Lian-Ming Wu

Renji Hospital, Shanghai, Shanghai Shi, China

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Publications (32)79.26 Total impact

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    ABSTRACT: Purpose To evaluate the performance of computed tomographic urography (CTU), static-fluid magnetic resonance urography (static-fluid MRU) and combinations of CTU, static-fluid MRU and diffusion weighted imaging (DWI) in the diagnosis of upper urinary tract cancer. Material and Methods Between January 2010 and June 2011, patients with suspected UUT cancer underwent CTU, static-fluid MRU and DWI(b = 1000 s/mm2) within a 1-week period. The diagnostic performances of CTU, static-fluid MRU and combinations of CTU, static-fluid MRU and DWI for upper urinary tract cancer were prospectively evaluated. The ureteroscopic and histopathologic findings were compared with the imaging findings. Results Compared to static-fluid MRU alone(sensitivity: 76%/75%, reader 1/reader 2), combining DWI with MRI can increase the sensitivity (sensitivity: 84%/84%, p = 0.031/p = 0.016) of upper urinary tract cancer diagnosis. CTU had greater sensitivity (95%/94%) and accuracy(92/91%) than both static-fluid MRU (sensitivity: p < 0.001/p < 0.001 and accuracy: 83%/81%, p = 0.001/p < 0.001) and static-fluid MRU with DWI (sensitivity:p = 0.023/p = 0.039 and accuracy: 87%/85%, p = 0.042/p = 0.049) for the diagnosis of upper urinary tract cancers. Compared with CTU alone, CTU with DWI did not significantly increase sensitivity, specificity or accuracy. However, the diagnostic confidence was improved when the combined technique was used (p = 0.031/p = 0.024). Moreover, there was no significant change in sensitivity, specificity,accuracy or diagnostic confidence when static-fluid MRU was used in combination with CTU and DWI. Conclusion Although there is a potential role for static-fluid MRU and static-fluid MRU with DWI in urinary tract imaging, CTU is still the better choice for the diagnosis of upper urinary tract cancer. Combining DWI with CTU can help improve confidence in upper urinary tract cancer diagnoses.
    European journal of radiology 01/2014; · 2.65 Impact Factor
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    ABSTRACT: To quantitatively assess the imaging characteristics of sellar lesion in dual-energy computed tomography (CT) imaging for differentiation of sellar meningiomas and pituitary adenomas during the arterial phase (AP) and venous phase (VP). 51 patients with sellar/parasellar tumors (33 macroadenomas and 18 meningiomas) were examined with CT spectral imaging during the AP and the VP. Iodine concentrations were derived from iodine-based material-decomposition CT images and normalized to the iodine concentration in the aorta. The difference in Normalized iodine concentrations (NICs), HU curve slope (λHU), and mean CT values of lesions between the AP and VP were calculated. The two-sample t test was performed to compare quantitative parameters between sellar meningiomas and pituitary adenomas. NICs, λHU, and mean CT values in patients with sellar meningiomas differed significantly from those in patients with pituitary adenomas: Mean NICs were 43.52 mg/mL±1.35 versus 9.23 mg/mL ±2.44, respectively, during the AP and 52.13 mg/mL ±1.04 versus 24.37 mg/mL ±2.23 respectively, during the VP. λHU were -3.03±3.42 versus -0.53±0.23, respectively, during the AP and -2.96±0.41 versus -0.47±0.25, respectively, during the VP. Mean CT values were 193.63±2.08 versus 63.98±2.85, respectively, during the AP and 203.98±0.18 versus 77.66±0.91, respectively, during the VP. The combination of NIC and Mean CT value during VP had highest sensitivity (90.9%) and specificity (100%) among all phases. Quantitative dual-energy CT imaging has promising potential for diagnostic differentiation of sellar meningiomas and pituitary adenomas.
    PLoS ONE 01/2014; 9(3):e90658. · 3.73 Impact Factor
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    ABSTRACT: To evaluate the ability of diffusion-weighted magnetic resonance imaging (DWI) in differentiating malignant thyroid nodules from benign lesions with a meta-analysis. Articles in English and Chinese language relating to the accuracy of DWI for this utility were retrieved. Pooled estimation and subgroup analysis data were obtained by statistical analysis. A total of seven studies (17 subsets) with 358 patients, who fulfilled all of the inclusion criteria, were considered for the analysis. No publication bias was found (bias = 7.03, P > .05). Methodological quality was relatively high. DWI sensitivity was 0.91 (95% confidence interval [CI], 0.87-0.94) and specificity was 0.93 (95% CI, 0.86-0.96). Overall, positive likelihood ratio was 12.24 (95% CI, 6.47-23.20) and negative likelihood ratio was 0.99 (95% CI, 0.06-0.15). Diagnostic odds ratio was 123.78 (95% CI, 56.85-269.48). The area under the curve of the summary receiver operating characteristic was 0.94 (95% CI, 0.92-0.96). In patients with high pretest probabilities, DWI enabled confirmation of malignant thyroid lesion; in patients with low pretest probabilities, DWI enabled exclusion of malignant thyroid lesion. Worst-case-scenario (pretest probability, 50%) posttest probabilities were 92% and 9% for positive and negative DWI results, respectively. A limited number of small studies suggests that quantitative DWI is a reliable diagnostic method for differentiation between benign and malignant thyroid lesions.
    Academic radiology 12/2013; · 2.09 Impact Factor
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    ABSTRACT: Diffusion-weighted magnetic resonance imaging (DW-MRI) has been considered to be useful in diagnosing upper urinary tract (UUT) disease; however, the value of DW-MRI with different b values has not been reported. To evaluate the performance of using conventional MRI alone and in combination with DWI with different b values in diagnosing UUT cancer. Seventy patients with suspected UUT cancer underwent conventional MRI (T1-weighted and T2-weighted) and DW-MRI (b = 500 and 1500 s/mm(2)) on a 3 T-MRI scanner. The ureteroscopic and histopathologic findings were compared with the imaging findings. The utility of detecting UUT cancer using conventional MRI (set A), combined DW-MRI (b = 500 s/mm(2)) and conventional MRI (set B), and combined DW-MRI (b = 1500 s/mm(2)) and conventional MRI (set C) were independently evaluated by two readers. A total of 32 patients had verified cancer; 23 patients had benign UUT diseases, and 15 had no abnormality. Sets B and C had significantly improved diagnostic accuracy for UUT cancer compared with set A; the specificity in diagnosing UUT cancer was significantly improved when using set C compared with sets A and B. In patients without UUT obstructions, improved sensitivity and accuracy in diagnosis was achieved when using sets B and C compared with set A. Using DW-MRI in combination with conventional MRI provides increased diagnostic accuracy and sensitivity in patients without UUT obstruction. The combination of conventional MRI and DW-MRI with a higher b value (1500 s/mm(2)) improved the specificity in diagnosing UUT cancer compared to conventional sequences and DW-MRI with a lower b value (500 s/mm(2)).
    Acta Radiologica 10/2013; · 1.33 Impact Factor
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    ABSTRACT: Gadoxetic acid is a recently developed hepatobiliary-specific contrast material used for magnetic resonance imaging (MRI) which enables highly sensitive detection of hepatocellular carcinoma (HCC). We performed a meta-analysis of all available studies of the diagnostic performance of gadoxetic acid-enhanced MRI (Gd-EOB-MRI) for detection of HCC in patients with chronic liver disease. Databases including MEDLINE and EMBASE were searched for relevant original articles published from January 2000 to April 2012. Pooled estimation and subgroup analysis data were obtained by statistical analysis. Across 10 studies of 570 patients, Gd-EOB-MRI sensitivity was 0.91 (95 % CI 0.77, 0.97) and specificity was 0.93 (95 % CI 0.85, 0.97). Overall, LR+ was 13.6 (95 % CI 5.6, 33.2), LR- was 0.10 (95 % CI 0.04, 0.27), and DOR was 140.36 (95 % CI 28, 696). Among patients with high pre-test probabilities, MRI enabled confirmation of HCC; among patients with low pre-test probabilities, MRI enabled exclusion of HCC. Worst-case-scenario (pre-test probability, 50 %) post-test probabilities were 93 and 9 % for positive and negative MRI results, respectively. In studies in which both Gd-EOB-MRI and contrast enhanced computed tomography (CE-CT) were performed, Gd-EOB-MRI was more sensitive than CE-CT (0.93 vs. 0.78; p < 0.05). Subgroup analysis suggested average lesion size (<2 vs. >2 cm) did not affect the diagnostic accuracy of the test (p > 0.05). A limited number of small studies suggest Gd-EOB-MRI has good diagnostic performance in the detection of HCC among patients with chronic liver disease. It is also confirmed to be a reliable tool for evaluation of small early-stage HCC.
    Digestive Diseases and Sciences 07/2013; · 2.26 Impact Factor
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    ABSTRACT: Breast cancer is the most common cancer in women worldwide. However, it remains a difficult diagnosis problem to differentiate between benign and malignant breast lesions, especially in small early breast lesions. To assess the diagnostic value of diffusion-weighted imaging (DWI) combined with T2-weighted imaging (T2WI) for small breast cancer characterization. Fifty-eight patients (65 lesions) with a lesion <2 cm in diameter underwent 3.0 Tesla breast magnetic resonance imaging (MRI) including DWI and histological analysis. Three observers with varying experience levels reviewed MRI. The probability of breast cancer in each lesion on MR images was recorded with a 5-point scale. Areas under the receiver-operating characteristic curve (AUCs) were compared by using the Z test; sensitivity and specificity were determined with the Z test after adjusting for data clustering. AUC of T2WI and DWI (Observer 1, 0.95; Observer 2, 0.91; Observer 3, 0.83) was greater than that of T2WI (Observer 1, 0.80; Observer 2, 0.74; Observer 3, 0.70) for all observers (P < 0.0001 in all comparisons). Sensitivity of T2WI and DWI (Observer 1, 90%; Observer 2, 93%; and Observer 3, 86%) was greater than that of T2WI alone (Observer 1, 76%; Observer 2, 83%; Observer 3, 79%) for all observers (P < 0.0001 in all comparisons). Specificity of T2WI and DWI was greater than that of T2WI alone for observer 1 (89% vs. 72%, P < 0.01) and observer 2 (94% vs. 78%, P < 0.001). DWI combined with T2WI can improve the diagnostic performance of MRI in small breast cancer characterization. It should be considered selectively in the preoperative evaluation of patients with small lesions of the breast.
    Acta Radiologica 07/2013; · 1.33 Impact Factor
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    ABSTRACT: RATIONALE AND OBJECTIVES: To prospectively assess the incremental value of diffusion-weighted imaging (DWI) combined with T2-weighted images (T2WI) in determining the T stage of bladder cancer by using pathologic findings as the reference standard. MATERIALS AND METHODS: This study is approved by the institutional review board; informed consent was waived. The study includes 362 patients (age range, 48-87 years; mean, 71 years) who underwent 3.0-T magnetic resonance imaging and histologic examination. Three observers with varying experience levels reviewed the T2WI data alone, DWI data alone, and combined T2WI and DWI data. Sensitivity, specificity, accuracy, and area under curve (AUC) were determined with the Z test after adjusting for data clustering. RESULTS: For differentiating Tis to T1 tumors from T2 to T4 tumors, the AUCs for T2WI and DWI (0.97 for observer 1 and 0.96 for observer 2) were greater than those for the DWI alone (0.92 for observer 1 and 0.90 for observer 2) (P < .05). Observer 3 had similar AUCs for T2WI and DWI compared to DWI alone. The accuracy of T2WI and DWI (observer 1, 98%; observer 2, 96%; observer 3, 92%) was greater than that of DWI alone (observer 1, 92%; observer 2, 90%; observer 3, 87%) for all observers (P < .05). The specificity of T2WI and DWI (observer 1, 100%; observer 2, 98%; observer 3, 93%) was greater than that of DWI alone (observer 1, 92%; observer 2, 90%; observer 3, 87%) for all observers (P < .05). Sensitivity was not improved even when T2WI and DWI were used. For differentiating Tis to T2 Tumors from T3 to T4 Tumors, the overall accuracy, specificity, and AUC for diagnosing T2 or higher stages were not significantly improved by combiningT2WI and DWI. CONCLUSIONS: T2WI combined with DWI can be a reliable sequence for preoperative evaluation of T stage urinary bladder cancer. It is particularly more useful in differentiating T1 or lower tumors from T2 or higher tumors compared to DWI alone.
    Academic radiology 06/2013; · 2.09 Impact Factor
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    ABSTRACT: PURPOSE: To assess diffusion-weighted magnetic resonance imaging (DWI-MRI) performed with apparent diffusion coefficient (ADC) values for the detection of cervical lymphadenopathy. MATERIALS AND METHODS: Studies evaluating DWI-MRI for the detection of cervical lymphadenopathy were systematically searched for in the MEDLINE, EMBASE, Cancerlit, and Cochrane Library and other database from January 1995 to November 2010. By node-based data analyses, Cochrane methodology was used for the results of this meta-analysis. RESULTS: Eight studies enrolling a total of 229 individuals were eligible for inclusion. Significant differences were found between malignant nodes and benign nodes of the mean ADC value (WMD [weighted-mean difference]: 1.19, 95% CI: [1.02, 1.35] × 10(-3) mm(2) /s, [P < 0.05]). In the secondary outcomes, significant differences were found between lymphomatous nodes and benign nodes (WMD: 1.33, 95% CI: [0.89, 1.77] × 10(-3) mm(2) /s), and nodes originating from highly or moderately differentiated cancer (WMD: 0.24, 95% CI: [0.21, 0.28] × 10(-3) mm(2) /s, [P < 0.05]), and nodes originating from poorly differentiated cancers (WMD: 0.10, 95% CI: [0.06, 0.14] × 10(-3) mm(2) /s, [P < 0.05]). CONCLUSION: DWI-MRI performed with ADC values shows significant differences among malignant nodes, lymphomatous nodes, and benign nodes in cervical lymphadenopathy. J. Magn. Reson. Imaging 2012;. © 2012 Wiley Periodicals, Inc.
    Journal of Magnetic Resonance Imaging 06/2013; · 2.57 Impact Factor
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    ABSTRACT: OBJECTIVE: This meta-analysis aimed to evaluate the accuracy of magnetic resonance imaging (MRI) in predicting responses in patients with locally advanced rectal cancer after preoperative neoadjuvant therapy. METHODS: Articles in English language relating to the accuracy of MRI for this utility were retrieved. Methodological quality was assessed by Quality Assessment of Diagnostic Accuracy Studies tool. Pooled estimation and subgroup analysis data were obtained by statistical analysis. RESULTS: Fourteen studies involved 751 pathologically confirmed patients met the inclusion criteria. Methodological quality was relatively high. To predict histopathological response in locally advanced rectal cancer by MRI, the pooled sensitivity and specificity were 0.78 [95 % confidence intervals (CI), 0.65, 0.87] and 0.81 (95 % CI, 0.72, 0.87), respectively. Positive likelihood ratio and negative likelihood ratio were 4.1 (95 %CI, 2.9, 5.8) and 0.27 (95 % CI, 0.17, 0.43), respectively. Subgroup analysis showing that imaging was performed at 3.0 T MRI devices had higher pooled sensitivity (0.92, 95 % CI, 0.84, 1.00) than the subgroup of MRI with ≤1.5 T (0.68, 95 % CI, 0.53, 0.82) (p < 0.05).The sensitivity and specificity of T2-weighted imaging (T2WI) with diffusion-weighted imaging (DWI) were 0.92 (95 % CI, 0.81, 1.00) and 0.75 (95 % CI, 0.54, 0.95); those of T2WI alone were 0.64 (95 % CI, 0.47, 0.82) and 0.88 (95 % CI, 0.81, 0.94) (p > 0.05). CONCLUSION: This meta-analysis indicates that MRI is an accurate tool in predicting pathologic response after preoperative therapy in patients with locally advanced rectal cancer. It is suggested to perform MRI by 3.0 T devices, which might be sensitive to identify responder. The addition of DWI to T2WI showed a non-significant improvement in sensitivity, which deserves further investigation.
    International Journal of Colorectal Disease 03/2013; · 2.24 Impact Factor
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    ABSTRACT: PurposeTo perform a meta-analysis of all available studies of the diagnostic performance of diffusion-weighted magnetic resonance imaging (DW-MRI) in patients with hepatic metastases.Methods Databases including MEDLINE and EMBASE were searched for relevant original articles published from January 2000 to February 2012. We determined sensitivities and specificities across studies, calculated positive and negative likelihood ratios (LR+ and LR–), diagnostic odds ratio (DOR) and constructed summary receiver operating characteristic curves using hierarchical regression models.ResultsAcross 11 studies (537 patients), DW-MRI sensitivity was 0.87 (95% confidence interval (CI), 0.80, 0.91) and specificity was 0.90 (95% CI, 0.86, 0.93). Overall, LR+ was 8.52 (95% CI, 6.17, 11.77), LR– was 0.15 (95% CI, 0.10, 0.22) and DOR was 57.36 (95% CI, 38.29, 85.93). In studies in which both DW-MRI and contrast-enhanced magnetic resonance imaging (CE-MRI) were performed, the comparison of DW-MRI performance with that of CE-MRI suggested no major differences against these two methods (p > 0.05). DW-MRI combined CE-MRI had higher sensitivity and specificity than DW-MRI alone (97% versus 86% and 91% versus 90%, respectively) (p < 0.05). The subgroup in which DW-MRI examinations were performed with a 3.0 Tesla (T) device had higher pooled specificity (0.91, 95% CI, 0.88–0.95) than the subgroup of DW-MRI with 1.5 T device (0.81, 95% CI, 0.67, 0.94) (p < 0.05). Average lesion size (⩽1.5 cm versus >1.5 cm) did not influence the diagnostic accuracy of the test (p > 0.05).Conclusion Our results demonstrate DW-MRI has good diagnostic performance in the overall evaluation of hepatic metastases and equivalent to CE-MRI. Combination of CE-MRI and DW-MRI can improve the diagnostic accuracy of magnetic resonance (MR) imaging. Our study further confirms that DW-MRI can accurately detect hepatic metastases regardless of the lesion size. It is suggested to perform DW-MRI by 3.0 T devices, which might have high specificity to identify liver metastases.
    European Journal of Cancer. 02/2013; 49(3):572–584.
  • Article: Reply.
    Lian-Ming Wu, Jian-Rong Xu, Jiani Hu
    American Journal of Roentgenology 02/2013; 200(2):W220-1. · 2.90 Impact Factor
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    ABSTRACT: GOALS:: To evaluate the overall diagnostic accuracy of magnetic resonance imaging (MRI) in assessing the activity of Crohn's disease (CD) in the small bowel. BACKGROUND:: Cross-sectional imaging techniques are playing an increasing role in the evaluation of suspected CD. Advantages of MRI include a lack of ionizing radiation, the ability to provide dynamic information regarding bowel distention and motility, improved soft-tissue contrast, and a relatively safe intravenous contrast agent profile. STUDY:: Two reviewers searched MEDLINE, EMBASE, and other electronic databases to identify studies in which MRI imaging was evaluated for assessing the activity of CD in the small bowel from January 2001 to September 2011. Bivariate random-effects meta-analytic methods were used to estimate summary, sensitivity, specificity, and receiver operating characteristic curves. RESULTS:: MRI had a pooled sensitivity of 0.87 [95% confidence interval (CI): 0.77, 0.93] and a pooled specificity of 0.91 (95% CI: 0.81, 0.96). Overall, likelihood ratio (LR)+ was 9.5 (95% CI: 4.4, 20.6) and LR- was 0.14 (95% CI: 0.08, 0.26). In patients with high pretest probabilities, MRI enabled confirmation of active CD; in patients with low pretest probabilities, MRI enabled exclusion of active CD. Worst-case-scenario (pretest probability, 50%) posttest probabilities were 90% and 13% for positive and negative MRI results, respectively. CONCLUSIONS:: A limited number of small studies suggest that MRI has high sensitivity and specificity for diagnosis of active CD in the small bowel; MRI will likely also prove to be suitable as the primary modality for active CD imaging surveillance.
    Journal of clinical gastroenterology 01/2013; · 2.21 Impact Factor
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    ABSTRACT: BACKGROUND AND AIM: The purpose of this study was to perform a meta-analysis of all available studies of the diagnostic performance of diffusion-weighted imaging (DWI) in the detection of hepatocellular carcinoma (HCC) in patients with chronic liver disease. METHODS: Databases including MEDLINE and EMBASE were searched for relevant original articles published from January 2000 to April 2012. Pooled estimation and subgroup analysis data were obtained by statistical analysis. RESULTS: Across 9 studies (476 patients), DWI sensitivity was 81% (95%CI: 67%-90%) and specificity was 89% (95% CI: 76%-95%). Overall, positive likelihood ratio was 7.11 (95%CI: 3.50, 14.48), negative likelihood ratio was 0.21 (95%CI: 0.12-0.37) and the diagnostic odds ratio (DOR) was 33.48 (95%CI: 16.67-67.25). The area under the curve of the summary receiver operator characteristic (ROC) was 0.92 (95% CI:0.89-0.94). In studies in which both DWI and conventional contrast-enhanced magnetic resonance imaging (CE-MRI) were performed, The comparison of DWI performance with that of conventional CE-MRI suggested no major differences against these two methods (P>0.05).DWI combined CE-MRI had higher pooled sensitivity than DWI alone (93% vs. 73%) (p<0.05). CONCLUSION: DWI has good diagnostic performance in the detection of HCC in patients with chronic liver disease and equivalent to conventional CE-MRI. Combination of CE-MRI and DWI can improve the diagnostic accuracy of MR imaging. Further larger prospective studies are still needed to establish its value for detecting HCC in patients with chronic liver disease.
    Journal of Gastroenterology and Hepatology 11/2012; · 3.33 Impact Factor
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    ABSTRACT: The aim of this study was to evaluate the diagnostic accuracy of diffusion-weighted magnetic resonance imaging (DWI) in prostate cancer. The MEDLINE, Embase, CANCERLIT, and Cochrane Library databases were searched for studies published from January 2001 to August 2011 evaluating the diagnostic performance of DWI in detecting prostate carcinoma. Sensitivities and specificities were determined across studies, and summary receiver-operating characteristic curves were constructed using hierarchical regression models. Sixteen studies (18 subsets) with a total of 852 patients were included. Six studies (seven subsets) examining men with pathologically confirmed prostate cancer (260 patients) had pooled sensitivity and specificity of 0.88 (95% confidence interval [CI], 0.76-0.95) and 0.84 (95% CI, 0.76-0.90), respectively. Compared to patients at high risk for clinically relevant cancer, sensitivity was higher in low-risk patients (0.94 [95% CI, 0.89-0.97] vs 0.62 [95% CI, 0.54-0.70], P < .05), but specificity was lower (0.86 [95% CI, 0.72-0.94] vs 0.89 [95% CI, 0.83-0.93], P < .05). Ten studies (11 subsets) examining patients with suspected prostate cancer (592 patients) had pooled sensitivity and specificity of 0.76 (95% CI, 0.68-0.84) and 0.86 (95% CI, 0.79-0.91). Sensitivity was lower in high-risk patients (0.74 [95% CI, 0.57-0.87] vs 0.78 [95% CI, 0.70-0.84], P > .05), but specificity was higher (0.92 [95% CI, 0.89-0.94] vs 0.78 [95% CI, 0.70-0.84], P < .05). A limited number of small studies suggest that DWI could be a rule-in test for high-risk patients. Further prospective studies including larger populations are necessary to confirm the actual value of DWI in this field.
    Academic radiology 10/2012; 19(10):1215-24. · 2.09 Impact Factor
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    ABSTRACT: Background MRI is of increasing importance in the diagnostic evaluation of gastrointestinal diseases, with depiction of mucosal enhancement obtained with conventional intravenous contrast. Routine clinical use of contrast agents has been carried out using intravenous injection for mucosal imaging. Contrast agents that specifically target the intestinal mucosa are therefore needed to improve clinical imaging of the mucosal surface. Purpose To synthesize a novel contrast agent for gadopentetic acid (Gd-DTPA)-loaded chitosan nanoparticles and observe the absorption of the nanoparticles in the colon wall of healthy rats by MR imaging in vivo. Material and Methods A contrast agent was successfully synthesized by a modified emulsion coalescence method, and the resulting agents were characterized in detail by dynamic light-scattering spectroscopy and inductively coupled plasma emission spectroscopy. The cytotoxicity of Gd-chitosan nanoparticles was evaluated by an MTT assay. Gadolinium-chitosan (Gd@chitosan) nanoparticles were administered to the colon mucosa of healthy rats by rectal administration, and MRI scans in vivo were carried out with a 3.0 T imaging scanner at various time points. Results The prepared Gd@chitosan nanoparticles were ∼420 nm in diameter with a 74.4% Gd-DTPA content. The MTT assay indicated little cytotoxicity. MRI results showed that nanoparticles can be retained in both the stratum submucosum and epithelial cells of the colon for almost 80 min. Transmission electron microscopy images further revealed that Gd@chitosan nanoparticles were localized inside the mucosal cells or intercellular space, while tissue from Gd-DTPA aqueous solution administration showed nothing. Due to the infusion of Gd@chitosan nanoparticles, the MR signal intensity of colon mucosa increased from about 6% to 35%, and the contrast enhancement was highest at 20 min after administration. Conclusion Gd@chitosan nanoparticles with high Gd-DTPA content were successfully prepared for use as a novel MRI contrast agent. All results indicated that rectally administered Gd@chitosan nanoparticles have the potential for MRI diagnosis of colon mucosal disease.
    Acta Radiologica 08/2012; 53(8):900-7. · 1.33 Impact Factor
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    ABSTRACT: Recent developments in diffusion-weighted magnetic resonance imaging (DWI) make it possible to image malignant tumors to provide tissue contrast based on difference with the diffusion of water molecules among tissues, which can be measured by the apparent diffusion coefficient (ADC) value. We aimed to assess the diagnostic accuracy of DWI for benign/malignant discrimination of pulmonary nodules/masses with a meta-analysis. The MEDLINE, EMBASE, Cancerlit and Cochrane Library database, from January 2001 to August 2011, were searched for studies evaluating the diagnostic accuracy of DWI for benign/malignant discrimination of pulmonary nodules. We determined sensitivities and specificities across studies, calculated positive and negative likelihood ratios (LRP and LRN), and constructed summary receiver operating characteristic SROC) curves. Across 10 studies (545 patients), there was no evidence of publication bias (P=.22, bias=-19.19). DWI had a pooled sensitivity of 0.84 (95% CI, 0.76-0.90) and a pooled specificity of 0.84 (95% CI, 0.64-0.94). Overall, LRP was 5.3 (95% CI, 2.1-13.0) and LRN was 0.19 (95% CI, 0.12-0.30). In patients with high pretest probabilities, DWI enabled confirmation of malignant pulmonary lesion; in patients with low pretest probabilities, DWI enabled exclusion of malignant pulmonary lesion. Worst-case-scenario (pretest probability, 50%) posttest probabilities were 84% and 16% for positive and negative DWI results, respectively. Diffusion-weighted magnetic resonance imaging can be used to differentiate malignant from benign pulmonary lesions. High-quality prospective studies regarding DWI in the evaluation of pulmonary nodules are still needed to be conducted.
    Magnetic Resonance Imaging 08/2012; · 2.06 Impact Factor
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    ABSTRACT: BACKGROUND: To obtain diagnostic performance values of T2-weighted imaging (T2WI) and contrast-enhanced magnetic resonance imaging (CE-MRI) in the prediction of myometrial invasion in patients with endometrial cancer. METHODS: Databases including MEDLINE and EMBASE were searched for relevant original articles published from January1995 to March 2012. Pooled estimation data were obtained by statistical analysis. RESULTS: Eleven articles (548 patients) were included. For assessing any myometrial involvement, the pooled sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for CE-MRI were 0.81 (95% CI, 0.72, 0.88), 0.72 (95% CI, 0.64, 0.79), 0.65 (95% CI, 0.56, 0.73) and 0.85 (95% CI, 0.78, 0.91); for T2WI, they were 0.87 (95% CI, 0.78, 0.94), 0.58 (95% CI, 0.47, 0.69), 0.64 (95% CI, 0.54, 0.73), 0.84 (95% CI, 0.73, 0.92) respectively. The pooled specificity of CE-MRI (0.72) was significantly higher than T2WI (0.58) (P < 0.05). For assessing deep myometrial involvement, there was no statistically significant difference between CE-MRI and T2WI, (P > 0.05). CONCLUSIONS: CE-MRI has a good diagnostic performance in the prediction of any myometrial invasion and is superior to T2WI. But its PPV is somewhat suboptimal. For assessing deep myometrial involvement, its NPV appears relative high and negative findings strongly suggest an absence of deep myometrial involvement, which can guide therapeutic decision-making. KEY POINTS : • CE-MRI is widely used for endometrial carcinoma • CE-MRI has a good performance in the prediction of any myometrial invasion • CE-MRI is superior to T2WI in the prediction of any myometrial invasion • For assessing deep myometrial involvement, its NPV appears relatively high.
    European Radiology 08/2012; · 3.55 Impact Factor
  • Lian-Ming Wu, Jiani Hu, Jian-Rong Xu
    Breast Cancer Research and Treatment 08/2012; 135(1):319-20. · 4.47 Impact Factor
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    ABSTRACT: We aimed to explore the role of diffusion-weighted imaging (DWI) in combination with T2-weighted imaging (T2WI) in detecting prostate carcinoma through a systematic review and meta-analysis. The MEDLINE, EMBASE, Cancerlit, and Cochrane Library databases were searched for studies published from January 2001 to July 2011 evaluating the diagnostic performance of T2WI combined with DWI in detecting prostate carcinoma. We determined sensitivities and specificities across studies, calculated positive and negative likelihood ratios, and constructed summary receiver operating characteristic curves. We also compared the performance of T2WI combined with DWI with T2WI alone by analyzing studies that had also used these diagnostic methods on the same patients. Across 10 studies (627 patients), the pooled sensitivity of T2WI combined with DWI was 0.76 (95% CI, 0.65-0.84), and the pooled specificity was 0.82 (95% CI, 0.77-0.87). Overall, the positive likelihood ratio was 4.31 (95% CI, 3.12-5.92), and the negative likelihood ratio was 0.29 (95% CI, 0.20-0.43). In seven studies in which T2WI combined with DWI and T2WI alone were performed, the sensitivity and specificity of T2WI combined with DWI were 0.72 (95% CI, 0.67-0.82) and 0.81 (95% CI, 0.76-0.86), respectively, and the sensitivity and specificity of T2WI alone were 0.62 (95% CI, 0.55-0.68) and 0.77 (95% CI, 0.71-0.82), respectively. T2WI combined with DWI may be a valuable tool for detecting prostate cancer in the overall evaluation of prostate cancer, compared with T2WI alone. High-quality prospective studies of T2WI combined with DWI to detect prostate carcinoma still need to be conducted.
    American Journal of Roentgenology 07/2012; 199(1):103-10. · 2.90 Impact Factor
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    ABSTRACT: To compare the diagnostic capability of diffusion-weighted magnetic resonance imaging (DWI) and (18)F-fluorodeoxyglucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) in the N stage assessment in patients with non-small-cell lung cancer. We performed a meta-analysis of all available studies of the diagnostic performance of DWI and (18)F-FDG PET/CT in the N stage assessment of patients with non-small-cell lung cancer. We determined the sensitivity and specificity across studies, calculated the positive and negative likelihood ratios (LR+ and LR-, respectively), and constructed the summary receiver operating characteristic curves using hierarchical regression models. The methodologic quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies tool. A total of 19 studies met the inclusion criteria and included a total of 2845 pathologically confirmed patients. No publication bias was found. The methodologic quality was relatively high. The pooled sensitivity estimate of DWI (0.72, 95% confidence interval [CI] 0.63-0.80) was not significantly difference between PET/CT (0.75, 95% CI 0.68-0.81; P = 0.09). The pooled specificity estimate for DWI (0.95, 95% CI 0.85-0.98) was significantly greater than (18)F-FDG PET/CT (0.89, 95% CI 0.85-0.91; P = 0.02). For DWI, the overall LR+ was 13.80 (95% CI 4.54-41.95) and the LR- was 0.29 (95% CI 0.21-0.40). For (18)F-FDG PET/CT, LR+ was 6.67 (95% CI 5.20-8.56) and LR- was 0.28 (95% CI 0.22-0.37). Our study has confirmed that DWI has a high specificity for N staging of non-small-cell lung cancer compared with (18)F-FDG PET/CT and has the potential to be a reliable alternative noninvasive imaging method for the preoperative staging of mediastinal and hilar lymph nodes in patients with non-small-cell lung cancer.
    Journal of Surgical Research 04/2012; 178(1):304-14. · 2.02 Impact Factor