Jie Qin

Accuracy of the diagnostic evaluation of hepatocellular carcinoma with LI-RADS:

Background There are few studies about the Liver Imaging Reporting and Data System (LI-RADS), which was developed with the purpose of standardizing the interpretation and reporting of liver imaging examinations in patients at risk for hepatocellular carcinoma (HCC). Purpose To evaluate the diagnostic accuracy of HCC diagnosis using LI-RADS. Material and Methods The computed tomography (CT), magnetic resonance imaging (MRI), and clinical data of 297 lesions in 249 patients between June 2012 and August 2013 were retrospectively analyzed. Using LI-RADS 2014, two radiologists evaluated the lesions and a LI-RADS category was retrospectively assigned to each nodule. Results The final diagnoses of 297 nodules in 249 patients consisted of 191 malignant and 106 benign lesions. Out of 44 LI-RADS category 1 lesions, none were HCCs. However, 2/25 category 2 lesions, 3/35 category 3 lesions, 16/25 category 4 lesions, 151/156 category 5 lesions, and 3/12 category LRM/OM (probable malignancy, not specific for HCC/other malignancy) lesions were HCCs. The Kappa value was 0.44 (95% confidence interval [CI]u2009=u20090.39–0.49) between two observers during LI-RADS grading. Conclusion The negative predictive value of LI-RADS category 1 was 100%. In addition, a relevant proportion of lesions categorized as category 2 or 3, or even as other malignancies, were HCCs. LI-RADS category 5 had a high specificity for HCC. LI-RADS was not able to give a differential diagnosis for the false-positive lesions of LI-RADS category 5.

Comparison of anomalous systemic artery to left lower lobe and pulmonary sequestration in left lower lobe by computed tomography.

Background Differentiation of anomalous systemic artery to the left lower lobe (ASALLL) from pulmonary sequestration (PS) is essential, as ASALLL can be corrected by anastomosis, embolization, or ligation of the anomalous artery. Purpose To compare computed tomography (CT) findings of ASALLL and PS in the left lower lobe (LLL). Materials and methods This study included 16 patients with ASALLL and 25 patients with PS in LLL confirmed by operative and pathologic findings. Results Cough and sputum were more common in PS (84% and 60%, respectively) than in ASALLL (25% and 12.5%, respectively) (Pu2009<u20090.05). Hemoptysis was more common in ASALLL (100%) than in PS (24%) (Pu2009<u20090.05). The frequency of ground glass opacity (GGO), normal bronchial distribution, dilated left inferior pulmonary veins, and absence of the interlobar artery distal to the origin of the superior segmental artery in LLL differed significantly between ASALLL and PS. Mass was less common in ASALLL (0%) than in PS (88%) (Pu2009<u20090.01). The mean diameter of the anomalous artery (11.88u2009±u20091.13u2009mm) in ASALLL was significantly larger than that (5.96u2009±u20090.98u2009mm) in PS (Pu2009<u20090.01). The presence of anomalous artery arising from thoracic aorta was not different between ASALLL (100%) and PS (72%). Conclusion Radiographic indications of ASALLL differ from those of PS in the LLL. Indications that may suggest ASALLL include an enlarged anomalous systemic artery arising from the thoracic aorta, dilated left inferior pulmonary veins, absence of the interlobar artery distal to the origin of the superior segmental artery, normal bronchial distribution, and GGO in the LLL.

Selection of glucocorticoid-sensitive patients in interstitial lung disease secondary to connective tissue diseases population by radiomics

Purpose The effect of glucocorticoid(s) on connective tissue disease (CTD)-related interstitial lung disease (ILD) is controversial. This multicenter study aimed to identify glucocorticoid-sensitive patients using a radiomics approach. Methods A total of 416 CTD-ILD patients who began glucocorticoid treatment at the discretion of the attending physician, with or without cyclophosphamide, were included in this study. High doses were defined as pulsed intravenous methylprednisolone, an initial dose of 1 mg/kg/day of prednisolone or 0.8 mg/kg/day of methylprednisolone. Low doses were defined as those less than high doses. Radiomics features were manually extracted from primary lung lesions delineated on computed tomography images, and selected by variance, univariate feature selection, and least absolute shrinkage and selection operator regression model. The prediction models were developed using data from 309 patients from two centers and externally validated in 107 patients from four other hospitals. Results Treatment response in the training and validation groups was 38.5% and 36.4%, respectively. Eleven radiomics features were selected from 1,029 features with predictive value. Random forest models built for radiomics features to predict treatment response yielded a sensitivity of 0.897. The calibration curve of a nomogram demonstrated good agreement between prediction and observation. Decision curve analysis indicated that glucocorticoid was beneficial if the predicted response rate was 50%–60% for an individual. High doses of glucocorticoids and cyclophosphamide yielded superior efficacy. Conclusion Radiomics-based predictive models reliably identified glucocorticoid-sensitive CTD-ILD patients. Short-term, high-dose glucocorticoid with cyclophosphamide yielded promising results as a potential therapy.

CT findings of anomalous systemic artery to the left lower lobe: Comparison with pulmonary sequestration in the left lower lobe

AIMnTo analyse and compare CT findings of anomalous systemic artery to the left lower lobe (ASALLL) and pulmonary sequestration (PS) in the left lower lobe (LLL).nnnMATERIALS AND METHODSnThe present study cohort comprised 16 patients with ASALLL and 25 patients with PS in the LLL confirmed by surgical and pathological findings. Medical records and CT images were reviewed retrospectively.nnnRESULTSnCough and sputum were more common in PS (84% and 60%, respectively) than in ASALLL (25% and 12.5%, respectively; p < 0.05). Haemoptysis was more common in ASALLL (100%) than in PS (24%; p < 0.05). The frequency of ground-glass opacity (GGO), normal bronchial distribution, dilated left inferior pulmonary veins, and absence of the interlobar artery distal to the origin of the superior segmental artery in the LLL differed significantly between ASALLL and PS. A mass was less common in ASALLL (0%) than in PS (88%; p < 0.01). The mean diameters of the anomalous artery (12.10 ± 1.49 mm) and left inferior pulmonary veins (13.20 ± 2.19 mm) in ASALLL were significantly larger than those (6.73 ± 2.59 mm, 10.04 ± 1.55 mm) in PS. The threshold diameters of the anomalous artery and left inferior pulmonary vein for ASALLL were 9.75 and 11.75 mm, respectively. The presence of an anomalous artery arising from the thoracic aorta was not different between ASALLL (100%) and PS (72%).nnnCONCLUSIONnThe following imaging features favour ASALLL over PS in the LLL: a larger anomalous systemic artery arising from the thoracic aorta, dilated left inferior pulmonary veins, absence of the interlobar artery distal to the origin of the superior segmental artery, normal bronchial distribution, and GGO in the LLL.