Exploring Variability in CT Characterization of Tumors: A Preliminary Phantom Study

PURPOSE: To explore the effects of computed tomography (CT) slice thickness and reconstruction algorithm on quantification of image features to characterize tumors using a chest phantom. MATERIALS AND METHODS: Twenty-two phantom lesions of known sizes (10 and 20 mm), shapes (spherical, elliptical, lobulated, and spiculated), and densities [-630, -10, and +100 Hounsfield Unit (HU)] were inserted into an anthropomorphic thorax phantom and scanned three times with relocations. The raw data were reconstructed using six imaging settings, i.e., a combination of three slice thicknesses of 1.25, 2.5, and 5 mm and two reconstruction kernels of lung and standard. Lesions were segmented and 14 image features representing lesion size, shape, and texture were calculated. Differences in the measured image features due to slice thickness and reconstruction algorithm were compared using linear regression method by adjusting three confounding variables (size, density, and shape). RESULTS: All 14 features were significantly different between 1.25 and 5 mm slice images. The 1.25 and 2.5 mm slice thicknesses were better than 5 mm for volume, density mean, density SD gray-level co-occurrence matrix (GLCM) energy and homogeneity. As for the reconstruction algorithm, there was no significant difference in uni-dimension, volume, shape index 9, and compactness. Lung reconstruction was better for density mean, whereas standard reconstruction was better for density SD. CONCLUSIONS: CT slice thickness and reconstruction algorithm can significantly affect the quantification of image features. Thinner (1.25 and 2.5 mm) and thicker (5 mm) slice images should not be used interchangeably. Sharper and smoother reconstructions significantly affect the density-based features.     

Dual Energy Spectral CT Imaging for Colorectal Cancer Grading: A Preliminary Study

Objectives

To assess the diagnostic value of dual energy spectral CT imaging for colorectal cancer grading using the quantitative iodine density measurements in both arterial phase (AP) and venous phase (VP).

Methods

81 colorectal cancer patients were divided into two groups based on their pathological findings: a low grade group including well (n = 13) and moderately differentiated cancer (n = 24), and a high grade group including poorly differentiated (n = 42) and signet ring cell cancer (n = 2). Iodine density (ID) in the lesions was derived from the iodine-based material decomposition (MD) image and normalized to that in the psoas muscle to obtain normalized iodine density (NID). The difference in ID and NID between AP and VP was calculated.

Results

The ID and NID values of the low grade cancer group were, 14.65±3.38mg/mL and 1.70±0.33 in AP, and 21.90±3.11mg/mL and 2.05± 0.32 in VP, respectively. The ID and NID values for the high grade cancer group were 20.63±3.72mg/mL and 2.95±0.72 in AP, and 26.27±3.10mg/mL and 3.51±1.12 in VP, respectively. There was significant difference for ID and NID between the low grade and high grade cancer groups in both AP and VP (all p<0.001). ROC analysis indicated that NID of 1.92 in AP provided 70.3% sensitivity and 97.7% specificity in differentiating low grade cancer from high grade cancer.

Conclusions

The quantitative measurement of iodine density in AP and VP can provide useful information to differentiate low grade colorectal cancer from high grade colorectal cancer with NID in AP providing the greatest diagnostic value.     

Assessment of Vascularity in Hepatic Alveolar Echinococcosis: Comparison of Quantified Dual-Energy CT with Histopathologic Parameters

Purpose

To investigate whether dual-energy computer tomography(DECT) could determine the angiographic vascularity of alveolar echinococcosis lesions by comparing the quantitative iodine concentration (IC) with the microvascular density (MVD).

Material and Methods

Twenty-five patients (16 men, 9 women; mean age, 40.9 ± 13.8 years) with confirmed hepatic alveolar echinococcosis (HAE) underwent DECT of the abdomen, consisting of arterial phase (AP), portal venous phase (PVP), and delayed phase (DP) scanning, in dual-source mode (100 kV/140 kV). Image data were processed with a DECT software algorithm that was designed for the evaluation of iodine distribution in the different layers (marginal zone, solid and cystic) of the lesions. The CT patterns of HAE lesions were classified into three types: solid type, pseudocystic type and ‘geographic map’ (mixed) type. The IC measurements in different layers and different types of lesions were statistically compared. MVD was examined using CD34 immunohistochemical staining of the resected HAE tissue and scored based on the percentage of positively stained cells and their intensity. Pearson’s correlation analysis was used to evaluate the potential correlation between DECT parameters and MVD.

Results

A total of 27 HAE lesions were evaluated, of which 9 were solid type, 3 were pseudocystic type and 15 were mixed type. The mean lesion size was 100.7 ± 47.3 mm. There was a significant difference in the IC measurements between different layers of HAE lesions during each scan phase (p < 0.001). The IC in the marginal zone was significantly higher than in the solid and cystic components in AP (2.15 mg/mL vs. 0.17 or 0.01 mg/mL), PVP (3.08 mg/mL vs. 0.1 or 0.02 mg/mL), and DP (2.93 mg/mL vs. 0.04 or 0.02 mg/mL). No significant difference was found among the different CT patterns of HAE lesions. Positive expression of CD34 in the marginal zones surrounding HAE lesions was found in 92.5% (25/27) of lesions, of which 18.5% (5/27) were strongly positive, 62.7% (17/27) were moderately positive, and 11.1% (3/27) were weakly positive. In contrast, 7.4% (2/27) of the lesions were negative for CD34. There was a positive correlation between IC measurements and MVD in the marginal zone of HAE lesions (r = 0.73, p < 0.05).

Conclusions

The DECT quantitative iodine concentration was significantly correlated with MVD in the marginal zones surrounding HAE lesions. Dual-energy CT using a quantitative analytic methodology can be used to evaluate the vascularity of AE.     

Utility of the Iodine Overlay Technique and Virtual Nonenhanced Images for the Preoperative T Staging of Colorectal Cancer by Dual-Energy CT with Tin Filter Technology

Objectives

To evaluate the diagnostic accuracy and the potential radiation dose reduction of dual-energy CT (DECT) for tumor (T) staging of colorectal cancer (CRC) using iodine overlay (IO) and virtual nonenhanced (VNE) images.

Materials and Methods

This retrospective study included 103 consecutive patients who underwent nonenhanced CT and enhanced DECT for preoperative CRC staging. Enhanced weighted-average (WA), IO and VNE images were reconstructed from enhanced 80 kVp and Sn140 kVp scans. Two radiologists assessed image qualities of the true nonenhanced (TNE) and VNE images. For T-staging, another two radiologists independently interpreted all scans in two separate reading sessions: in the first session, only images derived from the single phase DECT acquisition (IO and VNE images) were read. In the second reading session after 30 to 50 (average:42) days, the same assessment was again performed with the TNE and enhanced WA images thereby simulating conventional dual-phase single-energy CT. The tumor node metastasis (TNM) system was used for staging with histopathologic reports as gold standard. Analysis of variance was used for statistical analysis.

Results

The signal-to-noise ratios (SNRs) of the tumors and normal reference tissues showed significant correlation between the TNE and VNE images (P<0.01). The mean iodine overlay value (48.4 HU±12.2) and enhancement (49.4 HU±11.8) value of CRCs had no significant difference (P = 0.52).The mean image noise on TNE (5.0±1.1) and VNE (5.3±1.1) images were similar (P = 0.07). The quantitative qualities of the VNE images were mildly inferior to the TNE images. Overall accuracy of T-stage CRC when using single-phase acquisition was slightly better than the dual-phase acquisition (90.3% vs 87.4%) (P = 0.51). The mean dose of the single-phase DECT acquisition was 6.2mSv comparing with 14.3mSv of dual-phase.

Conclusion

Single-phase DECT using IO and VNE images yields a high accuracy in T-staging of CRCs. Thereby, the radiation exposure of the patients can be reduced.     

First-Person Perspective Virtual Body Posture Influences Stress: A Virtual Reality Body Ownership Study

In immersive virtual reality (IVR) it is possible to replace a person’s real body by a life-sized virtual body that is seen from first person perspective to visually substitute their own. Multisensory feedback from the virtual to the real body (such as the correspondence of touch and also movement) can also be present. Under these conditions participants typically experience a subjective body ownership illusion (BOI) over the virtual body, even though they know that it is not their real one. In most studies and applications the posture of the real and virtual bodies are as similar as possible. Here we were interested in whether the BOI is diminished when there are gross discrepancies between the real and virtual body postures. We also explored whether a comfortable or uncomfortable virtual body posture would induce feelings and physiological responses commensurate with the posture. We carried out an experiment with 31 participants in IVR realized with a wide field-of-view head-mounted display. All participants were comfortably seated. Sixteen of them were embodied in a virtual body designed to be in a comfortable posture, and the remainder in an uncomfortable posture. The results suggest that the uncomfortable body posture led to lesser subjective BOI than the comfortable one, but that participants in the uncomfortable posture experienced greater awareness of their autonomic physiological responses. Moreover their heart rate, heart rate variability, and the number of mistakes in a cognitive task were associated with the strength of their BOI in the uncomfortable posture: greater heart rate, lower heart rate variability and more mistakes were associated with higher levels of the BOI. These findings point in a consistent direction—that the BOI over a body that is in an uncomfortable posture can lead to subjective, physiological and cognitive effects consistent with discomfort that do not occur with the BOI over a body in a comfortable posture.     

Metabolic Side-Effects of the Novel Second-Generation Antipsychotic Drugs Asenapine and Iloperidone: A Comparison with Olanzapine

Background

The second generation antipsychotic (SGA) drugs are widely used in psychiatry due to their clinical efficacy and low incidence of neurological side-effects. However, many drugs in this class cause deleterious metabolic side-effects. Animal models accurately predict metabolic side-effects for SGAs with known clinical metabolic liability. We therefore used preclinical models to evaluate the metabolic side-effects of glucose intolerance and insulin resistance with the novel SGAs asenapine and iloperidone for the first time. Olanzapine was used as a comparator.

Methods

Adults female rats were treated with asenapine (0.01, 0.05, 0.1, 0.5, 1.0 mg/kg), iloperidone (0.03, 0.5, 1.0, 5.0, 10.0 mg/kg) or olanzapine (0.1, 0.5, 1.5, 5.0, 10.0 mg/kg) and subjected to the glucose tolerance test (GTT). Separate groups of rats were treated with asenapine (0.1 and 1.0 mg/kg), iloperidone (1.0 and 10 mg/kg) or olanzapine (1.5 and 15 mg/kg) and tested for insulin resistance with the hyperinsulinemic-euglycemic clamp (HIEC).

Results

Asenapine showed no metabolic effects at any dose in either test. Iloperidone caused large and significant glucose intolerance with the three highest doses in the GTT, and insulin resistance with both doses in the HIEC. Olanzapine caused significant glucose intolerance with the three highest doses in the GTT, and insulin resistance with the higher dose in the HIEC.

Conclusions

In preclinical models, asenapine shows negligible metabolic liability. By contrast, iloperidone exhibits substantial metabolic liability, comparable to olanzapine. These results emphasize the need for appropriate metabolic testing in patients treated with novel SGAs where current clinical data do not exist.     

胃癌组织中端粒酶活性表达的初步研究

目的 :端粒酶的激活与胃癌发生密切相关 ,通过检测胃癌组织中端粒酶活性表达水平 ,为胃癌及其发生的早期诊断提供一种有效的方法。方法 :应用PCR ELISA技术 ,把端粒酶重复序列扩增技术与微孔液相杂交酶联呈色技术有机结合 ,检测胃肠癌组织和腹水标本中的端粒酶活性表达。结果 :1 7例晚期胃癌组织标本中检出 1 3例端粒酶活性表达 ,阳性率为 76 47% ;2 3例中期胃肠癌组织标本中检出 1 9例端粒酶活性表达 ,阳性率为 78 2 6% ;66例早期胃癌组织标本中检出5 7例端粒酶活性表达 ,阳性率为 86 36% ;36例癌旁近端组织标本中检出 1 1例端粒酶活性表达 ,阳性率为 30 5 6% ;36例癌旁远端组织标本中检出 4例端粒酶活性表达 ,阳性率为 1 1 1 1 % ;2 6例胃肠癌腹水标本检出 1 9例端粒酶活性表达 ,阳性率为 73 0 8% ;5 4例正常人胸腹水标本中没有检出端粒酶活性表达。结论 :胃癌组织标本中有较高的端粒酶活性表达 ,端粒酶活性表达可以作为胃癌发生的有效指标 ,而PCR ELISA技术可以定量评价作为端粒酶活性表达从而作为诊断胃癌发生的一种快速简便有效的方法。     

福建苏铁调查研究初报

对福建苏铁经过三年多的调查、观察和研究,基本完成福建苏铁原产地的调查,认为福建原产两种苏铁,即苏铁与四川苏铁。本文还对福州树木园引种栽培的苏铁进行分类研究,有苏铁、四川苏铁、海南苏铁、攀枝花苏铁、广东苏铁、台东苏铁、元江苏铁、暹罗苏铁、石山苏铁、篦齿苏铁、越南苏铁、叉叶苏铁、多羽叉叶苏铁、多歧苏铁、刺叶苏铁等,另有三种形态特征比较特殊的苏铁也在本文进行了简要描述。     

Quantification of the Iodine Content of Perigastric Adipose Tissue by Dual-Energy CT: A Novel Method for Preoperative Diagnosis of T4-Stage Gastric Cancer

This study investigated the utility of quantifying iodine concentration (IC) in perigastric adipose tissue, using dual-energy computed tomography (DECT), for the detection of T4a-stage gastric cancer. Fifty-four patients with gastric cancer were enrolled at the Fourth Hospital of Hebei Medical University between January and June 2013. Patients were imaged preoperatively with conventional computed tomography (CT) scans and DECT, and the IC in perigastric fat adjacent to the tumor calculated from arterial phase (AP) and portal venous phase (PVP) images. The patients subsequently received surgical treatment (gastrectomy), and histologic analysis of resected specimens was used as a ‘gold standard’ reference for cancer staging. Receiver operating characteristic (ROC) curve analysis was employed to assess the utility of DECT for identifying T4a-stage gastric cancer, with optimal IC thresholds determined from the area under the ROC curve (AUC). Postoperative histology revealed that 32 patients had serosal invasion (group A), and 22 did not (group B). The accuracy of conventional CT for distinguishing stage T4 from non-T4 stages was 68.5% (37/54). IC was significantly higher in group A than in group B (AP: 0.60±0.34 vs. 0.09±0.19 mg/mL, p<0.001; PVP: 0.83±0.41 vs. 0.27±0.21 mg/mL, p<0.001). The sensitivity, specificity and AUC for detecting serosal invasion were 77.1%, 79.2% and 0.89 at an IC threshold of 0.25 mg/mL for AP images; and 80.0%, 79.2% and 0.90 at an IC threshold of 0.45 mg/mL for PVP images. These results indicated that Iodine quantification in perigastric fat using DECT is an accurate method for detecting serosal invasion by gastric cancer.     

The Microwave Syndrome: A Preliminary Study in Spain

A health survey was carried out in Murcia, Spain, in the vicinity of a Cellular Phone Base Station working in DCS‐1800 MHz. This survey contained health items related to “microwave sickness” or “RF syndrome.” The microwave power density was measured at the respondents' homes. Statistical analysis showed significant correlation between the declared severity of the symptoms and the measured power density. The separation of respondents into two different exposure groups also showed an increase of the declared severity in the group with the higher exposure.     

Sugarcane as a Bioenergy Source: History,Performance, and Perspectives for Second-Generation Bioethanol

For hundreds of years, sugarcane has been a main source of sugar, used as a sweetener, and alcohol, fermented from the plant juice. The high cost of petroleum towards the end of the twentieth century stimulated the development of new fermentation technologies for producing economically viable bioethanol from sugarcane as an alternative to importing petroleum. More recently, awareness of the effects of greenhouse gas emissions due to the global climate changes propelled bioethanol as a viable renewable fuel. Consequently, sugarcane gained importance as a bioenergy feedstock. However, the lack of knowledge about sugarcane physiology, notably on aspects of photosynthesis and source–sink relationship, has slowed the advance of this expanding bioenergy-producing system. Besides the changes in source–sink relationship, another option to increase bioethanol production even more would be to use a greater fraction of the total biomass of plants, i.e., not only the soluble sugars but also the sugars present in the cell wall fractions. Here, we review the history of sugarcane as a bioenergy crop and discuss some of the relevant routes that could be adopted in the near future to make sugarcane an even better feedstock for producing biofuels.     

Diazepam: A Preliminary Study of its Effects on Patients with Athetoid Cerebral Palsy

Diazepam was administered to seven severely affected athetoid children for a period of two to three months to determine whether beneficial effects could be demonstrated from its use. All patients were started on a daily dose of 2.5 mg. and the dose was increased as tolerated. The patients were assessed by a neurologist, an occupational therapist, a physiotherapist and a speech therapist before and after the trial.The dose of diazepam cannot be determined in advance. The optimum dose must be established by trial in each individual patient. No beneficial effects were noted in four of these children. One of those who showed improvement became significantly worse when the drug was withdrawn and it was necessary to reinstitute the drug. The response in any individual patient is unpredictable. The most significant side effect was drowsiness.     

Improving Image Quality of Bronchial Arteries with Virtual Monochromatic Spectral CT Images

Objective

To evaluate the clinical value of using monochromatic images in spectral CT pulmonary angiography to improve image quality of bronchial arteries.

Methods

We retrospectively analyzed the chest CT images of 38 patients who underwent contrast-enhanced spectral CT. These images included a set of 140kVp polychromatic images and the default 70keV monochromatic images. Using the standard Gemstone Spectral Imaging (GSI) viewer on an advanced workstation (AW4.6,GE Healthcare), an optimal energy level (in keV) for obtaining the best contrast-to-noise ratio (CNR) for the artery could be automatically obtained. The signal-to-noise ratio (SNR), CNR and objective image quality score (1–5) for these 3 image sets (140kVp, 70keV and optimal energy level) were obtained and, statistically compared. The image quality score consistency between the two observers was also evaluated using Kappa test.

Results

The optimal energy levels for obtaining the best CNR were 62.58±2.74keV.SNR and CNR from the 140kVp polychromatic, 70keV and optimal keV monochromatic images were (16.44±5.85, 13.24±5.52), (20.79±7.45, 16.69±6.27) and (24.9±9.91, 20.53±8.46), respectively. The corresponding subjective image quality scores were 1.97±0.82, 3.24±0.75, and 4.47±0.60. SNR, CNR and subjective scores had significant difference among groups (all p<0.001). The optimal keV monochromatic images were superior to the 70keV monochromatic and 140kVp polychromatic images, and there was high agreement between the two observers on image quality score (kappa>0.80).

Conclusions

Virtual monochromatic images at approximately 63keV in dual-energy spectral CT pulmonary angiography yielded the best CNR and highest diagnostic confidence for imaging bronchial arteries.     

Snail Stomach Cytase, A New Reagent for Plant Cytology

A very active mixture of cytase and other enzymes is present in the stomach fluid of Helix pomatia, the edible snail. This fluid makes an ideal macerating medium for squash preparations of root-tips and other similar plant tissues. The complete separation of all cells is easily achieved, while the chromosomes remain completely unaffected. The method of using this fluid is described; it can be applied in conjunction with any of the standard     

A Preliminary Study on Alien Invasive Plants in Jiangsu,China

From 1985 to 2013, there were only 9 literatures reports on alien invasive plants in Jiangsu, less than 025% of total 3665 similar reports during the same period in China, and it was much disproportionate with the development level of social, economic, cultural and other aspects of the province. Through field investigation, literature review and specimen inspection, the preliminary statistics, analysis and discussion of 47 families 128 genera and 209 species of alien invasive plants in Jiangsu have been made, including their composition, origin, and the life form. All alien invasive plants were ranked into 5 grades according to the damage to ecosystem and economy: twenty two malignant invasive species; forty one serious invasive species; thirty two local invasive species; fifty one general invasive species; a left 63 species with unknown damage wait for further observation. The characteristics of alien invasive plants in Jiangsu have been discussed, and the proposals of suggestion have been made.     

Adipokine Levels Are Altered by Shiftwork: A Preliminary Study

Shiftwork is often associated with metabolic diseases, and in the past few years, several cytokines have been postulated to contribute to various diseases, including insulin resistance. The aim of this study was to compare the concentrations of adiponectin, tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6) in samples of young adult men exposed to a fixed (i) night shift (n?=?9), working from 22:00 to 06:00?h; (ii) early morning shift (n?=?6), working from 06:00 to 14:00?h; and (iii) day shift (n?=?7), working from 08:00 to 17:00?h. The fixed night-shift and early-morning-shift samples were considered collectively as a shiftworker group given their work times. Blood samples were collected during the regular working day at 4-h intervals over the course of 24?h, thus totaling six samples. Morphological and physical activity parameters did not differ between the three groups. Total energy intake was lowest on the early morning shifts (p?<?.03). Both shiftworker groups ingested a significantly higher percentage of fat (p?<?.003) and a lower percentage of carbohydrate (p?<?.0005) than the day group. The early morning group had a lower mean 24-h level of adiponectin than the other two groups (p?=?.016), and both the early morning and night groups exhibited higher mean 24-h levels of TNF-α than the day group (p?=?.0001). The 24-h mean levels of IL-6 did not differ significantly between the groups (p?=?.147). None of the groups exhibited a significant circadian effect on adiponectin (p?=?.829), TNF-α (p?=?.779), or IL-6 (p?=?.979) levels. These results indicate that individuals who are enrolled in shiftwork are susceptible to alterations in the secretion of cytokines that are involved in insulin resistance and cardiovascular disease, both of which are known to affect this population. (Author correspondence: tmello@demello.net.br)