Heterogeneous Uptake of 68 Ga-DOTATATE and 18 F-FDG in Initial Diagnosed Neuroendocrine Tumors Patients : Which Patients Are Suitable for Dual-Tracer PET Imaging?

PURPOSE: This study was designed to assess the uptake heterogeneity in neuroendocrine tumor (NET) patients at initial diagnosis with dual-tracer PET imaging and the staging changes and prognostic value it brings to explore the indication of the use of dual-tracer PET. METHODS: Fifty-one newly diagnosed patients with pathologically confirmed NET who underwent 18 F-FDG and 68 Ga-DOTATATE PET imaging between January 2020 and September 2022 were enrolled. Dual-tracer uptake patterns were classified into 3 groups: A. 68 Ga-DOTATATE positive and 18 F-FDG negative, B. 68 Ga-DOTATATE positive and 18 F-FDG positive, and C. 68 Ga-DOTATATE negative and 18 F-FDG positive. Descriptive statistics were used to evaluate the heterogeneity of dual-tracer uptake patterns among different grading (G) groups, between primary and metastatic lesions, and staging changes. Moreover, dual-tracer uptake patterns, grade, age, sex, and stage were compared with progression-free survival (PFS) by Cox regression. RESULTS: In the different G groups, none of the patients with dual-tracer uptake pattern A had grade 3 histology, but 57% of patients with grade 1 disease had FDG avidity (25% of them resulting in dual-tracer uptake pattern C). Patients with no metastasis were well differentiated, but one of them presented with dual-tracer uptake pattern C. Different uptake patterns were also observed between primary and metastatic lesions, particularly 44% of patients with dual-tracer uptake pattern A of primary with FDG avidity of metastases. Moreover, 9 (17.6%) had new lesions detected by additional 18 F-FDG PET imaging, and 3 of them (5.9%) had clinical stage changed accordingly. The Cox regression test showed that the dual-tracer uptake patterns were significantly correlated with PFS by univariate and multivariate analyses ( P = 0.026 and 0.039, respectively), whereas the grade and stage did not correlate with survival (all P >0.05). CONCLUSION: The current study has proven the uptake heterogeneity of the NET at initial diagnosis and demonstrated the staging and prognostic value of dual-tracer PET imaging. Our preliminary results have confirmed the importance of dual-tracer imaging modalities and concluded that dual-tracer PET imaging could be considered as prognostic tool for all patients with an initial diagnosis of NET.

[Spatial Distribution and Pollution Evaluation of Carbon, Nitrogen, and Phosphorus in Sediments of Zhushan Bay at Taihu Lake].

To reveal the distribution characteristics of carbon, nitrogen and phosphorus in the sediments of Zhushan Bay at Taihu Lake, sedimentary columns were collected and sliced by 2 cm vertically from ten sampling points in three sections of Zhushan Bay. The content of total nitrogen (TN), total phosphorus (TP), and total organic carbon (TOC) were determined for each slice to reveal their horizontal and vertical distribution. The results showed that:spatially, the content of TN, TP, and TOC increased in the surface sediments of Zhushan Bay from the open lake area to the bay, and inside the bay these indexes were significantly higher than in the open lake area (P<0.01). The content of TN, TP, and TOC in the surface sediments in the bay (section A) were 1.53 mg·g-1, 1.55 mg·g-1, and 11.31 mg·g-1, respectively, while in the surface sediments near the open lake (section C) they were only 0.75 mg·g-1, 0.57 mg·g-1, and 6.70 mg·g-1, respectively. Vertically, a feature of surficial enrichment was shown, and the contents of carbon, nitrogen and phosphorus in all three sections showed a decreasing trend with increase of depth. The contents of TN, TP and TOC in the surface sediments are 2-3 times, 2-5 times, and 2-3 times those in the bottom sediments, respectively. Generally, the average TP content in the sediment of Zhushan Bay is 0.93 mg·g-1, suggesting an apparent heavy pollution, while the average TN content is 1.11 mg·g-1 as slight pollution. According to the organic nitrogen index and comprehensive pollution index, the northern part of Zhushan Bay is suffering from heavy pollution, where the organic pollution is relatively strong. The TP pollution index is between 1.03 and 3.87, indicating heavy pollution in Zhushan Bay.

[Composition and Distribution of Biodegradable Compounds in the Macrophyte Dominated Zone of Lake Taihu].

In shallow eutrophic lakes, benthic bioclastic deposits accumulate abundant organic carbon derived from macrophyte detritus. Taking the typical macrophyte-dominated Xukou Bay as the study area, field investigations were performed using sediment cores to evaluate benthic phytodetritus accumulation. Specifically, nutrient contents, TOC/TN ratios, pigmentation, and biodegradable compounds were measured as descriptive parameters. The results show that the benthic bioclastic deposit had accumulated abundant pigments, nutrients, and biodegradable compounds derived from macrophytes detritus. These were mainly localized in the top 15 cm of sediments. Nitrogen loading in the sediments was significantly higher than phosphorous loading, with a distinct spatial difference; the total nitrogen content ranged from 127.2-2092.8 mg·kg-1 and total phosphorous content ranged from 222.1-528.4 mg·kg-1. Moreover, nitrogen loading (1033.6 mg·kg-1) in the vegetated zones were higher than in the unvegetated zones (325.2 mg·kg-1). In addition, carbohydrate (3.7 mg·g-1) was the dominant component of sedimentary bioclastic material, with lipids (2.8 mg·g-1) being the second most abundant of the biodegradable compounds. The major sources of nutrients and biodegradable compounds in the sediment were massive aggregates of macrophyte detritus. The pigment, nutrient, and biodegradable compound contents in the vegetated zones were significantly higher than in unvegetated zones (P<0.01). The benthic eutrophic state showed a trend from mesotrophic to eutrophic in Xukou Bay, which should be given more attention in the future management of freshwater lake ecosystems.