To assess whether radiomics signature can identify aggressive behavior and predict recurrence of hepatocellular carcinoma (HCC) after liver transplantation. Methods: Our study consisted of a training dataset (n = 93) and a validation dataset (40) with clinically confirmed HCC after liver transplantation from October 2011 to December 2016. Radiomics features were extracted by delineating regions-of-interest (ROIs) around the lesion in four phases of CT images. A radiomics signature was generated using the least absolute shrinkage and selection operator (LASSO) Cox regression model. The association between radiomics signature and recurrence-free survival (RFS) was assessed. Preoperative clinical characteristics potentially associated with RFS were evaluated to develop a clinical model. A combined model incorporating clinical risk factors and radiomics signature was built. Results: The stable radiomics features associated with the recurrence of HCC were simply found in arterial phase and portal phase. The prediction model based on the radiomics features extracted from the arterial phase showed better prediction performance than the portal vein phase or the fusion signature combining both of arterial and portal vein phase. A radiomics nomogram based on combined model consisting of the radiomics signature and clinical risk factors showed good predictive performance for RFS with a C-index of 0.785 (95% confidence interval [CI]: 0.674-0.895) in the training dataset and 0.789 (95% CI: 0.620-0.957) in the validation dataset. The calibration curves showed agreement in both training (p = 0.121) and validation cohorts (p = 0.164). Conclusions: Radiomics signature extracted from CT images may be a potential imaging biomarker for liver cancer invasion and enable accurate prediction of HCC recurrence after liver transplantation.
Multimodal imaging nanoparticles that integrate different imaging modalities into one system could provide complementary and detailed imaging information to satisfy the request of precision medicine. However, most multimodal nanoparticles suffer from multistep synthesis and complicated compositions, which hinder their practical application in biomedical research. Therefore, development of a facile method to prepare a single-nanoparticle contrast agent to achieve multimodal imaging is of significance. In this paper, hyaluronic-acid-modified manganese tungstate nanoparticles (HA-MnWO4 NPs) were successfully synthesized via a facile one-step hydrothermal procedure for efficient T 1/T 2-weighted MR and CT trimodal imaging in vivo. In the single-nanoparticle, manganese (Mn) with five unpaired electrons offers strong relaxation for MR imaging, while tungsten (W) with high atomic number provides high X-ray attenuation coefficient for CT imaging. Furthermore, HA-template synthesis endows the HA-MnWO4 nanoparticle with good biocompatibility and active targeting ability. In vitro and in vivo experiments reveal that the HA-MnWO4 NPs possess good T 1/T 2 dual MRI and CT imaging ability, low cytotoxicity, and favorable active tumor homing, demonstrating that the HA-MnWO4 NPs have great potential in clinical MR/CT multimodal imaging. In addition, the liver and renal structures can be clearly displayed by HA-MnWO4-supported imaging. This work will provide technical guidance for the simple development of multifunctional nanoparticles.
Multifunctional nanoprobes with tumor microenvironment response are playing important roles in high-efficient theranostics of cancers. Herein, a kind of theranostic nanoprobe was synthesized by coating manganese dioxide (MnO2) on the...
BackgroundLiposomal prostaglandin E1 (Lipo‐PGE1) treatment should protect against hepatic warm ischemia‐reperfusion injury (WIRI). Improved methods are needed for the noninvasive evaluation of hepatic responses to prophylactic Lipo‐PGE1 pretreatment approaches.PurposeTo demonstrate that multiparametric MRI measurements permit noninvasive differentiation of Lipo‐PGE1 treatment outcomes in a hepatic WIRI animal model.Study TypeAnimal study.Animal ModelSeventy rabbits were randomly divided into a sham‐operated group (A0), warm ischemia groups experiencing increasing periods of ischemia (A1–A3), and corresponding intervention groups (I1–I3) (n = 10 for each group).Field Strength/SequenceImaging was performed at 3T using a multiecho gradient echo (GRE) sequence (repetition time / echo time [TR/TE], 75/2.57–24.25 msec) for R2* blood oxygenation level‐dependent (BOLD) measurements, free‐breathing single‐shot echo‐planar imaging (ss‐EPI) sequence with two b‐values (0 and 500 s/mm2) in 12 diffusion directions for diffusion tensor imaging (DTI), and a free‐breathing ss‐EPI sequence with eight b‐values (0 to 800 s/mm2) for intravoxel incoherent motion (IVIM) measurements.AssessmentThe BOLD‐derived parameter (R2*), DTI‐derived parameters (ADC, FA), and IVIM‐derived parameters (Dslow, Dfast, and PF) were calculated for comparisons between treatment groups and correlation to ALT, AST, and LDH levels.Statistical TestsOne‐way analysis of variance (ANOVA), independent sample t‐test, Spearman correlation, and receiver operating characteristic (ROC) analysis were performed.ResultsHistopathology confirmed the validity of the WIRI model and the efficacy of intervention with clear structure and morphology differences between the different ischemia times and between the Lipo‐PGE1 treatment and control groups. Prolonged warm ischemia times resulted in higher R2* and FA values and gradually lower ADC, Dslow, Dfast, and PF values (all P < 0.05). The R2* and FA values were lower, and the ADC, Dslow, Dfast, and PF values were higher in the Lipo‐PGE1 intervention groups compared with those in the warm ischemia group for each paired time. However, none of the parameters reached the levels of the A0 group (all P < 0.05). As the warm ischemia time increased, additional parameters demonstrated significant differences between warm ischemia time groups and corresponding intervention groups. At the shortest (30 min), middle (40 min), and longest (60 min) ischemia times, three, four, and five parameters were significantly different between the WIRI and intervention groups, respectively (all P < 0.05). ADC, Dslow, Dfast, and PF values were negatively correlated, while R2* and FA values were positively correlated with serum ALT (|r| = 0.312–0.606) and AST (|r| = 0.432–0.602) (all P < 0.05). ADC and Dfast values showed negative correlations, and R2* showed positive correlations with serum LDH (|r| = 0.323–0.542, all P < 0.05). ROC analysis showed that DTI yielded the strongest diagnostic performance for evaluating the improvement of WIRI.Data ConclusionMultiparametric MRI can serve as a noninvasive radiologic evaluation for monitoring the protective impact of Lipo‐PGE1 therapy on hepatic WIRI.Level of Evidence: 1Technical Efficacy Stage: 2J. Magn. Reson. Imaging 2020;52:217–228.
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