Publications by authors named "Ziao Li"

16 Publications

  • Page 1 of 1

Natural history and growth kinetics of clear cell renal cell carcinoma in sporadic and von Hippel-Lindau disease.

Transl Androl Urol 2021 Mar;10(3):1064-1070

Department of Urology, Peking University First Hospital, Beijing, China; Institute of Urology, Peking University, Beijing, China.

Background: To evaluate and compare the natural history and growth kinetics of sporadic clear cell renal cell carcinoma (ccRCC) with those of ccRCC in von Hippel-Lindau disease (VHL).

Methods: Sixty patients in the sporadic group with 61 tumors and 15 patients in the VHL group with 30 tumors whom all underwent delayed surgery after at least 12 months of active surveillance (AS) were enrolled to conduct a retrospective cohort study. The growth rate was calculated, and the growth kinetics between the sporadic and VHL groups were compared. The patient and tumor characteristics were reviewed, and their correlation with growth rate was analyzed.

Results: The mean growth rate of sporadic ccRCC was 0.91 cm/year (ranging from 0-4.74 cm/year) and that of VHL ccRCC was 0.47 cm/year (ranging from 0.04-1.89 cm/year). The growth rate of sporadic ccRCC showed a tendency of being faster than that of VHL ccRCC but did not reach statistical significance (P=0.07). The factors affecting the growth rate were different between the two groups. For VHL ccRCC, the only factor that correlated with growth rate was initial tumor diameter (P<0.001), but for sporadic ccRCC, the only factor was pathological nuclear grade (P<0.001).

Conclusions: The growth rate of VHL-associated ccRCC might be slower than that of sporadic ccRCC. Furthermore, we identified a disparity in growth kinetics between sporadic and VHL-associated ccRCC.
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http://dx.doi.org/10.21037/tau-20-1271DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8039623PMC
March 2021

Modified Laparoscopic and Robotic Flap Pyeloplasty for Recurrent Ureteropelvic Junction Obstruction with a Long Proximal Ureteral Stricture: The "Wishbone" Anastomosis and the "Ureteral Plate" Technique.

Urol Int 2021 10;105(7-8):642-649. Epub 2021 Feb 10.

Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Beijing, China.

Objectives: The aim of the study was to present our modified flap pyeloplasty techniques for recurrent ureteropelvic junction obstruction (UPJO) with a long proximal ureteral stricture and compare outcomes of laparoscopic and robotic procedures.

Materials And Methods: Between March 2018 and January 2020, 21 patients underwent modified laparoscopic or robotic flap pyeloplasty for recurrent UPJO with a long proximal ureteral stricture. Our surgical modifications included the "wishbone" anastomosis and "ureteral plate" technique. Demographic, perioperative, and follow-up data were recorded and compared retrospectively between the groups. Success was defined as subjective pain alleviation and hydronephrosis improvement.

Results: Thirteen modified laparoscopic flap pyeloplasty (mLFP) and 8 modified robotic flap pyeloplasty (mRFP) were performed successfully without conversion. mRFP tended to have shorter overall operative time (142.4 vs. 179.1 min, p = 0.122) and anastomosis time (43.1 vs. 61.0 min, p = 0.093) than mLFP. No difference was found in estimated blood loss (p = 0.723) and pararenal draining time (p = 0.175) between the groups. The mean postoperative hospital stay of mRFP was significantly shorter than that of mLFP (5.0 vs. 8.2 days, p = 0.015). No major complications occurred. During the mean follow-up of 17.9 months, the overall success rate was 90.5%, and there was no significant difference between 2 groups.

Conclusions: The modified flap pyeloplasty could be considered a practical and effective treatment option with a high success rate for recurrent UPJO with a long proximal ureteral stricture, and the robotic procedures showed advantages of higher efficiency and faster recovery.
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http://dx.doi.org/10.1159/000512994DOI Listing
February 2021

2-[F]FDG PET/CT parameters associated with WHO/ISUP grade in clear cell renal cell carcinoma.

Eur J Nucl Med Mol Imaging 2021 02 19;48(2):570-579. Epub 2020 Aug 19.

Department of Nuclear Medicine, Peking University First Hospital, Beijing, China.

Purpose: To explore the potential parameters from preoperative 2-[F]FDG PET/CT that might associate with the World Health Organization/the International Society of Urological Pathology (WHO/ISUP) grade in clear cell renal cell carcinoma (ccRCC).

Methods: One hundred twenty-five patients with newly diagnosed ccRCC who underwent 2-[F]FDG PET/CT prior to surgery or biopsy were retrospectively reviewed. The metabolic parameters and imaging features obtained from 2-[F]FDG PET/CT examinations were analyzed in combination with clinical characteristics. Univariate and multivariate logistic regression analyses were performed to identify the predictive factors of WHO/ISUP grade.

Results: Metabolic parameters of primary tumor maximum standardized uptake value (SUVmax), tumor-to-liver SUV ratio (TLR), and tumor-to-kidney SUV ratio (TKR) were significantly different between any two of the four different WHO/ISUP grades, except those between the WHO/ISUP grade 3 and grade 4. The optimal cutoff values to predict high WHO/ISUP grade for SUVmax, TLR, and TKR were 4.15, 1.63, and 1.59, respectively. TLR (AUC: 0.841) was superior to TKR (AUC: 0.810) in distinguishing high and low WHO/ISUP grades (P = 0.0042). In univariate analysis, SUVmax, TLR, TKR, primary tumor size, tumor thrombus, distant metastases, and clinical symptoms could discriminate between the high and low WHO/ISUP grades (P < 0.05). In multivariate analysis, TLR (P < 0.001; OR: 1.732; 95%CI: 1.289-2.328) and tumor thrombus (P < 0.001; OR: 6.199; 95%CI: 2.499-15.375) were significant factors for differentiating WHO/ISUP grades.

Conclusion: Elevated TLR (> 1.63) and presence of tumor thrombus from preoperative 2-[F]FDG PET/CT can distinguish high WHO/ISUP grade ccRCC effectively. 2-[F]FDG PET/CT may be a feasible method for noninvasive assessment of WHO/ISUP grade.
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http://dx.doi.org/10.1007/s00259-020-04996-4DOI Listing
February 2021

A Simple Modification for the Usage of Flexible Cystoscope in Modified Laparoscopic Pyeloplasty for Ureteropelvic Junction Obstruction with Renal Calculi: A Flexible Guiding Tube.

Urol Int 2019 10;102(3):262-268. Epub 2019 Jan 10.

Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Beijing, China.

Objective: To present our technique of laparoscopic pyeloplasty (LP) with concomitant pyelolithotomy in ureteropelvic junction obstruction (UPJO) complicated by renal calculi and compare outcome with a group of UPJO patients undergoing modified LP without coexistent calculi.

Materials And Methods: We retrospectively reviewed the charts of 51 UPJO patients undergoing modified LP from January 2013 to November 2016 at our institution. Sixteen patients were diagnosed as UPJO with coexistent ipsilateral renal calculi and underwent pyelolithotomy using our modified technique at the time of modified LP. The outcome data of this group were compared with those of 16 matched patients undergoing modified LP without calculi.

Results: No conversion to open surgery occurred. The mean operative time for modified LP and pyelolithotomy was 151.6 min, while the mean operative time for modified LP was 137.6 min (p = 0.21). Additionally, no differences in estimated blood loss (p = 0.96) or postoperative complications (p = 1.00) were observed between the 2 groups. The stone-free rate was 100%. During a mean follow-up of 27.1 months, there were no recurrent calculi or secondary UPJO.

Conclusions: The combination of our novel flexible guiding tube and modified suture technique provides a practical and economic approach with satisfying outcome in the treating of UPJO with concomitant renal calculi.
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http://dx.doi.org/10.1159/000495569DOI Listing
December 2019

Modified Laparoscopic Partial Ureterectomy for Adult Ureteral Fibroepithelial Polyp: Technique and Initial Experience.

Urol Int 2019 16;102(1):13-19. Epub 2018 Nov 16.

Department of Urology, Peking University First Hospital. Institute of Urology, Peking University. National Urological Cancer Center, Beijing, China.

Objectives: To present our modified laparoscopic partial ureterectomy technique for adult ureteral fibroepithelial polyp (FEP) and initial experience.

Methods: Between August 2009 and October 2017, 22 patients with ureteral FEP underwent modified laparoscopic partial ureterectomy by an experienced surgeon. In our method, a stay suture passing through the upper ureter was fixed to the abdominal wall to keep the ureter from twisting. The ureter was not completely dismembered until the first stitch, which was placed between the lowest points of the upper ureter and lower ureter end faces, was finished. Besides, we used a 3-step method to locate the polyp. Surgical success was defined as improved hydronephrosis and alleviated symptoms.

Results: The mean operative time was 152.18 min. The mean estimated blood loss was 22.73 mL. One patient complained of urinary tract infection postoperatively. The mean times to remove the drainage tube and catheter were 2.64 and 3.73 days respectively. The double-J tube was removed at 1-3 months after surgery. At a mean follow-up of 47.04 months, no patient experienced disease recurrence, and the operative success rate was 100%.

Conclusions: Modified laparoscopic partial ureterectomy, with a high success rate, could be considered a safe and efficient treatment option for ureteral FEP.
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http://dx.doi.org/10.1159/000494804DOI Listing
March 2019

18F-FDG PET/CT Findings in a Patient With IgG4-Related Sclerosing Mesenteritis.

Clin Nucl Med 2018 Apr;43(4):294-295

A large mass in the abdomen was revealed by ultrasonography on a 68-year-old woman presenting with abdominal pain and weight loss. To exclude the malignancy, an F-FDG PET/CT was performed, which showed a solitary soft tissue mass with heterogeneous F-FDG avidity at the root of small bowel mesentery. Because of the elevation of inflammatory markers and serum IgG4 level, IgG4-related sclerosing mesenteritis was suspected, which was proved by the subsequent biopsy. The mass gradually shrunk and ultimately disappeared in 6 months after a low-dose steroid therapy.
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http://dx.doi.org/10.1097/RLU.0000000000001999DOI Listing
April 2018

Occult Renal Granulomatous Inflammatory Lesions in Granulomatosis with Polyangiitis Detected by 18F-FDG PET/CT.

Clin Nucl Med 2017 Sep;42(9):707-708

From the *Department of Nuclear Medicine, Peking University First Hospital, Beijing; †Department of Nuclear Medicine, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China; ‡Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA.

A 33-year-old woman with a 7-month history of granulomatosis with polyangiitis F-FDG PET/CT scan due to low-grade intermittent fever and elevation of serum inflammatory markers, which revealed multiple hypermetabolic lesions in bilateral kidneys. Biopsy of a lesion showed granulomatosis with polyangiitis, consistent with renal involvement of granulomatosis with polyangiitis.
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http://dx.doi.org/10.1097/RLU.0000000000001746DOI Listing
September 2017

Leiomyoma Originated From Inferior Vena Cava Mimicking an Adrenal Malignant Tumor on 18F-FDG PET/CT.

Clin Nucl Med 2017 Jul;42(7):558-559

From the *Department of Nuclear Medicine, Peking University First Hospital, Beijing; †Department of Nuclear Medicine, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China; and ‡Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA.

PET/CT was performed on an asymptomatic 62-year-old woman with a suspected adrenal mass and revealed the lesion with high F-FDG avidity and inferior vena cava involvement. A malignant nonfunctioning adrenal tumor was suspected. However, histopathology of the resected lesion revealed a leiomyoma arising from the inferior vena cava.
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http://dx.doi.org/10.1097/RLU.0000000000001633DOI Listing
July 2017

Nasal-Tip Metastasis on 18F-FDG PET/CT Scan in a Patient With Squamous Lung Carcinoma.

Clin Nucl Med 2017 Jun;42(6):478-479

From the *Department of Nuclear Medicine, Peking University First Hospital, Beijing; †Department of Nuclear Medicine, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China; and ‡Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA.

A 64-year-old man found a painless soft tissue mass on his nasal tip 3 months ago. The biopsy pathology indicated a metastatic squamous carcinoma. An F-FDG PET/CT scan was performed to detect the primary malignancy, and it demonstrated multiple F-FDG-avid lesions involving the nasal tip, bilateral lungs, right hilum and mediastinum, and rectum. The nasal-tip mass with high radioactivity was diagnosed as the metastasis from squamous lung carcinoma, which was confirmed by the biopsy of a lung lesion.
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http://dx.doi.org/10.1097/RLU.0000000000001597DOI Listing
June 2017

Diffuse F-FDG accumulation in the subarachnoid space detected by PET/CT in a patient with subarachnoid hemorrhage and hyperglycemia.

Eur J Nucl Med Mol Imaging 2017 04 7;44(4):732-733. Epub 2017 Jan 7.

Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA.

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http://dx.doi.org/10.1007/s00259-016-3610-3DOI Listing
April 2017

IgG4-Related Renal Lesions Detected by Delayed 18F-FDG PET/CT Scan.

Clin Nucl Med 2017 Jan;42(1):66-67

From the *Department of Nuclear Medicine, Peking University First Hospital, Beijing; †Department of Nuclear Medicine, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China; and ‡Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA.

Multiple renal lesions, which showed clearly demarcated low densities on contrast-enhanced CT, were revealed in a 56-year-old woman. The F-FDG avidity of the renal lesions was equal to or mildly higher than that of the renal cortex on the routine PET/CT scan, but significantly higher on the delayed scan. IgG4-related disease with renal involvement was confirmed subsequently by the measurement of serous IgG4 and the pathology of renal lesion.
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http://dx.doi.org/10.1097/RLU.0000000000001427DOI Listing
January 2017

Diagnosis of Primary Intestinal-Type Adenocarcinoma in the Nasal Cavity by 18F-FDG PET/CT.

Clin Nucl Med 2016 Nov;41(11):888-889

From the *Department of Nuclear Medicine, Peking University First Hospital, Beijing, China; †Department of Nuclear Medicine, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China; and ‡Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA.

A soft-tissue lesion in the left nasal cavity was found on a 70-year-old man, which was pathologically proved to be an intestinal-type adenocarcinoma (ITAC) by biopsy. F-FDG PET/CT scan was performed to exclude the possibilities of metastasis from the other primary adenocarcinomas, but the nasal tumor was found to be the only lesion with F-FDG avidity. The primary ITAC in the nasal cavity was diagnosed, and it was resected successfully.
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http://dx.doi.org/10.1097/RLU.0000000000001363DOI Listing
November 2016

High (18)F-FDG uptake in urinary calculi on PET/CT: An unrecognized non-malignant accumulation.

Eur J Radiol 2016 Aug 24;85(8):1395-9. Epub 2016 May 24.

Department of Medical Imaging Services, Good Samaritan Hospital, Central Islips, NY 11722, USA.

Aim: To assess the high (18)F-fluorodeoxyglucose ((18)F-FDG) uptake in urinary calculi on positron-emission tomography/computed tomography (PET/CT).

Methods: In this study, (18)F-FDG PET/CT examinations were retrospectively reviewed from November 2013 to February 2016 in a single center, and patients with high (18)F-FDG uptake in urinary calculi were identified. The following data were collected from each patient, including age, sex, primary disease, method to verify the urinary calculus, and imaging characteristics of the calculus.

Results: A total of 2758 PET/CT studies (2567 patients) were reviewed, and 52 patients with urinary calculi were identified, in which 6 (11.5%, 6/52) patients (5 males, 1 female, age 34-73 years, median age 60.5 years) demonstrated high (18)F-FDG uptake in the urinary calculi. Among the 6 patients, 3 patients had bladder calculi, 2 patients had renal calculi, and 1 patient had both bladder and renal calculi. The size of the urinary calculi varied from sandy to 19mm on CT. The maximal Hounsfield units of the calculi ranged from 153 to 1078. The SUVmax of the calculi on the routine PET/CT scan ranged from 11.7 to 143.0. Delayed PET/CT scans were performed on 4 patients, which showed the calculi SUVmax increasing in 2 patients, while decreasing in the other 2 patients. One patient with bladder calculus underwent a follow-up PET/CT, which showed enlargement of the calculus as well as the increased SUVmax.

Conclusion: This study shows an uncommon high (18)F-FDG uptake in urinary calculi. Recognition of this non-malignant accumulation in urinary calculi is essential for correct interpretation of PET/CT findings.
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http://dx.doi.org/10.1016/j.ejrad.2016.05.010DOI Listing
August 2016

Occult Mediastinal Yolk Sac Tumor Producing α-Fetoprotein Detected by 18F-FDG PET/CT.

Clin Nucl Med 2016 Jul;41(7):585-6

From the *Department of Nuclear Medicine, Peking University First Hospital, Beijing; †Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China; and ‡Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA.

Malignant mediastinal yolk sac tumor (YST), especially adult onset, is rare. Herein, we report a case of occult mediastinal YST with α-fetoprotein production revealed by F-FDG PET/CT in a young adult, in which the intense tracer uptake was demonstrated in the anterior mediastinum. This case indicates F-FDG PET/CT may be a useful tool for detecting the occult primaries of YST.
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http://dx.doi.org/10.1097/RLU.0000000000001238DOI Listing
July 2016

Extramedullary Involvement of Mast Cell Leukemia Detected by 18F-FDG PET/CT.

Clin Nucl Med 2016 Jul;41(7):578-9

From the *Department of Nuclear Medicine, Peking University First Hospital; †Department of Nuclear Medicine, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China; and ‡Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA.

Mast cell leukemia (MCL) is a very rare subtype of systemic mastocytosis, characterized by the leukemic expansion of immature mast cells. We present a case of MCL with extramedullary involvement of cervical lymph node and lung demonstrated by the initial F-FDG PET/CT scan. After a transient complete remission by induction chemotherapy and allogeneic hematopoietic stem cell transplantation, the follow-up PET/CT showed extensive extramedullary relapse involving multiple lymph nodes and small bowel. F-FDG PET/CT may be a useful tool to comprehensively stage and follow-up MCL.
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http://dx.doi.org/10.1097/RLU.0000000000001207DOI Listing
July 2016

Is the bullhead sign on bone scintigraphy really common in the patient with SAPHO syndrome? A single-center study of a 16-year experience.

Nucl Med Commun 2016 Apr;37(4):387-92

aDepartment of Nuclear Medicine, Peking University First Hospital, Beijing, China bDepartment of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.

Objective: The aim of this study was to assess the bone lesion distribution and analyze the frequency of the bullhead sign in patients with SAPHO (synovitis, acne, pustulosis, hyperostosis, and osteitis) syndrome using whole-body bone scintigraphy (WBBS) in a relatively populous study population.

Methods: In this study, the Nuclear Medicine Department's records of one center were retrospectively reviewed and the patients who fulfilled the diagnostic criteria for SAPHO syndrome and underwent Tc-99m-methylene diphosphonate WBBS were identified over a 16-year period. The following data were collected from patients, including age, sex, surgically proved pathology of the bone lesions, WBBS surveillance interval, and SAPHO syndrome components. The bone lesion distribution and the frequency of bullhead sign involving the manubrium and bilateral sternoclavicular junctions were analyzed.

Results: Forty-eight patients were enrolled in this study. The initial WBBS indicated bone involvement in all of the 48 (100%) patients, in whom the most commonly affected region was the anterior chest wall (ACW) (100%, 48/48). The frequency of the upper costosternal junction involvement was the highest (38/48, 79.2%), and 28.9% (11/38) patients were found to show isolated involvement of the first rib in ACW. The frequency of the bullhead sign was only 22.9% (11/48, 95% CI: 12.0-37.3). In the eight (16.7%, 8/48) patients who were followed up using WBBS with an interval that ranged from 1 to 10 years, one patient with an initially single sternoclavicular junction lesion developed a typical bullhead sign over 10 years; other patients with or without the initial typical bullhead sign showed stable appearance over 1-4 years.

Conclusion: This retrospective study shows that in patients with proposed SAPHO syndrome, the bone lesions are most likely located in ACW, and the configuration of the bullhead sign is characteristic, but not entirely sensitive. The value of upper costosternal junction involvement, especially the first rib, may be underevaluated.
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http://dx.doi.org/10.1097/MNM.0000000000000451DOI Listing
April 2016
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