BACKGROUND Hypoxia-inducible factor 1α(HIF-1α) is a gene that regulates tumor survival,neovascularization and invasion. Overexpression of HIF-1α correlates with poor prognosis in hepatocellular carcinoma(HCC). RO70...BACKGROUND Hypoxia-inducible factor 1α(HIF-1α) is a gene that regulates tumor survival,neovascularization and invasion. Overexpression of HIF-1α correlates with poor prognosis in hepatocellular carcinoma(HCC). RO7070179 is a HIF-1α inhibitor that decreases HIF-1α mRNA and its downstream targets, it could be a potential treatment in HCC.AIM To evaluate safety and preliminary activity of RO7070179 in patients with previously treated HCC, with focus on a patient with prolonged response to RO7070179.METHODS In the preclinical study of RO7070179 in a HCC xenograft model, the mice wereseparated into 4 groups with each group received doses of 0, 3, 10 and 30 mg/kg for total 10 doses. HCC patients who failed at least one line of systemic treatment,received RO7070179 as a weekly infusion, each cycle is 6 wk. We evaluated the safety and HIF-1α mRNA levels of RO7070179.RESULTS Preclinical evaluation of RO7070179 in orthotopic HCC xenograft model showed no significant differences in HCC tumor weight between the 3 and 10 mg/kg groups. However, dose of 10 mg/kg of RO7070179, has shown 76% reduction of the amount of HIF-1α mRNA in HCC tissue. In the phase 1 b study of RO7070179 in previously treated HCC patients, 8 out of 9 were evaluable: 1 achieved PR and1 SD. The patient with PR responded after 2 cycles treatments, which has been maintained for 12 cycles. This patient also showed reduction in perfusion of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI) after 1 cycle of treatment. After 1 cycle of treatment, both patients with PR and SD showed decrease in HIF-1α mRNA at the root of biopsies(each biopsy was divided into 2 specimens, the tip and the root).CONCLUSION RO7070179 can reduce HIF-1α mRNA level in HCC patients with SD or PR. It is well tolerated at 10 mg/kg, with transaminitis as the dose of increased toxicity.This study indicates that RO7070179 might benefit HCC patients, and an early signal for clinical benefit can potentially be predicted through changes in either m RNA level or DCE-MRI withi展开更多
With the increasing clinical use of cytostatic and novel biologic targeted agents,conventional morphologic tumor burden assessments,including World Health Organization criteria and Response Evaluation Criteria in Soli...With the increasing clinical use of cytostatic and novel biologic targeted agents,conventional morphologic tumor burden assessments,including World Health Organization criteria and Response Evaluation Criteria in Solid Tumors,are confronting limitations because of their difficulties in distinguishing viable tumor from necrotic or fibrotic tissue.Therefore,the investigation for reliable quantitative biomarkers of therapeutic response such as metabolic imaging or functional imaging has been desired.In this review,we will discuss the conventional and new approaches to assess tumor burden.Since targeted therapy or locoregional therapies can induce biological changes much earlier than morphological changes,these functional tumor burden analyses are very promising.However,some of them have not gone thorough all steps for standardization and validation.Nevertheless,these new techniques and criteria will play an important role in the cancer management,and provide each patient more tailored therapy.展开更多
针对动态对比度增强磁共振灌注成像中脑血容积的计算,提出基于Hankel矩阵的奇异值分解(Singular Value Decomposition,SVD)算法。在奇异值数目的确定上采用差分谱量级差的研究方法,对算法进行理论推导与仿真模拟,得到较为理想的滤波效...针对动态对比度增强磁共振灌注成像中脑血容积的计算,提出基于Hankel矩阵的奇异值分解(Singular Value Decomposition,SVD)算法。在奇异值数目的确定上采用差分谱量级差的研究方法,对算法进行理论推导与仿真模拟,得到较为理想的滤波效果。由于成像过程存在测量噪声的干扰,分析了信噪比和示踪剂延迟对算法的影响。仿真结果表明,信噪比越低(SNR=5 d B),算法处理效果越明显;信噪比增高(SNR=100 d B),估计值偏差减小,结果越为准确。且该算法不受示踪剂延迟的影响。与传统奇异值分解算法相比,采用基于Hankel矩阵的奇异值算法可以更为准确地估计脑血容积。展开更多
In the current study, we sought to evaluate the diagnostic efficacies of conventional ultrasound（US）, contrastenhanced US（CEUS）, combined US and CEUS and magnetic resonance imaging（MRI） in detecting focal solid ...In the current study, we sought to evaluate the diagnostic efficacies of conventional ultrasound（US）, contrastenhanced US（CEUS）, combined US and CEUS and magnetic resonance imaging（MRI） in detecting focal solid breast lesions. Totally 117 patients with 120 BI-RADS category 4A-5 breast lesions were evaluated by conventional US and CEUS, and MRI, respectively. SonoVue was used as contrast agent in CEUS and injected as an intravenous bolus; nodule scan was performed 4 minutes after bolus injection. A specific sonographic quantification software was used to obtain color-coded maps of perfusion parameters for the investigated lesion, namely the time-intensity curve.The pattern of contrast enhancement and related indexes regarding the time-intensity curve were used to describe the lesions, comparatively with pathological results. Histopathologic examination revealed 46 benign and 74 malignant lesions. Sensitivity, specificity, and accuracy of US in detecting malignant breast lesions were 90.14%, 95.92%, and 92.52%, respectively. Meanwhile, CE-MRI showed sensitivity, specificity, and accuracy of 88.73%, 95.92%, and91.67%, respectively. The area under the ROC curve for combined US and CEUS in discriminating benign from malignant breast lesions was 0.936, while that of MRI was 0.923, with no significant difference between them, as well as among groups. The time-intensity curve of malignant hypervascular fibroadenoma and papillary lesions mostly showed a fast-in/fast-out pattern, with no good correlation between them（kappa 〈0.20）. In conclusion, the combined use of conventional US and CEUS displays good agreement with MRI in differentiating benign from malignant breast lesions.展开更多
文摘BACKGROUND Hypoxia-inducible factor 1α(HIF-1α) is a gene that regulates tumor survival,neovascularization and invasion. Overexpression of HIF-1α correlates with poor prognosis in hepatocellular carcinoma(HCC). RO7070179 is a HIF-1α inhibitor that decreases HIF-1α mRNA and its downstream targets, it could be a potential treatment in HCC.AIM To evaluate safety and preliminary activity of RO7070179 in patients with previously treated HCC, with focus on a patient with prolonged response to RO7070179.METHODS In the preclinical study of RO7070179 in a HCC xenograft model, the mice wereseparated into 4 groups with each group received doses of 0, 3, 10 and 30 mg/kg for total 10 doses. HCC patients who failed at least one line of systemic treatment,received RO7070179 as a weekly infusion, each cycle is 6 wk. We evaluated the safety and HIF-1α mRNA levels of RO7070179.RESULTS Preclinical evaluation of RO7070179 in orthotopic HCC xenograft model showed no significant differences in HCC tumor weight between the 3 and 10 mg/kg groups. However, dose of 10 mg/kg of RO7070179, has shown 76% reduction of the amount of HIF-1α mRNA in HCC tissue. In the phase 1 b study of RO7070179 in previously treated HCC patients, 8 out of 9 were evaluable: 1 achieved PR and1 SD. The patient with PR responded after 2 cycles treatments, which has been maintained for 12 cycles. This patient also showed reduction in perfusion of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI) after 1 cycle of treatment. After 1 cycle of treatment, both patients with PR and SD showed decrease in HIF-1α mRNA at the root of biopsies(each biopsy was divided into 2 specimens, the tip and the root).CONCLUSION RO7070179 can reduce HIF-1α mRNA level in HCC patients with SD or PR. It is well tolerated at 10 mg/kg, with transaminitis as the dose of increased toxicity.This study indicates that RO7070179 might benefit HCC patients, and an early signal for clinical benefit can potentially be predicted through changes in either m RNA level or DCE-MRI withi
文摘With the increasing clinical use of cytostatic and novel biologic targeted agents,conventional morphologic tumor burden assessments,including World Health Organization criteria and Response Evaluation Criteria in Solid Tumors,are confronting limitations because of their difficulties in distinguishing viable tumor from necrotic or fibrotic tissue.Therefore,the investigation for reliable quantitative biomarkers of therapeutic response such as metabolic imaging or functional imaging has been desired.In this review,we will discuss the conventional and new approaches to assess tumor burden.Since targeted therapy or locoregional therapies can induce biological changes much earlier than morphological changes,these functional tumor burden analyses are very promising.However,some of them have not gone thorough all steps for standardization and validation.Nevertheless,these new techniques and criteria will play an important role in the cancer management,and provide each patient more tailored therapy.
文摘目的 探讨应用平均表观传播子MRI(mean apparent propagator-magnetic resonance imaging, MAP-MRI)及动态对比增强MRI(dynamic contrast enhanced magnetic resonance imaging, DCE-MRI)预测3、4级胶质瘤患者O6-甲基鸟嘌呤-DNA-甲基转移酶(O6-methylguanine-DNA methyhransferase, MGMT)启动子甲基化状态的可行性。材料与方法 前瞻性纳入本院自2018年6月至2022年1月经病理证实的14例MGMT启动子甲基化和17例MGMT启动子非甲基化胶质瘤患者,进行了术前常规MRI、DCE-MRI及MAP-MRI扫描。通过手动勾画肿瘤实质区域为感兴趣区(region of interest, ROI)并提取ROI定量参数特征,测量DCE-MRI参数及MAP-MRI参数。参数与MGMT甲基化间的相关性采用Pearson相关分析。所有参数均采用两独立样本t检验,比较DCE-MRI和MAP-MRI对预测3、4级胶质瘤MGMT启动子甲基化状态的诊断效能。进一步建立单因素和多因素logistic回归模型,分析构建受试者工作特征(receiver operating characteristic, ROC)曲线,以DeLong检验比较DCE-MRI参数、MAP-MRI参数与多参数联合模型预测MGMT甲基化的诊断效果。结果 DCE-MRI参数容积转运常数(volume transfer constant,Ktrans)、血管外细胞外容积分数(fractional volume of the extravascular-extracellular space, Ve)以及MAP-MRI参数非高斯(non-Gaussianity, NG)、非高斯轴向(non-Gaussianity axial, NGAx)、Q空间逆方差(Q-space inverse variance,QIV)、返回原点概率(return to the origin probability, RTOP)、返回轴线概率(return to the axis probability,RTAP)与MGMT启动子甲基化间呈中等相关性,对预测3、4级胶质瘤MGMT启动子甲基化与非甲基化组间差异具有统计学意义(P<0.05);ROC曲线下面积(area under the curve, AUC)分别为0.803、0.815、0.807、0.803、0.765、0.790、0.739。多因素logistic分析显示Ve是预测MGMT启动子甲基化的最佳预测因子,其准确性最高,AUC为0.815(95%CI:0.659~0.971),比值比(odds ratio, OR)为0.891(95%CI:0.815~0.975)。DeLong检验�
文摘针对动态对比度增强磁共振灌注成像中脑血容积的计算,提出基于Hankel矩阵的奇异值分解(Singular Value Decomposition,SVD)算法。在奇异值数目的确定上采用差分谱量级差的研究方法,对算法进行理论推导与仿真模拟,得到较为理想的滤波效果。由于成像过程存在测量噪声的干扰,分析了信噪比和示踪剂延迟对算法的影响。仿真结果表明,信噪比越低(SNR=5 d B),算法处理效果越明显;信噪比增高(SNR=100 d B),估计值偏差减小,结果越为准确。且该算法不受示踪剂延迟的影响。与传统奇异值分解算法相比,采用基于Hankel矩阵的奇异值算法可以更为准确地估计脑血容积。
基金supported by the Natural Science Foundation of Jiangsu University(14KJB320003)
文摘In the current study, we sought to evaluate the diagnostic efficacies of conventional ultrasound（US）, contrastenhanced US（CEUS）, combined US and CEUS and magnetic resonance imaging（MRI） in detecting focal solid breast lesions. Totally 117 patients with 120 BI-RADS category 4A-5 breast lesions were evaluated by conventional US and CEUS, and MRI, respectively. SonoVue was used as contrast agent in CEUS and injected as an intravenous bolus; nodule scan was performed 4 minutes after bolus injection. A specific sonographic quantification software was used to obtain color-coded maps of perfusion parameters for the investigated lesion, namely the time-intensity curve.The pattern of contrast enhancement and related indexes regarding the time-intensity curve were used to describe the lesions, comparatively with pathological results. Histopathologic examination revealed 46 benign and 74 malignant lesions. Sensitivity, specificity, and accuracy of US in detecting malignant breast lesions were 90.14%, 95.92%, and 92.52%, respectively. Meanwhile, CE-MRI showed sensitivity, specificity, and accuracy of 88.73%, 95.92%, and91.67%, respectively. The area under the ROC curve for combined US and CEUS in discriminating benign from malignant breast lesions was 0.936, while that of MRI was 0.923, with no significant difference between them, as well as among groups. The time-intensity curve of malignant hypervascular fibroadenoma and papillary lesions mostly showed a fast-in/fast-out pattern, with no good correlation between them（kappa 〈0.20）. In conclusion, the combined use of conventional US and CEUS displays good agreement with MRI in differentiating benign from malignant breast lesions.
