Background & Aims-Hepatocellular carcinoma (HCC) recurs in approximately 70% of cases after resection. Vascular invasion by tumor cells can be classified as gross or microscopic (mVI) and is a risk factor for recurrence. We examined a large cohort of patients with HCC that were treated by resection to identify features of microvascular invasion that correlated with recurrence and survival.
Alterations of small bowel motility during CD flares significantly correlate with the level of calprotectin and CRP indicating that they represent inflammatory activity.
MT imaging of the small bowel wall is feasible in humans with sufficient image quality and may help with the identification of fibrotic scarring in patients with CD.
Objectives:The purpose of this study was to evaluate to which degree investment of acquisition time in more encoding directions leads to better image quality (IQ) and what influence the number of encoding directions and the choice of b-values have on renal diffusion tensor imaging (DTI) parameters.Material and Methods:Eight healthy volunteers (32.3 y ± 5.1 y) consented to an examination in a 1.5T whole-body MR scanner. Coronal DTI data sets of the kidneys were acquired with systematic variation of b-values (50, 150, 300, 500, and 700 s/mm2) and number of diffusion-encoding directions (6, 15, and 32) using a respiratory-triggered echo-planar sequence (TR/TE 1500 ms/67 ms, matrix size 128 × 128). Additionally, two data sets with more than two b-values were acquired (0, 150, and 300 s/mm2 and all six b-values). Parametrical maps were calculated on a pixel-by-pixel basis. Image quality was determined with a reader score.Results:Best IQ was visually assessed for images acquired with 15 and 32 encoding directions, whereas images acquired with six directions had significantly lower IQ ratings. Image quality, fractional anisotropy, and mean diffusivity only varied insignificantly for b-values between 300 and 500 s/mm2. In the renal medulla fractional anisotropy (FA) values between 0.43 and 0.46 and mean diffusivity (MD) values between 1.8-2.1 × 10-3 mm2/s were observed. In the renal cortex, the corresponding ranges were 0.24-0.25 (FA) and 2.2-2.8 × 10-3 mm2/s (MD). Including b-values below 300 s/mm2, notably higher MD values were observed, while FA remained constant. Susceptibility artifacts were more prominent in FA maps than in MD maps.Conclusion:In DTI of the kidneys at 1.5T, the best compromise between acquisition time and resulting image quality seems the application of 15 encoding directions with b-values between 300 and 500 s/mm2. Including lower b-values allows for assessment of fast diffusing spin components.
A number of treatments targeting VEGF or mTOR pathways have been approved for metastatic clear cell Renal Cell Carcinoma (ccRCC), but the majority of patients show disease progression after first line therapy with a very low rate of complete or long-term responders. It has been shown that miRs may play a role in prediction of treatment response in various cancer types. The aim of our study was to identify a miR signature predictive for RCC patients' response to antiangiogenic tyrosine kinase inhibitor (TKI) treatment in the first line therapy. Sequencing of 40 paired normal/tumor formalin fixed and paraffin embedded ccRCC tissues revealed separate clustering via unsupervised dendrograms. With supervised analysis, the strongest differential expression was obtained with miR-99b-5p, which was significantly lower in patients with short progression free survival (<8 months) and TKI non-responders (progressive disease patients according to RECIST) (p<0.0001, each). Validation using RTqPCR and a second patient cohort compiled from three different hospitals (n=65) showed higher expression of miR-99b-5p in complete responders, but this trend did not reach statistical significance. It is concluded that low miR-99b-5p expression analyzed with sequencing methodology may correlate with tumor progression in TKI-treated ccRCC patients.
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