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Objective:To evaluate the feasibility of PET automatic drug infusion system combined with power peripherally inserted central catheter (PICC) for 18F-FDG injection and PET/CT imaging. Methods:Fifty patients with malignant neoplasms who underwent 18F-FDG PET/CT imaging in Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine between December 2021 to July 2022 were prospectively enrolled. They were equally divided into power PICC group and peripheral venipuncture group. PET automatic drug infusion system was respectively connected with the pre-established channels of power PICC and peripheral venipuncture for 18F-FDG injection. Each patient underwent a routine PET/CT imaging at 1 h post-injection. The blood glucose, body weight, prescription dose and injection dose were recorded, and SUV max in the liver and cavoatrial junction were measured in both groups. The independent-sample t test was performed to compare the differences between 2 groups. The power PICC tip positions after 18F-FDG injection in power PICC group were observed. Results:The liver SUV max in the power PICC group and peripheral group were 2.54±0.50 and 2.57±0.31 ( t=0.37, P=0.716), and the SUV max of cavoatrial junction in the 2 groups were 1.68±0.25 and 1.63±0.22 ( t=-0.78, P=0.441), respectively. No significant differences were found in blood glucose, body weight, prescription dose and injection dose between the 2 groups ( t values: 0.00-0.13, all P>0.05). The ratios of injection dose to prescription dose in the 2 groups were 0.998 3±0.007 3 and 0.997 6±0.016 5, respectively, indicating high injection accuracy of the injection methods. No obvious drug residue was displayed at the end of catheter, resulting in good imaging quality. All the tip positions after injection were between T5 and T8, in line with the standardization management of power PICC. Conclusion:PET automatic drug infusion system combined with power PICC can be safely used for 18F-FDG injection and PET/CT imaging with less injection puncture.
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Objective:To observe the clinical efficacy of micro-needle therapy combined with Biotrisse BTS Lumin OX and Biotrisse BTS Brightline in the treatment of melasma.Methods:From September 2019 to June 2021, 80 patients with facial chloasma, aged 28-48 (37.3±4.9) years, were selected from Nanjing Jiangning Guze Clinic. The micro-needle therapy was combined with lumin OX and brightline for 6 times, and the observation time was 120 days. The mMASI score and VISIA photos before and after treatment were used to improve the results.Results:Eighty patients with refractory melasma on the face were treated with micro-needle therapy for 7 times (1 time per week for the first 5 times, and twice a week for the 9th and 10th weeks). The photos before and after treatment were compared and the mMASI of the patients' facial chloasma was compared. The scores were analyzed statistically, and the melasma were improved to varying degrees. Before treatment, the mMASI score was 5.4±3.22; 90 days later, the mMASI was 3.22±2.16, and the score decreased significantly ( t=5.9, P<0.05); after 120 days, mMASI score was 1.6±0.68, and the score decreased significantly ( t=7.55, P<0.05). Pigmentation occurred in one patient after treatment, and hypopigmentation after repair treatment; none of the patients had adverse reactions such as hypopigmentation. All the 80 patients had different degrees of improvement in pores and skin texture. Conclusions:The combination of micro-needling with lumin OX and brightline in the treatment of chloasma has a definite effect without obvious side effects. It provides a new method for the treatment of chloasma.
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Objective:To evaluate the advantages of PET automatic drug infusion system in nuclear medicine nursing by comparing radiation dose and precision injection between artificial injection and automatic injection.Methods:From August 2021 to September 2021, 40 patients (27 males, 13 females, average age: 59.6 years) were divided into two groups (20 patients in each group) for the injection of 18F-FDG by artificial injection and automatic injection in Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine. Portable radiation detector was used to measure the peak values of dose-equivalent rate in the arm and trunk of the nurse during the administration. The duration of administration process was recorded and the annual radiation doses were estimated and compared between the two injection methods. Independent-sample t test was used to compare the differences of injection parameters between two methods. Results:Based on 5 000 patients injected annually by artificial injection, the estimated annual radiation doses were about 220.19 mSv in the arm and 2.09 mSv in the trunk, while the radiation doses were approximately 0.19 and 0.08 mSv by automatic administration, respectively. Compared with the artificial injection, the automatic drug infusion system could reduce by 99% and 95% of equivalent doses in the arm and trunk, respectively. The significant difference was found in the empty needle activity between artificial injection and automatic drug infusion system ((18.87±7.77) and (0.22±0.19) MBq; t=10.65, P<0.001), while there were no statistical differences in full needle activity, injection activity and injection/prescription activity ratio ( t values: from -0.03 to 1.37, all P>0.05). Conclusion:PET automatic drug infusion system provides better radiation protection for nuclear medicine nursing.
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Objective:To explore the value of SPECT/CT imaging on programmed death receptor 1 ligand (PD-L1) expression in patients with non-small cell lung cancer (NSCLC) based on 99Tc m labeled anti-PD-L1 nanoantibodies (NM-01). Methods:From January 2019 to March 2020, a total of 14 patients (11 males, 3 females; age: (61.9±11.0) years) with pathologically confirmed NSCLC in Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine were prospectively enrolled. NM-01 were labeled with 99Tc m, and patients were recruited for SPECT/CT imaging 2 h after injection with 99Tc m-NM-01((359.1±68.0) MBq). The differences of SUV max in primary and metastatic lesions between PD-L1 positive and negative patients were compared by independent sample t test. The correlation between the SUV max and PD-L1 expression of primary lesions was analyzed by Pearson correlation analysis. Results:Of 14 patients, 6 were PD-L1 positive and 8 were PD-L1 negative. 99Tc m-NM-01 showed obviously increased uptake in kidneys and liver, while mildly increased uptake in spleen and bone marrow. The SUV max of primary lesions was 4.69±1.88 and the SUV max of metastatic lesions was 2.04±1.32. The SUV max of primary lesions in PD-L1 positive patients was significantly higher than that of PD-L1 negative patients (5.99±1.99 vs 3.72±1.10; t=5.98, P=0.039). There was no significant difference in the SUV max of metastatic lesions between PD-L1 positive and negative patients (1.66±1.03 vs 2.35±1.46; t=-1.77, P=0.084). The SUV max of primary lesions was positively correlated with PD-L1 expression ( r=0.648, P=0.042). Conclusion:99Tc m-NM-01 can demonstrate the expression of PD-L1 in primary and metastatic lesions in NSCLC.
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Objective:To assess the value of 18F-FDG PET/CT imaging and relevant factors in the interim therapeutic and prognostic evaluation of primary gastrointestinal lymphoma (PGIL) patients. Methods:From January 2008 to January 2018, 41 patients with B-cell PGIL (24 males, 17 females; age: 26-84 years) confirmed by pathology in Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine were retrospectively included. 18F-FDG PET/CT was performed before chemotherapy and radiotherapy and after 3-4 courses of chemotherapy. There were 17 cases of mucosa-associated lymphoid tissue (MALT) lymphoma and 24 cases of diffuse large B-cell lymphoma (DLBCL). Mann-Whitney U test was used to compare the differences of metabolic parameters (SUV max, metabolic tumor volume (MTV), total lesion glycolysis (TLG)) before treatment between MALT lymphoma and DLBCL patients. ROC curve analysis was used to analyze the predictive abilities of different parameters for progression-free survival (PFS), and Cox regression analysis was used to analyze the influencing factors for PFS. Results:The median follow-up time of 41 patients was 25 (6-84) months, with the 3-year PFS rate of 55.9% and the overall survival (OS) rate of 80.2%. The baseline SUV max (23.2±11.9), MTV (260.7(66.2, 740.7) cm 3) and TLG (1 902.9(592.2, 8 418.1) g) in DLBCL were significantly higher than those in MALT lymphoma (7.9(6.2, 9.8), 45.9(28.4, 104.2) cm 3, 121.1(72.8, 295.6) g; z values: -4.02, -3.10, -3.92, all P<0.05). ΔSUV max in DLBCL patients (AUC=0.80, P=0.012), ΔSUV max% (AUC=0.89, P=0.007; AUC=0.80, P=0.012), ΔMTV%(AUC=0.91, P=0.005; AUC=0.77, P=0.026) and ΔTLG% (AUC=0.87, P=0.011; AUC=0.77, P=0.026) in MALT lymphoma and DLBCL patients before and after treatment were predictive factors of PFS. Multivariate analysis showed that ΔSUV max% was an independent factor for PFS of MALT lymphoma (hazard ratio ( HR)=17.192, 95% CI: 2.035-145.245, P=0.009), while ΔMTV% and ΔTLG% were factors for PFS of DLBCL (both HR=7.556, 95% CI: 1.968-29.016, P=0.003). Conclusions:There are significant differences in metabolic parameters between MALT lymphoma and DLBCL before treatment. Interim PET/CT is effective for the prediction of prognosis of MALT lymphoma and DLBCL.
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Objective:To assess the predictive value of 18F-fluorodeoxyglucose (FDG) PET/CT imaging and relevant factors in the prognosis of patients with classic Hodgkin lymphoma (cHL) before or after autologous stem cell transplantation (ASCT). Methods:From January 2008 to June 2017, 55 cHL patients (28 males, 27 females; age: (28.8±9.6) years) confirmed by pathology in Shanghai General Hospital were retrospectively included. 18F-FDG PET/CT imaging was performed before ASCT in 43 cases and after ASCT in 34 cases (22 patients underwent the imaging both before and after ASCT). Patients were divided into positive group (≥4) and negative group (<4) according to 18F-FDG PET/CT imaging results using Deauville 5-point scale. The predictive value of relevant factors in the prognosis was evaluated with progression-free survival (PFS) and overall survival (OS) using Kaplan-Meier survival analysis and log-rank test. Hazard ratio ( HR) was calculated by Cox regression model. Results:Of 55 cHL patients, 29 (53%) had a progression of disease after a median follow-up of 8 months, and 11 (20%) patients died after a median follow-up of 29.5 months, with the 3-year PFS rate of 46.4% and OS rate of 84.5%. Significant differences of PFS rate were found between patients with or without B symptoms, between patients with or without large mediastinal mass, between patients with international prognostic score (IPS) of 0-2 and those with IPS of 3-7, among patients with different effect of salvage chemotherapy (complete remission (CR), partial remission (PR) + stable disease (SD), progressive disease (PD)), and between patients with negative or positive PET/CT imaging results before or after ASCT ( χ2 values: 5.52-20.01, HR: 2.21(95% CI: 1.56-3.12)-5.51(95% CI: 1.86-16.33), all P<0.05). B symptoms and large mediastinal mass were also prognostic factors for OS rate ( HR: 5.28(95% CI: 1.14-24.51) and 4.27(95% CI: 1.24-14.79), both P<0.05). The combination of 18F-FDG PET/CT imaging before and after ASCT was statistically significant for predicting PFS ( χ2=11.28, P<0.01). Multivariate survival analysis showed that the risk of progression in patients with positive PET/CT results after ASCT was significantly higher than those with negative results ( HR=6.20, P<0.01), and the risk of death in patients with B symptoms was significantly higher than those without B symptoms ( HR=5.28, P<0.05). Conclusion:18F-FDG PET/CT imaging results after ASCT have important values for predicting PFS in cHL patients after ASCT, and B symptoms can be used as an important prognostic indicator of OS after ASCT.
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Health care workers have higher risk of influenza infection because of their occupational exposure to infected patients. Infection of the health care workers may not only result in the increasing risk of the nosocomial infection and family transmission, but also disrupt the health services due to absence from work. Health care workers were recommended as a priority group of influenza vaccinationin more than 40 countries and regions in the world. In recent years, domestic surveys show that the influenza vaccine coverage among health care workers was low. This paper outlines the current status and related policies of influenza vaccination among health care workers in China and global. Additionally, we analyzed and discussed the proper immunization strategy of influenza vaccine for medical staff in China.
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Objective@#To evaluate the current status and related factors of influenza vaccination among health care workers (HCWs) in tertiary hospitals of Xining city after the implementation of the free influenza vaccination policy.@*Methods@#In August 2018, the cluster sampling method was used to select four medical institutions in Xining that had previously conducted investigations and interventions. All HCWs(excluding logistic staff) in each medical institution were included in the study. A total of 3 260 valid respondents were included. Questionnaires were used to collect the demographic characteristics, influenza and influenza vaccination awareness, implementation of free policy in the influenza epidemic season from 2017 to 2018, influenza vaccination status, awareness of influenza vaccination schedule and free policy. The multivariate logistic regression model was used to analyze related factors of influenza vaccination.@*Results@#The age of respondents was (31.41±5.00) years. The influenza vaccination rate was 6.80% (226/3 260) in 2017-2018 influenza epidemic season. After controlling for related factors, the awareness of the influenza vaccination schedule (OR=17.05, 95%CI: 5.86-49.59), vaccination frequency (OR=8.22, 95%CI: 2.98-22.61) and the free policy (OR=3.15, 95%CI: 1.49-6.67) had higher vaccination rate.@*Conclusion@#The influenza vaccination rate of HCWs in tertiary hospitals of Xining city was low. Increasing the awareness of the vaccination schedule, frequency and free policy may promote the influenza vaccination rate of HCWs.
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Objective To assess the value of 18F-fluorodeoxyglucose (FDG) PET/CT in the staging,interim therapeutic and prognostic evaluation of mucosa-associated lymphoid tissue (MALT) lymphoma.Methods Thirty-six MALT lymphoma patients (20 males,16 females;average age:61.7 years) confirmed by pathology from January 2008 to January 2018 were retrospectively analyzed.18F-FDG PET/CT were performed before chemotherapy and radiotherapy for staging.The detective sensitivity was evaluated.The staging results of gastric MALT lymphoma and extragastric MALT lymphoma by PET/CT were compared with Fisher exact probability method.PET/CT was performed in 17 of 36 patients after 4 courses of chemotherapy,and 17 patients were divided into positive group (≥≥4) and negative group (<4) according to scores of Deauville 5-point scale.The progression-free survival (PFS) was evaluated using Kaplan-Meier survival analysis.Results FDG-positive lesions were found in 31 of 36 patients with the sensitivity of 86.1% (31/36).The results of PET/CT were negative in stage Ⅰ patients.In stage]Ⅱ-Ⅳ patients,the results of 18F-FDG PET/CT combined with bone marrow biopsy were in accordance with the results of clinical staging.The accuracy of PET/CT in staging of gastric MALT lymphoma patients was 9/17,which was significantly lower than that of extragastric MALT lymphoma patients (17/19;P=0.025).The PFS of negative group evaluated by interim PET/CT was longer than that of positive group (x2 =4.16,P<0.05).The 2-year PFS rates of the 2 groups were (85.7± 13.2)% and (27.8 ±21.3)%,respectively.The PFS of patients with low expression of Ki-67 was significantly longer than that of patients with high Ki-67 expression (x2=4.22,P<0.05).Conclusions In stage]Ⅱ-Ⅳ MALT patients,18F-FDG PET/CT combined with bone marrow biopsy can improve the staging accuracy.The staging accuracy of PET/CT in extragastric MALT lymphoma is significantly higher than that of gastric MALT lymphoma.PET/CT and Ki-67 can provide effective information on the prognostic evaluation for patients with MALT lymphoma.
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Objective: To investigate the influenza vaccination and its influencing factors among the clinical staff in Xining, Qinghai province, in the 2016-2017 influenza season, and to explore the promoting strategies to encourage the target population for influenza vaccination. Methods: Four sample hospitals were randomly selected from the total 11 tertiary hospitals in Xining city. Clinical staff that worked in the four hospitals and agreed to participate were recruited for investigation via a self-administered questionnaire. Results: During the 2016-2017 influenza season, the coverage rate of influenza vaccines among the clinical staff was 5.14% (95%CI: 4.80%-5.49%). Multivariate logistic regression showed that knowing the priority of vaccination, the frequency of vaccination, effect of vaccination, and possessing higher professional qualifications were major influencing factors for influenza vaccination. The intention on recommendation of seasonal influenza vaccine was higher in vaccinated group than that in the unvaccinated group (χ(2)=99.57, P<0.001). Conclusion: The lower coverage rate was primarily associated with the lack of knowledge about influenza vaccine among the clinical staff of the hospital. Tailored information should be provided to the clinical staff through effective methods to improve vaccination and the recommendation of influenza vaccine.
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Humans , Attitude of Health Personnel , China , Cities , Health Knowledge, Attitudes, Practice , Hospitals , Influenza Vaccines/administration & dosage , Influenza, Human/prevention & control , Logistic Models , Seasons , Surveys and Questionnaires , VaccinationABSTRACT
Objective To investigate the influenza vaccination and its influencing factors among the clinical staff in Xining,Qinghai province,in the 2016-2017 influenza season,and to explore the promoting strategies to encourage the target population for influenza vaccination.Methods Four sample hospitals were randomly selected from the total 11 tertiary hospitals in Xining city.Clinical staff that worked in the four hospitals and agreed to participate were recruited for investigation via a self-administered questionnaire.Results During the 2016-2017 influenza season,the coverage rate of influenza vaccines among the clinical staff was 5.14% (95% CI:4.80%-5.49%).Multivariate logistic regression showed that knowing the priority of vaccination,the frequency of vaccination,effect of vaccination,and possessing higher professional qualifications were major influencing factors for influenza vaccination.The intention on recommendation of seasonal influenza vaccine was higher in vaccinated group than that in the unvaccinated group (x2=99.57,P<0.001).Conclusion The lower coverage rate was primarily associated with the lack of knowledge about influenza vaccine among the clinical staff of the hospital.Tailored information should be provided to the clinical staff through effective methods to improve vaccination and the recommendation of influenza vaccine.
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Objective:To analyze the difference of glomerular filtration rate (GFR) among image processing of the renal dynamic imaging through various methods.Methods: The renal dynamic imaging was processed through various methods, and using the image post-processing software. Using SPSS statistic system to analyze the data.Results: The methods of image processing had impacts on GFR. (1)The difference of GFR data obtained from images which were processed by different operators were not statistically significant. (2) The difference of GFR data obtained from images which image processing repeatedly by the same operator were not statistically significant. (3)GFR data measured based on background detecting regions of interest (ROI) (manually defined or auto-defined ROI) placed in different positions of kidney image had statistical significant. (4) The difference of GFR data were measured by manually defined and auto-defined background ROI had statistical significant.Conclusion: Choosing the proper image processing way, combining clinical appearance and detection, and gaining real data help to ensure the accuracy of imaging diagnostic reports.
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Objective To investigate the prognostic value of △SUV and Deauville 5-point scoring (5-PS) in patients with DLBCL.Methods Thirty-nine patients (20 males,19 females;median 58 (23-85) years) with pathologically confirmed DLBCL were retrospectively analyzed from January 2009 to April 2015.PET/CT imaging was performed before and after 4 courses of chemotherapy.The optimum cutoff values of △SUVmax and its decline proportion (△SUVmax%) were calculated by ROC curve,and then the Kaplan-Meier analysis and Cox regression analysis were performed in patients with different △SUVmax and △SUVmax%.Patients were also evaluated by the observers using Deauville 5-PS,Kaplan-Meier analysis and Cox regression analysis were performed in patients with scores ≥ 4 and those with scores < 4.x2 test and Spearman correlation analysis were used.Results (1) There were 10 patients (25.64%,10/39) with progressed disease within the 2 year-follow-up.The △SUVmax,△SUVmax% of progressed group were markedly lower than those of non-progressed group:9.55± 11.90 vs 15.61±7.86,71.66% (33.90%-78.91%) vs 87.83%(76.51%-92.43%);t=-2.37,z=-3.25,both P<0.05.(2)The optimum cutoff values of the △SUVmax,△SUVmax% were 11.2 and 72.88% respectively.(3) The patients with △SUVmax < 11.2,△SUVmax% <72.88% or Deauville 5-PS≥4 showed shorter PFS and △SUVmax% was proved to be an independent prognostic factor(x2 =5.734,14.821,5.851,all P<0.05).(4) △SUVmax% and Deauville 5-PS were correlated (rs =-0.633,P<0.001).Conclusions △SUV and Deauville 5-PS could be used for prognosis prediction in DLBCL patients and △SUVmax% might be an independent predictive factor.The values of △SUVmax % and Deauville present a negative relationship.
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Glioma is the most common malignant brain tumor with high malignancy and lethality.The specific potential radiolabeled nanoparticles have been applied in the glioma research for non-invasive,dynamic,real-time and quantitative evaluation.Furthermore,radiolabeled nanoparticles have shown great potential in targeted therapy of glioma.The up-to-date application of radiolabeled nanoparticles in SPECT imaging,PET imaging,multimodality imaging and theranostics in glioma are reviewed in this article.
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Objective To investigate the clinical significance of the expression of lymphocytes and cytokines in patients with laryngeal tuberculosis.Methods 96 cases of laryngeal tuberculosis were selected as the research objects.Of which 42 cases of infiltrating type,31 cases of ulcer type,mass type in 23 cases,the other 50 cases of healthy persons were selected as the healthy control group,all the research objects,extracting the morning fasting venous peripheral blood for detection of T lymphocyte subsets and cytokines were detected,and the results were compared.Results Invasive laryngeal tuberculosis CD3+ index (63.10 ± 5.33) % (t =1.922),CD4+ (40.32 ± 5.06) % (t =1.758),CD8+ (24.41 ± 4.59) % (t =1.710),compared with the control group,CD4+,CD3+ index significantly reduced,CD8+ index increased significantly,the differences had statistical significance (t =1.922,1.758,1.710,all P < 0.05),and the ulcer type and mass type results compared with invasive had significant difference(all P <0.05).In the analysis of laryngeal tuberculosis pathological types,reduced the mass type CD3+,CD4+ T index and CD8+ index of lymphocyte increased obviously the most significant;all laryngeal tuberculosis in patients with IL-4,IL-10 and TNF-alpha significantly increased compared with the control group,while the IFN-gamma was significantly reduced,and the mass in the type of change was the most significant,the differences had statistical significance(all P < 0.05).Conclusion The use of lymphocytes and cytokines detection can improve the laryngeal tuberculosis patients with the clinical diagnosis rate,with the detection results of different degree and different pathological types of laryngeal tuberculosis patients,can be used for preliminary assessment of laryngeal tuberculosis disease and pathological type,the choice of treatment modality for patients with guidance value,with in-depth clinical study and promotion application of value.
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Objective:To evaluate efficacy of tympanic membrane PE tube placement combined with oral endoscopic adenoidectomy in treating otitis media with effusion(OME) in children. Methods:Selected 87 cases(102ears)patients of secretory otitis media as research subjects between January 2012 to August 2014, in department of Otolaryngology in Heilongjiang Province, randomly divided into observation group(45cases, 55ears) and control group(42cases, 47ears),observation group used tympanostomy tube siphon drainage method combined with adenoidectomy for treatment, control group alone tympanostomy tube siphon drainage therapy, postoperative complications recorded data of patients later from the hospital after six and twelve months. Results:Two groups of patients after six months treatment and after twelve months(x2=5.705, x2=7.460;P<0.05), the results were statistically significant(P<0.05);in the middle ear effusion time, recurrent ear number, the number of ear infections, the results were also statistically significant(t=7.662, x2=4.197, x2=4.752;P<0.05). Conclusion:Under the ear drum using endoscopic drainage siphon tube method combined with adenoidectomy can effectively reduce postoperative complications in patients with quick, injury, etc, with high short-term and long-term efficacy, worthy application.
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Objective To investigate the relationship between childhood obesity,asthma and lung function.Method Based on body weight and whether with asthma the 45 children were divided into normal control group,asthma group,obesity and asthma group,15 cases each.Each child was measured leptin levels and pulmonary function was measured with a spirometer.Each asthmatic children was surveyed by Asthma Control Test (C-ACT) questions.Results Asthmatic children have varying degrees harm of lung function.Obesity and asthma group compared with asthma group of children is more decreased in lung function.Children with asthma compared with normal control group of children is more higher in serum leptin concentration.Obesity and asthma children is highest in serum leptin concentrations.Asthmatic children C-ACT average score than obesity and asthma score,the difference was statistically significant (P < 0.01).Conclusion Lung function and leptin abnormalities are exist in children with asthma.Also in the case of asthma,the abnormal levels of lung function and leptin in obese children compared with normal-weight children are more apparent,C-ACT score are more lower,and asthma is more severe.Weight control in obese children with asthma is favorable measures to control asthma attacks.
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Objective To explore the clinical diagnostic value of 18 F-FDG PET/CT in patients with kidney neoplasms.Methods Seventy-nine patients (52 males,27 females,average age (57.3 ± 14.1) years),who had definitive diagnosis of kidney neoplasms by 18F-FDG PET/CT and pathological or clinical comprehensive diagnosis in recent five years,were analyzed retrospectively.The diagnosis by PET/CT was made according to the changes of kidney shape,tumor density and FDG uptake (SUVmax).The diagnostic efficacy was calculated.Results Among the 79 patients,70 cases were finally diagnosed as malignant tumors (including 40 cases of renal cell carcinoma,5 cases of renal pelvis carcinoma,8 cases of lymphoma,16 cases of metastatic tumor,and 1 case of renal fascia capsule liposarcoma) and 9 cases of benign tumors (including 7 cases of angiomyolipomas,1 case of renal acidophilic cell adenoma,1 case of metanephric adenoma; the benign tumors did not contain small lipid sample hamartoma cases).The detective rate of kidney neoplasms with 18F-FDG PET/CT was 97.5% (77/79).For the identification of benign and malignant lesions,the sensitivity of 18F-FDG PET/CT was 92.9% (65/70),specificity was 7/9,accuracy was 91.1% (72/79),positive predictive value was 97.0% (65/67),and negative predictive value was 58.3 % (7/12).Conclusions 18 F-FDG PET/CT can detect and identify most of kidney tumors.Whole-body checking and comprehensive evaluation on kidney cancer patients are still the main advantages of PET/CT.
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Objective To investigate the value of 18F-FDG PET/CT for the detection of primary malignancy in patients with cervical lymph node metastases from unknown origin.Methods Seventy-eight patients (48 males,30 females,average age (56.4± 14.7) years) who were diagnosed as cervical lymph node metastases from unknown origin by fine needle aspiration underwent 18F-FDG PET/CT from 2007 to 2012.ROI was drawn with SUVm~ calculated.The distribution of the lymph nodes was classified according to the standard levels Ⅰ to Ⅵ,as well as the retropharyngeal and supraclavicular stations.The short axis of lymph node was defined as the lesion size.The final diagnosis was confirmed by pathology and clinical follow-up.Data collection and interpretation included identification of primary malignancy,pathologic types of primary tumors,distribution,size and SUVmax of the metastatic lymph nodes.One-way analysis of variance and linear correlation analysis were used for data analysis.Results In 78 subjects,75 were diagnosed as having malignant and 3 as benign lymph nodes by excisional biopsy.18F-FDG PET/CT detected primary malignancy in 56 cases (71.8%,56/78).In these 56 cases,57.1%(32/56) had head and neck cancer with metastatic lymph nodes mainly distributed in levels Ⅱ,Ⅲ and Ⅳ (90.6%,29/32).The remaining 24/56 (42.9%) patients had primary malignancy of the trunk with metastatic lymph nodes primarily involving supraclavicular fossa (95.8%,23/24).There was no statistical difference in size and SUVmax of lymph node among different primary locations or pathological types (F=0.037-2.413,all P>0.05).Conclusion 18FFDG PET/CT may play an important role in the detection of primary cancers for patients with metastatic cervical lymph nodes from unknown origin.
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ObjectiveTo evaluate the safety and efficacy of biological meshes (human aceUular dermal matrix mesh) in single-stage repair of infected or contaminated abdominal abdominal wall defects and abdominal hernias. MethodsSeventeen patients with abdominal wall defects or abdominal hernias were enrolled. The wounds of all these patients were infected or contaminated due to the existence of enterocutaneous fistula or stoma, wound infection and synchronous colonic resection. The diagnosis included enterocutaeneous fistula 8 cases, incisional hernia 6 cases, incarcerated inguinal hernia 1 case and cylindrical abdominoperineal resection for rectal cancer for 2 cases. The sizes of abdominal defects ranged from 3 cm × 2 cm to 6 cm × 17 cm, and all the cases were repaired with human acellular dermal matrix mesh(RENOV(R)). Most of the patients were repaired with intraperitoneal onlay mesh technique( IPOM, for 12 cases), and other methods included Lichtenstein operation for 1 case, inlay repair for 2 cases and sublay for 2 cases. Results All the 17 patients recovered uneventfully. For 12 patients, the wounds were sutured at operation and only one case of delayed healing occurred due to fat liquefaction. For the other 5 patients, the wounds were left open and healed after vacuum assisted closure (VAC) therapy or wet- to- dry dressing changes. On follow up for 8.3 ±4.5 months ( 1 to 15 months), no occurrence of incisional hernia or recurrence was found. laxity of abdominal wall occurred in one case. A patient complained intermittent pain of the site of suture for mesh fixing two months after operation and the pain resolved spontaneously one month later. ConclusionsThe biological mesh, acellular dermal matrix mesh, could be used in single- stage repair of infected or contaminated abdominal wall defects safely and effectively, although the long-term outcome still needs further evaluation.