To measure glomerular filtration rates (GFRs) using kidney dynamic contrast material-enhanced (DCE)-CT perfusion scans and correlate them with estimated GFRs (eGFRs). Split-bolus CT urography, including pre-contrast and nephrographic-excretory phase imaging, was performed with a kidney DCE-CT perfusion scan protocol. We analysed 55 patients with suspected renal disease. All CT acquisitions were obtained on a 256-slice CT scanner for 3.5 min continuously with shallow breathing. Renal volume, perfusion and permeability values were calculated using a dedicated prototype software. Based on Patlak plots, split and total renal GFR values were determined. Paired t-tests, Pearson’s correlation analysis and Bland-Altman plots were used for comparisons between kidney DCE-CT perfusion scan-derived GFR (CT-GFR) and the corresponding eGFR value. The p values 0.05). Excellent correlation and agreement between CT-GFR and eGFRs (correlation coefficient r = 0.91 for CKD-EPI and 0.84 for MDRD equations, respectively) were confirmed. Kidney DCE-CT perfusion is an accurate and feasible technique to assess renal function.

Estimation of renal function using kidney dynamic contrast material-enhanced CT perfusion: accuracy and feasibility.

Background The systemic inflammation response index (SIRI) has been reported to associate with survival outcomes in breast cancer patients. However, the effects of baseline SIRI and SIRI change after neoadjuvant chemotherapy (NACT) have not been thoroughly investigated. This study aimed to evaluate the role of baseline SIRI and SIRI change after NACT in predicting survival outcomes, and establish a nomogram based on SIRI. Methods A total of 260 patients diagnosed with breast cancer who received NACT between January 2014 and December 2018 at our hospital were included. The clinical data were retrospectively collected from the medical records management system. The associations between clinicopathological factors and baseline SIRI, pathological complete response (pCR) were analyzed by Student’s t-test, Chi-squared test, or Fisher’s exact test. The association between clinicopathological factors and disease-free survival (DFS) was evaluated by univariate and multivariate Cox regression analyses. Results Patients with a tumor-node-metastasis (TNM) stage of I, II, and III were 1.9%, 20.0%, and 78.1% respectively. The median follow-up time was 40 months, and 74 (28.5%) patients had cancer recurrence during the follow-up. Both in the univariate and multivariate analysis, Ki-67, pCR, and baseline SIRI were independent factors associated with DFS. Patients with low baseline SIRI had prolonged DFS compared with those with high baseline SIRI [≤1.6×109 vs. >1.6×109, hazard ratio (HR) =0.545, P=0.028]. In addition, SIRI change after NACT was also an independent factor associated with DFS, and patients with minor SIRI change had longer DFS than patients with major SIRI change (>50% or <−30% vs. ≤50% and ≥−30%, HR =1.721, P=0.037). Nomograms were established based on Ki-67, pCR, and baseline SIRI or SIRI change after NACT with a concordance index of 0.665 and 0.663 respectively, and the nomogram provided a convenient tool for predicting the probability of DFS. Conclusions The baseline SIRI and SIRI change after NACT could act as potential biomarkers for predicting survival outcomes in breast cancer. Besides, the nomogram with SIRI is an economic and convenient tool for predicting DFS. Larger prospective studies are needed to verify the results.

Development of a nomogram for predicting survival of breast cancer patients with neoadjuvant chemotherapy: a dynamic analysis for systemic inflammation response index

Background Early detection of kidney diseases can be challenging as conventional methods such as blood tests or imaging techniques (computed tomography (CT), magnetic resonance imaging (MRI), or ultrasonography) may be insufficient to assess renal function. A single-photon emission CT (SPECT) renal scan provides a means of measuring glomerular filtration rates (GFRs), but its diagnostic accuracy is limited due to its planar imaging modality and semi-quantification property. In this study, we aimed to improve the accuracy of GFR measurement by preparing a positron emission tonometry (PET) tracer 68Ga-Ethylenediaminetetraacetic acid (68Ga-EDTA) and comprehensively evaluating its performance in healthy mice and murine models of renal dysfunction. Methods Dynamic PET scans were performed in healthy C57BL/6 mice and in models of renal injury, including acute kidney injury (AKI) and unilateral ureter obstruction (UUO) using 68Ga-EDTA. In a 30-min dynamic scan, PET images and time-activity curves (TACs) were acquired. Renal function and GFR values were measured using renograms and validated through serum renal function parameters, biodistribution results, and pathological staining. Results 68Ga-EDTA dynamic PET imaging quantitatively captured the tracer elimination process. The calculated GFR values were 0.25 ± 0.02 ml/min in healthy mice, 0.01 ± 0.00 ml/min in AKI mice, and 0.25 ± 0.04, 0.29 ± 0.03 and 0.24 ± 0.01 ml/min in UUO mice, respectively. Furthermore, 68Ga-EDTA dynamic PET imaging and GFRPET were able to differentiate mild renal impairment before serum parameters indicated any changes. Conclusions Our findings demonstrate that 68Ga-EDTA dynamic PET provides a reliable and precise means of evaluating renal function in two murine models of renal injury. These results hold promise for the widespread clinical application of 68Ga-EDTA dynamic PET in the near future.

Quantitative assessment of renal functions using 68Ga-EDTA dynamic PET imaging in renal injury in mice of different origins

Noninvasive assessment of single kidney glomerular filtration rate using multiple diffusion weighted imaging models

Introduction The systemic immune-inflammation index (SII), based on peripheral lymphocyte, neutrophil, and platelet counts, has recently been investigated as a prognostic marker in several tumors. However, the SII has rarely been reported in skin cancers. In this study, we aimed to assess the association between SII values and the risk of occurrence of skin cancers. Material and methods This cross-sectional study was based on National Health and Nutrition Examination Survey data from 2010 to 2018 and involved 32,012 participants. The SII was calculated as the platelet count × neutrophil count/lymphocyte count. A weighted multivariate logistic analysis was conducted to examine the relationship between SII values and the occurrence of skin cancers. In addition, a subgroup analysis and a sensitivity analysis were conducted to identify underlying moderators and the stability of the relationship, respectively. Results Compared with participants in the lowest quartile of SII values, the odds ratios for non-melanoma skin cancer were 1.650 (95% CI: 1.158–2.352) for participants in the quartile with the highest SII values after multivariate adjustments. In subgroup analyses, we found significant interactions between log-transformed SII values and age (p &lt; 0.001 for interaction), race (p &lt; 0.001 for interaction), education level (p &lt; 0.001 for interaction), marital status (p &lt; 0.001 for interaction), and annual household incomes (p &lt; 0.001 for interaction) in the association with non-melanoma skin cancer. Conclusions Our findings suggest a positive association between high SII values and skin cancers in the U.S. population. Age, levels of education, marital status, and annual household incomes affect the positive association between high SII values and non-melanoma skin cancers. 

Systemic immune-inflammation index values are associated with non-melanoma skin cancers: evidence from the National Health and Nutrition Examination Survey 2010–2018

To develop a convenient and rapid single-kidney CT-GFR technique. One hundred and twelve patients referred for multiphasic renal CT and 99mTc-DTPA renal dynamic imaging Gates-GFR measurement were prospectively included and randomly divided into two groups of 56 patients each: the training group and the validation group. On the basis of the nephrographic phase images, the fractional renal accumulation (FRA) was calculated and correlated with the Gates-GFR in the training group. From this correlation a formula was derived for single-kidney CT-GFR calculation, which was validated by a paired t test and linear regression analysis with the single-kidney Gates-GFR in the validation group. In the training group, the FRA (x-axis) correlated well (r = 0.95, p < 0.001) with single-kidney Gates-GFR (y-axis), producing a regression equation of y = 1665x + 1.5 for single-kidney CT-GFR calculation. In the validation group, the difference between the methods of single-kidney GFR measurements was 0.38 ± 5.57 mL/min (p = 0.471); the regression line is identical to the diagonal (intercept = 0 and slope = 1) (p = 0.727 and p = 0.473, respectively), with a standard deviation of residuals of 5.56 mL/min. A convenient and rapid single-kidney CT-GFR technique was presented and validated in this investigation. • The new CT-GFR method takes about 2.5 min of patient time.
 • The CT-GFR method demonstrated identical results to the Gates-GFR method.
 • The CT-GFR method is based on the fractional renal accumulation of iodinated CM.
 • The CT-GFR method is achieved without additional radiation dose to the patient.

Determination of glomerular filtration rate (GFR) from fractional renal accumulation of iodinated contrast material: a convenient and rapid single-kidney CT-GFR technique.

Background The systemic immune inflammation index has been used to evaluate the prognosis of patients with a variety of malignant tumors. However, studies were limited in primary liver cancer (PLC) patients. This study aimed to investigate the association between the systemic immune inflammation index and recurrence or metastasis after interventional therapy in patients with PLC. Methods From January 2016 to December 2017, 272 patients with PLC admitted to the 941st Hospital of PLA Joint Logistics Support Force were retrospectively collected. All patients received interventional treatment, there were no residual lesions after interventional treatment. The patients were followed up for 5 years to monitor the rates of recurrence or metastasis. The patients were divided into a recurrence or metastasis group (n=112) and a control group (n=160). The differences in clinical features between the 2 groups were compared, and the predictive value of systemic immune inflammation index on recurrence or metastasis after interventional treatment in patients with PLC was analyzed. Results Compared with the control group (8.12%), the proportion of patients with ≥2 lesions in the recurrence or metastasis group (19.64%) was significantly increased (P=0.005); the proportion of patients with vascular invasion was significantly increased in the recurrence or metastasis group (10.71% vs. 4.38%, P=0.044); albumin decreased significantly in the recurrence or metastasis group (39.69±6.17 vs. 41.69±6.82 g/L, P=0.014); neutrophils (%) were significantly increased in the recurrence or metastasis group (0.70±0.08 vs. 0.64±0.08, P<0.001); lymphocytes (%) were significantly reduced in the recurrence or metastasis group (0.25±0.06 vs. 0.30±0.06, P<0.001); and platelet count was significantly increased in the recurrence or metastasis group (179.22±39.52 vs. 160.81±34.13 109/L, P<0.001). The systemic immune inflammation index was significantly increased in the recurrence or metastasis group (535.23±174.05 vs. 357.84±120.21, P<0.001). Systemic immune inflammation index was valuable in predicting recurrence or metastasis, and the area under the curve was 0.795 (95% CI: 0.742–0.848, P<0.001). Systemic immune inflammation index >405.08 was an independent risk factor of recurrence or metastasis [relative risk (95% CI: 1.878–5.329), P=0.000]. Conclusions Elevated systemic immune inflammation index is associated with recurrence or metastasis after interventional therapy in patients with PLC.

Association between the systemic immune inflammation index and recurrence or metastasis after interventional therapy in patients with primary liver cancer- a retrospective cohort study

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Determination of glomerular filtration rate (GFR) from fractional renal accumulation of iodinated contrast material: a convenient and rapid single-kidney CT-GFR technique.

Association between the systemic immune inflammation index and recurrence or metastasis after interventional therapy in patients with primary liver cancer- a retrospective cohort study