Objective To explore the value of low contrast dose and low flow rate one-stop craniocervical CT angiography(CT A)-cerebral CT perfusion(CTP)for detecting carotid atherosclerosis(CAS).Methods Totally 117 CAS patients were prospectively enrolled and divided into group A(n=19),B(n=52),C(n=46),and low contrast dose and low flow rate one-stop craniocervical CTA-brain CTP scanning,low contrast dose and low flow rate craniocervical CT A scanning,as well as conventional craniocervical CT A scanning were performed,respectively.Virtual monoenergetic images(VMI)of 40,50 and 60 keV were reconstructed in group A and B.The subjective and objective evaluations of image quality were compared among 3 groups.Results Subjective scores of image quality and diagnostic confidence of 40 and 50 keV VMI,and the diagnostic confidence of 60 keV VMI in group A and B were not significant different compared with those in group C(all P＞0.05).Signal-to-noise ratio(SNR)and contrast-to-noise ratio(CNR)of each segment of craniocervical blood vessels at 40 and 50 keV VMI in group A and B were all higher than those in group C(all P＜0.05).CNR of cavernous sinus segment of internal carotid artery(C5 segment),horizontal segment of middle cerebral artery(MCA)(A1 segment),lateral sulcus segment of MCA(M2 segment)and basilar artery(BA)segment in group A at 60 keV VMI were all higher than those in group C(all P＜0.05).SNR of C5 segment,A1 segment and BA segment,as well as CNR of BA segment of 60 keV VMI in group B were all higher than those in group C(all P＜0.05).Conclusion Low contrast dose and low flow rate one-stop craniocervical was feasible for detecting CAS.

Objective To explore the value of low contrast dose and low flow rate one-stop craniocervical CT angiography(CT A)-cerebral CT perfusion(CTP)for detecting carotid atherosclerosis(CAS).Methods Totally 117 CAS patients were prospectively enrolled and divided into group A(n=19),B(n=52),C(n=46),and low contrast dose and low flow rate one-stop craniocervical CTA-brain CTP scanning,low contrast dose and low flow rate craniocervical CT A scanning,as well as conventional craniocervical CT A scanning were performed,respectively.Virtual monoenergetic images(VMI)of 40,50 and 60 keV were reconstructed in group A and B.The subjective and objective evaluations of image quality were compared among 3 groups.Results Subjective scores of image quality and diagnostic confidence of 40 and 50 keV VMI,and the diagnostic confidence of 60 keV VMI in group A and B were not significant different compared with those in group C(all P＞0.05).Signal-to-noise ratio(SNR)and contrast-to-noise ratio(CNR)of each segment of craniocervical blood vessels at 40 and 50 keV VMI in group A and B were all higher than those in group C(all P＜0.05).CNR of cavernous sinus segment of internal carotid artery(C5 segment),horizontal segment of middle cerebral artery(MCA)(A1 segment),lateral sulcus segment of MCA(M2 segment)and basilar artery(BA)segment in group A at 60 keV VMI were all higher than those in group C(all P＜0.05).SNR of C5 segment,A1 segment and BA segment,as well as CNR of BA segment of 60 keV VMI in group B were all higher than those in group C(all P＜0.05).Conclusion Low contrast dose and low flow rate one-stop craniocervical was feasible for detecting CAS.

Objective: To prospectively compare single-shot (SS) echo-planar imaging (EPI) and field-of-view optimized and constrained undistorted single-shot multiplexed sensitivity-encoding (FOCUS MUSE) for diffusion-weighted imaging (DWI) in evaluating thyroid-associated ophthalmopathy (TAO). Materials and Methods: SS EPI and FOCUS MUSE DWIs were obtained from 39 patients with TAO (18 male; mean ± standard deviation: 48.3 ± 13.3 years) and 26 healthy controls (9 male; mean ± standard deviation: 43.0 ± 18.5 years). Two radiologists scored the visual image quality using a 4-point Likert scale. The image quality score, signal-to-noise ratio (SNR), contrast-tonoise ratio (CNR), and apparent diffusion coefficient (ADC) of extraocular muscles (EOMs) were compared between the two DWIs. Differences in the ADC of EOMs were also evaluated. The performance of discriminating active from inactive TAO was assessed using receiver operating characteristic curves. The correlation between ADC and clinical activity score (CAS) was analyzed using Spearman correlation. Results: Compared with SS EPI DWI, FOCUS MUSE DWI demonstrated significantly higher image quality scores (P < 0.001), a higher SNR and CNR on the lateral rectus muscle (LRM) and medial rectus muscle (MRM) (P < 0.05), and a non-significant difference in the ADC of the LRM and MRM. Active TAO showed higher ADC than inactive TAO and healthy controls with both SS EPI and FOCUS MUSE DWIs (P < 0.001). Inactive TAO and healthy controls did not show a significant ADC difference with both DWIs. Compared with SS EPI DWI, FOCUS MUSE DWI demonstrated better discrimination of active from inactive TAO (AUC:0.925 vs. 0.779; P = 0.007). The ADC was significantly correlated with CAS in SS EPI DWI (r = 0.391, P < 0.001) and FOCUS MUSE DWI (r = 0.645, P < 0.001). Conclusion FOCUS MUSE DWI provides better images for evaluating EOMs and better performance in diagnosing active TAO than SS EPI DWI. The application of FOCUS MUSE will facilitate the DWI evaluation of TAO.

CT angiography is an important method for vascular examination of head and neck. This examination should focus not only on endovascular contrast to meet the needs of post-processing and diagnosis,on radiation dose from extensive scans and multiple follow-up examinations,but also on the potential risk of renal impairment. Achieving low contrast agent dosage and low radiation dose,while ensuring good image quality,is the ultimate clinical pursuit for head and neck CT angiography examination. Clinical practice shows that the image noise caused by low contrast agent and low radiation dose has become a disturbing factor for imaging quality and diagnostic accuracy,so how to properly apply and combine the low contrast agent and low radiation dose conditions has always been a key point. Starting from the clinical needs,this paper reviews and sorts out the current progress and principles of low contrast agent as well as low radiation dose technology,the significant effect of image reconstruction algorithm on image quality improvement,and the current application research of deep learning reconstruction algorithms in this direction.

CT angiography is an important method for vascular examination of head and neck. This examination should focus not only on endovascular contrast to meet the needs of post-processing and diagnosis,on radiation dose from extensive scans and multiple follow-up examinations,but also on the potential risk of renal impairment. Achieving low contrast agent dosage and low radiation dose,while ensuring good image quality,is the ultimate clinical pursuit for head and neck CT angiography examination. Clinical practice shows that the image noise caused by low contrast agent and low radiation dose has become a disturbing factor for imaging quality and diagnostic accuracy,so how to properly apply and combine the low contrast agent and low radiation dose conditions has always been a key point. Starting from the clinical needs,this paper reviews and sorts out the current progress and principles of low contrast agent as well as low radiation dose technology,the significant effect of image reconstruction algorithm on image quality improvement,and the current application research of deep learning reconstruction algorithms in this direction.

Surgery is currently the most appropriate treatment for early-stage non-small cell lung cancer (NSCLC). Increasing unilateral or bilateral multiple primary lung cancer being found, segmentectomy has attracted wide attention for its unique advantages in the treatment for such tumors. Ground glass opacity dominant early-stage NSCLC is associated with a good prognosis and can be cured by segmentectomy, however, the treatment of solid-dominant NSCLC remains controversial owing to the invasive nature. With the in-depth study on the lymph node metastasis pathway, radiological characteristics and molecular biology of NSCLC, a large part of solid nodules with certain characteristics can also be cured by segmentectomy. This paper reviews the research status and progress about the indication of segmentectomy.
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Objective To compare the dosemetry between helical tomotherapy (HT) and intensity-modulated radiotherapy (IMRT) for early-stage postoperative breast cancer and provide more valuable evidences to the clinical researches. Methods Clinical trails of dosimetric comparing between HT and IMRT for early-stage breast cancer were obtained from PubMed, Embase, Sciencedirect, CNKI, VIP and Wanfang databases, evaluated and analyzed with the Cochrane Collaboration's RevMan 5.2 software. Results 10 studies were included with a total of 135 patients. Compared to IMRT plans, HT plans provided a significantly better conformity index (P<0.000 1), mean (P<0.000 01) and maximal dose (P=0.003) of the planning target volume (PTV). HT plans had a lower heart maximal dose (P=0.005), V20 (P=0.05), V30 (P=0.003), and ipsilateral lung maximal dose (P=0.003), V20 (P=0.02), as while as had a higher contralateral breast V5 (P=0.01), mean (P=0.05) and maximal dose (P<0.000 01). There was no significantly difference between HT and IMRT plans for homogeneity index of PTV, heart V5, V10, mean dose, ipsilateral lung V5, V10, V30, mean dose, contralateral breast V10, contralateral lung mean and maximal dose (all P >0.05). Conclusion Compared to IMRT plans, HT plans have the dosimetry superiority for early-stage breast cancer with significantly better coverage and dose conformity while maintaining lower doses to high risk organs.