Objective To compare image quality and clinical usefulness between single breath-hold three-dimensional magnetic resonance cholangiopancreatography with compressed sensing(3D BH-CS-MRCP)and with gradient and spin-echo(3D BH-GRASE-MRCP)and conventional three-dimensional breath-triggered magnetic resonance cholangiopancreatography(3D RT-MRCP).Methods A retrospective analysis was performed in 48 patients(26 males and 22 females,mean age of 53.14±15.19 years),who underwent 3D BH-GRASE-MRCP,3D BH-CS-MRCP and 3D RT-MRCP from September to December 2023.Pancreaticobiliary duct visibility,motion artifacts,background suppression,and overall image quality were scored on a 5-point scale by two radiologists.The relative contrast ratio of three bile duct segmentations(common bile duct,left and right intrahepatic bile ducts)were calculated,and the acquisition time of the three sequences was recorded.Friedman test with a post-hoc test was performed to compare image acquisition time,qualitative and quantitative results.Results The acquisition time was significantly shorter in the two breath-hold groups than for conventional 3D RT-MRCP(P＜0.001).There were no significant differences in overall image quality,motion artifacts,common bile duct and primary branch of intrahepatic bile duct among the three groups.The relative contrast ratio,intrahepatic biliary secondary branch visibility and background suppression score of 3D RT-MRCP and BH-CS-MRCP were significantly higher than those of BH-GRASE-MRCP(P＜0.01).The pancreatic duct(proximal,middle,distal)visibility score of 3D RT-MRCP was significantly better than that of BH-GRASE-MRCP(P=0.002,0.043,0.001),but the gallbladder and gallbladder duct visibility score of BH-GRASE-MRCP was higher than that of 3D RT-MRCP(P=0.036).There was no significant difference between 3D RT-MRCP and BH-CS-MRCP scores except for the middle and distal pancreatic duct visibility.Conclusion Breath-hold 3D MRCP with GRASE and CS can give us feasible options for pancreaticobiliary diagnosis,which significantly shortens the acquisition time without reducing the overall image quality.Compared with BH-GRASE-MRCP,BH-CS-MRCP has better consistency in pancreaticobiliary duct visibility and background suppression.

Objective To investigate the impact of the artificial intelligence iterative reconstruction (AIIR) algorithm on image quality in chest computed tomography (CT) at different radiation doses, and assess its value in reducing radiation dose during chest CT examinations. Methods A simulated chest phantom was scanned with 12 groups of tube voltages and milliampere-seconds, and the radiation dose was recorded for each group. The images of each group were reconstructed using seven methods: AIIR with noise levels 1-5, KARL iterative reconstruction, and filtered back projection (FBP). The CT values and standard deviations of soft tissue, thoracic vertebrae, pulmonary nodules, and the mediastinum were measured, with standard deviation representing image noise. Subjective evaluation of image quality was performed. The Friedman test was used to compare CT values among the seven reconstruction groups, a linear mixed model was employed for statistical analysis of image noise, and the Friedman test was also used for comparing subjective evaluation scores. Results The reconstruction algorithm, tube voltage, milliampere-seconds, and their interactions all showed statistically significant effects on image noise for the four tissues (F = 2.041-391.283, P < 0.05). Among the reconstruction algorithms, noise reduction capability decreased in the following order: AIIR levels 1-5, KARL, and FBP. The interaction between the reconstruction algorithm and tube voltage or milliampere-seconds indicated that AIIR exhibited improved noise reduction efficacy under low tube voltage and low milliampere-second conditions (|t| = 1.892-8.245, P < 0.05). In terms of subjective evaluation of image quality, there was no statistically significant difference among AIIR levels 3-5 (|Z| ≤ 0.567, P > 0.05), and the score of AIIR level 3 was significantly higher than those of AIIR level 1, AIIR level 2, FBP, and KARL level 2 (|Z| = 3.449-5.906, P < 0.05). Conclusion The AIIR reconstruction algorithm significantly reduced image noise in chest CT examinations. For improving image quality while maintaining image realism, AIIR level 3 is recommended, which can reduce the radiation dose by more than 75%. Furthermore, AIIR showed superior performance in noise reduction under low tube voltage and low milliampere-second conditions, demonstrating significant potential for reducing radiation dose.

This report describes a 72-year-old male patient with occipitotemporal cavernous hemangioma(CCH).The patient presented with persistent pain in the right occipital and retro auricular areas for over one year.Physical examination detected a tender mass in the right occipital region.Imaging studies showed destruction of the right occipitotemporal bone with a heterogeneous signal mass and irregular enhancement on magnetic resonance imaging(MRI).Positron emission tomography/computed tomography(PET/CT)examination revealed increased fluorodeoxyglucose(FDG)uptake(SUVmax=5.9),suggesting a benign lesion.Complete surgical excision of the tumor and involved skull was performed,with pathological diagnosis confirming cavernous hemangioma.The patient's symptoms completely resolved with no recurrence during three months of follow-up.This case represents the first report of PET/CT application in diagnosing occipitotemporal CCH,providing valuable reference for improving diagnostic accuracy and reducing misdiagnosis rates for this rare condition.

Objective To compare image quality and clinical usefulness between single breath-hold three-dimensional magnetic resonance cholangiopancreatography with compressed sensing(3D BH-CS-MRCP)and with gradient and spin-echo(3D BH-GRASE-MRCP)and conventional three-dimensional breath-triggered magnetic resonance cholangiopancreatography(3D RT-MRCP).Methods A retrospective analysis was performed in 48 patients(26 males and 22 females,mean age of 53.14±15.19 years),who underwent 3D BH-GRASE-MRCP,3D BH-CS-MRCP and 3D RT-MRCP from September to December 2023.Pancreaticobiliary duct visibility,motion artifacts,background suppression,and overall image quality were scored on a 5-point scale by two radiologists.The relative contrast ratio of three bile duct segmentations(common bile duct,left and right intrahepatic bile ducts)were calculated,and the acquisition time of the three sequences was recorded.Friedman test with a post-hoc test was performed to compare image acquisition time,qualitative and quantitative results.Results The acquisition time was significantly shorter in the two breath-hold groups than for conventional 3D RT-MRCP(P＜0.001).There were no significant differences in overall image quality,motion artifacts,common bile duct and primary branch of intrahepatic bile duct among the three groups.The relative contrast ratio,intrahepatic biliary secondary branch visibility and background suppression score of 3D RT-MRCP and BH-CS-MRCP were significantly higher than those of BH-GRASE-MRCP(P＜0.01).The pancreatic duct(proximal,middle,distal)visibility score of 3D RT-MRCP was significantly better than that of BH-GRASE-MRCP(P=0.002,0.043,0.001),but the gallbladder and gallbladder duct visibility score of BH-GRASE-MRCP was higher than that of 3D RT-MRCP(P=0.036).There was no significant difference between 3D RT-MRCP and BH-CS-MRCP scores except for the middle and distal pancreatic duct visibility.Conclusion Breath-hold 3D MRCP with GRASE and CS can give us feasible options for pancreaticobiliary diagnosis,which significantly shortens the acquisition time without reducing the overall image quality.Compared with BH-GRASE-MRCP,BH-CS-MRCP has better consistency in pancreaticobiliary duct visibility and background suppression.

This report describes a 72-year-old male patient with occipitotemporal cavernous hemangioma(CCH).The patient presented with persistent pain in the right occipital and retro auricular areas for over one year.Physical examination detected a tender mass in the right occipital region.Imaging studies showed destruction of the right occipitotemporal bone with a heterogeneous signal mass and irregular enhancement on magnetic resonance imaging(MRI).Positron emission tomography/computed tomography(PET/CT)examination revealed increased fluorodeoxyglucose(FDG)uptake(SUVmax=5.9),suggesting a benign lesion.Complete surgical excision of the tumor and involved skull was performed,with pathological diagnosis confirming cavernous hemangioma.The patient's symptoms completely resolved with no recurrence during three months of follow-up.This case represents the first report of PET/CT application in diagnosing occipitotemporal CCH,providing valuable reference for improving diagnostic accuracy and reducing misdiagnosis rates for this rare condition.

Objective:To investigate the level of serum lipoprotein a [Lp (a)] in patients with diffuse large B-cell lymphoma (DLBCL) and its clinical significance.Methods:A retrospective cohort study was performed. The clinical data of 87 patients with DLBCL who were treated at Changshu No.2 People's Hospital from January 2017 to June 2022 (the newly treated DLBCL group) were retrospectively analyzed, and 78 healthy physical examination subjects were selected as the control group. The level of Lp(a) in the two groups and the level of Lp(a) in DLBCL patients achieving different therapeutic effects after treatment were compared. The receiver operating characteristic (ROC) curve was used to analyze the efficacy of serum Lp(a) in predicting the therapeutic effect of DLBCL patients, and the area under the curve (AUC) was calculated to determine the optimal critical value. Based on the optimal critical value, patients with DLBCL were divided into low Lp(a) group and high Lp(a) group, and the clinicopathological characteristics of DLBCL patients with different Lp(a) levels were compared. Cox proportional hazards model was used to analyze the factors affecting the prognosis of DLBCL patients. Kaplan-Meier method was used to compare the relapse-free survival (RFS) and overall survival (OS) of DLBCL patients with different Lp(a) levels.Results:The level of Lp (a) in the newly treated DLBCL group was higher than that in the control group[ (0.24±0.09) g/L vs. (0.09±0.06) g/L], and the difference was statistically significant ( t = 3.61, P = 0.019). Among 87 patients, 54 achieved complete remission (CR), 23 achieved partial remission (PR), and 10 achieved progression of the disease (PD). The Lp (a) levels of patients achieving CR, PR, and PD were (0.09±0.09) g/L, (0.12±0.08) g/L, and (0.25±0.15) g/L, respectively. The Lp (a) levels in patients achieving CR and PR were lower than those in the newly treated DLBCL patients [(0.24±0.09) g/L], and the differences were statistically significant (all P < 0.05). There was no statistically significant difference in the Lp (a) levels between patients achieving PD and the newly treated DLBCL patients ( P > 0.05). The ROC curve results showed that the optimal critical value of serum Lp (a) in predicting the efficacy of DLBCL patients was 0.25 g/L, AUC was 0.776 (95% CI: 0.676-0.876, P < 0.05), and its sensitivity and specificity was 66.67%, 82.76%, respectively. According to the optimal critical value of Lp (a) (0.25 g/L), patients were divided into the low Lp (a) group (≤ 0.25 g/L) (57 cases) and the high Lp (a) group (>0.25 g/L) (30 cases). The proportion of patients with lactate dehydrogenase level >227 U/L, Ann Arbor stage Ⅲ-Ⅳ, and extranodal organ involvement >1 in the high Lp (a) group was higher than that in the low Lp (a) group, and the differences were statistically significant (all P < 0.05). Cox multivariate analysis results showed that Ann Arbor stage Ⅲ-Ⅳ, international prognostic index (IPI) score 3-5, and Lp (a)>0.25 g/L were independent risk factors for OS in DLBCL patients (all P < 0.05); Ann Arbor stage Ⅲ-Ⅳ and IPI score 3-5 were independent risk factors for RFS in DLBCL patients (all P < 0.05). The median OS in the low Lp (a) group was not reached; the median OS of the high Lp (a) group was 21 months, and there was a statistically significant difference in OS between the two groups ( P = 0.001). The median RFS time was not reached in the low Lp (a) group and the high Lp (a) group; and there was no statistically significant difference in RFS between the two groups ( P = 0.102) . Conclusions:Lp(a) level of DLBCL patients is increased, and Lp(a) could be a factor influencing the prognosis of DLBCL.

Antibody-drug conjugates(ADCs)are a new type of targeting antibodies that conjugate with highly toxic anticancer drugs via chemical linkers to exert high specificity and efficient killing of tumor cells,thereby attracting considerable attention in precise oncology therapy.Cetuximab(Cet)is a typical antibody that offers the benefits of good targeting and safety for individuals with advanced and inoperable cutaneous squamous cell carcinoma(cSCC);however,its anti-tumor activity is limited to a single use.Cisplatin(CisPt)shows good curative effects;however,its adverse effects and non-tumor-targeting ability are major drawbacks.In this study,we designed and developed a new ADC based on a new cytotoxic platinum(Ⅳ)prodrug(C8Pt(Ⅳ))and Cet.The so-called antibody-platinum(Ⅳ)prodrugs conjugates,named Cet-C8Pt(Ⅳ),showed excellent tumor targeting in cSCC.Specifically,it accurately delivered C8Pt(Ⅳ)into tumor cells to exert the combined anti-tumor effect of Cet and CisPt.Herein,metabolomic analysis showed that Cet-C8Pt(Ⅳ)promoted cellular apoptosis and increased DNA damage in cSCC cells by affecting the vitamin B6 metabolic pathway in tumor cells,thereby further enhancing the tumor-killing ability and providing a new strategy for clinical cancer treatment using antibody-platinum(Ⅳ)prodrugs conjugates.

Objective To evaluate the application value of the three-point localization method in improving the quality and efficiency of four-chamber view acquisition in cardiac magnetic resonance(CMR)imaging.Methods A total of 215 patients who underwent four-chamber view in CMR imaging from January 2022 to October 2023 were retrospectively enrolled and divided into two groups.The control group(n=109)received traditional localization method while the study group(n=106)received three-point localization method.The image quality of mitral valve,tricuspid valve and cruciform structure in four-chamber view images were assessed by two radiologists using a Likert 4-piont scale.The time-consumption from scout imaging to the finish of four-chamber view imaging was recorded.Constituent data and numeral data were compared by Chi-square test and two-sample t test,respectively.Kappa test was used to analyze the inter-observer consistency.Results There were no significant inter-group differences in gender,age,disease profile,or the radiographers'experience.The mean quality scores of the mitral valve,tricuspid valve and cruciform structure in the control group and the study group were 3.44±0.64 and 3.63±0.49(P=0.023),3.43±0.67 and 3.53±0.60(P=0.202),3.71±0.49 and 3.83±0.35(P=0.047),respectively.The image quality score was higher in the study group than in the control group,with the differences in mitral valve and cruciform structure reaching statistical significance.The time-consumption for obtaining four-chamber view for the control group and the study group was 11.67±3.49 minutes and 7.212±1.83 minutes,respectively,with statistically significant differences(P＜0.001).Conclusion Compared with the traditional localization method,the three-point localization method provides better image quality in four-chamber view imaging with shortened imaging time.

Objective To investigate the value of abdominal aortic combined with routine one-stop triple rule-out computed tomography angiography(TRO-CTA)in the examination of patients with acute chest pain.Methods A total of 1 482 patients with nontraumatic chest pain were included in this retrospective study.Of them 414 patients underwent the conventional TRO-CTA scanning while 1 068 patients underwent TRO-CTA that included the abdominal aorta(TRO-CTAwAA)under the request of clinicians.All scanning parameters were the same,except the scanning range for the third phase in TRO-CTA:conventional TRO-CTA covered only the thoracic aorta,while TRO-CTAwAA extended to the entire aorta.Patient etiology was investigated and the detection rates of major vessel abnormalities(aortic dissection,aneurysm,penetrating ulcer,intramural hematoma,vascular occlusion,and thrombosis)between the two groups was compared using chi square tests.The radiation dose(CTDIvol and DLP)and scanning time between the two groups were compared using analysis of variance(ANOVA).Results The TRO-CTAwAA had significantly higher detection rate of major artery abnormalities than the TRO-CTA group(35.1％vs.4.8％,P＜0.001).In the TRO-CTAwAA group,26.5％of the vascular anomalies were detected in both the thoracic and abdominal aortas,and another 8.6％were seen only in the abdominal aorta.With regard to the radiation dose between the two groups,the total DLP was significantly higher in the TRO-CTAwAA group than in the conventional TRO-CTA group(P＜0.001).The two groups did not significantly differ in scanning time(P=0.410).Conclusion TRO-CTA with scan range including the abdominal aorta significantly improves the detection rate for major vessel abnormalities in patients with chest pain without increasing the examination process.

Objective To evaluate the relationship between the pericoronary fat attenuation index(FAI)and the image reconstruction parameters of computed tomography(CT)coronary angiography,including reconstruction kernel,iterative reconstruction algorithm and image thickness.Methods Forty-four CT coronary angiography scans were prospectively enrolled.All scans were reconstructed by three means as follows:① Four different kernels(Soft_AA,Soft_BA,Soft_CA,and Soft_DA,sharpness from low to high)as the iterative reconstruction algorithm(KARL5)and image thickness(0.5 mm)remained unchanged.② Filtered back projection(FBP)and iterative reconstruction kernel(KARL5)as the kernel and image thickness(0.5 mm)remained unchanged.③ Different image thickness(0.5 mm and 1 mm)as the kernel(Soft_AA)and iterative reconstruction algorithm(KARL5)remained unchanged.The FAI of left anterior descending artery(LAD),left circumflex artery(LCX),and right coronary artery(RCA)was calculated using a dedicated software.Paired t-test and analysis of variance were used for statistical analysis.Results For LAD,LCX and RCA:① The differences of FAI among different reconstruction kernels reached statistical significance(P＜0.001),and FAI decreased as the sharper kernel was used.③ Compared with FBP,the FAI of KARL5-reconstructed images significantly increased(P＜0.001).③ Compared with 0.5 mm,the FAI of images with 1.0 mm thickness significantly decreased(P＜0.001).Conclusion The kernel,iterative reconstruction algorithms,and image thickness all have a significant impact on the FAI of each coronary artery.When using FAI for clinical diagnosis,the effect of CT reconstruction parameters should be taken into account.