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Guo HH, Song BY, Wang XR, Cui JX, Zhang ZB, Wang BY, Liu Y, Tan BB, Zhao Q. [A case of diaphragmatic hemangioma misdiagnosed as gastrointestinal stromal tumor of stomach]. Zhonghua Wei Chang Wai Ke Za Zhi 2023; 26:1194-1195. [PMID: 38110283 DOI: 10.3760/cma.j.cn441530-20230613-00204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/20/2023]
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Park NJ, Hiniker SM, Guo HH, Advani RH, Hoppe RT, Binkley MS. Investigating PET Responses to Treatment in Nodular Lymphocyte-Predominant Hodgkin Lymphoma. Int J Radiat Oncol Biol Phys 2023; 117:e480. [PMID: 37785523 DOI: 10.1016/j.ijrobp.2023.06.1699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) There is no standard treatment for nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL). Although response by positron emission tomography (PET) for classic Hodgkin lymphoma (cHL) has allowed for response-adapted treatment, similar approaches for NLPHL have not been developed. This is in part due to the lack of data for PET response to treatment. Therefore, we sought to investigate PET responses to management for NLPHL. MATERIALS/METHODS We retrospectively identified 47 patients who were diagnosed with or treated for NLPHL between 2001-2018 at a single institution and underwent a staging PET. We recorded clinical data and PET metrics for patients who received various forms of management, including chemotherapy (CT), radiation therapy (RT), combined modality therapy (CMT = CT+RT, with rituximab in a subset), rituximab monotherapy, and observation after excision. Metabolic response was scored according to the Deauville 5-point scale criteria, with complete metabolic response defined as a score 1-3. RESULTS We identified 47 patients with median age of 26 (IQR = 17-50). They predominantly were male (74.5%) and had early stage (23.4% I, 36.2% II) versus advanced stage (29.8% III, 10.5% IV) NLPHL. The majority of patients had their immunoarchitectural pattern scored (n = 36, 76.6%), with typical pattern (A/B) being the most frequent type (58.3%). The median follow-up was 5.7 years (IQR = 2.3-9.3). Overall survival was 100% at 5 years and 92.3% at 10 years. Primary management included CMT (n = 10, 21.3%; with rituximab in a subset n = 1, 10.0%), CT alone (n = 22, 46.8%; with rituximab in a subset n = 5, 22.7%), RT alone (n = 8, 17.0%), rituximab alone (n = 3, 6.4%), and observation after excision (n = 4, 8.5%). On baseline PET, median SUVmax was 10.7 (range = 1.7-35.4). Of the 10 patients who received CMT, the complete metabolic response rates were 42.9% at interim-chemotherapy PET and 75% at post-chemotherapy PET, which improved to 100% after consolidative radiotherapy. There was no difference in complete metabolic response rate to chemotherapy for typical versus variant pattern (P = 0.60). Of the 22 patients who received CT alone, 66.7% had a complete metabolic response at the interim PET and 72.7% at the end of chemotherapy. For RT, rituximab alone, and observation, the complete metabolic response rates at median 3 months (range 1-5 months) after treatment were 87.5%, 66.7%, 75.0%, respectively. CONCLUSION Based on our cohort, we found that patients with NLPHL had a lower complete metabolic response to CT (∼75%) compared to cHL (∼85-90%) and PET-response was improved following RT for those receiving CMT. There was no significant difference in PET-response for those with variant versus typical immunoarchitectural patterns. Our findings will allow for the development of PET response-adapted therapy for NLPHL.
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Affiliation(s)
- N J Park
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - S M Hiniker
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - H H Guo
- Department of Nuclear Medicine, Stanford University School of Medicine, Stanford, CA
| | - R H Advani
- Department of Medicine, Division of Oncology, Stanford University School of Medicine, Stanford, CA
| | - R T Hoppe
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - M S Binkley
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
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Ning HY, Cai HJ, Ma TT, Fan CE, Wu DD, Gao FY, Kong F, Zhang FJ, Wang R, Guo HH, Ma RL, Zheng CY, Hao B, Wang HT, Zhang JJ, Zhang L, Wang XY. [Investigation and analysis of airborne allergenic pollen in 4 districts and 5 counties of Hohhot City]. Zhonghua Yu Fang Yi Xue Za Zhi 2023; 57:1364-1372. [PMID: 37743296 DOI: 10.3760/cma.j.cn112150-20230116-00034] [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] [Grants] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
Objective: To investigate the species, concentration and seasonal trends of main airborne allergenic pollen in 4 districts and 5 counties of Hohhot City. Methods: The Department of allergy, Beijing Shijitan Hospital Affiliated to Capital Medical University conducted a cross-sectional study about monitoring the airborne allergenic pollen from August 1, 2021 to July 31, 2022 by the gravitational method in 4 districts and 5 counties of Hohhot City, which include Yuquan District, Xincheng District, Huimin District, Saihan District, Tuoketuo County, Helingeer County, Tumotezuoqi County, Wuchuan County and Qingshuihe County. Daily pollens were counted and identified by optical microscopy, and the data were analyzed. Results: The airborne allergenic pollen was collected every month all year round in 4 districts and 5 counties of Hohhot city. Through the whole year of the total quantity of pollens ranged from 24 850 to 50 154 grains per 1 000 mm2 and two peaks of pollen concentration in air were observed,which happened in spring (from March to May) and in summer and autumn (from July to September). In spring, the main pollens were tree pollens, which principally distributed in Populus pollen (18.29%), Ulmus pollen (8.36%), Pinus pollen (6.20%), Cupressaceae pollen (5.23%), Betulaceae pollen (2.73%), Salix pollen (1.80%) and Quercus pollen (1.16%). In summer and autumn, the main pollens were weed pollens, which mainly included Artemisia pollen (42.73%), Chenopodiaceae pollen or Amaranthaceae pollen (7.46%), Poaceae pollen (2.26%), Humulus pollen or Cannabis pollen (0.60%). Conclusion: There were two peaks of main airborne allergenic pollen in 4 districts and 5 counties of Hohhot City. In the spring peak of pollen, the main airborne pollens were tree pollens. In the summer and autumn peak of pollen, the main airborne pollens were weed pollens. The Artemisia pollen was the most major airborne pollen in this area.
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Affiliation(s)
- H Y Ning
- Department of Allergy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China Allergy Center, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - H J Cai
- Allergy Center, Hohhot First Hospital, Hohhot 010030, China
| | - T T Ma
- Department of Allergy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China Allergy Center, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - C E Fan
- Allergy Center, Hohhot First Hospital, Hohhot 010030, China
| | - D D Wu
- Department of Primary Health Care, Hohhot Health Committee, Hohhot 010010, China
| | - F Y Gao
- Department of Allergy, Qingshuihe County Hospital, Hohhot 011600, China
| | - F Kong
- Department of Allergy, Hohhot Huimin District Hospital, Hohhot 010030, China
| | - F J Zhang
- Department of Clinical Laboratory, Ying Xin Road Office East Community Health Service Centre, Hohhot 010000, China
| | - R Wang
- Department of Clinical Laboratory, Daxuexi Road Community Health Service Centre, Hohhot 010018, China
| | - H H Guo
- Department of Allergy and Department of Clinical Laboratory, Tumotezuoqi People's Hospital, Hohhot 010100, China
| | - R L Ma
- Department of Allergy, Tuoketuo County Hospital, Hohhot 010200, China
| | - C Y Zheng
- Department of Allergy, Helingeer County Hospital, Hohhot 011500, China
| | - B Hao
- Department of Allergy, Wuchuan County Hospital, Hohhot 011700, China
| | - H T Wang
- Department of Allergy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China Allergy Center, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - J J Zhang
- Allergy Center, Hohhot First Hospital, Hohhot 010030, China
| | - L Zhang
- Department of Otorhinolaryngology Head and Neck Surgery and Department of Allergy, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China Beijing Key Laboratory of Allergic Diseases, Beijing Institute of Otorhinolaryngology, Beijing 100005, China
| | - X Y Wang
- Department of Allergy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China Allergy Center, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
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Eke I, Guo HH, Loo BW, Sung AW, Diehn M, Vitzthum L, Chin AL, Gensheimer MF. Unilateral Diaphragmatic Paralysis After Stereotactic Ablative Radiation Therapy to a Lung Tumor Abutting the Course of the Phrenic Nerve. Pract Radiat Oncol 2023; 13:e383-e388. [PMID: 37150318 DOI: 10.1016/j.prro.2023.04.010] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 04/24/2023] [Accepted: 04/29/2023] [Indexed: 05/09/2023]
Abstract
We present the case of a woman with metastatic adenoid cystic carcinoma who received stereotactic ablative radiation therapy with a total dose of 50 Gy in 4 fractions to 2 lung metastases and developed symptomatic left phrenic nerve injury 2 years after radiation. The maximum dose to the approximate location of the phrenic nerve was 57.7 Gy, which corresponds to a biologically effective dose for late effects (using α/β ratio = 3) of 335.14 Gy. Here, we discuss the case, planning considerations by radiation oncologists and medical physicists, and the multidisciplinary medical management of this patient.
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Affiliation(s)
- Iris Eke
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California
| | - H Henry Guo
- Department of Radiology, Stanford University School of Medicine, Stanford, California
| | - Billy W Loo
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California; Stanford Cancer Institute, Stanford University School of Medicine, Stanford, California
| | - Arthur W Sung
- Department of Medicine, Stanford University School of Medicine, Stanford, California
| | - Maximilian Diehn
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California; Stanford Cancer Institute, Stanford University School of Medicine, Stanford, California; Institute for Stem Cell Biology & Regenerative Medicine, Stanford University School of Medicine, Stanford, California
| | - Lucas Vitzthum
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California
| | - Alexander L Chin
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California
| | - Michael F Gensheimer
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California.
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Guo HH, Hu YY, Tian Y, Yang PG, Ding PA, Wang D, Zhang ZD, Zhao XF, Liu Y, Li Y, Zhao Q. [Da Vinci robotic surgery for synchronous gastric and colorectal primary tumors: 8 cases]. Zhonghua Wei Chang Wai Ke Za Zhi 2023; 26:787-789. [PMID: 37574296 DOI: 10.3760/cma.j.cn441530-20221029-00440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 08/15/2023]
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Wang ZY, Chang QG, Guo HH, Du X, Liu YH, Yin DT. [Establishment and validation of a nomogram model for evaluating the metastasis of lymph nodes posterior to the right recurrent laryngeal nerve in papillary thyroid carcinoma]. Zhonghua Yi Xue Za Zhi 2023; 103:2175-2182. [PMID: 37482730 DOI: 10.3760/cma.j.cn112137-20221107-02336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 07/25/2023]
Abstract
Objective: To explore the related factors of lymph nodes posterior to the right recurrent laryngeal nerve (LN-prRLN) metastasis in papillary thyroid carcinoma (PTC) and establish a nomogram model for evaluating LN-prRLN metastasis. Methods: The clinical data of patients with PTC who underwent surgery in the Department of Thyroid Surgery of the First Affiliated Hospital of Zhengzhou University from January 2020 to December 2021 were retrospectively analyzed. Multivariate logistic regression was used to analyze the related factors of LN-prRLN metastasis and construct a nomogram model for evaluating LN-prRLN metastasis. Meanwhile, the data of 120 patients from January to June 2022 were also collected for external verification. Results: A total of 466 patients with PTC were enrolled, including 106 males and 360 females, and aged 44 (33, 53) years. There were 280 cases in the training group and 186 cases in the internal validation group, respectively. Multivariate logistic regression analysis showed that age (OR=0.966, 95%CI: 0.938-0.996, P=0.027), tumor size (OR=1.048, 95%CI: 1.001-1.098, P=0.043), multifocality (OR=2.459, 95%CI: 1.268-4.767, P=0.008), right central lymph node metastasis reported by ultrasound (OR=3.099, 95%CI: 1.255-7.651, P=0.014), extrathyroid extension (OR=3.561, 95%CI: 1.255-10.102, P=0.017) and serum thyroglobulin level (OR=1.010, 95%CI: 1.001-1.018, P=0.032) were related factors for LN-prRLN metastasis. The area under the curve (AUC) values of receiver operating characteristic (ROC) curves of the training group, internal validation group and external validation group were 0.765 (95%CI: 0.691-0.840), 0.747 (95%CI: 0.657-0.837) and 0.754 (95%CI: 0.639-0.869), respectively. Conclusion: Dissection of the LN-prRLN is recommended for young PTC patients with large tumor size, multifocality, right central lymph node metastasis reported by ultrasound, extrathyroid extension and high serum thyroglobulin level.
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Affiliation(s)
- Z Y Wang
- Department of Thyroid Surgery, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Q G Chang
- Department of Thyroid Surgery, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - H H Guo
- Department of Thyroid Surgery, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - X Du
- Department of Thyroid Surgery, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Y H Liu
- Department of Thyroid Surgery, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - D T Yin
- Department of Thyroid Surgery, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
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Kimura RH, Sharifi H, Shen B, Berry GJ, Guo HH. α vβ 6 Integrin Positron Emission Tomography of Lung Fibrosis in Idiopathic Pulmonary Fibrosis and Long COVID-19. Am J Respir Crit Care Med 2023; 207:1633-1635. [PMID: 36693032 DOI: 10.1164/rccm.202206-1107im] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Affiliation(s)
| | - Husham Sharifi
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, and
| | - Bin Shen
- Department of Radiology and Nuclear Medicine
| | - Gerald J Berry
- Department of Pathology, School of Medicine, Stanford University, Palo Alto, California
| | - H Henry Guo
- Department of Radiology and Nuclear Medicine
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Madani MH, Riess JW, Brown LM, Cooke DT, Guo HH. Imaging of lung cancer. Curr Probl Cancer 2023:100966. [PMID: 37316337 DOI: 10.1016/j.currproblcancer.2023.100966] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 04/29/2023] [Accepted: 05/23/2023] [Indexed: 06/16/2023]
Abstract
Lung cancer is the leading cause of cancer-related mortality globally. Imaging is essential in the screening, diagnosis, staging, response assessment, and surveillance of patients with lung cancer. Subtypes of lung cancer can have distinguishing imaging appearances. The most frequently used imaging modalities include chest radiography, computed tomography, magnetic resonance imaging, and positron emission tomography. Artificial intelligence algorithms and radiomics are emerging technologies with potential applications in lung cancer imaging.
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Affiliation(s)
- Mohammad H Madani
- Department of Radiology, University of California, Davis, Sacramento, CA.
| | - Jonathan W Riess
- Division of Hematology/Oncology, Department of Internal Medicine, UC Davis Medical Center, UC Davis Comprehensive Cancer Center, Sacramento, CA
| | - Lisa M Brown
- Division of General Thoracic Surgery, Department of Surgery, UC Davis Health, Sacramento, CA
| | - David T Cooke
- Division of General Thoracic Surgery, Department of Surgery, UC Davis Health, Sacramento, CA
| | - H Henry Guo
- Department of Radiology, Stanford University School of Medicine, Stanford, CA
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Yang SY, Deng WW, Zhao RZ, Long XP, Wang DM, Guo HH, Jiang LX, Chen WM, Shi B. Exosomes Derived from Endothelial Cells Inhibit Neointimal Hyperplasia Induced by Carotid Artery Injury in Rats via ROS-NLRP3 Inflammasome Pathway. Bull Exp Biol Med 2023; 174:762-767. [PMID: 37162629 DOI: 10.1007/s10517-023-05788-0] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Indexed: 05/11/2023]
Abstract
This study attempted to investigate whether exosomes derived from rat endothelial cells (EC-Exo) attenuate intimal hyperplasia after balloon injury using hematoxylin and eosin staining, immunohistochemistry, immunofluorescence staining, Evans blue staining, and Western blotting. The results indicated that EC-Exo inhibited intimal hyperplasia in the carotid artery after balloon injury, promoted re-endothelialization, and reduced vascular inflammation and ROS-NLRP3-mediated cell pyroptosis. Thus, EC-Exo can inhibit neointimal hyperplasia after carotid artery injury in rats presumably by inhibiting the ROS-NLRP3 inflammasome and phenotypic transformation of vascular smooth muscle cells.
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Affiliation(s)
- S Y Yang
- Department of Cardiology, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - W W Deng
- Department of Cardiology, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - R Z Zhao
- Department of Cardiology, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - X P Long
- Department of Cardiology, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - D M Wang
- Department of Cardiology, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - H H Guo
- Department of Cardiology, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - L X Jiang
- Department of Cardiology, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - W M Chen
- Department of Cardiology, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - B Shi
- Department of Cardiology, Affiliated Hospital of Zunyi Medical University, Zunyi, China.
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Pogatchnik BP, Swenson KE, Duong DK, Shaller B, Bedi H, Guo HH. Immediate and Follow-up Imaging Findings after Cone-Beam CT-guided Transbronchial Lung Cryobiopsy. Radiol Cardiothorac Imaging 2023; 5:e220149. [PMID: 37124647 PMCID: PMC10141444 DOI: 10.1148/ryct.220149] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 01/23/2023] [Accepted: 02/08/2023] [Indexed: 05/02/2023]
Abstract
Purpose To evaluate findings after transbronchial lung cryobiopsy (TBLC) using intraprocedural cone-beam CT (CBCT) and follow-up chest CT examinations. Materials and Methods A single-center, prospective cohort study was performed with 14 participants (mean age, 65 years ± 13 [SD]; eight male participants) undergoing CBCT-guided TBLC between August 2020 and February 2021 who underwent follow-up chest CT imaging. Intraprocedural CBCT and follow-up chest CT images were interpreted for changes compared with baseline CT images. Statistical analyses were performed using independent samples t test and analysis of variance. Results A total of 62 biopsies were performed, with 48 in the field of view of CBCT immediately after biopsy. All 48 biopsy sites had evidence of postprocedural hemorrhage, and 17 (35%) had pneumatoceles at the biopsy site. Follow-up CT images showed resolution of these findings. Solid nodules developed at 18 of the 62 (29%) biopsy sites. Conclusion Postbiopsy hemorrhage and pneumatoceles on intraprocedural CBCT images (which were clinically occult and resolved spontaneously) and new solid nodules on follow-up chest CT images were commonly observed after TBLC. These findings may help alleviate unnecessary follow-up imaging and tissue sampling.Keywords: Biopsy/Needle Aspiration, CT, Lungs, Lung Biopsy, Interventional Bronchoscopy© RSNA, 2023.
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Motlaghzadeh Y, Nesbit S, Guo HH, Yang E, Desai K, Lui NS. Surgical resection of mediastinal ectopic thyroid tissue: a case series. J Thorac Dis 2023; 15:1473-1481. [PMID: 37065554 PMCID: PMC10089840 DOI: 10.21037/jtd-22-479] [Citation(s) in RCA: 1] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 01/30/2023] [Indexed: 03/05/2023]
Abstract
Background Ectopic thyroid tissue (ETT) is characterized by the presence of thyroid tissue in any location other than its normal anatomic position. Mediastinal ectopic thyroid gland is a rare entity, accounting for 1% of all ETT cases. In this article, we present seven cases with mediastinal ETT over the last 26 years admitted to Stanford hospital. Case Description Searching Stanford pathology database for specimens that contained term "ectopic thyroid" between 1996 and 2021, a total of 202 patients were collected. Among those seven were classified as mediastinal ETT. Patients' electronic medical records were reviewed for data collection purposes. The mean age of our seven cases was 54 years on the day of surgery, and four were female. Chest pressure, cough, and neck pain were most reported presenting symptoms. Four of our patients had thyroid stimulating hormone (TSH) checks all within normal limits. All patients in our study had computed tomography (CT) imaging of the chest detecting the mediastinal mass. Histopathology of the mass revealed ectopic thyroid tissue negative for malignancy in all cases. Conclusions Ectopic mediastinal thyroid tissue is a rare clinical entity that should be considered in the differential diagnosis of all mediastinal masses as it usually requires different management and treatment.
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Affiliation(s)
- Yasaman Motlaghzadeh
- Department of Medicine, Division of Endocrinology, Stanford University School of Medicine, Palo Alto, USA
| | - Shannon Nesbit
- Department of Cardiothoracic Surgery, Stanford University School of Medicine, Palo Alto, USA
| | - H. Henry Guo
- Department of Radiology, Stanford University School of Medicine, Palo Alto, USA
| | - Eric Yang
- Department of Pathology, Stanford University School of Medicine, Palo Alto, USA
| | - Kaniksha Desai
- Department of Medicine, Division of Endocrinology, Stanford University School of Medicine, Palo Alto, USA
| | - Natalie S. Lui
- Department of Cardiothoracic Surgery, Stanford University School of Medicine, Palo Alto, USA
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Obeid J, Hiniker SM, Schroers‐Martin J, Guo HH, No HJ, Moding EJ, Advani RH, Alizadeh AA, Hoppe RT, Binkley MS. Investigating and modeling positron emission tomography factors associated with large cell transformation from low-grade lymphomas. EJHaem 2023; 4:90-99. [PMID: 36819184 PMCID: PMC9928791 DOI: 10.1002/jha2.615] [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] [Figures] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 10/27/2022] [Accepted: 10/31/2022] [Indexed: 11/27/2022]
Abstract
Low-grade lymphomas have a 1%-3% annual risk of transformation to a high-grade histology, and prognostic factors remain undefined. We set to investigate the role of positron emission tomography (PET) metrics in identification of transformation in a retrospective case-control series of patients matched by histology and follow-up time. We measured PET parameters including maximum standard uptake value (SUV-max) and total lesion glycolysis (TLG), and developed a PET feature and lactate dehydrogenase (LDH)-based model to identify transformation status within discovery and validation cohorts. For our discovery cohort, we identified 53 patients with transformation and 53 controls with a similar distribution of follicular lymphoma (FL). Time to transformation and control follow-up time was similar. We observed a significant incremental increase in SUV-max and TLG between control, pretransformation and post-transformation groups (P < 0.05). By multivariable analysis, we identified a significant interaction between SUV-max and TLG such that SUV-max had highest significance for low volume cases (P = 0.04). We developed a scoring model incorporating SUV-max, TLG, and serum LDH with improved identification of transformation (area under the curve [AUC] = 0.91). Our model performed similarly for our validation cohort of 23 patients (AUC = 0.90). With external and prospective validation, our scoring model may provide a specific and noninvasive tool for risk stratification for patients with low-grade lymphoma.
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Affiliation(s)
- Jean‐Pierre Obeid
- Department of Radiation OncologyStanford University School of MedicineStanfordCaliforniaUSA
| | - Susan M. Hiniker
- Department of Radiation OncologyStanford University School of MedicineStanfordCaliforniaUSA
| | - Joseph Schroers‐Martin
- Department of MedicineDivision of Oncology, Stanford University School of MedicineStanfordCaliforniaUSA
| | - H. Henry Guo
- Department of RadiologyStanford University School of MedicineStanfordCaliforniaUSA
| | - Hyunsoo Joshua No
- Department of Radiation OncologyStanford University School of MedicineStanfordCaliforniaUSA
| | - Everett J. Moding
- Department of Radiation OncologyStanford University School of MedicineStanfordCaliforniaUSA
| | - Ranjana H. Advani
- Department of MedicineDivision of Oncology, Stanford University School of MedicineStanfordCaliforniaUSA
| | - Ash A. Alizadeh
- Department of MedicineDivision of Oncology, Stanford University School of MedicineStanfordCaliforniaUSA
| | - Richard T. Hoppe
- Department of Radiation OncologyStanford University School of MedicineStanfordCaliforniaUSA
| | - Michael S. Binkley
- Department of Radiation OncologyStanford University School of MedicineStanfordCaliforniaUSA
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Byrd CT, Lui NS, Guo HH. Applications of Three-Dimensional Printing in Surgical Oncology. Surg Oncol Clin N Am 2022; 31:673-684. [DOI: 10.1016/j.soc.2022.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Wang J, Falkson SR, Guo HH. Radiopaque Recreations of Lung Pathologies From Clinical Computed Tomography Images Using Potassium Iodide Inkjet 3-dimensional Printing: Proof of Concept. J Thorac Imaging 2022; 37:146-153. [PMID: 34334783 DOI: 10.1097/rti.0000000000000607] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The purpose of this study was to develop a 3-dimensional (3D) printing method to create computed tomography (CT) realistic phantoms of lung cancer nodules and lung parenchymal disease from clinical CT images. MATERIALS AND METHODS Low-density paper was used as substrate material for inkjet printing with potassium iodide solution to reproduce phantoms that mimic the CT attenuation of lung parenchyma. The relationship between grayscale values and the corresponding CT numbers of prints was first established through the derivation of exponential fitted equation from scanning data. Next, chest CTs from patients with early-stage lung cancer and coronavirus disease 2019 (COVID-19) pneumonia were chosen for 3D printing. CT images of original lung nodule and the 3D-printed nodule phantom were compared based on pixel-to-pixel correlation and radiomic features. RESULTS CT images of part-solid lung cancer and 3D-printed nodule phantom showed both high visual similarity and quantitative correlation. R2 values from linear regressions of pixel-to-pixel correlations between 5 sets of patient and 3D-printed image pairs were 0.92, 0.94, 0.86, 0.85, and 0.83, respectively. Comparison of radiomic measures between clinical CT and printed models demonstrated 6.1% median difference, with 25th and 75th percentile range at 2.4% and 15.2% absolute difference, respectively. The densities and parenchymal morphologies from COVID-19 pneumonia CT images were well reproduced in the 3D-printed phantom scans. CONCLUSION The 3D printing method presented in this work facilitates creation of CT-realistic reproductions of lung cancer and parenchymal disease from individual patient scans with microbiological and pathology confirmation.
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Affiliation(s)
- Jia Wang
- Environmental Health and Safety, Stanford University
| | | | - H Henry Guo
- Department of Radiology, Stanford Medical Center, Palo Alto, CA
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15
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Byrd CT, Vyas D, Guo HH, Lui NS. 3-D printed model of surgically resectable angioinvasive pulmonary mucormycosis. JTCVS Tech 2022; 13:244-246. [PMID: 35711220 PMCID: PMC9197082 DOI: 10.1016/j.xjtc.2022.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 03/14/2022] [Accepted: 04/11/2022] [Indexed: 12/03/2022] Open
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Sharifi H, Guenther ZD, Leung ANC, Johnston L, Lai YK, Hsu JL, Guo HH. Head-to-head Comparison of Qualitative Radiologist Assessment With Automated Quantitative Computed Tomography Analysis for Bronchiolitis Obliterans Syndrome After Hematopoietic Cell Transplantation. J Thorac Imaging 2022; 37:109-116. [PMID: 33999570 DOI: 10.1097/rti.0000000000000595] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE Computed tomography (CT) findings of bronchiolitis obliterans syndrome (BOS) can be nonspecific and variable. This study aims to measure the incremental value of automated quantitative lung CT analysis to clinical CT interpretation. A head-to-head comparison of quantitative CT lung density analysis by parametric response mapping (PRM) with qualitative radiologist performance in BOS diagnosis was performed. MATERIALS AND METHODS Inspiratory and end-expiratory CTs of 65 patients referred to a post-bone marrow transplant lung graft-versus-host-disease clinic were reviewed by 3 thoracic radiologists for the presence of mosaic attenuation, centrilobular opacities, airways dilation, and bronchial wall thickening. Radiologists' majority consensus diagnosis of BOS was compared with automated PRM air trapping quantification and to the gold-standard diagnosis of BOS as per National Institutes of Health (NIH) consensus criteria. RESULTS Using a previously established threshold of 28% air trapping on PRM, the diagnostic performance for BOS was as follows: sensitivity 56% and specificity 94% (area under the receiver operator curve [AUC]=0.75). Radiologist review of inspiratory CT images alone resulted in a sensitivity of 80% and a specificity of 69% (AUC=0.74). When radiologists assessed both inspiratory and end-expiratory CT images in combination, the sensitivity was 92% and the specificity was 59% (AUC=0.75). The highest performance was observed when the quantitative PRM report was reviewed alongside inspiratory and end-expiratory CT images, with a sensitivity of 92% and a specificity of 73% (AUC=0.83). CONCLUSIONS In the CT diagnosis of BOS, qualitative expert radiologist interpretation was noninferior to quantitative PRM. The highest level of diagnostic performance was achieved by the combination of quantitative PRM measurements with qualitative image feature assessments.
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Affiliation(s)
- Husham Sharifi
- Department of Medicine, Division of Pulmonary, Allergy, and Critical Care Medicine
| | | | - Ann N C Leung
- Department of Radiology, Stanford University School of Medicine
| | - Laura Johnston
- Department of Medicine, Division of Blood and Marrow Transplantation, Stanford University School of Medicine, Stanford, CA
| | - Yu K Lai
- Department of Medicine, Division of Pulmonary, Allergy, and Critical Care Medicine
| | - Joe L Hsu
- Department of Medicine, Division of Pulmonary, Allergy, and Critical Care Medicine
| | - H Henry Guo
- Department of Radiology, Stanford University School of Medicine
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Kelahan L, Cheng SN, Kagoma YK, Horowitz JM, Miller FH, Guo HH, Chow L. Using Online Survey Software to Enhance Radiology Learning. Acad Radiol 2021; 28:1799-1809. [PMID: 32972839 DOI: 10.1016/j.acra.2020.08.032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 08/13/2020] [Accepted: 08/17/2020] [Indexed: 11/25/2022]
Abstract
RATIONALE AND OBJECTIVES Online educational modules can augment radiology learning by creating opportunities to interact with images in more dynamic ways than with static presentation of images in lectures or journal articles. Building these modules on an online survey platform allows for quantitative assessment and learner feedback, without requiring programming knowledge or need for new website creation. MATERIALS AND METHODS Interactive online tutorials were built on a web-based survey platform (Qualtrics, Provo, Utah) accessible by computer or mobile device to teach radiology imaging findings of selected high-morbidity diagnoses. Topics included congenital-type internal hernias (module 1), acute appendicitis in the pregnant patient (module 2), and unintentionally retained surgical instruments (RSI; module 3). Modules consisted of pretest, educational module, and post-test components. For modules 1 and 2, graphics interchange formats were utilized to show CT and MRI image stacks for the diagnosis of congenital-type internal hernias and acute appendicitis in pregnant patients, respectively. For module 3, the "Heat Map" format was chosen to showcase intraoperative radiograph cases, which allowed participants to click on the potential RSI in the image. Pre- and post-test scores were evaluated. To determine statistical significance, an alpha level of 0.05 was utilized. RESULTS Module 1 (Internal Hernia): Twenty-one radiology trainees completed the module. The mean pretest score was 3.66 (±1.13) points out of a total 6 possible points (61%), compared to 4.52 (±1.03) points on the post-test (75%). This was a statistically significant increase on the post-test of 0.87 points (95% CI [confidence interval] 0.36, 1.38), t(20) = 3.53, p= 0.002. Module 2 (MR Appendicitis): Seventeen radiology trainees completed the module. The mean pretest score was 3.18 (±1.42) points out of a total 6 possible points (53%), compared to 5.12 (±0.86) points on the post-test (85%). This was a statistically significant increase on the post-test of 1.94 points (95% CI 1.12, 2.76), t(16) = 5.00, p< 0.001. Module 3 (RSI): One hundred seven participants completed the module. The mean pretest score was 3.60 (±1.53) points out of a total 6 possible points (60%), compared to 4.54 (±1.36) points on the post-test (76%). This was a statistically significant increase on the post-test of 0.94 points (95% CI 0.67, 1.21), t(106) = 6.84, p< 0.001. CONCLUSION An online survey platform can be used to build interactive education modules. Post-test scores significantly improved from pretest scores with these educational modules.
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Ding PA, Yang PG, Tian Y, Li F, Guo HH, Liu Y, Zhang ZD, Wang D, Li Y, Zhao Q. [The clinical value of further accurate staging of pT2 gastric cancer based on the depth of invasion]. Zhonghua Zhong Liu Za Zhi 2021; 43:1197-1202. [PMID: 34794224 DOI: 10.3760/cma.j.cn112152-20200309-00189] [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 clinical value of pT2 gastric cancer staging pT2a and pT2b according to the depth of muscularis propria invasion in evaluating the prognosis of gastric cancer. Methods: According to the 8th edition of TNM staging system for gastric cancer proposed by the Union for International Cancer Control (UICC) and the American Joint Committee on Cancer (AJCC), patients with gastric cancer who underwent radical surgery in the Fourth Hospital of Hebei Medical University from January 1, 2008 to January 1, 2015 were selected and divided into pT2a and pT2b stage group according to the depth of tumor invasion. The 5-year overall survival (OS) and disease-free survival (DFS) were compared between the two groups. Results: The median follow-up time of 1 411 patients with postoperative pathological pT2 stage was 68.8 months, and 1 347 patients (95.46%) received complete follow-up data. The 5-year OS rate was 65.85%, and the 5-year DFS rate was 67.83 %. The 5-year OS rate and 5-year DFS rate of 709 pT2a patients were 72.50% and 73.91%, respectively. The 5-year OS rate and 5-year DFS rate of 638 pT2b patients were 58.46% and 61.13%, respectively, significantly different from those of the pT2a group (P<0.001). Hierarchical analysis was performed according to N staging. The 5-year OS rates of pT2aN0M0 (274 cases), pT2aN1M0 (192 cases), pT2aN2M0 (147 cases), pT2aN3aM0 (59 cases) and pT2aN3bM0 (37 cases) were 83.58 %, 72.40 %, 68.71 %, 54.24 % and 35.12 %, respectively. The 5-year DFS rates were 84.67 %, 77.08 %, 67.35 %, 54.24 % and 35.14 %, respectively. In the pT2b group, the 5-year OS rates of pT2bN0M0 (209 cases), pT2bN1M0 (166 cases), pT2bN2M0 (127 cases), pT2bN3aM0 (78 cases) and pT2bN3bM0 (58 cases) were 76.08%, 62.05%, 56.69%, 37.18% and 17.24%, respectively, and the 5-year DFS rates were 80.86%, 69.28%, 54.33%, 35.90% and 15.52%, respectively. Under the same N stage, the OS rates of patients in the pT2a group were better than those in the pT2b group (P values were 0.023, 0.034, 0.034, 0.043 and 0.018, respectively). When the N stage was N0 and N1, there was no significant difference in the 5-year DFS rate between the pT2a group and the pT2b group (P values were 0.199 and 0.090, respectively). When the N stages were N2, N3a and N3b, the difference between the pT2a stage group and the pT2b stage group was statistically significant (P values were 0.027, 0.022 and 0.025, respectively). Conclusions: In the 8th edition of AJCC/UICC gastric cancer staging system, pT2 stage can be divided into pT2a stage (invasion of superficial muscularis) and pT2b stage (invasion of deep muscularis) according to the infiltration depth of muscularis propria. There are significant differences in prognosis between the two groups. Combined with the number of lymph node metastasis, the prognosis of patients with pT2 gastric cancer can be more accurately evaluated.
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Affiliation(s)
- P A Ding
- Department of External Medicine, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
| | - P G Yang
- Department of External Medicine, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
| | - Y Tian
- Department of External Medicine, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
| | - F Li
- Department of Pathology, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
| | - H H Guo
- Department of External Medicine, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
| | - Y Liu
- Department of External Medicine, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
| | - Z D Zhang
- Department of External Medicine, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
| | - D Wang
- Department of External Medicine, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
| | - Y Li
- Department of External Medicine, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
| | - Q Zhao
- Department of External Medicine, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
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Song J, Guo HH. An Opportunity to Reduce Disparities in Lung Cancer Screening. JAMA Netw Open 2021; 4:e2129126. [PMID: 34636918 DOI: 10.1001/jamanetworkopen.2021.29126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Jiangdian Song
- College of Health Management, China Medical University, Liaoning, China
| | - H Henry Guo
- Department of Radiology, School of Medicine Stanford University, Palo Alto, California
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Lui N, Wei N, Trope W, Nesbit S, Bhandari P, Lee CH, Hu H, Guo HH, Liou DZ, Shrager JB, Backhus LM, Berry MF, Yang E. A new model using artificial intelligence to predict recurrence after surgical resection of stage I-II non-small cell lung cancer. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.8537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
8537 Background: Five-year survival for stage I-II lung cancer is quite low even after complete surgical resection. Current guidelines recommend adjuvant treatment only for selected patients with stage II or higher disease. A prediction model that identifies patients at high risk of recurrence who may benefit from adjuvant treatment is greatly needed. Many existing prediction models include a small number of genes that were found to be significant in previous studies. We propose using artificial intelligence to analyze a microarray of > 20,000 well-annotated genes to create a model that predicts recurrence after surgical resection of stage I-II lung cancer. Methods: We identified 275 patients who underwent surgical resection for pathologic stage I-II lung adenocarcinoma or squamous cell carcinoma from 2009 to 2019 in our institution’s prospective surgical database. We excluded patients who had follow up time less than 3 years or received adjuvant therapy and had not had a recurrence, as well as patients with missing specimen blocks. Patient characteristics and recurrence information were obtained from chart review. The patients were divided into training (192 patients) and validation (83 patients) cohorts, and the recurrence status for the validation cohort was initially blinded. Gene expression levels were generated using Clariom S human array (ThermoFisher) from 10um sections cut from the formalin-fixed, paraffin-embedded surgical specimen blocks. The artificial intelligence algorithm Support Vector Machine (SVM) was used to create a prediction model for recurrence using the gene expression and recurrence status of the patients in the training cohort. The model was then tested on the validation cohort using Kaplan-Meier analysis and the area under the receiver operator curve (AUROC). Results: The recurrence prediction model separated the validation cohort into 15 (18.1%) patients in the high-risk group and 68 (81.9%) patients in the low-risk group. Kaplan-Meier analysis showed the five-year disease-free survival was significantly higher in the low-risk group compared to the high-risk group (86 vs. 50%, HR = 4.41, p = 0.0025). The AUROC for predicting recurrence was 0.744. Conclusions: Our model uses artificial intelligence to successfully predict recurrence after surgical resection for stage I-II non-small cell lung cancer. With an AUROC of 0.744, our model outperforms previously described models with AUROC up to 0.6. Our model separates patients into high-risk and low-risk groups, which will make management decisions clearer compared to other models that also include an intermediate-risk group. Patients in the low-risk group had 86% five-year disease-free survival; patients in the high-risk group had 50% five-year disease-free survival and may benefit from increased postoperative surveillance or adjuvant therapy.
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Affiliation(s)
| | | | | | | | | | | | - Hu Hu
- Georgia Institute of Technology, Atlanta, GA
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Guo HH, Persson M, Weinheimer O, Rosenberg J, Robinson TE, Wang J. A calibration CT mini-lung-phantom created by 3-D printing and subtractive manufacturing. J Appl Clin Med Phys 2021; 22:183-190. [PMID: 33949078 PMCID: PMC8200432 DOI: 10.1002/acm2.13263] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 10/03/2020] [Revised: 01/15/2021] [Accepted: 03/30/2021] [Indexed: 11/06/2022] Open
Abstract
We describe the creation and characterization of a calibration CT mini‐lung‐phantom incorporating simulated airways and ground‐glass densities. Ten duplicate mini‐lung‐phantoms with Three‐Dimensional (3‐D) printed tubes simulating airways and gradated density polyurethane foam blocks were designed and built. Dimensional accuracy and CT numbers were measured using micro‐CT and clinical CT scanners. Micro‐CT images of airway tubes demonstrated an average dimensional variation of 0.038 mm from nominal values. The five different densities of incorporated foam blocks, simulating ground‐glass, showed mean CT numbers (±standard deviation) of −897.0 ± 1.5, −844.1 ± 1.5, −774.1 ± 2.6, −695.3 ± 1.6, and −351.0 ± 3.7 HU, respectively. Three‐Dimensional printing and subtractive manufacturing enabled rapid, cost‐effective production of ground‐truth calibration mini‐lung‐phantoms with low inter‐sample variation that can be scanned simultaneously with the patient undergoing lung quantitative CT.
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Affiliation(s)
- H Henry Guo
- Department of Radiology, Stanford Medical Center, Stanford, CA, USA
| | - Mats Persson
- Department of Physics, KTH Royal Institute of Technology, Stockholm, Sweden
| | - Oliver Weinheimer
- Department of Radiology, University of Heidelberg, Heidelberg, Germany
| | | | - Terry E Robinson
- Emeritus, Department of Pediatrics, Stanford Medical Center, Stanford, CA, USA
| | - Jia Wang
- Environmental Health and Safety, Stanford University, Stanford, CA, USA
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Binkley MS, Hiniker SM, Younes S, Yoo C, Wignarajah A, Jin M, Guo HH, Gupta NK, Natkunam Y, Advani RH, Hoppe RT. Stage I-II diffuse large B-cell lymphoma treated with rituximab and chemotherapy with or without radiotherapy. Leuk Lymphoma 2021; 62:1840-1849. [PMID: 33622155 DOI: 10.1080/10428194.2021.1876859] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
We set to identify prognostic factors in a retrospective cohort of consecutive patients with stage I-II diffuse large B-cell lymphoma treated with rituximab-chemotherapy with or without radiotherapy from 2001 through 2017 at our institution. We identified 143 patients with median follow-up of 7.7 years. The majority were male (59.4%), had stage II (53.1%), had stage-modified IPI 0-1 (smIPI, 58.1%), and had non-bulky disease (<7 cm, 68.5%). 99 patients (69.2%) received rituximab-chemotherapy followed by radiotherapy, and 44 patients (30.8%) received rituximab-chemotherapy alone. The 5-year progression-free survival (PFS) and overall survival (OS) were 81.2% and 88.9%, respectively. The 5-year PFS for those with smIPI 0-1 versus 2-4 was 89.5% versus 69.7%, respectively (P = 0.005). Bulky disease (≥7 cm) was associated with worse PFS and OS on univariable and multivariable analyses (P < 0.05). Patients with smIPI 0-1 without bulky disease have excellent outcomes. However, patients with smIPI 2-4 or bulky disease have a high risk of progression.
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Affiliation(s)
- Michael S Binkley
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA, USA
| | - Susan M Hiniker
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA, USA
| | - Sheren Younes
- Department of Pathology, Stanford University School of Medicine, Stanford, CA, USA
| | - Christopher Yoo
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA, USA
| | - Anjali Wignarajah
- Department of Pathology, Stanford University School of Medicine, Stanford, CA, USA
| | - Michael Jin
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA, USA
| | - H Henry Guo
- Department of Nuclear Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Neel K Gupta
- Department of Medicine, Division of Oncology, Stanford University School of Medicine, Stanford, CA, USA
| | - Yasodha Natkunam
- Department of Pathology, Stanford University School of Medicine, Stanford, CA, USA
| | - Ranjana H Advani
- Department of Medicine, Division of Oncology, Stanford University School of Medicine, Stanford, CA, USA
| | - Richard T Hoppe
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA, USA
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Ding PA, Yang PG, Tian Y, Lin XC, Li F, Zhang ZD, Wang D, Guo HH, Liu Y, Li Y, Zhao Q. [The effect of cancer nodules on survival prognosis of gastric cancer patients]. Zhonghua Zhong Liu Za Zhi 2021; 43:194-201. [PMID: 33601484 DOI: 10.3760/cma.j.cn112152-20200408-00323] [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 explore the relationship between cancer nodules and clinicopathological characteristics of gastric cancer, and analyze its impact on survival prognosis of gastric cancer patients. Methods: A retrospective analysis of 2 386 patients with gastric cancer who underwent radical surgery from January 1, 2012 to January 1, 2015 in the Third Surgery Department of the Fourth Hospital of Hebei Medical University was performed. The relationship between cancer nodules and clinicopathological characteristics of gastric cancer and its impact on survival prognosis of gastric cancer patients were analyzed. Results: Among the 2 386 patients, there were 459 cases (19.24%) with cancer nodules, and 1 927 cases (80.76%) without cancer nodules. Logistic multivariate analysis showed that pT staging (P=0.036), pN staging (P=0.024), pTNM staging (P=0.032), Borrmann classification (P=0.008), vascular tumor thrombus (P=0.001) were independent risk factors for cancer nodules. The complete follow-up date of 2 273 cases (95.26%) of 2 386 patients with gastric cancer were obtained. A total of 1 259 patients relapsed and 1 152 died during the follow-up period. The 5-years overall survival (OS) rate was 49.32%, and the 5-years disease-free survival (DFS) rate was 44.61%. Among them, the 5-years OS rate and DFS rate of those with cancer nodules were 26.76% and 24.94%, while the 5-years OS rate and DFS rate of those without cancer nodules were 54.75% and 49.34%, respectively (P<0.001). Patients with positive cancer nodules were divided into 3 groups according to the number of cancer nodules: 1 (115 cases), 2 to 3 (202 cases), and more than 4 (124 cases). The 5-years OS rates of 3 groups were 41.74%, 30.69% and 10.48%, respectively (P<0.001). The 5-years DFS rates were 40.00%, 28.22% and 9.68%, respectively (P<0.001). Cox multivariate analysis showed that histological type (P=0.004), pT staging (P=0.007), pN staging (P=0.004), pTNM staging (P=0.002), vascular tumor thrombus (P=0.034), cancer nodules (P=0.005) and the number of cancer nodules (P=0.001) were independent risk factors for the prognosis of gastric cancer patients, and postoperative adjuvant chemotherapy (P=0.043) was a protective factor for the prognosis of gastric cancer patients. Conclusion: Cancer nodules are closely related to the tumor stage and prognosis of gastric cancer patients. The number of cancerous nodules is an independent risk factor for the prognosis of gastric cancer patients.
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Affiliation(s)
- P A Ding
- The Third Department of Surgery, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
| | - P G Yang
- The Third Department of Surgery, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
| | - Y Tian
- The Third Department of Surgery, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
| | - X C Lin
- The Third Department of Surgery, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
| | - F Li
- Department of Pathology, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
| | - Z D Zhang
- The Third Department of Surgery, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
| | - D Wang
- The Third Department of Surgery, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
| | - H H Guo
- The Third Department of Surgery, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
| | - Y Liu
- The Third Department of Surgery, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
| | - Y Li
- The Third Department of Surgery, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
| | - Q Zhao
- The Third Department of Surgery, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
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Pogatchnik BP, Swenson KE, Sharifi H, Bedi H, Berry GJ, Guo HH. Radiology-pathology Correlation in Recovered COVID-19, Demonstrating Organizing Pneumonia. Am J Respir Crit Care Med 2020; 202:598-599. [PMID: 32609531 PMCID: PMC7427386 DOI: 10.1164/rccm.202004-1278im] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Brian P Pogatchnik
- Stanford University School of Medicine, 10624, Radiology, Stanford, California, United States
| | - Kai E Swenson
- Stanford University School of Medicine, 10624, Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, Stanford, California, United States
| | - Husham Sharifi
- Stanford University School of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, Stanford, California, United States
| | - Harmeet Bedi
- Stanford University School of Medicine, 10624, Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, Stanford, California, United States
| | - Gerald J Berry
- Stanford University School of Medicine, 10624, Pathology, Stanford, California, United States
| | - H Henry Guo
- Stanford University School of Medicine, Radiology, Stanford, California, United States;
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Ding PA, Liu Y, Guo HH, Yang PG, Tian Y, Fan LQ, Tan BB, Li Y, Zhao Q. [Application of laparoscopic exploration combined with abdominal exfoliative cytology in the diagnosis and treatment of locally advanced gastric cancer]. Zhonghua Wei Chang Wai Ke Za Zhi 2020; 23:170-176. [PMID: 32074798 DOI: 10.3760/cma.j.issn.1671-0274.2020.02.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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 explore the clinical significance of laparoscopic exploration combined with abdominal exfoliative cytology in the diagnosis and treatment of patients with locally advanced gastric cancer. Methods: Inclusion criteria: (1) cancer confirmed by gastroscopy and pathology without preoperative anti-tumor treatment; (2) no distant metastases found in preoperative imaging examinations; (3) patients without surgical contraindications and being tolerant to surgery; (4) patients were willing to undergo laparoscopic exploration and abdominal exfoliative cytology examination, and signed informed consent. A retrospective cohort study method was used to collect and analyze the clinicopathological data of 225 patients with advanced gastric cancer based on the above inclusion criteria from a prospective, multicenter, open, randomized controlled phase III clinical trial (registration No. NCT01516944) conducted between February 2012 and December 2018 in The Fourth Hospital of Hebei Medical University, including 162 males and 63 females with age ranged from 23 to 78 years old. Forty-five patients (20.0%) were classified as Borrmann type I to II, and 180 (80.0%) were classified as type III to IV. All the patients underwent laparoscopy and peritoneal lavage cytology under general anesthesia. Laparoscopic exploration sequence: left and right diaphragm→liver and spleen→parietal peritoneum→pelvic cavity→greater omentum, small intestine, mesentery→transverse colon mesentery →stomach. Contents of exploration: (1) with or without ascites; (2) whether metastatic lesions existed in the peritoneum, mesentery, omentum and Douglas pouch; (3) whether metastasis existed on the liver surface; (4) whether the gastric lymph nodes were swollen; (5) whether infiltration occurred on the gastric serosa surface; (6) whether gastric wall was stiff. The left and right subphrenic, the abdominal and pelvic peritoneum, and the mesentery were rinsed with 500 ml of sterilized normal saline. Position of the reverse Trendelenburg was used in the Douglas pouch. The peritoneal lavage fluid under the liver and spleen fossa was collected. Cytological examination was carried out for exfoliative tumor cells. Evaluation criteria: (1) peritoneal metastasis (P): P0 meant no peritoneal metastasis, P1 meant peritoneal metastasis; (2) free peritoneal cancer cells (CY): CY0 meant no cancer cells in peritoneal lavage fluid cytology, CY1 meant cancer cells in peritoneal lavage fluid cytology. The results of patients undergoing laparoscopic exploration combined with abdominal exfoliative cytology, treatment options and prognosis were analyzed. Kaplan-Meier method was used to calculate the survival rate and a survival curve was drawn. Log-rank test was used for survival analysis. Results: After laparoscopic exploration in 225 patients, clinical staging was corrected in 68 (30.2%) patients, of whom 7 (3.1%) downstaged and 61 (27.1%) increased in staging. Of 164 patients evaluated as P0CY0 after the first laparoscopy and peritoneal cytology examination, 126 underwent radical D2 surgery, and the other 38 patients were found to have later local lesions or extensive fusion of local lymph nodes, so then received neoadjuvant chemotherapy. Twenty-nine patients evaluated as P1CY0 or P1CY1 and 32 patients as P0CY1 underwent intraperitoneal hyperthermic chemotherapy+conversion therapy, and then a second laparoscopic exploration was performed to determine the treatment plan. In total, the original treatment regimens were changed after laparoscopic exploration in 99(44.0%) cases. The follow-up period ended in January 2019. The overall 2-year survival rate of 225 patients was 64.0%. As for those who were evaluated as P0CY0, P0CY1 and P1CY0-1 after the first laparoscopic exploration, the 2-year overall survival rate was 70.7%, 65.6% and 24.1%, respectively (P=0.002). The stratified analysis showed that among 180 patients with stage III tumor, after laparoscopic exploration combined with abdominal exfoliative cytology, 125 patients were found to be P0CY0, 28 were P0CY1, and 27 were P1CY0-1, whose 2-year overall survival rates were 70.4%, 64.3%, and 29.6% respectively, and the difference among these 3 groups was statistically significant (P=0.009). Conclusion: Laparoscopic exploration combined with abdominal exfoliative cytology in patients with locally advanced gastric cancer has important clinical guiding significance in improving accurate staging, treatment options and prognosis evaluation, and can avoid non-therapeutic open-close abdominal surgery.
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Affiliation(s)
- P A Ding
- The Third Department of Surgery, The Fourth Hospital, Hebei Medical University, Shijiazhuang 050017, China
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Lindholm P, Swenson ER, Martínez-Jiménez S, Guo HH. From Ocean Deep to Mountain High: Similar Computed Tomography Findings in Immersion and High-Altitude Pulmonary Edema. Am J Respir Crit Care Med 2019; 198:1088-1089. [PMID: 30044644 DOI: 10.1164/rccm.201803-0581im] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Peter Lindholm
- 1 Department of Radiology, Stanford University School of Medicine, Stanford, California.,2 Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Erik R Swenson
- 3 Medical Service, VA Puget Sound Health Care System, University of Washington, Seattle, Washington; and
| | - Santiago Martínez-Jiménez
- 4 Department of Radiology, Saint Luke's Hospital of Kansas City, University of Missouri-Kansas City, Kansas City, Missouri
| | - H Henry Guo
- 1 Department of Radiology, Stanford University School of Medicine, Stanford, California
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Affiliation(s)
| | - Gabriela Gayer
- 2 Department of Radiology, Stanford University School of Medicine, Stanford, California
| | - H Henry Guo
- 2 Department of Radiology, Stanford University School of Medicine, Stanford, California
| | - Viswam S Nair
- 1 Division of Pulmonary and Critical Care and.,2 Department of Radiology, Stanford University School of Medicine, Stanford, California
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Binkley MS, King MT, Shrager JB, Bush K, Chaudhuri AA, Popat R, Gensheimer MF, Maxim PG, Henry Guo H, Diehn M, Nair VS, Loo BW. Pulmonary function after lung tumor stereotactic ablative radiotherapy depends on regional ventilation within irradiated lung. Radiother Oncol 2017; 123:270-275. [PMID: 28460826 DOI: 10.1016/j.radonc.2017.03.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Revised: 03/07/2017] [Accepted: 03/20/2017] [Indexed: 12/17/2022]
Abstract
PURPOSE To determine if regional ventilation within irradiated lung volume predicts change in pulmonary function test (PFT) measurements after stereotactic ablative radiotherapy (SABR) of lung tumors. METHODS We retrospectively identified 27 patients treated from 2007 to 2014 at our institution who received: (1) SABR without prior thoracic radiation; (2) pre-treatment 4-dimensional computed tomography (4-D CT) imaging; (3) pre- and post-SABR PFTs <15months from treatment. We defined the ventilation ratio (VR20BED3) as the quotient of mean ventilation (mean Jacobian-based per-voxel volume change on deformably registered inhale/exhale 4-D CT phases) within the 20Gy biologically effective dose (α/β=3Gy) isodose volume and that of the total lung volume (TLV). RESULTS Most patients had moderate to very severe COPD by GOLD criteria (n=19, 70.1%). Higher VR20BED3 significantly predicted worse change in Forced Expiratory Volume/s normalized by baseline value (ΔFEV1/FEV1pre, p=0.04); n=7 had VR20BED3>1 (high regional ventilation) and worse ΔFEV1/FEV1pre (median=-0.16, range=-0.230 to -0.20). Five had VR20BED3<1 (low regional ventilation) and improved ΔFEV1/FEV1pre (median=0.13, range=0.07 to 0.20). In a multivariable linear model, increasing VR20BED3 and time to post-SABR PFT predicted decreasing ΔFEV1/FEV1pre (R2=0.25, p=0.03). CONCLUSIONS After SABR to high versus low functioning lung regions, we found worsened or improved global pulmonary function, respectively. If pre-SABR VR20BED3 is validated as a predictor of eventual post-SABR PFT in larger studies, it may be used for individualized treatment planning to preserve or even improve pulmonary function after SABR.
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Affiliation(s)
- Michael S Binkley
- Department of Radiation Oncology and Cancer Institute, Stanford University School of Medicine, United States
| | - Martin T King
- Department of Radiation Oncology and Cancer Institute, Stanford University School of Medicine, United States
| | - Joseph B Shrager
- Department of Cardiothoracic Surgery, Division of Thoracic Surgery, Stanford University School of Medicine, United States; Stanford Cancer Institute and Department of Medicine, United States
| | - Karl Bush
- Department of Radiation Oncology and Cancer Institute, Stanford University School of Medicine, United States
| | - Aadel A Chaudhuri
- Department of Radiation Oncology and Cancer Institute, Stanford University School of Medicine, United States
| | - Rita Popat
- Department of Health Research & Policy, Stanford University School of Medicine, United States
| | - Michael F Gensheimer
- Department of Radiation Oncology and Cancer Institute, Stanford University School of Medicine, United States
| | - Peter G Maxim
- Department of Radiation Oncology and Cancer Institute, Stanford University School of Medicine, United States; Stanford Cancer Institute and Department of Medicine, United States
| | - H Henry Guo
- Department of Radiology, Stanford University School of Medicine, United States
| | - Maximilian Diehn
- Department of Radiation Oncology and Cancer Institute, Stanford University School of Medicine, United States; Institute for Stem Cell Biology & Regenerative Medicine, Stanford University School of Medicine, United States; Stanford Cancer Institute and Department of Medicine, United States
| | - Viswam S Nair
- Department of Radiology, Stanford University School of Medicine, United States; Department of Medicine, Division of Pulmonary and Critical Care Medicine, Stanford Cancer Institute and Department of Medicine, United States; Stanford Cancer Institute and Department of Medicine, United States.
| | - Billy W Loo
- Department of Radiation Oncology and Cancer Institute, Stanford University School of Medicine, United States; Stanford Cancer Institute and Department of Medicine, United States.
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Gevaert O, Echegaray S, Khuong A, Hoang CD, Shrager JB, Jensen KC, Berry GJ, Guo HH, Lau C, Plevritis SK, Rubin DL, Napel S, Leung AN. Predictive radiogenomics modeling of EGFR mutation status in lung cancer. Sci Rep 2017; 7:41674. [PMID: 28139704 PMCID: PMC5282551 DOI: 10.1038/srep41674] [Citation(s) in RCA: 103] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Accepted: 12/21/2016] [Indexed: 11/18/2022] Open
Abstract
Molecular analysis of the mutation status for EGFR and KRAS are now routine in the management of non-small cell lung cancer. Radiogenomics, the linking of medical images with the genomic properties of human tumors, provides exciting opportunities for non-invasive diagnostics and prognostics. We investigated whether EGFR and KRAS mutation status can be predicted using imaging data. To accomplish this, we studied 186 cases of NSCLC with preoperative thin-slice CT scans. A thoracic radiologist annotated 89 semantic image features of each patient’s tumor. Next, we built a decision tree to predict the presence of EGFR and KRAS mutations. We found a statistically significant model for predicting EGFR but not for KRAS mutations. The test set area under the ROC curve for predicting EGFR mutation status was 0.89. The final decision tree used four variables: emphysema, airway abnormality, the percentage of ground glass component and the type of tumor margin. The presence of either of the first two features predicts a wild type status for EGFR while the presence of any ground glass component indicates EGFR mutations. These results show the potential of quantitative imaging to predict molecular properties in a non-invasive manner, as CT imaging is more readily available than biopsies.
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Affiliation(s)
- Olivier Gevaert
- Stanford Center for Biomedical Informatics Research, Department of Medicine &Department of Biomedical Data Science, Stanford University, Stanford, CA, USA
| | | | - Amanda Khuong
- Thoracic and GI Oncology Branch, CCR, National Institutes of Health, National Cancer Institute, Bethesda, MD, USA
| | - Chuong D Hoang
- Thoracic and GI Oncology Branch, CCR, National Institutes of Health, National Cancer Institute, Bethesda, MD, USA
| | - Joseph B Shrager
- Thoracic and GI Oncology Branch, CCR, National Institutes of Health, National Cancer Institute, Bethesda, MD, USA
| | - Kirstin C Jensen
- Department of Pathology, Stanford University Medical Center, Stanford, CA, USA.,Pathology and Laboratory Service of Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
| | - Gerald J Berry
- Department of Pathology, Stanford University Medical Center, Stanford, CA, USA
| | - H Henry Guo
- Department of Radiology, Stanford University, Stanford, CA, USA
| | - Charles Lau
- Department of Radiology, Stanford University, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
| | | | - Daniel L Rubin
- Department of Radiology, Stanford University, Stanford, CA, USA
| | - Sandy Napel
- Department of Radiology, Stanford University, Stanford, CA, USA
| | - Ann N Leung
- Department of Radiology, Stanford University, Stanford, CA, USA
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Sun SX, Guo HH, Zhang J, Yu B, Sun KN, Jin QH. BMP-2 and titanium particles synergistically activate osteoclast formation. ACTA ACUST UNITED AC 2014; 47:461-9. [PMID: 24820069 PMCID: PMC4086172 DOI: 10.1590/1414-431x20132966] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2013] [Accepted: 11/25/2013] [Indexed: 02/06/2023]
Abstract
A previous study showed that BMP-2 (bone morphogenetic protein-2) and wear debris can
separately support osteoclast formation induced by the receptor activator of NF-κB
ligand (RANKL). However, the effect of BMP-2 on wear debris-induced osteoclast
formation is unclear. In this study, we show that neither titanium particles nor
BMP-2 can induce osteoclast formation in RAW 264.7 mouse leukemic monocyte macrophage
cells but that BMP-2 synergizes with titanium particles to enhance osteoclast
formation in the presence of RANKL, and that at a low concentration, BMP-2 has an
optimal effect to stimulate the size and number of multinuclear osteoclasts,
expression of osteoclast genes, and resorption area. Our data also clarify that the
effects caused by the increase in BMP-2 on phosphorylated SMAD levels such as c-Fos
expression increased throughout the early stages of osteoclastogenesis. BMP-2 and
titanium particles stimulate the expression of p-JNK, p-P38, p-IkB, and P50 compared
with the titanium group. These data suggested that BMP-2 may be a crucial factor in
titanium particle-mediated osteoclast formation.
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Affiliation(s)
- S X Sun
- Department of Orthopedics, Affiliated Hospital of Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region, China
| | - H H Guo
- Ningxia Medical University, Ningxia Hui Autonomous Region, China
| | - J Zhang
- Institute of Pathology, Xi'an Jiaotong University, Xi'an Shaanxi, China
| | - B Yu
- Ningxia Medical University, Ningxia Hui Autonomous Region, China
| | - K N Sun
- Department of Orthopedics, Affiliated Hospital of Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region, China
| | - Q H Jin
- Department of Orthopedics, Affiliated Hospital of Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region, China
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Guo HH, Yu CC, Sun SX, Ma XJ, Yang XC, Sun KN, Jin QH. Adenovirus-mediated siRNA targeting TNF-α and overexpression of bone morphogenetic protein-2 promotes early osteoblast differentiation on a cell model of Ti particle-induced inflammatory response in vitro. Braz J Med Biol Res 2013; 46:831-8. [PMID: 24141610 PMCID: PMC3854310 DOI: 10.1590/1414-431x20133092] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2013] [Accepted: 07/01/2013] [Indexed: 11/21/2022] Open
Abstract
Wear particles are phagocytosed by macrophages and other inflammatory cells,
resulting in cellular activation and release of proinflammatory factors, which
cause periprosthetic osteolysis and subsequent aseptic loosening, the most
common causes of total joint arthroplasty failure. During this pathological
process, tumor necrosis factor-alpha (TNF-α) plays an important role in
wear-particle-induced osteolysis. In this study, recombination adenovirus (Ad)
vectors carrying both target genes [TNF-α small interfering RNA (TNF-α-siRNA)
and bone morphogenetic protein 2 (BMP-2)] were synthesized and transfected into
RAW264.7 macrophages and pro-osteoblastic MC3T3-E1 cells, respectively. The
target gene BMP-2, expressed on pro-osteoblastic MC3T3-E1 cells and silenced by
the TNF-α gene on cells, was treated with titanium (Ti) particles that were
assessed by real-time PCR and Western blot. We showed that recombinant
adenovirus (Ad-siTNFα-BMP-2) can induce osteoblast differentiation when treated
with conditioned medium (CM) containing RAW264.7 macrophages challenged with a
combination of Ti particles and Ad-siTNFα-BMP-2 (Ti-ad CM) assessed by alkaline
phosphatase activity. The receptor activator of nuclear factor-κB ligand was
downregulated in pro-osteoblastic MC3T3-E1 cells treated with Ti-ad CM in
comparison with conditioned medium of RAW264.7 macrophages challenged with Ti
particles (Ti CM). We suggest that Ad-siTNFα-BMP-2 induced osteoblast
differentiation and inhibited osteoclastogenesis on a cell model of a Ti
particle-induced inflammatory response, which may provide a novel approach for
the treatment of periprosthetic osteolysis.
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Affiliation(s)
- H H Guo
- Affiliated Hospital of Ningxia Medical University, Department of Orthopedic Surgery, Yinchuan, China
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Guo HH, Sweeney RT, Regula D, Leung AN. Best cases from the AFIP: fatal 2009 influenza A (H1N1) infection, complicated by acute respiratory distress syndrome and pulmonary interstitial emphysema. Radiographics 2010; 30:327-33. [PMID: 20068001 DOI: 10.1148/rg.302095213] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- H Henry Guo
- Department of Radiology, Stanford University Medical Center, 300 Pasteur Dr, Stanford, CA 94305-5621, USA.
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Huai RC, Yi CL, Ru LB, Chen GH, Guo HH, Luo L. Traumatic carotid cavernous fistula concomitant with pseudoaneurysm in the sphenoid sinus. Interv Neuroradiol 2008; 14:59-68. [PMID: 20557787 PMCID: PMC3313707 DOI: 10.1177/159101990801400108] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2007] [Accepted: 02/29/2008] [Indexed: 11/16/2022] Open
Abstract
SUMMARY This study was designed to elucidate the generating mechanism, diagnosis and treatment of traumatic carotid cavernous fistula (tCCF) concomitant with pseudoaneurysm in the sphenoid sinus. Six cases of tCCF concomitant with pseudoaneurysm in the sphenoid sinus were analyzed in this study. Clinical history, neurological examination, CT and MRI scans, pre- and postembolization cerebral angiograms and follow-up data were included. All patients presented with massive epistaxis and symptoms of tCCF. The pseudoaneurysms and fistulas were occluded with detachable balloons, and preservation of the parent artery in two cases. One patient also had indirect carotid cavernous fistula (CCF) on the contralateral side embolized by transfacial vein approach with microcoils. Complete symptom resolution was achieved in all cases, without procedure related complications. During the follow-up period all patients returned to work. Falling from a high speed motorcycle without wearing a helmet may be one of the main causes of this disease. The site of impact during the accident mostly localizes in the frontal and lateral of the orbit. Intracavernous sinus hypertension of tCCF combining with fracture of the lateral wall of the sphenoid may lead to the formation of a pseudoaneurysm in the sphenoid sinus. MRI scan is very helpful in the diagnosis of this disease before the patient receives angiography. Detachable balloon occlusion of the pseudoaneurysm and fistula is a safe and efficient treatment.
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Affiliation(s)
- R C Huai
- Department of Neurosurgery, Changzheng Hospital, the Shanghai Neurosurgical Institute, Shanghai China -
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ten Tije AJ, Wieman TJ, Taber SW, Tseng MT, Cerrito PB, Jansen JM, Guo HH, Fingar VH. Analysis of pulmonary microvasculature changes after photodynamic therapy delivered to distant sites. Photochem Photobiol 1999; 69:494-9. [PMID: 10212583] [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] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
Photodynamic therapy (PDT) can exert local damage by direct tumor cytotoxicity, by disruption of the microvasculature or by a combination of these effects. Although systemic effects after PDT of small tissue areas (< 1% total body surface area) are unlikely, treatment of larger areas may result in an accumulated effect leading to toxicity. Several investigators have described animal death after high dose PDT to tumors on the hind limb of animals and hypothesized that a toxic shock syndrome caused by vasoactive agents released after PDT is responsible. Because one of the most vulnerable organs to toxic shock injury is the lung, we studied the systemic effects of local PDT to this organ by intravital microscopy using a pulmonary window chamber. The PDT treatment conditions (25 mg/kg Photofrin, 24 h, 150 J/cm2 630 nm, maximum area 6.28 cm2) were chosen that produce systemic toxicity and lethality in rats. Adhesion of leukocytes in the lung was monitored in vivo using anti-CD-13-labeled microspheres. The progression of pulmonary edema was assessed by monitoring the leakage of rhodamine-labeled albumin and by wet-to-dry lung weight ratios. Although an increased leukocyte adherence was observed and a significant number of animals died after the extensive PDT treatment, no biologically significant lung edema could be demonstrated. These data indicate that lung edema and acute respiratory distress syndrome is not the cause of death in these animals and that the toxicity is related to other mechanisms including circulatory shock after extensive muscle damage.
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Affiliation(s)
- A J ten Tije
- Department of Internal Medicine, St. Clara Hospital, Rotterdam, The Netherlands
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Fingar VH, Guo HH, Lu ZH, Peiper SC. Expression of chemokine receptors by endothelial cells: detection by intravital microscopy using chemokine-coated fluorescent microspheres. Methods Enzymol 1997; 288:148-58. [PMID: 9356993 DOI: 10.1016/s0076-6879(97)88013-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
MESH Headings
- Animals
- Antigens, CD/analysis
- Antigens, CD/biosynthesis
- Endothelium, Vascular/cytology
- Endothelium, Vascular/metabolism
- Escherichia coli
- Gene Expression/genetics
- Interleukin-8/isolation & purification
- Interleukin-8/metabolism
- Microscopy, Fluorescence/methods
- Microscopy, Video
- Microspheres
- Rats
- Rats, Sprague-Dawley
- Receptors, Chemokine/analysis
- Receptors, Chemokine/biosynthesis
- Receptors, Interleukin/analysis
- Receptors, Interleukin/biosynthesis
- Receptors, Interleukin-8A
- Recombinant Fusion Proteins/isolation & purification
- Recombinant Fusion Proteins/metabolism
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Affiliation(s)
- V H Fingar
- Department of Surgery, University of Louisville, Kentucky 40292, USA
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36
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Affiliation(s)
- Z X Wang
- Department of Biochemistry and Molecular Biology, Henry Vogt Cancer Research Institute, James Graham Brown Cancer Center, University of Louisville, Kentucky 40292, USA
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Doranz BJ, Lu ZH, Rucker J, Zhang TY, Sharron M, Cen YH, Wang ZX, Guo HH, Du JG, Accavitti MA, Doms RW, Peiper SC. Two distinct CCR5 domains can mediate coreceptor usage by human immunodeficiency virus type 1. J Virol 1997; 71:6305-14. [PMID: 9261347 PMCID: PMC191903 DOI: 10.1128/jvi.71.9.6305-6314.1997] [Citation(s) in RCA: 169] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
The chemokine receptor CCR5 is the major fusion coreceptor for macrophage-tropic strains of human immunodeficiency virus type 1 (HIV-1). To define the structures of CCR5 that can support envelope (Env)-mediated membrane fusion, we analyzed the activity of homologs, chimeras, and mutants of human CCR5 in a sensitive gene reporter cell-cell fusion assay. Simian, but not murine, homologs of CCR5 were fully active as HIV-1 fusion coreceptors. Chimeras between CCR5 and divergent chemokine receptors demonstrated the existence of two distinct regions of CCR5 that could be utilized for Env-mediated fusion, the amino-terminal domain and the extracellular loops. Dual-tropic Env proteins were particularly sensitive to alterations in the CCR5 amino-terminal domain, suggesting that this domain may play a pivotal role in the evolution of coreceptor usage in vivo. We identified individual residues in both functional regions, Asp-11, Lys-197, and Asp-276, that contribute to coreceptor function. Deletion of a highly conserved cytoplasmic motif rendered CCR5 incapable of signaling but did not abrogate its ability to function as a coreceptor, implying the independence of fusion and G-protein-mediated chemokine receptor signaling. Finally, we developed a novel monoclonal antibody to CCR5 to assist in future studies of CCR5 expression.
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Affiliation(s)
- B J Doranz
- Department of Pathology, University of Pennsylvania, Philadelphia 19104, USA
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Rana S, Besson G, Cook DG, Rucker J, Smyth RJ, Yi Y, Turner JD, Guo HH, Du JG, Peiper SC, Lavi E, Samson M, Libert F, Liesnard C, Vassart G, Doms RW, Parmentier M, Collman RG. Role of CCR5 in infection of primary macrophages and lymphocytes by macrophage-tropic strains of human immunodeficiency virus: resistance to patient-derived and prototype isolates resulting from the delta ccr5 mutation. J Virol 1997; 71:3219-27. [PMID: 9060685 PMCID: PMC191454 DOI: 10.1128/jvi.71.4.3219-3227.1997] [Citation(s) in RCA: 159] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
The alpha-chemokine receptor fusin (CXCR-4) and beta-chemokine receptor CCR5 serve as entry cofactors for T-cell (T)-tropic and macrophage (M)-tropic human immunodeficiency virus type 1 (HIV-1) strains, respectively, when expressed with CD4 in otherwise nonpermissive cells. Some M-tropic and dual-tropic strains can also utilize other beta-chemokine receptors, such as CCR2b and CCR3. A mutation of CCR5 (delta ccr5) was recently found to be common in certain populations and appears to confer protection against HIV-1 in vivo. Here, we show that this mutation results in a protein that is expressed intracellularly but not on the cell surface. Primary CD4 T cells from delta ccr5 homozygous individuals were highly resistant to infection with prototype M-tropic HIV-1 strains, including an isolate (YU-2) that uses CCR5 and CCR3, but were permissive for both a T-tropic strain (3B) and a dual-tropic variant (89.6) that uses CXCR-4, CCR5, CCR3, or CCR2b. These cells were also resistant to M-tropic patient isolates but were readily infected by T-tropic patient isolates. Primary macrophages from delta ccr5 homozygous individuals were also resistant to infection with M-tropic strains, including YU-2, but the dual-tropic strain 89.6 was able to replicate in them even though macrophages are highly resistant to CXCR-4-dependent T-tropic isolates. These data show that CCR5 is the essential cofactor for infection of both primary macrophages and T lymphocytes by most M-tropic strains of HIV-1. They also suggest that CCR3 does not function for HIV-1 entry in primary lymphocytes or macrophages, but that a molecule(s) other than CCR5 can support entry into macrophages by certain virus isolates. These studies further define the cellular basis for the resistance to HIV-1 infection of individuals lacking functional CCR5.
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MESH Headings
- CD4 Antigens/immunology
- CD8 Antigens/immunology
- Cells, Cultured
- HIV-1/immunology
- HIV-1/physiology
- Humans
- Lymphocytes/cytology
- Lymphocytes/virology
- Macrophages/cytology
- Macrophages/virology
- Mutagenesis
- Receptors, CCR3
- Receptors, CCR5
- Receptors, Chemokine
- Receptors, Cytokine/genetics
- Receptors, Cytokine/immunology
- Receptors, Cytokine/physiology
- Receptors, HIV/genetics
- Receptors, HIV/immunology
- Receptors, HIV/physiology
- Species Specificity
- Virus Replication
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Affiliation(s)
- S Rana
- Division of Pulmonary and Critical Care, University of Pennsylvania School of Medicine, Philadelphia 19104, USA
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39
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Guo HH, Zhou LF. [Further experience in the diagnosis and treatment of sphenoidal ridge meningioma]. Zhonghua Wai Ke Za Zhi 1994; 32:740-2. [PMID: 7774425] [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: 01/27/2023]
Abstract
72 cases with sphenoidal ridge meningioma operated on in recent 12 years in our department were reported. In the microsurgical group and non-microsurgical group, the rate of total removal of medial tumors was 65% and 20% respectively (P < 0.01); lateral tumors was 100% and 77% respectively (P > 0.05); the mortality was 6.7% and 11.9% respectively (P > 0.05); the rate of neurological impaired was 33.3% and 64.3% respectively (P < 0.001); good rate of following up for a long time was 87.5% and 16.7% in medial group respectively (P < 0.05); 66.7% and 75% in lateral group respectively (P > 0.05). It is believed that application of CT and angiography and microsurgical technique is helpful to the diagnosis and treatment of sphenoidal ridge meningioma.
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Affiliation(s)
- H H Guo
- Huashan Hospital, Shanghai Medical University
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Guo HH, Pan YH, Zhou LF, Shi YQ. Research on hemodynamics of cerebral arteriovenous malformation by Doppler ultrasound. Chin Med J (Engl) 1993; 106:351-6. [PMID: 8404277] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Combined extracranial and transcranial Doppler (TCD) instruments were used to study the hemodynamics of 20 patients with cerebral arteriovenous malformation (AVM) proved angiographically. It was discovered that the flow velocities in AVM-feeding arteries and their proximal arteries were increased; the increase of flow velocities in feeding arteries close to AVM was more remarkable than that in feeding-arteries proximal to extracranial internal carotid artery far from AVM; pulsating indexes of AVM-feeding arteries were decreased; increase of flow velocities in AVM-feeding arteries was related to the decrease of pulsating index; the flow velocities of nontapering feeding arteries were faster than those of tapering arteries; the greater the size of AVM, the faster the velocity in feeding artery; and the flow velocities and pulsating indexes of AVM-feeding arteries were gradually recovered to normal 3-5 weeks after resection of AVM. It is believed that increase of flow velocity in AVM-feeding artery is associated with distention and decreased resistance of flow in AVM-feeding artery. TCD combined with CT scans are helpful to the diagnosis of AVM. Combination of TCD and cerebral angiography (CAG) to evaluate comprehensively the preoperative hemodynamics of AVM and to monitor postoperative changes is helpful to detecting cerebral steal due to steal leakage in circle of Willis and preventing the hazardous postoperative complications caused by pressure breakthrough of normal perfusion.
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Affiliation(s)
- H H Guo
- Institute of Neurology, Shanghai Medical University
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