Publications by authors named "Jinwei Qiang"

19 Publications

  • Page 1 of 1

The role of volumetric ADC histogram analysis in preoperatively evaluating the tumour subtype and grade of endometrial cancer.

Eur J Radiol 2021 Apr 30;140:109745. Epub 2021 Apr 30.

Department of Radiology, Jinshan Hospital, Fudan University, Longhang Road, Shanghai, 201508, People's Republic of China. Electronic address:

Purpose: To assess the value of volumetric ADC histogram metrics in evaluating the histological subtype and grade of endometrial cancer.

Method: Preoperative MRI datasets of 317 patients with endometrial cancer were used to obtain volumetric ADC histogram metrics (tumour volume; minADC, maxADC and meanADC; 10th, 25th, 50th, 75th and 90th percentiles of ADC; skewness; and kurtosis). The Mann-Whitney test or Student's t-test was used to compare the difference in ADC histogram metrics between endometrioid adenocarcinomas (EACs) and serous endometrial cancers (SECs) and between different tumour grades (G1, G2, G3). The area under the curve (AUC) of the receiver operating characteristic (ROC) curve was used to evaluate the performance of ADC histogram metrics or combined models in predicting the tumour subtype and grade.

Results: SECs showed a significantly larger tumour volume (P < 0.001) and lower meanADC, 50th, 75th and 90th percentiles of ADC than EACs (all P < 0.05). MinADC, maxADC, meanADC, 10th, 25th, 50th, 75th, 90th percentiles of ADC were significantly higher in G1 than in G2 and G3 EACs (all P < 0.05), while were not significantly different between G2 and G3 EACs (all P > 0.05). A tumour volume ≥ 7.752 cm allowed for the prediction of SECs, with an AUC of 0.765 (0.714-0.810). A meanADC ≥ 0.892 × 10  mm/s enabled to discriminate G1 from G2 and G3 EACs, with an AUC of 0.818 (0.769-0.861).

Conclusion: Volumetric ADC histogram analysis is helpful for non-invasive preoperatively predicting the subtype of endometrial cancer and differentiating G1 from G2 and G3 EACs.
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http://dx.doi.org/10.1016/j.ejrad.2021.109745DOI Listing
April 2021

MR T1 mapping for quantifying brain manganese deposition in type C hepatic encephalopathy rats.

Biometals 2021 Apr 29. Epub 2021 Apr 29.

Department of Radiology, Jinshan Hospital of Fudan University, 1508 Longhang Road, Shanghai, 201508, China.

To evaluate magnetic resonance (MR) T1 mapping for quantifying brain manganese (Mn) deposition in type C hepatic encephalopathy (CHE) rats and to investigate the mechanism of magnesium sulfate (MgSO) therapy. Thirty Sprague-Dawley rats were randomly assigned into normal control group (NC, n = 6) and CHE groups (n = 24). Thioacetamide (TAA) was used for modeling CHE rats. CHE groups were further divided into 4 subgroups: TAA group, MgSO low dose (Mg-L) group, MgSO high dose (Mg-H) group and deionized water (DW) group (n = 6 for each group). TAA, Mg-L, Mg-H and DW groups were received intraperitoneal injections of 250 mg TAA/kg, twice a week for 8 weeks. Mg-L and Mg-H groups were orally received MgSO of 124 and 248 mg/kg daily, respectively, for another 8 weeks (without TAA). MR T1 mapping was performed in NC, TAA, Mg-L, Mg-H and DW groups at various time points. T1 value and Mn content in basal ganglia, hippocampus, cerebral cortex and cerebellum were evaluated. Morris water maze (MWM) and narrow beat test (NBT) were utilized to evaluate rats' learning, memory and motor ability. Contents of interleukin-6 (IL-6), tumor necrosis factor-a (TNF-a) and calcium-binding adaptor 1 protein (Iba1) were evaluated. Reduced T1 values in basal ganglia, hippocampus and cerebral cortex (P < 0.01, P < 0.05 and P < 0.05, respectively); increased Mn content in basal ganglia, hippocampus and cerebral cortex (all P < 0.05); reduced times of head contacting with region of interest (ROI), reduced times of entrance into the target quadrant (both P < 0.05); increased NBT total time (P < 0.05); increased brain contents of IL-6 (P < 0.001), TNF-α (P < 0.01) and over-expression of Iba1 were found in TAA group compared to NC group. After treated by MgSO, increased T1 value and reduced Mn content in basal ganglia, hippocampus and cerebral cortex (all P < 0.01); increased times of head contacting with ROI, increased times of entrance into the target quadrant (both P < 0.05); reduced NBT total time (P < 0.01); reduced brain content of IL-6, TNF-α (both P < 0.05) and reduced expression of Iba1 were found. T1 values were negatively correlated with Mn contents in basal ganglia (r = - 0.834, P < 0.01), hippocampus (r = - 0.739, P < 0.05), cortex (r = - 0.801, P < 0.05) and cerebellum (r = - 0.788, P < 0.05). T1 mapping could quantify brain Mn deposition in CHE rats. MgSO could improve cognition and motor ability of CHE rats by reducing brain Mn deposition, alleviating neurological inflammation and achieve the effective therapy for CHE. Mn may participate in the pathogenesis of CHE through neuroinflammation.
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http://dx.doi.org/10.1007/s10534-021-00311-2DOI Listing
April 2021

Noninvasive prediction of residual disease for advanced high-grade serous ovarian carcinoma by MRI-based radiomic-clinical nomogram.

Eur Radiol 2021 Apr 16. Epub 2021 Apr 16.

Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou, 215163, China.

Objectives: To develop a preoperative MRI-based radiomic-clinical nomogram for prediction of residual disease (RD) in patients with advanced high-grade serous ovarian carcinoma (HGSOC).

Methods: In total, 217 patients with advanced HGSOC were enrolled from January 2014 to June 2019 and randomly divided into a training set (n = 160) and a validation set (n = 57). Finally, 841 radiomic features were extracted from each tumor on T2-weighted imaging (T2WI) and contrast-enhanced T1-weighted imaging (CE-T1WI) sequence, respectively. We used two fusion methods, the maximal volume of interest (MV) and the maximal feature value (MF), to fuse the radiomic features of bilateral tumors, so that patients with bilateral tumors have the same kind of radiomic features as patients with unilateral tumors. The radiomic signatures were constructed by using mRMR method and LASSO classifier. Multivariable logistic regression analysis was used to develop a radiomic-clinical nomogram incorporating radiomic signature and conventional clinico-radiological features. The performance of the nomogram was evaluated on the validation set.

Results: In total, 342 tumors from 217 patients were analyzed in this study. The MF-based radiomic signature showed significantly better prediction performance than the MV-based radiomic signature (AUC = 0.744 vs. 0.650, p = 0.047). By incorporating clinico-radiological features and MF-based radiomic signature, radiomic-clinical nomogram showed favorable prediction ability with an AUC of 0.803 in the validation set, which was significantly higher than that of clinico-radiological signature and MF-based radiomic signature (AUC = 0.623, 0.744, respectively).

Conclusions: The proposed MRI-based radiomic-clinical nomogram provides a promising way to noninvasively predict the RD status.

Key Points: • MRI-based radiomic-clinical nomogram is feasible to noninvasively predict residual disease in patients with advanced HGSOC. • The radiomic signature based on MF showed significantly better prediction performance than that based on MV. • The radiomic-clinical nomogram showed a favorable prediction ability with an AUC of 0.803.
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http://dx.doi.org/10.1007/s00330-021-07902-0DOI Listing
April 2021

Blockage of C-C Chemokine Ligand 2 Alleviated the Appendicitis-Induced Injury in Rabbit Model.

J Interferon Cytokine Res 2020 09 27;40(9):446-453. Epub 2020 Aug 27.

Department of Radiology, Jinshan Hospital, Fudan University, Shanghai, China.

C-C chemokine ligand 2 (CCL2), a low-molecular-weight cytokine, is upregulated in inflammation-related diseases. However, the underlying function of CCL2 remains unknown in human appendicitis. The present study aimed to examine the role of CCL2 in appendicitis. An enzyme-linked immunosorbent assay was performed to examine the secretion of CCL2 in the peripheral blood of patients with simple and complex appendicitis, respectively. A flow cytometry assay was used to quantify the level of the CCL2 receptor, CCR2. Moreover, we constructed an appendicitis model in rabbits. Quantitative real time-polymerase chain reaction and Western blot were used to determine CCL2 and CCR2 levels in the appendicitis model. CCL2 antibodies were used to silence the endogenous activity of CCL2 Magnetic resonance imaging and a histopathology assay were used to examine the appendicitis-induced injury in rabbits. Our results suggested that CCL2 and its main receptor CCR2 were upregulated in patients with appendicitis, particularly those with complex appendicitis (gangrenous and perforated appendicitis). Moreover, CCL2 silencing alleviated the appendicitis-induced injury in rabbits. Our findings not only illustrate the potential value of CCL2 as a biomarker in appendicitis diagnosing but also provide novel insight into appendicitis treatment.
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http://dx.doi.org/10.1089/jir.2020.0050DOI Listing
September 2020

Blood Supply of Early Lung Adenocarcinomas in Mice and the Tumor-supplying Vessel Relationship: A Micro-CT Angiography Study.

Cancer Prev Res (Phila) 2020 Dec 14;13(12):989-996. Epub 2020 Aug 14.

Department of Radiology, Suzhou Municipal Hospital (Eastern), Suzhou Hospital Affiliated to Nanjing Medical University, Suzhou, China.

This study aimed to investigate the blood supply of early lung adenocarcinomas in mice and the relationship between tumors and their supplying vessels by using micro-CT. An early lung adenocarcinoma model was established in 10 female mice with subcutaneous injections of a 1-methyl-3-nitro-1-nitrosoguanidine solution. Micro-CT pulmonary and bronchial arteriography were performed to demonstrate the blood supply of early lung adenocarcinomas, especially the tumor-vessel relationships, and the findings were correlated with the pathology results. The quantitative and texture changes in the tumor-supplying vessels were analyzed. Micro-CT showed that the pulmonary artery was densely distributed in and around tumors in 141 (84%) of 167 early lung adenocarcinomas, the bronchial artery was not related to tumors, and there were four patterns of tumor-pulmonary artery relationships that correlated well with pathologic findings. Quantitative and texture analyses showed that the tumor size had positive correlations with vessel volume (VV), VV fraction (VVF), vessel thickness (VT), vessel number (VN), inverse difference moment, long run emphasis, gray level nonuniformity (GLN), and run length nonuniformity (RLN) and negative correlations with vessel separation (VS), inertia, and short run emphasis (SRE); the size of the solid component had positive correlations with VV, VVF, VT, VN, GLN, and RLN and negative correlations with VS, cluster shade, and SRE. This study concluded that early lung adenocarcinomas are mainly supplied by the pulmonary arteries in mice, and micro-CT angiography can clearly demonstrate the morphologic changes of pulmonary arteries and their relationships with tumors.
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http://dx.doi.org/10.1158/1940-6207.CAPR-20-0036DOI Listing
December 2020

MR image-based radiomics to differentiate type Ι and type ΙΙ epithelial ovarian cancers.

Eur Radiol 2021 Jan 2;31(1):403-410. Epub 2020 Aug 2.

Department of Radiology, Jinshan Hospital, Fudan University, 1508 Longhang Road, Jinshan District, Shanghai, 201508, China.

Objectives: Epithelial ovarian cancers (EOC) can be divided into type I and type II according to etiology and prognosis. Accurate subtype differentiation can substantially impact patient management. In this study, we aimed to construct an MR image-based radiomics model to differentiate between type I and type II EOC.

Methods: In this multicenter retrospective study, a total of 294 EOC patients from January 2010 to February 2019 were enrolled. Quantitative MR imaging features were extracted from the following axial sequences: T2WI FS, DWI, ADC, and CE-T1WI. A combined model was constructed based on the combination of these four MR sequences. The diagnostic performance was evaluated by ROC-AUC. In addition, an occlusion test was carried out to identify the most critical region for EOC differentiation.

Results: The combined radiomics model exhibited superior diagnostic capability over all four single-parametric radiomics models, both in internal and external validation cohorts (AUC of 0.806 and 0.847, respectively). The occlusion test revealed that the most critical region for differential diagnosis was the border zone between the solid and cystic components, or the less compact areas of solid component on direct visual inspection.

Conclusions: MR image-based radiomics modeling can differentiate between type I and type II EOC and identify the most critical region for differential diagnosis.

Key Points: • Combined radiomics models exhibited superior diagnostic capability over all four single-parametric radiomics models, both in internal and external validation cohorts (AUC of 0.834 and 0.847, respectively). • The occlusion test revealed that the most crucial region for differentiating type Ι and type ΙΙ EOC was the border zone between the solid and cystic components, or the less compact areas of solid component on direct visual inspection on T2WI FS. • The light-combined model (constructed by T2WI FS, DWI, and ADC sequences) can be used for patients who are not suitable for contrast agent use.
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http://dx.doi.org/10.1007/s00330-020-07091-2DOI Listing
January 2021

Multiparametric MRI-Based Radiomics Nomogram for Predicting Lymph Node Metastasis in Early-Stage Cervical Cancer.

J Magn Reson Imaging 2020 09 25;52(3):885-896. Epub 2020 Feb 25.

Department of Radiology, Jinshan Hospital, Fudan University, Shanghai, China.

Background: Lymph node metastasis (LNM) is a critical risk factor affecting treatment strategy and prognosis in patients with early-stage cervical cancer.

Purpose: To establish a multiparametric MRI (mpMRI)-based radiomics nomogram for preoperatively predicting LNM status.

Study Type: Retrospective.

Population: Among 233 consecutive patients, 155 patients were randomly allocated to the primary cohort and 78 patients to the validation cohort.

Field Strength: Radiomic features were extracted from a 1.5T mpMRI scan (T -weighted imaging [T WI], fat-saturated T -weighted imaging [FS-T WI], contrast-enhanced [CE], diffusion-weighted imaging [DWI], and apparent diffusion coefficient [ADC] maps).

Assessment: The performance of the nomogram was assessed with respect to its calibration, discrimination, and clinical usefulness. The area under the receiver operating characteristics curve (ROC AUC), accuracy, sensitivity, and specificity were also calculated.

Statistical Tests: The least absolute shrinkage and selection operator (LASSO) method was used for dimension reduction, feature selection, and radiomics signature building. Multivariable logistic regression analysis was used to develop the radiomics nomogram. An independent sample t-test and chi-squared test were used to compare the differences in continuous and categorical variables, respectively.

Results: The radiomic signature allowed a good discrimination between the LNM and non-LNM groups, with a C-index of 0.856 (95% confidence interval [CI], 0.794-0.918) in the primary cohort and 0.883 (95% CI, 0.809-0.957) in the validation cohort. Additionally, the radiomics nomogram also had a good discriminating performance and yielded good calibration both in the primary and validation cohorts (C-index, 0.882 [95% CI, 0.827-0.937], C-index, 0.893 [95% CI, 0.822-0.964], respectively). Decision curve analysis demonstrated that the radiomics nomogram was clinically useful.

Data Conclusion: A radiomics nomogram was developed by incorporating the radiomics signature with the MRI-reported LN status and FIGO stage. This nomogram might be used to facilitate the individualized prediction of LNM in patients with early-stage cervical cancer.

Level Of Evidence: 3 TECHNICAL EFFICACY STAGE: 2 J. Magn. Reson. Imaging 2020;52:885-896.
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http://dx.doi.org/10.1002/jmri.27101DOI Listing
September 2020

MRI-Based Machine Learning for Differentiating Borderline From Malignant Epithelial Ovarian Tumors: A Multicenter Study.

J Magn Reson Imaging 2020 09 11;52(3):897-904. Epub 2020 Feb 11.

Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou, China.

Background: Preoperative differentiation of borderline from malignant epithelial ovarian tumors (BEOT from MEOT) can impact surgical management. MRI has improved this assessment but subjective interpretation by radiologists may lead to inconsistent results.

Purpose: To develop and validate an objective MRI-based machine-learning (ML) assessment model for differentiating BEOT from MEOT, and compare the performance against radiologists' interpretation.

Study Type: Retrospective study of eight clinical centers.

Population: In all, 501 women with histopathologically-confirmed BEOT (n = 165) or MEOT (n = 336) from 2010 to 2018 were enrolled. Three cohorts were constructed: a training cohort (n = 250), an internal validation cohort (n = 92), and an external validation cohort (n = 159).

Field Strength/sequence: Preoperative MRI within 2 weeks of surgery. Single- and multiparameter (MP) machine-learning assessment models were built utilizing the following four MRI sequences: T -weighted imaging (T WI), fat saturation (FS), diffusion-weighted imaging (DWI), apparent diffusion coefficient (ADC), and contrast-enhanced (CE)-T WI.

Assessment: Diagnostic performance of the models was assessed for both whole tumor (WT) and solid tumor (ST) components. Assessment of the performance of the model in discriminating BEOT vs. early-stage MEOT was made. Six radiologists of varying experience also interpreted the MR images.

Statistical Tests: Mann-Whitney U-test: significance of the clinical characteristics; chi-square test: difference of label; DeLong test: difference of receiver operating characteristic (ROC).

Results: The MP-ST model performed better than the MP-WT model for both the internal validation cohort (area under the curve [AUC] = 0.932 vs. 0.917) and external validation cohort (AUC = 0.902 vs. 0.767). The model showed capability in discriminating BEOT vs. early-stage MEOT, with AUCs of 0.909 and 0.920, respectively. Radiologist performance was considerably poorer than both the internal (mean AUC = 0.792; range, 0.679-0.924) and external (mean AUC = 0.797; range, 0.744-0.867) validation cohorts.

Data Conclusion: Performance of the MRI-based ML model was robust and superior to subjective assessment of radiologists. If our approach can be implemented in clinical practice, improved preoperative prediction could potentially lead to preserved ovarian function and fertility for some women.

Level Of Evidence: Level 4.

Technical Efficacy: Stage 2. J. Magn. Reson. Imaging 2020;52:897-904.
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http://dx.doi.org/10.1002/jmri.27084DOI Listing
September 2020

Histogram Analysis Comparison of Monoexponential, Advanced Diffusion-Weighted Imaging, and Dynamic Contrast-Enhanced MRI for Differentiating Borderline From Malignant Epithelial Ovarian Tumors.

J Magn Reson Imaging 2020 07 10;52(1):257-268. Epub 2020 Jan 10.

Department of Radiology, Jinshan Hospital, Fudan University, Shanghai, China.

Background: The accurate preoperative differentiation between borderline and malignant epithelial ovarian tumors (BEOTs vs. MEOTs) is crucial for determining the proper surgical strategy and improving the patient's postoperative quality of life. Several diffusion and perfusion MRI technologies are valuable for the differentiation; however, which is the best remains unclear.

Purpose: To compare the whole solid-tumor volume histogram analysis of diffusion-weighted imaging (DWI), diffusion kurtosis imaging (DKI), intravoxel incoherent motion (IVIM), and dynamic contrast-enhanced MRI (DCE-MRI) in the differentiation of BEOTs vs. MEOTs and to identify the correlations between the perfusion parameters from IVIM and DCE-MRI.

Study Type: Retrospective.

Population: Twenty patients with BEOTs and 42 patients with MEOTs.

Field Strength/sequence: 1.5T/DWI, DKI, and IVIM models fitting from 13 different b factors and 40 phases DCE-MRI.

Assessment: Histogram metrics were derived from the apparent diffusion coefficient (ADC), diffusion kurtosis (K), diffusion coefficient (Dk), pure diffusion coefficient (D), pseudodiffusion coefficient (D*), perfusion fraction (f), volume transfer constant (K ), rate constant (k ), and extravascular extracellular volume fraction (v ).

Statistical Tests: The Mann-Whitney U-test and receiver operating characteristic curve were used to determine the best histogram metrics and parameters. Multivariate logistic regression analysis was used to determine the best combined model for each two from the four technologies. Spearman's rank correlation was used to analyze the correlations between the IVIM and DCE-MRI parameters.

Results: ADC, D, Dk, and D* were significantly higher in BEOTs than in MEOTs (P < 0.05). K, K , k , and v were significantly lower in BEOTs than in MEOTs (P < 0.05). The 10th percentile of Dk was the most reliable single metric, with an area under the curve (AUC) of 0.921. Dk combined with K yielded the highest AUC of 0.950. A weak inverse correlation was found between D and K (r = -0.320, P = 0.025) and between D and k (r = -0.267, P = 0.037).

Data Conclusion: The 10th percentile of Dk was the most valuable metric and Dk combined with K had the best performance for differentiating BEOTs from MEOTs. There was no evident link between perfusion-related parameters derived from IVIM and DCE-MRI.

Level Of Evidence: 4 Technical Efficacy Stage: 2 J. Magn. Reson. Imaging 2020;52:257-268.
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http://dx.doi.org/10.1002/jmri.27037DOI Listing
July 2020

Diagnostic performance of MR imaging in evaluating prognostic factors in patients with cervical cancer: a meta-analysis.

Eur Radiol 2020 Mar 27;30(3):1405-1418. Epub 2019 Nov 27.

Department of Radiology, Jinshan Hospital, Fudan University, 1508 Longhang Road, Shanghai, 201508, China.

Objectives: This study aims to determine the diagnostic performance of conventional magnetic resonance imaging (MRI) in assessing the distance between the tumor and the internal os, stromal infiltration, lymph node metastasis, and parametrial invasion in patients with cervical cancer.

Methods: A systematic English-language literature search of conventional MRI in the evaluation of human cervical cancer was performed in the PubMed, Cochrane Library, Embase, and Web of Science databases from 1995 to 2018. The pooled sensitivity, specificity, diagnostic odds ratio (DOR), and positive and negative likelihood ratios (PLR and NLR) of all studies were calculated. The results were then plotted in a hierarchical summary receiver operating characteristic (HSROC) plot, and meta-regression and subgroup analyses of the parametrial invasion were also performed.

Results: The pooled sensitivity, specificity, DOR, PLR, and NLR were 86%, 97%, 167.91, 24.74, and 0.15, respectively, in evaluating the internal os involvement (6 studies, 454 patients); 87%, 91%, 73.41, 10.22, and 0.14, respectively, in evaluating the stromal infiltration (11 studies, 672 patients); 51%, 89%, 8.63, 4.72, and 0.55, respectively, in evaluating the lymph node metastasis (15 studies, 997 patients); and 75%, 92%, 34.01, 9.38, and 0.28, respectively, in evaluating the parametrial invasion (19 studies, 1748 patients). The meta-regression of the parametrial invasion showed that the application of contrast enhancement was a significant factor affected the heterogeneity (p = 0.039).

Conclusions: Conventional MRI can accurately evaluate the distance between the tumor and the internal os, as well as stromal infiltration, and performs well in diagnosing the parametrial invasion. However, this method exhibited a limited ability in diagnosing the lymph node metastasis.

Key Points: • MRI can help clinicians to accurately assess the distance between the tumor and the internal os, stromal infiltration, and parametrial invasion in patients with uterine cervical neoplasms. • MRI exhibits a limited ability in diagnosing the lymph node metastasis. • Management of patients with uterine cervical neoplasms becomes more appropriate.
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http://dx.doi.org/10.1007/s00330-019-06461-9DOI Listing
March 2020

Differentiation between sinonasal natural killer/T-cell lymphomas and diffuse large B-cell lymphomas by RESOLVE DWI combined with conventional MRI.

Magn Reson Imaging 2019 10 15;62:10-17. Epub 2019 Jun 15.

Scientific Marketing, Diagnostic Imaging, Siemens Healthcare, Shanghai 201318, China.

Objective: To explore the feasibility of using RESOLVE DWI combined with conventional magnetic resonance imaging (MRI) to discriminate between sinonasal NKTLs and DLBCLs and to investigate the correlation between ADC value and Ki-67 expression in the two subtypes of NHLs.

Materials And Methods: Sixty patients with NKTLs and twenty-six patients with DLBCLs in the sinonasal region who were confirmed by histopathology underwent high-resolution DWI and conventional MRI. The apparent diffusion coefficients (ADCs) and conventional MRI features associated with NKTLs and DLBCLs were compared using multivariate logistic regression. Receiver operating characteristic (ROC) curve analysis was performed, and the area under the curve (AUC) values for conventional MRI and MRI in combination with DWI were compared to determine the diagnostic performances of the approaches in the differentiation of NKTLs and DLBCLs. Spearman's rank correlations were used to analyze the correlation between ADC value with the higher AUC and Ki-67 expression.

Results: For conventional MRI, localization in the nasal cavity and poor or moderate enhancement indicated an NKTL, whereas localization in the paranasal sinus and intense enhancement indicated a DLBCL, with sensitivity, specificity and area under the curve(AUC)value of 88.5%, 85.0% and 0.883, respectively. A combination with a cut-off ADC value of 0.646 × 10 mm/s yielded sensitivity, specificity and AUC values of 100.0%, 80.0% and 0.951, respectively. A significant difference between the AUCs for conventional MRI and MRI in combination with DWI (p = 0.02) was identified. Ki-67 expression of NKTLs was significantly lower than that of DLBCLs (p < 0.001). Besides, there was an inversely poor correlation between them in the overall sample (r = -0.395, p < 0.001). However, the ADC value was not significantly correlated with Ki-67 LI in neither NKTLs nor DLBCLs (both p > 0.05).

Conclusions: Location and enhancement degree were the most valuable conventional MRI features for differentiating between NKTLs and DLBCLs. A combination of DWI and MRI could significantly improve the differential performance. ADC values may be used to noninvasively evaluate the proliferation level of sinonasal NHLs.
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http://dx.doi.org/10.1016/j.mri.2019.06.011DOI Listing
October 2019

miR-212 and mTOR form a regulation loop to modulate autophagy in colorectal adenoma HT-29 cells.

Discov Med 2018 06;25(140):265-275

Department of Radiology, Jinshan Hospital and Shanghai Medical College, Fudan University, Shanghai 201508, China.

Autophagy is a conserved lysosomal degradation pathway that regulates cell survival and death in order to maintain cellular homeostasis. Dysfunctional autophagy is associated with different types of cancer, making it an attractive therapeutic target. Mammalian target of rapamycin (mTOR) signaling negatively regulates autophagy and suppresses the efficacy of certain cancer therapeutic agents. NVP-BEZ235 is a dual inhibitor of the PI3K/mTOR signaling pathway and exhibits anti-cancer activities; it also induced autophagy and inhibited proliferation in colorectal adenoma HT-29 cells. Colorectal adenoma and colorectal cancer have been recently shown to have elevated levels of miR-212. In the current study, we examined the role of miR-212 in NVP-BEZ235-induced autophagy in HT-29 cells. NVP-BEZ235 at the concentration as low as of 1 nM effectively induced autophagy and dose-dependently inhibited the expression of microRNA-212 (miR-212) whereas mTOR activator MHY1485 elevated the miR-212 expression. Transfection of miR-212 mimics inhibited autophagy whereas miR-212 inhibitors promoted autophagy as assessed by the LC3B-I conversion to LC3B-II and the expression levels of beclin-1. Furthermore, miR-212 mimics activated mTOR whereas miR-212 inhibitors suppressed mTOR activation as shown by the levels of phospho-mTOR. miR-212 mimics further enhanced the effect of NVP-BEZ235 in reducing the viability of HT-29 cells. Our data support that miR-212 is a target of mTOR signaling as well as an activator of mTOR to negatively regulate autophagy. Thus, miR-212 and mTOR signalings may form a positive regulation loop in maintaining cellular homeostasis. This study warrants further investigation of miR-212 as an effective target of autophagy-based cancer therapeutic strategies.
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June 2018

Standard diffusion-weighted, diffusion kurtosis and intravoxel incoherent motion MR imaging of sinonasal malignancies: correlations with Ki-67 proliferation status.

Eur Radiol 2018 Jul 30;28(7):2923-2933. Epub 2018 Jan 30.

Siemens Healthcare Ltd., Shanghai, 201318, People's Republic of China.

Objectives: To explore the correlations of parameters derived from standard diffusion-weighted imaging (DWI), diffusion kurtosis imaging (DKI) and intravoxel incoherent motion (IVIM) with the Ki-67 proliferation status.

Methods: Seventy-five patients with histologically proven sinonasal malignancies who underwent standard DWI, DKI and IVIM were retrospectively reviewed. The mean, minimum, maximum and whole standard DWI [apparent diffusion coefficient (ADC)], DKI [diffusion kurtosis (K) and diffusion coefficient (Dk)] and IVIM [pure diffusion coefficient (D), pseudo-diffusion coefficient (D*) and perfusion fraction (f)] parameters were measured and correlated with the Ki-67 labelling index (LI). The Ki-67 LI was categorised as high (> 50%) or low (≤ 50%).

Results: The K and f values were positively correlated with the Ki-67 LI (rho = 0.295~0.532), whereas the ADC, Dk and D values were negatively correlated with the Ki-67 LI (rho = -0.443~-0.277). The ADC, Dk and D values were lower, whereas the K value was higher in sinonasal malignancies with a high Ki-67 LI than in those in a low Ki-67 LI (all p < 0.05). A higher maximum K value (K > 0.977) independently predicted a high Ki-67 status [odds ratio (OR) = 7.614; 95% confidence interval (CI) = 2.197-38.674; p = 0.017].

Conclusion: ADC, Dk, K, D and f are correlated with Ki-67 LI. K is the strongest independent factor for predicting Ki-67 status.

Key Points: • DWI-derived parameters from different models are capable of providing different pathophysiological information. • DWI, DKI and IVIM parameters are associated with Ki-67 proliferation status. • K derived from DKI is the strongest independent factor for the prediction of Ki-67 proliferation status.
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http://dx.doi.org/10.1007/s00330-017-5286-xDOI Listing
July 2018

Differentiating between benign and malignant sinonasal lesions using dynamic contrast-enhanced MRI and intravoxel incoherent motion.

Eur J Radiol 2018 Jan 1;98:7-13. Epub 2017 Nov 1.

Department of Radiology, Jinshan Hospital, Fudan University, Shanghai 201508, China. Electronic address:

Purpose: To explore the value of dynamic contrast-enhanced MRI (DCE-MRI) and intravoxel incoherent motion (IVIM) for distinguishing between benign and malignant sinonasal lesions and investigate the correlations between the two methods.

Methods And Materials: Patients with sinonasal lesions (42 benign and 31 malignant) who underwent DCE-MRI and IVIM before confirmation by histopathology were enrolled in this prospective study. Parameters derived from DCE-MRI and IVIM were measured, the optimal cut-off values for differential diagnosis were determined, and the correlations between the two methods were evaluated. Statistical analyses were performed using the Wilcoxon rank sum test, receiver operating characteristic (ROC) curve analysis, and Spearman's rank correlation.

Results: Significantly higher K and K values but lower D and f values were found in malignant lesions than in benign lesions (all p<0.001). There were no significant differences in the V and D* values between the two groups. The area under the curve (AUC) of K was significantly higher than those of other parameters. There was no significant difference between the AUCs of DCE-MRI and IVIM with parameters combined (p=0.86). Significant inverse but weak correlations were found between D and K (r=-0.46, p<0.001), f and K (r=-0.41, p<0.001), D and K (r=-0.37, p=0.008), and f and K (r=-0.33, p=0.004).

Conclusions: DCE-MRI and IVIM can effectively differentiate between benign and malignant sinonasal lesions. IVIM findings correlate with DCE-MRI results and may represent an alternative to DCE-MRI.
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http://dx.doi.org/10.1016/j.ejrad.2017.10.028DOI Listing
January 2018

Targeting of GIT1 by miR-149* in breast cancer suppresses cell proliferation and metastasis in vitro and tumor growth in vivo.

Onco Targets Ther 2017 11;10:5873-5882. Epub 2017 Dec 11.

Department of Radiology, Jinshan Hospital, Fudan University, Shanghai, China.

Breast cancer remains a major cause of cancer-related death in women worldwide. Dysregulation of microRNAs (miRNAs) is involved in the initiation and progression of breast cancer. Moreover, it was found that GIT1 was widely involved in the development of many human cancers. Herein, we aimed to investigate the expression changes of miR-149* and GIT1 and the functional effects of miR-149*/GIT1 link in breast cancer. Quantitative reverse transcription-polymerase chain reaction (qRT-PCR) and Western blot (WB) were used to examine the expression levels of miR-149* and GIT1. Dual luciferase reporter assay was utilized to confirm the target interaction between miR-149* and GIT1. The biological functions, including cell proliferation, invasion, and migration, of miR-149* and GIT1 were determined by MTT assay and Transwell assays, respectively. Eventually, the tumor xenograft model in nude mice injected with stable transfected MDA-MB-231 cells was established to verify the effects of miR-149* and GIT1 on tumor growth. Our results showed that miR-149* expression was decreased, whereas GIT1 expression was increased in clinical samples of breast cancer. Based on the inverse expression trend between miR-149* and GIT1, we further demonstrated that miR-149* indeed directly targets GIT1. Subsequently, it was observed that inhibition of miR-149* significantly promoted cell proliferation, invasion, and migration, but the ability of cell proliferation, invasion, and migration was obviously declined after silencing of GIT1 in MDA-MB-231 cells transfected with miR-149* mimic and/or si-GIT1. Finally, it was also found that elevated miR-149* decelerated the tumor growth, while restored GIT1 accelerated the tumor growth in nude mice after 35 days of tumor xenograft. Collectively, these findings concluded that miR-149* might exert a tumor suppressive role in breast cancer by targeting GIT1.
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http://dx.doi.org/10.2147/OTT.S144280DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5729835PMC
December 2017

Differentiation of olfactory neuroblastomas from nasal squamous cell carcinomas using MR diffusion kurtosis imaging and dynamic contrast-enhanced MRI.

J Magn Reson Imaging 2018 02 29;47(2):354-361. Epub 2017 Jun 29.

Siemens Healthcare Ltd, Shanghai, P.R. China.

Purpose: To evaluate the use of magnetic resonance (MR) diffusion kurtosis imaging (DKI) and dynamic contrast-enhanced MR imaging (DCE-MRI) in the differentiation of olfactory neuroblastomas (ONBs) from squamous cell carcinomas (SCCs).

Materials And Methods: DKI and DCE-MRI were performed in 17 patients with ONBs and 23 patients with SCCs on a 3T MR scanner. Parameters derived from DKI and DCE-MRI were measured and compared between ONBs and SCCs using an independent samples t-test. The sensitivity, specificity, accuracy, positive predictive values (PPV), negative predictive values (NPV), and the area under the receiver operating characteristic (ROC) curve were determined.

Results: The mean kurtosis (K) value of ONBs was significantly higher than that of SCCs (P < 0.001), and the mean fractional volume in the extravascular extracellular space (V ) value of ONBs was lower than that of SCCs (P < 0.001). The ROC curve analyses yielded a cutoff K value of 0.953, with a sensitivity of 94.1%, a specificity of 69.6%, and an accuracy of 80.0%; the cutoff V value was 0.493, with a sensitivity of 70.6%, a specificity of 95.7%, and an accuracy of 85.0%. A parallel test with K value >0.953 or V value ≤0.493 achieved a sensitivity of 94.1%, a specificity of 100.0%, and an accuracy of 97.5% for differentiating ONBs from SCCs.

Conclusion: The K value of DKI and V value of DCE-MRI have potential use in the differentiation of ONBs and SCCs.

Level Of Evidence: 3 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018;47:354-361.
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http://dx.doi.org/10.1002/jmri.25803DOI Listing
February 2018

Magnetic Resonance Spectroscopy for Evaluating Portal-Systemic Encephalopathy in Patients with Chronic Hepatic Schistosomiasis Japonicum.

PLoS Negl Trop Dis 2016 12 15;10(12):e0005232. Epub 2016 Dec 15.

Department of Radiology, Jinshan Hospital & Shanghai Medical College, Fudan University, Shanghai, China.

Portal-systemic encephalopathy (PSE) is classified as type B hepatic encephalopathy. Portal-systemic shunting rather than liver dysfunction is the main cause of PSE in chronic hepatic schistosomiasis japonicum (HSJ) patients. Owing to lack of detectable evidence of intrinsic liver disease, chronic HSJ patients with PSE are frequently clinically undetected or misdiagnosed, especially chronic HSJ patients with covert PSE (subclinical encephalopathy). In this study, we investigated whether magnetic resonance spectroscopy (MRS) could be a useful tool for diagnosing PSE in chronic HSJ patients. Magnetic resonance (MR) T1-weighted imaging, diffusion-weighted imaging, and MRS were performed in 41 chronic HSJ patients with suspected PSE and in 21 age-matched controls. The T1 signal intensity index (T1SI) and apparent diffusion coefficient (ADC) value were obtained in the Globus pallidus. Liver function was also investigated via serum ammonia and liver function tests. Higher T1SI and ADC values, increased lactate and glutamine levels, and decreased myo-inositol were found in the bilateral Globus pallidus in chronic HSJ patients with PSE. No significantly abnormal serum ammonia or liver function tests were observed in chronic HSJ patients with PSE. On the basis of these findings, we propose a diagnostic procedure for PSE in chronic HSJ patients. This study reveals that MRS can be useful for diagnosing PSE in chronic HSJ patients.
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http://dx.doi.org/10.1371/journal.pntd.0005232DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5199111PMC
December 2016

Incidence of insulin resistance and diabetes in patients with portosystemic shunts without liver dysfunction.

J Int Med Res 2016 Oct 29;44(5):1040-1048. Epub 2016 Sep 29.

3 Department of Gastroenterology, Jinshan Hospital, Fudan University, Shanghai, China.

Objective To investigate the incidence of insulin resistance (IR) and diabetes in patients with chronic hepatic schistosomiasis japonica (HSJ) and portosystemic shunts (PSS). Methods Pre- and post-contrasted computed tomography images obtained from patients with HSJ and control subjects were reviewed by two radiologists who identified and graded any shunting vessels. Anthropometric measurements, hepatic enzymes, lipid profile, blood levels of albumin, glucose, insulin and homeostasis model assessment (HOMA-2) index of all participants were also assessed. Results Fifty-two patients with HSJ and 30 control subjects were involved in the study. The coronary, short gastric and perisplenic veins were the most common shunting vessels. There were no significant differences between patients and controls in terms of body mass index or liver function. The degree of shunting vessels, blood glucose, oral glucose tolerance test, insulin, HOMA-2 index, glycosylated haemoglobin, cholesterol, high- and low-density lipoprotein, and C-reactive protein were significantly higher in the patients with IR. A positive correlation was found between the degree of the shunting vessels and the HOMA-2 index. Conclusions Patients with chronic HSJ and PSS without liver dysfunction had a high incidence of IR and diabetes. The study showed that PSS and IR are related and therefore patients with PSS should be screened for IR and vice versa.
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http://dx.doi.org/10.1177/0300060516659392DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5536557PMC
October 2016

Computed Tomography Perfusion Imaging Detection of Microcirculatory Dysfunction in Small Intestinal Ischemia-Reperfusion Injury in a Porcine Model.

PLoS One 2016 26;11(7):e0160102. Epub 2016 Jul 26.

Department of Surgery, Jinshan Hospital, Shanghai Medical College, Fudan University, Shanghai 201508, China.

Objective: To evaluate multi-slice computed tomography (CT) perfusion imaging (CTPI) for identifying microcirculatory dysfunction in small intestinal ischemia-reperfusion (IR) injury in a porcine model.

Materials And Methods: Fifty-two pigs were randomly divided into 4 groups: (1) the IR group (n = 24), where intestinal ischemia was induced by separating and clamping the superior mesenteric artery (SMA) for 2 h, followed by reperfusion for 1, 2, 3, and 4 h (IR-1h, IR-2h, IR-3h, and IR-4h; n = 6, respectively); (2) the sham-operated (SO) group (n = 20), where the SMA was separated without clamping and controlled at postoperative 3, 4, 5, and 6 h (SO-3h, SO-4h, SO-5h, and SO-6h; n = 5, respectively); (3) the ischemia group (n = 4), where the SMA was separated and clamped for 2 h, without reperfusion, and (4) baseline group (n = 4), an additional group that was not manipulated. Small intestinal CTPI was performed at corresponding time points and perfusion parameters were obtained. The distal ileum was resected to measure the concentrations of malondialdehyde (MDA) and superoxide dismutase (SOD) and for histopathological examination.

Results: The perfusion parameters of the IR groups showed significant differences compared with the corresponding SO groups and the baseline group (before ischemia). The blood flow (BF), blood volume (BV), and permeability surface (PS) among the 4 IR groups were significantly different. BF and BV were significantly negatively correlated with MDA, and significantly positively correlated with SOD in the IR groups. Histopathologically, the effects of the 2-h ischemic loops were not significantly exacerbated by reperfusion.

Conclusion: CTPI can be a valuable tool for detecting microcirculatory dysfunction and for dynamic monitoring of small intestinal IR injury.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0160102PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4961382PMC
July 2017