Objective To investigate the imaging features observed in preoperative Gd-EOB-DTPA-dynamic enhanced MRI and correlated with the presence of microvascular invasion (MVI) in hepatocellular carcinoma (HCC) patients. Methods 66 HCCs in 60 patients with preoperative Gd-EOB-DTPA-dynamic enhanced MRI were retrospectively analyzed. Features including tumor size, signal homogeneity, tumor capsule, tumor margin, peritumor enhancement during mid-arterial phase, peritumor hypointensity during hepatobiliary phase, signal intensity ratio on DWI and apparent diffusion coefficients (ADC), T1 relaxation times, and the reduction rate between pre- and postcontrast enhancement images were assessed. Correlation between these features and histopathological presence of MVI was analyzed to establish a prediction model. Results Histopathology confirmed that MVI were observed in 17 of 66 HCCs. Univariate analysis showed tumor size (p = 0.003), margin (p = 0.013), peritumor enhancement (p = 0.001), and hypointensity during hepatobiliary phase (p = 0.004) were associated with MVI. A multiple logistic regression model was established, which showed tumor size, margin, and peritumor enhancement were combined predictors for the presence of MVI (α = 0.1). R2 of this prediction model was 0.353, and the sensitivity and specificity were 52.9% and 93.0%, respectively. Conclusion Large tumor size, irregular tumor margin, and peritumor enhancement in preoperative Gd-EOB-DTPA-dynamic enhanced MRI can predict the presence of MVI in HCC.

OBJECTIVE. The purpose of this study was to determine an optimal multiparametric MRI protocol for characterizing tumors of low versus high grade and differentiating tumors as T1 versus T2 for preoperative staging of bladder urothelial carcinoma. SUBJECTS AND METHODS. Thirty-nine patients underwent MRI within 1 week before surgery. Three image sets-T2-weighted plus diffusion-weighted MRI (DWI), T2-weighted plus dynamic contrast-enhanced MRI (DCE-MRI), and T2-weighted plus DCEMRI plus DWI-were independently interpreted by two readers at 2-week intervals. ROC curves were plotted for both readers to compare the diagnostic efficacy of the three sets for detrusor muscle invasion for each reader, and the areas under the ROC curve were compared by use of the Bonferroni test. The apparent diffusion coefficient (ADC) values were correlated with histopathologic grade. RESULTS. A total of 49 category T1 and T2 lesions were analyzed. The average ADC of 11 low-grade tumors (1.141 ± 0.164 × 10(-3) mm(2)/s) was significantly (p < 0.05) higher than that of 20 high-grade malignant tumors (0.766 ± 0.091 × 10(-3) mm(2)/s). Neither reader considered T1 tumors as probably having muscle invasion (category T2) in the T2-weighted plus DWI image sets or the T2-weighted plus DWI plus DCE-MRI image sets. Using the T2-weighted plus DCE-MRI sets, the two readers overstaged 13 and 15 of 36 tumors by misdiagnosing category T1 as T2. With the cutoff ADC value of 0.899 × 10-3 mm(2)/s, the sensitivity and specificity for differentiating high- and low-grade bladder urothelial carcinoma were 100% and 95%. CONCLUSION. Multiparametric MRI with T2-weighted plus DWI plus DCE technique is the optimal protocol for preoperative staging of organ-confined bladder urothelial carcinoma. The ADC of low-grade tumors is significantly higher than that of high-grade tumors with 100% sensitivity and 95% specificity at a cutoff ADC value of 0.899 mm(2)/s.

The aim of the study is to investigate if the fat content of the liver and pancreas may indicate impaired glucose tolerance (IGT) or type 2 diabetes mellitus (T2DM). A total of 83 subjects (34 men; aged 46.5 ± 13.5 years) were characterized as T2DM, IGT, or normal glucose tolerant (NGT). NGT individuals were stratified as <40 or ≥40 years. Standard laboratory tests were conducted for insulin resistance and β-cell dysfunction. The magnetic resonance imaging Dixon technique was used to determine fat distribution in the liver and pancreas. Correlations among liver and pancreatic fat volume fractions (LFVFs and PFVFs, respectively) and laboratory parameters were analyzed. Among the groups, fat distribution was consistent throughout sections of the liver and pancreas, and LFVFs closely correlated with PFVFs. LFVFs correlated more closely than PFVFs with insulin resistance and β-cell function. Both the LFVFs and PFVFs were the highest in the T2DM patients, less in the IGT, and least in the NGT; all differences were significant. The PFVFs of the NGT subjects ≥40 years were significantly higher than that of those <40 years. The fat content of the liver and pancreas, particularly the liver, may be a biomarker for IGT and T2DM.

ObjectiveTo explore the correlations between liver fat content and clinical index in patients with impaired glucose tolerance (IGT) and healthy subjects.Materials and Methods56 subjects were enrolled and each of them underwent upper-abdominal MRI examination that involved a T1 VIBE Dixon sequence. 14 was clinically diagnosed with IGT (collectively as IGT group ) while 42 showed normal glucose tolerance,(collectively as NGT group). NGT group was further divided into NGTFat (BMI≥25, 18 subjects) and NGTLean (BMI<25, 24 subjects). The total liver fat contents was measured and compared with clinical findings and laboratory results in order to determine statistical correlations between these parameters. Differences among IGT, NGTFat and NGTLean groups were evaluated.ResultsFor all the subjects, fat volume fractions (FVFs) ranged from 4.2% to 24.2%, positive correlations was observed with BMI, waist hip ratio(WHR), low density lipoprotein(LDL), fasting plasma insulin(FPI), homeostasis model assessment insulin resistance (HOMA-IR) and homeostasis model assessment β(HOMAβ). FVFs of IGT group (p = 0.004) and NGTFat group (p = 0.006) were significantly higher than those of NGTLean group.ConclusionsPeople with higher BMI, WHR and LDL levels tend to have higher liver fat content. Patients with BMI≥25 are more likely to develop IGT. Patients with higher FVF showed higher resistance to insulin, thus obtained a higher risk of developing type 2 diabetes mellitus.

BackgroundThe triblock copolymers PEG-P(Asp-DIP)-P(Lys-Ca) (PEALCa) of polyethylene glycol (PEG), poly(N-(N’,N’-diisopropylaminoethyl) aspartamide) (P(Asp-DIP)), and poly (lysine-cholic acid) (P(Lys-Ca)) were synthesized as a pH-sensitive drug delivery system. In neutral aqueous environment such as physiological environment, PEALCa can self-assemble into stable vesicles with a size around 50-60 nm, avoid uptake by the reticuloendothelial system (RES), and encase the drug in the core. However, the PEALCa micelles disassemble and release drug rapidly in acidic environment that resembles lysosomal compartments.Methodology/Principal FindingsThe anticancer drug Paclitaxel (PTX) and hydrophilic superparamagnetic iron oxide (SPIO) were encapsulated inside the core of the PEALCa micelles and used for potential cancer therapy. Drug release study revealed that PTX in the micelles was released faster at pH 5.0 than at pH 7.4. Cell culture studies showed that the PTX-SPIO-PEALCa micelle was effectively internalized by human colon carcinoma cell line (LoVo cells), and PTX could be embedded inside lysosomal compartments. Moreover, the human colorectal carcinoma (CRC) LoVo cells delivery effect was verified in vivo by magnetic resonance imaging (MRI) and histology analysis. Consequently effective suppression of CRC LoVo cell growth was evaluated.Conclusions/SignificanceThese results indicated that the PTX-SPION-loaded pH-sensitive micelles were a promising MRI-visible drug release system for colorectal cancer therapy.