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Objective@#To investigate the relationship between 18F-FDG PET/CT semi-quantitative parameters and the International Association for the Study of Lung Cancer, American Thoracic Society/European Respiratory Society (IASLC/ATS/ERS) histopathologic classification, including histological subtypes, proliferation activity, and somatic mutations. @*Materials and Methods@#This retrospective study included 419 patients (150 males, 269 females; median age, 59.0 years;age range, 23.0–84.0 years) who had undergone surgical removal of stage IA–IIIA lung adenocarcinoma and had preoperative PET/CT data of lung tumors. The maximum standardized uptake values (SUVmax), background-subtracted volume (BSV), and background-subtracted lesion activity (BSL) derived from PET/CT were measured. The IASLC/ATS/ERS subtypes, Ki67 score, and epidermal growth factor/anaplastic lymphoma kinase (EGFR/ALK) mutation status were evaluated. The PET/CT semiquantitative parameters were compared between the tumor subtypes using the Mann–Whitney U test or the Kruskal–Wallis test. The optimum cutoff values of the PET/CT semi-quantitative parameters for distinguishing the IASLC/ATS/ERS subtypes were calculated using receiver operating characteristic curve analysis. The correlation between the PET/CT semi-quantitative parameters and pathological parameters was analyzed using Spearman’s correlation. Statistical significance was set at p < 0.05. @*Results@#SUVmax, BSV, and BSL values were significantly higher in invasive adenocarcinoma (IA) than in minimally IA (MIA), and the values were higher in MIA than in adenocarcinoma in situ (AIS) (all p < 0.05). Remarkably, an SUVmax of 0.90 and a BSL of 3.62 were shown to be the optimal cutoff values for differentiating MIA from AIS, manifesting as pure ground-glass nodules with 100% sensitivity and specificity. Metabolic-volumetric parameters (BSV and BSL) were better potential independent factors than metabolic parameters (SUVmax) in differentiating growth patterns. SUVmax and BSL, rather than BSV, were strongly or moderately correlated with Ki67 in most subtypes, except for the micropapillary and solid predominant groups. PET/CT parameters were not correlated with EGFR/ALK mutation status. @*Conclusion@#As noninvasive surrogates, preoperative PET/CT semi-quantitative parameters could imply IASLC/ATS/ERS subtypes and Ki67 index and thus may contribute to improved management of precise surgery and postoperative adjuvant therapy.
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Objective The aim of this study was to explore the values of IHP standard visual judgment,deauville(5-porint scoring and 5-PS)and maximum standard uptake rate(△SUVmax)image methods in the evaluation of early-and mid-term sensi-tivity determination and prognosis in malignant lymphoma patients. Methods A total of 51 patients with lymphoma who met the in-clusion criteria were selected for retrospectively analyses. PET/CT images of patients were analyzed by IHP standard visual judgment and deauville five-point methods. The△SUVmax value of the patient in the early and middle stages of treatment was calculated be-fore treatment, and the optimal cut-off value of PET/CT for early- and mid-term sensitivity determination and prognosis of evalu-ation△SUVmax was obtained by ROC curve. The differences between the diagnostic efficiencies of three methods were compared. The Kaplan-Meier analysis and Cox proportional hazard regression model were used for univariate and multivariate analyses. Results The results of ROC curve analysis showed that PET/CT had the best diagnostic efficiency when△SUVmax was 56. 95% . IHP stand-ard visual judgment,deauville quintile and△SUVmax methods could obtain high sensitivity and negative predictive values for the ear-ly-term treatment of lymphoma treatment. The positive predictive values and accuracy of △SUVmax method were higher than other two methods. Conclusion IHP standard visual judgment,deauville 5,and △SUVmax have high clinical values in the evaluation of early and middle stage of lymphoma treatment and prognosis. They can be used as independent risk factors for prognosis.
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Objective To prepare a kind of 99Tcm-labeled estrogen receptor (ER) SPECT imaging agent,and evaluate its binding characteristics with ER by in vitro and in vivo studies.Methods EDL was prepared from estrone and then reacted with GAP to synthesize GAP-EDL.Then,GAP-EDL was labeled with 99Tcm to obtain 99Tcm-GAP-EDL.Cell uptake and blocking assays were performed in vitro on MCF-7and MDA-MB-231 cells.The biodistribution study of 99Tcm-GAP-EDL was performed on normal BALB/c mice at 30,60,120,180 and 240 min post injection.Nude mice bearing either MCF-7 or MDA-MB-231derived tumors were injected with 99Tcm-GAP-EDL,and subjected to γimaging at 1,2,4 h post injection.The mice injected with excess unlabeled GAP-EDL or estradiol were used as the blocking control.Two-sample t test was used for data analysis.Results The radiolabeling yield of 99Tcm-GAP-EDL was (98.8 ±0.5) ％ and the radiochemical purity after 24 h was over 90％.The cell uptake rate of MCF-7 cells at 240min was (4.84± 0.21) ％,which was significantly higher than that of MDA-MB-231 cells ((2.11±0.21) ％;t =15.96,P＜0.05).99 Tcm-GAP-EDL uptake rate of MCF-7 cells in blocking groups ((2.31 ± 0.28) ％ and (2.05±0.35) ％) decreased significantly compared to that of non-blocking group(t=11.52,11.16,both P＜0.05).Biodistribution studies showed that 99Tcm-GAP-EDL was mainly metabolized by the liver and kidneys,and exhibited quick blood clearance.Gamma imaging showed high uptake in MCF-7 tumors 1 h post injection and the uptake reached the highest at 4 h,while there was little 99Tcm-GAP-EDL uptake in MDA-MB231 tumors and blocked MCF-7 tumors.Conclusions 99Tcm-GAP-EDL may be prepared under mild conditions with high labeling purity and stability.The in vitro and in vivo characteristics of 99Tcm-GAP-EDL suggest that it may be a promising probe for ER positive tumor imaging.
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Objective To prepare 18F-5-fluoro-N-(2-(diethylamino) ethyl) picolinamide (18F-5-FPN) and evaluate its binding affinity with melanin.Methods 5-bromo-N-(2-(diethylamino) ethyl)picolinamide (precursor) was synthesized and the structure was characterized by ultraviolet (UV),nuclear magnetic resonance (NMR) and mass spectrometry.18F-5-FPN was prepared with FX-XN module through nucleophilic substitution reaction.The product was purified and identified by HPLC.The binding specificity of 18F-5-FPN with melanin was demonstrated by in vitro study of cellular uptake,and in vivo static PET imaging of pigmented B16F10 and amelanotic A375m allografts.Biodistribution study was performed to evaluate the pharmacokinetics of 18F-5-FPN in vivo.Two-sample t test was used for data analysis.Results The structure of precursor was characterized by UV,1H NMR,13C NMR and mass spectrometry.18 F-5-FPN was successfully prepared with radiochemical yield of 5％-8％,radiochemical purity ＞95％ and the specific activity of 100-120 GBq/μmol.The cell uptake study showed that the uptakes of 18F-5-FPN in B16F10 cells at 30,60 and 120 min ((9.80±0.46) ％,(10.34±0.32) ％,(7.27±0.26)％) were significantly higher than those in A375m cells ((1.36±0.14)％,(1.75±0.12)％,(1.54±0.09)％;t =30.3,46.8,38.4,all P＜0.05),and the optimal uptakes were observed at 60 min for both cells.In static PET imaging,the tumors in B16F10-bearing mice were clearly visible with the uptake value of (18.20±3.21) ％ID/g and the T/B ratio of 19.17±10.03 at 1 h postinjection,while no tumor uptake was seen in A375m-bearing mice.The main clearance pathway of 18F-5-FPN was the renal system,which cleared the unbound tracer rapidly.Conclusions 18F-5-FPN can specifically target the melanin in vitro and in vivo with favorable pharmacokinetics and good T/B ratio.18F-5-FPN may be an ideal molecular probe for diagnosis of malignant melanoma.
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Early diagnosis and accurate staging are important for planning therapeutic intervention to improve outcomes in patients with malignant melanoma (MM).Noninvasive molecular imaging has been extensively studied in cancer diagnosis,staging,therapeutic evaluation,and prognosis.Several radiopharmaceuticals have been developed to diagnose and treat MM,such as monoclonal antibodies,melanocortin receptors,benzamide (BZA) and BZA analogs.In this review,the characteristics and limitations of these radionuclide molecular probes are summarized and discussed.
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ObjectiveTo investigate the application effect of Delphi method to establish the preoperative visit mode. MethodsTaking the Delphi method to establish the standardized procedures of preoperative visit.The average length of stay,hospital costs and satisfaction degree of patients before and after application of standardized procedures of preoperative visit were compared. ResultsThe study showed that after taking the Delphi method to establish the preoperative visit mode,the patients' hospital stay for the same type of surgery,treatment costs and satisfaction degree of patients improved significantly than those before.The differences before and after treatment were significant. ConclusionsUsing Delphi method to establish a standardized procedures of preoperative visit has the advantage of strong target,strong representation,high degree of authority.It takes advantage of the excellent medical care experience and provides uniform and stable preoperative preparation work.It lays a foundation for patients to get better medical care and is worthy of clinical application.