Angiogenesis is one of the hallmarks of cancer and plays a crucial role in carcinogenesis and progression of epithelial ovarian cancer. Antiangiogenic agent is the first approved targeted agent in ovarian cancer. Anti-angiogenic agents mainly include agents target VEGF/VEGFR pathway, such as bevacizumab and agents target receptor tyrosine kinase, and non-VEGF/VEGFR targets of angiogenesis. Antiangiogenic agents demonstrate certain effects in ovarian cancer treatment either as monotherapy or combined with chemotherapy. Unfortunately, antiangiogenic agents, such as bevacizumab, integrated into the ovarian cancer treatment paradigm do not increase cures. Thus, the benefits of anti-angiogenic agents must be carefully weighed against the cost and associated toxicities. Antiangiogenic agents drug resistance and short of predictive biomarkers are main obstacles in ovarian cancer treatment. A combination of poly (ADP-ribose) polymerase inhibitors or immune checkpoint inhibitors might be great strategies to overcome resistance as well as enhance anti-tumor activity of anti-angiogenic drugs. Predictive biomarkers of antiangiogenic agents are in urgent need.

MR Radiomics based on cervical lesions from one single scanner has achieved promising results. However, it is a challenge to achieve clinical translation. Considering multi-scanners and non-uniform scanning parameters from different centers in a real-world medical scenario, we should first identify the influence of such conditions on the robustness of MR radiomics features (RFs) based on the female cervix. In this study, 9 healthy female volunteers were enrolled and 3 kiwis were selected as references. Each of them underwent T2 weighted imaging in three different 3.0-T MR scanners with uniform acquisition parameters, and in one MR scanner with various scanning parameters. A total of 396 RFs were extracted from their images with and without decile intensity normalization. The RFs’ reproducibility was evaluated by coefficient of variation (CV) and quartile coefficient of dispersion (QCD). Representative features were selected using the hierarchical cluster analysis and their discrimination abilities were estimated by ROC analysis through retrospective comparison with the junctional zone and the outer muscular layer of healthy cervix in patients (n = 58) with leiomyoma. This study showed that only a few RFs were robust across different MR scanners and acquisition parameters based on females’ cervix, which might be improved by decile intensity normalization method.

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Background: To investigate the diagnostic performance of quantified plaque analysis and high-risk plaque characterization by coronary computed tomography angiography (CCTA) for identifying thin-cap fibroatheroma (TCFA).Methods: Patients who underwent both CCTA and intravascular ultrasound (IVUS) within 4 weeks were retrospectively included. CT-derived quantitative and qualitative parameters, including diameter stenosis, minimal lumen area (MLA), low attenuation plaque (LAP) volume napkin-ring sign (NRS), positive remodeling (PR) and spotty calcification, were recorded. TCFA lesions and non-TCFA lesions were determined by IVUS.Multivariate regression analysis was used to determine the independent predictors of TCFA lesions.Results: Sixty-five patients (mean age: 69.8±9.2 years, 29 females) with 89 lesions were finally included.LAP and NRS were more frequently presented in the group of TCFA lesions. The mean LAP volume of TCFA lesions was significantly larger than that of non-TCFA lesions [16.5 (11.0-23.0) vs. 0 (0-1.5) mm 3 , P<0.001]. According to multivariate logistic regression analysis, LAP volume was the only significant predictor for IVUS-confirmed vulnerable plaques (odds ratio =3.294, 95% confidence interval: 1.177-9.223, P=0.023). LAP volume showed largest area under curve (AUC) for diagnosing TCFA lesions (AUC =0.901, 95% confidence interval: 0.819-0.954, P<0.0001). When using >8 mm 3 as the best cutoff value, the diagnostic accuracy, sensitivity and specificity of LAP volume for predicting TCFA lesions were 91.0% (81/89), 84.6% (22/26) and 96.8% (61/63) respectively.Conclusions: CT-derived LAP volume of TCFA lesions was significantly higher than those of non-TCFA lesions. LAP volume was the strongest predictor for TCFA lesions as validated by IVUS.

Abstract. Struma ovarii is an uncommon ovarian teratoma comprised predominantly of mature thyroid tissue. The combination of pseudo-Meigs' syndrome, and elevation of CA 125 to the struma ovarii is a rare condition that can mimic ovarian malignancy. We reported a case of benign struma ovarii, presenting with the clinical features of advanced ovarian carcinoma: complex pelvic mass, gross ascites, bilateral pleural effusion and markedly elevated serum CA 125 levels. The patient underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy. Ascites and pleural effusion were not evident and the CA 125 levels returned to normal following surgical excision. A systematic review of reported cases of coexistent benign struma ovarii, pseudo-Meigs' syndrome and elevated serum CA 125 was performed. Struma ovarii accompanied by pseudo-Meigs' syndrome and elevated serum CA 125 should be considered in the differential diagnosis of ovarian epithelial cancer. IntroductionStruma ovarii is a rare ovarian neoplasm consisting almost exclusively of mature thyroid tissue (>50%) derived from germ cells in a mature teratoma (1). Few of these cases undergo malignant transformation (2). Meigs' syndrome refers to a solid benign ovarian neoplasm, such as fibroma or thecoma accompanied by ascites and hydrothorax which are required to completely resolve following removal of the tumor (3). Pesudo-Meigs' syndrome is often characterized by pleural effusion and ascites caused by a pelvic tumor other than an ovarian fibroma. Rare cases of ovarian tumors have been associated with pseudo-Meigs' syndrome, such as struma ovarii tumors, mucinous or serous cystadenomas, germ cell tumors and ovarian metastasis from colon and gastric cancers (2). When coexisting with pesudo-Meigs' syndrome and elevation of CA 125, struma ovarii is highly suspected as an ovarian malignancy. Struma ovarii mimicking advanced ovarian carcinoma can cause difficulties in preoperative diagnosis (1). Diagnosis of struma ovarii can only be made by conducting histopathology (4). The present study focused on a patient presenting with struma ovarii, who was initially thought to have an ovarian malignancy prior to surgery based on clinical, radiological findings and raised CA 125 levels. However, the frozen section and final histopathology reports revealed benign struma ovarii. A systematic review of the related literatures on struma ovarii presenting as pseudo-Meigs' syndrome with elevated serum CA 125 was also conducted. Written informed consent was obtained from the patient. Case reportOn April 3, 2014, a 52-year-old, Chinese female, premenopausal, gravida 3, para 1, was admitted to the United Hospital of Dezhou (Dezhou City, China), complaining of oppression in chest and shortness of breath for 5 days. The patient's previous menstrual period was March 31, 2014. The patient did not complain of any pain or changes in micturition or bowel movements. The patient's medical history included surgery for an ovarian tumor 26 years previously and surgery for a broad ligament tum...