Objective: To explore the clinical value of BRAF V600E gene detection in diagnosing the benign and malignant nodules of the atypia of undetermined significance or follicular lesion of undetermined significance (AUS/FLUS). Methods: A retrospective analysis was performed on 96 patients (with 97 nodules) diagnosed as AUS/FLUS by fine-needle aspiration biopsy (FNAB) before surgery and with complete ultrasound evaluation report and BRAF V600E detection results from Nanjing Hospital Affiliated to Nanjing Medical University (Nanjing First Hospital) from March 2019 to October 2022. With postoperative pathology as the gold standard, the application value of BRAF V600E gene detection in diagnosing benign and malignant AUS/FLUS nodules was studied through statistical methods. Results: Among the postoperative histopathological findings of 97 AUS/FLUS nodules, 11 were benign, 86 were malignant, and 71 had mutations in the BRAF V600E gene, all of which were papillary carcinoma of the thyroid (PTC). The sensitivity, specificity, and accuracy of the BRAF V600E gene detection in the diagnosis of AUS/FLUS nodules were 82.6%, 100.0%, and 84.5%. By calculating the area under the curve (AUC) of receiver operating characteristic (ROC) curve, it is confirmed that the BRAF V600E gene detection has a high diagnostic value for the diagnosis of AUS/FLUS nodules. BRAF V600E mutation examination can increase the malignant detection rate of AUS/FLUS nodules (P＜0.05). Conclusion: The BRAF V600E gene detection has high diagnostic value for the diagnosis of AUS/FLUS nodules. Combining FNAB can improve the detection rate of malignant AUS/FLUS nodules, which is very helpful for clinical treatment planning.

Prostate cancer (PCa) is one of the common malignant tumors threatening the life and health of middle-aged and elderly men. Prostate-specific membrane antigen (PSMA) is a type Ⅱ transmembrane glycoprotein expressed in prostate epithelial cells. Compared with non-diseased prostate tissues, the expression of PSMA in prostate cancer was increased by 100-1 000 times. In recent years, PSMA has been attracted much attention as a target for prostate cancer imaging and treatment. It plays a unique and important role in prostate cancer staging, restaging, treatment and efficacy evaluation. Based on this, this paper briefly reviewed the latest progress of the application of PSMA molecular targeting probe in PCa imaging and treatment of PCa, in order to better serve the clinic.

Objective: To compare the value of  ¹⁸ F-prostate-specific membrane antigen (PSMA)-1007 positron emission tomography (PET)/computed tomography (CT) and multiparametric magnetic resonance imaging (mpMRI) images for the diagnosis of primary prostate cancer (PCa) using prostate puncture pathology as gold standard and to evaluate the value of maximum standard uptake value (SUV _max ) in predicting the benignity and malignancy of primary prostate foci and the risk stratification of PCa. Methods: From September 2019 to December 2022, fifty-six patients with suspected PCa who underwent  ¹⁸ F-PSMA-1007 PET/CT at the Fudan University Shanghai Cancer Center were retrospectively recruited. Forty-eight of these patients also underwent mpMRI. The prostate was divided into four segments, the left and right central glands and the left and right peripheral zones, corresponding to the pathological findings of the prostate puncture. Differences in detection rates between groups were compared using the χ ² test or Fisher’s exact test and sensitivity, specificity, positive predictive value and negative predictive value were calculated for the diagnosis of PCa. Spearman rank correlation analysis was used to determine the correlation between prostate-specific antigen (PSA), the Gleason score (GS) and SUV _max . Differences in SUV _max were analyzed by the Mann-Whitney U test. The area under curve (AUC) was calculated using the receiver operating characteristic (ROC) curve to derive the optimal diagnostic threshold for SUV _max . Results: About 57.1% (32/56) patients had confirmed PCa by puncture pathology and 42.9% (24/56) patients were benign. There were 10 benign patients with prostate inflammation. PSA and SUV _max were significantly higher in PCa patients than in benign patients (P=0.002, P＜0.001). The ROC curve for predicting the benignity or malignancy of the primary prostate foci by SUV _max was constructed based on the results of segmental lesion detection, with an AUC of 0.93. When SUV _max =9.45 was used as the optimal diagnostic threshold, the sensitivity and specificity were 82.0% and 89.6%, respectively. Based on segment analysis, there was no significant difference in detection rate (80.7% vs 77.1%, P=0.568) between  ¹⁸ F-PSMA PET/CT and mpMRI. More segmental lesions were detected with the combination of  ¹⁸ F-PSMA-1007 PET/CT and mpMRI (84.3%, 70/83), but there was no significant difference in detection rate compared to  ¹⁸ F-PSMA-1007 PET/CT alone and mpMRI alone (P=0.540, P=0.238, respectively). SUV _max was significantly higher in segments with prostate inflammation than in those with benign prostate tissue (P=0.007). Based on patient analysis, the sensitivity, accuracy and negative predictive value of  ¹⁸ F-PSMA-1007 PET/CT for detecting primary prostate cancer were slightly higher than that of mpMRI (78.1% vs 76.7%, 73.2% vs 72.9%, 69.6% vs 63.2%, respectively). In terms of detection of regional lymph nodes and bone metastases,  ¹⁸ F-PSMA-1007 were higher than mpMRI. The SUV _max of PCa primary foci was positively correlated with both PSA (r=0.467, P=0.008) and GS (r=0.571, P＜0.001). The detection rate of PCa was 100% when SUV _max ≥18.00. SUV _max =22.40 was identified by ROC curve (AUC=0.79) as the optimal diagnostic threshold to distinguish between high and low-moderate risk of PCa, with corresponding sensitivity and specificity of 62.7% and 100.0%, respectively. Conclusion:  ¹⁸ F-PSMA-1007 PET/CT had better diagnostic efficacy in detecting PCa primary foci and improved the detection of tumor extent in combination with mpMRI. The semi-quantitative index SUV _max had promising predictive value for the identification of benign or malignant primary prostate foci and for risk stratification of PCa.

Objective: To compare the diagnostic efficacy of radiologists of different seniority in assessing clinically significant prostate cancer (csPCa) based on the Prostate Imaging Reporting and Data System version 2.1 (PI-RADS v2.1) and to test the consistency of the scores. Methods: Three radiologists with different seniority (working years are 8, 6, 3 years respectively) retrospectively analyzed images of 583 patients who underwent multiparametric magnetic resonance imaging (mpMRI) before prostate biopsy. Receiver operating characteristic (ROC) curve was drawn from the obtained diagnostic results and pathological results to determine the best diagnostic performance of the three. Using the Kappa test to assess the consistency of diagnostic scores among three radiologists. Results: The area under the ROC curve (AUC) of the diagnostic efficacy of three radiologists with different seniority were 0.85, 0.86, 0.80. There was no significant difference in AUC between senior and middle-aged physicians (P=0.43). There was a statistically significant difference in AUC between senior and middle-aged radiologists and junior senior radiologists (P＜0.05). The sensitivity, specificity, positive predictive value and negative predictive value of high, middle, and low-qualified physicians were 87%, 82%, 81%, 88%, and 89%, 82%, 81%, 90%, and 79%, 82%, 79%, 82%. The consistency results of the comparison of diagnostic scores between senior and middle-qualified physicians was moderate (Kappa=0.70), between middle-qualified and junior physicians was good (Kappa=0.76), and between senior and junior-qualified physicians was moderate (Kappa=0.64). Conclusion: The diagnostic efficacy of PI-RADS v2.1 for csPCa is high among physicians of different levels of experience and it’s recommended for clinical application. The diagnostic efficacy of PI-RADS v2.1 differed among different years of experience of physicians, with senior and middle-qualified physicians outperforming junior physicians, but the consistency of their diagnoses was average, and PI-RADS v2.1 still needs further improvement.

Objective: To investigate the diagnostic efficacy of  ⁶⁸ Ga-prostate-specific membrane antigen (PSMA) positron emission tomography (PET)/computed tomography (CT) for pelvic lymph node metastasis after endocrine therapy for prostate cancer Methods: The clinical data of 76 patients with prostate cancer who underwent laparoscopic radical prostatectomy and pelvic lymph node dissection in Chongqing University Cancer Hospital from December 2019 to December 2022 were retrospectively analyzed. All the patients underwent  ⁶⁸ Ga-PSMA PET/CT before surgery. The patients were divided into two groups according to the presence or absence of preoperative endocrine therapy, including 48 cases in the untreated group and 28 cases in the treated group. With pathological results as the gold standard, the diagnostic sensitivity and specificity of  ⁶⁸ Ga-PSMA PET/CT for pelvic lymph node metastasis in the two groups were analyzed based on patients and lymph nodes, respectively. The receiver operating characteristic (ROC) curve was mapped and the diagnostic accuracy of the two groups was compared by area under curve (AUC). Results: Based on patient, the diagnostic sensitivity, specificity and AUC of  ⁶⁸ Ga-PSMA PET/CT for the untreated group were 83.33%, 97.62% and 0.905, and the diagnostic sensitivity, specificity and AUC for the endocrine therapy group were 80.00%, 88.89% and 0.844, respectively. Based on lymph node, the diagnostic sensitivity, specificity and AUC of  ⁶⁸ Ga-PSMA PET/CT were 77.78%, 99.69% and 0.899 for the untreated group, and 77.27%, 98.52% and 0.825 for the endocrine therapy group, respectively. There were no significant differences in sensitivity, specificity and AUC of  ⁶⁸ Ga-PSMA PET/CT diagnosis of pelvic lymph node metastasis between the two groups based on patient and lymph node analysis (P＞0.05). Conclusion: The diagnostic efficacy of  ⁶⁸ Ga-PSMA PET/CT for prostate cancer patients with pelvic lymph node metastasis was not significantly reduced after endocrine therapy.  68 Ga-PSMA PET/CT has high specificity and negative predictive value for the diagnosis of pelvic lymph node metastasis after endocrine therapy. However, the sample size needs to be expanded for further verification.

Prostate-specific membrane antigen (PSMA) first discovered in prostate cancer cells is an important target for diagnosis and treatment of prostate cancer.  ⁶⁸ Ga/ ¹⁸ F-PSMA positron emission tomography (PET)/computed tomography (CT) or PET/magnetic resonance imaging (MRI) plays an important role in prostate cancer. With the rapid development of research and application, liver cancer, lung cancer, kidney cancer and other solid tumors can also accumulate  ⁶⁸ Ga/ ¹⁸ F-PSMA reflecting the important applications of  ⁶⁸ Ga/ ¹⁸ F-PSMA PET/CT in these tumors. This paper reviewed the application of  ⁶⁸ Ga/ ¹⁸ F-PSMA PET/CT in the diagnosis and treatment of non-prostate cancer tumors.

Early recurrence of hepatocellular carcinoma (HCC) after resection is an important risk factor for patients with poor prognosis. The role of preoperative magnetic resonance imaging (MRI)-related imaging markers in predicting early recurrence of HCC has been widely recognized. And surgical margin width, as an intraoperative indicator of HCC prognosis, combined with preoperative MRI markers to predict the prognosis of HCC seems to be more meaningful than preoperative MRI markers alone. And the latter could provide guidance for the selection of margin width. This article reviewed the research progress of preoperative MRI markers combined with surgical margins in predicting early recurrence of HCC after radical surgery.

Breast cancer has become the world’s largest cancer, seriously endangering women’s health, which also indicates the importance of early diagnosis and treatment. Integrated positron emission tomography (PET)/magnetic resonance imaging (MRI), as a new multi-modal imaging tool with great potential, has gradually entered clinical practice. It can not only provide metabolic information based on PET, but also obtain high-resolution morphological data based on MRI and perform multi-sequence functional imaging. It can more accurately judge lymph node, bone, liver metastasis and evaluate the efficacy of neoadjuvant chemotherapy under the condition of low radiation dose, and is expected to show its unique advantages in the field of breast cancer. This article reviewed the application of integrated PET/MRI in the diagnosis and treatment of breast cancer, and evaluated its strengths and weaknesses.

Objective: To explore the clinical value of the Ovarian-Adnexal Reporting and Data System (O-RADS) combined with contrast-enhanced ultrasound (CEUS) to identify benign and malignant tumors of the ovaries. Methods: Retrospective analysis of 159 cases of ovarian tumors using transvaginal (transabdominal) ultrasound and O-RADS risk stratification was conducted. At the same time, combined with the CEUS, the ultrasound and CEUS features of benign and malignant ovarian tumors were compared, and the diagnostic efficacies of O-RADS, CEUS, and their combination in ovarian tumors were observed. Results: Taking pathology as the gold standard, among the 159 ovarian tumors in this study, 88 cases were benign tumors and 71 cases were malignant tumors. The mean age, maximum tumor diameter, carbohydrate antigen (CA) 125, and human epididymis protein 4 (HE4) of malignant tumor patients were higher than those of benign tumor patients (P＜0.01). There were differences in ultrasound characteristics, color Doppler score, ascites, CEUS enhancement time, enhancement level and enhancement morphology between benign and malignant ovarian tumors (P＜0.01). The sensitivity and specificity of O-RADS in the diagnosis of ovarian malignant tumors were 93.0% and 70.5% respectively, and CEUS were 85.9% and 87.5% respectively, and O-RADS combined with CEUS were 87.3% and 88.6% respectively. The area under curve (AUC) of O-RADS combined with CEUS was significantly different from O-RADS (Z=2.920, P=0.004) or CEUS (Z=3.265, P=0.001). Conclusion: The clinical value of O-RADS combined with CEUS for ovarian tumors is higher than O-RADS or CEUS.

Objective: To evaluate cranial ultrasound markers in routine screening scan for open spina bifida (OSB) between 11 and 13+6 weeks of gestation. Methods: This was a retrospective study including 6 cases of spina bifida ［three cases were OSB and the others were closed spina bifida (CSB)］ and 30 controls in Obstetrics and Gynecology Hospital of Fudan University between June 2020 and December 2021. Indirect cranial markers of OSB were evaluated on stored ultrasound images and the medical records were reviewed. Four lines view (4LV) and maxillo-occipital (MO) line were assessed on the sagittal view, whereas the ratio of mean choroid plexus length and occipitofrontal diameter (R-CP) were measured on the axial plane. All cases of spina bifida or controls diagnosed prenatally were confirmed at birth or by autopsy. Results: The 4LV sign and the junction between the midbrain and the brain stem above the MO line on the sagittal view were found, and R-CP on the axial plane were between 0.43-0.55 in 3 CSB fetus and 30 controls. 3LV and the junction between the midbrain and the brain stem below the MO line were seen and the R-CP were 0.62, 0.68 and 0.67 in OSB fetus, which were significantly higher than the other groups (P＜0.001). Conclusion: The 4LV and MO line on the sagittal view and R-CP on the axial plane appear to be the effective indirect cranial sonographic markers of OSB and can be easily obtained during the routine first-trimester scan.

 Objective: To compare the effectiveness and safety of preoperative lung localization by pulmonary nodule localization wire and Hook-wire. Methods: A retrospective analysis of the clinical data of 119 patients with preoperative pulmonary nodules located by computed tomography (CT)-guided percutaneous puncture was performed. According to the use of different localization method, they were divided into localization wire group (50 cases) and Hook-wire group (69 cases). The location of lesion, nodule size, distance between nodule and pleura, localization time, localization success rate, and incidence of complications were compared between the two groups. Related risk factors of complications were analyzed by logistic regression. Results: There was no significant difference between the two groups in nodule position, nodule diameter and the distance between the pulmonary nodule. The localization time was similar in the two groups ［16(14,19) min vs 16(14,18.5) min, t=-0.416, P=0.677］. The localization success rate was similar in the two groups (98.0% vs 94.2%, χ ² =1.038, P=0.397). The overall complications in the localization wire group were significantly lower than those in the Hook-wire group (16.0% and 47.8%, χ ² =13.003, P＜0.001), The pneumothorax (12.0% vs 27.5%, χ ² =4.217, P=0.004), pulmonary hemorrhage (4.0% vs 18.8%, χ ² =5.796, P=0.016), local pain (0.0% vs 8.7%, χ ² =4.579, P＜0.001) in the localization wire group were lower than the Hook-wire group in the subgroup analysis. Through the analysis of related risk factors, different localization methods were independent risk factors (OR=0.208, 95% CI 0.085-0.507, P＜0.001). Conclusion: The localization time and localization success rate are similar, but the localization wire group has fewer complications than the Hook-wire method, and is worthy of promotion.

Objective: To explore the calcification characteristics that may predict the invasiveness of breast lesions based on the morphology and distribution of calcification in mammography. Methods: A total of 267 patients with suspicious calcification detected by mammography were analyzed retrospectively. All these patients were females, with an average age of (48.1±9.7) years and were also diagnosed by biopsy. According to the pathological results, invasive carcinoma and ductal carcinoma in situ with microinvasion were defined as invasive lesions while ductal carcinoma in situ and various benign lesions were defined as non-invasive lesions. The morphology and distribution of calcification that may predict the invasiveness of the lesions were explored. χ ² test was used in univariate analysis while logistic regression analysis was used in multivariate analysis to establish a predictive model. Then, receiver operating characteristic (ROC) curve was drawn and area under curve (AUC) was calculated to assess the predictive value of the model. At last, Hosmer-Lemeshow test was used to assess the overall fit of the model. Results: Univariate analysis showed that the suspicious calcification with punctate/round calcification and amorphous calcification had predictive value for non-invasive breast lesions (χ ² =10.567, P=0.001; χ ² =31.153, P＜0.001), while fine linear or fine linear branching calcification and suspicious calcification in segmental distribution had predictive value for invasive breast lesions (χ ² =36.275, P＜0.001; χ ² =5.147, P=0.023). Multivariate logistic regression analysis showed that amorphous calcification was independent predictor of non-invasive breast lesions (OR=0.273, 95% CI 0.135-0.553, P＜0.001), while fine linear or fine linear branching calcification was independent predictor of invasive breast lesions (OR=5.211, 95% CI 1.819-14.931, P=0.002). The AUC of predictive model was 0.759 (95% CI 0.686-0.833) and Hosmer-Lemeshow test showed a good fit of the model (P＞0.05). Conclusion: It is feasible to predict the invasiveness of breast lesions based on the morphology and distribution of calcification in mammography and which significance is to take corresponding intervention or management measures for lesions of different natures as early as possible according to mammography screening.

Objective: To explore the application value of breast magnetic resonance imaging (MRI) in breast reconstruction with nipple-areola complex (NAC)-preserving stage Ⅰ breast reconstruction. Methods: A total of 75 breast cancer patients in Huizhou Third People’s Hospital were selected and all underwent NAC-preserving stage Ⅰ breast reconstruction. Before surgery, breast MRI was used to evaluate the thickness of fat in the breast, the thickness of the glands, and the distance from the tumor edge to the NAC. According to the preoperative MRI measurement data, the tumor resection range was determined, the planned tissue volume was calculated, and the size of the prosthesis was guided. During the operation, the thickness of the breast fat, the thickness of the glands, and the distance from the tumor edge to the NAC were measured, the volume of the tissues removed and the volume of the prosthesis was measured during operation, and the MRI and intraoperative measurement data were compared. The Pearson correlation coefficient model was used to analyze the two groups the linear relationship of the data, the statistics of postoperative complications, and the beauty effect of breast reconstruction. Results: There was no statistically significant difference between the distance of the tumor margin from the skin in the breast measured by breast MRI and intraoperative measurement (P＞0.05), and the two were positively correlated (r=0.747, P＜0.05). Breast MRI measured gland thickness was compared with intraoperative measurement, and the difference was not statistically significant (P＞0.05), and the two were positively correlated (r=0.744, P＜0.05). The distance between the tumor edge and the NAC measured by breast MRI was not statistically significant (P＞0.05), the two were positively correlated (r=0.752, P＜0.05). There was no statistically significant difference between the planned resected tissue volume measured by breast MRI and the actual resected tissue volume and the implanted prosthesis volume (P＞0.05). The planned resected tissue volume was positively correlated with the volume of the actual tissue removed and the volume of the implant (r=0.762, 0.776, P＜0.05). The total incidence of postoperative complications was 6.67%, and the excellent rate of subjective cosmetic effect was 86.67%, and the objective cosmetic effect was excellent the rate is 82.67%. Conclusion: Before the NAC-preserving stage Ⅰ breast reconstruction, breast MRI can be used to measure the tumor location, breast fat thickness, gland thickness, and distance between tumor edge and NAC in breast cancer patients, which can guide tumor tissue resection and prosthesis size selection, which facilitates the safe preservation of part of the fatty tissue in part of the breast during the operation, so as to obtain a good beauty result of breast reconstruction and reduce postoperative complications.

Objective: To investigate the influencing factors of radioiodine therapy in papillary carcinoma of the thyroid (PTC) patients with postoperative residual lymph node metastases for providing more reference for subsequent individualized treatment. Methods: A total of 151 PTC patients with postoperative residual lymph node metastases before  ¹³¹ I treatment were retrospectively chosen in the period from January 2011 to January 2016 in 3201 Hospital. All patients were grouped according to  ¹³¹ I treatment effect and included best response group (92 cases) and non-optimum response group (59 cases). The clinical characteristics of 2 groups were compared and multivariate logistic regression model was used to evaluate the independent influencing factors of  ¹³¹ I treatment effect. Receiver operating characteristic (ROC) curve was drawn to evaluate the clinical efficiency of above independent influencing factors in predicting for  ¹³¹ I treatment effect. Results: The levels of thyroglobulin (Tg) level in thyroid-stimulating hormone (TSH) excited state and the minimal length of metastatic lymph nodes of best response group were significantly less than non-optimum response group（P＜0.05）. Logistic regression model multivariate analysis showed that Tg level in the excited state of TSH, the smallest metastatic lymph node and American Thyroid Association (ATA) risk stratification were independent influencing factors for clinical efficacy of  ¹³¹ I treatment（P＜0.05）. ROC curve analysis showed that Tg level in TSH excited state, minimal metastatic lymph node and ATA risk stratification could be used to predict clinical efficacy of  ¹³¹ I treatment, and combination of above three had the best prediction efficiency, and the predictive efficiency of Tg level in TSH excited state was better than other two. Conclusion: The clinical efficacy of radioiodine therapy is not only related to the smallest of metastatic lymph nodes and the ATA risk stratification, but also independently affected by the Tg level in the excited state of TSH in PTC patients with postoperative residual lymph node metastasis. And the level of Tg can be used to predict the clinical efficiency of radioiodine therapy and the combination with other factors has better predictive efficiency.

Objective: To analyze the imaging features of granular cell tumor of the breast (GCT-B), as well as clinicopathological characteristics, in order to improve the understanding and the ability of differential diagnosis of GCB-T for clinicians. Methods: Imaging findings on digital mammograph (DM) and magnetic resonance imaging (MRI), clinical presentations, pathological and immunohistochemical examinations of 11 cases of GCT-B confirmed by pathology in Fudan University Shanghai Cancer Center from March 2017 to October 2022 were retrospectively analyzed, including 10 cases of DM, 6 cases of MRI. Results: In the 11 GCT-B cases, 1 was male and 10 were female, the age of onset ranged from 20 to 66 years, with a median age of 35 years, more frequently in were premenopausal women (8 cases), mostly found by accident (10 cases). The lesions were all solitary small mass, with a diameter range from 14 to 17 mm, mostly located in the upper quadrants of the breast (10 cases). The lesions have different shapes on DM, 5 cases with spiculate boundary, none with calcification. On MRI plain scan, the signal of the tumor is variable. After dynamic enhancement, all mases showed rapid enhanced in early-phase, with persistent or enhanced enhancement in delay-phase. 11 cases with S-100 positivity, 10 cases with SOX-10 positivity, 8 cases with CD68 positivity, Ki-67 proliferative indexs were less than 10%. There was no recurrence during 4 to 70 month follow-up. Conclusion: GCT-B is a rare tumor of the breast, which usually occurs in the upper part of the breast and was more common in premenopausal women. GCT-B presents as solitary mass on DM, usually without calcification, and shows rapid mass-like enhancement in early phase on dynamic enhanced MRI, which are of significance for clinical diagnosis.

Objective: To analyze the value of fast spin-echo diffusion-weighted imaging (TSE-DWI) in the evaluation of focal activity in children with intraocular simultaneous unilateral retinoblastoma (RB). Methods: The magnetic resonance imaging (MRI) data and relevant clinical data of 180 children with intraocular simultaneous unilateral RB who were clinically diagnosed and treated in the Affiliated Children’s Hospital of Shandong University from May 2014 to July 2018 and 53 communal healthy volunteers (control group) were collected. All cases were performed MRI routine sequence, TSE-DWI and dynamic contrast-enhanced MRI (DCE-MRI), and were examined once before treatment, after treatment and in stable period, the control group was scanned once. The changes of apparent diffusion coefficient (ADC) and signal intensity enhancement ratio (△SI) in the active and stable stage of the intraocular lesions and the control group were compared, and their effectiveness in evaluating whether the lesions were active or no. Results: The TSE-DWI of lesions before treatment showed high signal, the corresponding ADC image showed low signal, and the enhanced scanning showed enhancement with different degrees. After treatment, the lesion volume decreased, the DWI signal decreased, the ADC image signal increased，no or medium enhancement. The differences of ADC and △SI in active phase, stable phase and control group were statistically significant (P＜0.001). When △SI=1.14%, the sensitivity, specificity and accuracy  of identifying whether the lesion was active were 75.91%, 82.31%, and 87.56% respectively. When ADC=1.17×10 ^-3 /mm ² , the sensitivity, specificity and accuracy of identifying whether the lesion was active were 95.72%, 87.23%and 93.76% respectively. The energy efficiency of the two method to distinguish whether the lesion was active similarly. Conclusion: In assessing whether the lesion is active or not, the value of TSE-DWI was similar to the DCE-MRI, but TSE-DWI has the advantage.

Objective: To investigate the magnetic resonance imaging (MRI) features of solid papillary carcinoma (SPC) and to explore the diagnostic value of MRI in SPC. Methods: This respective study collected 57 patients with 61 pathologically confirmed SPC between January 2017 and December 2021 Xinhua Hospital , Shanghai Jiao Tong University School of Medicine. All the patients had preoperative MRI examinations. Of the 57 patients, 45 patients with 48 SPC and 52 patients with 55 SPC underwent preoperative mammography and ultrasound examination respectively. The detection rate and diagnostic accuracy of mammography, ultrasound, and MRI for SPC based on the preoperative Breast Imaging Reporting and Data System (BI-RADS) categories were calculated. A BI-RADS ≥4A category was considered as the suspicion of malignancy. According to the morphology of the lesions, lesions was divided into non-mass enhancement (NME) and mass two groups. The difference in size and the rate of duct dilation were compared between the two groups, using the Mann-Whitney U test and the χ ² test, respectively. Results: The detection rate of mammography, ultrasound, and MRI for SPC was 64.6% (31/48), 83.6% (46/55), and 100.0% (61/61), respectively. The accuracy of mammography, ultrasound, and MRI for SPC was 52.1% (25/48), 65.5% (36/55), and 98.4% (60/61), respectively. On MRI, SPC was more commonly presented as a NME lesion than a mass lesion (67.2% vs 32.8%). The NME lesion had a larger size ［2.5(1.6, 4.0)cm vs 1.4(1.0, 1.8) cm, P=0.001］ and a more frequent rate of duct dilation ［82.9%(34/41) vs 25.0%(5/20), P＜0.001］. Conclusion: Breast MRI showed a higher detection rate and accuracy than mammography and ultrasound. SPC was more commonly presented as an NME lesion than a mass lesion. The NME lesion had a larger size and a more frequent rate of duct dilation.

Objective: To investigate the efficacy and prognosis of computed tomography (CT)-guided radiofrequency ablation for elderly patients with non-small cell lung cancer (NSCLC) who cannot be treated with surgery. Methods: From January 2010 to January 2014, 191 elderly patients with NSCLC who could not be treated surgically were selected as the study subjects. To observe the efficacy, safety and prognosis of radiofrequency ablation in the treatment of elderly NSCLC. Results: 191 elderly patients with NSCLC underwent CT-guided radiofrequency ablation successfully. The total effective rate was 47.12%. The incidence of complications was 49.74% in 191 patients, and there was no death. The 1, 3, 5-year overall survival rates of 191 patients with NSCLC were 94.76%, 70.68% and 37.70%, while the 1, 3 and 5-year disease-free survival rates were 84.82%, 62.83% and 28.27%. Cox univariate and multivariate analysis showed that tumor diameter, TNM stage, lymph node metastasis, molecular targeted therapy and lymphovascular invasion (LVI) were closely related to the overall survival of elderly patients with NSCLC. Tumor diameter, lymph node metastasis and LVI were closely related to the disease-free survival of elderly patients with NSCLC. Conclusion: CT- guided radiofrequency ablation might have a certain curative effect on inoperable elderly patients with NSCLC, and the safety is acceptable. Tumor diameter, TNM stage, lymph node metastasis, molecular targeted therapy, and LVI may affect the prognosis of patients receiving radiofrequency ablation.

Objective: To investigate the relationship between clinicopathologic and ultrasonographic features of Luminal A breast cancer and axillary lymph node metastasis. Methods: In this study, a total of 301 female patients with Luminal A breast cancer confirmed by pathology in Nanjing Medical University First Hospital from January 2016 to October 2022 were selected, of whom 82 were in the lymph node metastasis group and 219 were in the non-metastasis group. The correlation between clinicopathological and ultrasonographic features of Luminal A breast cancer and axillary lymph node metastasis was determined by univariate and logistic regression analyses. Results: The results of univariate analysis showed statistically significant differences in size, shape, margin of tumor and short diameter, long diameter/short diameter (L/S＜2), loss of lymphatic portal structures, cortical thickness (＞3 mm), type of blood supply (non-lymphoid portal type) and vascularity of lymph node (abundant) between the two groups, which correlated with lymph node metastasis (P＜0.05). Logistic regression analysis showed that size of the tumor (OR=1.842, P=0.016), cortical thickness of lymph node (OR=2.649, P=0.036), L/S (OR=0.354, P=0.007) and vascularity of lymph node (OR=2.255, P=0.039) were independent risk factors for axillary lymph node metastasis in Luminal A breast cancer. Conclusion: Clinicopathological and ultrasonographic features of patients with Luminal A breast cancer can predict axillary lymph node metastasis and provide a reference for clinicians in the treatment of Luminal A breast cancer.

The Oncology Imaging Professional Committee of the China Anti-Cancer Association organized experts to write the CACA Guidelines for Holistic Integrative Management of Cancer · X-rays Examination in 2023. The CACA guidelines emphasized that mammography has been proven to be the only imaging examination for detecting the early breast cancer and reducing the patients’ mortality. The new technologies of mammography, as its derivative methods, make up for the deficiency of traditional mammography to a certain extent, especially for Chinese women with dense breast. According to the guidelines, this paper introduced the core contents of the new technologies of mammography, which could provide an effective principle in the clinic.

After decades of development, ultrasound (US) has become the first-line imaging method in the diagnosis and treatment of thyroid diseases since US was applied in thyroid in 1967. The risk stratification system of thyroid nodules based on conventional US plays a pivotal role in the diagnosis of thyroid diseases. In recent years, contrasted-enhanced US (CEUS), molecular diagnosis based on thyroid fine-needle aspiration biopsy and artificial intelligence have been widely used in thyroid diseases diagnosis. Thermal ablation of thyroid tumors has played the advantages of precise positioning, less trauma and maximum preservation of thyroid function. The relevant guideline consensuses regulate the minimally invasive treatment operation of thyroid diseases. Thyroid science popularization will further standardize the diagnosis and treatment of diseases and improve the treatment level of nationwide. This review summarized the representative research progress in the field of thyroid US in 2022.

Objective: To investigate the gray scale ultrasound, color Doppler ultrasound and ultrasonic elastography findings of solid papillary carcinoma of the breast (SPC), and to explore the correlation between the ultrasound findings of SPC and its pathology. Methods: The clinical data of 71 patients with SPC confirmed by surgery and pathology were analyzed, including gray scale and color Doppler ultrasound findings of 75 SPC lesions and ultrasonic elastography findings of 35 SPC lesions. To compare the ultrasonographic features and pathological correlation of different pathological subtypes of SPC. Results: Most of the sonographic manifestations of SPC were solitary hypoechoic solid masses with parallel origin, irregular shape, ill-defined margin, enhanced or unchanged posterior echo, and could be accompanied by duct dilation and calcification. Adler blood flow grade was Ⅱ-Ⅲ, and the resistance index (RI) range was 0.62-0.84. There was almost no axillary lymph node metastasis. The pathological molecular subtype of 75 SPC lesions was Luminal A type. Ki-67 proliferation index was ＜20% in 42 in situ SPC lesions, and the expression range was 20%-60% in 15 invasive SPC lesions, with a statistically significant difference between the subtypes (P=0.000). Conclusion: The ultrasound manifestations of SPC has certain characteristics. Combining gray scale, color Doppler, and ultrasonic elastography can improve the diagnostic accuracy. Ultrasound cannot distinguish between in situ SPC and invasive SPC. The Ki-67 proliferation index is related to whether SPC is infiltrating.

Accurate diagnosis and treatment of breast cancer significantly improve patient outcomes. Ultrasound is commonly used in the screening, diagnosis, and evaluation of therapeutic effects in breast cancer. Ultrasound radiomics uses high-throughput methods to extract numerous features from ultrasound images, reflecting the microscopic changes and biological behavior of the tumors. Ultrasound radiomics models based on artificial intelligence are gradually developed and applied in the diagnosis and treatment evaluation of breast cancer, aiming to facilitate the precise diagnosis and treatment of breast cancer. This article briefly introduced the research progress of ultrasound imaging based on artificial intelligence in breast cancer screening and diagnosis, molecular classification, axillary lymph node metastasis assessment, and neoadjuvant treatment efficacy assessment, summarized the limitations, challenges and the future development direction of the application of this technology.

Objective: To investigate the optimal acquisition and reconstruction protocol of uMI780 positron emission tomography (PET)/computed tomography (CT) in the clinical application of  ¹⁸ F-FDG for whole-body (head+body) imaging. Methods: A total of 400 subjects from August 2017 to May 2018 were collected. The 400 subjects were applied with two levels of FDG injection dose, 3 or 2 min for brain scan, 2 or 1.5 min/bed for body scan, OSEM and FBP resulted brain images, and 2- or 3-iteration OSEM body images with two Gaussian kernel for post-smoothing. Image quality was evaluated qualitatively and quantitatively and scored by two clinical physicians. Results: The OSEM image quality was significantly better than that FBP (P＜0.001), but there was no significant difference in brain PET image quality between different injection doses or different scan times. When the injection doses of  ¹⁸ F-FDG was injected with 2.96 MBq/kg, image quality of body PET imaging with 2 min/bed were significantly better than the 1.5 min/bed (P＜0.05); but, when the injection was 3.70 MBq/kg, there was no difference in image quality of body between 2 and 1.5 min/bed. When scan time was 2 min/bed, there was no significant difference in between image qualities of using 3.70 MBq/kg and 2.96 MBq/kg; but for 1.5 min/bed, the image quality of 3.70 MBq/kg was better than 2.96 MBq/kg. Two-iteration OSEM image quality of body were significantly better than that of 3 iterations (P＜0.01). Image quality by using 4 mm FWHM Gaussian was significantly better than 3 mm Gaussian (P＜0.01). Conclusion: By the study, we could obtain two optimal image and reconstruction protocols of ¹⁸ F-FDG for uMI780 PET/CT in clinical application: ① 2.96 MBq/kg injection dose; 2 min brain scan, 2 min/bed body scan with 2-iteration OSEM reconstruction with 4 mm Gaussian smoothing; ② 3.70 MBq/kg injection dose; 2 min brain scan, 1.5 min/bed body scan with 2-iteration OSEM reconstruction with 4 mm Gaussian smoothing.

Objective: To investigate the value of ultrasound-based peri-tumoral radiomics in discriminating benign and malignant breast nodules. Methods: A total of 300 cases of breast masses patients who were screened by regular ultrasound examination in The Sixth People’s Hospital, Shanghai Jiao Tong University School of Medicine were retrospectively collected. For、 the lesion on the regular ultrasound image, the largest dimension was selected to outline the region of interest. Subsequently, this area was automatically expanded by 2 mm in all directions, conformally and outwardly, to extract intra- and peritumor radiomics features. The included cases were randomly divided into a training group (210 cases) and a validation group (90 cases) in a ratio of 7∶3. Apply the least absolute shrinkage and selection operator (LASSO) to perform feature selection and obtain the optimal feature combination. The optimal features of the included models were retained by dimensionality reduction of the imaging omics features. The support vector machine (SVM) model was used to classify benign and malignant breast nodules, establish the intra-tumoral, peritumoral, clinical variables, intra-tumoral + peritumoral, intra-tumoral + peritumoral + clinical variables respectively, and evaluate the diagnostic efficacy of ultrasonic breast nodules by the receiver operating characteristics (ROC) curve. Results: Among 300 breast nodules, 101 were malignant nodules and 199 were benign nodules. The ultrasound-based intra-tumoral radiomics model had an area under curve (AUC) value of 0.927 (95% CI 0.889-0.965) in the training group and 0.808 (95% CI 0.710-0.905) in the validation group. The accuracy, sensitivity, specificity, F1 value, and precision were 0.753, 0.731, 0.763, 0.644, and 0.576 in the validation group, respectively in the ultrasound-based intra-tumoral radiomics model. The ultrasound-based peri-tumoral radiomics model had an AUC value of 0.930 (95% CI 0.891-0.969) in the training group and 0.857 (95% CI 0.763-0.949) in the validation group, and the accuracy, sensitivity, specificity, F1 value, and precision of this model were 0.812、0.846、0.797、0.733、0.647 for the validation group, respectively in the ultrasound-based peri-tumoral radiomics model. The intratumorally combined with peritumoral ultrasound imaging histological features had an AUC value of 0.941 (95% CI 0.843-0.967) in the training group and 0.865 (95% CI 0.781-0.949) in the validation group, the accuracy, sensitivity, specificity, F1 value, and precision of the model were 0.824, 0.692, 0.881, 0.706, 0.720 in the validation group, respectively. The model with intra-perineural radiomics features combined with clinical variables had an AUC value of 0.952 (95% CI 0.924-0.979) in the training set and an AUC value of 0.873 (95% CI: 0.788 to 0.958) in the validation group, and the accuracy, sensitivity, specificity, F1 value, and precision of the validation group were 0.859, 0.692, 0.932, 0.750, and 0.818, respectively. The diagnostic efficacy of the intra-peri-tumoral combined with clinical variables model was better than that of the clinical variables group and intratumoral imaging histology, with statistically significant differences (P＜0.05); it was higher than that of the peri-tumoral and intratumoral combined with peri-tumoral models, but the differences were not statistically significant (P＞0.05). Conclusion: Both intra-tumoral and peri-tumoral ultrasound radiomics have high value in the diagnosis of benign and malignant breast nodules. The application of intra-tumoral and peri-tumoral radiomics can reduce the missed rate of breast cancer and unnecessary biopsies.

Lung cancer is the common malignant tumor in China, and its incidence and mortality rank first. Due to atypical early symptoms and lack of effective screening methods, most lung cancer patients are detected at an advanced stage and often lead to poor prognosis. The key factors for improving the prognosis of lung cancer patients are early detection, early diagnosis and early treatment. With the continuous progress of cutting-edge technologies such as artificial intelligence and medical big data analysis, Deep learning, as a major branch of artificial intelligence, is recognized as a valuable tool in the field of medical image analysis, and has been widely used in the screening and diagnosis of early-stage lung cancer, treatment decision-making, prediction of prognosis and follow-up of advanced lung cancer, and many results have been reported in previous literatures. This paper reviewed the development status of deep learning technology in the diagnosis and treatment of lung cancer  18 F-FDG PET/CT in recent years, covered the aspects of image acquisition and reconstruction, lesion detection and segmentation, diagnosis and differential diagnosis, gene mutation status and molecular therapeutic target prediction, treatment response and outcome prediction, and analyzed its development prospects and challenges.

Objective: To evaluate the predictive value of conventional ultrasound combined with contrast-enhanced ultrasound for efficacy of neoadjuvant chemotherapy (NAC) in breast cancer to guide the selection of NAC evaluation method. Methods: Sixty- nine patients with breast cancer who underwent NAC in Lanzhou University Second Hospital were enrolled. All patients underwent conventional ultrasound and contrast-enhanced ultrasound before chemotherapy and underwent 6-8 cycles of NAC after surgery. Univariate analysis was used to compare the characteristics of conventional ultrasound and contrast-enhanced ultrasound before NAC between the two groups. Logistic multivariate analysis was used to analyze the independent predictors of the efficacy of breast cancer NAC and the receiver operating characteristic (ROC) curve of the prediction model was established. Results: Among the 69 patients, 54 (78.26%) were pathologically effective and 15 (21.74%) were not. Univariate analysis showed that edge burr, posterior echo attenuation, enhancement pattern, and enlarged lesion area after enhancement were correlated with the efficacy of NAC (χ ² =4.438, P=0.035; χ ² =4.193, P=0.041; χ ² =4.277, P=0.039; χ ² =4.334, P=0.037). The above indicators were included in binary logistic regression analysis, which showed that no attenuation of the echo behind the lesion and no expansion of the lesion after contrast-enhanced ultrasound were effective independent predictors of NAC pathology. The prediction model was constructed based on the parameters of posterior echo attenuation and lesion range after angiography, and the diagnostic performance of the model was high (area under curve was 0.759, sensitivity was 46.3%, specificity was 100.0%). Conclusion: Conventional ultrasound and contrast-enhanced ultrasound can predict the pathological efficacy of breast cancer NAC. The prediction model has high predictive ability, which has guiding significance for the clinical diagnosis and treatment of breast cancer NAC.

Objective: To investigate ultrasound sonographic characteristics of different molecular subtypes of breast cancer in young women under the age of 40 years. Methods: A retrospective analysis of 60 young patients diagnosed in The Affiliated Hospital of Nanjing University of Chinese Medicine from January 2019 to May 2023 was conducted, who had received breast ultrasound examination and breast cancer resection, then they were pathologically confirmed as breast cancer after surgery. The cases were divided into type Luminal A, type Luminal B, triple-negative type and human epidermal growth factor receptor 2 (HER2) overexpression type according to immunohistochemistry. The ultrasound characteristics of different subtypes in the maximum diameter, the orientation, the aspect ratio, the shape, the boundary, marginal spiculate, internal echo, calcification, posterior echo, the blood flow grade, and the elastic score of the mass were analyzed. Results: In 60 breast cancer cases, Luminal A type was relatively common (40.0%), while the HER2 overexpression type was the rarest (15.0%). Among different molecular subtypes, the differences in the marginal burr, calcification and posterior echo of the mass were statistically significant (P＜0.05), among which the Luminal A type and Luminal B type mainly showed marginal spiculate (79.2%, 55.3%), the triple-negative type mainly showed enhancement or with no change (91.7%), and HER2 overexpression type mainly showed calcification (88.9%). However, there was no statistical significance in the maximum diameter, the orientation, the aspect ratio, the shape, the boundary, internal echo, the blood flow grade, and the elasticity score of the mass (P＞0.05). Conclusion: The ultrasound sonographic characteristics of young female patients with breast cancer are associated with their molecular subtypes, which can provide a valuable reference for predicting the molecular subtypes of breast cancers before a surgery.

Since the American College of Radiology published the second edition of the Breast Imaging Reporting and Data System (BI-RADS) in 2013, both the clinical practice and scientific research of breast ultrasound have greatly benefited. This article summarized the clinical applications and innovations, existing issues and challenges, as well as future development opportunities of breast ultrasound imaging technology in the ten years since the publication of the second edition of Ultrasound BI-RADS in 2013. The aim was to provide valuable insights and assistance for clinical diagnosis and treatment, guideline promotion, and application.

Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease, with an estimated prevalence of up to 30% in the whole population. Liver steatosis is an important histological feature of NAFLD, which can lead to liver fibrosis or cirrhosis, and even increase the risk of hepatocellular carcinoma as the disease progresses. The gold standard for quantitatively evaluating liver steatosis is liver biopsy, but it is invasive. Imaging technology enables non-invasive and quantitative assessment of liver fat. The guidelines recommend ultrasound as the first-line imaging diagnostic method for NAFLD, which has the advantages of being convenient, real-time, non-invasive and visualization. Recently, quantitative ultrasonic technologies have emerged, and the technical parameters include attenuation coefficient, backscatter coefficient, and sound velocity. However, there is limited evidence for the clinical application of various new ultrasound technologies, and a large amount of research is needed to explore and optimize operational methods to reduce the impact factors on measurement. This review introduced the change in the name of fatty liver disease, the current status of clinical diagnosis, the interpretation of international consensus from the World Federation for Ultrasound in Medicine and Biology, and introduced representative quantitative ultrasound techniques based on attenuation coefficient, with their diagnostic value in the detection of hepatic steatosis. Moreover, this review evaluated diagnosis, monitoring, and prediction by ultrasound quantitative detection technology for the application of hepatic steatosis.

Objective: To analyze the characteristics of two-dimensional ultrasound and contrast-enhanced ultrasound (CEUS) of retroperitoneal ganglioneuroma (RGN) for improving its preoperative diagnostic accuracy. Methods: The ultrasonic images of 12 patients with RGN confirmed pathologically in Zhongshan Hospital, Fudan University from January 2012 to December 2022 were collected for analysis. Eight patients underwent CEUS examination. The enhancement method, enhancement intensity and performance characteristics in different enhancement phases were observed. Results: Twelve patients had a total of 12 lesions, all of which were single. Twelve lesions were hypoechoic and hyperechoic capsules were seen around them. The internal echo of 8 lesions was uneven and 4 lesion was uniform. Seven lesions were accompanied by punctate calcification. Eight lesions were irregular in shape and 4 lesions were regular in oval shape. Four lesions had clear borders and 8 lesion had unclear border. Color Doppler flow imaging (CDFI) detected a small amount of punctate color blood flow inside 7 lesions. In the arterial phase, 5 lesions showed mild overall uniform enhancement, 1 had mild overall uneven enhancement, and 2 lesions showed mild peripheral uneven enhancement on CEUS. All 8 lesions gradually decreased and showed hypoechoic in the venous phase and the delayed phase. Conclusion: RGN is mostly manifested as an inhomogeneous low-echo tumor with a high-echo capsule on two-dimensional ultrasound. Spotty calcification has certain characteristics, with irregular morphology, and is more suggestive when it appears in a “tear-drop” shape. Although the lesion is large, there is little blood flow signal detected by CDFI. On CEUS, the lesion often shows mild enhancement, with slow regression in the venous and delayed phases.

Objective: To explore the independent predictive risk factors and their predictive value of conventional ultrasound and contrast-enhanced ultrasound (CEUS) sonographic performance for high-grade ductal carcinoma in situ (DCIS) of the breast. Methods: Clinical and ultrasound imaging data of patients diagnosed with DCIS between January 2018 and December 2021 were retrospectively analyzed. Included patients underwent surgical resection to obtain final pathology with clear nuclear grading results. Included patients had preoperative well-established and good quality conventional ultrasound and CEUS imaging data within 1 month, and independent predictors on conventional ultrasound and CEUS were analyzed by multifactorial logistic regression and predictive efficacy was calculated. Results: Finally, 94 simple DCIS lesions were included in the study, including 23 cases of low grade, 41 cases of intermediate grade and 30 cases of high grade. Low and intermediate grade were grouped together and high grade were grouped together, and there were no significant differences in patient age, focus maximum diameter, symptoms and lymph node metastasis between the two groups. The morphological classification of lesions on conventional ultrasound (i.e., mass-like and non-mass-like) and the presence of microcalcifications were significantly different between the groups (P＜0.05), and microcalcifications were independent predictors of risk with an odd ratio (OR) value of 3.071 and an area under the curve (AUC) of 0.636 (P=0.014). On CEUS, there were significant differences between the groups of enhancement uniformity, presence of radial vessels at the edge of the lesion and signs of increased extent after enhancement (P＜0.05), with radial vessels at the edge being an independent predictor (OR=3.319, AUC=0.640, P=0.013). The combined modalities of conventional ultrasound and CEUS predicted high-level. The sensitivity, specificity and AUC of DCIS were 46.7%, 90.6% and 0.686, respectively, and the specificity of the combination was significantly higher than that of conventional ultrasound or CEUS modality alone (P＜0.05). Conclusion: Both conventional ultrasound and CEUS sonographic manifestations can help to predict high-grade DCIS, with microcalcifications on conventional ultrasound and radial vessels at the lesion margin on CEUS as independent predictors, and the combination of both significantly can improve the predictive specificity compared with modality alone.