scholarly journals The Significance of Preoperative Computed Tomography for Predicting Optimal Cytoreduction in Advanced Ovarian Cancer

2020 ◽  
Vol 80 (09) ◽  
pp. 915-923
Author(s):  
Angrit Stachs ◽  
Karen Engel ◽  
Johannes Stubert ◽  
Toralf Reimer ◽  
Bernd Gerber ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Ovarian Cancer ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Advanced Ovarian Cancer ◽  
Figo Stage ◽  
Tumour Resection ◽  
Residual Tumour ◽  
Optimal Cytoreduction

Abstract Introduction Optimal cytoreduction is the most important prognostic factor in advanced ovarian cancer. Although staging and assessment of operability are made by exploratory surgery, preoperative computed tomography (CT) of the abdomen is regarded as standard. The aim of this study was to examine various CT parameters with regard to prediction of optimal cytoreduction. Patients and Methods The retrospective study included 131 patients with ovarian cancer newly diagnosed between 2010 and 2014. Of these, n = 36 with FIGO stage I to IIB were excluded from the study. A preoperative abdominal CT was available for n = 75 of the 95 patients with FIGO stage IIC to IV. The CT scans underwent blinded review. The 11 evaluated CT parameters were examined by means of χ2 test and logistic regression analysis with regard to the endpoints of macroscopic residual tumour and residual tumour > 1 cm. Survival analyses used the Kaplan-Meier method and log rank test. Results Of 75 patients, 28 (37.3%) had complete tumour resection and 26 (34.7%) had residual tumour ≤ 1 cm. Residual tumours > 1 cm were found in 21 (28%) patients, five of which were not resectable. Overall survival with residual tumour > 1 cm differed significantly from the group with no macroscopic residual tumour (p = 0.003) and with residual tumour ≤ 1 cm (p = 0.04). The CT parameters tumour foci in the diaphragm, mesocolon, greater omentum and peritoneum as well as ascites correlated with macroscopic residual tumour. In the multivariate logistic regression analysis only the CT parameter intraparenchymal liver metastasis was statistically significant with regard to prediction of suboptimal tumour resection (> 1 cm) (OR 8.04; 95% CI 1.57 – 42.4; p = 0.0134). The sensitivity, specificity, PPV and NPV were 37.5, 89.7, 66.7 and 72.2%. Conclusion Although risk parameters for suboptimal tumour reduction can be identified by CT of the abdomen, surgical exploration with histological confirmation of the diagnosis is essential because of the poor diagnostic accuracy.

Power contrast injections through a totally implantable venous power port: A retrospective multicenter study

2019 ◽  
Vol 35 (4) ◽  
pp. 268-272 ◽  
Author(s):  
Ryong seong Son ◽  
Yun Gyu Song ◽  
Jeonghyun Jo ◽  
Byeong-Ho Park ◽  
Gyoo-sik Jung ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Contrast Media ◽  
Logistic Regression Analysis ◽  
Computed Tomography Scan ◽  
Power Injection ◽  
Oncologic Patients ◽  
Computed Tomography Scans ◽  
Tomography Scan

Objectives To evaluate the feasibility and safety of power injection of contrast media through totally implantable venous power ports during computed tomography scans in oncologic patients. Methods The study population consisted of 417 patients who underwent computed tomography scan through a totally implantable venous power port. Clinical data were examined. Logistic regression analysis was used to assess the associations between clinical covariables and computed tomography scan failure. Results Successful computed tomography scans were achieved in 534 of 540 examinations (98.9%). Logistic regression analysis showed that contrast media above a 350 concentration was significantly associated with computed tomography scan failure (95% confidence interval: 1.01–1.13, p = 0.012). No major complications were noted. Conclusions Power injection of contrast media through a totally implantable venous power port for computed tomography examination is feasible and safe. This procedure provides an acceptable alternative in oncologic patients with inadequate peripheral intravenous access when computed tomography examination with contrast enhancement is needed.

scholarly journals The clinical and pathological characteristics and survival of patients with advanced ovarian cancer

2021 ◽  
Vol 52 (3) ◽  
pp. 205-210
Author(s):  
Miroslav Popović ◽  
Tanja Milić-Radić ◽  
Arnela Cerić-Banićević
Keyword(s):  
Ovarian Cancer ◽  
Residual Disease ◽  
Advanced Ovarian Cancer ◽  
Figo Stage ◽  
Ovarian Tumour ◽  
Ca 125 ◽  
Optimal Cytoreduction ◽  
Chi Square ◽  
Pathological Characteristics ◽  
Significant Difference

Introduction: Ovarian cancer has the highest mortality rate of all gynaecologic malignancies. The aim of this study was the evaluation of the clinical pathological characteristics and survival analysis of primarily operated patients with advanced stages of malignant epithelial ovarian tumour. Methods: The research was conducted as a cohort study with 59 patients with FIGO stage III and IV, which were primarily operated between 1 January 2008 and 31 December 2010 (three years). Age, comorbidities, BMI, presence of ascites, the level of the marker CA-125, histopathology and FIGO stage were analysed. The survival rate was estimated at the level of 1, 3 and 5 years. Results: The median age was 53 years (range 29-86). The most common histopathological type was serous (66.1 %) and the most common FIGO stage was 3a (49.2 %). Optimal cytoreduction was performed in 35.5 % of patients, 84.7 % of patients survived for one year, 44.1 % three years and 37.3 % for five years. The median survival was 26.25 months (range 0-91). Chi-square test showed significant difference between the number of months of survival and: the value of CA125 (t = 2.004, p = 0.050), cytoreduction (p < 0.001) and FIGO stage (p < 0.01). Conclusion: According to the results of this study, optimal cytoreduction and FIGO stage significantly influence survival (p < 0.001). Optimal cytoreduction (< 2 cm of residual disease) had the highest prognostic value for survival. A total five-year survival in this study was 37.3 %.

Differential Diagnosis of Malignant Thyroid Calcification Nodule Based on Computed Tomography Image Texture

2021 ◽  
Vol 11 (3) ◽  
pp. 767-772
Author(s):  
Wenxian Peng ◽  
Yijia Qian ◽  
Yingying Shi ◽  
Shuyun Chen ◽  
Kexin Chen ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Support Vector Machine ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Ensemble Learning ◽  
Logistic Regression Analysis ◽  
Texture Features ◽  
Support Vector ◽  
Classification Algorithms ◽  
Feature Optimization

Purpose: Calcification nodules in thyroid can be found in thyroid disease. Current clinical computed tomography systems can be used to detect calcification nodules. Our aim is to identify the nature of thyroid calcification nodule based on plain CT images. Method: Sixty-three patients (36 benign and 27 malignant nodules) found thyroid calcification nodules were retrospectively analyzed, together with computed tomography images and pathology finding. The regions of interest (ROI) of 6464 pixels containing calcification nodules were manually delineated by radiologists in CT plain images. We extracted thirty-one texture features from each ROI. And nineteen texture features were picked up after feature optimization by logistic regression analysis. All the texture features were normalized to [0, 1]. Four classification algorithms, including ensemble learning, support vector machine, K-nearest neighbor, decision tree, were used as classification algorithms to identity the benign and malignant nodule. Accuracy, PPV, NPV, SEN, and AUC were calculated to evaluate the performance of different classifiers. Results: Nineteen texture features were selected after feature optimization by logistic regression analysis (P <0.05). Both Ensemble Learning and Support Vector Machine achieved the highest accuracy of 97.1%. The PPV, NPV, SEN, and SPC are 96.9%, 97.4%, 98.4%, and 95.0%, respectively. The AUC was 1. Conclusion: Texture features extracted from calcification nodules could be used as biomarkers to identify benign or malignant thyroid calcification.

VEGF-A and i-NOS expression are prognostic factors in serous epithelial ovarian carcinomas after complete surgical resection

2009 ◽  
Vol 62 (5) ◽  
pp. 448-454 ◽  
Author(s):  
K Engels ◽  
A du Bois ◽  
P Harter ◽  
A Fisseler-Eckhoff ◽  
F Kommoss ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Prognostic Factors ◽  
Progression Free Survival ◽  
Figo Stage ◽  
Tumour Resection ◽  
Residual Tumour ◽  
Serous Ovarian Cancer ◽  
Free Survival ◽  
Complete Tumour Resection ◽  
Complete Tumour

Aims:Clinical stage at the time of diagnosis and achievement of complete macroscopic resection during initial surgery are key factors determining the outcome of ovarian cancer. However, prediction of outcome lacks accuracy and more reliable prognostic factors are required. Therefore, an analysis and evaluation of key angiogenic factors was carried out to determine their diagnostic and prognostic value in serous ovarian cancer.Methods:Expression levels of vascular endothelial growth factor (VEGF)-A, hypoxia-inducible factor (HIF)1-α and inducible nitric oxide synthase (i-NOS) were analysed by immunohistochemistry in a homogenous group of 112 patients with serous adenocarcinoma of the ovary. Vascular density as an indicator of angiogenesis was assessed using the Chalkley eyepiece method after staining for CD34. The correlation of these data with survival and established prognostic factors such as histological grade, Federation of Gynecology and Obstetrics (FIGO) stage, and residual tumour after surgery, was evaluated. Survival analyses, multivariate analyses and correlation tests were performed.Results:In the patient group with macroscopic complete tumour resection (R0) there was a significant correlation between VEGF-A and i-NOS expression. Kaplan–Meier analysis further revealed improved progression-free survival for R0 patients with VEGF-A-positive and i-NOS-negative tumours. The predictive relevance of VEGF-A regarding progression-free survival was sustained in multivariate analysis using FIGO stage, grading and resection status as fixed variables.Conclusion:VEGF-A and i-NOS are prognostic markers for clinical outcome in serous ovarian cancer patients with macroscopic complete tumour resection (R0). Hence, pre-therapeutic assessment of VEGF-A as predictive factor for an antiangiogenic therapy might be of clinical value.

scholarly journals Computed Tomography-Based Radiomics for Preoperative Prediction of Tumor Deposits in Rectal Cancer

2021 ◽  
Vol 11 ◽  
Author(s):  
Yumei Jin ◽  
Mou Li ◽  
Yali Zhao ◽  
Chencui Huang ◽  
Siyun Liu ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Rectal Cancer ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Characteristic Curve ◽  
Clinical Factors ◽  
Combined Model ◽  
Portal Venous Phase ◽  
Preoperative Prediction

ObjectiveTo develop and validate a computed tomography (CT)-based radiomics model for predicting tumor deposits (TDs) preoperatively in patients with rectal cancer (RC).MethodsThis retrospective study enrolled 254 patients with pathologically confirmed RC between December 2017 and December 2019. Patients were divided into a training set (n = 203) and a validation set (n = 51). A large number of radiomics features were extracted from the portal venous phase images of CT. After selecting features with L1-based method, we established Rad-score by using the logistic regression analysis. Furthermore, a combined model incorporating Rad-score and clinical factors was developed and visualized as the nomogram. The models were evaluated by the receiver operating characteristic curve (ROC) analysis and area under the ROC curve (AUC).ResultsOne hundred and seventeen of 254 patients were eventually found to be TDs+. Rad-score and clinical factors including carbohydrate antigen (CA) 19-9, CT-reported T stage (cT), and CT-reported peritumoral nodules (+/-) were significantly different between the TDs+ and TDs- groups (all P &lt; 0.001). These factors were all included in the combined model by the logistic regression analysis (odds ratio = 2.378 for Rad-score, 2.253 for CA19-9, 2.281 for cT, and 4.485 for peritumoral nodules). This model showed good performance to predict TDs in the training and validation cohorts (AUC = 0.830 and 0.832, respectively). Furthermore, the combined model outperformed the clinical model incorporating CA19-9, cT, and peritumoral nodules (+/-) in both training and validation cohorts for predicting TDs preoperatively (AUC = 0.773 and 0.718, P = 0.008 and 0.039).ConclusionsThe combined model incorporating Rad-score and clinical factors could provide a preoperative prediction of TDs and help clinicians guide individualized treatment for RC patients.

Computed tomography characteristics of multiple myeloma and other osteolytic metastatic bone lesions

2020 ◽  
pp. 028418512097703
Author(s):  
Uygar Mutlu ◽  
Ali Balci ◽  
Güner Hayri Özsan ◽  
Sermin Özkal ◽  
Ahmet Şeyhanli ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Multiple Myeloma ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Ct Images ◽  
High Density ◽  
Bone Lesions ◽  
Chi Square ◽  
Contrast Enhanced Ct

Background Differentiation of multiple myeloma (MM) from osteolytic metastatic (OM) bone lesions may be critical in patients with lytic bone lesions but can be challenging for radiologists. Purpose To determine whether computed tomography (CT) can be used to distinguish between MM and other OM bone lesions. Material and Methods In this retrospective study, 320 lesions of 207 patients diagnosed with MM or OM, based on biopsy or clinical examination, were evaluated. Eight qualitative features were evaluated by two radiologists blinded to the diagnoses. The chi-square and Fisher exact tests, and logistic regression analysis, were used to evaluate the relationships between the CT findings and diagnoses. Results High-density areas were more common in OM than MM lesions (85.2% and 19%, P < 0.001), as were perilesional sclerosis (38.9% vs. 13.2%, P < 0.001), heterogeneity (on non-contrast CT images, 60% vs. 19.1%, P < 0.001; on contrast enhanced CT images, 80.6% vs. 28.2%, P < 0.001), and ill-defined margins (34.6% vs. 9.1%, P < 0.001). Similarly, OM lesions showed high-density areas more than MM in evaluation of skeletal system subgroups (vertebrae, 93.8% vs. 29.8%, P < 0.0001; thoracic cage bones, 69.6% vs. 19.2%, P < 0.001; pelvic bones and sacrum, 84.8% vs. 7.7%, P < 0.001; peripheral skeletal bones, 81.5% vs. 8.3%, P < 0.001). Logistic regression analysis revealed that the presence of a high-density area in the lesion increased the probability of a metastasis 25.88-fold (R2 = 0.516, P < 0.001). Conclusion MM and OM lesions can be differentiated by CT; OM lesions exhibit high- density areas.

scholarly journals Selecting Patients for Lobar Lung Volume Reduction Therapy: What Quantitative Computed Tomography Parameters Matter?

2018 ◽  
Vol 191 (01) ◽  
pp. 40-47 ◽  
Author(s):  
Dorothea Theilig ◽  
Ralf-Harto Huebner ◽  
Konrad Neumann ◽  
Alexander Poellinger ◽  
Felix Doellinger
Keyword(s):  
Computed Tomography ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Lung Volume ◽  
Quantitative Computed Tomography ◽  
Volume Reduction ◽  
Successful Outcome ◽  
Lung Volume Reduction ◽  
Heterogeneity Index

Purpose Evaluation of emphysema distribution with quantitative computed tomography (qCT) prior to endoscopic lung volume reduction (ELVR) is recommended. The aim of this study was to determine which of the commonly assessed qCT parameters prior to endoscopic lung volume reduction (ELVR) best predicts outcome of treatment. Materials and Methods 50 patients who underwent technically successful ELVR at our institution were retrospectively analyzed. We performed quantitative analysis of the CT scans obtained prior to ELVR and carried out Mann-Whitney U-tests and a logistic regression analysis to identify the qCT parameters that predict successful outcome of ELVR in terms of improved forced expiratory volume in 1 second (FEV1). Results In the Mann-Whitney U-test, the interlobar emphysema heterogeneity index (p = 0.008) and the pulmonary emphysema score (p = 0.022) showed a statistically significant difference between responders and non-responders. In multiple logistic regression analysis only the interlobar emphysema heterogeneity index (p = 0.008) showed a statistically significant impact on the outcome of ELVR, while targeted lobe volume, total lung volume, targeted lobe emphysema score and total lung emphysema score did not. Conclusion Of all commonly assessed quantitative CT parameters, only the heterogeneity index definitely allows prediction of ELVR outcome in patients with advanced chronic obstructive pulmonary disease (COPD). Key Points  Citation Format

Improved survival for ovarian cancer patients stage IIIC treated at the Norwegian Radium Hospital between 1984 - 2001

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 16044-16044
Author(s):  
C. Trope ◽  
H. Oksefjell ◽  
B. Sandstad
Keyword(s):  
Ovarian Cancer ◽  
Advanced Ovarian Cancer ◽  
Progression Free Survival ◽  
Figo Stage ◽  
Primary Treatment ◽  
Lymph Node Staging ◽  
Residual Tumour ◽  
Stage Iiic ◽  
Primary Surgery ◽  
Norwegian Radium Hospital

16044 Background: The aim of this study was to evaluate the treatment of FIGO stage IIIC patients who were primarily treated completely or partially at the Norwegian Radium Hospital (NRH) during a 15-year period in order to discover possibilities for improvement of prognosis of advanced ovarian cancer. Methods: A retrospective study based on record information from all patients with epithelial ovarian cancer stage IIIC treated at NRH 1985 - 2000, in total 776 patients. Results: We found age, amount of residual tumour after surgery for primary treatment and type of chemotherapy to be the most significant prognostic factors for overall survival. During the last 5-year period primary surgery was increasingly centralised, surgery was improved with lymph node staging and paclitaxel was used. Survival was significantly best during the last 5-year period and after macroscopically radical surgery. Also progression-free survival was best with no macroscopic tumour left. Conclusions: Improved survival during the last 5-year period is partly attributed to improved surgery, partly to the addition of paclitaxel. We believe that a further centralisation of primary surgery for advanced ovarian cancer can contribute towards a better prognosis. No significant financial relationships to disclose.

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