Publications by authors named "Liling Long"

29 Publications

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Quantification of bone marrow edema in rheumatoid arthritis by using high-speed T2-corrected multiecho acquisition of H magnetic resonance spectroscopy: a feasibility study.

Clin Rheumatol 2021 Jun 21. Epub 2021 Jun 21.

Department of Radiology, The First Affiliated Hospital of Guangxi Medical University, No. 6 Shuangyong Road, Nanning, Guangxi, 530021, People's Republic of China.

Objective: To determine whether high-speed T2-corrected multiecho (HISTO) sequences can quantify bone marrow edema (BME) in the capitate bone in rheumatoid arthritis (RA), and whether the HISTO fat fraction (FF) reflects therapeutic effectiveness.

Methods: In this prospective study, 25 RA patients (19 women; average age, 45.08 ± 13.48 years) underwent 3.0-T MRI with HISTO at the baseline and after 4, 8, and 12 weeks of treatment. Rheumatoid factor (RF), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), platelet (PLT) count, and 28-joint Disease Activity Score using ESR (DAS28-ESR) were recorded on the day of each MRI examination by a rheumatologist blinded to the MRI findings. In addition, 21 healthy subjects (15 women; age, 49.17 ± 6.56 years) underwent only the HISTO sequence at a single time point.

Results: HISTO FF values were significantly higher in the control group (74.5% ± 3.1%; range, 68.6-79.3%) than in the patient group (55.8% ± 17.7%; range, 15.6-79.0%) at the baseline (independent-samples t-test: t = 5.257, P = 0.000). The changes in HISTO FF and DAS28-ESR showed moderate negative correlations with each other at 4, 8, and 12 weeks, and all of them were statistically significant (P < 0.05). As the HISTO FF increased, the DAS28-ESR decreased.

Conclusion: The HISTO sequence can measure the bone marrow FF of the wrist joint bones in RA patients. The HISTO FF value increased as the DAS28-ESR decreased. The HISTO sequence may help quantify BME in RA and help monitor the effectiveness of RA treatment. Key Points •The HISTO sequence could measure the bone marrow FF of the wrist joint bones. •FF value increased as the DAS28-ESR decreased in RA patients. •The HISTO sequence can monitor the therapeutic effect of RA.
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http://dx.doi.org/10.1007/s10067-021-05764-xDOI Listing
June 2021

Comparison of Conventional Gadoxetate Disodium-Enhanced MRI Features and Radiomics Signatures With Machine Learning for Diagnosing Microvascular Invasion.

AJR Am J Roentgenol 2021 06 7;216(6):1510-1520. Epub 2021 Apr 7.

Department of Radiology, Guangxi Medical University First Affiliated Hospital, No. 6 Shuangyong Rd, Nanning, Guangxi 530021, China.

This study aimed to determine the best model for predicting microvascular invasion (MVI) of hepatocellular carcinoma (HCC) using conventional gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (gadoxetate disodium)-enhanced MRI features and radiomics signatures with machine learning. This retrospective study included 269 patients with a postoperative pathologic diagnosis of HCC. Gadoxetate disodium-enhanced MRI features were assessed, including T1 relaxation time, tumor margin, tumor size, peritumoral enhancement, peritumoral hypointensity, and ADC. Radiomics models were constructed and validated by machine learning. The least absolute shrinkage and selection operator (LASSO) was used for feature selection, and radiomics-based LASSO models were constructed with six classifiers. Predictive capability was assessed using the ROC AUC. Histologic examination confirmed MVI in 111 (41.3%) of the 269 patients. ADC value, nonsmooth tumor margin, and 20-minute T1 relaxation time showed diagnostic accuracy with AUC values of 0.850, 0.847, and 0.846, respectively ( < .05 for all). A total of 1395 quantitative imaging features were extracted. In the hepatobiliary phase (HBP) model, the support vector machine (SVM), extreme gradient boosting (XGBoost), and logistic regression (LR) classifiers showed greater diagnostic efficiency for predicting MVI, with AUCs of 0.942, 0.938, and 0.936, respectively ( < .05 for all). ADC value, nonsmooth tumor margin, and 20-minute T1 relaxation time show high diagnostic accuracy for predicting MVI. Radiomics signatures with machine learning can further improve the ability to predict MVI and are best modeled during HBP. The SVM, XGBoost, and LR classifiers may serve as potential biomarkers to evaluate MVI.
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http://dx.doi.org/10.2214/AJR.20.23255DOI Listing
June 2021

OATP1B3 Expression in Hepatocellular Carcinoma Correlates with Intralesional Gd-EOB-DTPA Uptake and Signal Intensity on Gd-EOB-DTPA-Enhanced MRI.

Cancer Manag Res 2021 9;13:1169-1177. Epub 2021 Feb 9.

Department of Radiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, People's Republic of China.

Background: To evaluate the predictive value of the OATP1B3 expression in hepatocellular carcinoma (HCC) for the gadolinium ethoxybenzyl-diethylenetriaminepentaacetic acid (Gd-EOB-DTPA) uptake and the signal intensity (SI) in the hepatobiliary (HB) phase.

Methods: In this retrospective study, we analyzed 69 liver nodules of 64 patients who underwent Gd-EOB-DTPA enhancement magnetic resonance imaging (MRI) before operation. Based on the SI in the HB phase, the patients were categorized into the hypointense HCC and iso- or hyperintense HCC groups. The OATP1B3 expression was detected by polymerase chain reaction (PCR) and immunohistochemistry. The differences between the expression of OATP1B3 and Gd-EOB-DTPA enhanced magnetic resonance imaging between the two groups of hepatocellular carcinoma were compared. The relationship between the OATP1B3 expression and the SI and relative enhancement (RE) was analyzed.

Results: The examined HCC nodules were 59 hypointense HCC and 10 iso- or hyperintense. The relative expressions of OATP1B3, HB-phase signal, and the RE of the HB phase in iso- or hyperintense were significantly higher than those of the hypointense HCC, while the RE of the HB phase increased with an increase in the OATP1B3 expression (P < 0.05).

Conclusion: The OATP1B3 expression in HCC can predict the uptake of Gd-EOB-DTPA and the SI of the HB phase. We believe that the evaluation of OATP1B3 expression will facilitate the comprehension of imaging performance of HCC in Gd-EOB-DTPA-enhanced MRI.
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http://dx.doi.org/10.2147/CMAR.S292197DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7882717PMC
February 2021

Diffusion-weighted imaging with background body signal suppression (DWIBS) distinguishes benign lesions from malignant pulmonary solitary lesions.

Am J Transl Res 2021 15;13(1):88-101. Epub 2021 Jan 15.

Department of Radiology, People's Hospital of Guangxi Zhuang Autonomous Region Nanning, China.

This study aimed to determine applicable value of DWIBS in diagnosis of solitary pulmonary lesions. This study involved 32 solitary lung disease patients. T1W1, T2W1, T2WI-SPAIR were examined using MRI scanner and analyzed with View-forum 6.0 workstation. Imaging characteristics of pulmonary solitary lesions on DWIBS and ADC when b=300, 500 and 800 s/mm were observed. Signal-to-noise ratio (SNR), contrast-noise-ratio (CNR) and ADC value of lesions under different b-values were measured. Image quality in different b-values was compared by analyzing SNR and CNR. ADC values of benign and malignant lesions in different b-value groups were tested using -test. ROC curve was used to evaluate diagnostic efficacy of ADC value, and obtain diagnostic threshold. The results indicated that SNR and CNR value of 300 and 500 s/mm group was significantly higher compared to 800 s/mm group (<0.05). When b-value was assigned as 500 s/mm, DWIBS demonstrated better and ideal images. ADC value of malignant lesions in different b-values was significantly lower compared to benign lesions (<0.05), suggesting ADC value is a feasible approach for distinguishing benign from malignant lesions. AUC value of b=500 s/mm was significantly higher compared to b=300 and b=800 s/mm group (<0.05). When b-value was assigned as 500 s/mm, the best ADC threshold value was 1.435×10 mm/s, with high sensitivity, specificity and accuracy of 80.0%, 83.3% and 84.4%, respectively. In conclusion, quantitative analysis of DWIBS examination and ADC value was helpful for qualitative diagnosis of pulmonary solitary lesions, and demonstrated potential to distinguish benign and malignant pulmonary solitary lesions.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7847530PMC
January 2021

Efficacy of Diffusion-Weighted Imaging in Neoadjuvant Chemotherapy for Osteosarcoma: A Systematic Review and Meta-Analysis.

Acad Radiol 2020 Dec 29. Epub 2020 Dec 29.

Department of Radiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021, People's Republic of China (W.Y., J.H., L.L.). Electronic address:

Rationale And Objectives: Diffusion-weighted imaging (DWI) is a noninvasive imaging technique that reflects the diffusion movement of water molecules through apparent diffusion coefficient (ADC) values. The role of DWI in predicting the histological response to neoadjuvant chemotherapy in osteosarcoma is being increasingly researched, and a systematic review and meta-analysis of this topic is urgently required to help determine the potential diagnostic value of DWI.

Materials And Methods: The present meta-analysis included 13 studies (303 patients). We divided the target population into good responders and poor responders based on tumor necrosis on histological biopsy (≥90%, good responders). The mean ADC values and ADC ratio were extracted and/or calculated for the two groups.

Results: The mean difference in ADC values before and after neoadjuvant chemotherapy was significantly higher in good responders than in poor responders (mean difference, 0.33; 95% confidence interval [CI], 0.18-0.49; p< 0.0001), and significant heterogeneity was present among the 10 studies that reported these values (I = 66%, p< 0.05). The ADC ratio was also significantly higher in good responders than in poor responders (mean difference, 28.34; 95% CI, 1.83-54.85; p = 0.04), and significant heterogeneity in ADC ratio was present among 7 studies (I = 97%, p< 0.05).

Conclusion: The mean differences in ADC values and ADC ratios before and after neoadjuvant chemotherapy for osteosarcoma were significantly higher in good responders than in poor responders.
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http://dx.doi.org/10.1016/j.acra.2020.11.013DOI Listing
December 2020

A 15-years follow-up of deferasirox in beta-thalassaemia major patients with iron overload.

Br J Haematol 2020 11 18;191(3):e81-e83. Epub 2020 Sep 18.

Department of Hematology, the First Affiliated Hospital of Guangxi Medical University, Nanning, China.

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http://dx.doi.org/10.1111/bjh.17035DOI Listing
November 2020

Sarcopenia is Associated with Perioperative Outcomes in Gastric Cancer Patients Undergoing Gastrectomy.

Ann Nutr Metab 2019 17;75(4):213-222. Epub 2019 Dec 17.

Department of Nutrition, The First Affiliated Hospital of Guangxi Medical University, Nanning, China.

Background: Sarcopenia is a syndrome in which skeletal muscle reduction is the main manifestation of age-related and/or disease-related malnutrition associated with postoperative complications and mortality.

Objectives: The aim of the current study was to investigate the association between sarcopenia and postoperative complications as well as the nutrition risk of patients with gastric cancer (GC) who received gastrectomy. In addition, a comparative analysis was performed to evaluate the diagnostic accuracy of total psoas muscle area (TPA) and skeletal muscle area (SMA) in sarcopenia.

Methods: Preoperative computed tomography scans were obtained from 279 GC patients who received a gastrectomy from June 2011 to May 2016. TPA and SMA at the level of the third lumbar vertebra (L3) were used as the sarcopenia diagnostic index. Patients were diagnosed with sarcopenia via the total psoas muscle index (TPI) and skeletal muscle index (SMI) methods. TPI and SMI were normalized with the square of the patient's height (m2) by TPA and SMA. The Clavien-Dindo complications score system was used to classify the complication extent after gastrectomy. Univariate and multivariate logistic regression analyses were carried out to evaluate the risk factors for postoperative complications.

Results: A total of 68 and 125 patients were diagnosed with sarcopenia by TPI and SMI, respectively. Eighty-eight (31.5%) patients experienced postoperative complications. Patients with sarcopenia also had a significantly extended postoperative stay (TPI-sarcopenia, 15.0 days vs. non-sarcopenia, 11.0 days, p < 0.001; and SMI-sarcopenia, 14.0 days vs. non-sarcopenia, 11.0 days, p < 0.001) and hospital stay (TPI-sarcopenia, 22.5 days vs. non-sarcopenia, 17.0 days, p < 0.001; and SMI-sarcopenia, 21.0 days vs. non-sarcopenia, 16.5 days, p < 0.001). Multivariate logistic analysis showed that both TPI-sarcopenia (OR 7.561, p < 0.001) and SMI-sarcopenia (OR 10.085, p < 0.001) were associated with the risk of postoperative complications. Furthermore, univariate analysis showed a high correlation between nutrition risk screening 2002 (NRS2002) and sarcopenia (p < 0.001). A total of 54 (79.4%) of the 68 patients who were classified as having sarcopenia by TPI and 94 (75.3%) of the 125 patients who were classified as having sarcopenia by SMI were diagnosed with nutritional risk.

Conclusions: Sarcopenia is associated with the total length of hospital stay, postoperative hospital stay, and severe complications in GC patients undergoing gastrectomy. Moreover, SMI may be a more meaningful index than TPI in reducing the rate of misdiagnosis and in predicting adverse perioperative risk. In addition, sarcopenia may cause severe malnutrition and increases perioperative adverse risk. Thus, both sarcopenia and the NRS2002 nutritional score should be assessed during preoperative nutritional screening and evaluation for GC patients.
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http://dx.doi.org/10.1159/000504283DOI Listing
September 2020

Imaging Examination and Quantitative Detection and Analysis of Gastrointestinal Diseases Based on Data Mining Technology.

Authors:
Tao Li Liling Long

J Med Syst 2019 Dec 14;44(1):31. Epub 2019 Dec 14.

First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Ghuangxi, China.

The medical image storage and transmission system completes the collection, storage, management, diagnosis and information processing of digital medical image information generated from digital medical devices, accumulates a large amount of data resources, and uses these valuable data resources to extract corresponding diseases. Diagnostic rules that help improve the accuracy of clinical disease diagnosis have always been the subject of medical research and management. Gastrointestinal diseases are common high-risk digestive diseases. This paper studies the imaging detection and quantitative detection and analysis of gastrointestinal diseases based on data mining, aiming to improve the accuracy of doctors' clinical diagnosis, reduce the misdiagnosis and misdiagnosis of patients' diseases, and reduce the burden on patients. With the high computing speed and computational accuracy of the computer, combined with the flexible analysis and judgment ability of the human body, the doctor can help the semi-structured and unstructured diagnosis problems. Experiments demonstrate the effectiveness and robustness of the proposed method.
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http://dx.doi.org/10.1007/s10916-019-1482-3DOI Listing
December 2019

Comparison of Imaging and Clinically Relevant Features of Combined Hepatocellular Carcinoma and Cholangiocarcinoma with Hepatocellular Carcinoma.

Med Sci Monit 2019 Nov 14;25:8595-8601. Epub 2019 Nov 14.

Department of Radiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China (mainland).

BACKGROUND The aim of this study was to compare the clinical, imaging, pathological, and prognostic characteristics of combined hepatocellular carcinoma and cholangiocarcinoma (cHCC-CC) and hepatocellular carcinoma (HCC). MATERIAL AND METHODS Medical records of 21 patients with cHCC-CC and 21 patients with HCC were retrospectively reviewed. Patients underwent a computed tomography (CT) examination within 1 month before surgery and did not receive preoperative interventional therapy. Clinical, imaging, pathological, and prognostic characteristics of cHCC-CC and HCC were compared. RESULTS On multi-phase contrast-enhanced CT, cHCC-CC could be differentiated from HCC based on the presence of a pseudocapsule (p<0.0001; χ²=14.538) and extensive necrosis (p=0.009; χ²=8.400). The changes in the arterial phase and venous phase (V>A) and arterial phase and delayed phase (D>A) of CT enhanced scanning in HCC and cHCC-CC were statistically significant (both p<0.0001, χ²=28.560 and 25.846). Immunohistochemistry showed more HCC were positive for VEGF (P=0.012, χ²=7.785). A Kaplan-Meier survival analysis showed no statistically significant difference in progression-free survival (PFS) after treatment between patients with cHCC-CC and those with HCC (p=0.526). CONCLUSIONS Multi-phase contrast-enhanced CT may be useful for preoperative diagnosis of cHCC-CC in tumors with a diffuse boundary, no pseudocapsule, extensive necrosis (>50%), and a dilated bile duct, and when the CT value in the delayed phase is higher than in the arterial phase. VEGF expression is more likely to be positive in HCC than cHCC-CC. There was no significant difference between cHCC-CC and HCC in prognosis, but cHCC-CC was more likely to recur after treatment than HCC.
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http://dx.doi.org/10.12659/MSM.917418DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6873632PMC
November 2019

Diagnostic Value of Gd-EOB-DTPA-Enhanced MRI for the Expression of Ki67 and Microvascular Density in Hepatocellular Carcinoma.

J Magn Reson Imaging 2020 06 1;51(6):1755-1763. Epub 2019 Nov 1.

Siemens Healthineers, Department of MR Application, Guangdong Province, China.

Contract Grant Sponsor: National Natural Science Foundation of China; Contract grant number: 81260214.

Background: Recent studies have highlighted the diagnostic value of Gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced MRI in small hepatocellular carcinoma (HCC). Ki67 and CD34 are histologic markers that reflect the proliferation of tumor cells and the microvascular density (MVD).

Purpose: To explore the diagnostic value of Gd-EOB-DTPA-enhanced MRI for Ki67 expression and MVD in HCC.

Study Type: Retrospective.

Subjects: In all, 180 patients with HCC.

Field Strength/sequence: 3.0T, Gd-EOB-DTPA-enhanced T WI volumetric interpolated breath-hold examination (VIBE) axial fat suppression plain, and enhanced scanning.

Assessment: The T relaxation time (T rt) and signal intensity (SI) of the lesion were measured. The Ki67 expressions and MVD were evaluated by immunohistochemistry.

Statistical Test: Receiver operating characteristic (ROC) curves were used to analyze the diagnostic efficacy of T rt for high Ki67 expression (≥50%) and high MVD (≥100).

Results: The T rt-20min, rrT rt-20min, and SI-hepatobiliary phase (SI-HBP) were strongly correlated with Ki67, the r values were 0.846, -0.765, and -0.760 (P < 0.05), respectively. There were moderate correlations with CD34, with r values -0.444, 0.336, and -0.463 (P < 0.05), respectively. The T rt-Pre, T rt-20min, SI-Pre, and SI-HBP were significantly different both between the high and low ki67 expression groups (P < 0.05) and between the high MVD and low MVD groups (P < 0.05). In the two groups the T rt-20min and SI-HBP was 800.06 ± 128.91 vs. 530.06 ± 139.29 (P < 0.05) and 122.29 ± 39.39 vs. 173.49 ± 46.15 (P < 0.05); T rt-20min was found to have high diagnostic efficiency for high ki67 expression (area under the curve [AUC], 0.937; P < 0.05) T rt-20min had moderate diagnostic value for high MVD (AUC, 0.716; P < 0.05).

Data Conclusion: The T rt and SI of Gd-EOB-DTPA-enhanced MRI were correlated with Ki67 expression and MVD. T rt-20min has a high diagnostic value for high ki67 expression and high MVD in HCC tissues.

Level Of Evidence: 3 Technical Efficacy Stage: 2 J. Magn. Reson. Imaging 2020;51:1755-1763.
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http://dx.doi.org/10.1002/jmri.26974DOI Listing
June 2020

Radiomics for diagnosis of dual-phenotype hepatocellular carcinoma using Gd-EOB-DTPA-enhanced MRI and patient prognosis.

J Cancer Res Clin Oncol 2019 Dec 29;145(12):2995-3003. Epub 2019 Oct 29.

Huiying Medical Technology Co., Ltd, Room A206, B2, Dongsheng Science and Technology Park, HaiDian District, Beijing City, 100192, China.

Purpose: To describe the clinical characteristics and outcomes of patients with dual-phenotype hepatocellular carcinoma (DPHCC) and investigate the use of radiomics to establish an image-based signature for preoperative differential diagnosis.

Methods: This study included 50 patients with a postoperative pathological diagnosis of DPHCC (observation group) and 50 patients with CK7- and CK19-negative HCC (control group) who attended our hospital between January 2015 and December 2018. All patients underwent Gd-EOB-DTPA-enhanced MRI within 1 month before surgery. Arterial phase (AP), portal venous phase (PVP), delayed phase (DP) and hepatobiliary phase (HBP) images were transferred into a radiomics platform. Volumes of interest covered the whole tumor. The dimensionality of the radiomics features were reduced using LASSO. Four classifiers, including multi-layer perceptron (MLP), support vector machines (SVM), logistic regression (LR) and K-nearest neighbor (KNN) were used to distinguish DPHCC from CK7- and CK19-negative HCC. Kaplan-Meier survival analysis was used to assess 1-year disease-free survival (DFS) and overall survival (OS) in the observation and control groups.

Results: The best preoperative diagnostic power for DPHCC will likely be derived from a combination of different phases and classifiers. The sensitivity, specificity and accuracy of LR in PVP (0.740, 0.780, 0.766), DP (0.893, 0.700, 0.798), HBP (0.800, 0.720, 0.756) and MLP in PVP (0.880, 0.720, 0.798) were better performance. The 1-year DFS and OS of the patients in the observation group were 69% and 78%, respectively. The 1-year DFS and OS of the patients in the control group were 83% and 85%, respectively. Kaplan-Meier survival analysis showed no statistical difference in DFS and OS between groups (P = 0.231 and 0.326), but DFS and OS were numerically lower in patients with DPHCC.

Conclusion: The radiomics features extracted from Gd-EOB-DTPA-enhanced MR images can be used to diagnose preoperative DPHCC. DPHCC is more likely to recur and cause death than HCC, suggesting that active postoperative management of patients with DPHCC is required.
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http://dx.doi.org/10.1007/s00432-019-03062-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6861194PMC
December 2019

Value of radiomics in differential diagnosis of chromophobe renal cell carcinoma and renal oncocytoma.

Abdom Radiol (NY) 2020 10;45(10):3193-3201

Department of Radiology, The First Affiliated Hospital of Guangxi Medical University, No. 6 Shuangyong Road, Nanning, Guangxi, China.

Purpose: To explore the value of CT-enhanced quantitative features combined with machine learning for differential diagnosis of renal chromophobe cell carcinoma (chRCC) and renal oncocytoma (RO).

Methods: Sixty-one cases of renal tumors (chRCC = 44; RO = 17) that were pathologically confirmed at our hospital between 2008 and 2018 were retrospectively analyzed. All patients had undergone preoperative enhanced CT scans including the corticomedullary (CMP), nephrographic (NP), and excretory phases (EP) of contrast enhancement. Volumes of interest (VOIs), including lesions on the images, were manually delineated using the RadCloud platform. A LASSO regression algorithm was used to screen the image features extracted from all VOIs. Five machine learning classifications were trained to distinguish chRCC from RO by using a fivefold cross-validation strategy. The performance of the classifier was mainly evaluated by areas under the receiver operating characteristic (ROC) curve and accuracy.

Results: In total, 1029 features were extracted from CMP, NP, and EP. The LASSO regression algorithm was used to screen out the four, four, and six best features, respectively, and eight features were selected when CMP and NP were combined. All five classifiers had good diagnostic performance, with area under the curve (AUC) values greater than 0.850, and support vector machine (SVM) classifier showed a diagnostic accuracy of 0.945 (AUC 0.964 ± 0.054; sensitivity 0.999; specificity 0.800), showing the best performance.

Conclusions: Accurate preoperative differential diagnosis of chRCC and RO can be facilitated by a combination of CT-enhanced quantitative features and machine learning.
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http://dx.doi.org/10.1007/s00261-019-02269-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7455587PMC
October 2020

Hepatocellular carcinoma grading and recurrence prediction using T mapping on gadolinium-ethoxybenzyl diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging.

Oncol Lett 2019 Sep 4;18(3):2322-2329. Epub 2019 Jul 4.

Department of Magnetic Resonance Scientific Marketing, Siemens Healthineers, Guangzhou, Guangdong 510620, P.R. China.

The aim of the present study was to explore the value of T mapping on gadolinium-ethoxybenzyl diethylenetriamine pentaacetic (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) for grading hepatocellular carcinoma (HCC) and predicting its recurrence rate. A retrospective study was performed that included 75 patients (66 men and 9 women; mean age, 52.89 years; age range, 23-79 years) with HCC who had undergone Gd-EOB-DTPA-enhanced MRI with T mapping before surgery. The T relaxation time of the 81 lesions and non-tumorous liver parenchyma in 75 patients with HCC were measured before Gd-EOB-DTPA was injected and then at 5, 10 and 20 min after administration, respectively. T (%) was calculated as the increment rate of the T value in the lesions relative to the non-tumorous liver parenchyma. One-way analysis of variance and Spearman's correlation analysis was used to compare the differences and relationship of T mapping values among the three grades of HCC. A total of 81 lesions were divided into well-differentiated HCC (grades I; n=21), moderately differentiated HCC (grades II; n=40) and poorly differentiated HCC (grades III; n=20) according to the histopathology. The T (%) value among grades I, II and III HCC on pre-contrast results and on post-contrast results at the 5-, 10- and 20-min hepatobiliary phase (HBP) were significantly different (P<0.05), and T (%) was correlated with the histological grade of HCC at each time point (r=0.637, r=0.554, r=0.499 and r=0.560, respectively, P<0.001). A total of 41 recurrence cases [grade I (n=5), grade II (n=23) and grade III (n=13)] were verified by imaging (CT, MRI or ultrasound) or reoperation. Patients with grade III and grade II HCC had higher recurrence rates compared with that in patients with grade I HCC (P<0.05; median recurrence times were 258 days, 605 days and undefined, respectively). According to the optimal cut-off point for the T (%) of the three grades of HCC, patients with HCC in the low T (%) value group (≤155.15%) had lower cumulative recurrence rates compared with that in the medium (T (%) >155.15% and T1 (%) ≤241.20%) and high (T (%) >241.20%) value groups at the 20-min HBP (P<0.05; median recurrence times were undefined, 530 days and 447 days, respectively). These results indicate that the parameters of T mapping would be beneficial for predicting the grading and recurrence of HCC.
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http://dx.doi.org/10.3892/ol.2019.10557DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6676719PMC
September 2019

Assessing Cerebral White Matter Microstructure in Children With Congenital Sensorineural Hearing Loss: A Tract-Based Spatial Statistics Study.

Front Neurosci 2019 21;13:597. Epub 2019 Jun 21.

Department of Diagnostic Radiology, City of Hope National Medical Center, Duarte, CA, United States.

Objectives: To assess the microstructural properties of cerebral white matter in children with congenital sensorineural hearing loss (CSNHL).

Methods: Children (>4 years of age) with profound CSNHL and healthy controls with normal hearing (the control group) were enrolled and underwent brain magnetic resonance imaging (MRI) scans with diffusion tensor imaging (DTI). DTI parameters including fractional anisotropy, mean diffusivity, axial diffusivity, and radial diffusivity were obtained from a whole-brain tract-based spatial statistics analysis and were compared between the two groups. In addition, a region of interest (ROI) approach focusing on auditory cortex, i.e., Heschl's gyrus, using visual cortex, i.e., forceps major as an internal control, was performed. Correlations between mean DTI values and age were obtained with the ROI method.

Results: The study cohort consisted of 23 children with CSHNL (11 boys and 12 girls; mean age ± SD: 7.21 ± 2.67 years; range: 4.1-13.5 years) and 18 children in the control group (11 boys and 7 girls; mean age ± SD: 10.86 ± 3.56 years; range: 4.5-15.3 years). We found the axial diffusivity values being significantly greater in the left anterior thalamic radiation, right corticospinal tract, and corpus callosum in the CSHNL group than in the control group ( < 0.05). Significantly higher radial diffusivity values in the white matter tracts were noted in the CSHNL group as compared to the control group ( < 0.05). The fractional anisotropy values in the Heschl's gyrus in the CSNHL group were lower compared to the control group ( = 0.0015). There was significant negative correlation between the mean fractional anisotropy values in Heschl's gyrus and age in the CSNHL group < 7 years of age ( = -0.59, = 0.004).

Conclusion: Our study showed higher axial and radial diffusivities in the children affected by CNHNL as compared to the hearing children. We also found lower fractional anisotropy values in the Heschl's gyrus in the CSNHL group. Furthermore, we identified negative correlation between the fractional anisotropy values and age up to 7 years in the children born deaf. Our study findings suggest that myelination and axonal structure may be affected due to acoustic deprivation. This information may help to monitor hearing rehabilitation in the deaf children.
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http://dx.doi.org/10.3389/fnins.2019.00597DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6598398PMC
June 2019

Quantification of pancreatic proton density fat fraction in diabetic pigs using MR imaging and IDEAL-IQ sequence.

BMC Med Imaging 2019 05 14;19(1):38. Epub 2019 May 14.

Radiology Department, The First Affiliated Hospital of Guangxi Medical University, No. 6 Shuangyong Road, Nanning, 530021, Guangxi, China.

Background: Recent studies have highlighted the correlation between diabetes and pancreatic fat infiltration. Notably, pancreatic fat content (PFC) is a potential biomarker in diabetic patients, and magnetic resonance imaging (MRI) provides an effective method for noninvasive assessment of pancreatic fat infiltration. However, most reports of quantitative measurement of pancreatic fat have lacked comparisons of pathology results. The primary objective of this study was to determine the feasibility and accuracy of pancreatic MRI by using pancreatic fat fraction (PFF) measurements with the IDEAL-IQ sequence; the secondary objective was to explore changes in PFC between pigs with and without diabetes.

Methods: In this prospective study, 13 Bama Mini-pigs (7 females, 6 males; median age, 2 weeks) were randomly assigned to diabetes (n = 7) or control (n = 6) groups. Pigs in the diabetes group received high fat/high sugar feed, combined with streptozotocin injections. At the end of 15 months, biochemical changes were evaluated. All pigs underwent axial MRI with the IDEAL-IQ sequence to measure PFF; PFC of fresh pancreatic parenchyma was measured by the Soxhlet extraction method; and pancreatic fat distribution was observed by histopathology. Results of all analyses were compared between the diabetes and control groups by using the Mann-Whitney U-test. Correlations of PFF and PFC, fasting blood glucose (GLU), and serum insulin (INS) were calculated by using the Spearman correlation coefficient. Single-measure intraclass correlation coefficient (ICC) was used to assess interreader agreement.

Results: There were significant differences between diabetes and control groups: GLU (mmol/L) was 18.06 ± 6.03 and 5.06 ± 1.41 (P < 0.001); INS (mU/L) was 21.59 ± 2.93 and 29.32 ± 3.27 (P = 0.003); PFC (%) was 34.60 ± 3.52 and 28.63 ± 3.25 (P = 0.027); and PFF (%) was 36.51 ± 4.07 and 27.75 ± 3.73 (P = 0.003). There was a strongly positive correlation between PFF and PFC (r = 0.934, P < 0.001); there were moderate correlations between PFF and GLU (r = 0.736, P = 0.004; positive correlation), and between PFF and INS (r = - 0.747, P = 0.003; negative correlation). Excellent interreader agreement was observed for PFF measurements (ICC, 0.954).

Conclusions: Pancreatic fat infiltration shows a clear association with diabetes. MRI with the IDEAL-IQ sequence can be used to accurately and reproducibly quantify PFC.
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http://dx.doi.org/10.1186/s12880-019-0336-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6515681PMC
May 2019

Magnetic resonance imaging: Proton density fat fraction for assessment of pancreatic fatty infiltration during progression of T2DM bama minipigs.

J Magn Reson Imaging 2019 12 21;50(6):1905-1913. Epub 2019 Apr 21.

First Affiliated Hospital of Guangxi Medical University, Radiology Department, Guangxi, China.

Background: Recent studies have highlighted the correlation between diabetes and pancreatic fat infiltration. However, pancreatic fat content (PFC) is rarely confirmed by pathological results, and a change of PFC during progression of type 2 diabetes (T2DM) is currently controversial.

Purpose: To evaluate the relationship of MRI-pancreatic proton density fat fraction to serologic changes and histology in an experimental model of diabetes.

Study Type: Prospective animal study.

Animal Model: Thirteen Bama pigs were randomly assigned to diabetes (n = 7) or control (n = 6) groups. Pigs in the diabetic group received high-fat/high-sugar feed, combined with three doses of streptozotocin injections.

Field Strength/sequence: 3.0T, IDEAL-IQ sequence.

Assessment: Starting in the fifth month, biochemical changes were evaluated; all pigs underwent axial MRI with the IDEAL-IQ sequence to measured pancreatic fat fraction (PFF). PFC was measured by the Soxhlet extraction method. Pancreatic fat distribution and pancreas islet morphology were observed by histopathology.

Statistical Tests: A Mann-Whitney U-test, independent-samples t-test, Pearson correlation, Spearman correlation, single-measure intraclass correlation coefficient (ICC) were performed.

Results: During the development of T2DM, the PFF, weight, fasting blood glucose (FBG), triglyceride (TG), total cholesterol (TCHO), low-density lipoprotein (LDL), and HOMA-IR (insulin resistance) of the experimental group showed an upward trend; fasting insulin (INS), high-density lipoprotein (HDL), and HOMA-β showed decreasing trends. At the end of the fifteenth month, FBG (mmol/L) was 18.06 ± 6.03 and 5.06 ± 1.41 (P < 0.001), PFF (%) was 36.52 ± 4.07 and 27.75 ± 3.73 (P = 0.002), INS (mU/L) was 21.59 ± 2.93 and 29.32 ± 3.27 (P = 0.001), HOMA-IR was 16.83 ± 4.22 and 6.70 ± 2.45 (P < 0.001), HOMA-β was 1.50 ± 0.24 and 2.77 ± 0.45 (P < 0.001), between the experimental and control groups. There were strong and moderate positive correlations between PFF and PFC (r = 0.968, P < 0.001), and FBG (r = 0.657, P = 0.015), and HOMA-IR (r = 0.608, P = 0.028).

Data Conclusion: MRI-proton density fat fraction can measure the fat content of the pancreas with great accuracy and repeatability; PFF is a potential biomarker that can reflect the different stages of diabetes development.

Level Of Evidence: 2 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;50:1905-1913.
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http://dx.doi.org/10.1002/jmri.26754DOI Listing
December 2019

Therapeutic Evaluation of Radiotherapy with Contrast-Enhanced Ultrasound in Non-Resectable Hepatocellular Carcinoma Patients with Portal Vein Tumor Thrombosis.

Med Sci Monit 2018 Nov 14;24:8183-8189. Epub 2018 Nov 14.

Department of Radiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China (mainland).

BACKGROUND Therapeutic evaluation of 3-dimensional conformal radiotherapy (3DCRT) is rarely reported for non-resectable hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT). The aim of this study was to determine the value of contrast-enhanced ultrasound (CEUS) in evaluating the therapeutic response of HCC with PVTT treated with 3DCRT. MATERIAL AND METHODS PVTT reduction rate in the study was determined after 3DCRT using time intensity curve (TIC) analysis software before and after radiotherapy. Seventy-nine HCC patients with PVTT treated with 3DCRT were studied. HCC and PVTT were performed by CEUS, before and after 3DCRT, over time. The parameters of blood flow, including arrival time (AT), time to peak (TTP), peak intensity (PI), washout time (WT), and area under the curve (AUC), were quantified and evaluated on still images by CEUS. RESULTS After 3DCRT, typing and staging of PVTT in 38 patients was decreased, the reduction rate was 48.1%. HCC was effective in 45 patients, the effective rate was 57%; No differences were found between the PVTT reduction rate and the HCC effective rate (χ2=2.96, P>0.05). In the effective group, the PI and AUC of HCCs and PVTTs after 3DCRT were significantly lower than before 3DCRT, while the other parameters of TIC were not significantly different before and after 3DCRT. CONCLUSIONS CEUS might be a useful monitoring option for the evaluation of HCC with PVTT treated with 3DCRT. CEUS might be useful as an important choice for monitoring and evaluation HCC with PVTT after 3DCRT. TIC parameters might provide quantitative data for efficacy evaluation, which helps to modify treatment strategies timely and accurately.
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http://dx.doi.org/10.12659/MSM.911073DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6247761PMC
November 2018

Imaging characteristics of cerebral extraventricular neurocytoma with pathological correlation.

J Neurooncol 2018 Nov 30;140(2):289-296. Epub 2018 Jul 30.

Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90033, USA.

Purpose: Extraventricular neurocytoma (EVN) is an exceedingly rare tumor. In this study, we sought to characterize the imaging and pathological features of this uncommon tumor.

Methods: Retrospective review of 18 patients (9 male; 9 female) with pathologically confirmed EVN treated at a single center between 2005 and 2017.

Results: All patients had a solitary lesion. Sixteen lesions were found in hemispheres. The greatest tumor diameter ranged from 2.6 to 8 cm. The lesions were generally solid with cystic components; the solid portion appeared isodense or hyperdense on CT, isointense to hypointense on T1WI, and slightly hyperintense on T2WI. Heterogeneous hyperintensity interspersed with isointense or hypointense areas suggestive of hemorrhage, calcification or vascular flow voids were seen on T2WI. Heterogeneous enhancement was noted in 17 lesions; no enhancement was observed in one lesion. Cystic components were observed in 13 lesions; 9 of these showed characteristic perilesional cysts (9/13). Mild to moderate peritumoral edema (15/18), calcification (4/16), intratumoral hemorrhage (11/18) and vascular flow voids (10/16) were observed in some lesions. Pathologically, tumor cells showed round nucleus and fine neuropil matrix. Foci of calcification in the solid portion of the tumor were seen in five cases. Microcystic changes were observed in almost all cases. Some lesions exhibited positive staining for synaptophysin (Syn) (15/16) and neuronal nuclei (NeuN) (7/8). MIB-1 was determined for 10 patients; seven of these had an MIB-1 ≥ 3. These six patients experienced recurrence; four of them relapsed twice.

Conclusions: EVNs occur as single intracranial solid mass with cystic components (especially peripherally located cysts); solid portion exhibits slight hyperintensity or heterogeneous signal intensity. Mild to moderate peritumoral edema, calcification, intratumoral hemorrhage and vascular flow voids were characteristic features of extraventricular neurocytoma. Positive staining for synaptophysin and neuronal nuclei confirmed the diagnosis. A combination of atypical pathologic features and atypical radiologic features should be considered for prognostic assessment.
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http://dx.doi.org/10.1007/s11060-018-2952-zDOI Listing
November 2018

Decreased interhemispheric functional connectivity in insula and angular gyrus/supramarginal gyrus: Significant findings in first-episode, drug-naive somatization disorder.

Psychiatry Res Neuroimaging 2016 Feb 18;248:48-54. Epub 2016 Jan 18.

Mental Health Center, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi 530021, PR China. Electronic address:

Neuroimaging data have demonstrated brain functional alterations in patients with somatization disorder (SD). However, there is little information on interhemispheric resting-state functional connectivity (FC) in SD. In this study, resting-state functional magnetic resonance imaging (fMRI) and voxel-mirrored homotopic connectivity (VMHC) were applied to examine the changes of interhemispheric FC of the whole brain in patients with SD. A total of 25 first-episode, medication-naive SD patients and 28 age-, sex-, education-matched healthy controls (HC) underwent resting-state fMRI, and the data were analyzed by VMHC. Compared with HC, patients had lower VMHC in the angular gyrus/supramarginal gyrus (AG/SG) and insula. The reproducibility of the results was validated using the split-half and leave-one-out validations. No significant correlation was found between the VMHC in AG/SG or insula and clinical variables. Our findings indicate that the interhemispheric FC in the AG/SG and insula is decreased in first-episode, treatment-naive patients with SD, and thus provide new insight for disruption of interhemispheric FC in the pathophysiological mechanism of SD.
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http://dx.doi.org/10.1016/j.pscychresns.2016.01.008DOI Listing
February 2016

Abnormal default-mode network homogeneity and its correlations with personality in drug-naive somatization disorder at rest.

J Affect Disord 2016 Mar 30;193:81-8. Epub 2015 Dec 30.

Mental Health Center, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi 530021, China. Electronic address:

Background: While the default-mode network (DMN) appears to play a crucial role in patients suffering from somatization disorder (SD), the abnormalities of the network homogeneity (NH) of the DMN in SD patients have been poorly explored. The aim of this study is to examine DMN NH using an NH approach in patients suffering from SD at rest and determine its correlations with personality as measured by the Eysenck Personality Questionnaire (EPQ).

Methods: A total of 25 drug-naive patients with SD and 28 sex-, age-, and education-matched healthy controls underwent functional magnetic resonance imaging scans at rest. The data were analyzed by an automated NH method.

Results: Patients showed increased NH in the left superior frontal gyrus and decreased NH in the bilateral precuneus. Moreover, a significantly negative correlation was observed between the NH values in the bilateral precuneus and the EPQ--Neuroticism scores.

Limitations: The present study should be considered preliminary due to a lenient, uncorrected threshold of p<0.01.

Conclusions: The results suggest that abnormal DMN NH exists in drug-naive SD and further highlight the importance of the DMN in the pathophysiology of SD.
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http://dx.doi.org/10.1016/j.jad.2015.12.052DOI Listing
March 2016

Effective staging of fibrosis by the selected texture features of liver: Which one is better, CT or MR imaging?

Comput Med Imaging Graph 2015 Dec 18;46 Pt 2:227-36. Epub 2015 Sep 18.

Department of Intelligent Image Information, Graduate School of Medicine, Gifu University, Gifu 501-1193, Japan.

Purpose: Texture patterns of hepatic fibrosis are one of the important biomarkers to diagnose and classify chronic liver disease from initial to end stage on computed tomography (CT) or magnetic resonance (MR) images. Computer-aided diagnosis (CAD) of liver cirrhosis using texture features has become popular in recent research advances. To date, however, properly selecting effective texture features and image parameters is still mostly undetermined and not well-defined. In this study, different types of datasets acquired from CT and MR images are investigated to select the optimal parameters and features for the proper classification of fibrosis.

Methods: A total of 149 patients were scanned by multi-detector computed tomography (MDCT) and 218 patients were scanned using 1.5T and 3T superconducting MR scanners for an abdominal examination. All cases were verified by needle biopsies as the gold standard of our experiment, ranging from 0 (no fibrosis) to 5 (cirrhosis). For each case, at least four sequenced phase images are acquired by CT or MR scanners: pre-contrast, arterial, portal venous and equilibrium phase. For both imaging modalities, 15 texture features calculated from gray level co-occurrence matrix (GLCM) are extracted within an ROI in liver as one set of input vectors. Each combination of these input subsets is checked by using support vector machine (SVM) with leave-one-case-out method to differentiate fibrosis into two groups: non-cirrhosis or cirrhosis. In addition, 10 ROIs in the liver are manually selected in a disperse manner by experienced radiologist from each sequenced image and each of the 15 features are averaged across the 10 ROIs for each case to reduce the validation time. The number of input items is selected from the various combinations of 15 features, from which the accuracy rate (AR) is calculated by counting the percentage of correct answers on each combination of features aggregated to determine a liver stage score and then compared to the gold standard.

Results: According to the accuracy rate (AR) calculated from each combination, the optimal number of texture features to classify liver fibrosis degree ranges from 4 to 7, no matter which modality was utilized. The overall performance calculated by the average sum of maximum AR value of all 15 features is 66.83% in CT images, while 68.14%, and 71.98% in MR images, respectively; among the 15 texture features, mean gray value and entropy are the most commonly used features in all 3 imaging datasets. The correlation feature has the lowest AR value and was removed as an effective feature in all datasets. AR value tends to increase with the injection of contrast agency, and both CT and MR images reach the highest AR performance during the equilibrium phase.

Conclusions: Comparing the accuracy of classification with two imaging modalities, the MR images have an advantage over CT images with regards to AR performance of the 15 selected texture features, while 3T MRI is better than 1.5T MRI to classify liver fibrosis. Finally, the texture analysis is more effective during equilibrium phase than in any of the other phased images.
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http://dx.doi.org/10.1016/j.compmedimag.2015.09.003DOI Listing
December 2015

Abnormal regional homogeneity and its correlations with personality in first-episode, treatment-naive somatization disorder.

Int J Psychophysiol 2015 Aug 27;97(2):108-12. Epub 2015 May 27.

Mental Health Center, the First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi 530021, China. Electronic address:

Background: Structural and functional abnormalities of the default mode network (DMN) and their correlations with personality have been found in somatization disorder (SD). However, no study is conducted to identify regional neural activity and its correlations with personality in SD. In this study, regional homogeneity (ReHo) was applied to explore whether abnormal regional neural activity is present in patients with SD and its correlations with personality measured by Eysenck Personality Questionnaire (EPQ).

Methods: Twenty-five first-episode, treatment-naive patients with SD and 28 sex-, age-, and education-matched healthy controls participated in the whole study. During the scanning, all subjects were instructed to lie still with their eyes closed and remain awake. A ReHo approach was employed to analyze the data.

Results: The SD group had a significantly increased ReHo in the left angular gyrus (AG) compared to healthy controls. The increased ReHo positively correlated to the neuroticism scores of EPQ (EPQ-N). No other correlations were detected between the ReHo values and other related factors, such as symptom severity and education level.

Conclusions: Our results suggest that abnormal regional neural activity of the DMN may play a key role in SD with clinical implications and emphasize the importance of the DMN in the pathophysiological process of SD.
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http://dx.doi.org/10.1016/j.ijpsycho.2015.05.012DOI Listing
August 2015

Alterations in white matter integrity in first-episode, treatment-naive patients with somatization disorder.

Neurosci Lett 2015 Jul 21;599:102-8. Epub 2015 May 21.

Mental Health Center, The First Affiliated Hospital, Guangxi Medical University,Guangxi, Nanning 530021, China. Electronic address:

White matter (WM) abnormality in somatization disorder (SD) has not been reported yet. This study was designed to elucidate the alterations in WM integrity in SD. A total of 25 patients with SD and 28 healthy controls were enrolled in the study. WM integrity was analyzed using tract-based spatial statistics. No differences were found between the patients and the controls for fractional anisotropy (FA) values, mean diffusivity (MD), axial diffusivity, and radial diffusivity values at the corrected p<0.05 level. Patients with SD had significantly decreased FA values in the cingulum and inferior fronto-occipital fasciculus, and significantly increased MD values in the anterior thalamic radiation and corticospinal tract compared with the controls at the uncorrected p<0.005 level. Somatization severity was correlated with the FA values of the cingulum and inferior fronto-occipital fasciculus in the patients. The patients exhibit suggestive alterations in WM integrity in the cingulum, inferior fronto-occipital fasciculus, anterior thalamic radiation, and corticospinal tract.
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http://dx.doi.org/10.1016/j.neulet.2015.05.037DOI Listing
July 2015

Increased functional connectivity strength of right inferior temporal gyrus in first-episode, drug-naive somatization disorder.

Aust N Z J Psychiatry 2015 Jan 13;49(1):74-81. Epub 2014 Oct 13.

Mental Health Center, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, China

Background: Evidence of brain structural and functional alterations have been implicated in patients with somatization disorder (SD). However, little is known about brain functional connectivity in SD. In the present study, resting-state functional magnetic resonance imaging (fMRI) and graph theory were used to obtain a comprehensive view of whole-brain functional connectivity and to investigate the changes of voxel-wise functional networks in patients with SD.

Methods: Twenty-five first-episode, medication-naive patients with SD and 28 age-, sex- and education-matched healthy controls (HCs) underwent resting-state fMRI. The graph theory approach was employed to analyze the data.

Results: Compared to the HCs, patients with SD showed significantly increased functional connectivity strength in the right inferior temporal gyrus (ITG). There is a significant positive correlation between the z-values of the cluster in the right ITG and Hamilton Anxiety Scale scores.

Conclusions: Our findings indicate that there is a disruption of the functional connectivity pattern in the right ITG in first-episode, treatment-naive patients with SD, which bears clinical significance.
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http://dx.doi.org/10.1177/0004867414553949DOI Listing
January 2015

Dissociation of regional activity in default mode network in medication-naive, first-episode somatization disorder.

PLoS One 2014 1;9(7):e99273. Epub 2014 Jul 1.

Mental Health Center, the First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, China.

Background: Patients with somatization disorder (SD) have altered neural activity in the brain regions of the default mode network (DMN). However, the regional alteration of the DMN in SD remains unknown. The present study was designed to investigate the regional alterations of the DMN in patients with SD at rest.

Methods: Twenty-five first-episode, medication-naive patients with SD and 28 age-, sex-, education- matched healthy controls underwent a resting-state functional magnetic resonance imaging (fMRI) scan. The fractional amplitude of low-frequency fluctuations (fALFF) was applied to analyze the data.

Results: Patients with SD showed a dissociation pattern of resting-state fALFF in the DMN, with increased fALFF in the bilateral superior medial prefrontal cortex (MPFC, BA8, 9) and decreased fALFF in the left precuneus (PCu, BA7). Furthermore, significantly positive correlation was observed between the z values of the voxels within the bilateral superior MPFC and somatization subscale scores of the Symptom Check List (SCL-90) in patients with SD.

Conclusions: Our findings indicate that there is a dissociation pattern of the anterior and posterior DMN in first-episode, treatment-naive patients with SD. The results provide new insight for the importance of the DMN in the pathophysiology of SD.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0099273PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4077566PMC
October 2015

How early can myocardial iron overload occur in beta thalassemia major?

PLoS One 2014 22;9(1):e85379. Epub 2014 Jan 22.

Department of Hematology, the First Affiliated Hospital of Guangxi Medical University, Nanning, China.

Background: Myocardial siderosis is the most common cause of death in patients with beta thalassemia major(TM). This study aimed at investigating the occurrence, prevalence and severity of cardiac iron overload in a young Chinese population with beta TM.

Methods And Results: We analyzed T2* cardiac magnetic resonance (CMR), left ventricular ejection fraction (LVEF) and serum ferritin (SF) in 201 beta TM patients. The median age was 9 years old. Patients received an average of 13 units of blood per year. The median SF level was 4536 ng/ml and 165 patients (82.1%) had SF>2500 ng/ml. Myocardial iron overload was detected in 68 patients (33.8%) and severe myocardial iron overload was detected in 26 patients (12.6%). Twenty-two patients ≤10 years old had myocardial iron overload, three of whom were only 6 years old. No myocardial iron overload was detected under the age of 6 years. Median LVEF was 64% (measured by CMR in 175 patients). Five of 6 patients with a LVEF<56% and 8 of 10 patients with cardiac disease had myocardial iron overload.

Conclusions: The TM patients under follow-up at this regional centre in China patients are younger than other reported cohorts, more poorly-chelated, and have a high burden of iron overload. Myocardial siderosis occurred in patients younger than previously reported, and was strongly associated with impaired LVEF and cardiac disease. For such poorly-chelated TM patients, our data shows that the first assessment of cardiac T2* should be performed as early as 6 years old.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0085379PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3899006PMC
December 2014

Liver iron quantification by 3 tesla MRI: calibration on a rabbit model.

J Magn Reson Imaging 2013 Dec 23;38(6):1585-90. Epub 2013 May 23.

Department of Radiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China.

Purpose: To determine the feasibility of liver iron quantification by 3 Tesla (T) MRI using a novel iron overload rabbit model.

Materials And Methods: Forty-two rabbits underwent iron dextran loading from 1 to 15 weeks. MRI signal intensity ratio (SIR) was measured using a gradient-echo sequence, and R2(1/T2) measured using an eight-echo spin-echo sequence at 3T. Ex vivo hepatic pathology was obtained for all rabbits studied. Postmortem assessments of liver iron concentration (LIC) were conducted in an atomic absorption spectrophotometer. MRI measures were fitted against LIC using linear regression for 30 of the iron-loaded rabbits. The remaining 12 iron-loaded rabbits were used to test the prediction accuracy of the derived models.

Results: LIC was linearly correlated to both liver-to-muscle SIR (r = -0.845) and R2 (r = 0.965) in a range achieved in this study (LIC < 10 mg/g dry tissue) at 3T. By regression, the linear equations were determined as: Y1 = 10.581-5.924X1 (Y1 : LIC, X1 :SIR); Y2 = -1.273+0.103X2 (Y2 :LIC, X2 :R2). In the 12 test rabbits, the predicted LICs using the derived equations agreed well with the results obtained using the spectrophotometer.

Conclusion: Both SIR and R2 are highly correlated with LIC in a novel rabbit model. MRI quantification of liver iron overload is feasible at 3T.
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http://dx.doi.org/10.1002/jmri.24074DOI Listing
December 2013

Decreased interhemispheric resting-state functional connectivity in first-episode, drug-naive major depressive disorder.

Prog Neuropsychopharmacol Biol Psychiatry 2013 Mar 16;41:24-9. Epub 2012 Nov 16.

Mental Health Center, the First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi 530021, China.

Background: Major depressive disorder (MDD) is shown to have structural and functional abnormalities in specific brain areas and connections by recent neuroimaging studies. However, little is known about the alterations of the interhemispheric resting-state functional connectivity (FC) in patients with MDD. In the present study, we used a newly developed voxel-mirrored homotopic connectivity (VMHC) method to investigate the interhemispheric FC of the whole brain in patients with MDD at rest.

Methods: Twenty-four first-episode, drug-naive patients with MDD and 24 age-, gender-, and education-matched healthy subjects underwent a resting-state functional magnetic resonance imaging (fMRI). An automated VMHC approach was used to analyze the data.

Results: Patients with MDD showed lower VMHC than healthy subjects in the medial prefrontal cortex (MPFC) and the posterior cingulate cortex/precuneus (PCC/PCu), two core regions within default mode network (DMN). Both left and right MPFC showed reduced FC with the other frontal areas and with right anterior cingulate gyrus (ACC), while PCC/PCu exhibited abnormal FC with the frontal areas and thalamus in patient group. Significant positive correlation was observed between VMHC in MPFC and persistent error response of Wisconsin Card Sorting Test (WCST-Pre) in patients. Further ROC analysis revealed that VMHC in the MPFC and PCC/PCu could be used to differentiate the patients from healthy subjects with relatively high sensitivity and specificity.

Conclusions: Our results suggest that decreased VMHC in brain regions within DMN may underlie the pathogenesis of MDD.
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http://dx.doi.org/10.1016/j.pnpbp.2012.11.003DOI Listing
March 2013

Brain magnetic resonance imaging and manganese concentrations in red blood cells of smelting workers: search for biomarkers of manganese exposure.

Neurotoxicology 2007 Jan 22;28(1):126-35. Epub 2006 Aug 22.

Department of Occupational Health and Toxicology, Guangxi Medical University, and Department of Radiology, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China.

The MRI technique has been used in diagnosis of manganism in humans and non-human primates. This cross-sectional study was designed to explore whether the pallidal signal intensity in T1-weighted MRI correlated with Mn levels in the blood compartment among Mn-exposed workers and to understand to what extent the MRI signal could reflect Mn exposure. A group of 18 randomly selected male Mn-exposed workers of which 13 were smelting workers with high exposure (mean of airborne Mn in work place: 1.26 mg/m3; range: 0.31-2.93 mg/m3), and 5 power distribution control workers with low exposure (0.66 mg/m3 and 0.23-0.77 mg/m3) from a ferroalloy factory, and another group of 9 male subjects as controls from a non-smelting factory who were office or cafeteria workers (0.01 mg/m3 and 0-0.03 mg/m3) were recruited for neurological tests, MRI examination, and analysis of Mn in whole blood (MnB), plasma (MnP) or red blood cells (MnRBC). No clinical symptoms and signs of manganism were observed among these workers. MRI data showed average increases of 7.4% (p<0.05) and 16.1% (p<0.01) in pallidal index (PI) among low- and high-exposed workers, respectively, as compared to controls. Fourteen out of 18 Mn-exposed workers (78%) had intensified PI values, while this proportion was even higher (85%) among the high Mn-exposed workers. Among exposed workers, the PI values were significantly associated with MnRBC (r=0.55, p=0.02). Our data suggest that the workers exposed to airborne Mn, but without clinical symptoms, display an exposure-related, intensified MRI signal. The MRI, as well as MnRBC, may be useful in early diagnosis of Mn exposure.
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http://dx.doi.org/10.1016/j.neuro.2006.08.005DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3983995PMC
January 2007
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