Shi-Ting Feng

CT Enterography in Evaluating Postoperative Recurrence of Crohn's Disease after Ileocolic Resection: Complementary Role to Endoscopy.

Background:Ileocolonoscopy is the gold standard to assess postoperative recurrence (POR) in patients with Crohn’s disease (CD) who have undergone ileocolic resection. Although computed tomographic enterography (CTE) yields striking findings in the small bowel of CD, its role in POR is undefined. The aim of this study was to compare ileocolonoscopy and CTE for evaluating POR in CD. Methods:The analysis included 32 patients with CD with ileocolic resection. Ileocolonoscopy and CTE were performed within 1 week. Endoscopic recurrence was defined using Rutgeerts score (i0–i4), whereas CTE recurrence was assessed according to a previously validated CTE score (CTE0–CTE3). Patients were followed up for a maximum of 30 months, and the primary endpoint was reoperation. Results:There was a good correlation between endoscopic and CTE recurrence (r = 0.782, P < 0.0001). Moreover, CTE identified the presence of jejunal and proximal ileum disease (n = 7), fistula (n = 3), and abscess (n = 4). Therapeutic management was thereby modified in 8 of 32 patients (25.0%). Eleven patients received major reoperation. There was no significant difference regarding the rate of reoperation between subgroups Rutgeerts score i3–4 and i0–2 (P > 0.05), whereas there was significant difference between subgroups’ CTE2–CTE3 and CTE0–CTE1 (P < 0.05). Conclusions:CTE is a reliable method in assessing POR in patients with CD who have undergone ileocolic resection. CTE may serve as an important complementary tool to endoscopy for evaluation of the postoperative course of CD.

Pancreatic neuroendocrine tumours: correlation between MSCT features and pathological classification.

ObjectivesWe aimed to evaluate the multi-slice computed tomography (MSCT) features of pancreatic neuroendocrine neoplasms (P-NENs) and analyse the correlation between the MSCT features and pathological classification of P-NENs.MethodsForty-one patients, preoperatively investigated by MSCT and subsequently operated on with a histological diagnosis of P-NENs, were included. Various MSCT features of the primary tumour, lymph node, and distant metastasis were analysed. The relationship between MSCT features and pathologic classification of P-NENs was analysed with univariate and multivariate models.ResultsContrast-enhanced images showed significant differences among the three grades of tumours in the absolute enhancement (Pu2009=u20090.013) and relative enhancement (Pu2009=u20090.025) at the arterial phase. Univariate analysis revealed statistically significant differences among the tumours of different grades (based on World Health Organization [WHO] 2010 classification) in tumour size (Pu2009=u20090.001), tumour contour (Pu2009<u20090.001), cystic necrosis (Pu2009=u20090.001), tumour boundary (Pu2009=u20090.003), dilatation of the main pancreatic duct (Pu2009=u20090.001), peripancreatic tissue or vascular invasion (Pu2009<u20090.001), lymphadenopathy (Pu2009=u20090.011), and distant metastasis (Pu2009=u20090.012). Multivariate analysis suggested that only peripancreatic tissue or vascular invasion (HR 3.934, 95xa0% CI, 0.426–7.442, Pu2009=u20090.028) was significantly associated with WHO 2010 pathological classification.ConclusionsMSCT is helpful in evaluating the pathological classification of P-NENs.Key Points• P-NENs are potentially malignant, and classification of P-NENs carries important prognostic value.• MSCT plays an important role in the diagnosis and staging of P-NENs.• Correlations between classification of P-NENs and imaging findings have not been systematically evaluated.• MSCT could predict P-NENs classification and may be a useful prognostication tool.

pH-Sensitive Nanomicelles for Controlled and Efficient Drug Delivery to Human Colorectal Carcinoma LoVo Cells

Background The triblock copolymers PEG-P(Asp-DIP)-P(Lys-Ca) (PEALCa) of polyethylene glycol (PEG), poly(N-(N’,N’-diisopropylaminoethyl) aspartamide) (P(Asp-DIP)), and poly (lysine-cholic acid) (P(Lys-Ca)) were synthesized as a pH-sensitive drug delivery system. In neutral aqueous environment such as physiological environment, PEALCa can self-assemble into stable vesicles with a size around 50-60 nm, avoid uptake by the reticuloendothelial system (RES), and encase the drug in the core. However, the PEALCa micelles disassemble and release drug rapidly in acidic environment that resembles lysosomal compartments. Methodology/Principal Findings The anticancer drug Paclitaxel (PTX) and hydrophilic superparamagnetic iron oxide (SPIO) were encapsulated inside the core of the PEALCa micelles and used for potential cancer therapy. Drug release study revealed that PTX in the micelles was released faster at pH 5.0 than at pH 7.4. Cell culture studies showed that the PTX-SPIO-PEALCa micelle was effectively internalized by human colon carcinoma cell line (LoVo cells), and PTX could be embedded inside lysosomal compartments. Moreover, the human colorectal carcinoma (CRC) LoVo cells delivery effect was verified in vivo by magnetic resonance imaging (MRI) and histology analysis. Consequently effective suppression of CRC LoVo cell growth was evaluated. Conclusions/Significance These results indicated that the PTX-SPION-loaded pH-sensitive micelles were a promising MRI-visible drug release system for colorectal cancer therapy.

Microstructural brain abnormalities of children of idiopathic generalized epilepsy with generalized tonic-clonic seizure: a voxel-based diffusional kurtosis imaging study.

The above article, published online on 3 May 2014 in Wiley Online Library (wileyonlinelibrary.com), has been retracted by agreement between the authors, the journal Editor in Chief, and Wiley Periodicals, Inc. The retraction has been agreed due to errors in the results of the published article. The authors stated in the Methods section that ‘. . . only clusters with a false discovery rate (FDR)‐corrected P‐value less than 0.05 were included.’ However, it was subsequently discovered that the FDG‐correction had not been performed correctly. Had this been carried out in the right way, the difference between the case group and the control group in most of the presented regions would have been insignificant.

Noninvasive fat quantification of the liver and pancreas may provide potential biomarkers of impaired glucose tolerance and type 2 diabetes.

AbstractThe aim of the study is to investigate if the fat content of the liver and pancreas may indicate impaired glucose tolerance (IGT) or type 2 diabetes mellitus (T2DM). A total of 83 subjects (34 men; aged 46.5u200a±u200a13.5 years) were characterized as T2DM, IGT, or normal glucose tolerant (NGT). NGT individuals were stratified as <40 or ≥40 years. Standard laboratory tests were conducted for insulin resistance and &bgr;-cell dysfunction. The magnetic resonance imaging Dixon technique was used to determine fat distribution in the liver and pancreas. Correlations among liver and pancreatic fat volume fractions (LFVFs and PFVFs, respectively) and laboratory parameters were analyzed. Among the groups, fat distribution was consistent throughout sections of the liver and pancreas, and LFVFs closely correlated with PFVFs. LFVFs correlated more closely than PFVFs with insulin resistance and &bgr;-cell function. Both the LFVFs and PFVFs were the highest in the T2DM patients, less in the IGT, and least in the NGT; all differences were significant. The PFVFs of the NGT subjects ≥40 years were significantly higher than that of those <40 years. The fat content of the liver and pancreas, particularly the liver, may be a biomarker for IGT and T2DM.

MR Quantification of Total Liver Fat in Patients with Impaired Glucose Tolerance and Healthy Subjects

Objective To explore the correlations between liver fat content and clinical index in patients with impaired glucose tolerance (IGT) and healthy subjects. Materials and Methods 56 subjects were enrolled and each of them underwent upper-abdominal MRI examination that involved a T1 VIBE Dixon sequence. 14 was clinically diagnosed with IGT (collectively as IGT group ) while 42 showed normal glucose tolerance,(collectively as NGT group). NGT group was further divided into NGTFat (BMI≥25, 18 subjects) and NGTLean (BMI<25, 24 subjects). The total liver fat contents was measured and compared with clinical findings and laboratory results in order to determine statistical correlations between these parameters. Differences among IGT, NGTFat and NGTLean groups were evaluated. Results For all the subjects, fat volume fractions (FVFs) ranged from 4.2% to 24.2%, positive correlations was observed with BMI, waist hip ratio(WHR), low density lipoprotein(LDL), fasting plasma insulin(FPI), homeostasis model assessment insulin resistance (HOMA-IR) and homeostasis model assessment β(HOMAβ). FVFs of IGT group (pu200a=u200a0.004) and NGTFat group (pu200a=u200a0.006) were significantly higher than those of NGTLean group. Conclusions People with higher BMI, WHR and LDL levels tend to have higher liver fat content. Patients with BMI≥25 are more likely to develop IGT. Patients with higher FVF showed higher resistance to insulin, thus obtained a higher risk of developing type 2 diabetes mellitus.

Somatostatin receptor expression indicates improved prognosis in gastroenteropancreatic neuroendocrine neoplasm, and octreotide long‑acting release is effective and safe in Chinese patients with advanced gastroenteropancreatic neuroendocrine tumors

Gastroenteropancreatic neuroendocrine neoplasm (GEP-NEN) is known to overexpress somatostatin receptors (SSTRs), most commonly SSTR2 and SSTR5. The expression of SSTRs on tumor cells forms the basis for somatostatin analog treatment of patients with NEN. The present study detected the expression of SSTR2 and SSTR5 in GEP-NEN and investigated the efficacy and safety of octreotide long-acting release (LAR) in the treatment of advanced gastroenteropancreatic neuroendocrine tumors (GEP-NET) in China. The present study reported that functionality of the pancreas, G1 and G2 grading, NET classification and Tumor-Node-Metastasis stages I and II were associated with higher SSTR2 positive expression. Similarly, SSTR5 was increased in pancreatic and well-differentiated tumors. SSTR2 and SSTR5 positive expression predicted improved survival in GEP-NEN patients. The median overall survival of patients treated with octreotide LAR was not reached. The median time to progression was 20.2 months, with the objective response rate being 5.6% and the stable disease rate being 79.6%. A total of 25.9% of the patients experienced adverse drug reactions. In conclusion, the present study demonstrated that SSTR2 and SSTR5 are heterogeneously expressed in GEP-NEN. Both markers may serve as potential prognostic factors. Octreotide LAR is effective and safe in the treatment of Chinese patients with advanced GEP-NET.

Sunitinib is effective and tolerable in Chinese patients with advanced pancreatic neuroendocrine tumors: a multicenter retrospective study in China

AbstractPurposenTo determine the efficacy and safety of sunitinib in Chinese patients with unresectable or metastatic pancreatic neuroendocrine tumors (pNETs) and the clinical significance of steady-state sunitinib serum concentrations.MethodsWe conducted a multicenter retrospective study including six centers from across China. A total of 60 patients with unresectable or metastatic pNETs who were treated with sunitinib were evaluated retrospectively.ResultsThe median overall survival (OS) was 47.5xa0months and the median time to progression (TTP) was 15.3xa0months. The objective response rate was 5.0%, and the stable disease (SD) rate was 81.7%. About 35.2% of patients required a dosage decrease from 37.5 to 25xa0mg/day due to adverse events, which in most cases were alleviated or disappeared with the dosage reduction. In 14 patients who experienced sunitinib-related hypertension, 2 achieved a partial response (PR) and 11 had SD. The median OS and TTP of these 14 patients experienced hypertension were both not reached. The median Css of sunitinib was similar between patients treated with sunitinib 37.5 and 25xa0mg/day (Pxa0=xa00.955), but higher in patients who had PR than in those who achieved SD or progressive disease, although no statistically significant difference was found (Pxa0=xa00.173).ConclusionsSunitinib had similar treatment efficacy to western patients with pNET in China. A 25xa0mg/day dosage was better tolerated than 37.5xa0mg/day in Chinese patients, and there were no significant differences in sunitinib Css between the two dosage groups. Patients with higher sunitinib Css seem to have better efficacy. Sunitinib-related hypertension may be a predictor of a better treatment effect.

Functional magnetic resonance cholangiography enhanced with Gd-EOB-DTPA: Effect of liver function on biliary system visualization

To evaluate effect of liver function on biliary system visualization using gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd‐EOB‐DTPA)‐enhanced magnetic resonance cholangiography (CE‐MRC).

CT Evaluation of Gastroenteric Neuroendocrine Tumors: Relationship Between CT Features and the Pathologic Classification

OBJECTIVEnThe objective of our study was to compare the CT features of gastroenteric neuroendocrine neoplasms (GE-NENs) with the pathologic classification and to analyze the correlation between the CT features and classification of GE-NENs.nnnMATERIALS AND METHODSnFifty-six cases of pathologically and immunohisto-chemically proven GE-NENs, including 25 cases of neuroendocrine tumors (NETs) (i.e., G1 and G2 tumors) and 31 cases of neuroendocrine carcinomas (NECs) (i.e., G3 tumors and mixed adenoneuroendocrine carcinomas) were studied. We analyzed various CT features of the primary tumor, nodal status, and metastasis and compared these features with pathologic grading.nnnRESULTSnThe CT features that favor NEC over NET include larger tumor size (> 4.0 cm), transmural invasion, circumscribed tumor with both intra- and extraluminal involvement, circumferential growth, areas of cystic change or necrosis, ulceration, mesenteric fat infiltration, and lymphadenopathy, with p values of 0.044, 0.002, 0.024, 0.008, 0.002, 0.007, 0.002, and < 0.001, respectively. The CT features that do not distinguish between the two types of GE-NENs include tumor boundary, growth pattern, degree of enhancement, adjacent organ invasion, distant organ metastasis, and peritoneal seeding, with p values of 0.277, 0.153, 0.672, 1.000, 0.159, and 0.877, respectively.nnnCONCLUSIONnCT can be useful in the classification of GE-NENs.