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Xiang Y, Zhang Q, Chen X, Sun H, Li X, Wei X, Zhong J, Gao B, Huang W, Liang W, Sun H, Yang Q, Ren X. Synthetic MRI and amide proton transfer-weighted MRI for differentiating between benign and malignant sinonasal lesions. Eur Radiol 2024; 34:6820-6830. [PMID: 38491129 DOI: 10.1007/s00330-024-10696-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 02/13/2024] [Accepted: 02/22/2024] [Indexed: 03/18/2024]
Abstract
OBJECTIVES To explore the value of the synthetic MRI (SyMRI), combined with amide proton transfer-weighted (APTw) MRI for quantitative and morphologic assessment of sinonasal lesions, which could provide relative scale for the quantitative assessment of tissue properties. METHODS A total of 80 patients (31 malignant and 49 benign) with sinonasal lesions, who underwent the SyMRI and APTw examination, were retrospectively analyzed. Quantitative parameters (T1, T2, proton density (PD)) and APT % were obtained through outlining the region of interest (ROI) and comparing the two groups utilizing independent Student t test or a Wilcoxon test. Receiver operating characteristic curve (ROC), Delong test, and logistic regression analysis were performed to assess the diagnostic efficiency of one-parameter and multiparametric models. RESULTS SyMRI-derived mean T1, T2, and PD were significantly higher and APT % was relatively lower in benign compared to malignant sinonasal lesions (p < 0.05). The ROC analysis showed that the AUCs of the SyMRI-derived quantitative (T1, T2, PD) values and APT % ranged from 0.677 to 0.781 for differential diagnosis between benign and malignant sinonasal lesions. The T2 values showed the best diagnostic performance among all single parameters for differentiating these two masses. The AUCs of combined SyMRI-derived multiple parameters with APT % (AUC = 0.866) were the highest than that of any single parameter, which was significantly improved (p < 0.05). CONCLUSION The combination of SyMRI and APTw imaging has the potential to reflect intrinsic tissue characteristics useful for differentiating benign from malignant sinonasal lesions. CLINICAL RELEVANCE STATEMENT Combining synthetic MRI with amide proton transfer-weighted imaging could function as a quantitative and contrast-free approach, significantly enhancing the differentiation of benign and malignant sinonasal lesions and overcoming the limitations associated with the superficial nature of endoscopic nasal sampling. KEY POINTS • Synthetic MRI and amide proton transfer-weighted MRI could differentiate benign from malignant sinonasal lesions based on quantitative parameters. • The diagnostic efficiency could be significantly improved through synthetic MRI + amide proton transfer-weighted imaging. • The combination of synthetic MRI and amide proton transfer-weighted MRI is a noninvasive method to evaluate sinonasal lesions.
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Affiliation(s)
- Ying Xiang
- Department of Radiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Qiujuan Zhang
- Department of Radiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Xin Chen
- Department of Radiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Honghong Sun
- Department of Radiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Xiaohui Li
- Department of Radiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | | | - Jinman Zhong
- Department of Radiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Bo Gao
- Department of Radiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Wei Huang
- Department of Radiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Wenbin Liang
- Department of Radiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Haiqiao Sun
- Department of Radiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Quanxin Yang
- Department of Radiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
| | - Xiaoyong Ren
- Department of Otorhinolaryngology Head and Neck Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
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Lin N, Shi Y, Ye M, Wang L, Sha Y. Multiparametric MRI-based radiomics approach with deep transfer learning for preoperative prediction of Ki-67 status in sinonasal squamous cell carcinoma. Front Oncol 2024; 14:1305836. [PMID: 38939344 PMCID: PMC11208468 DOI: 10.3389/fonc.2024.1305836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 05/14/2024] [Indexed: 06/29/2024] Open
Abstract
Purpose Based on comparison of different machine learning (ML) models, we developed the model that integrates traditional hand-crafted (HC) features and ResNet50 network-based deep transfer learning (DTL) features from multiparametric MRI to predict Ki-67 status in sinonasal squamous cell carcinoma (SNSCC). Methods Two hundred thirty-one SNSCC patients were retrospectively reviewed [training cohort (n = 185), test cohort (n = 46)]. Pathological grade, clinical, and MRI characteristics were analyzed to choose the independent predictor. HC and DTL radiomics features were extracted from fat-saturated T2-weighted imaging, contrast-enhanced T1-weighted imaging, and apparent diffusion coefficient map. Then, HC and DTL features were fused to formulate the deep learning-based radiomics (DLR) features. After feature selection and radiomics signature (RS) building, we compared the predictive ability of RS-HC, RS-DTL, and RS-DLR. Results No independent predictors were found based on pathological, clinical, and MRI characteristics. After feature selection, 42 HC and 10 DTL radiomics features were retained. The support vector machine (SVM), LightGBM, and ExtraTrees (ET) were the best classifier for RS-HC, RS-DTL, and RS-DLR. In the training cohort, the predictive ability of RS-DLR was significantly better than those of RS-DTL and RS-HC (p< 0.050); in the test set, the area under curve (AUC) of RS-DLR (AUC = 0.817) was also the highest, but there was no significant difference of the performance between DLR-RS and HC-RS. Conclusions Both the HC and DLR model showed favorable predictive efficacy for Ki-67 expression in patients with SNSCC. Especially, the RS-DLR model represented an opportunity to advance the prediction ability.
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Affiliation(s)
- Naier Lin
- Department of Radiology, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Yiqian Shi
- Department of Radiology, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Min Ye
- Department of Pathology, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Luxi Wang
- Department of Radiology, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Yan Sha
- Department of Radiology, Eye & ENT Hospital, Fudan University, Shanghai, China
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Wang T, Hao J, Gao A, Zhang P, Wang H, Nie P, Jiang Y, Bi S, Liu S, Hao D. An MRI-Based Radiomics Nomogram to Assess Recurrence Risk in Sinonasal Malignant Tumors. J Magn Reson Imaging 2023; 58:520-531. [PMID: 36448476 DOI: 10.1002/jmri.28548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 11/19/2022] [Accepted: 11/21/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Sinonasal malignant tumors (SNMTs) have a high recurrence risk, which is responsible for the poor prognosis of patients. Assessing recurrence risk in SNMT patients is a current problem. PURPOSE To establish an MRI-based radiomics nomogram for assessing relapse risk in patients with SNMT. STUDY TYPE Retrospective. POPULATION A total of 143 patients with 68.5% females (development/validation set, 98/45 patients). FIELD STRENGTH/SEQUENCE A 1.5-T and 3-T, fat-suppressed fast spin echo (FSE) T2-weighted imaging (FS-T2WI), FSE T1-weighted imaging (T1WI), and FSE contrast-enhanced T1WI (T1WI + C). ASSESSMENT Three MRI sequences were used to manually delineate the region of interest. Three radiomics signatures (T1WI and FS-T2WI sequences, T1WI + C sequence, and three sequences combined) were built through dimensional reduction of high-dimensional features. The clinical model was built based on clinical and MRI features. The Ki-67-based and tumor-node-metastasis (TNM) model were established for comparison. The radiomics nomogram was built by combining the clinical model and best radiomics signature. The relapse-free survival analysis was used among 143 patients. STATISTICAL TESTS The intraclass/interclass correlation coefficients, univariate/multivariate Cox regression analysis, least absolute shrinkage and selection operator Cox regression algorithm, concordance index (C index), area under the curve (AUC), integrated Brier score (IBS), DeLong test, Kaplan-Meier curve, log-rank test, optimal cutoff values. A P value < 0.05 was considered statistically significant. RESULTS The T1 + C-based radiomics signature had best prognostic ability than the other two signatures (T1WI and FS-T2WI sequences, and three sequences combined). The radiomics nomogram had better prognostic ability and less error than the clinical model, Ki-67-based model, and TNM model (C index, 0.732; AUC, 0.765; IBS, 0.185 in the validation set). The cutoff values were 0.2 and 0.7 and then the cumulative risk rates were calculated. DATA CONCLUSION A radiomics nomogram for assessing relapse risk in patients with SNMT may provide better prognostic ability than the clinical model, Ki-67-based model, and TNM model. EVIDENCE LEVEL 3. TECHNICAL EFFICACY Stage 5.
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Affiliation(s)
- Tongyu Wang
- Department of Radiology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Jingwei Hao
- Department of Radiology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Aixin Gao
- Department of Radiology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Peng Zhang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Hexiang Wang
- Department of Radiology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Pei Nie
- Department of Radiology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Yan Jiang
- Department of Otolaryngology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Shucheng Bi
- Department of Radiology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Shunli Liu
- Department of Radiology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Dapeng Hao
- Department of Radiology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
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Veuger J, Kuipers NC, Willems SM, Halmos GB. Tumor Markers and Their Prognostic Value in Sinonasal ITAC/Non-ITAC. Cancers (Basel) 2023; 15:3201. [PMID: 37370810 DOI: 10.3390/cancers15123201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 06/08/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023] Open
Abstract
One of the rare tumor entities present in the nose and paranasal sinuses is sinonasal (non-) intestinal-type adenocarcinoma (ITAC/non-ITAC). Currently, surgery with postoperative radiotherapy is the cornerstone of the treatment of these tumors. Systemic treatment is usually applied in a palliative setting. The prognosis of these tumors is very diverse. Biomarkers that may have prognostic value in these rare malignancies could help clinicians in decision-making. A systematic search of the literature was performed using the PubMed database. All studies investigating the prognostic significance of biomarkers in paranasal sinus ITAC/non-ITAC were retrieved. The findings were categorized within the hallmarks of cancer, to gain an understanding of the functions of possible prognostic biomarkers in the development of ITAC/non-ITAC. There were twenty-one studies reporting on twenty-one possible biomarkers included in the review. The expression of Mucin antigen sialosyl-Tn, C-erbB-2 oncoprotein, TIMP3 methylation, TP53, VEGF, ANXA2, MUC1 and the mucinous histological subtype were found to have a significant negative effect on survival. None of the biomarkers were found to have a positive effect on prognosis. The hallmarks 'activating invasion and metastasis' and 'sustaining proliferative signaling' seem to play the largest role in sinonasal (non-)ITAC. It could be concluded that there are multiple biomarkers foreboding a negative prognosis for ITAC/non-ITAC patients.
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Affiliation(s)
- Julius Veuger
- Department of Otorhinolaryngology/Head and Neck Surgery, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The Netherlands
| | - Nona C Kuipers
- Department of Otorhinolaryngology/Head and Neck Surgery, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The Netherlands
- Department of Surgery, St. Antonius Hospital, 3543 AZ Utrecht, The Netherlands
| | - Stefan M Willems
- Department of Pathology, University Medical Center Groningen, University of Groningen, 9723 GZ Groningen, The Netherlands
| | - Gyorgy B Halmos
- Department of Otorhinolaryngology/Head and Neck Surgery, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The Netherlands
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Gedon J, Kessler M, Schmidt JM. Frontal sinus carcinoma in forty-one dogs (2001-2022). Vet Comp Oncol 2023; 21:231-239. [PMID: 36745079 DOI: 10.1111/vco.12880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 01/29/2023] [Accepted: 01/30/2023] [Indexed: 02/07/2023]
Abstract
Reports on canine frontal sinus carcinomas (FSCs) are scarce. This retrospective review of 41 dogs with FSC (2001-2022) describes demographic and clinical characteristics of canine FSC and reports the clinical experience and overall survival following treatment with toceranib phosphate (TOC) and meloxicam in 10 cases. Median age at diagnosis was 10.6 years (range: 6.5-15.4 years). There was a male-to-female-ratio of 2.4:1. The most common breeds were Jack Russell Terriers (JRT) (n = 7; 17.1%) and Rottweilers (n = 3, 7.3%). Mesocephalic breeds (70.6%) were most commonly affected, brachycephalics accounted for 8.8%. The most frequent clinical signs included skull deformation dorsomedial to the eye (87.5%), pain/head-shyness (40.0%), ocular (22.5%)/nasal (17.5%) discharge, and exophthalmos (17.5%). Duration of symptoms prior to diagnosis varied from a few days to 9 months. There were no neurological signs at initial presentation despite imaging evidence of osteolysis of the lamina interna of the frontal bone in most dogs (69.4%). In 11.5%, pulmonary changes suggestive of metastasis or concurrent primary pulmonary neoplasia were present. Tumour types included squamous cell carcinoma (58.5%), unspecified carcinoma (29.3%), and adenocarcinoma (9.8%). Ten dogs were treated with TOC (median 2.8 mg/kg EOD or three times per week) and meloxicam (0.1 mg/kg, EOD) (TOC-M), resulting in subjective regression of skull deformity in 8/10 (80.0%) patients. Overall median survival time with TOC-M was 183.5 days (range: 120-434 days). FSCs typically present with skull deformation, but no overt neurological signs. Male dogs and JRT may be overrepresented. The use of TOC-M in FSC appears promising and warrants further prospective evaluation.
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Affiliation(s)
- Julia Gedon
- Division of Oncology, Small Animal Clinic Hofheim, Hofheim, Germany
| | - Martin Kessler
- Division of Oncology, Small Animal Clinic Hofheim, Hofheim, Germany
| | - Jarno M Schmidt
- Division of Oncology, Small Animal Clinic Hofheim, Hofheim, Germany
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Lucidi D, Cantaffa C, Miglio M, Spina F, Alicandri Ciufelli M, Marchioni A, Marchioni D. Tumors of the Nose and Paranasal Sinuses: Promoting Factors and Molecular Mechanisms-A Systematic Review. Int J Mol Sci 2023; 24:ijms24032670. [PMID: 36768990 PMCID: PMC9916834 DOI: 10.3390/ijms24032670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/22/2023] [Accepted: 01/29/2023] [Indexed: 02/01/2023] Open
Abstract
Sinonasal neoplasms are uncommon diseases, characterized by heterogeneous biological behavior, which frequently results in challenges in differential diagnosis and treatment choice. The aim of this review was to examine the pathogenesis and molecular mechanisms underlying the regulation of tumor initiation and growth, in order to better define diagnostic and therapeutic strategies as well as the prognostic impact of these rare neoplasms. A systematic review according to Preferred Reporting Items for Systematic Review and Meta-Analysis criteria was conducted between September and November 2022. The authors considered the three main histological patterns of sinonasal tumors, namely Squamous Cell Carcinoma, Intestinal-Type Adenocarcinoma, and Olfactory Neuroblastoma. In total, 246 articles were eventually included in the analysis. The genetic and epigenetic changes underlying the oncogenic process were discussed, through a qualitative synthesis of the included studies. The identification of a comprehensive model of carcinogenesis for each sinonasal cancer subtype is needed, in order to pave the way toward tailored treatment approaches and improve survival for this rare and challenging group of cancers.
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Affiliation(s)
- Daniela Lucidi
- Department of Otolaryngology, Head and Neck Surgery, University Hospital of Modena, 41124 Modena, Italy
| | - Carla Cantaffa
- Department of Otolaryngology, Head and Neck Surgery, University Hospital of Modena, 41124 Modena, Italy
- Correspondence: ; Tel.: +39-3385313850; Fax: +39-0594222402
| | - Matteo Miglio
- Department of Otolaryngology, Head and Neck Surgery, University Hospital of Modena, 41124 Modena, Italy
| | - Federica Spina
- Department of Otolaryngology, Head and Neck Surgery, University Hospital of Modena, 41124 Modena, Italy
| | - Matteo Alicandri Ciufelli
- Department of Otolaryngology, Head and Neck Surgery, University Hospital of Modena, 41124 Modena, Italy
| | - Alessandro Marchioni
- Respiratory Diseases Unit, Department of Medical and Surgical Sciences, University Hospital of Modena, 41124 Modena, Italy
| | - Daniele Marchioni
- Department of Otolaryngology, Head and Neck Surgery, University Hospital of Modena, 41124 Modena, Italy
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Bi S, Li J, Wang T, Man F, Zhang P, Hou F, Wang H, Hao D. Multi-parametric MRI-based radiomics signature for preoperative prediction of Ki-67 proliferation status in sinonasal malignancies: a two-centre study. Eur Radiol 2022; 32:6933-6942. [PMID: 35687135 DOI: 10.1007/s00330-022-08780-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 03/18/2022] [Accepted: 03/26/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To assess the predictive ability of a multi-parametric MRI-based radiomics signature (RS) for the preoperative evaluation of Ki-67 proliferation status in sinonasal malignancies. METHODS A total of 128 patients with sinonasal malignancies that underwent multi-parametric MRIs at two medical centres were retrospectively analysed. Data from one medical centre (n = 77) were used to develop the predictive models and data from the other medical centre (n = 51) constitute the test dataset. Clinical data and conventional MRI findings were reviewed to identify significant predictors. Radiomics features were determined using maximum relevance minimum redundancy and least absolute shrinkage and selection operator algorithms. Subsequently, RSs were established using a logistic regression (LR) algorithm. The predictive performance of RSs was assessed using calibration, decision curve analysis (DCA), accuracy, and AUC. RESULTS No independent predictors of high Ki-67 proliferation were observed based on clinical data and conventional MRI findings. RS-T1, RS-T2, and RS-T1c (contrast enhancement T1WI) were established based on a single-parametric MRI. RS-Combined (combining T1WI, FS-T2WI, and T1c features) was developed based on multi-parametric MRI and achieved an AUC and accuracy of 0.852 (0.733-0.971) and 86.3%, respectively, on the test dataset. The calibration curve and DCA demonstrated an improved fitness and benefits in clinical practice. CONCLUSIONS A multi-parametric MRI-based RS may be used as a non-invasive, dependable, and accurate tool for preoperative evaluation of the Ki-67 proliferation status to overcome the sampling bias in sinonasal malignancies. KEY POINTS • Multi-parametric MRI-based radiomics signatures (RSs) are used to preoperatively evaluate the proliferation status of Ki-67 in sinonasal malignancies. • Radiomics features are determined using maximum relevance minimum redundancy (mRMR) and least absolute shrinkage and selection operator (LASSO) algorithms. • RSs are established using a logistic regression (LR) algorithm.
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Affiliation(s)
- Shucheng Bi
- The Department of Radiology, The Affiliated Hospital of Qingdao University, 16, Jiangsu Road, Qingdao, 266003, China
| | - Jie Li
- The Department of Radiology, The Affiliated Hospital of Qingdao University, 16, Jiangsu Road, Qingdao, 266003, China
| | - Tongyu Wang
- The Department of Radiology, The Affiliated Hospital of Qingdao University, 16, Jiangsu Road, Qingdao, 266003, China
| | - Fengyuan Man
- The Department of Radiology, The PLA Rocket Force Characteristic Medical Center, Beijing, 100088, China
| | - Peng Zhang
- The Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China
| | - Feng Hou
- The Department of Pathology, The Affiliated Hospital of Qingdao University, Qingdao, 266003, China
| | - Hexiang Wang
- The Department of Radiology, The Affiliated Hospital of Qingdao University, 16, Jiangsu Road, Qingdao, 266003, China.
| | - Dapeng Hao
- The Department of Radiology, The Affiliated Hospital of Qingdao University, 16, Jiangsu Road, Qingdao, 266003, China.
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Wang P, Tang Z, Xiao Z, Hong R, Wang R, Wang Y, Zhan Y. Dual-energy CT in differentiating benign sinonasal lesions from malignant ones: comparison with simulated single-energy CT, conventional MRI, and DWI. Eur Radiol 2021; 32:1095-1105. [PMID: 34427744 DOI: 10.1007/s00330-021-08159-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 06/11/2021] [Accepted: 06/15/2021] [Indexed: 12/21/2022]
Abstract
OBJECTIVES To explore the value of dual-energy CT (DECT) for differentiating benign sinonasal lesions from malignant ones, and to compare this finding with simulated single-energy CT (SECT), conventional MRI (cMRI), and diffusion-weighted imaging (DWI). METHODS Patients with sinonasal lesions (38 benign and 34 malignant) who were confirmed by histopathology underwent DECT, cMRI, and DWI. DECT-derived parameters (iodine concentration (IC), effective atomic number (Eff-Z), 40-180 keV (20-keV interval), virtual non-enhancement (VNC), slope (k), and linear-mixed 0.3 (Mix-0.3)), DECT morphological features, cMRI characteristics, and ADC value of benign and malignant tumors were compared using t test or chi-square test. Receiver operating characteristic (ROC) curve was performed to evaluate the diagnostic performance, and the area under the ROC curve (AUC) was compared using the Z test to select the optimal diagnostic approach. RESULTS Significantly higher DECT-derived single parameters (IC, Eff-Z, 40 keV, 60 keV, 80 keV, slope (k), Mix-0.3) were found in malignant lesions than those of benign sinonasal lesions (all p < 0.004, Bonferroni correction). Combined quantitative parameters (IC, Eff-Z, 40 keV, 60 keV, 80 keV, slope (k)) can improve the diagnostic efficiency for discriminating these two entities. Combination of DECT quantitative parameters and morphological features can further improve the overall diagnostic performance, with AUC, sensitivity, specificity, and accuracy of 0.935, 96.67%, 90.00%, and 93.52%. Moreover, the AUC of DECT was higher than those of Mix-0.3 (simulated SECT), cMRI, DWI, and cMRI+DWI. CONCLUSIONS Compared with simulated SECT, cMRI, and DWI, DECT appears to be a more accurate imaging technique for differentiating benign from malignant sinonasal lesions. KEY POINTS • DE can differentiate benign sinonasal lesions from malignant ones based on DECT-derived qualitative parameters. • DECT appears to be more accurate in the diagnosis of sinonasal lesions when compared with simulated SECT, cMRI, and DWI.
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Affiliation(s)
- Peng Wang
- Department of Radiology, Eye & ENT Hospital of Shanghai Medical School, Fudan University, 83 Fenyang Road, Shanghai, 200031, People's Republic of China.,Department of Radiology, The Affiliated Renmin Hospital of Jiangsu University, Zhenjiang, Jiangsu, 212002, People's Republic of China
| | - Zuohua Tang
- Department of Radiology, Eye & ENT Hospital of Shanghai Medical School, Fudan University, 83 Fenyang Road, Shanghai, 200031, People's Republic of China.
| | - Zebin Xiao
- Department of Radiology, Eye & ENT Hospital of Shanghai Medical School, Fudan University, 83 Fenyang Road, Shanghai, 200031, People's Republic of China.,Department of Biomedical Sciences, University of Pennsylvania, Philadelphia, 19104, USA
| | - Rujian Hong
- Department of Radiology, Eye & ENT Hospital of Shanghai Medical School, Fudan University, 83 Fenyang Road, Shanghai, 200031, People's Republic of China
| | - Rong Wang
- The Shanghai Institution of Medical Imaging, Zhongshan Hospital, Fudan University, Shanghai, 200032, People's Republic of China
| | - Yuzhe Wang
- Department of Radiology, Eye & ENT Hospital of Shanghai Medical School, Fudan University, 83 Fenyang Road, Shanghai, 200031, People's Republic of China
| | - Yang Zhan
- The Shanghai Institution of Medical Imaging, Zhongshan Hospital, Fudan University, Shanghai, 200032, People's Republic of China
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9
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Wu W, Jiang G, Xu Z, Wang R, Pan A, Gao M, Yu T, Huang L, Quan Q, Li J. Three-dimensional pulsed continuous arterial spin labeling and intravoxel incoherent motion imaging of nasopharyngeal carcinoma: correlations with Ki-67 proliferation status. Quant Imaging Med Surg 2021; 11:1394-1405. [PMID: 33816177 PMCID: PMC7930700 DOI: 10.21037/qims-20-349] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 11/05/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND Recurrence and distant metastasis are still the main problems affecting the long-term prognosis of nasopharyngeal carcinoma (NPC) patients, and may be related to the Ki-67 proliferation status. We therefore explored the potential correlation between Ki-67 proliferation status in NPC with the parameters derived from two imaging techniques: three-dimensional pulsed continuous arterial spin labeling (3D pCASL) and intravoxel incoherent motion (IVIM). METHODS Thirty-six patients with pathologically confirmed NPC were included, and the Ki-67 labeling index (LI) was measured by immunohistochemistry. All patients underwent plain and contrast-enhanced magnetic resonance imaging (MRI), IVIM, and 3D pCASL examination. The mean, maximum, and minimum of blood flow (BF), minimum of apparent diffusion coefficient (ADC), pure diffusion coefficient (D), pseudodiffusion coefficient (D*), and perfusion fraction (f) parameters were all measured, and Spearman's correlation analysis was performed to evaluate the relationships between these parameters and the Ki-67 LI. According to the Ki-67 values, the patients were divided into two groups: high (>50%) and low (≤50%). The rank-sum test (Mann-Whitney U test) was then used to compare the differences in quantitative parameters between the high and low Ki-67 groups. RESULTS Ki-67 LI was positively correlated with BFmean and BFmax (r=0.415 and 0.425). D*mean and D*min did have positive correlation with Ki-67, but this was not significant (P=0.082 and 0.072). BFmax was significantly different between the high and low Ki-67 groups (P=0.028). CONCLUSIONS 3D pCASL and IVIM are noninvasive functional MR perfusion imaging techniques that can evaluate perfusion information and perfusion parameters. Our study suggests that 3D pCASL is more effective than IVIM for assessing the proliferation status of NPC, which is beneficial for evaluating the prognosis of patients. Furthermore, BFmax is the best biomarker for distinguishing high from low Ki-67 levels.
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Affiliation(s)
- Wenxiu Wu
- Department of Radiology, The First People’s Hospital of Foshan, Foshan, China
| | - Guihua Jiang
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Zhifeng Xu
- Department of Radiology, The First People’s Hospital of Foshan, Foshan, China
| | - Ruoning Wang
- Minimally Invasive Center, Tumor hospital, Sun Yat-Sen University, Guangzhou, China
| | - Aizhen Pan
- Department of Radiology, The First People’s Hospital of Foshan, Foshan, China
| | - Mingyong Gao
- Department of Radiology, The First People’s Hospital of Foshan, Foshan, China
| | - Tian Yu
- Department of Radiology, The First People’s Hospital of Foshan, Foshan, China
| | - Linwen Huang
- Department of Radiology, The First People’s Hospital of Foshan, Foshan, China
| | - Qiang Quan
- Nasopharyngeal Radiotherapy Department 2, The First People’s Hospital of Foshan, Foshan, China
| | - Jin Li
- Pathology Department, The First People’s Hospital of Foshan, Foshan, China
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Xiao Z, Tang Z, Zhang J, Yang G, Zeng W, Luo J, Song Y, Zhang Z. Whole-tumor histogram analysis of monoexponential and advanced diffusion-weighted imaging for sinonasal malignant tumors: Correlations with histopathologic features. J Magn Reson Imaging 2019; 51:273-285. [PMID: 31271488 DOI: 10.1002/jmri.26857] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 06/21/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The histopathological basis of monoexponential diffusion-weighted imaging (DWI), intravoxel incoherent motion (IVIM), and diffusion kurtosis imaging (DKI) in the characterization of sinonasal malignant tumors is still unclear. PURPOSE To explore the correlations of histogram metrics from monoexponential DWI, IVIM, and DKI with histopathologic features in sinonasal malignant tumors. STUDY TYPE Retrospective. SUBJECTS In all, 76 patients with sinonasal malignant tumors. FIELD STRENGTH/SEQUENCE Fourteen different b values (b = 0, 50, 100, 150, 200, 250, 300, 350, 400, 800, 1000, 1500, 2000, and 2500 sec/mm2 ) were used to perform different DWI models at 3.0T. ASSESSMENT The whole-tumor histogram metrics were calculated on the apparent diffusion coefficient (ADC), pure diffusion coefficient (D), pseudodiffusion coefficient (D*), perfusion fraction (f), diffusion kurtosis (K), and diffusion coefficient (Dk) maps. Histopathologic features, including nuclear, cytoplasmic, cellular, stromal fractions, and the nuclear-to-cytoplasmic (N/C) ratio, were measured. STATISTICAL TESTS Spearman correlations and stepwise multiple linear regression analyses were performed to determine the correlations between histogram metrics and histopathologic features. RESULTS ADC, Dk, and f histogram metrics showed significant correlations with investigated histopathologic features; D and K histogram metrics were significantly correlated with cellular, stromal, and nuclear fractions (all P < 0.05). Significant correlations between the 75th percentile of D and cytoplasmic fraction and between the kurtosis of K and the N/C ratio were observed (P < 0.05). The skewness of Dk, K, and the 75th percentile of D were independently associated with cellular and nuclear fractions; the skewness of Dk and K were independently associated with stromal fraction (P < 0.05). DATA CONCLUSION Monoexponential and advanced DWI histogram parameters were significantly correlated with histopathologic features in sinonasal malignancies. LEVEL OF EVIDENCE 3 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2020;51:273-285.
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Affiliation(s)
- Zebin Xiao
- Department of Radiology, Eye & ENT Hospital of Shanghai Medical School, Fudan University, Shanghai, P.R. China
| | - Zuohua Tang
- Department of Radiology, Eye & ENT Hospital of Shanghai Medical School, Fudan University, Shanghai, P.R. China
| | - Jing Zhang
- Shanghai Key Laboratory of Magnetic Resonance, East China Normal University, Shanghai, P.R. China
| | - Guang Yang
- Shanghai Key Laboratory of Magnetic Resonance, East China Normal University, Shanghai, P.R. China
| | - Wenjiao Zeng
- Department of Pathology, School of Basic Medical Sciences, Fudan University, Shanghai, P.R. China
| | - Jianfeng Luo
- Department of Biostatistics, School of Public Health, Fudan University, Shanghai, P.R. China
| | - Yang Song
- Shanghai Key Laboratory of Magnetic Resonance, East China Normal University, Shanghai, P.R. China
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Xiao Z, Zhong Y, Tang Z, Qiang J, Qian W, Wang R, Wang J, Wu L, Tang W, Zhang Z. Standard diffusion-weighted, diffusion kurtosis and intravoxel incoherent motion MR imaging of sinonasal malignancies: correlations with Ki-67 proliferation status. Eur Radiol 2018; 28:2923-2933. [PMID: 29383521 DOI: 10.1007/s00330-017-5286-x] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2017] [Revised: 12/11/2017] [Accepted: 12/22/2017] [Indexed: 01/12/2023]
Abstract
OBJECTIVES To explore the correlations of parameters derived from standard diffusion-weighted imaging (DWI), diffusion kurtosis imaging (DKI) and intravoxel incoherent motion (IVIM) with the Ki-67 proliferation status. METHODS Seventy-five patients with histologically proven sinonasal malignancies who underwent standard DWI, DKI and IVIM were retrospectively reviewed. The mean, minimum, maximum and whole standard DWI [apparent diffusion coefficient (ADC)], DKI [diffusion kurtosis (K) and diffusion coefficient (Dk)] and IVIM [pure diffusion coefficient (D), pseudo-diffusion coefficient (D*) and perfusion fraction (f)] parameters were measured and correlated with the Ki-67 labelling index (LI). The Ki-67 LI was categorised as high (> 50%) or low (≤ 50%). RESULTS The K and f values were positively correlated with the Ki-67 LI (rho = 0.295~0.532), whereas the ADC, Dk and D values were negatively correlated with the Ki-67 LI (rho = -0.443~-0.277). The ADC, Dk and D values were lower, whereas the K value was higher in sinonasal malignancies with a high Ki-67 LI than in those in a low Ki-67 LI (all p < 0.05). A higher maximum K value (Kmax > 0.977) independently predicted a high Ki-67 status [odds ratio (OR) = 7.614; 95% confidence interval (CI) = 2.197-38.674; p = 0.017]. CONCLUSION ADC, Dk, K, D and f are correlated with Ki-67 LI. Kmax is the strongest independent factor for predicting Ki-67 status. KEY POINTS • DWI-derived parameters from different models are capable of providing different pathophysiological information. • DWI, DKI and IVIM parameters are associated with Ki-67 proliferation status. • K max derived from DKI is the strongest independent factor for the prediction of Ki-67 proliferation status.
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Affiliation(s)
- Zebin Xiao
- Department of Radiology, Eye & ENT Hospital of Shanghai Medical School, Fudan University, 83 Fenyang Road, Shanghai, 200031, People's Republic of China
| | - Yufeng Zhong
- Department of Radiology, Eye & ENT Hospital of Shanghai Medical School, Fudan University, 83 Fenyang Road, Shanghai, 200031, People's Republic of China.,Department of Radiology, Jinshan Hospital of Shanghai Medical School, Fudan University, 1508 Longhang Road, Shanghai, 201508, People's Republic of China
| | - Zuohua Tang
- Department of Radiology, Eye & ENT Hospital of Shanghai Medical School, Fudan University, 83 Fenyang Road, Shanghai, 200031, People's Republic of China.
| | - Jinwei Qiang
- Department of Radiology, Jinshan Hospital of Shanghai Medical School, Fudan University, 1508 Longhang Road, Shanghai, 201508, People's Republic of China.
| | - Wen Qian
- Department of Radiology, Eye & ENT Hospital of Shanghai Medical School, Fudan University, 83 Fenyang Road, Shanghai, 200031, People's Republic of China
| | - Rong Wang
- Department of Radiology, Eye & ENT Hospital of Shanghai Medical School, Fudan University, 83 Fenyang Road, Shanghai, 200031, People's Republic of China
| | - Jie Wang
- Department of Radiotherapy, Eye & ENT Hospital of Shanghai Medical School, Fudan University, Shanghai, 200031, China
| | - Lingjie Wu
- Department of Otolaryngology, Eye & ENT Hospital of Shanghai Medical School, Fudan University, Shanghai, 200031, China
| | - Wenlin Tang
- Siemens Healthcare Ltd., Shanghai, 201318, People's Republic of China
| | - Zhongshuai Zhang
- Siemens Healthcare Ltd., Shanghai, 201318, People's Republic of China
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Jiang J, Xiao Z, Tang Z, Zhong Y, Qiang J. Differentiating between benign and malignant sinonasal lesions using dynamic contrast-enhanced MRI and intravoxel incoherent motion. Eur J Radiol 2017; 98:7-13. [PMID: 29279173 DOI: 10.1016/j.ejrad.2017.10.028] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 10/04/2017] [Accepted: 10/29/2017] [Indexed: 11/30/2022]
Abstract
PURPOSE To explore the value of dynamic contrast-enhanced MRI (DCE-MRI) and intravoxel incoherent motion (IVIM) for distinguishing between benign and malignant sinonasal lesions and investigate the correlations between the two methods. METHODS AND MATERIALS Patients with sinonasal lesions (42 benign and 31 malignant) who underwent DCE-MRI and IVIM before confirmation by histopathology were enrolled in this prospective study. Parameters derived from DCE-MRI and IVIM were measured, the optimal cut-off values for differential diagnosis were determined, and the correlations between the two methods were evaluated. Statistical analyses were performed using the Wilcoxon rank sum test, receiver operating characteristic (ROC) curve analysis, and Spearman's rank correlation. RESULTS Significantly higher Ktrans and Kep values but lower D and f values were found in malignant lesions than in benign lesions (all p<0.001). There were no significant differences in the Ve and D* values between the two groups. The area under the curve (AUC) of Ktrans was significantly higher than those of other parameters. There was no significant difference between the AUCs of DCE-MRI and IVIM with parameters combined (p=0.86). Significant inverse but weak correlations were found between D and Ktrans (r=-0.46, p<0.001), f and Ktrans (r=-0.41, p<0.001), D and Kep (r=-0.37, p=0.008), and f and Kep (r=-0.33, p=0.004). CONCLUSIONS DCE-MRI and IVIM can effectively differentiate between benign and malignant sinonasal lesions. IVIM findings correlate with DCE-MRI results and may represent an alternative to DCE-MRI.
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Affiliation(s)
- Jingxuan Jiang
- Department of Radiology, Jinshan Hospital, Fudan University, Shanghai 201508, China; Department of Radiology, Eye and ENT Hospital, Fudan University, Shanghai 200031, China; Department of Radiology, Affiliated Hospital of Nantong University, Nantong 226001, China
| | - Zebin Xiao
- Department of Radiology, Eye and ENT Hospital, Fudan University, Shanghai 200031, China
| | - Zuohua Tang
- Department of Radiology, Eye and ENT Hospital, Fudan University, Shanghai 200031, China.
| | - Yufeng Zhong
- Department of Radiology, Jinshan Hospital, Fudan University, Shanghai 201508, China; Department of Radiology, Eye and ENT Hospital, Fudan University, Shanghai 200031, China
| | - Jinwei Qiang
- Department of Radiology, Jinshan Hospital, Fudan University, Shanghai 201508, China.
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Merlin S, Cannizzo ES, Borroni E, Bruscaggin V, Schinco P, Tulalamba W, Chuah MK, Arruda VR, VandenDriessche T, Prat M, Valente G, Follenzi A. A Novel Platform for Immune Tolerance Induction in Hemophilia A Mice. Mol Ther 2017; 25:1815-1830. [PMID: 28552407 DOI: 10.1016/j.ymthe.2017.04.029] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Revised: 04/27/2017] [Accepted: 04/28/2017] [Indexed: 12/14/2022] Open
Abstract
Hemophilia A (HA) is an X-linked bleeding disease caused by factor VIII (FVIII) deficiency. We previously demonstrated that FVIII is produced specifically in liver sinusoid endothelial cells (LSECs) and to some degree in myeloid cells, and thus, in the present work, we seek to restrict the expression of FVIII transgene to these cells using cell-specific promoters. With this approach, we aim to limit immune response in a mouse model by lentiviral vector (LV)-mediated gene therapy encoding FVIII. To increase the target specificity of FVIII expression, we included miRNA target sequences (miRTs) (i.e., miRT-142.3p, miRT-126, and miRT-122) to silence expression in hematopoietic cells, endothelial cells, and hepatocytes, respectively. Notably, we report, for the first time, therapeutic levels of FVIII transgene expression at its natural site of production, which occurred without the formation of neutralizing antibodies (inhibitors). Moreover, inhibitors were eradicated in FVIII pre-immune mice through a regulatory T cell-dependent mechanism. In conclusion, targeting FVIII expression to LSECs and myeloid cells by using LVs with cell-specific promoter minimized off-target expression and immune responses. Therefore, at least for some transgenes, expression at the physiologic site of synthesis can enhance efficacy and safety, resulting in long-term correction of genetic diseases such as HA.
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Affiliation(s)
- Simone Merlin
- Department of Health Sciences, Università del Piemonte Orientale "A. Avogadro", 28100 Novara, Italy
| | - Elvira Stefania Cannizzo
- Department of Health Sciences, Università del Piemonte Orientale "A. Avogadro", 28100 Novara, Italy
| | - Ester Borroni
- Department of Health Sciences, Università del Piemonte Orientale "A. Avogadro", 28100 Novara, Italy
| | - Valentina Bruscaggin
- Department of Health Sciences, Università del Piemonte Orientale "A. Avogadro", 28100 Novara, Italy
| | - Piercarla Schinco
- Azienda Ospedaliera Universitaria Città della Salute e della Scienza, 10126 Torino, Italy
| | - Warut Tulalamba
- Department of Gene Therapy & Regenerative Medicine, Free University of Brussels, 1050 Brussels, Belgium; Department of Cardiovascular Sciences, KU Leuven, 3000 Leuven, Belgium
| | - Marinee K Chuah
- Department of Gene Therapy & Regenerative Medicine, Free University of Brussels, 1050 Brussels, Belgium; Department of Cardiovascular Sciences, KU Leuven, 3000 Leuven, Belgium
| | - Valder R Arruda
- The Children's Hospital of Philadelphia, Perelman School of Medicine at University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Thierry VandenDriessche
- Department of Gene Therapy & Regenerative Medicine, Free University of Brussels, 1050 Brussels, Belgium; Department of Cardiovascular Sciences, KU Leuven, 3000 Leuven, Belgium
| | - Maria Prat
- Department of Health Sciences, Università del Piemonte Orientale "A. Avogadro", 28100 Novara, Italy
| | - Guido Valente
- Department of Translational Medicine, Università del Piemonte Orientale "A. Avogadro", 28100 Novara, Italy
| | - Antonia Follenzi
- Department of Health Sciences, Università del Piemonte Orientale "A. Avogadro", 28100 Novara, Italy.
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Grosjean R, Gallet P, Baumann C, Jankowski R. Transfacial versus endoscopic approach in the treatment of woodworker's nasal adenocarcinomas. Head Neck 2014; 37:347-56. [PMID: 24415438 DOI: 10.1002/hed.23601] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2013] [Revised: 10/14/2013] [Accepted: 01/07/2014] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND The purpose of this study was to present a monocentric retrospective study designed to compare oncologic results and morbidity between transfacial surgery and endoscopic endonasal surgery for nasal adenocarcinomas. METHODS Between 1998 and 2003, 31 patients were operated on via transfacial surgery, and between 2004 and 2009, 43 patients were operated on via endoscopic endonasal surgery. Overall and specific survival, local control, and morbidity (length of hospitalization, intensive care unit [ICU] monitoring, need for nasal packing, and complications) were compared. RESULTS There was no difference in prognostic factors between groups, but the median age was significantly higher for endoscopic endonasal surgery. Three-year overall survival, specific survival, and local control were not different between groups (respectively, 76.7%, 86%, and 81.4% for endoscopic endonasal surgery vs 61.3%, 67.7%, and 71% for transfacial surgery). Morbidity was significantly lower with endoscopic endonasal surgery for all criteria. CONCLUSION Endoscopic surgery may replace transfacial surgery in the treatment of woodworker's adenocarcinomas. Older patients can be operated on by decreasing morbidity and mortality with at least similar oncologic results.
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Affiliation(s)
- Rémy Grosjean
- Head and Neck Surgery, CHU, de Nancy-Hôpital Central, Nancy, France; University of Lorraine, Nancy, France
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15
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Antognoni P, Turri-Zanoni M, Gottardo S, Molteni M, Volpi L, Facco C, Freguia S, Mordacchini C, AlQahtani A, Bignami M, Capella C, Castelnuovo P. Endoscopic resection followed by adjuvant radiotherapy for sinonasal intestinal-type adenocarcinoma: Retrospective analysis of 30 consecutive patients. Head Neck 2014; 37:677-84. [DOI: 10.1002/hed.23660] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2013] [Revised: 11/25/2013] [Accepted: 03/01/2014] [Indexed: 11/10/2022] Open
Affiliation(s)
- Paolo Antognoni
- Department of Radiotherapy; Ospedale di Circolo e Fondazione Macchi; Varese Italy
| | - Mario Turri-Zanoni
- Department of Otorhinolaryngology, Ospedale di Circolo e Fondazione Macchi; University of Insubria; Varese Italy
| | - Stefania Gottardo
- Department of Radiotherapy; Ospedale di Circolo e Fondazione Macchi; Varese Italy
| | - Marinella Molteni
- Department of Radiotherapy; Ospedale di Circolo e Fondazione Macchi; Varese Italy
| | - Luca Volpi
- Department of Otorhinolaryngology, Ospedale di Circolo e Fondazione Macchi; University of Insubria; Varese Italy
| | - Carla Facco
- Department of Pathology, Ospedale di Circolo e Fondazione Macchi; University of Insubria; Varese Italy
| | - Stefania Freguia
- Department of Pathology, Ospedale di Circolo e Fondazione Macchi; University of Insubria; Varese Italy
| | - Cinzia Mordacchini
- Department of Medical Physics, Ospedale di Circolo e Fondazione Macchi; University of Insubria; Varese Italy
| | - Abdulaziz AlQahtani
- Department of Otorhinolaryngology, Ospedale di Circolo e Fondazione Macchi; University of Insubria; Varese Italy
| | - Maurizio Bignami
- Department of Otorhinolaryngology, Ospedale di Circolo e Fondazione Macchi; University of Insubria; Varese Italy
| | - Carlo Capella
- Department of Pathology, Ospedale di Circolo e Fondazione Macchi; University of Insubria; Varese Italy
| | - Paolo Castelnuovo
- Department of Otorhinolaryngology, Ospedale di Circolo e Fondazione Macchi; University of Insubria; Varese Italy
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Recommandations pour la surveillance médicoprofessionnelle des travailleurs exposés à l’effet cancérigène des poussières de bois. ARCH MAL PROF ENVIRO 2011. [DOI: 10.1016/j.admp.2011.02.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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17
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de Gabory L, Maunoury A, Maurice-Tison S, Merza Abdulkhaleq H, Darrouzet V, Bébéar JP, Stoll D. Long-Term Single-Center Results of Management of Ethmoid Adenocarcinoma: 95 Patients over 28 Years. Ann Surg Oncol 2010; 17:1127-34. [DOI: 10.1245/s10434-010-0933-3] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2009] [Indexed: 11/18/2022]
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18
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Gontero P, Ceratti G, Guglielmetti S, Andorno A, Terrone C, Bonvini D, Faggiano F, Tizzani A, Frea B, Valente G. Prognostic factors in a prospective series of papillary renal cell carcinoma. BJU Int 2008; 102:697-702. [PMID: 18489525 DOI: 10.1111/j.1464-410x.2008.07756.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
OBJECTIVE To prospectively assess the clinical outcome of a series of papillary renal cell carcinomas (PRCCs) to identify possible prognostic clinical variables and tumour markers, as previous retrospective series of PRCC do not provide unanimous results on the prognostic utility of clinicopathological variables. PATIENTS AND METHODS Forty-six patients with PRCC (median follow-up 40 months) diagnosed in one institution from 1989 to 2002 were prospectively followed until May 2006. The pathology was reviewed, the PRCC subtyped (type 1 and 2) and immunohistochemistry assessed for MIB-1, vascular endothelial growth factor (VEGF), CD31 and c-met oncogenic protein, by a referee pathologist. Prognostic values were estimated by fitting a Cox model. RESULTS The 5-year survival rate was 49.5%; type 2 histology was predominant and was almost significant in the univariate analysis. Stage and MIB-1 were significant prognostic factors only in the univariate model, while the Cox model identified only the Fuhrman grade as an independent predictor of survival (hazard ratio 3.054; P = 0.007). MET expression, CD31 and VEGF had no prognostic utility. CONCLUSION These patients with PRCC followed prospectively fared worse than in previously reported series. The Fuhrman grade was the sole independent predictor of survival.
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Affiliation(s)
- Paolo Gontero
- Dipartimento di Discipline Medico Chirurgiche, Clinica Urologica, University of Torino, Torino, Italy.
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Moon EJ, Brizel DM, Chi JTA, Dewhirst MW. The potential role of intrinsic hypoxia markers as prognostic variables in cancer. Antioxid Redox Signal 2007; 9:1237-94. [PMID: 17571959 DOI: 10.1089/ars.2007.1623] [Citation(s) in RCA: 70] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Tumor hypoxia is related to tumor progression and therapy resistance, which leads to poor patient outcome. It has been suggested that measuring the hypoxic status of a tumor helps to predict patient outcome and to select more targeted treatment. However, current methods using needle electrodes or exogenous markers have limitations due to their invasiveness or necessity for preinjection. Recent studies showed that hypoxia-regulated genes could be alternatively used as endogenous hypoxia markers. This is a review of 15 hypoxia-regulated genes, including hypoxia-inducible factor-1 and its targets, and their correlation with tumor hypoxia and patient outcome from 213 studies. Though most of the studies showed significance of these genes in predicting prognosis, there was no definitive prognostic and hypoxia marker. In conclusion, this review suggests the need for further studies with standardized methods to examine gene expression, as well as the use of multiple gene expressions.
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Affiliation(s)
- Eui Jung Moon
- Department of Pathology, Duke University Medical Center, Durham, North Carolina 27710, USA
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20
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Steurer M, Zoller H, Augustin F, Fong D, Heiss S, Strasser-Weippl K, Gastl G, Tzankov A. Increased angiogenesis in chronic idiopathic myelofibrosis: vascular endothelial growth factor as a prominent angiogenic factor. Hum Pathol 2007; 38:1057-1064. [PMID: 17442379 DOI: 10.1016/j.humpath.2006.12.011] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2006] [Revised: 11/18/2006] [Accepted: 12/12/2006] [Indexed: 11/26/2022]
Abstract
Increased angiogenesis has been suggested to be implicated in the pathogenesis of chronic idiopathic myelofibrosis (CIMF). We hypothesized that vascular endothelial growth factor (VEGF) drives CIMF-associated angiogenesis, and thus, we aimed to determine its expression and biologic impact in newly diagnosed patients. All patients with CIMF diagnosed between 1990 and 2001, for whom adequate bone marrow specimens and clinical data were available, were deemed eligible. Each case was reclassified according to World Health Organization criteria. Microvessel density (MVD), as assessed by CD34 staining, and VEGF expression were examined by standard immunohistochemistry on paraffin-embedded trephine bone marrow biopsy specimens. The cytogenetic phenotype was determined by fluorescence in situ hybridization. Appropriate summary statistics were used for comparisons between groups; survival was calculated using Kaplan-Meier estimates. Parameters found to be of prognostic significance in univariate analysis were verified in a multivariate Cox regression model. Fifty-five patients with CIMF were investigated. With a median of 43 vascular lumina per 0.747 mm(2), patients with CIMF displayed significantly greater MVD than did age-matched controls (n = 10; median MVD, 19; P < .001) with equal distribution between the various fibrosis stages. Moreover, VEGF expression was significantly increased in CIMF (median, 12 cells/0.747 mm(2) versus 1.4 cells/0.747 mm(2); P = .01) and correlated with MVD (P = .001). However, neither MVD nor VEGF expression correlated with cytogenetics or clinical outcome. We conclude that in CIMF, increased MVD is detectable even in early (pre-)fibrotic stages. Moreover, we found significantly elevated VEGF expression correlating with MVD, thus suggesting VEGF to play a prominent angiogenic role and representing a novel potential therapeutic target in CIMF.
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Affiliation(s)
- Michael Steurer
- Division of Haematology and Oncology, Innsbruck Medical University, A-6020 Innsbruck, Austria.
| | - Heinz Zoller
- Division of Gastroenterology and Hepatology, Innsbruck Medical University, A-6020 Innsbruck, Austria
| | - Florian Augustin
- Division of Haematology and Oncology, Innsbruck Medical University, A-6020 Innsbruck, Austria
| | - Dominic Fong
- Division of Haematology and Oncology, Innsbruck Medical University, A-6020 Innsbruck, Austria
| | - Simone Heiss
- Department of Pathology, Innsbruck Medical University, A-6020 Innsbruck, Austria
| | - Kathrin Strasser-Weippl
- First Medical Department with Medical Oncology, Wilhelminen Hospital, A-1160 Vienna, Austria
| | - Guenther Gastl
- Division of Haematology and Oncology, Innsbruck Medical University, A-6020 Innsbruck, Austria
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