Fibroglandular Tissue and Background Parenchymal Enhancement on Breast MR Imaging Correlates With Breast Cancer

ObjectivesTo evaluate the association of breast cancer with both the background parenchymal enhancement intensity and volume (BPEI and BPEV, respectively) and the amount of fibroglandular tissue (FGT) using an automatic quantitative assessment method in breast magnetic resonance imaging (MRI).Materials and MethodsAmong 17,274 women who underwent breast MRI, 132 normal women (control group), 132 women with benign breast lesions (benign group), and 132 women with breast cancer (cancer group) were randomly selected and matched by age and menopausal status. The area under the receiver operating characteristic curve (AUC) was compared in Cancer vs Control and Cancer vs Benign groups to assess the discriminative ability of BPEI, BPEV and FGT.ResultsCompared with the control groups, the cancer group showed a significant difference in BPEV with a maximum AUC of 0.715 and 0.684 for patients in premenopausal and postmenopausal subgroup, respectively. And the cancer group showed a significant difference in BPEV with a maximum AUC of 0.622 and 0.633 for patients in premenopausal and postmenopausal subgroup, respectively, when compared with the benign group. FGT showed no significant difference when breast cancer group was compared with normal control and benign lesion group, respectively. Compared with the control groups, BPEI showed a slight difference in the cancer group. Compared with the benign group, no significant difference was seen in cancer group.ConclusionIncreased BPEV is correlated with a high risk of breast cancer While FGT is not.

Plasma exosomal miRNA-205 can be used for early diagnosis and prognostic evaluation of ovarian cancer

Background Ovarian cancer (OC) is a serious threat to women's health around the world and new biomarkers are urgently needed for early detection. Our previous published research have confirmed that miR-205 can promote the invasion and metastasis of OC cells by inhibiting the expression of the tumor suppressor gene TCF21. This study is based on the previous work, using exosomal liquid biopsy technology to detect the expression levels of the four genes miR-205, CA125, HE4 and TCF21 in the plasma exosomes of OC patients; at the same time, combined with the clinicopathological parameters of OC patients data analysis aims to provide efficient and non-invasive laboratory testing basis for the early diagnosis of OC. Methods Collected 36 OC patients diagnosed in local hospitals from September 2020 to July 2021 as OC group, selected 31 cases of surgically diagnosed ovarian benign lesions for benign group and 32 healthy people who underwent physical examination during the same period as a control group, and used transmission electron microscope (TEM), western blotting (WB) and nanoparticle tracking analysis (NTA) to identify after extracting plasma exosomes from kits. The expression levels of miR-205, CA125, HE4 and TCF21 genes in plasma exosomes were detected by real-time fluorescence quantitative PCR (qRT-PCR) method. At the same time, combined with the relationship between clinical pathological parameters in OC patients, the Receiver Operating Characteristic (ROC) curves were used to evaluate the diagnostic efficacy of plasma exosomal miR-205, CA125, HE4 and TCF21 for OC. Results Plasma exosomes were successfully isolated; the expression level of plasma exosomal miR-205 in the OC group was higher than that of the benign group and the control group, and the difference was statistically significant (P < 0.05); plasma exosomal miR-205 was elevated during the III-IV period of OC and lymph node metastasis; combined detection of plasma exosomal miR-205 can improve the diagnostic ability of OC. Conclusion The plasma exosomal miR-205 can be used as a potential tumor biomarker to improve the diagnostic effectiveness of OC.

MRI Image Segmentation Model with Support Vector Machine Algorithm in Diagnosis of Solitary Pulmonary Nodule

This study focused on the application value of MRI images processed by a Support Vector Machine (SVM) algorithm-based model in diagnosis of benign and malignant solitary pulmonary nodule (SPN). The SVM algorithm was constrained by a self-paced regularization item and gradient value to establish the MRI image segmentation model (SVM-L) for lung. Its performance was compared factoring into the Dice index (DI), sensitivity (SE), specificity (SP), and Mean Square Error (MSE). 28 SPN patients who underwent the parallel MRI examination were selected as research subjects and were divided into the benign group (11 patients) and malignant group (17 patients) according to different plans for diagnosis and treatment. The apparent diffusion coefficient (ADC) at different b values was analyzed, and the steepest slope (SS) and washout ratio (WR) values in the two groups were calculated. The result showed that the MSE, DI, SE, SP values, and operation time of the SVM-L model were (0.41 ± 0.02), (0.84 ± 0.13), (0.89 ± 0.04), (0.993 ± 0.004), and (30.69 ± 2.60)s, respectively, apparently superior to those of the other algorithms, but there were no statistic differences ( P > 0.05 ) in the WR value between the two groups of patients. The SS values of the time-signal curve in the benign and malignant groups were (2.52 ± 0.69) %/s and (3.34 ± 00.41) %/s, respectively. Obviously, the SS value of the benign group was significantly lower than that of the malignant group ( P < 0.01 ). The ADC value with different b values in the benign group was significantly lower than that of the malignant group ( P < 0.01 ). It suggested that the SVM-L model significantly improved the quality of lung MRI images and increased the accuracy to differentiate benign and malignant SPN, providing reference for the diagnosis and treatment of SPN patients.

Serum WNT-induced secreted protein 1 level as a potential biomarker for thyroid nodules

Background. Thyroid nodule (TN) is a common thyroid disease worldwide, and it has increased significantly last decades. Most TNs are usually incidental findings of asymptomatic, benign lesions discovered by imaging modalities performed for reasons unrelated to thyroid diseases. The purpose of this study was to investigate the value of serum WNT-induced secreted protein 1 (WISP1) level as a supporting biomarker to perform differential diagnosis of benign and non-benign thyroid nodules. Materials and methods. The study was completed with the 89 patients undergone fine needle aspiration biopsy and 43 controls. The patients were composed of 96 (72.7 %) females and 36 (27.3 %) males. And they were divided into 2 group according to the Bethesda cytological evaluation as Benign (Bethesda 2) and Non-Benign (Bethesda 3–6) groups. Their serum WISP1 levels were measured by an ELISA method. Results. There were 58 (43.9 %) patients in Benign (Bethesda 2) and 31 (23.5 %) in non-Benign (Bethesda 3–6) groups. In the contrary nodule size was bigger in the Non-benign group than that benign group (p = 0.006). The serum WISP1 level in the Benign (Bethesda 2) group was significantly higher than that in the and Non-Benign (Bethesda 3–6) group, and controls (p < 0). The difference between benign and non-benign group accordingly to their echogenicitiy was significant (p < 0.05). In benign group there was 76.9 % mixed echoic nodules, 76.7 % isoechoic nodules 68.4 % isohypoechoic nodules and 35.7 % hypoechoic nodules. In the non-benign group, the highest hypoechoic echo (64.3 %), the least mixed echo (23.1 %), while in the benign group, the most mixed echo (76.9 %), the least hypoechoic echo (35.7 %) was present. There was no relation between WISP1 levels and echogenicity with Kruskal-Wallis H test. Conclusions. According to the preliminary results of current study, addition of serum WISP1 measurement to the differential diagnostic work-up of thyroid nodules patients may provide supportive information. In thyroid nodules patients with Benign (Bethesda 2) category of cytological evaluation, a higher level of serum WISP1 may support cytological diagnosis.

MRI Features of Solitary Vertebral Masses in Dogs: 20 Cases (2010–2019)

The objective of the study was to describe the MRI features of cytologically or histologically diagnosed solitary vertebral masses in dogs and identify potential MRI features enabling differentiation between malignant and benign lesions. Patients were divided into malignant and benign groups according to the final diagnosis. Medical records and MRI studies were retrospectively reviewed, and specific imaging features were compared. The malignant group comprised 15 dogs, with 5 dogs included in the benign group. MRI features of the different histopathologic/cytologic types of masses are described. Involvement of the vertebral body, a hyperintense signal on T2-weighted, short tau inversion recovery, T1-weighted, and T1-weighted gradient echo sequences and evidence of cortical destruction were significantly associated with malignancy (P &lt; .05). Hypointensity on T1-weighted gradient echo sequence was significantly associated with benign masses (P &lt; .05). The presence of bone sclerosis was significantly associated with osteosarcomas compared with other malignant masses (P &lt; .05). Fractures (5 cases) were only seen in the group of malignant masses. This pilot study identifies some MRI features that may help differentiate between malignant and benign solitary vertebral masses. Greater case numbers are needed in future studies.

Association Between 18F-FDG PET/CT-Based SUV Index and Malignant Status of Persistent Ground-Glass Nodules

To explore the association between 18F-FDG PET/CT-based SUV index and malignant risk of persistent ground-glass nodules (GGNs). We retrospectively analyzed a total of 166 patients with GGN who underwent PET/CT examination from January 2012 to October 2019. There were 113 women and 53 men, with an average age of 60.8 ± 9.1 years old. A total of 192 GGNs were resected and confirmed by pathology, including 22 in benign group and 170 in adenocarcinoma group. They were divided into three groups according to SUV index tertiles: Tertile 1 (0.14–0.54), Tertile 2 (0.55–1.17), and Tertile 3 (1.19–6.78), with 64 GGNs in each group. The clinical and imaging data of all patients were collected and analyzed. After adjusting for the potential confounding factors, we found that the malignancy risk of GGN significantly decreased as the SUV index increased (OR, 0.245; 95%CI, 0.119–0.504; P &lt;0.001), the average probability of malignant GGN was 89.1% (95% CI, 53.1–98.3%), 80.5% (95% CI, 36.7–96.7%), and 34.3% (95%CI, 9.5–72.2%) for Tertile 1 to Tertile 3. And the increasing trend of SUV index was significantly correlated with the reduction of malignant risk (OR, 0.099; 95%CI, 0.025–0.394; P = 0.001), especially between Tertile 3 versus Tertile 1 (OR, 0.064; 95%CI, 0.012–0.356; P = 0.002). Curve fitting showed that the SUV index was linearly and negatively correlated with the malignant risk of GGN. SUV index is an independent correlation factor for malignancy risk of GGN, the higher the SUV index, the lower the probability of GGN malignancy.

Comparison of miRNA expressions among benign, premalignant and malignant lesions of the larynx: could they be transformation biomarkers?

Background The malignancy potential of the laryngeal lesions are one of the major concerns of the surgeons about choosing the treatment options, forming surgical margins, deciding the follow-up periods. Finding a biomarker to overcome these concerns are ongoing challenges and recently microRNAs (miRNAs) are attributed as possible candidates since they can regulate gene expressions in the human genome. The objective of our study was to investigate their capability as a transformation biomarker for malignant laryngeal lesions. Materials and methods We investigated mature miRNA expressions in paraffin-embedded surgical specimens of human laryngeal tissues grouped as benign, premalignant or malignant (n = 10 in each). miRNA profiling was carried out by quantitative Real-Time polymerase chain reaction (RT-qPCR) and data were analyzed according to fold regulation. Results Our results demonstrated that 9 miRNAs were upregulated as the lesions become more malignant. Among them Hs_miR-183_5p, Hs_miR-155_5p, and Hs_miR-106b_3p expressions were significantly 4.16 (p = 0.032), 2.72 (p = 0.028) and 3.01 (p = 0.022) fold upregulated respectively in premalignant lesions compared to the benign lesions. Moreover, their expressions were approximately 2.76 fold higher in the malignant group than in the premalignant group compared to the benign group. Besides them, significant 7.57 (p = 0.036), 4.45 (p = 0.045) and 5.98 (p = 0.023) fold upregulations of Hs_miR-21_5p, Hs_miR-218_3p, and Hs_miR-210_3p were noticed in the malignant group but not in the premalignant group when compared to the benign group, respectively. Conclusion MiRNAs might have important value to help the clinicians for their concerns about the malignancy potentials of the laryngeal lesions. Hs_miR-183_5p, Hs_miR-155_5p, and Hs_miR-106b_3p might be followed as transformation marker, whereas Hs_miR-21_5p, Hs_miR-218_3p, and Hs_miR-210_3p might be a biomarker prone to malignancy.

Chronic Inflammation on Prostate Needle Biopsy as a Significant Predictor of the Lower Incidence Risk of Prostate Cancer

Purpose: At present, there is no clear relationship between prostatitis and prostate cancer(PCa). Therefore, in order to further understand the inflammation of prostate tissue and the occurrence of PCa, we conducted this study.Method: A total of 686 patients were enrolled in the study. All patients underwent prostate biopsy in our hospital. A retrospective analysis of the biopsy results was performed to assess the assocition between chronic inflammation and the risk of PCa.Result: Of the 686 patients, 354 were diagnosed with PCa, and 332 were benign. A total of 403 patients had prostate inflammation. PCa patients had lower prostate volume and transition zone volume than benign group(p＜0.001). Compared with benign group, PCa patients had lower PSA and PSA density (PSAD)(p＜0.001). We also found that the probability of inflammation in PCa patients is lower than that in the benign group (p＜0.001). In multivariate analyses, chronic inflammation was negatively correlated with the incidence of PCa（OR=0.80; p=0.015). Conclusion: Chronic inflammation in biopsy tissue might serve as a predicted factor for low incidence risk of PCa.

Dilemma of the differential diagnosis of hilar cholangiocarcinoma and benign diseases:a single-center retrospective study

Hilar cholangiocarcinoma, which lacks specific clinical manifestations, remains very difficult to distinguish from benign disease. This distinction is further complicated by the complex hilar anatomy. We conducted the present study to evaluate the differential diagnosis of these conditions. Sixty-five patients underwent resection surgery for suspected hilar cholangiocarcinoma between January 2011 and October 2018. Institutional Review Board of Shengjing hospital agreed this study and all particpants sign an informed consent document prior to participation in a research study. Following a postoperative pathology analysis, all patients were divided into 2 groups: malignant group (54 patients with HCCA) and benign group (11 cases with benign lesions). Compared to the benign group, the malignant group had a significantly higher median age and serum CA19-9, CEA, ALT, BILT, and BILD levels (P &lt;0.05). By contrast, the groups did not differ significantly in terms of the sex distribution, clinical manifestations, serum levels of AST and ALKP, and imaging findings. In a receiver operating characteristic curve analysis, we identified a CA19-9 cut-off point of 233.15 U/ml for the differential diagnosis and CEA cut-off point of 2.98 ng/ml for the differential diagnosis. The differential diagnosis of HCCA and benign hilar lesions remains difficult. However, we found that patients with HCCA tended to have an older age at onset and higher serum levels of CA19-9, CEA, BILT, ALT, and BILD. Furthermore, patients with a serum CA19-9 level &gt;233.15 U/ml and CEA level &gt;2.98 ng/ml are more likely to have malignant disease.

Application of ultrasound artificial intelligence in the differential diagnosis between benign and malignant breast lesions of BI-RADS 4A

Background The classification of Breast Imaging Reporting and Data System 4A (BI-RADS 4A) lesions is mostly based on the personal experience of doctors and lacks specific and clear classification standards. The development of artificial intelligence (AI) provides a new method for BI-RADS categorisation. We analysed the ultrasonic morphological and texture characteristics of BI-RADS 4A benign and malignant lesions using AI, and these ultrasonic characteristics of BI-RADS 4A benign and malignant lesions were compared to examine the value of AI in the differential diagnosis of BI-RADS 4A benign and malignant lesions. Methods A total of 206 lesions of BI-RADS 4A examined using ultrasonography were analysed retrospectively, including 174 benign lesions and 32 malignant lesions. All of the lesions were contoured manually, and the ultrasonic morphological and texture features of the lesions, such as circularity, height-to-width ratio, margin spicules, margin coarseness, margin indistinctness, margin lobulation, energy, entropy, grey mean, internal calcification and angle between the long axis of the lesion and skin, were calculated using grey level gradient co-occurrence matrix analysis. Differences between benign and malignant lesions of BI-RADS 4A were analysed. Results Significant differences in margin lobulation, entropy, internal calcification and ALS were noted between the benign group and malignant group (P = 0.013, 0.045, 0.045, and 0.002, respectively). The malignant group had more margin lobulations and lower entropy compared with the benign group, and the benign group had more internal calcifications and a greater angle between the long axis of the lesion and skin compared with the malignant group. No significant differences in circularity, height-to-width ratio, margin spicules, margin coarseness, margin indistinctness, energy, and grey mean were noted between benign and malignant lesions. Conclusions Compared with the naked eye, AI can reveal more subtle differences between benign and malignant BI-RADS 4A lesions. These results remind us carefully observation of the margin and the internal echo is of great significance. With the help of morphological and texture information provided by AI, doctors can make a more accurate judgment on such atypical benign and malignant lesions.