RADS)in Chinese breast cancer screening. Methods A total number of 3483 women participated in breast cancer screening with mammography in Hexi district in Tianjin from August to December 2009, which was organized by ministry of public health. BI-RADS assessment categories and recommendations were compared with histological findings. The precision, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated. Results Among 3483 screening mammography cases, 267 were almost entirely fat breast, 1245 were scauered fibroglandular, 1890 were dense and 81 extremely dense.There were 1011 patients(29.0%) with category 1, 1741 (50.0%) with category 2, 383 (11.0%) with category 3, 59 patients(1. 7%) with category 4 and 16 (0. 5%) with category 5 according to BI-RADS assessment categories. Totally, 71 women with 77 lesions were confirmed by histological examinations. There were 29 malignant and 48 benign lesions. The diagnostic precision, sensitivity, specificity of BI-RADS were 63. 6% (49/77) , 93. 1% (27/29) and 45.8% (22/48) . The general PPV of BI-RADS was 50. 9%(27/53). The PPV of categories 0, 4, 5 were 25.0% (1/4), 36. 4% (12/33) and 87. 5% (14/16). The NPV of categories 2 and3 were90.9% (10/11), 100.0% (12/12). Conclusions B1-RADS is of much value in assessing the breast malignancy. It is applicable in Chinese breast cancer screening.

Objective To explore the normal range of the volume of frontal lobe in Chinese adults of the Han nationality and provide morphological data for the construction of database for Chinese Standard Brain. Methods This is a clinical multi-center study. Two hundred Chinese healthy volunteers (age range= 18 to 70) recruited from 16 hospitals were divided into 5 groups, i. e. , age range from 18 to 30, age range from 31 to 40, age range from 41 to 50, age range from 51 to 60, and age range from 61 to 70. Each group contained 20 males and 20 females. All of the volunteers were scanned by MR using T1 weighted threedimensional magnetization prepared rapid acquisition gradient echo sequence. We used the manual method to trace the region of interest and measured the left and right frontal lobe volumes separately. All the data were analyzed with SPSS (version 13.0). The sex differences in the frontal lobe volumes were analyzed by independent-samples t test, and the side differences were analyzed by paired-samples t test. Correlation and regression analysis was used between the age and the frontal lobe volumes. Results In 200 healthy Chinese Han volunteers, the total frontal lobe volumes was (563 ± 73) cm3. For male, the volumes of the left and the right frontal lobe were (288±42) cm3 and (292 ±41 ) cm3 ,respectively. The volumes of the left and right frontal lobe in 100 women were (273 ±30) cm3 and (274 ± 30) cm3 respectively. The differences of sex (t = 3. 334, P < 0. 05 ) and side ( t = - 3.09, P < 0. 05 ) in the total frontal lobe volumes reach significant. There was no significant differences in women ( t = - 1. 304, P > 0. 05 ). There were negative correlations between the frontal lobe volumes and age in men and women ( r = - 0. 586, - 0. 498, P <0. 01 ). Conclusions The total frontal lobe volume of men was larger than that of women. The volume of the right frontal lobe was larger than the left frontal lobe in men, and the asymmetries didn't exist in women.The total frontal lobe volumes were both shrinking with age in men and women, which was more rapid in men than in women.