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Qian BS, Jia HM, Weng YB, Li XC, Chen CD, Guo FX, Han YZ, Huang LF, Zheng Y, Li WX. Analysis of urinary C-C motif chemokine ligand 14 (CCL14) and first-generation urinary biomarkers for predicting renal recovery from acute kidney injury: a prospective exploratory study. J Intensive Care 2023; 11:11. [PMID: 36941674 PMCID: PMC10026399 DOI: 10.1186/s40560-023-00659-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 03/07/2023] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND Acute kidney injury (AKI) is a frequent syndrome in the intensive care unit (ICU). AKI patients with kidney function recovery have better short-term and long-term prognoses compared with those with non-recovery. Numerous studies focus on biomarkers to distinguish them. To better understand the predictive performance of urinary biomarkers of renal recovery in patients with AKI, we evaluated C-C motif chemokine ligand 14 (CCL14) and two first-generation biomarkers (cell cycle arrest biomarkers and neutrophil gelatinase-associated lipocalin) in two ICU settings. METHODS We performed a prospective study to analyze urinary biomarkers for predicting renal recovery from AKI. Patients who developed AKI after ICU admission were enrolled and urinary biomarkers including tissue inhibitor of metalloproteinase-2 (TIMP-2), insulin-like growth factor-binding protein 7 (IGFBP7), CCL14, and neutrophil gelatinase-associated lipocalin (NGAL) were detected on the day of AKI diagnosis. The primary endpoint was non-recovery from AKI within 7 days. The individual discriminative ability of CCL14, [TIMP-2] × [IGFBP7] and NGAL to predict renal non-recovery were evaluated by the area under receiver operating characteristics curve (AUC). RESULTS Of 164 AKI patients, 64 (39.0%) failed to recover from AKI onset. CCL14 showed a fair prediction ability for renal non-recovery with an AUC of 0.71 (95% CI 0.63-0.77, p < 0.001). [TIMP-2] × [IGFBP7] showed the best prediction for renal non-recovery with an AUC of 0.78 (95% CI 0.71-0.84, p < 0.001). However, NGAL had no use in predicting non-recovery with an AUC of 0.53 (95% CI 0.45-0.60, p = 0.562). A two-parameter model (non-renal SOFA score and AKI stage) predicted renal non-recovery with an AUC of 0.77 (95% CI 0.77-0.83, p = 0.004). When [TIMP-2] × [IGFBP7] was combined with the clinical factors, the AUC was significantly improved to 0.82 (95% CI 0.74-0.87, p = 0.049). CONCLUSIONS Urinary CCL14 and [TIMP-2] × [IGFBP7] were fair predictors of renal non-recovery from AKI. Combing urinary [TIMP-2] × [IGFBP7] with a clinical model consisting of non-renal SOFA score and AKI stage enhanced the predictive power for renal non-recovery. Urinary CCL14 showed no significant advantage in predicting renal non-recovery compared to [TIMP-2] × [IGFBP7].
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Affiliation(s)
- Ben-Shu Qian
- Department of Surgical Intensive Critical Unit, Beijing Chao-Yang Hospital, Capital Medical University, 8 Gongren Tiyuchang Nanlu, Chaoyang District, Beijing, 100020, China
| | - Hui-Miao Jia
- Department of Surgical Intensive Critical Unit, Beijing Chao-Yang Hospital, Capital Medical University, 8 Gongren Tiyuchang Nanlu, Chaoyang District, Beijing, 100020, China
| | - Yi-Bing Weng
- Department of Emergent Intensive Critical Unit, Beijing Lu-He Hospital, Capital Medical University, Beijing, 101100, China
| | - Xin-Cheng Li
- Department of Surgical Intensive Critical Unit, Beijing Chao-Yang Hospital, Capital Medical University, 8 Gongren Tiyuchang Nanlu, Chaoyang District, Beijing, 100020, China
| | - Chao-Dong Chen
- Department of Surgical Intensive Critical Unit, Beijing Chao-Yang Hospital, Capital Medical University, 8 Gongren Tiyuchang Nanlu, Chaoyang District, Beijing, 100020, China
| | - Fang-Xing Guo
- Department of Surgical Intensive Critical Unit, Beijing Chao-Yang Hospital, Capital Medical University, 8 Gongren Tiyuchang Nanlu, Chaoyang District, Beijing, 100020, China
| | - Yu-Zhen Han
- Department of Surgical Intensive Critical Unit, Beijing Chao-Yang Hospital, Capital Medical University, 8 Gongren Tiyuchang Nanlu, Chaoyang District, Beijing, 100020, China
| | - Li-Feng Huang
- Department of Surgical Intensive Critical Unit, Beijing Chao-Yang Hospital, Capital Medical University, 8 Gongren Tiyuchang Nanlu, Chaoyang District, Beijing, 100020, China
| | - Yue Zheng
- Department of Surgical Intensive Critical Unit, Beijing Chao-Yang Hospital, Capital Medical University, 8 Gongren Tiyuchang Nanlu, Chaoyang District, Beijing, 100020, China.
| | - Wen-Xiong Li
- Department of Surgical Intensive Critical Unit, Beijing Chao-Yang Hospital, Capital Medical University, 8 Gongren Tiyuchang Nanlu, Chaoyang District, Beijing, 100020, China.
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Guo FX, Ding Q, Li WX. [Reality and expectation of machine learning in critically ill patients with acute kidney injury]. Zhonghua Yi Xue Za Zhi 2022; 102:755-759. [PMID: 35325955 DOI: 10.3760/cma.j.cn112137-20210913-02086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The prediction model constructed by machine learning can early predict acute kidney injury (AKI) in critically ill patients, which contributes to taking preventive measures to reduce incidence of AKI as soon as possible. Machine learning can also identify AKI subtypes in real time, so as to facilitate the implementation of precise treatments for their subtypes in the future, which may improve the prognosis of patients. In this article, the construction of forecasting model of AKI and identification of AKI subtypes in critically ill patients and it's precise treatment with machine learning, limitations and development trend of machine learning in the field of AKI in critically ill patients is addressed for clinical reference.
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Affiliation(s)
- F X Guo
- SICU, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - Q Ding
- SICU, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - W X Li
- SICU, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
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Jia HM, Cheng L, Weng YB, Wang JY, Zheng X, Jiang YJ, Xin X, Guo SY, Chen CD, Guo FX, Han YZ, Zhang TE, Li WX. Cell cycle arrest biomarkers for predicting renal recovery from acute kidney injury: a prospective validation study. Ann Intensive Care 2022; 12:14. [PMID: 35150348 PMCID: PMC8840946 DOI: 10.1186/s13613-022-00989-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 01/29/2022] [Indexed: 12/20/2022] Open
Abstract
Background Acute kidney injury (AKI) is a common disease in the intensive care unit (ICU). AKI patients with nonrecovery of renal function have a markedly increased risk of death compared with patients with recovery. The current study aimed to explore and validate the utility of urinary cell cycle arrest biomarkers for predicting nonrecovery in patients who developed AKI after ICU admission. Methods We prospectively and consecutively enrolled 379 critically ill patients who developed AKI after admission to the ICU, which were divided into a derivation cohort (194 AKI patients) and a validation cohort (185 AKI patients). The biomarkers of urinary tissue inhibitor of metalloproteinase-2 (TIMP-2) and insulin-like growth factor-binding protein 7 (IGFBP7) were detected at inclusion immediately after AKI diagnosis (day 0) and 24 h later (day 1). The optimal cut-off values of these biomarkers for predicting nonrecovery were estimated in the derivation cohort, and their predictive accuracy was assessed in the validation cohort. The primary endpoint was nonrecovery from AKI (within 7 days). Results Of 379 patients, 159 (41.9%) patients failed to recover from AKI onset, with 79 in the derivation cohort and 80 in the validation cohort. Urinary [TIMP-2]*[IGFBP7] on day 0 showed a better prediction ability for nonrecovery than TIMP-2 and IGFBP7 alone, with an area under the reciever operating characteristic curve (AUC) of 0.751 [95% confidence interval (CI) 0.701–0.852, p < 0.001] and an optimal cut-off value of 1.05 ((ng/mL)2/1000). When [TIMP-2]*[IGFBP7] was combined with the clinical factors of AKI diagnosed by the urine output (UO) criteria, AKI stage 2–3 and nonrenal SOFA score for predicting nonrecovery, the AUC was significantly improved to 0.852 (95% CI 0.750–0.891, p < 0.001), which achieved a sensitivity and specificity of 88.8% (72.9, 98.7) and 92.6% (80.8, 100.0), respectively. However, urine [TIMP-2]*[IGFBP7], TIMP-2 alone, and IGFBP7 alone on day 1 performed poorly for predicting AKI recovery. Conclusion Urinary [TIMP-2]*[IGFBP7] on day 0 showed a fair performance for predicting nonrecovery from AKI. The predictive accuracy can be improved when urinary [TIMP-2]*[IGFBP7] is combined with the clinical factors of AKI diagnosed by the UO criteria, AKI stage 2–3 and nonrenal SOFA score. Supplementary Information The online version contains supplementary material available at 10.1186/s13613-022-00989-8.
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Affiliation(s)
- Hui-Miao Jia
- Department of Surgical Intensive Critical Unit, Beijing Chao-yang Hospital, Capital Medical University, 8 Gongren Tiyuchang Nanlu, Chaoyang District, Beijing, 100020, China
| | - Li Cheng
- Department of Emergent Intensive Critical Unit, Beijing Lu-He Hospital, Capital Medical University, Beijing, 101100, China
| | - Yi-Bing Weng
- Department of Emergent Intensive Critical Unit, Beijing Lu-He Hospital, Capital Medical University, Beijing, 101100, China
| | - Jing-Yi Wang
- Department of Surgical Intensive Critical Unit, Beijing Chao-yang Hospital, Capital Medical University, 8 Gongren Tiyuchang Nanlu, Chaoyang District, Beijing, 100020, China
| | - Xi Zheng
- Department of Surgical Intensive Critical Unit, Beijing Chao-yang Hospital, Capital Medical University, 8 Gongren Tiyuchang Nanlu, Chaoyang District, Beijing, 100020, China
| | - Yi-Jia Jiang
- Department of Surgical Intensive Critical Unit, Beijing Chao-yang Hospital, Capital Medical University, 8 Gongren Tiyuchang Nanlu, Chaoyang District, Beijing, 100020, China
| | - Xin Xin
- Department of Surgical Intensive Critical Unit, Beijing Chao-yang Hospital, Capital Medical University, 8 Gongren Tiyuchang Nanlu, Chaoyang District, Beijing, 100020, China
| | - Shu-Yan Guo
- Department of Surgical Intensive Critical Unit, Beijing Chao-yang Hospital, Capital Medical University, 8 Gongren Tiyuchang Nanlu, Chaoyang District, Beijing, 100020, China
| | - Chao-Dong Chen
- Department of Surgical Intensive Critical Unit, Beijing Chao-yang Hospital, Capital Medical University, 8 Gongren Tiyuchang Nanlu, Chaoyang District, Beijing, 100020, China
| | - Fang-Xing Guo
- Department of Surgical Intensive Critical Unit, Beijing Chao-yang Hospital, Capital Medical University, 8 Gongren Tiyuchang Nanlu, Chaoyang District, Beijing, 100020, China
| | - Yu-Zhen Han
- Department of Surgical Intensive Critical Unit, Beijing Chao-yang Hospital, Capital Medical University, 8 Gongren Tiyuchang Nanlu, Chaoyang District, Beijing, 100020, China
| | | | - Wen-Xiong Li
- Department of Surgical Intensive Critical Unit, Beijing Chao-yang Hospital, Capital Medical University, 8 Gongren Tiyuchang Nanlu, Chaoyang District, Beijing, 100020, China.
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Sun HT, Jiang YL, Ji Z, Guo FX, Peng R, Fan JH, Wang JJ. [3D printing non-coplanar template-assisted 125-iodine seed implantation for thorax movement tumor: individual template design method]. Zhonghua Yi Xue Za Zhi 2020; 99:3699-3702. [PMID: 31874493 DOI: 10.3760/cma.j.issn.0376-2491.2019.47.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To compare the dosimetric data between preoperative plans and postoperative verification in computed tomography CT-guided and 3D printing template-assisted 125-iodine ((125)I) seed implantation for thorax movement tumor and to explore the feasibility and accuracy of the individualized template design method. Methods: A total of 35 patients, 20 males and 15 females with median age of 62 (17-87) years old, who registered from January 2016 to December 2017 applied with 3D printing guided template assisted radioactive seed implantations in Peking University Third Hospital were included in this study. (125)I seeds with a prescribed dose of 110-180 Gy were impanted. 3D printing templates were designed and produced for 35 cases. The dosimetric parameters: D(90), minimum peripheral dose (mPD), V(100), V(150), V(200), conformal index (CI), external index (EI), and homogeneity index (HI) were compared between pre-and post-plannings. Statistical method was two group of related non-parameters test. Results: The design and production of 35 cases' templates were in place well. Compared with the preoperative planning, the postoperative D(90), V(100), V(150), V(200), mPD, CI, EI and HI differences were 5.57%, 0.34%, 0.33%, -1.20%, 21%, 2.8%, -14.2%, 4.71%, -10.4%. All the included dosimetry parameters changed slightly after surgery compared with before surgery, but the difference was not statistically significant(all P>0.05). Conclusions: The dosimetric parameters of postoperative verification are consistent well with the preoperative planning and have good accuracy, the results could meet the clinical requirements.
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Affiliation(s)
- H T Sun
- Department of Radiation Oncology, Peking University of Third Hospital, Beijing 100191, China
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Xie ZW, Li JP, Guan YJ, Zhang XY, Guo FX, Chen BB, Pan CQ. [A clinical study of antiviral therapy for patients with compensated hepatitis C cirrhosis]. Zhonghua Gan Zang Bing Za Zhi 2019; 25:827-833. [PMID: 29325276 DOI: 10.3760/cma.j.issn.1007-3418.2017.11.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Objective: To investigate the effect of antiviral therapy on the progression of liver cirrhosis and related predictive factors through a retrospective analysis of patients with compensated hepatitis C cirrhosis. Methods: The patients with compensated hepatitis C cirrhosis who were treated in our hospital from 2004 to 2015 were divided into sustained virologic response (SVR) group, non-SVR (NSVR) group, and untreated group. The baseline features of patients with or without liver cirrhosis were compared to identify the predictive factors for the progression of liver cirrhosis. The changes in platelet count, spleen sizes, Model for End-Stage Liver Disease (MELD) score, Sequential Organ Failure Assessment (SOFA) score, and Child-Turotte-Pugh (CTP) score were analyzed, and the incidence rate of liver cancer was compared between groups. A one-way analysis of variance, the Kruskal-wallis H test, the two-independent-sample t test, the chi-square test, and a multivariate logistic regression analysis were used for data analysis based on data type. Results: A total of 89 patients with compensated liver cirrhosis were enrolled, among whom 42 received the antiviral treatment with interferon and ribavirin (30 were treated with pegylated interferon-α and 12 were treated with ordinary interferon) and 47 did not receive any antiviral therapy. Among the patients who received the antiviral treatment with interferon and ribavirin, 20 achieved SVR and 22 did not achieve SVR. Compared with baseline values, platelet count in the SVR group and the NSVR group was increased by (44.93 ± 32.66)×10(9)/L and (9.73 ± 28.83)×10(9)/L, respectively, and platelet count in the untreated group was reduced by (19.76 ± 54.5)×10(9)/L; the three groups had a significant change in platelet count (F = 14.731, P < 0.001). Spleen size was reduced by 0.91 ± 1.09 cm in the SVR group and increased by 0.20±0.84 cm and 1.11 ± 1.69 cm in the NSVR group and the untreated group, respectively; the three groups had a significant change in spleen size (F = 14.943, P < 0.001). The three groups had no significant changes in MELD, SOFA, and CTP scores (P > 0.05). One patient (5.00%) in the SVR group, 5 (22.73%) in the NSVR group, and 6 (12.77%) in the untreated group progressed to liver cancer (χ (2) = 13.787, P = 0.001). The univariate analysis showed that SVR, HCV RNA, total bilirubin, and albumin were predictive factors for disease progression, and the multiple logistic regression analysis demonstrated that SVR and total bilirubin were predictive factors for disease progression. Conclusion: Interferon combined with ribavirin has a marked clinical effect in the treatment of compensated hepatitis C cirrhosis with good short- and long-term efficacy.
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Affiliation(s)
- Z W Xie
- Department of Hepatology Division II, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou 510060, China
| | - J P Li
- Department of Hepatology Division II, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou 510060, China
| | - Y J Guan
- Department of Hepatology Division II, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou 510060, China
| | - X Y Zhang
- Department of Hepatology Division II, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou 510060, China
| | - F X Guo
- Department of Hepatology Division II, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou 510060, China
| | - B B Chen
- Department of Hepatology Division II, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou 510060, China
| | - Calvin Q Pan
- 11355, Division of Gastroenterology and Hepatology, NYU Langone Medical Center New York University School of Medicine, New York 11355, USA
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Qu A, Wang JJ, Jiang YL, Sun HT, Jiang P, Ji Z, Guo FX, Fan JH, Li WY. [Comparison of preoperative planning of radioactive seed implantation for pelvic wall recurrent gynecological malignant tumors between 3D-printing non-coplanar template and 3D-printing coplanar template]. Zhonghua Yi Xue Za Zhi 2019; 99:841-843. [PMID: 30893728 DOI: 10.3760/cma.j.issn.0376-2491.2019.11.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To compare the difference of preoperative planning parameters between 3D-printing non-coplanar template (3D-PNCT) and 3D-printing coplanar template (3D-PCT) in the treatment of pelvic wall recurrent gynecological malignant tumor with radioactive seeds implantation, and to guide the clinical application. Methods: From January 2016 to March 2018, 33 patients with pelvic wall recurrent gynecological malignant tumor were treated with radioactive seeds implantation assisted by 3D-printing template and in Peking University Third Hospital. All patients underwent 3D-PNCT and 3D-PCT preoperative planning. The D(90) of target remained similar for the same patient. The parameters were compared with Wilcoxon test or Kruskal-Wallis test. Results: D(90) was similar between the two groups (P>0.05). The number of inserting needles through intestine and bone in 3D-PNCT group was less than that in 3D-PCT group (0 (0-13), 0 (0-25), Z=-2.941, P<0.05;0 (0-3), 0 (0-25), Z=-2.232, P<0.05). Conclusion: For patients with gynecological malignancies with pelvic recurrence, both of the two peroperative plans could achieve prescription dose, but 3D-PNCT is more safer.
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Affiliation(s)
- A Qu
- Department of Radiation Oncology, Peking University Third Hospital, Beijing 100191, China
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Jiang YL, Ji Z, Tian SQ, Guo FX, Yuan HS, Liu C, Sun HT, Wang JJ. [CT-guidance interstitial Iodine-125 seed brachytherapy as a salvage therapy for recurrent head and neck carcinoma]. Zhonghua Yi Xue Za Zhi 2018; 98:3686-3691. [PMID: 30526780 DOI: 10.3760/cma.j.issn.0376-2491.2018.45.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the efficacy of CT-guidance interstitial Iodine-125 seed brachytherapy as a salvage therapy for recurrent head and neck carcinoma. Methods: A total of 122 patients who had been treated for recurrent head and neck carcinoma with CT-guided Iodine-125 seed permanent implantation were conducted a retrospective analysis at Peking University Third Hospital from February 2003 to December 2015. The study included 78 male and 44 female patients. Of the 122 patients, 76 had undergone radical surgery, 106 had received EBRT. Among the patients who underwent EBRT, the total dose delivered to PTV ranged from 30 to 140 Gy (median, 68.4 Gy). The actuarial median number of the implanted Iodine-125 seeds was 38 (range, 5-158). The specific activity of Iodine-125 seeds ranged from 14.8 to 28.9 MBq/seed (median, 22.2 MBq). The evaluation of post plan showed the actuarial D90 ranged from 46 to 282 Gy (median, 121 Gy). The overall local control and survival times were determined by using the Kaplan-Meier method from SPSS 13.0.Univariate analysis was performed on the local control rate and overall survival rate. Results: Tumor responses rate was 75.4%. The median local control time was 10.0 months (95% CI 9.8-24.2 months), and the 1-, 2-, 3-, and 5-year local control were 41.9%, 21.2%, 3.7%, and 3.7%, respectively. Univariate analysis showed that the local control in D90≥120 Gy group had an increasing tendency, but no statistical difference were found. The effect of local control in the squamous cell carcinoma group was slightly worse than that in the non-squamous cell carcinoma group (P=0.032). Multi-factor analysis showed that the effect of local control in the squamous cell carcinoma group was slightly poor (P=0.03). The median survival time was 14 months (95% CI 14.4-35.8 months), and the 1-, 2-, 3- and 5-year survival rate were 51.5%, 34.2%, 19.4%, and 19.4%, respectively. The three factors, such as the tumor responses, KPS status before the seed implantation, and the D90 after the seed implantation, had a tendency to improve the total survival, but there was still no statistical differences. Multivariate analysis showed no clear influence factors. Conclusions: Interstitial permanent Iodine-125 seed implantation is an effective salvage re-irradiation modality for recurrent head and neck carcinoma after previous surgery and/or EBRT. CT image-guided method could yield the reliable seeds configuration and accurate dose distribution.
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Affiliation(s)
- Y L Jiang
- Department of Radiation Oncology, Peking University Third Hospital, Beijing 100191, China
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Jiang YL, Yu JP, Sun HT, Guo FX, Ji Z, Fan JH, Zhang LJ, Li X, Wang JJ. [Effect of image fusion technology of radioactive particles implantation before and after the planning target and dosimetry]. Zhonghua Yi Xue Za Zhi 2017; 97:2275-2279. [PMID: 28780842 DOI: 10.3760/cma.j.issn.0376-2491.2017.29.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Objective: To compare the post-implant target volumes and dosimetric evaluation with pre-plan, the gross tumor volume(GTV) by CT image fusion-based and the manual delineation of target volume in CT guided radioactive seeds implantation. Methods: A total of 10 patients treated under CT-guidance (125)I seed implantation during March 2016 to April 2016 were analyzed in Peking University Third Hospital.All patients underwent pre-operative CT simulation, pre-operative planning, implantation seeds, CT scanning after seed implantation and dosimetric evaluation of GTV.In every patient, post-implant target volumes were delineated by both two methods, and were divided into two groups. Group 1: image fusion pre-implantation simulation and post-operative CT image, then the contours of GTV were automatically performed by brachytherapy treatment planning system; Group 2: the contouring of the GTV on post-operative CT image were performed manually by three senior radiation oncologists independently. The average of three data was sets. Statistical analyses were performed using SPSS software, version 3.2.0. The paired t-test was used to compare the target volumes and D(90) parameters in two modality. Results: In Group 1, average volume of GTV in post-operation group was 12-167(73±56) cm(3). D(90) was 101-153 (142±19)Gy. In Group 2, they were 14-186(80±58)cm(3) and 96-146(122±16) Gy respectively. In both target volumes and D(90), there was no statistical difference between pre-operation and post-operation in Group 1.The D(90) was slightly lower than that of pre-plan group, but there was no statistical difference (P=0.142); in Group 2, between pre-operation and post-operation group, there was a significant statistical difference in the GTV (P=0.002). The difference of D(90) was similarly (P<0.01). Conclusion: The method of delineation of post-implant GTV through fusion pre-implantation simulation and post-operative CT scan images, the contours of GTV are automatically performed by brachytherapy treatment planning system appears to have improved more accuracy, reproducibility and convenience than manual delineation of target volume by maximum reduce the interference from artificial factor and metal artifacts. Further work and more cases are required in the future.
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Affiliation(s)
- Y L Jiang
- Department of Radiation Oncology, Peking University Third Hospital, Beijing 100191, China
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Ji Z, Jiang YL, Guo FX, Peng R, Sun HT, Fan JH, Wang JJ. [Dosimetry verification of radioactive seed implantation with 3D printing template and CT guidance for paravertebral/retroperitoneal malignant tumor]. Zhonghua Yi Xue Za Zhi 2017; 97:996-1000. [PMID: 28395417 DOI: 10.3760/cma.j.issn.0376-2491.2017.13.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Objective: To compare the dose distributions of postoperative plans with preoperative plans for seeds implantations of paravertebral/retroperitoneal tumors assisted by 3D printing guide template and CT guidance, explore the effects of the technology for seeds implantations in dosimetry level and provide data support for the optimization and standardization in seeds implantation. Methods: Between December 2015 and July 2016, a total of 10 patients with paravertebral/retroperitoneal tumors (12 lesions) received 3D printing template assist radioactive seeds implantations in department of radiation oncology of Peking University Third Hospital, and included in the study. The diseases included cervical cancer, kidney cancer, abdominal stromal tumor, leiomyosarcoma of kidney, esophageal cancer and carcinoma of ureter. The prescribed doses was 110-150 Gy. All patients received preoperative planning design, individual template design and production, and the dose distribution of postoperative plan was compared with preoperative plan. Dose parameters including D(90), MPD, V(100), V(150,)conformal index(CI), EI of target volume and D(2cc) of organs at risk (spinal cord, aorta, kidney). Statistical software was SPSS 19.0 and statistical method was non-parameters Wilcoxon symbols test. Results: A total of 10 3D printing templates were designed and produced which were including 12 treatment areas.The mean D(90) of postoperative target area (GTV) was 131.1 (97.8-167.4 Gy) Gy. The actual seeds number of post operation increased by 3 to 12 in 5 cases (42.0%). The needle was well distributed. For postoperative plans, the mean D(90,)MPD, V(100,)V(150) was 131.1 Gy, 69.3 Gy, 90.2% and 65.2%, respectively, and which was 140.2 Gy, 65.6 Gy, 91.7% and 26.8%, respectively, in preoperative plans. This meant that the actual dose of target volume was slightly lower than preplanned dose, and the high dose area of target volume was larger than preplanned range, but there was no statistical difference in P value between the two groups except V(150)(P=0.004). The actual dose conformity of target volume was worse than preplanned (CI was 0.58 and 0.62, respectively) and the difference was statistically significant(P=0.019). The actual dose of external target volume was higher than preplanned (EI was 55% and 45.9%, respectively) and the difference had no significance. For organs at risk, the actual mean D(2cc) of spinal cord, aorta and kidney was 24.7, 54.4 and 29.7 Gy, respectively, which was higher than preplanned(20.6, 51.6 and 28.6 Gy, respectively), and there was no significant difference in two groups. Conclusions: Most parameters of postoperative validations for 3D printing template assisted seeds implantation in paravertebral/retroperitoneal are closed to the expectations of preoperative plans which means the improvement of accuracy in treatment.
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Affiliation(s)
- Z Ji
- Department of Radiation Oncology, Peking University Third Hospital, Beijing 100191, China
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Wang H, Wang JJ, Jiang YL, Tian SQ, Ji Z, Guo FX, Sun HT, Fan JH, Xu YP. [CT guidance 125I seed implantation for pelvic recurrent rectal cancer assisted by 3D printing individual non-coplanar template]. Zhonghua Yi Xue Za Zhi 2016; 96:3782-3786. [PMID: 28057090 DOI: 10.3760/cma.j.issn.0376-2491.2016.47.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To analyze the difference of dosimetric parameters between pre-plan and post-plan of 125I radioactive seed implantation assisted by 3D printing individual non-coplanar template (3D printing template) for locally recurrent rectal cancer (LRRC). Methods: From February 2016 to April 2016, a total of 10 patients with locally recurrent rectal cancer received 125I seeds implantation under CT guidance assisted by 3D printing template in Department of Radiation Oncology, Peking University Third Hospital.Each patient underwent CT simulation, three-dimentional treatment planning pre-implantation, 3D printing template design, radioactive seed implantation assisted by 3D printing template and dosimetric verification post implantation. The median activity of seed was 0.63 mCi (0.58 to 0.7 mCi) (2.15- 2.59×107 Bq), and the median number of seeds was 80 (19 to 192). D90, D100, V100, V150, CI, EI, HI, D5cc, D2cc of bladder and bowel of pre-plan and post-plan were calculated, respectively.Paired t test was used to evaluate the difference of dosimetric parameters between pre-plan and post-plan. Results: The median D90 of pre-plan and post-plan were 13 761.0 and 12 798.8 cGy, respectively.The median D100 of pre-plan and post-plan were 5 293.6 and 5 397.9 cGy, respectively.The median V100 of pre-plan and post-plan were 90.0% and 90.0%, respectively.The median V150 of pre-plan and post-plan were 63.8% and 62.4%, respectively.The median CI of pre-plan and post-plan were 0.73 and 0.67.The median EI of pre-plan and post-plan were 0.22 and 0.30, respectively. The median HI of pre-plan and post-plan were 0.29 and 0.31.The median bladder D2cc of pre-plan and post-plan were 3 088.8 and 4 240.4 cGy, respectively.The median bowel D2cc of pre-plan and post-plan were 7 051.6 and 7 903.9 cGy, respectively. Conclusions: 3D printing template might be helpful for locally recurrent rectal cancer patients who received 125I radioactive seed implantation assisted by 3D printing individual template.Seed implantation might have more chances to achieve prescription dose and dose limitation of organs at risk of pre-plan, which is important for precise implantation and quality control.
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Affiliation(s)
- H Wang
- Department of Radiation Oncology, Peking University Third Hospital, Beijing 100191, China
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Tao DL, Huang BG, Xu YZ, Li WH, Yang ZL, Wu JG, Sun LD, Yan CH, Liu XX, Guo FX, Xu DF. [Energy transfer between electric polymer PVK and terbium complex and its transmission electronmicroscope (TME) study]. Guang Pu Xue Yu Guang Pu Fen Xi 2001; 21:740-744. [PMID: 12958882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
A chloroform-soluble terbium complex, which is confirmed to be Tb(aspirin)3 phen using element analysis and FT-IR spectroscopy, was synthesized. Photoluminescent investigation on the terbium complex and PVK-terbium complex composite was conducted. Förster energy transfer occurred between the terbium complex and the PVK matrix. There are no overlap between UV spectrum of the complex and the emission spectrum of PVK, however, overlap is observed between the excitation spectrum of the complex and the emission spectrum of PVK. Therefore, we suggest that the necessary condition of Förster energy transfer should be overlap between the excitation (not UV) spectrum of one complex and the emission spectrum of polymer matrix. Further investigation indicates that the emission of PVK can be suppressed at different extents by doping various amount of Tb(aspirin)3 phen into PVK films. The ratio of Tb(aspirin)3 phen: PVK = 1:2 (wt%) are regarded as an optimized ratio for limiting the emission of PVK. TEM images of PVK/Tb(aspirin)3 phen films reveal that nanoparticles of the Tb complex are dispersed in the PVK matrix. The size of the aggregated complex in PVK matrix is 20-30 nm. The film is not homogeneous as dark regions co-exist with light region in the TEM images. This phenomenon may be related to the short lifetime of electroluminescent devices.
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Affiliation(s)
- D L Tao
- Department of Chemistry, State Key Laboratory of Rare Earth Materials Chemistry and Applications, Peking University, Beijing 100871, China
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Zhuang WG, Lin ZS, Guo FX. [Predication of the prognosis of patients with tongue carcinoma]. Shanghai Kou Qiang Yi Xue 1993; 2:170-1. [PMID: 15159836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Affiliation(s)
- W G Zhuang
- Department of Dentistry, Fujian Provincial Hospital. Fuzhou 350001, China
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