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PurposeOur purpose was to assess the differences in growth rates of multiple pulmonary metastatic nodules using three-dimensional (3D) computed tomography (CT) volumetry and propose a concept of CT spatial tumor heterogeneity.Materials and methodsWe manually measured the largest diameter of metastatic pulmonary nodules on chest CT scans, and calculated the 3D maximum diameter and the volume using a semi-automated 3D CT volumetry of each nodule. The tumor response was assessed according to the revised RECIST 1.1. We defined a nodule as an outlier based on 1.5 times growth during follow-up. The CT spatial tumor heterogeneity was statistically analyzed by the "minimum combination t-test method" devised in our study.ResultsOn manual measurement, the tumor response category was stable disease (SD) in all 10 patients. Of them, total 155 metastatic nodules (4-52 nodules per patient) were segmented using the 3D CT volumetry. In the 3D maximum diameter, 9 patients had SD except for one patient with partial response in the two selected nodules; for the volume, all 10 patients were SD. For the 3D maximum diameter, six patients had at least one outlier; whereas five patients had the outlier on the volume measurement. Six patients were proven to have overall CT spatial tumor heterogeneity.ConclusionsThe spatial tumor heterogeneity determined in a CT parametric approach could be statistically assessed. In patients with CT spatial heterogeneity, tumors with different growth rates may be neglected when the nodules are assessed according to the current guideline.

Inorganic/organic nanocomposite counter electrodes comprised of sheetlike CoS nanoparticles dispersed in polystyrenesulfonate-doped poly(3,4-ethylenedioxythiophene (CoS/PEDOT:PSS) offer a synergistic effect on catalytic performance toward the reduction of triiodide for dye-sensitized solar cells (DSSCs), yielding 5.4% power conversion efficiency, which is comparable to that of the conventional platinum counter electrode (6.1%). The electrochemical impedance spectroscopy (EIS) and cyclic voltammetry measurements revealed that the composite counter electrodes exhibited better catalytic activity, fostering rate of triiodide reduction, than that of pristine PEDOT: PSS electrode. The simple preparation of composite (CoS/PEDOT:PSS) electrode at low temperature with improved electrocatalytic properties are feasible to apply in flexible substrates, which is at most urgency for developing novel counter electrodes for lightweight flexible solar cells.