Publications by authors named "Pei Nie"

40 Publications

Proton density fat fraction measurements of rotator cuff muscles: Accuracy, repeatability, and reproducibility across readers and scanners.

Magn Reson Imaging 2022 May 24. Epub 2022 May 24.

Department of Radiology, The Affiliated Hospital of Qingdao University, Qingdao 266003, Shandong, China. Electronic address:

Purpose: To determine the accuracy, repeatability, and reproducibility of magnetic resonance imaging-based proton density fat fraction (MRI-PDFF) measurements of rotator cuff muscles between two readers and three different scanners.

Methods: Thirty-one volunteers underwent serial shoulder MRI examinations of both left and right sides on one 1.5-T MRI scanner and two 3.0-T MRI scanners. Two independent readers measured muscular PDFF of the supraspinatus, infraspinatus/teres minor muscle, and subscapularis. MR spectroscopy-based proton density fat fraction (MRS-PDFF) was regarded as the reference standard for assessing accuracy. A "coffee break" examination method was used to test the repeatability of each scanner. Bland-Altman plots, Pearson correlation, and linear regression analysis were used to assess bias and linearity. The Wilcoxon signed-rank test and Friedman test were applied to evaluate repeatability and reproducibility.

Results: MRI-PDFF measurements indicated strong linearity (R = 0.749) and small bias (-0.18%) in comparison with the MRS-PDFF measurements. A very strong positive Pearson correlation (r = 0.955-0.986) between the PDFF estimates of the two repeat scans indicated excellent repeatability. The PDFF measurements showed high reproducibility, with a strong positive Pearson correlation (r = 0.668-0.698) and a small mean bias (-0.04 to -0.10%) across different scanners.

Conclusion: MRI-PDFF measurements of rotator cuff muscles were highly accurate, repeatable, and reproducible across different readers and scanners, leading us to the conclusion that PDFF can be a reliable and robust quantitative imaging biomarker for longitudinal or multi-center studies.
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http://dx.doi.org/10.1016/j.mri.2022.05.013DOI Listing
May 2022

Pulmonary artery intimal sarcoma: a rare cause of filling defects in pulmonary arteries.

Am J Med Sci 2022 May 16. Epub 2022 May 16.

Department of Radiology, The Affiliated Hospital of Qingdao University, Qingdao, China, 266003. Electronic address:

Pulmonary artery intimal sarcomas are very rare and arise from primitive pluripotent mesenchymal cells. They are often misdiagnosed as pulmonary thromboembolism, leading to futile anticoagulation treatment and delayed diagnosis. We present a case of a patient who showed nonspecific pulmonary symptoms and characteristic imaging manifestation. Progressive symptoms and additional imaging led to the suspicion of a pulmonary artery intimal sarcoma, which was finally confirmed by pathological biopsy. This case serves as a reminder to consider pulmonary artery intimal sarcomas in the differential diagnosis of patients with dyspnea and filling defects on computed tomography pulmonary angiography or contrast-enhanced computed tomography.
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http://dx.doi.org/10.1016/j.amjms.2022.05.009DOI Listing
May 2022

Relationship Between Somatic Cell Counts and Mammary Gland Parenchyma Ultrasonography in Buffaloes.

Front Vet Sci 2022 21;9:842105. Epub 2022 Mar 21.

Key Laboratory of Animal Genetics, Breeding and Reproduction, Ministry of Education, College of Animal Science and Technology, Huazhong Agricultural University, Wuhan, China.

The aim of the present study was to determine whether the echotextural features of the mammary gland parenchyma in buffaloes during lactation at different somatic cell levels could be used to diagnose mastitis. This study was divided into two parts. In the first experiment, experimental buffaloes ( = 65) with somatic cell counts (SCC) tests ( = 94) in different seasons, including spring ( = 22), summer ( = 24), autumn ( = 37), and winter ( = 11), were used to obtain ultrasonic variables for each quarter of mammary gland that could best explain the corresponding somatic cell level. In the second part of the study, the first part's experimental results were verified by subjecting at least one-quarter udder of eight buffaloes to ultrasonography seven times during mid-July to mid-August for obtaining ultrasonic values at different somatic cell levels. The echo textural characteristics [mean numerical pixel values (NPVs) and pixel heterogeneity (pixel standard deviation, PSD)] were evaluated using 16 ultrasonographic images of each buffalo with Image ProPlus software. The effects of SCC, days in milk (DIM), scanning order (SO), season, as well as the scanning plane and udder quarter (SP + UQ) on both the PSD and NPVs of the mammary gland were significant ( < 0.05). The correlation coefficient between pre-milking sagittal PSD and somatic cell score (SCS) was the highest ( = 0.4224, < 0.0001) with fitted linear model: = 0.19445x (dependent variable: SCS, independent variables: pre-milking sagittal PSD; = 0.84, < 0.0001). In addition, SCC and ultrasonic of udder quarter were followed for 1 month, confirming that pre-milking sagittal PSD of mammary gland value could explain the SCC variation in milk. The current study demonstrated that the ultrasonographic examination of the udder could be one of the complementary tools for diagnosing subclinical mastitis in buffaloes.
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http://dx.doi.org/10.3389/fvets.2022.842105DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8978442PMC
March 2022

The radiomics-based tumor heterogeneity adds incremental value to the existing prognostic models for predicting outcome in localized clear cell renal cell carcinoma: a multicenter study.

Eur J Nucl Med Mol Imaging 2022 Jul 28;49(8):2949-2959. Epub 2022 Mar 28.

Department of Urology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.

Purpose: Tumor heterogeneity, which is associated with poor outcomes, has not been exhibited in the University of California, Los Angeles, Integrated Staging System (UISS), and the Stage, Size, Grade and Necrosis (SSIGN) scores. Radiomics allows an in-depth characterization of heterogeneity across the tumor, but its incremental value to the existing prognostic models for clear cell renal cell carcinoma (ccRCC) outcome is unknown. The purpose of this study was to evaluate the association between the radiomics-based tumor heterogeneity and postoperative risk of recurrence in localized ccRCC, and to assess its incremental value to UISS and SSIGN.

Methods: A multicenter 866 ccRCC patients derived from 12 Chinese hospitals were studied. The endpoint was recurrence-free survival (RFS). A CT-based radiomics signature (RS) was developed and assessed in the whole cohort and in the subgroups stratified by UISS and SSIGN. Two combined nomograms, the R-UISS (combining RS and UISS) and R-SSIGN (combining RS and SSIGN), were developed. The incremental value of RS to UISS and SSIGN in RFS prediction was evaluated. R statistical software was used for statistics.

Results: Patients with low radiomics scores were 4.44 times more likely to experience recurrence than those with high radiomics scores (P<0.001). Stratified analysis suggested the association is significant among low- and intermediate-risk patients identified by UISS and SSIGN. The R-UISS and R-SSIGN showed better predictive capability than UISS and SSIGN did with higher C-indices (R-UISS vs. UISS, 0.74 vs. 0.64; R-SSIGN vs. SSIGN, 0.78 vs. 0.76) and higher clinical net benefit.

Conclusions: The radiomics-based tumor heterogeneity can predict outcome and add incremental value to the existing prognostic models in localized ccRCC patients. Incorporating radiomics-based tumor heterogeneity in ccRCC prognostic models may provide the opportunity to better surveillance and adjuvant clinical trial design.
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http://dx.doi.org/10.1007/s00259-022-05773-1DOI Listing
July 2022

A CT-based radiomics nomogram for differentiation of renal oncocytoma and chromophobe renal cell carcinoma with a central scar-matched study.

Br J Radiol 2022 Jan 4;95(1129):20210534. Epub 2021 Nov 4.

Department of Radiology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.

Objective: Pre-operative differentiation between renal oncocytoma (RO) and chromophobe renal cell carcinoma (chRCC) is critical due to their different clinical behavior and different clinical treatment decisions. The aim of this study was to develop and validate a CT-based radiomics nomogram for the pre-operative differentiation of RO from chRCC.

Methods: A total of 141 patients (84 in training data set and 57 in external validation data set) with ROs ( = 47) or chRCCs ( = 94) were included. Radiomics features were extracted from tri-phasic enhanced-CT images. A clinical model was developed based on significant patient characteristics and CT imaging features. A radiomics signature model was developed and a radiomics score (Rad-score) was calculated. A radiomics nomogram model incorporating the Rad-score and independent clinical factors was developed by multivariate logistic regression analysis. The diagnostic performance was evaluated and validated in three models using ROC curves.

Results: Twelve features from CT images were selected to develop the radiomics signature. The radiomics nomogram combining a clinical factor (segmental enhancement inversion) and radiomics signature showed an AUC value of 0.988 in the validation set. Decision curve analysis revealed that the diagnostic performance of the radiomics nomogram was better than the clinical model and the radiomics signature.

Conclusions: The radiomics nomogram combining clinical factors and radiomics signature performed well for distinguishing RO from chRCC.

Advances In Knowledge: Differential diagnosis between renal oncocytoma (RO) and chromophobe renal cell carcinoma (chRCC) is rather difficult by conventional imaging modalities when a central scar was present.A radiomics nomogram integrated with the radiomics signature, demographics, and CT findings facilitates differentiation of RO from chRCC with improved diagnostic efficacy.The CT-based radiomics nomogram might spare unnecessary surgery for RO.
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http://dx.doi.org/10.1259/bjr.20210534DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8722238PMC
January 2022

A CT-based radiomics nomogram for differentiation of small masses (< 4 cm) of renal oncocytoma from clear cell renal cell carcinoma.

Abdom Radiol (NY) 2021 11 15;46(11):5240-5249. Epub 2021 Jul 15.

Department of Radiology, the Affiliated Hospital of Qingdao University, Qingdao, China.

Purpose: Renal oncocytoma (RO) is the most commonly resected benign renal tumor because of misdiagnosis as renal cell carcinoma. This misdiagnosis is generally owing to overlapping imaging features. This study describes the building of a radiomics nomogram based on clinical data and radiomics signature for the preoperative differentiation of RO from clear cell renal cell carcinoma (ccRCC) on tri-phasic contrast-enhanced CT.

Methods: A total of 122 patients (85 in training set and 37 in external validation set) with ROs (n = 46) or ccRCCs (n = 76) were enrolled. Patient characteristics and tri-phasic contrast-enhanced CT imaging features were evaluated to build a clinical factors model. A radiomics signature was constructed by extracting radiomics features from tri-phasic contrast-enhanced CT images and a radiomics score (Rad-score) was calculated. A radiomics nomogram was then built by incorporating the Rad-score and significant clinical factors according to a multivariate logistic regression analysis. The diagnostic performance of the above three models was evaluated in training and validation sets.

Results: Central stellate area and perirenal fascia thickening were selected to build the clinical factors model. Eleven radiomics features were combined to construct the radiomics signature. The AUCs of the radiomics nomogram, which was based on the selected clinical factors and Rad-score, were 0.960 and 0.898 in the training and validation sets, respectively. The decision curves of the radiomics nomogram and radiomics signature in the validation set indicated an overall net benefit over the clinical factors model.

Conclusion: Our radiomics nomogram can effectively predict the preoperative diagnosis of ROs and may therefore be of assistance in sparing unnecessary surgery and tailoring precise therapy. The ROC curves of the clinical model, the radiomics signature and the radiomics nomogram for the validation set. RO = Renal oncocytoma; ccRCC = Clear cell renal cell carcinoma.
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http://dx.doi.org/10.1007/s00261-021-03213-6DOI Listing
November 2021

Radiomics Analysis of Contrast-Enhanced CT Predicts Survival in Clear Cell Renal Cell Carcinoma.

Front Oncol 2021 25;11:671420. Epub 2021 Jun 25.

Department of Positron Emission Tomography-Computed Tomography (PET-CT) Center, The Affiliated Hospital of Qingdao University, Qingdao, China.

Purpose: To develop and validate the radiomics nomogram that combines clinical factors and radiomics features to estimate overall survival (OS) in patients with clear cell renal cell carcinoma (ccRCC), and assess the incremental value of radiomics for OS estimation.

Materials And Methods: One hundred ninety-four ccRCC cases were included in the training cohort and 188 ccRCC patients from another hospital as the test cohort. Three-dimensional region-of-interest segmentation was manually segmented on multiphasic contrast-enhanced abdominal CT images. Radiomics score (Rad-score) was calculated from a formula generated least absolute shrinkage and selection operator (LASSO) Cox regression, after which the association between the Rad-score and OS was explored. The radiomics nomogram (clinical factors + Rad-score) was developed to demonstrate the incremental value of the Rad-score to the clinical nomogram for individualized OS estimation, which was then evaluated in relation to calibration and discrimination.

Results: Rad-score, calculated using a linear combination of the 11 screened features multiplied by their respective LASSO Cox coefficients, was significantly associated with OS. Calibration curves showed good agreement between the OS predicted by the nomograms and observed outcomes. The radiomics nomogram presented higher discrimination capability compared to clinical nomogram in the training (C-index: 0.884; 95% CI: 0.808-0.940 0.803; 95% CI: 0.705-0.899, P < 0.05) and test cohorts (C-index: 0.859; 95% CI: 0.800-0.921 0.846; 95% CI: 0.777-0.915, P < 0.05).

Conclusions: The radiomics nomogram may be used for predicting OS in patients with ccRCC, and radiomics is useful to assist quantitative and personalized treatment.
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http://dx.doi.org/10.3389/fonc.2021.671420DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8268016PMC
June 2021

An FDG PET/CT metabolic parameter-based nomogram for predicting the early recurrence of hepatocellular carcinoma after liver transplantation.

Eur J Nucl Med Mol Imaging 2021 10 4;48(11):3656-3665. Epub 2021 Apr 4.

Department of Nuclear Medicine, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.

Purpose: To construct an FDG PET/CT metabolic parameter-based model to predict early recurrence of hepatocellular carcinoma (HCC) after liver transplantation (LT).

Methods: A total of 62 patients with HCC after LT were enrolled with a follow-up period of 1 year. Basic clinical, pathology, and laboratory data, CT features (CPLC), and PET metabolic parameters (CPLCP) were collected for model construction. A CPLC nomogram without metabolic parameters and a CPLCP nomogram with metabolic parameters were established. The net reclassification index (NRI) and integrated discrimination improvement (IDI) of the two models were calculated. The constructed model was compared with Milan criteria and University of California San Francisco (UCSF) criteria. The time-dependent area under the receiver operating characteristic curve (time-AUC) was used to compare the efficiency of the models, and the bootstrap method was used to for verification. Harrell's concordance index (C-index) was used to evaluate the performance of these models. Decision curve analysis (DCA) was used to evaluate the clinical practicability of each model.

Results: Thirty out of 62 patients experienced a recurrence during the 1-year follow-up. BCLC stage (P = 0.009), MVI (P = 0.032), AFP (P = 0.004), CTdmax (P = 0.033), and MTV (P = 0.039) were the independent predictors. The CPLC nomogram and the CPLCP nomogram were established. Compared with the CPLC nomogram, the NRI of the CPLCP nomogram increased by 38.98% (95% CI = -18.77-60.43%) and the IDI increased by 4.40% (95% CI = -1.00-16.62%). The AUC value of the CPLCP nomogram was higher than those of Milan criteria and UCSF criteria in the time-AUC curve. Moreover, the CPLCP nomogram had a higher C-index (0.774) than other models. Finally, the DCA curve showed that clinical practicability of the CPLCP nomogram outperformed the Milan criteria and UCSF criteria.

Conclusions: The CPLCP nomogram combining basic clinical data, pathology data, laboratory data, CT features, and PET metabolic parameters showed good efficacy and high clinical practicability in predicting the early recurrence of HCC after LT.
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http://dx.doi.org/10.1007/s00259-021-05328-wDOI Listing
October 2021

Pulmonary mucosa-associated lymphoid tissue lymphoma: CT findings and pathological basis.

J Surg Oncol 2021 Apr 1;123(5):1336-1344. Epub 2021 Feb 1.

Department of Respiratory and Critical Care, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.

Background: Pulmonary mucosa-associated lymphoid tissue lymphoma (MALToma) is the most frequent subset of primary pulmonary lymphoma. This study aimed to identify radiologic characteristics of pulmonary MALToma based on computed tomography (CT) observations and pathologic features, and further investigate its prognosis.

Methods: Sixty-six patients (55.4 ± 10.9 years; 51.5% male) diagnosed as pulmonary MALToma by pathology were retrospectively enrolled. According to distributions and features of lesions shown on CT, patients were divided into three patterns, including single nodular/mass, multiple nodular/mass, and pneumonia-like consolidative.

Results: Variety of the location and extent of the lymphomatous infiltration accounted for different characteristics demonstrated at CT. The pneumonia-like consolidative pattern was the most frequent pattern observed in 42 patients (63.6%), followed by single nodular/mass (21.2%) and multiple nodular/mass (15.2%). CT features included air bronchogram (72.7%), well-marginated halo sign (53.0%), coarse spiculate with different lengths (72.7%), angiogram sign (77.1% of 35 patients), peribronchovascular thickening (48.5%), irregular cavitation (16.7%) and pulmonary cyst (7.6%). The estimated 5-year cumulative overall survival rate of pulmonary MALToma was 100.0%.

Conclusions: Pulmonary MALToma demonstrates several characteristics at CT. Identification of the significant pulmonary abnormalities of this indolent disease entity might be helpful for early diagnosis and optimal treatment.
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http://dx.doi.org/10.1002/jso.26403DOI Listing
April 2021

Differential diagnosis of renal oncocytoma and chromophobe renal cell carcinoma using CT features: a central scar-matched retrospective study.

Acta Radiol 2022 Feb 26;63(2):253-260. Epub 2021 Jan 26.

Department of Radiology, the Affiliated Hospital of Qingdao University, Qingdao, Shandong, PR China.

Background: Renal oncocytoma (RO) and chromophobe renal cell carcinoma (chRCC) have a common cellular origin and different clinical management and prognosis.

Purpose: To explore the utility of computed tomography (CT) in the differentiation of RO and chRCC.

Material And Methods: Twenty-five patients with RO and 73 patients with chRCC presenting with the central scar were included retrospectively. Two experienced radiologists independently reviewed the CT imaging features, including location, tumor size, relative density ratio, segmental enhancement inversion (SEI), necrosis, and perirenal fascia thickening, among others. Interclass correlation coefficient (ICC, for continuous variables) or Kappa coefficient test (for categorical variables) was used to determine intra-observer and inter-observer bias between the two radiologists.

Results: The inter- and intra-reader reproducibility of the other CT imaging parameters were nearly perfect (>0.81) except for the measurements of fat (0.662). RO differed from chRCC in the cortical or medullary side ( = 0.005), relative density ratio ( = 0.020), SEI ( < 0.001), and necrosis ( = 0.045). The logistic regression model showed that location (right kidney), hypo-density on non-enhanced CT, SEI, and perirenal fascia thickening were highly predictive of RO. The combined indicators from logistic regression model were used for ROC analysis. The area under the ROC curve was 0.923 ( < 0.001). The sensitivity and specificity of the four factors combined for diagnosing RO were 88% and 86.3%, respectively. The correlation coefficient between necrosis and tumor size in all tumors including both of RO and chRCC was 0.584, indicating a positive correlation ( < 0.001).

Conclusion: The CT imaging features of location (right kidney), hypo-density on non-enhanced CT, SEI, and perirenal fascia thickening were valuable indicators in distinguishing RO from chRCC.
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http://dx.doi.org/10.1177/0284185120988109DOI Listing
February 2022

Improved Cellular Delivery of Antisense Oligonucleotide for miRNA-21 Imaging In Vivo Using Cell-Penetrating Peptide-Based Nanoprobes.

Mol Pharm 2021 03 22;18(3):787-795. Epub 2021 Jan 22.

Department of Nuclear Medicine, The Affiliated Hospital of Qingdao University, No. 59, Haier Road, Qingdao 266061, Shandong, China.

Most oligonucleotides fail to enter a cell and cannot escape from endosomes after endocytosis because of their negative charge and large molecular weight. More efficient cellular delivery of oligonucleotides should be developed for the widespread implementation of antisense imaging. The purpose of this study was to construct a novel antisense nanoprobe, Tc-labeled anti-miRNA oligonucleotides/cell-penetrating peptide PepFect6 (Tc-AMO/PF6), and to evaluate its efficacy for imaging the miRNA-21 expression in A549 lung adenocarcinoma xenografts. Naked AMO and commercial Lipofectamine 2000-based nanoparticles (AMO/LIP) were used for comparison. The cellular delivery efficiency of AMO/PF6 was first investigated by laser confocal scanning microscopy using Cy5.5-labeled probes and further validated by in vivo fluorescence imaging. Then, the probes were labeled with Tc via hydrazinonicotinamide (HYNIC). The cytotoxicity assay, cellular uptake, and retention kinetics of the probes were evaluated in vitro. The biodistribution of the probes was investigated in A549 lung cancer xenografts, and SPECT imaging was performed in vivo. AMO/PF6 showed lower cytotoxicity than AMO/LIP ( < 0.05) but showed no significant difference with naked AMO. Fluorescence microscopy demonstrated more extensive and scattered signal distribution inside the A549 cells by AMO/PF6 than AMO/LIP. The labeling efficiency of Tc-AMO/PF6 was 72.6 ± 1.42%, and the specific activity was 11.6 ± 0.13 MBq/ng. The cellular uptake of Tc-PF6/AMO peaked at 12 h, with the uptake of 11.24 ± 0.12 mol/cell × 10, and the cellular retention of Tc-AMO/PF6 was 3.92 ± 0.15 mol/cell × 10 at 12 h after interrupted incubation. AMO/PF6 showed higher cellular uptake and retention than naked AMO and AMO/LIP. The biodistribution study showed that the tumor had the highest radioactivity accumulation, with the uptake ratio of tumor/muscle (T/M) increasing from 14.59 ± 0.67 to 21.76 ± 0.98 between 1 and 6 h after injection, followed by the uptake in the kidneys and the liver. The results of in vivo fluorescence and SPECT imaging were consistent with the results of the biodistribution. The tumor was visualized at 6 h after injection of AMO/PF6 with the highest T/M ratio among these probes ( < 0.05). PF6 improves cellular delivery of antisense oligonucleotides via noncovalent nanoparticles. Tc-AMO/PF6 shows favorable imaging properties and is promising for miRNAs imaging in vivo.
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http://dx.doi.org/10.1021/acs.molpharmaceut.0c00160DOI Listing
March 2021

Deep learning-assisted magnetic resonance imaging prediction of tumor response to chemotherapy in patients with colorectal liver metastases.

Int J Cancer 2021 04 29;148(7):1717-1730. Epub 2020 Dec 29.

Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiology, Peking University Cancer Hospital & Institute, Beijing, China.

Accurate evaluation of tumor response to preoperative chemotherapy is crucial for assigning appropriate patients with colorectal liver metastases (CRLM) to surgery or conservative therapy. However, there is no well-recognized method for predicting pathological response before surgery. Our study constructed and validated a deep learning algorithm using prechemotherapy and postchemotherapy magnetic resonance imaging (MRI) to predict pathological response in CRLM. CRLM patients from center one who had ≤5 lesions and were scheduled to receive preoperative chemotherapy followed by liver resection between January 2013 and November 2016, were included prospectively and chronologically divided into a training cohort (80% of patients) and a testing cohort (20% of patients). Patients from center two were included January 2017 and December 2018 as an external validation cohort. MRI-based models were constructed to discriminate according to pathology tumor regression grade (TRG) between the response (TRG1/2) and nonresponse (TRG3/4/5) groups at the lesion level. From center one, 155 patients (328 lesions) were included; chronologically, 101 (264 lesions) in the training cohort and 54 (64 lesions) in the testing cohort. The model achieved better accuracy (0.875 vs 0.578) and AUC (0.849 vs 0.615) than RECIST for discriminating response; it also distinguished the survival outcomes after hepatectomy better than the RECIST criteria. Evaluations of the external validation cohort (25 patients, 61 lesions) also showed good ability with an AUC of 0.833. In conclusion, the MRI-based deep learning model provided accurate prediction of pathological tumor response to preoperative chemotherapy in patients with CRLM and may inform individualized treatment.
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http://dx.doi.org/10.1002/ijc.33427DOI Listing
April 2021

Feasibility of Low Volume of High-Concentration Iodinated Contrast Medium With 70 kVp Tube Voltage on High-Pitch Dual-Source Computed Tomography Angiography in Children With Congenital Heart Disease.

J Comput Assist Tomogr 2021 Jan-Feb 01;45(1):52-58

Nuclear Medicine, Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.

Objective: The objective of this study was to investigate the feasibility of high-concentration iodinated contrast medium (CM) with 70 kVp tube voltage on high-pitch dual-source computed tomography (DSCT) in children with congenital heart disease (CHD).

Methods: Fifty-eight CHD patients underwent high-pitch DSCT in 2 protocols: 70 kVp tube voltage, 1.0 mL/kg CM volume, 370 mg I/mL concentration (group A); 80 kVp tube voltage, 1.5 mL/kg CM volume, 350 mg I/mL concentration (group B). The diagnostic accuracy, image quality, iodine delivery rate, iodine dose, and radiation dose were compared.

Results: There was no significant difference in the diagnostic accuracy (P > 0.05), image quality (P > 0.05) and iodine delivery rate (P > 0.05) between the 2 groups. The iodine dose (P < 0.05) and radiation dose (P < 0.05) in group A were significantly lower than those in group B.

Conclusions: Reduction in iodine dose and radiation exposure can be achieved with 70 kVp high-pitch DSCT by administering a smaller volume of high-concentration CM in children with CHD.
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http://dx.doi.org/10.1097/RCT.0000000000001033DOI Listing
January 2021

2D and 3D texture analysis to predict lymphovascular invasion in lung adenocarcinoma.

Eur J Radiol 2020 Aug 3;129:109111. Epub 2020 Jun 3.

Department of Nuclear Medicine, the Affiliated Hospital of Qingdao University, Qingdao, Shandong, China. Electronic address:

Purpose: Lymphovascular invasion (LVI) impairs surgical outcomes in lung adenocarcinoma (LAC) patients. Preoperative prediction of LVI is challenging by using traditional clinical and imaging factors. The purpose of this study was to evaluate the value of two-dimensional (2D) and three-dimensional (3D) CT texture analysis (CTTA) in predicting LVI in LAC.

Methods: A total of 149 LAC patients (50 LVI-present LACs and 99 LVI-absent LACs) were retrospectively enrolled. Clinical data and CT findings were analyzed to select independent clinical predictors. Texture features were extracted from 2D and 3D regions of interest (ROI) in 1.25 mm slice CT images. The 2D and 3D CTTA signatures were constructed with the least absolute shrinkage and selection operator algorithm and texture scores were calculated. The optimized CTTA signature was selected by comparing the predicting efficacy and clinical usefulness of 2D and 3D CTTA signatures. A CTTA nomogram was developed by integrating the optimized CTTA signature and clinical predictors, and its calibration, discrimination and clinical usefulness were evaluated.

Results: Maximum diametre and spiculation were independent clinical predictors. 1125 texture features were extracted from 2D and 3D ROIs and reduced to 11 features to build 2D and 3D CTTA signatures. There was significant difference (P < 0.001) in AUC (area under the curve) between 2D signature (AUC, 0.938) and 3D signature (AUC, 0.753) in the training set. There was no significant difference (P = 0.056) in AUC between 2D signature (AUC, 0.856) and 3D signature (AUC, 0.701) in the test set. Decision curve analysis showed the 2D signature outperformed the 3D signature in terms of clinical usefulness. The 2D CTTA nomogram (AUC, 0.938 and 0.861, in the training and test sets), which incorporated the 2D signature and clinical predictors, showed a similar discrimination capability (P = 1.000 and 0.430, in the training and test sets) and clinical usefulness as the 2D signature, and outperformed the clinical model (AUC, 0.678 and 0.776, in the training and test sets).

Conclusions: 2D CTTA signature performs better than 3D CTTA signature. The 2D CTTA nomogram with the 2D signature and clinical predictors incorporated provides the similar performance as the 2D signature for individual LVI prediction in LAC.
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http://dx.doi.org/10.1016/j.ejrad.2020.109111DOI Listing
August 2020

Additional value of metabolic parameters to PET/CT-based radiomics nomogram in predicting lymphovascular invasion and outcome in lung adenocarcinoma.

Eur J Nucl Med Mol Imaging 2021 01 25;48(1):217-230. Epub 2020 May 25.

Department of Nuclear Medicine, The Affiliated Hospital of Qingdao University, No. 59 Haier Road, Qingdao, Shandong, China.

Purpose: Lymphovascular invasion (LVI) impairs surgical outcomes in lung adenocarcinoma (LAC) patients. Preoperative prediction of LVI is challenging by using traditional clinical and imaging parameters. The purpose of this study was to investigate the value of the radiomics nomogram integrating clinical factors, CT features, and maximum standardized uptake value (SUVmax) to predict LVI and outcome in LAC and to evaluate the additional value of the SUVmax to the PET/CT-based radiomics nomogram.

Methods: A total of 272 LAC patients (87 LVI-present LACs and 185 LVI-absent LACs) with PET/CT scans were retrospectively enrolled, and 160 patients with SUVmax ≥ 2.5 of them were used for PET radiomics analysis. Clinical data and CT features were analyzed to select independent LVI predictors. The performance of the independent LVI predictors and SUVmax was evaluated. Two-dimensional (2D) and three-dimensional (3D) CT radiomics signatures (RSs) and PET-RS were constructed with the least absolute shrinkage and selection operator algorithm and radiomics scores (Rad-scores) were calculated. The radiomics nomograms, incorporating Rad-score and independent clinical and CT factors, with SUVmax (RNWS) or without SUVmax (RNWOS) were built. The performance of the models was assessed with respect to calibration, discrimination, and clinical usefulness. All the clinical, PET/CT, pathologic, therapeutic, and radiomics parameters were assessed to identify independent predictors of progression-free survival (PFS).

Results: CT morphology was the independent LVI predictor. SUVmax provided better discrimination capability compared with CT morphology in the training set (P < 0.001) and test set (P = 0.042). A total of 1409 CT and PET radiomics features were extracted and reduced to 8, 8, and 10 features to build the 2D CT-RS, 3D CT-RS, and the PET-RS, respectively. There was no significant difference in AUC between the 2D-RS and 3D-RS (P > 0.05), and 2D CT-RS showed a relatively higher AUC than 3D CT-RS. The CT-RS, the CT-RNWOS, and the CT-RNWS showed good discrimination in the training set (AUC [area under the curve], 0.799, 0.796, and 0.851, respectively) and the test set (AUC, 0.818, 0.822, and 0.838, respectively). There was significant difference in AUC between the CT-RNWS and CT-RNWOS (P = 0.044) in the training set. Decision curve analysis (DCA) demonstrated the CT-RNWS outperformed the CT-RS and the CT-RNWOS in terms of clinical usefulness. Furthermore, DCA showed the PETCT-RNWS provided the highest net benefit compared with the PET-RNWS and CT-RNWS. PFS was significantly different between the pathologic and RNWS-predicted LVI-present and LVI-absent patients (P < 0.001). Carbohydrate antigen 125 (CA125), carcinoembryonic antigen (CEA), neuron-specific enolase (NSE), pathologic LVI, histologic subtype, and SUVmax were independent predictors of PFS in the 244 CT-RNWS-predicted cohort; and CA125, NSE, pathologic LVI, and SUVmax were the independent predictors of PFS in the 141 PETCT-RNWS-predicted cohort.

Conclusions: The radiomics nomogram, incorporating Rad-score, clinical and PET/CT parameters, shows favorable predictive efficacy for LVI status in LAC. Pathologic LVI and SUVmax are associated with LAC prognosis.
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http://dx.doi.org/10.1007/s00259-020-04747-5DOI Listing
January 2021

CT-Based Radiomics Nomogram: A Potential Tool for Differentiating Hepatocellular Adenoma From Hepatocellular Carcinoma in the Noncirrhotic Liver.

Acad Radiol 2021 06 5;28(6):799-807. Epub 2020 May 5.

Department of Radiology, the Affiliated Hospital of Qingdao University, No. 16 Jiangsu Road, Qingdao 266000, Shandong, China. Electronic address:

Rationale And Objectives: To evaluate the value of a radiomics nomogram for preoperative differentiating hepatocellular adenoma (HCA) from hepatocellular carcinoma (HCC) in the noncirrhotic liver.

Materials And Methods: One hundred and thirty-one patients with HCA (n = 46) and HCC (n = 85) were divided into a training set (n = 93) and a test set (n = 38). Clinical data and CT findings were analyzed. Radiomics features were extracted from the triphasic contrast CT images. A radiomics signature was constructed with the least absolute shrinkage and selection operator algorithm and a radiomics score was calculated. Combined with the radiomics score and independent clinical factors, a radiomics nomogram was developed by multivariate logistic regression analysis. The performance of the radiomics nomogram was assessed by calibration, discrimination and clinical usefulness.

Results: Gender, age, and enhancement pattern were the independent clinical factors. Three thousand seven hundred and sixty-eight features were extracted and reduced to 7 features as the optimal discriminators to build the radiomics signature. The radiomics nomogram (area under the curve [AUC], 0.96; 95% confidence interval [CI], 0.93-0.99) and the clinical factors model (AUC, 0.93; 95%CI, 0.88-0.99) showed better discrimination capability (p = 0.001 and 0.047) than the radiomics signature (AUC, 0.83; 95%CI, 0.74-0.92) in the training set. In the test set, the radiomics nomogram (AUC, 0.94; 95%CI, 0.87-1.00) performed better (p = 0.013) than the radiomics signature (AUC, 0.75; 95%CI, 0.59-0.91). Decision curve analysis showed the radiomics nomogram outperformed the clinical factors model and the radiomics signature in terms of clinical usefulness.

Conclusion: The CT-based radiomics nomogram has the potential to accurately differentiate HCA from HCC in the noncirrhotic liver.
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http://dx.doi.org/10.1016/j.acra.2020.04.027DOI Listing
June 2021

A CT-based radiomics nomogram for differentiation of focal nodular hyperplasia from hepatocellular carcinoma in the non-cirrhotic liver.

Cancer Imaging 2020 Feb 24;20(1):20. Epub 2020 Feb 24.

Department of Radiology, the Affiliated Hospital of Qingdao University, No.16, Jiangsu Road, Qingdao, 266000, Shandong, China.

Background: The purpose of this study was to develop and validate a radiomics nomogram for preoperative differentiating focal nodular hyperplasia (FNH) from hepatocellular carcinoma (HCC) in the non-cirrhotic liver.

Methods: A total of 156 patients with FNH (n = 55) and HCC (n = 101) were divided into a training set (n = 119) and a validation set (n = 37). Radiomics features were extracted from triphasic contrast CT images. A radiomics signature was constructed with the least absolute shrinkage and selection operator algorithm, and a radiomics score (Rad-score) was calculated. Clinical data and CT findings were assessed to build a clinical factors model. Combined with the Rad-score and independent clinical factors, a radiomics nomogram was constructed by multivariate logistic regression analysis. Nomogram performance was assessed with respect to discrimination and clinical usefulness.

Results: Four thousand two hundred twenty-seven features were extracted and reduced to 10 features as the most important discriminators to build the radiomics signature. The radiomics signature showed good discrimination in the training set (AUC [area under the curve], 0.964; 95% confidence interval [CI], 0.934-0.995) and the validation set (AUC, 0.865; 95% CI, 0.725-1.000). Age, Hepatitis B virus infection, and enhancement pattern were the independent clinical factors. The radiomics nomogram, which incorporated the Rad-score and clinical factors, showed good discrimination in the training set (AUC, 0.979; 95% CI, 0.959-0.998) and the validation set (AUC, 0.917; 95% CI, 0.800-1.000), and showed better discrimination capability (P < 0.001) compared with the clinical factors model (AUC, 0.799; 95% CI, 0.719-0.879) in the training set. Decision curve analysis showed the nomogram outperformed the clinical factors model in terms of clinical usefulness.

Conclusions: The CT-based radiomics nomogram, a noninvasive preoperative prediction tool that incorporates the Rad-score and clinical factors, shows favorable predictive efficacy for differentiating FNH from HCC in the non-cirrhotic liver, which might facilitate clinical decision-making process.
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http://dx.doi.org/10.1186/s40644-020-00297-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7041197PMC
February 2020

Application of Digital Tomosynthesis in the Diagnosis of Urolithiasis: Comparison with MDCT.

J Endourol 2020 02 9;34(2):145-150. Epub 2020 Jan 9.

Department of Radiology, The Affiliated Hospital of Qingdao University, Qingdao, China.

To investigate the diagnostic value of digital tomosynthesis in urolithiasis compared with multidetector computed tomography (MDCT). This study received the approval of institutional review board and obtained the informed consents of all subjects. Fifty patients with acute renal colic and hematuria from February 2014 to February 2015 were enrolled. They underwent both MDCT and digital tomosynthesis. Images were interpreted by two experienced radiologists, and inter-reader agreement was assessed. The diagnostic performance of urinary stones with digital tomosynthesis and MDCT was compared. The entrance surface dose (ESD) in MDCT and digital tomosynthesis for patients was measured and compared. No significant difference was found between digital tomosynthesis and MDCT in the diagnosis of urinary stones ( = 1.357,  > 0.05). The ESD in digital tomosynthesis was lower than that in both routine-dose and low-dose MDCT for patients ( < 0.05). Digital tomosynthesis has great diagnostic value in urolithiasis. Compared with MDCT, digital tomosynthesis can significantly decrease ESD for patients and financial loan with a similar detection rate.
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http://dx.doi.org/10.1089/end.2019.0327DOI Listing
February 2020

Contrast-Enhanced CT Texture Analysis for Distinguishing Fat-Poor Renal Angiomyolipoma From Chromophobe Renal Cell Carcinoma.

Mol Imaging 2019 Jan-Dec;18:1536012119883161

PET-CT Center, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.

Objective: To evaluate the value of 2-dimensional (2D) and 3-dimensional (3D) computed tomography texture analysis (CTTA) models in distinguishing fat-poor angiomyolipoma (fpAML) from chromophobe renal cell carcinoma (chRCC).

Methods: We retrospectively enrolled 32 fpAMLs and 24 chRCCs. Texture features were extracted from 2D and 3D regions of interest in triphasic CT images. The 2D and 3D CTTA models were constructed with the least absolute shrinkage and selection operator algorithm and texture scores were calculated. The diagnostic performance of the 2D and 3D CTTA models was evaluated with respect to calibration, discrimination, and clinical usefulness.

Results: Of the 177 and 183 texture features extracted from 2D and 3D regions of interest, respectively, 5 2D features and 8 3D features were selected to build 2D and 3D CTTA models. The 2D CTTA model (area under the curve [AUC], 0.811; 95% confidence interval [CI], 0.695-0.927) and the 3D CTTA model (AUC, 0.915; 95% CI, 0.838-0.993) showed good discrimination and calibration ( > .05). There was no significant difference in AUC between the 2 models ( = .093). Decision curve analysis showed the 3D model outperformed the 2D model in terms of clinical usefulness.

Conclusions: The CTTA models based on contrast-enhanced CT images had a high value in differentiating fpAML from chRCC.
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http://dx.doi.org/10.1177/1536012119883161DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6801892PMC
June 2020

A CT-based radiomics nomogram for differentiation of renal angiomyolipoma without visible fat from homogeneous clear cell renal cell carcinoma.

Eur Radiol 2020 Feb 10;30(2):1274-1284. Epub 2019 Sep 10.

Urology Department, The Affiliated Hospital of Qingdao University, No. 16, Jiangsu Road, Qingdao, 266005, Shandong, China.

Objectives: To develop and validate a radiomics nomogram for preoperative differentiating renal angiomyolipoma without visible fat (AML.wovf) from homogeneous clear cell renal cell carcinoma (hm-ccRCC).

Methods: Ninety-nine patients with AML.wovf (n = 36) and hm-ccRCC (n = 63) were divided into a training set (n = 80) and a validation set (n = 19). Radiomics features were extracted from corticomedullary phase and nephrographic phase CT images. A radiomics signature was constructed and a radiomics score (Rad-score) was calculated. Demographics and CT findings were assessed to build a clinical factors model. Combined with the Rad-score and independent clinical factors, a radiomics nomogram was constructed. Nomogram performance was assessed with respect to calibration, discrimination, and clinical usefulness.

Results: Fourteen features were used to build the radiomics signature. The radiomics signature showed good discrimination in the training set (AUC [area under the curve], 0.879; 95%; confidence interval [CI], 0.793-0.966) and the validation set (AUC, 0.846; 95% CI, 0.643-1.000). The radiomics nomogram showed good calibration and discrimination in the training set (AUC, 0.896; 95% CI, 0.810-0.983) and the validation set (AUC, 0.949; 95% CI, 0.856-1.000) and showed better discrimination capability (p < 0.05) compared with the clinical factor model (AUC, 0.788; 95% CI, 0.683-0.893) in the training set. Decision curve analysis demonstrated the nomogram outperformed the clinical factors model and radiomics signature in terms of clinical usefulness.

Conclusions: The CT-based radiomics nomogram, a noninvasive preoperative prediction tool that incorporates the Rad-score and clinical factors, shows favorable predictive efficacy for differentiating AML.wovf from hm-ccRCC, which might assist clinicians in tailoring precise therapy.

Key Points: • Differential diagnosis between AML.wovf and hm-ccRCC is rather difficult by conventional imaging modalities. • A radiomics nomogram integrated with the radiomics signature, demographics, and CT findings facilitates differentiation of AML.wovf from hm-ccRCC with improved diagnostic efficacy. • The CT-based radiomics nomogram might spare unnecessary surgery for AML.wovf.
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http://dx.doi.org/10.1007/s00330-019-06427-xDOI Listing
February 2020

Astragaloside IV Exerts a Myocardial Protective Effect against Cardiac Hypertrophy in Rats, Partially via Activating the Nrf2/HO-1 Signaling Pathway.

Oxid Med Cell Longev 2019 11;2019:4625912. Epub 2019 Jun 11.

Department of Cardiology, Affiliated Hospital of Jining Medical University, Jining 272029, China.

Previous evidence suggested that astragaloside IV (ASIV) had a cardioprotective effect, but the potential mechanisms were undetermined. This study is aimed at validating the prevention of cardiac hypertrophy in chronic heart failure (CHF) rats and hypertrophy in H9c2 cardiomyocytes by ASIV and at exploring the potential mechanism involved. CHF rat models of abdominal aortic constriction (AAC) were used with the aim of determining the protective effect of ASIV in cardiac hypertrophy in the rats. We proved that ASIV could attenuate cardiac hypertrophy by improving left ventricular function and structure and showed that the expression of nuclear factor-erythroid 2-related factor 2 (Nrf2) and its downstream gene heme oxygenase-1 (HO-1) increased in the high-dose ASIV intervention group. To further investigate the specific mechanism of ASIV, we hypothesized that ASIV might prevent cardiac hypertrophy via activating the Nrf2/HO-1 signaling pathway. We established a cardiomyocyte hypertrophy model induced by angiotensin II (Ang II), which was then transfected with Nrf2 shRNA, to knock down the expression of the Nrf2 gene. We found that the protective effect of ASIV against Ang II-induced cardiomyocyte hypertrophy was abolished in the Nrf2 shRNA transfection group, ultimately aggravating cardiomyocyte hypertrophy induced by Ang II, and it is possible that oxidative stress may be involved in this process. Our results demonstrated that ASIV improved cardiac function and inhibited cardiac hypertrophy by upregulating Nrf2, and this effect was partially achieved by stimulating the Nrf2/HO-1 signaling pathway, suggesting that ASIV could have therapeutic potential for the treatment of cardiac hypertrophy and CHF.
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http://dx.doi.org/10.1155/2019/4625912DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6594267PMC
January 2020

Primary hepatic perivascular epithelioid cell tumors: imaging findings with histopathological correlation.

Cancer Imaging 2019 Jun 6;19(1):32. Epub 2019 Jun 6.

PET-CT Center, the Affiliated Hospital of Qingdao University, Qingdao, 266000, Shandong, China.

Background: Hepatic PEComas are very rare. Few systematic reports are available characterizing the imaging and pathological features of hepatic PEComa. The aim of this study was to investigate the imaging findings of primary hepatic perivascular epithelioid cell tumors (PEComa) and its correlation with histopathological features.

Methods: The CT, MRI and ultrasound images and pathological findings of 22 patients with primary hepatic PEComa were retrospectively reviewed.

Results: More females (14/22) were affected with the mean age of 47.1 years. Most patients (17/22) were asymptomatic and the routine laboratory tests were normal. More tumors occurred in the right lobe (13/22) with a mean diameter of 76.7 mm. Surgery was performed in 21 patients, and biopsy was performed in 1 patient. Immunohistochemical studies showed the expression rate of HMB-45 and Melan A was 100% (22/22) and 86.4% (19/22) within the tumor cells. The pathology diagnoses were angiomyolipoma (n = 18), lymphangioleiomyoma (n = 2), clear-cell myomelanocytic tumor of falciform ligament/ligamentum teres (n = 1), and not otherwise specified (n = 1). Fifteen cases were classified as uncertain malignant potential (n = 13) or malignant (n = 2). CT, MRI and ultrasound features included well-defined margins (19/22), internal heterogeneity (20/22), arterial enhancement (20/22), dysmorphic vessels (17/22), fat (9/22), hemorrhage (3/22), necrosis (8/22), and calcification (2/22). The diagnostic accuracy was only 27.3% (6/22). No local recurrence or metastasis was found in the follow-up patients (12/22).

Conclusions: On CT, MRI and ultrasound images, most hepatic PEComas are well-defined, heterogeneous, arterial enhanced masses with dysmorphic vessels, with or without fat, especially in middle-aged females. With the potential to be malignant, timely surgical resection and long-term follow-up may be helpful for improving the prognosis.
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http://dx.doi.org/10.1186/s40644-019-0212-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6555711PMC
June 2019

Radiomics nomogram for differentiating between benign and malignant soft-tissue masses of the extremities.

J Magn Reson Imaging 2020 01 6;51(1):155-163. Epub 2019 Jun 6.

Department of Radiology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.

Background: Preoperative differentiation between malignant and benign tumors is important for treatment decisions.

Purpose/hypothesis: To investigate/validate a radiomics nomogram for preoperative differentiation between malignant and benign masses.

Study Type: Retrospective.

Population: Imaging data of 91 patients.

Field Strength/sequence: T -weighted images (570 msec repetition time [TR]; 17.9 msec echo time [TE], 200-400 mm field of view [FOV], 208-512 × 208-512 matrix), fat-suppressed fast-spin-echo (FSE) T -weighted images (T WIs) (4331 msec TR; 87.9 msec TE, 200-400 mm FOV, 312 × 312 matrix), slice thickness 4 mm, and slice spacing 1 mm.

Assessment: Fat-suppressed FSE T WIs were selected for extraction of features. Radiomics features were extracted from fat-suppressed T WIs. A radiomics signature was generated from the training dataset using least absolute shrinkage and selection operator algorithms. Independent risk factors were identified by multivariate logistic regression analysis and a radiomics nomogram was constructed. Nomogram capability was evaluated in the training dataset and validated in the validation dataset. Performance of the nomogram, radiomics signature, and clinical model were compared.

Statistical Tests: 1) Independent t-test or Mann-Whitney U-test: for continuous variables. Fisher's exact test or χ test: comparing categorical variables between two groups. Univariate analysis: evaluating associations between clinical/morphological characteristics and malignancy. 2) Least absolute shrinkage and selection operator (LASSO)-logistic regression model: selection of malignancy features. 3) Significant clinical/morphological characteristics and radiomics signature were input variables for multiple logistic regression analysis. Area under the curve (AUC): evaluation of ability of the nomogram to identify malignancy. Hosmer-Lemeshow test and decision curve: evaluation and validation of nomogram results.

Results: The radiomics nomogram was able to differentiate malignancy from benignity in the training and validation datasets with an AUC of 0.94. The nomogram outperformed both the radiomics signature and clinical model alone.

Data Conclusion: This radiomics nomogram is a noninvasive, low-cost preoperative prediction method combining the radiomics signature and clinical model.

Level Of Evidence: 3 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2020;51:155-163.
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http://dx.doi.org/10.1002/jmri.26818DOI Listing
January 2020

Computed Tomography Imaging Findings of Pulmonary Chondroma.

Biomed Res Int 2018 30;2018:4387689. Epub 2018 Dec 30.

Department of Radiology, The Affiliated Hospital of Qingdao University, Qingdao 266003, Shandong, China.

Purpose: To characterize the computed tomography (CT) imaging findings in patients with pulmonary chondroma.

Methods: We examined CT imaging findings of eight patients with histopathologically verified pulmonary chondroma. We assessed the location, size, shape, margins, amount of calcification, calcification pattern, and attenuation on precontrast and enhancement CT.

Results: All patients exhibited solitary, mildly lobulated pulmonary masses, which were located in the right lung in four cases and the left lung in four cases. The mean lesion size was 3.7 cm (range 0.9-10.7 cm). All eight tumours had a well-defined margin. On plain CT images, seven of the cases (87.5%) showed a mass with varying degrees of calcification, which included strip-like punctate (n=5) and ring (n=2) patterns. One patient with a large lesion (10.7 cm) showed chest wall adhesion. On contrast-enhanced CT images, all lesions demonstrated slight inhomogeneous enhancement ≤14 HU.

Conclusion: CT is the reference standard diagnostic technique for locating pulmonary chondroma. In most cases, CT findings show some characteristics that are important in the diagnosis, surgical planning, and follow-up of the tumour.
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http://dx.doi.org/10.1155/2018/4387689DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6330836PMC
May 2019

MRI Findings of Early Myositis Ossificans without Calcification or Ossification.

Biomed Res Int 2018 3;2018:4186324. Epub 2018 Sep 3.

Department of Radiology, The Affiliated Hospital of Qingdao University Qingdao, Shandong, China.

Purpose: To characterize and evaluate the MR imaging features of early myositis ossificans (MO) without calcification or ossification.

Methods: The MRI manifestations of seven patients with pathologically proven early MO were retrospectively analyzed with regard to tumor location, size, margins, signal intensity, and enhancement appearance in MR images. Additionally, the surrounding soft-tissue edema and adjacent bone change were assessed.

Results: All cases (n=7) had intramuscular tumor-like masses without calcifications. The lesions appeared as isointense in T1-weighted images (T1-WI) and inhomogeneous hyperintense in T2-weighted MR images (T2-WI). On T2-WI and postcontrast T1-WI, the heterogeneously high signal intensity in the expanded muscle interspersed with a few hypointense linear structures consistent with intact muscle fibers showed "striate pattern" in the plane parallel with muscle fibers. The relatively hypointense areas with geometrical pattern consistent with the bundles of intact muscle fibers are found within the lesion with diffuse high signal intensity, displaying the "checkerboard-like pattern" in the plane vertical to muscle fibers. A "striate pattern" (n = 7) and "checkerboard-like pattern" (n = 3) in the lesion appeared in T2-WI. In contrast-enhanced MRI images, all cases showed diffuse "striate pattern" enhancement. Among them, one case demonstrated "checkerboard-like pattern" enhancement. All cases had diffuse and prominent muscle edema that preserved the muscle fascicles. For two lesions located in the deep muscle group, the adjacent bone showed bone marrow edema.

Conclusion: MR imaging has unique advantages for diagnosis of early MO without calcification or ossification: the "striate pattern" and "checkerboard-like pattern" appearance shown in T2-WI and contrast-enhanced MRI images can be helpful for differential diagnosis. MRI can delineate the extent of the tumor and provides accurate anatomical information, which is important in diagnosis, treatment, and follow-up.
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http://dx.doi.org/10.1155/2018/4186324DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6140134PMC
January 2019

CT and MRI Findings of Soft Tissue Adult Fibrosarcoma in Extremities.

Biomed Res Int 2018 6;2018:6075705. Epub 2018 Mar 6.

Department of Radiology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.

Objective: To characterize and evaluate CT and MRI features of extremity soft tissue adult fibrosarcoma.

Methods: CT and MRI images from 10 adult patients with pathologically proven fibrosarcomas were retrospectively analyzed with regard to tumor location, size, number, shape, margins, attenuation, signal intensity, and enhancement patterns on MR images. Additionally, the relationships between lesions, deep fascia, and change in adjacent bones were also assessed.

Results: Nineteen tumor lesions in 10 patients were selected for this study. Eighteen lesions were lobulated and one was oval in shape. Most cases were located under the deep fascia, including seven cases that had a nodular lump adjacent to the deep fascia and one case that had broken lesion through the deep fascia. On CT, the adult fibrosarcomas mostly showed iso-attenuated soft tissue masses ( = 6). On MRI, all the cases ( = 9) displayed low signal on T1-weighted imaging (T1WI) and heterogeneous low and high intensity signals on T2-weighted imaging (T2WI), with band-like areas of low signal on both T1WI and T2WI. On contrast-enhanced MRI images, three cases showed heterogeneous peripheral enhancement and one case demonstrated a spoke-wheel-like enhancement. Eight cases showed muscle edema signals in the peritumoral muscle and one case involved adjacent bone.

Conclusion: CT and MR imaging have respective advantages in diagnosing adult fibrosarcoma. Combined application of CT and MR is recommended for patients with suspected adult fibrosarcoma.
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http://dx.doi.org/10.1155/2018/6075705DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5859867PMC
September 2018

[Response of water status indicators in apple saplings to drought stress under shelter from rain.]

Ying Yong Sheng Tai Xue Bao 2016 Aug;27(8):2459-2466

State Key Laboratory of Crop Biology/National Research Center of Apple Engineering and Technology/College of Horticultural Science and Engineering, Shandong Agricultural University, Tai'an 271018, Shandong, China.

The main tree water status indicators which sensitively responded to drought stress and related to tree water balance were investigated in treatment of progressive decrease of soil water potential under shelter from rain. The results showed that stem maximum daily shrinkage (MDS) and midday stem water potential (Ψ) were most sensitive to drought stress among all the water status indicators. MDS not only significantly responded to reference crop evapotranspiration (ET), but also was sensitive to soil drought stress. MDS was significantly positively related to ET, and the correlation between relative stem daily maximum shrinkage (MDS) and relative soil water potential (Ψ) was highly significant. Moreover, the stems could be measured in succession and recorded automatically. Midday Ψ was also sensitive to soil drought stress, and significantly negatively related to ET. The correlation between relative midday stem potential (Ψ) and Ψ was significant. But so far, it is difficult to automatically measure either leaf or stem water potential. Predawn leaf water potential (Ψ), daily stem growth (DG) or stomatal conductance (g) also responded to drought stress to some extent under moderate or heavy drought stress, but they were not sensitive.
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http://dx.doi.org/10.13287/j.1001-9332.201608.040DOI Listing
August 2016

Morphometric MRI changes in intracranial hypertension due to cerebral venous thrombosis: a retrospective imaging study.

Clin Radiol 2016 Jul 11;71(7):691-7. Epub 2016 May 11.

Department of Radiology, The Affiliated Hospital of Qingdao University, NO.16, Jiangsu Road, Qingdao 266000, China. Electronic address:

Aim: To evaluate whether some magnetic resonance imaging (MRI) signs suggesting idiopathic intracranial hypertension (IIH) could also be found in intracranial hypertension (IH) due to cerebral venous thrombosis (CVT) and to assess their possible contribution to diagnosing this disorder.

Materials And Methods: Thirty-one patients with IH due to CVT were evaluated prospectively using MRI. A group of 33 age- and sex-matched healthy volunteers served as controls. The optic nerve and sheath, pituitary gland, and ventricles were assessed. The prevalence of each imaging feature was compared between the two groups.

Results: Optic nerve sheath (ONS) dilatation and decreased pituitary gland height were the most valid signs suggesting IH in CVT patients: sensitivity 70.97% and 87.1%, respectively; specificity 96.97% and 72.73%, respectively; area under the curve 0.840 and 0.809, respectively. The MRI finding that showed the strongest association with IH in CVT patients was ONS dilatation (odds ratio 78.5).

Conclusions: The combination of T1-weighted volumetric MRI and magnetic resonance venography could be helpful for diagnosing IH with CVT. Abnormalities of the ONS and the pituitary gland were reliable diagnostic signs for IH due to CVT.
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http://dx.doi.org/10.1016/j.crad.2016.04.011DOI Listing
July 2016

(18)F-FDG hepatic superscan caused by a non-germinal center subtype of diffuse large B-cell lymphoma.

Eur J Nucl Med Mol Imaging 2016 Sep 3;43(10):1928. Epub 2016 May 3.

Department of Pathology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, China.

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http://dx.doi.org/10.1007/s00259-016-3399-0DOI Listing
September 2016
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