Huadan Xue

Super-paramagnetic responsive nanofibrous scaffolds under static magnetic field enhance osteogenesis for bone repair in vivo

A novel nanofibrous composite scaffold composed of super-paramagnetic γ-Fe2O3 nanoparticles (MNP), hydroxyapatite nanoparticles (nHA) and poly lactide acid (PLA) was prepared using electrospinning technique. The scaffold well responds extern static magnetic field with typical saturation magnetization value of 0.049 emu/g as well as possesses nanofibrous architecture. The scaffolds were implanted in white rabbit model of lumbar transverse defects. Permanent magnets are fixed in the rabbit cages to provide static magnetic field for the rabbits post surgery. Results show that MNP incorporated in the nanofibers endows the scaffolds super-paramagnetic responsive under the applied static magnetic field, which accelerates new bone tissue formation and remodeling in the rabbit defect. The scaffold also exhibits good compatibility of CK, Cr, ALT and ALP within normal limits in the serum within 110 days post implantation. In conclusion, the super-paramagnetic responding scaffold with applying of external magnetic field provides a novel strategy for scaffold-guided bone repair.

Whole-body diffusion-weighted imaging: technical improvement and preliminary results.

To optimize the free‐breathing whole‐body diffusion‐weighted imaging (WB‐DWI) protocol by using the short TI inversion‐recovery diffusion‐weighted echo‐planar imaging (STIR‐DWEPI) sequence and the built‐in body coil. Additionally, to evaluate the feasibility of tumor screening using high‐resolution three‐dimensional (3D) maximum intensity projection (MIP) images.

Glucagon-Like Peptide-1 Receptor PET/CT with 68Ga-NOTA-Exendin-4 for Detecting Localized Insulinoma: A Prospective Cohort Study

Preoperative localization of insulinoma is a clinical dilemma. We aimed to investigate whether glucagon-like peptide-1 receptor (GLP-1R) PET/CT with 68Ga-NOTA-MAL-cys40-exendin-4 (68Ga-NOTA-exendin-4) is efficient in detecting insulinoma. Methods: In our prospective cohort study, patients with endogenous hyperinsulinemic hypoglycemia were enrolled. CT, MRI, endoscopic ultrasound, and 99mTc-hydrazinonicotinamide-TOC SPECT/CT were done according to standard protocols. GLP-1R PET/CT was performed 30–60 min after the injection of 68Ga-NOTA-exendin-4. The gold standard for diagnosis was the histopathologic results after surgery. Results: Of 52 recruited patients, 43 patients with histopathologically proven insulinomas were included for the imaging studies. Nine patients did not undergo surgical intervention. 68Ga-NOTA-exendin-4 PET/CT correctly detected insulinomas in 42 of 43 patients with high tumor uptake (mean SUVavg ± SD, 10.2 ± 4.9; mean SUVmax ± SD, 23.6 ± 11.7), resulting in sensitivity of 97.7%. In contrast, 99mTc-hydrazinonicotinamide-TOC SPECT/CT showed a low sensitivity of 19.5% (8/41) in this group of patients; however, it successfully localized the tumor that was false-negative with GLP-1R PET/CT. The sensitivities of CT, MR, and endoscopic ultrasonography were 74.4% (32/43), 56.0% (14/25), and 84.0% (21/25), respectively. Conclusion: 68Ga-NOTA-exendin-4 PET/CT is a highly sensitive imaging technique for the localization of insulinoma.

Clinical Application of Body Diffusion Weighted MR Imaging in the Diagnosis and Preoperative N Staging of Cervical Cancer

OBJECTIVE To evaluate the clinical impact of body diffusion weighted imaging (DWI) on the diagnosis and preoperative N staging of cervical cancer. METHODS Twenty-four patients (mean age 37.9 years old) with proved cervical cancer by cervical biopsy and 24 female patients with other suspected pelvic abnormalities received preoperative body DWI scan. Results of body DWI were compared with pathological findings. The apparent diffusion coefficient (ADC) values of normal cervix and different pathological types of cervical cancer were compared. ADC value of normal or inflammatory lymph nodes was also compared with that of metastatic ones. Students t test was used for statistical analysis. RESULTS There were 5 adenocarcinomas and 19 epitheliomas showed with biopsy results, and DWI showed 21 cervical lesions out of them (87.5%). ADC values of the normal cervix (n = 24), epithelioma (n = 19), and adenocarcinoma (n = 5) were (1.73 +/- 0.31) x 10(-3), (0.88 +/- 0.22) x 10(-3), and (1.08 +/- 0.12) x 10(-3) mm2/s, respectively. Statistical analysis showed significant difference in ADC value between normal cervical tissue and either tumor tissues (both P < 0.01). In patients had lymphadenectomy (n = 24), totally 67 lymph nodes including 16 metastatic lymph nodes were pathologically analyzed, and DWI showed 66 (98.5%) out of them. ADC values of normal/inflammatory and metastatic lymph nodes were (1.07 +/- 0.16) x 10(-3) and (0.77 +/- 0.13) x 10(-3) mm2/s (P < 0.01). Receiver operating characteristic (ROC) curve of ADC value of metastatic lymph node showed that area under curve was 0.961. CONCLUSIONS ADC value in cervical carcinoma is lower than that in normal cervix, and ADC may have predictive value in subtype discrimination. ADC value may improve the preoperative characterization of lymph node metastasis. And at least abdominal and pelvic DWI scan is suggested for N staging evaluation in such patients.

Application Of Whole Body Diffusion Weighted MR Imaging for Diagnosis and Staging of Malignant Lymphoma

OBJECTIVE To evaluate the clinical impact of whole body diffusion weighted imaging (WB-DWI) on diagnosis and staging of malignant lymphoma. METHODS Thirty-one patients with suspected lymphadenopathy were enrolled. WB-DWI was performed by using short TI inversion recovery echo-planar imaging sequence with free breathing and built-in body coil. Axial T2-weighted imaging images of the same location were used as reference. The results of WB-DWI were compared with pathological results and other imaging modalities. The mean apparent diffusion coefficient (ADC) values of different kinds of lymph nodes were compared. RESULTS WB-DWI was positive in all 18 cases with lymphoma, 5 cases with metastatic lymph nodes and 4 of 8 cases with benign lymphadenopathy. The mean ADC value of lymphomatous, metastatic and benign lymph nodes was (0.87 +/- 0.17) x 10(-3), (0.98 +/- 0.09) x 10(-3) and (1.20 +/- 0.10) x 10(-3) mm2/s. There was significant difference in ADC value between benign lymph nodes and other two groups (P < 0.01). The sensitivity, specificity and accuracy of WB-DWI in diagnosis of lymphoma were 100% (18/18), 30.8% (4/13) and 71.0% (22/31). When an ADC value of 1.08 x 10(-3) mm2/s was used as the threshold value for differentiating malignant from benign lymph nodes, the best results were obtained with sensitivity of 87.8% and specificity of 91.3%. Sixteen of eighteen cases (88.9%) of lymphoma were accurately staged in accordance with clinical staging. CONCLUSIONS WB-DWI is a sensitive, but less specific technique for diagnosis of lymphoma. It is difficult to differentiate lymphomatous from metastatic lymph nodes using WB-DWI. However, it is a valuable imaging modality for staging of patients with malignant lymphoma.

Reduction of metal artifacts from alloy hip prostheses in computer tomography.

Objective The objective of this study was to evaluate the feasibility of reducing artifacts from large metal implants with gemstone spectral imaging (GSI) and metal artifact reduction software (MARS). Methods Twenty-three in-vivo cobalt-chromium-molybdenum alloy total hip prostheses were prospectively scanned by fast kV-switching GSI between 80 and 140 kVp. The computed tomography images were reconstructed with monochromatic energy and with/without MARS. Both subjective and objective measurements were performed to assess the severity of metal artifacts. Results Increasing photon energy was associated with reduced metal artifacts in GSI images (P < 0.001). Combination of GSI with MARS further diminished the metal artifacts (P < 0.001). Artifact reduction at 3 anatomical levels (femoral head, neck, and shaft) were evaluated, with data showing that GSI and MARS could reduce metal artifacts at all 3 levels (P = 0.011, P < 0.001, and P = 0.003, respectively). Nevertheless, in certain cases, GSI without MARS produced more realistic images for the clinical situation. Conclusions Proper usage of GSI with/without MARS could reduce the computed tomography artifacts of large metal parts and improve the radiological evaluation of postarthroplasty patients.

Anti-CXCR4 monoclonal antibody conjugated to ultrasmall superparamagnetic iron oxide nanoparticles in an application of MR molecular imaging of pancreatic cancer cell lines.

Background Chemokine receptor 4(CXCR4) plays an important role in the potential growth of pancreatic tumor and its ability to develop metastasis. Ultrasmall superparamagnetic iron oxide (USPIO) nanoparticles offer strong contrast-enhancing effect for MR imaging of pancreatic tissue. Purpose To establish a biomarker-targeted nanoparticulate contrast agent CXCR4-USPIO for pancreatic cancer cell MR imaging and to investigate the relationship between in vitro MR T2 enhancement ratio, ΔR2 values, and the cellular CXCR4 expression levels. Material and Methods The CXCR4 monoclonal antibody and bovine serum albumin (BSA) were bioconjugated with USPIO using carbodiimide. The T2 and T2* values of CXCR4-USPIO, BSA-USPIO, and USPIO were evaluated at the same iron concentration levels. After incubating four pancreatic cancer cell lines (AsPC-1, BxPC-3, CFPAC-1, PANC-1) with CXCR4-USPIO and BSA-USPIO, respectively, changes of T2 values were measured with a clinical 1.5-T MRI scanner. Western blot and immunofluorescence tests were applied to semi-quantitatively analyze the expression levels of CXCR4 in the four cell lines. Results MR imaging revealed a linear correlation between ΔR2 and ΔR2* values of CXCR4-USPIO nanoparticles and the iron concentrations. The T2 enhancement ratio and ΔR2 values of AsPC-1, BxPC-3, CFPAC-1, PANC-1 cell lines in the CXCR4-USPIO group exhibited strong correlation with the CXCR4 peptide relative grey values measured by western blot (r = 0.976, P = 0.024; r = 0.959, P = 0.041, respectively) and the mean fluorescence signal intensity detected by laser scanning confocal microscopy (r = 0.996, P = 0.004; r = 0.962, P = 0.038, respectively). Conclusion The targeted probe CXCR4-USPIO was created for MR molecular imaging of pancreatic cancer cell lines. The T2 enhancement ratio and ΔR2 values of CXCR4-USPIO nanoparticles could semi-quantitatively assess the cellular CXCR4 expression levels.

Dual-source dual-energy computed tomography angiography for active gastrointestinal bleeding: A preliminary study

AIM To assess the utility of dual-source dual-energy computed tomography angiography (DSDECTA) in the diagnosis of active gastrointestinal bleeding (GIB). MATERIALS AND METHODS From June 2010 to September 2011, 58 consecutive patients with clinical signs of active GIB underwent DSDECTA. Two radiologists, blinded to clinical data, interpreted images from DSDECTA independently, with discordant interpretation resolved by consensus. The standards of reference included digital subtraction angiography, endoscopy, surgery, or final pathology reports. Sensitivity, specificity, positive (PPV) and negative (NPV) predictive values, and accuracy of DSDECTA for detection of active GIB were evaluated. Receiver-operating characteristic (ROC) analysis was undertaken and the area under the curve (AUC) calculated. RESULTS Active GIB source was identified in 39 of 58 patients (67.2%), all of which were confirmed by one or more reference standard. Negative DSDECTA results were obtained in 19 patients (32.8%). Of these, 15 patients did not require any further intervention and were discharged without incident. The overall sensitivity, specificity, PPV, NPV, and accuracy of DSDECTA was 88.6, 100, 100, 73.7, and 91.4%, respectively. The AUC was 0.935 ± 0.063. The dose reduction of a dual-phase DSDECTA protocol was approximately 30%, compared with that of a triple-phase protocol used in a previous study. CONCLUSION DSDECTA can act as an accurate method for detection and localization of active GIB and has a relatively low radiation dose.

Ultralow-Radiation-Dose Chest CT: Accuracy for Lung Densitometry and Emphysema Detection

OBJECTIVE The purpose of this study was to determine whether ultralow-radiation-dose chest CT can be used for quantification of lung density and for emphysema detection in participants undergoing lung cancer screening. SUBJECTS AND METHODS Fifty-two patients were prospectively enrolled and underwent scanning twice with low-dose CT (reference parameters, 120 kV, 50 effective mAs) and ultralow-dose CT (reference parameters, 80 kV, 4-5 effective mAs). Images were reconstructed by filtered back projection (FBP) for low-dose CT and FBP and iterative reconstruction (IR) for ultralow-dose CT. Radiation dose was recorded. Image noise, mean lung attenuation, 15th percentile of lung attenuation, and emphysema index were measured in each image series and compared. Test characteristics of ultralow-dose CT in detecting more than subtle emphysema (emphysema index≥3%) were calculated. RESULTS The effective dose of low-dose CT was 2.1±0.5 mSv, and that of ultralow-dose CT was 0.13±0.04 mSv. Compared with the findings for low-dose CT, absolute overestimation of emphysema index was 7% on ultralow-dose CT images reconstructed with FBP and 2% on those processed with IR. The 15th percentile of lung attenuation was underestimated by 21.3 HU on ultralow-dose FBP images and by 5.8 HU on IR images. No relevant bias was observed for mean lung attenuation. Four patients (8%) had more than subtle emphysema. The emphysema index measured at ultralow-dose CT with FBP and IR had 100% and 100% sensitivity and 92% and 96% specificity in identifying patients with more than subtle emphysema at a cutoff of greater than 12.1% for FBP and greater than 6.7% for IR. CONCLUSION Ultralow-dose chest CT performed for lung cancer screening can be used for quantification of lung density and for emphysema detection. IR improves the accuracy of ultralow-dose CT in this setting.

Quantitative hepatic CT perfusion measurement: Comparison of Couinaud's hepatic segments with dual-source 128-slice CT

PURPOSE To compare the quantitative liver computed tomography perfusion (CTP) differences among eight hepatic segments. MATERIALS AND METHODS This retrospective study was based on 72 acquired upper abdomen CTP scans for detecting suspected pancreas tumor. Patients with primary or metastatic liver tumor, any focal liver lesions except simple cyst (<3 cm in diameter), history of liver operation or splenectomy, evidence of liver cirrhosis or invasion of portal vein were excluded. The final analysis included 50 patients (M:F=21:29, mean age=43.2 years, 15-76 years). Arterial liver perfusion (ALP), portal-venous perfusion (PVP), total hepatic perfusion (THP=ALP+PVP), and hepatic perfusion index (HPI) of each hepatic segment were calculated and compared by means of one-way analysis of variance (ANOVA) and the Bonferonni correction method. RESULTS Compared to hepatic segments 5, 6, 7 and 8, segments 2 and 3 showed a tendency of higher ALPs, lower PVPs, and higher HPIs, most of which were statistically significant (p<0.05). Hepatic segments 1 and 4 had higher mean values of ALP and HPI and lower mean values of PVP than segments 5, 6, 7 and 8 as well, although no significant differences were detected except for ALP and HPI for liver segments 1 and 7 (p=0.001 and 0.035 respectively), and ALP for liver segments 1 and 5 (p=0.039). Higher ALP and HPI were showed in hepatic segment 3 compared to segment 4 (p=0.000 and 0.000 respectively). No significant differences were found for THP among eight segments. CONCLUSIONS Intra-hepatic perfusion differences exist in normal hepatic parenchyma especially between lateral sector (segments 2 and 3) and right lobe (segments 5, 6, 7 and 8). This might have potential clinical significance in liver-perfusion-related protocol design and result analysis.