Most of the cervical lymph node metastasis comes from thyroid cancer and squamous cell carcinoma of different regions of the neck. Origin of the primary cancer could be general speculated based on thefirst metastatic station site. The metastatic lymph nodes of squamous cell carcinoma and thyroid carcinoma have their own characteristics. These metastatic lymph nodes need to be differentiated from lymph node inflammatory changes, tuberculosis, lymphoma, Castleman's disease, and soft tissue tumors.

Digital breast tomosynthesis is a 3D radiographic technique that obtains information from a few projection images, these images are the reconstructed into a set of images. Breast tomosynthesis could be used in breast cancer screening and diagnosis. This technique reduced the call-back rate in breast cancer screening, and increased the sensitivity and accuracy in detection of the lesion. Contrast-enhanced dual-energy digital mammography processes low-energy image and subtraction image from high and low energy images, iodine enhancement was performed, which could better depict the enhanced tumor. This technique was only used to diagnosis, it could improve the sensitivity of breast cancer detection compared to the conventional mammography and combined the mammography and ultrasound. Contrast-enhanced dual-energy digital mammography had a higher specificity for detecting index cancer than did enhanced MR imaging, and sensitivity was equal.

Objective To improve understanding of the varied, especially atypical mammographic appearances of breast infiltrating lobular carcinoma(ILC). Methods We retrospectively studied 28 ILC (27 patients) mammographic appearances and correlated with the clinical examination, ultrasonographic(US) findings.Results ①The most frequent mammographic finding was an uncalcified mass (13), followed by a mass with calcifications (5), architecture distortion was seen in 4 lesions, two lesions appeared indistinct calcifications. Pleomorphic microcalcifications, focal asymmetric density were 1 respectively, negative mammogram was in two cases. ②Eighteen lesions appeared a mass with or without calcifications on mammogram. Of them, 5 lesions appeared irregular shape. The mass with indistinct margins and spiculated borders were 9 and 6 lesions respectively. ③Seven lesions appeared subtle features, such as architecture distortion (4), indistinct calcifications (2) and focal asymmertric density (1). ④The sensitivity of mammographic detection was 86%(24/28), clinical examination was 64%(18/28), US was 85% (17/20). The sensitivity could be improved to 96%(27/28) by the use of integrated mammography, US, and clinical examination.Conclusion The irregular mass with indistinct or spiculated margins is the predominant mammographic sign in ILC. Atypical features, such as architectural distortion etc are frequently findings. The combination of mammography, ultrasonography and clinical examination is effective to detect ILC.

It has been shown that MR imaging of breast is superior to conventional mammography and ultrasonography on early diagnosis and cancer staging on breast cancer due to MRI’s high soft-tissue contrast and no radiation. The concept of multidisciplinary treatment of breast cancer has been increasingly accepted in clinical practice of breast cancer care. Investigation of breast MRI on cancer staging, selecting conservative therapy, detecting the primary malignant of patients presenting as axillary metastases, evaluating residual disease after neoadjuvant chemotherapy(NAC), predicting response in the early phase of treatment as well as monitoring recurrence during follow-up has been carried out along with its board clinical application. The advantages of breast MRI in mapping the disease accurately provide measures to select appropriate use of variable treatments.

0.05,respectively. Chi-square test, Fisher′s exact method). Conclusion The mammographic features of mucinous breast carcinoma show differences in pure and mixed types of the tumor. The most common mammographic appearance of pure mucinous carcinomas with high volume of mucin is a mass with microlobulated margins. Pure type of carcinomas with small volume of mucin and mixed type carcinomas have more aggressive imaging characteristics.

Purpose:We present the imaging and pathological features of pPNET tumor in six patients,to add to the knowledge of this tumor. Methods:Retrospective analysis of six pPNETs integrated with data of radiography and pathology. Results:The CT appearance of the tumor arising in soft tissue showed a large,ill-defined,non-calcified mass and heterogeneous appearance with hypodense cystic areas. The tumors demonstrated heterogeneous contrast enhancement. The pPNET arising in bone demonstrated extensive lytic lesion with large soft tissue mass,no newly-born bone and demonstrated heterogeneous contrast enhancement. MRI in SE sequences on T 1 W demonstrated homogeneous intensity for muscle and showed enhancement pattern of multiple internal septa and envelope. On T 2 W image,the tumors were heterogeneous with hyperintense signal. Conclusions:The study of clinic and radiology on pPENT does not show specificity. CT and MRI findings on pPENT can provide more information of it's internal structure,involved area,adjacent vascular and nervous structures. CT and MRI can also be useful in detection of recurrent and metastatic disease and very useful in preoperative staging,and in the planning of the surgical appproach.

Objective To discuss the features of MRI and molybdenum target X-ray in mammary primary non-Hodgkin's lymphoma.Methods 3 cases of mammary primary non-Hodgkin's lymphoma were studied.The features of MRI and molybdenum target X-ray werecollected and analyzed(all 3 cases had molybdenum target X-ray in MLO site and CC site,one had MRI image).Results All 3 caseslesions were in single side,one case had two lesions in one side.The diameter of all the lesions were more than 3cm.The lesion presented as iso-or slight hyperdensity shadow,and related to breast tissue and density was hemogeneous.The tumor was irregular but no bristle andcalcification.There was no skin and nipple involved in superficial of mammary gland.In T_1WI showed even low signal.In T_2WI showedeven little high or equal signal.Intensity was hemogeneous and obvious.The curve of time-signal intensity was platform pattern.Conclusion The features of MRI and molybdenum target X-ray in mammary primary non-Hodgkin's lymphoma are characteristic and helpful for deciding correct therapy plan.

Background and purpose:The lymph node metastatic model of rectal tumor is a useful tool for the research on tumor occurrence, development, metastasis and antineoplastic therapy. There are few reports about establishment of larger animal model. This study aimed to establish feasible and reproducible lymph node metastatic models of VX2 tumor in rabbits.Methods:The VX2 tumor tissue was put into the puncture needle. The VX2 tumor tissue in the needle was orthotopically transplanted into the rectal wall of the New Zealand white rabbits successfully. Twenty New Zealand white rabbits were transplanted. Two experimental rabbits were scanned by MR weekly. Tumor growth curve and lymph node numbers were observed on MR. Experimental rabbit tumor volumes were measured by MR post-processing software. The rectal tumor and surrounding lymph nodes were resected, and the specimens were ifxed. The sections were stained with HE. We explored the relationship between tumor volume and growth time, the number of metastatic lymph nodes and tumor volume, respectively.Results:Thirteen models were successfully established with a rate of 65%. Tumors limited in the rectal wall were observed on the fourth week. Tumor size increased over time. There was significant difference in the tumor volume between different periods (growth cycle number) (F=52.865,P<0.05). There was a signiifcantly positive correlation between tumor volume and the growth cycle number (r=0.910,P<0.05). The metastatic lymph nodes could be observed when VT>9 cm3. The number of metastatic lymph node increased obviously from the ninth week. The more tumor volume, the greater the number of metastatic lymph nodes was observed (F=92.531,P<0.05). There was a signiifcantly positive correlation between the number of metastatic lymph nodes and the tumor volume (r=0.945,P<0.05).Conclusion:Metastatic lymph node models of VX2 tumor in New Zealand white rabbits were established successfully. This model has some value in the research on local growth, invasion mechanism, lymph node metastasis and biological characteristics of rectal cancer.

Objective To determine the value of dynamic contrast enhanced (DCE?MRI) in predicting treatment response before preoperative chemoradiotherapy in locally advanced rectal cancer. Methods A cohort of consecutive patients with histologically confirmed rectal adenocarcinoma treated with preoperative chemoradiotherapy followed by total mesorectal excision (TME) surgery was enrolled in a prospective, pilot trial. All enrolled patients were examined using DCE?MRI at two time points: 2 to 5 days before neoadjuvant chemoradiation, 1 to 4 days before surgery. The following perfusion parameters (Ktrans, Kep, Ve) were measured for tumor. The patients were classified into pathological complete response (pCR) and non?pCR group according to the pathological results after operation. Those perfusion parameters were compared between the pCR and the non?pCR group and between before and after CRT in pCR and the non?pCR group with the t test. Receiver?operating curves (ROC) were constructed to further investigate the predictive value of Ktrans, Kep, Ve before neoadjuvant chemoradiation and were used to determine a threshold value at which patents with pCR could be distinguished from patients without complete response. Results The final study population consisted of 38 patients. There were 12 patients with a pCR and 26 patients with non?pCR. Before neoadjuvant chemoradiation, the mean tumor Ktrans, Kep and Ve for pCR group were (1.25 ± 0.56)/min, (2.10 ± 1.61)/min and 0.73 ± 0.34, respectively, for non?pCR group they were (0.46 ± 0.39)/min, (1.15 ± 0.77)/min and 0.32±0.12, respectively. All perfusion parameters showed significant difference between those two groups(t values were 3.45,5.67 and 6.23 respectively, all P<0.05). After neoadjuvant chemoradiation, the mean tumor Ktrans, Kep and Ve for pCR group were (0.28 ± 0.13)/min, (0.62 ± 0.27)/min and 0.21 ± 0.13 respectively, for non?pCR group, they were (0.32±0.12)/min, (0.83±0.42)/min and 0.17±0.10, respectively. All perfusion parameters showed no difference between those two groups(P>0.05), as well as the changes before and after neoadjuvant chemoradiation in those groups(P>0.05). ROC analysis for Ktrans pre?treatment revealed that Ktrans had an AUC of 0.837 in predicting pCR. A Ktrans of 0.66/min was emerged as the optimal cut?off for distinguishing pCR from non?pCR and for Ktrans>0.66/min, the sensitivity and specificity for predicting pCR were 75.0% (9/12) and 96.2% (25/26). Kep and Ve showed an AUC of 0.655 and 0.654 in predicting pCR. Conclusions In locally advanced rectal cancer, DCE?MRI can aid in predicting treatment response before preoperative chemoradiotherapy. Ktrans may become a better predictor to classify which patients will benefit from neoadjuvant chemoradiation.

Objective To explore the efficacy of high-resolution MRI in the prediction of tumor complete response after neoadjuvant chemoradiation therapy for T3 rectal cancer.Methods The clinical data of 108 patients with T3 rectal cancer who were admitted to Shanghai Cancer Center of Fudan University from 2010 to 2012 were retrospectively analyzed.The TNM stage of tumor,extramural depth of tumor invasion (mrT3 stage),involvement of mesorectum and rectal fascia,tumor diameter and distance from anal edge to lower edge of tumor were the main items of evaluation using the high-resolution MRI.A total of 108 patients underwent surgical resection of tumor after neoadjuvant chemoradiation therapy.The tumor complete response after neoadjuvant chemoradiation therapy was evaluated by tumor node metastasis (TNM) stage and tumor regression grade (TRG).The categorical data and multivariate analysis were done by the single factor analysis of variance (ANOVA) and Logistic regression analysis.Results The positive response rate of the T3a,T3b and T3c in the patients were 61.5％ (16/26),36.9％ (24/65) and 11.8％ (2/17) after neoadjuvant chemoradiation therapy,respectively.The mrT3,mrN and tumor diameter were the potential factors affecting response of neoadjuvant chemoradiation therapy by the univariate analysis of pathological restaging (x2 =50.474,30.985,8.318,P ＜ 0.05).The mrT3 was an independent risk factor affecting response of neoadjuvant chemoradiation therapy by the multivariate analysis of pathological restaging (OR =4.473,95 ％ confidence interval:2.003-9.991,P ＜ 0.05).There was no significant difference between the mrT3 stage,N stage,involvement of mesorectum and rectal fascia,tumor diameter and distance from anal edge to lower edge of tumor before therapy and the response after neoadjuvant chemoradiation therapy based on the tumor regression grade(TRG) (x2 =6.264,6.159,2.949,2.189,6.335,P ＞ 0.05).Conclusion The mrT3 in patients undergoing high-resolution MRI before neoadjuvant chemoradiation therapy could predict the tumor complete response after neoadjuvant chemoradiation therapy for T3 rectal cancer.