Single agent nanoparticle for radiotherapy and radio-photothermal therapy in anaplastic thyroid cancer

Anaplastic thyroid carcinoma (ATC) is one of the most aggressive human malignancies. The aggressive behavior of ATC and its resistance to traditional treatment limit the efficacy of radiotherapy, chemotherapy, and surgery. The purpose of this study is aimed at enhancing the therapeutic efficacy of radiotherapy (RT) combined with photothermal therapy (PTT) in murine orthotopic model of ATC, based on our developed single radioactive copper sulfide (CuS) nanoparticle platform. We prepare a new dual-modality therapy for ATC consisting of a single-compartment nanoplatform, polyethylene glycol-coated [⁶⁴Cu]CuS NPs, in which the radiotherapeutic property of ⁶⁴Cu is combined with the plasmonic properties of CuS NPs. Mice with Hth83 ATC were treated with PEG-[⁶⁴Cu]CuS NPs and/or near infrared laser. Antitumor effects were assessed by tumor growth and animal survival. We found that in mice bearing orthotopic human Hth83 ATC tumors, micro-PET/CT imaging and biodistribution studies showed that about 50% of the injected dose of PEG-[⁶⁴Cu]CuS NPs was retained in tumor 48 h after intratumoral injection. Human absorbed doses were calculated from biodistribution data. In antitumor experiments, tumor growth was delayed by PEG-[⁶⁴Cu]CuS NP-mediated RT, PTT, and combined RT/PTT, with combined RT/PTT being most effective. In addition, combined RT/PTT significantly prolonged the survival of Hth83 tumor-bearing mice compared to no treatment, laser treatment alone, or NP treatment alone without producing acute toxic effects. These findings indicate that this single-compartment multifunctional NPs platform merits further development as a novel therapeutic agent for ATC.     

成人内听道底相关结构的多层螺旋CT解剖学观察

目的：应用64层MSCT观测成人内听道底及其相关的解剖结构,为临床应用提供影像解剖学依据。方法筛选2011年4—12月广东省人民医院采用64层MSCT扫描的乳突气化良好、无中耳或内耳病变且无眩晕等平衡功能障碍症状的40例共80耳成人CT资料进行回顾性分析。在MSCT图像上观测：横嵴,横嵴至前庭内侧骨壁的距离（ D1),面神经管迷路段、上前庭神经管、下前庭神经管和后壶腹神经管（单管)各管的长度、宽径,以及后壶腹神经管的内听道开口（单孔)至前庭内侧骨壁的距离（D2)。结果80耳的横嵴、面神经管迷路段、上前庭神经管、下前庭神经管和后壶腹神经管、单孔在横断位、冠状位及矢状位均能显示。其中横嵴局部解剖位置清晰、稳定,位于内听道底的中部,内侧缘自前内向后外走行,D1为（1．56±0．55)mm（0．55~2．67 mm)。面神经管迷路段长度（2．60±0．34)mm（1．54~3．27 mm),宽径（0．91±0．23)mm（0．50~1．58 mm);上前庭神经管长度（3．39±0．52) mm（2．50~5．06 mm),宽径（1．03±0．19)mm（0．74~1．62 mm);下前庭神经管长度（1．35±0．27) mm（0．74~2．17 mm),宽径（1．34±0．25)mm（0．85~2．34 mm);后壶腹神经管长度（3．88±0．84) mm （2．58~6．00 mm),宽径（0．63± 0．12) mm （0．42~0．98 mm)。 D2为（2．50±0．72)mm（1．37~5．01 mm)。结论64层螺旋CT能较好地显示位于内听道底的横嵴以及面神经管迷路段、前庭上神经、前庭下神经、后壶腹神经各骨管和单孔的走行及形态特征,为内耳疾病的诊断、鉴别诊断及术前评估提供有参考价值的信息。     

超低管电压（70 kVp）结合迭代重建技术在低体重儿童胸部检查中的可行性研究

目的：研究超低管电压(70 kVp)与迭代重建联合应用对低体重(<20 kg)儿童胸部CT图像质量及辐射剂量的影响。方法：收集2014年12月1日至2015年3月31日进行胸部平扫的连续30例低体重(<20 kg)儿童患者,管电压降低为70 kVp,分别进行滤波反投影重建(filter back projection,FBP)及迭代重建(Sinogram Affirmed Iterative Reconstruction,SAFIRE,Siemens)获得图像,从PACS挑选30例体重及年龄匹配的低体重儿童(<20 kg)作为对照组,对CT容积辐射指数(the volume CT dose index,CTDIvol)(mGy)、剂量长度乘积(dose-length product,DLP)(mGy·cm)、有效辐射剂量(effective dose,ED)(mSv)、图像噪声、信噪比及总体主观图像质量、呼吸运动伪影进行对比评价。结果：超低管电压组较对照组CTDIvol(mGy)、DLP(mGy·cm)、ED(mSv)分别减少18.7%、21.6%、20.2%(P<0.001)。超低管电压组SAFIRE重建较FBP重建噪声减少35.1%,信噪比(signal to noise ratio,SNR)提高16%(P<0.05),SAFIRE的图像的主观评分显著低于FBP。超低管电压组FBP重建较对照组,噪音增加18.2%(P<0.05),SNR下降3.8%(P>0.05),图像主观评分无统计学差异。结论：超低管电压(70 kVp)与迭代重建联合应用较传统螺旋扫描获得临床可以接受的图像质量,同时显著减少了辐射剂量。     

Impact of Coronary Plaque Characteristics on Late Stent Malapposition after Drug-Eluting Stent Implantation

Purpose

To evaluate the impact of pre-procedural coronary plaque composition assessed by virtual histology intravascular ultrasound (VH-IVUS) on late stent malapposition assessed by optical coherence tomography (OCT) following drug-eluting stent (DES) implantation.

Materials and Methods

The study population consisted of 121 patients (121 lesions) who underwent both pre-procedural VH-IVUS and follow-up OCT after DES implantation. The association between pre-procedural plaque composition [necrotic core (NC), dense calcium (DC), fibrotic (FT), and fibro-fatty (FF) volumes] assessed by VH-IVUS and late stent malapposition (percent malapposed struts) or strut coverage (percent uncovered struts) assessed by follow-up OCT was evaluated.

Results

Pre-procedural absolute total NC, DC, FT, and FF plaque volumes were 22.9±19.0, 7.9±9.6, 63.8±33.8, and 16.5±12.4 mm³, respectively. At 6.3±3.1 months post-intervention, percent malapposed and uncovered struts were 0.8±2.5% and 15.3±16.7%, respectively. Pre-procedural absolute total NC and DC plaque volumes were positively correlated with percent malapposed struts (r=0.44, p<0.001 and r=0.45, p<0.001, respectively), while pre-procedural absolute total FT plaque volume was weakly associated with percent malapposed struts (r=0.220, p=0.015). Pre-procedural absolute total DC plaque volume was the only independent predictor of late stent malapposition on multivariate analysis (β=1.12, p=0.002). There were no significant correlations between pre-intervention plaque composition and percent uncovered struts.

Conclusion

Pre-procedural plaque composition was associated with late stent malapposition but not strut coverage after DES implantation. Larger pre-procedural absolute total DC plaque volumes were associated with greater late stent malapposition.     

形变配准技术分析呼吸运动对肝癌患者正常肝脏及其鞍区形态影响

目的结合四维CT(four-dimension computed tomography,4D-CT)技术,应用自由变形模型(free form deformation,FFD)形变配准算法分析呼吸运动对原发性肝癌患者肝脏及其靶区形态的影响。方法选取2010-08-01-2011-08-30山东省肿瘤医院8例接受放疗的原发性肝癌患者,获得患者4D-CT的模拟定位图像,将4D-CT图像依据呼吸周期均分为CT0、CT10、CT20、CT30、CT40、CT50、CT60、CT70、CT80和CT9010套CT图像。以呼气末时相图像CT50为参考图像,其他9幅图像采用基于B样条的自由变形模型FFD算法与其配准。然后用差分位图、Hausdroff距离及互信息技术分析呼吸运动对肝脏及其肿瘤形态的影响。结果从一个完整呼吸周期10个时相的CT图像及差分位图可以看出,呼吸运动对正常肝脏及肿瘤靶区形态造成的影响,其中吸气末和呼气末的变化最大。基于B样条的多分辨率网格自由变形模型FFD形变配准算法,可有效实现不同CT图像间的形变配准。其将肝脏和肿瘤靶区配准前CT0与CT50的Hausdroff距离由0.091 4减小到0.043 2,平均减小了54.1%;互信息从0.789 0提高到0.814 0;平均提高了3.17%。结论呼吸运动造成的肝脏及其肿瘤靶区的形变是显著的,基于B样条的多分辨率网格自由变形模型FFD形变配准算法可有效实现4D-CT图像间的形变配准。     

Four‐dimensional computed tomography (4DCT): A review of the current status and applications

The applications of conventional computed tomography (CT) have been widely researched and implemented in clinical practice. A recent technological innovation in the field of CT is the emergence of four‐dimensional computed tomography (4DCT), where a three‐dimensional computed tomography volume containing a moving structure is imaged over a period of time, creating a dynamic volume data set. 4DCT has previously been mainly utilised in the setting of radiation therapy planning, but with the development of wide field of view CT, 4DCT has opened major avenues in the diagnostic arena. The aim of this study is to provide a comprehensive narrative review of the literature regarding the current clinical applications of 4DCT. The applications reviewed include both routine diagnostic usage as well as an appraisal of the current research literature. A systematic review of the studies related to 4DCT was conducted. The Medline database was searched using the MeSH subject heading ‘Four‐Dimensional Computed Tomography’. After excluding non‐human and non‐English papers, 2598 articles were found. Further exclusion criteria were applied, including date range (since wide field of view CT was introduced in 2007), and exclusion of technical/engineering/physics papers. Further filtration of papers included identification of Review papers. This process yielded 67 papers. Of these, exclusion of papers not specifically discussing 4DCT (cone beam, 4D models) yielded 38 papers. As part of the review, the technique for 4DCT is described, with perspectives as to how it has evolved and its benefits in different clinical indications.     

直肠神经内分泌肿瘤的影像学分析

目的 分析新病理分级下直肠神经内分泌肿瘤(neuroendocrine neoplasm,NEN)的影像学表现,提高对直肠NEN的术前诊断率.方法 收集2010-03-01-2014-03-31经手术病理确诊、有完整影像学资料的直肠NEN患者37例,分析直肠NEN的影像学表现及不同级别间影像学表现差异.结果 37例直肠NEN均为无功能性.参照WHO 2010年消化系统肿瘤分类和2010年中国病理学诊断共识,G1级32例,G2级1例,G3级4例,单发多见(33/37).G1～G2级33例,长径均＜2.0 cm(平均1.0 cm,G2级1例长径为5 cm),边界清楚,增强均为明显强化;其中30例为黏膜面息肉样或结节隆起型病变,31例黏膜表面光滑,1例出现淋巴结转移,均未见肝转移.G3级4例,病变长径均＞2.0 cm(平均6.4cm),均侵犯肠管1/2周以上或呈环周性生长,侵犯浆膜外或纤维膜外,边界不清楚,黏膜表面不规则,增强扫描明显强化;其中3例出现淋巴结转移,1例出现肝转移.结论 增强扫描明显强化是直肠神经内分泌肿瘤的影像特征,低级别(G1、G2级)病灶长径小,形态规则,远处转移少见,而高级别(G3级)病变长径大,侵袭性生长特点明显.