1.Imaging research progress on complete pathological remission after neoadjuvant therapy for rectal cancer
Journal of Chinese Physician 2024;26(2):306-310
Rectal cancer is a common malignant tumor in China, with a high mortality rate ranking fifth. Neoadjuvant therapy for rectal cancer can improve patient prognosis and even achieve pathological complete remission (pCR) in some patients, thereby avoiding complications and functional damage caused by radical surgery. Therefore, how to accurately evaluate pCR before surgery is currently a research hotspot. In recent years, new imaging technologies such as endorectal ultrasound, magnetic resonance imaging (MRI), and positron emission computed tomography (PET-CT) have developed rapidly, and imaging evaluation of pCR after neoadjuvant therapy for rectal cancer has achieved good results. This article provides a review of this field, aiming to provide a basis for personalized treatment of rectal cancer patients.
2.The value of transrectal ultrasonography and MRI in preoperative diagnosis of peripherally incised margin of middle and low rectal cancer
Journal of Chinese Physician 2024;26(11):1627-1631
Objective:To evaluate the value of transrectal ultrasound (ERUS) and magnetic resonance imaging (MRI) in the preoperative diagnosis of peripheral margin (CRM) for middle and low rectal cancer.Methods:The clinical data of 89 patients with rectal cancer treated in the Inner Mongolia Autonomous Region People′s Hospital from January 2015 to January 2023 were retrospectively analyzed. The relationship between clinicopathological factors and CRM involvement in middle and low rectal cancer was analyzed. Using postoperative pathology as the gold standard, the accuracy and diagnostic efficacy of CRM in preoperative assessment of low and middle rectal cancer by ERUS and MRI were analyzed.Results:All the 89 patients had postoperative pathological results of rectal cancer, of which 77 were CRM-negative and 12 were CRM-positive, the positive rate was 13.48%(12/89). Pathological TN stage and extramural vascular invasion (EMVI) of rectal cancer were associated with CRM involvement in middle and low rectal cancer, with statistical significance (all P<0.05). Compared with the pathological results, the accuracy of ERUS preoperative assessment of CRM involvement was 88.76% (Kappa=0.578, P<0.001), the sensitivity was 75.00%, the specificity was 90.91%, the negative predictive value was 95.89%, the positive predictive value was 56.25%, and area under the curve (AUC) was 0.788. The accuracy rate of CRM involvement before MRI was 88.76% (Kappa=0.602, P<0.001), sensitivity was 83.33%, specificity was 89.61%, negative predictive value was 97.18%, positive predictive value was 55.56%, and AUC was 0.830. There was no significant difference in AUC between the two groups ( Z=0.420, P=0.674). Conclusions:ERUS and MRI have high accuracy in preoperative assessment of CRM status in patients with middle and low rectal cancer. ERUS can be used as a supplement to MRI for preoperative assessment of CRM in patients with middle and low rectal cancer.
3.Clinical Value of Endorectal Ultrasonography in Preoperative Staging and Sphincter-preserving Surgery of Middle and Low Rectal Cancer
Journal of Medical Research 2024;53(8):132-136
Objective To explore the clinical value of preoperative TN staging and sphincter-preserving of middle and low rectal cancer by endorectal ultrasonography(ERUS).Methods A total of 178 patients with middle and low rectal cancer admitted to the Peo-ple's Hospital of Inner Mongolia Autonomous Region from January 2015 to January 2023 underwent ERUS examination before surgery.x2 test was used to compare the imaging features of ERUS,clinicopathological features and sphincter-preserving in patients with middle and low rectal cancer.Using postoperative pathology as the gold standard,the accuracy of ERUS in preoperative evaluation of TN staging of middle and low rectal cancer was analyzed.Using clinical operation as the standard,the accuracy of ERUS in preoperative evaluation of sphincter-preserving for middle and low rectal cancer was analyzed.Results Pathological T stage,pathological differentiation degree,infiltration depth of tumor,distance of lower tumor margin from anal margin and ultrasonic T stage had statistical significance in the selec-tion of surgical program for middle and low rectal cancer(P<0.05).Compared with the actual pathological results,the T stage of middle and low rectal cancer assessed by ERUS before surgery was highly consistent(Kappa=0.730,P<0.001),and the N stage assessed by ERUS before surgery was moderately consistent(Kappa=0.524,P<0.001).Compared with the actual surgical procedure,the preoper-ative surgical protocol assessed by ERUS before surgery was highly consistent(Kappa=0.676,P<0.001).Conclusion ERUS exami-nation has high accuracy in preoperative TN staging assessment of middle and low rectal cancer,and preoperative assessment of sphincter-preserving is highly consistent with clinical practice,which can be used as a clinical reference.
4.Strengthening management of latent tuberculosis infection and accelerating the elimination of the tuberculosis epidemic
Xin SHEN ; Wenjing XIAO ; Qichao PAN ; Guozhu WU
Shanghai Journal of Preventive Medicine 2023;35(3):199-202
Screening and preventive treatment for latent tuberculosis infection (LTBI) are important measures to reduce the incidence of active tuberculosis (TB) and its global burden. This paper discusses the current status of LTBI prevalence and preventive treatment, risk of incidence in high-risk groups, screening methods, and other interventions, emphasizing the importance of prevention and control as early as possible in a scientific strategy, so as to lay a solid foundation for eliminating TB by 2030.
5.Advances in preoperative imaging evaluation of extramural vascular invasion of rectal cancer
Journal of Chinese Physician 2023;25(2):296-299
Rectal cancer is a common malignancy of the gastrointestinal tract. Extramural vascular invasion (EMVI) is a key indicator of risk stratification for rectal cancer and an important reference factor in determining individualised treatment options, so it is important to accurately assess whether extramural vessels are infiltrated by the tumour before surgery. The main imaging methods for rectal cancer include magnetic resonance imaging (MRI), computed tomography (CT) and transrectal ultrasound (TRUS). This article focuses on the performance and diagnostic efficacy of these imaging methods in the diagnosis of EMVI in rectal cancer, and provides clinical reference.
6.Research progress and clinical significance of the correlation between breast cancer heterogeneity and contrast-enhanced ultrasound
Journal of Chinese Physician 2023;25(3):477-480
Breast cancer is a highly heterogeneous tumor originating from genetic basis, with significant differences in morphology, immunophenotype and therapeutic response, which poses great challenges to the treatment of breast cancer patients. Therefore, it is very important to understand the diversity of different molecular biological states and expressions in tumor cells to obtain good therapeutic effects for breast cancer. Contrast-enhanced ultrasound (CEUS) is widely used as a non-invasive real-time diagnostic technique for breast tumors. At present, many domestic and foreign literatures have reported that there is a certain correlation between molecular biological indicators related to breast cancer and the characteristics of CEUS, which is expected to provide a reference for preoperative treatment through non-invasive and convenient ultrasound examination. The combination of ultrasound contrast agent and ultrasound can mediate the drug therapy of breast cancer, which makes the targeted delivery and targeted regulation of drugs possible, thus improving the efficiency of chemotherapy drugs. In this review, we reviewed the relationship between molecular markers related to breast cancer and CEUS and the application of ultrasound contrast agents in targeted therapy of breast cancer.
7.Application of contrast-enhanced ultrasonography in differentiating benign and malignant breast BI-RADS 4 nodules
Journal of Chinese Physician 2023;25(7):988-992,997
Objective:To explore the application value of contrast-enhanced ultrasound (CEUS) in differentiating benign and malignant breast imaging reporting and data system (BI-RADS) type 4 nodules.Methods:The clinical data of 81 patients (82 nodules) with breast tumors admitted to the People′s Hospital of Inner Mongolia from February 2018 to January 2022 were retrospectively analyzed, all of whom were classified as BI-RADS. All patients underwent preoperative CEUS examination and underwent puncture biopsy or surgical treatment. Quantitative analysis software was used to draw a time intensity curve (TIC), quantitatively analyzing peak intensity (PI), area under the curve (AUC), baseline intensity (BI), time to peak (TTP), arrival time of contrast agent (AT), slope up (AS), half peak time (DT/2), and slope down (DS). We analyzed the differences in imaging parameters of the tumor edge zone in patients with benign and malignant breast tumors, and plotted the subject operating characteristic (ROC) curve for predicting benign and malignant breast tumors using statistically significant quantitative parameters. Area under the curve and cutoff values were calculated. The differences in imaging parameters between different regions of the tumor in the malignant breast group were analyzed.Results:PI and AUC at the margin of breast malignant tumor were higher than those of breast benign tumor (all P<0.001); There was no significant difference in PI, AUC in the central and surrounding tissues of breast malignant tumor, and BI, TTP, AT, DT/2, DS, AS in the central, marginal and surrounding tissues of breast malignant tumor compared with benign tumor of breast (all P>0.05). After drawing the receiver operating characteristic of PI and AUC at the edge of breast tumor, it was concluded that the area under the curve of PI in predicting benign and malignant breast tumors was 0.740 ( P<0.001), the sensitivity was 67.6%, the specificity was 77.8%, and the Youden′s J statistic was 0.453; The area under the curve of AUC was 0.743 ( P<0.001), the sensitivity was 67.6%, the specificity was 73.3%, and the Youden′s J statistic was 0.409. There was no statistically significant difference in PI and AUC at the edge of breast malignant tumors compared to the center of the tumor ( P=0.471, P=0.988); The PI and AUC of the center and edge of breast malignant tumors were higher than those of the surrounding breast tissue (all P<0.001). Conclusions:The blood flow perfusion characteristics of the marginal zone of breast tumors have certain diagnostic value in distinguishing between benign and malignant tumors, and can be used as a non-invasive indicator for distinguishing between benign and malignant breast tumors.
8.Progress in the application of transrectal ultrasound in preoperative evaluation of anal preservation in low and middle rectal cancer surgery
Journal of Chinese Physician 2023;25(9):1423-1427
Rectal cancer is one of the most common malignant tumors in the digestive system, and mid to low rectal cancer has attracted great attention due to its unique anatomy, examination, and treatment. Accurate diagnosis and appropriate treatment are key to improving the prognosis of rectal cancer patients. One of the long-standing technical challenges in colorectal surgery is how to make a more accurate evaluation of the surgical plan for rectal cancer before surgery. Transrectal intracavitary ultrasound can provide some effective objective basis for the selection of surgical plans for middle and low rectal cancer. This article reviews the application value and progress of preoperative evaluation of preoperative staging and anal preservation of middle and low rectal cancer using transrectal intracavitary ultrasound.
9.Progress in the application of new ultrasound technology in evaluation the efficacy of neoadjuvant chemotherapy for breast cancer
Journal of Chinese Physician 2022;24(10):1590-1593
In recent years, the incidence rate of breast cancer has increased rapidly and is tending to be younger. The application of neoadjuvant chemotherapy (NAC) can reduce the tumor stage, which is conducive to surgical resection or breast conserving surgery. Therefore, it is very important to evaluate the curative effect of NAC in breast cancer by imaging for the choice of operation timing. In recent years, with the rapid development of new ultrasound technologies such as contrast-enhanced ultrasound and elastography, these new technologies can provide more abundant imaging information and basis for individualized treatment of breast cancer, which has become a research hotspot of the curative effect of breast cancer NAC. This article reviews the research progress of new ultrasound technology in evaluating the curative effect of NAC in breast cancer in recent years.
10.Research progress of artificial intelligence in ultrasound diagnosis of breast cancer
Journal of Chinese Physician 2022;24(11):1748-1752
Breast cancer is the cancer with the largest number of new cases in the world, and ranks first in the incidence spectrum and cause of death among women in most countries. In recent years, artificial intelligence (AI), especially deep learning and computer-aided diagnosis, has shown remarkable performance in image analysis and processing, computer vision and other aspects, and has great development potential in the field of medical and health lesions identification, disease diagnosis and other aspects. This paper mainly discusses the application and progress of AI in ultrasound diagnosis of breast cancers.

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