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Presynaptic dopaminergic PET imaging is a useful method for the diagnosis of parkinsonism. Based on the expert consensus on operation and clinical application of dopamine transporter brain PET imaging technology published in 2020, this paper further recommends the relevant elements of result interpretation of presynaptic dopaminergic PET imaging.
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Objective:To explore the β-amyloid (Aβ) deposition pattern of subjects with the preclinical Alzheimer′s disease (AD), community-derived amnestic mild cognitive impairment (aMCI) and normal cognition (NC) from communities of Shanghai.Methods:According to the inclusion and exclusion criteria, 273 subjects (104 males, 169 females; age (64.2±7.6) years) were recruited from Shanghai community and memory clinics from December 2018 to July 2020. All subjects underwent MRI, 18F-AV45 PET imaging and neuropsychological scale tests and were grouped into AD, aMCI and NC groups based on clinical diagnosis. Differences in demographic information, the neuropsychological scale tests′ scores and positive rate of Aβ deposition among each group were analyzed by one-way analysis of variance or χ2 test. Aβ deposition patterns of AD and MCI groups were analyzed at voxel level, and the differences of Aβ deposition among different groups were compared. Results:Among 273 patients, the positive rates of Aβ deposition in AD, aMCI and NC groups were 84.4%(38/45), 36.4%(20/55) and 23.1%(40/173), respectively ( χ2=58.37, P<0.001). Among AD, aMCI, NC and NC (Aβ-) groups ( n=132), the education years of AD group was the lowest ((9.7±4.6) years; F=8.86, P<0.001). In addition, there were significant differences in the scores of several neuropsychological scale tests among AD, aMCI, NC groups and NC (Aβ-) group ( F values: 27.68-235.50, all P<0.001). Compared with subjects in NC(Aβ-) group, the Aβ depositions in the aMCI and AD groups were widely distributed in the whole cerebral cortex; and AD group had higher Aβ deposition in bilateral frontal, parietal, temporal, occipital lobe, cingulate gyrus and precuneus than aMCI group. Conclusions:The positive rate of Aβ deposition in the preclinical AD population from the Shanghai community is obtained. There are significant different Aβ deposition patterns in subjects at different stages of AD.
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Hepatocellular carcinoma (HCC) has high mortality, low early diagnosis rate, relatively poor treatment outcomes and prognosis. 18F-FDG PET/CT has an important application value on the detection of HCC metastasis, early recurrence and treatment prognosis. This paper summarizes and reviews the research progress on the application of 18F-FDG PET/CT in HCC diagnosis, liver transplantation, surgical resection and local ablation, to provide references for clinicians to make rational use of 18F-FDG PET/CT imaging technology in accurate diagnosis and treatment of HCC.
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Objective:To investigate the value of 18F-FDG PET/CT in qualitative evaluation of disease activity in patients with Takayasu arteritis (TA), and discuss the relationship between PET vascular activity score (PETVAS) and disease activity. Methods:A total of 84 patients (12 males, 72 females, age: (30.0±7.3) years) with TA, who underwent 18F-FDG PET/CT imaging in the First Affiliated Hospital of Zhengzhou University between February 2016 and August 2021, were retrospectively reviewed. All patients were divided into active ( n=68) and inactive groups ( n=16) according to Kerr score. PET/CT images were semiquantitatively evaluated according to the visual score and PETVAS was calculated. Mann-Whitney U test was used to compare the differences of PETVAS and inflammatory indexes (erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP)) between two groups. Spearman rank correlation analysis was used to evaluate the relationships among PETVAS, Kerr score and inflammatory indexes. ROC curve analysis was employed to compare the diagnostic efficiencies of PETVAS, ESR and CRP for disease activity. Results:The sensitivity, specificity and accuracy of 18F-FDG PET/CT in evaluating the activity of TA by visual score (≥2) were 86.8%(59/68), 15/16 and 88.1%(74/84), respectively. PETVAS, ESR(mm/1 h) and CRP(mg/L) in active group were higher than those in inactive group (11.0 (6.0, 18.0) vs 0.0 (0.0, 3.0), 67.0 (25.3, 104.0) vs 10.1 (7.1, 20.8) and 32.3 (7.1, 72.1) vs 1.8 (1.0, 5.3), respectively; z values: 4.53-5.23, all P<0.001). PETVAS was positively correlated with Kerr score ( rs=0.65, P<0.001), ESR ( rs=0.57, P<0.001) and CRP ( rs=0.56, P<0.001). The correlation coefficient between Kerr score and PETVAS was higher than that between Kerr score and CRP ( rs=0.55, P<0.001) and ESR ( rs=0.55, P<0.001). ROC AUC and Youden Index (YI) of PETVAS (AUC=0.92, YI=0.77) were higher than those of CRP (AUC=0.87, YI=0.65) and ESR ( AUC=0.87, YI=0.66). Conclusions:18F-FDG PET/CT is an effective tool for qualitative evaluation of TA disease activity. PETVAS is helpful in evaluating disease activity of TA, with a better efficacy than inflammatory indexes.
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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:To explore the classification of the therapeutic effect of patients with high-risk differentiated thyroid carcinoma (DTC) after surgery and 131I treatment, and to analyze the relevant factors that affect the therapeutic effect. Methods:From January 2015 to January 2018, 256 high-risk DTC patients (70 males, 186 females; age (47.6±12.9) years) in the First Affiliated Hospital of Zhengzhou University were retrospectively analyzed. According to the 2015 American Thyroid Association(ATA)guidelines for therapeutic effect classification standards and the data measured during 6 months postoperative stimulation state, patients were divided into excellent response (ER) group, inderterminate response (IDR) group, biochemical incomplete response (BIR) group and structurally incomplete response (SIR) group, and the latter two groups were further combined into incomplete response (IR) group. χ2 test, Fisher exact test and Kruskal-Wallis rank sum test were used to compare the clinical characteristics among the four groups. The receiver operating characteristic (ROC) curve of the relationship with ER and IR was established. Multivariate logistic regression was used to analyze the independent influencing factors of ER and IR. The subgroups with B-Raf proto-oncogene, serine/threonine kinase (BRAF) V006E results were individually tested with χ2 test of therapeutic efficacy. Results:There were 48.05%(123/256), 20.31%(52/256), 19.53%(50/256) and 12.11%(31/256) of DTC patients in ER, IDR, BIR and SIR groups respectively. The differences in gender ( χ2=11.495, P=0.008), tumor size ( H=21.368, P<0.001), N stage ( χ2=42.012, P<0.001), distant metastasis ( P<0.001) and pre-ablation stimulated thyroglobulin (psTg) level ( H=142.829, P<0.001) were statistically significant among the 4 groups. The cut-off values of psTg for predicting ER and IR were 5.38 μg/L and 15.85 μg/L with the sensitivities of 79.7%(98/123) and 88.9%(72/81), with the specificities of 84.2%(112/133) and 91.4%(160/175) respectively. The cut-off values of tumor size for predicting ER and IR were 1.45 cm and 1.95 cm with the sensitivities of 63.4%(78/123) and 53.1%(43/81), with the specificities of 66.2%(88/133) and 74.3%(130/175) respectively. Multivariate regression analysis showed that female (odds ratio ( OR)=2.305, 95% CI: 1.041-5.104), N0 stage ( OR=2.365, 95% CI: 1.104-5.066), psTg<5.38 μg/L ( OR=17.271, 95% CI: 8.561-34.841) and tumor size <1.5 cm ( OR=2.194, 95% CI: 1.092-4.409) were independent predictors of ER; psTg≥15.85 μg/L ( OR=81.544, 95% CI: 30.561-217.577), N1b stage ( OR=3.617, 95% CI: 1.276-10.253) and tumor size >4.0 cm( OR=47.060, 95% CI: 2.449-904.360) were independent predictors of IR. The BRAF V006E mutation rate of patients in the distant metastasis subgroup of the SIR group was significantly lower than that in ER, IDR, and BIR groups ( χ2 values: 20.852-40.905, all P<0.008). Conclusions:About 48.05% of high-risk patients can achieve ER half a year after the initial treatment and be classified as low-risk again. Female, patients with N0 stage, psTg<5.38 μg/L and tumor size <1.5 cm have better therapeutic effect after initial treatment; patients with N1b stage, psTg≥15.85 μg/L and tumor size >4.0 cm have poor therapeutic effect after initial treatment.
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Purpose@#There is no optimal prognostic model for T-cell lymphoblastic lymphoma (T-LBL). Here, we discussed the predictive value of total metabolic tumor volume (TMTV) and total lesion glycolysis (TLG) measured on 18F-fluorodeoxyglucose positron emission tomography–computed tomography (PET-CT) in T-LBL. @*Materials and Methods@#Thirty-seven treatment naïve T-LBL patients with PET-CT scans were enrolled. TMTV was obtained using the 41% maximum standardized uptake value (SUVmax) threshold method, and TLG was measured as metabolic tumor volume multiplied by the mean SUV. Progression-free survival (PFS) and overall survival (OS) were analyzed by Kaplan-Meier curves and compared by the log-rank test. @*Results@#The optimal cutoff values for SUVmax, TMTV, and TLG were 12.7, 302 cm3, and 890, respectively. A high SUVmax, TMTV, and TLG indicated a shorten PFS and OS. On multivariable analysis, TMTV ≥ 302 cm3, and central nervous system (CNS) involvement predicted inferior PFS, while high SUVmax, TLG and CNS involvement were associated with worse OS. Subsequently, we generated a risk model comprising high SUVmax, TMTV or TLG and CNS involvement, which stratified the population into three risk groups, which had significantly different median PFS of not reached, 14 months, and 7 months for low-risk group, mediate-risk group, and high-risk group, respectively (p < 0.001). Median OS were not reached, 27 months, and 13 months, respectively (p < 0.001). @*Conclusion@#Baseline SUVmax, TMTV, and TLG measured on PET-CT are strong predictors of worse outcome in T-LBL. A risk model integrating these three parameters with CNS involvement identifies patients at high risk of disease progression.
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Objective:To screen the factors that were conducive to prolonging the effective half-life of 131I, and to provide a basis for selecting more suitable patients for the treatment of hyperthyroidism with lithium carbonate assisted radioactive 131I. Methods:Between July 2017 and March 2019, a total of 61 patients (23 males, 38 females, age: 13-73 (37.7±1.9) years) who received lithium carbonate adjuvant therapy before 131I treatment in the First Affiliated Hospital of Zhengzhou University were collected into this prospective study. Clinical parameters (serum free triiodothyronine (FT 3), serum free thyroxine (FT 4), iodine uptake rate (2 h, 12 h, 24 h) and ratio of iodine uptake rate (2 h/24 h, 4 h/24 h) before and after taking lithium carbonate were compared by using paired t test. The factors which were conducive to prolonging the effective half-life of 131I were analyzed by linear and multiple regression analyses. Results:Compared with the pretreatment results, lithium carbonate treatment significantly improved the 24 h iodine uptake rate ((74.82±2.69)% vs (82.38±2.33)%; t=2.674, P=0.010), decreased the ratio of 4 h/24 h iodine uptake rate ((88.96±2.85)% vs (82.12±2.27)%; t=2.644, P=0.010), prolonged the effective half-life of 131I ((123.03±3.09) vs (130.38±2.49) h; t=2.656, P=0.010), and decreased serum FT 3 ((26.46±1.65) vs (21.31±1.42) pmol/L; t=3.421, P=0.001) and serum FT 4 ((56.59±2.12) vs (49.24±2.19) pmol/L; t=3.289, P=0.002). Linear regression analysis showed that 2 h and 4 h iodine uptake rate, the ratios of 2 h/24 h and 4 h/24 h iodine uptake rate, and effective half-life of 131I before lithium carbonate treatment were related to the effective half-life of 131I after lithium carbonate treatment ( b values: from -0.576 to 0.642, all P<0.05). Multiple linear regression analysis showed that the ratio of 4 h/24 h iodine uptake rate was the main factor affecting the effective half-life of 131I after taking lithium carbonate ( b=0.642, 95% CI: 0.453-0.832, P<0.001). Multiple linear regression equation was y=-49.785+ 0.642 x. Lithium carbonate treatment could prolong the effective half-life of 131I if the ratio of 4 h/24 h iodine uptake exceeded 77.55%. Conclusion:The ratio of 4 h/24 h iodine uptake rate is the main factor affecting the change of the effective half-life of 131I after lithium carbonate treatment, and patients with hyperthyroidism whose ratio of 4 h/24 h iodine uptake rate exceeds 77.55% can effectively prolong the effective half-life of 131I after taking lithium carbonate.
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Purpose@#There is no optimal prognostic model for T-cell lymphoblastic lymphoma (T-LBL). Here, we discussed the predictive value of total metabolic tumor volume (TMTV) and total lesion glycolysis (TLG) measured on 18F-fluorodeoxyglucose positron emission tomography–computed tomography (PET-CT) in T-LBL. @*Materials and Methods@#Thirty-seven treatment naïve T-LBL patients with PET-CT scans were enrolled. TMTV was obtained using the 41% maximum standardized uptake value (SUVmax) threshold method, and TLG was measured as metabolic tumor volume multiplied by the mean SUV. Progression-free survival (PFS) and overall survival (OS) were analyzed by Kaplan-Meier curves and compared by the log-rank test. @*Results@#The optimal cutoff values for SUVmax, TMTV, and TLG were 12.7, 302 cm3, and 890, respectively. A high SUVmax, TMTV, and TLG indicated a shorten PFS and OS. On multivariable analysis, TMTV ≥ 302 cm3, and central nervous system (CNS) involvement predicted inferior PFS, while high SUVmax, TLG and CNS involvement were associated with worse OS. Subsequently, we generated a risk model comprising high SUVmax, TMTV or TLG and CNS involvement, which stratified the population into three risk groups, which had significantly different median PFS of not reached, 14 months, and 7 months for low-risk group, mediate-risk group, and high-risk group, respectively (p < 0.001). Median OS were not reached, 27 months, and 13 months, respectively (p < 0.001). @*Conclusion@#Baseline SUVmax, TMTV, and TLG measured on PET-CT are strong predictors of worse outcome in T-LBL. A risk model integrating these three parameters with CNS involvement identifies patients at high risk of disease progression.
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Objective:To explore the clinical value of surgical resection combined with 131Ⅰ therapy in the treatment of differentiated thyroid carcinoma(DTC)in the elderly. Methods:From January 2010 to December 2015, 168 elderly patients with DTC admitted to the general surgery department of our hospital were divided into the combined treatment group(n=97)and the surgery group(n=71). During the same period, 68 young and middle-aged patients with DTC were enrolled as the control group.The combined treatment and control groups were treated with total or subtotal thyroidectomy combined with 131Ⅰ therapy, while the surgery group received surgical resection only.An enzyme-linked immunosorbent assay(ELISA)was used to monitor the thyroglobulin(Tg)level of patients in the three groups before and 1 week after treatment and 1, 3, 6 months after treatment, and adverse reactions and clinical efficacy grading within 6 months after treatment were evaluated.Tumor recurrence and metastasis and patient survival in the three groups were followed up for 5 years. Results:After 1 month of treatment, serum Tg levels showed significant differences between the three groups( F=15.329, P=0.011), and Tg levels were lower in the control group than in the combined treatment and surgery groups[(30.47±6.97) μg/L vs.(47.13±7.34) μg/L, (46.12±6.55) μg/L, t=3.462 and 4.791, P=0.017 and 0.023)]. After 3 and 6 months of treatment, serum Tg levels still had significant differences between the three groups( F=22.641 and 34.182, P=0.000 and 0.000), and Tg levels were lower in the combined treatment and control groups than in the surgery group[(28.27±10.16) μg/L, (41.82±9.83) μg/L vs.(13.17±2.69), t=3.164 and 4.649, P=0.012 and 0.005; (11.16±5.43) μg/L, (28.67±9.19) μg/L vs.(1.45±0.28) μg/L, t=4.251 and 7.283, P=0.009 and 0.000)], and the control group had lower Tg levels than the combined treatment group( t=2.184 and 4.537, P=0.011 and 0.000). After 6 months of treatment, the incidences of myelosuppression(21.6%, 0.0% vs.11.8%, χ2=17.851, P=0.000)and gastrointestinal reaction(37.1%, 11.3% vs.27.9%, χ2=14.070, P=0.001)were higher in the combined treatment group than in the surgery and control groups.The control group had a higher rate of effectiveness than the other two groups(73.5% vs.62.9%, 31.0%, χ2=8.796 and 33.834, P=0.032 and 0.000)and the combined treatment group had a higher effectiveness rate than the surgery group, (62.9% vs.31.0%, χ2=18.825, P=0.000). During the follow-up, the tumor recurrence-free time and the survival time were better in the control group than in the other two groups( Log Rankχ2=30.335 and 20.628, P=0.000 and 0.000). Conclusions:Surgical resection combined with 131Ⅰ therapy can reduce local progression, recurrence and metastasis of DTC, but its clinical effectiveness is worse in elderly patients than in young and middle-aged patients.
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Objective@#To evaluate the residual radioactivity after 131I treatment in postoperative inpatients with differentiated thyroid carcinoma (DTC) using service robot in nuclear medicine ward, and assess the time for patients to be released from isolation.@*Methods@#From September 2017 to June 2018, 297 patients (94 males, 203 females, age: 19-80 years) with DTC who underwent 131I treatment after surgery were included. According to the purpose of treatment and the prescription dosage of 131I, patients were divided into 8 groups: 4 groups accepted 131I remnant ablation therapy (RAT) with different dosages, which were 3 700 MBq (RAT1, n=34), 4 440 MBq (RAT2, n=122), 5 550 MBq (RAT3, n=81) and 7 400 MBq (RAT4, n=27), respectively; 4 groups had 131I treatment for recurrent/metastatic lesions (RMLT), and the dosages were 3 700 MBq (n=1), 4 440 MBq (n=2), 5 550 MBq (n=14) and 7 400 MBq (n=16). At 4, 24, 48 and 72 h after 131I administration, the dose equivalent rates at 2 cm away from the patient′s neck and at 1 m away from the body were measured by the robot designed for nuclear medicine ward. Kruskal-Wallis rank sum test and Mann-Whitney U test were used to analyze the data.@*Results@#Neck dose equivalent rates for patients with RAT at different time points (4, 24, 48 and 72 h) after 131I administration were significantly different among 4 groups (H values: 20.889-46.410, all P<0.05), as well as the body dose equivalent rates (H values: 27.181-35.497, all P<0.05). The neck dose equivalent rates at 24, 48 and 72 h after 131I administration were statistically different between group 3 and 4 for patients with RMLT (z values: 2.328-3.076, all P<0.05; data in group 1 and 2 were too limited to be compared), while there was no statistical difference for the body dose equivalent rates (z values: 0.333-1.621, all P>0.05). The radioactivity retention in patients decreased rapidly within 24 h, then slowed down gradually and became extremely low at 72 h. At 72 h after 131I administration, 96.6%(255/264) patients with RAT and 100%(33/33) patients with RMLT were lower than 23.3 μSv/h, which meant the patients could be discharged from hospitalization.@*Conclusions@#Nuclear medicine ward service robots may dynamically measure residual radioactivity in DTC patients who take 131I treatment, providing individualized isolation solutions.
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Objective To evaluate the residual radioactivity after 131 I treatment in postoperative in-patients with differentiated thyroid carcinoma ( DTC) using service robot in nuclear medicine ward, and as-sess the time for patients to be released from isolation. Methods From September 2017 to June 2018, 297 patients ( 94 males, 203 females, age:19-80 years) with DTC who underwent 131 I treatment after surgery were included. According to the purpose of treatment and the prescription dosage of 131 I, patients were divid-ed into 8 groups:4 groups accepted 131 I remnant ablation therapy ( RAT) with different dosages, which were 3700 MBq ( RAT1, n=34) , 4440 MBq ( RAT2, n=122) , 5550 MBq ( RAT3, n=81) and 7400 MBq ( RAT4, n=27) , respectively;4 groups had 131 I treatment for recurrent/metastatic lesions ( RMLT) , and the dosages were 3700 MBq ( n=1) , 4440 MBq ( n=2) , 5550 MBq ( n=14) and 7400 MBq ( n=16) . At 4, 24, 48 and 72 h after 131 I administration, the dose equivalent rates at 2 cm away from the patient's neck and at 1 m away from the body were measured by the robot designed for nuclear medicine ward. Kruskal-Wallis rank sum test and Mann-Whitney U test were used to analyze the data. Results Neck dose equivalent rates for patients with RAT at different time points ( 4, 24, 48 and 72 h) after 131 I administration were significantly different among 4 groups (H values:20.889-46.410, all P<0.05), as well as the body dose equivalent rates (H values:27.181-35.497, all P<0.05). The neck dose equivalent rates at 24, 48 and 72 h after 131 I administration were statistically different between group 3 and 4 for patients with RMLT ( z values:2.328-3.076, all P<0.05;data in group 1 and 2 were too limited to be compared) , while there was no statistical difference for the body dose equivalent rates (z values:0.333-1.621, all P>0.05). The radioactivity retention in patients decreased rapidly within 24 h, then slowed down gradually and became ex-tremely low at 72 h. At 72 h after 131I administration, 96.6％(255/264) patients with RAT and 100％(33/33) patients with RMLT were lower than 23.3 μSv/h, which meant the patients could be discharged from hospitalization. Conclusions Nuclear medicine ward service robots may dynamically measure residual radi-oactivity in DTC patients who take 131 I treatment, providing individualized isolation solutions.
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Objective To evaluate the changes of hypoxic conditions in non-small cell lung cancer (NSCLC) patients before and after radiotherapy and assess the value of 18F-fluoromisonidzaole (FMISO)PET/CT for radiotherapy efficacy evaluation.Methods A total of 21 NSCLC patients (15 males,6 females,age 30-74 years) from January 2014 to October 2016 were prospectively enrolled.18F-FMISO PET/CT was performed before and after radiotherapy,and all patients underwent 18F-fluorodeoxyglucose (FDG)PET/CT before radiotherapy.Routine chest CT was performed at the 3rd and 6th month after radiotherapy.The maximum standardized uptake value (SUVmax) of tumor and muscle,tumor volume and hypoxic volume (HV) were measured.Tumor-to-muscle (T/M) value of 18F-FMISO was calculated,and T/M ≥ 1.3 was considered as the hypoxia cut-off value.Data were analyzed using Pearson correlation,paired t test,signed rank sum test and Wilcoxon rank sum test.Results Totally 81.0％(17/21) of NSCLC patients had hypoxia.There were significant positive correlations between 18F-FMISO T/M value and tumor volume or 18F-FDG SUVmax(r:0.72,0.60,both P＜0.05).The T/M value after radiotherapy was significantly lower than that before radiotherapy (1.42± 1.12 vs 2.08±0.71;t =3.62,P＜0.05),and median HV was also significantly lower than that before radiotherapy (6.53 vs 12.41 cm3;z =-3.83,P＜0.05).The median T/M values of effective group (n =14) and ineffective group (n =7) before radiotherapy were significantly different (2.14 vs 2.87;z=-2.27,P＜0.05),and the median HV of 2 groups before radiotherapy was also significantly different (6.43 vs 10.20 cm3;z=-2.14,P＜0.05).Conclusions Most NSCLC patients have hypoxia before radiotherapy.The larger tumor volume,the higher degree of hypoxia.Radiotherapy can alleviate the hypoxia of tumors.18F-FMISO PET/CT imaging before radiotherapy can be used to predict the efficacy of patients with NSCLC.
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Objective To analyze safety,effectiveness and prognosis of thyroidectomy in elderly patients with thyroid carcinoma.Methods A retrospective analysis was conducted in 142 elderly patients undergoing thyroidectomy for thyroid carcinoma in our hospital from October 2010 to March 2012.Clinical data of surgical treatment and postoperative pathogenetic conditions,including the incidence rate of operation complications,the rate of local relapse and distant metastasis,were analyzed.And the influencing factors on prognosis were also analyzed.Results Thyroidectomies for thyroid carcinoma were successfully completed in all patients.There were a total of 13 cases with postoperative complications,yielding a total complication rate of 9.15 ％,including an incision infection in 6 patients,hoarseness in 1 patient,and hypocalcemia in 6 patients.During median follow-up of 51 months,there were 12 patients dead,16 patients relapsing,and 6 patients with local and distant metastasis.Univariate analysis showed that age,lymph node metastasis,and clinical stage may affect the prognosis of elderly patients with thyroid cancer.Multivariate Cox Logistical analysis indicated that age,lymph node metastasis,and clinical stage were independent factors associated with the prognosis of elderly patients with thyroid carcinoma.Conclusions Age,lymph node metastasis,and clinical stage are independent factors for prognosis of elderly patients with thyroid carcinoma.
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Objective To explore the value of metabolic volume of cardiac tumor (MTV1 to that of the maximum extracardiac tumor (MTV2) ratio in predicating the cardiac tumor origin.Methods A total of 35 consecutive cases (19 males,16 females,age range:18-68 years) with multiple cardiac and extracardiac tumors were enrolled in this retrospective analysis.All of them were confirmed by pathology or clinical follow-up results and examined by 18F-fluorodeoxyglucose PET/CT from January 2010 to February 2016.Maximum standardized uptake value (SUVmax) 3.63 was used as the background threshold.MTV1 and MTV2 were automatically obtained by PETVCRA software.Receiver operating characteristic (ROC) curve was drawn to obtain the diagnostic threshold of MTV1/MTV2 ratio for cardiac tumors,and the sensitivity,specificity and accuracy were calculated.Mann-Whitney u test was used to analyze the data.Results Twelve patients were confirmed to have primary cardiac malignant tumors (PCMT),and 23 cases were metastatic cardiac malignant tumors (MCMT).There was statistical difference of MTV1 between PCMT and MCMT patients:52.9(33.3,703.4) cm3vs 8.1(1.2,24.6) cm3(z=-3.70,P＜0.05).MTV2 was 11.7(1.8,38.4) cm3 in PCMT patients,which was lower than that in MCMT patients (182.0(100.1,238.0) cm3;z=-4.17,P＜ 0.05).MTV1/MTV2 ratio of PCMT was 16.20(9.40,71.80),which was significantly higher than that of MCMT (0.10(0.01,0.60),z=-4.66,P＜0.05).When MTV1/MTV2 ratio=1.2 was selected as the cut-off value,the sensitivity,specificity and accuracy were 12/12,91.30％(21/23),94.29％(33/35) respectively.Conclusion It may be an important criterion for the diagnosis of PCMT that MTV 1 is greater than MTV2.
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Objective To explore the prognostic value of pretreatment 18F-fluorodeoxyglucose (FDG) PET/CT in pediatric neuroblastoma (NB).Methods Twenty-seven NB patients (18 males,9 females;average age (4.6±2.4) years) confirmed by pathology from June 2012 to November 2015 were retrospectively included.All patients had detailed clinical and follow up data.They underwent 18F-FDG PET/CT scan before any treatment,and the largest diameter of primary tumors,maximum standardized uptake value (SUVmax) of primary tumor (Tmax),SUVmax of liver (Lmax),Tmax/Lmax ratio,clinical staging,serum ferritin,serum lactate dehydrogenase (LDH) and serum neuron-specific enolase (NSE) were recorded as prognostic factors.Patients were followed up after treatment for 3-32 months (median:24 months).KaplanMeier survival analysis was used to analyze the influence of Tmax and Tmax/Lmax ratio on 2-year progression free survival (PFS).Cox regression analysis was used to comprehensive analyze the influence of various factors on PFS.Results Of the 27 patients,12(44.4％) experienced disease progression during the follow-up period.Univariate analysis showed that N-myc gene amplification,serum LDH,serum NSE,serum ferritin,the largest diameter of primary tumors,Tmax and Tmax/Lmax ratio were significant prognostic factors for 2-year PFS.The multivariate analysis showed that only the Tmax and Tmax/Lmax,ratio were independent prognostic factors for 2-year PFS.Conclusion 18F-FDG PET/CT can provide effective information on the prognostic information for pediatric NB patients.
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Objective To explore the location value of preoperative SPECT/CT fusion imaging in ectopic gastric mucosa lesions.Methods Twenty-five children with ectopic gastric mucosa were examined with SPECT/CT.Patients who had fixed abnormal uptake lesions in abdomen within 20 min of the dynamic planar imaging underwent SPECT/CT and image fusion at the end of 20 min.The localization results of lesions by SPECT/CT fusion imaging were compared with intraoperative findings.Results Twenty-five patients with positive planar imaging underwent tomography fusion imaging,and then positive findings were noticed in 17 patients,among them 14 patients' intraoperative findings had high consistency with location of lesions of tomography fusion imaging (Kappa =0.746,P ＜ 0.05).Conclusion SPECT/CT fusion imaging can locate ectopic gastric mucosa lesions accurately and has high application value.
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Objective To evaluate the diagnostic value of neck ultrasonography (NUS) and 18F-FDG PET/CT imaging during the follow-up of DTC patients with elevated serum TgAb but negative serum Tg and 131I-Dx-WBS after thyroidectomy and 131I ablation.Methods From September 2014 to March 2016,41 DTC patients (10 males,31 females,age 16-73 years) with elevated serum TgAb level (＞115 kU/L) but negative serum Tg and 131I-Dx-WBS were enrolled in this prospective study.Patients were divided into positive group and negative group,according to the results of NUS.The rates of recurrence or metastasis between the 2 groups were compared.18F-FDG PET/CT imaging was performed and the results were compared with pathological results.x2 test was used to analyze the data.Results The rate of recurrence or metastasis in the NUS positive patients(9/17) was significantly higher than that in the patients with negative NUS results (16.67％,4/24;x2 =6.047,P＜0.05).The sensitivity,specificity,positive predictive value,negative predictive value of 18F-FDG PET/CT imaging for diagnosis of recurrence or metastasis were 12/13,78.57％ (22/28),12/18 and 95.65％ (22/23) respectively.ROC curve analysis showed that the sensitivity and specificity of 18F-FDG PET/CT imaging were 11/13 and 100％ (28/28) respectively when the threshold of SUVmax was set at 4.35.The treatment strategy was changed after 18 F-FDG PET/CT imaging in 12 patients,of which 8 underwent surgery and 4 underwent 131I ablation therapy.Conclusion The NUS and 18F-FDG PET/CT imaging have important significance in clinical diagnosis and subsequent treatment of the DTC patients with elevated serum level of TgAb but negative serum Tg and 131I-Dx-WBS.
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Objective To investigate the impact on image quality of bone imaging and patients safety when whole body bone imaging was performed on the sme day of renal dynamic imaging.Methods Fifty-three adult patients underwent renal dynamic imaging and whole body bone imaging were selected as observation group.Firstly,99 Tcm-DTPA renal dynamic imaging was performed,and 2 h later,99Tcm-MDP was injected,then whole body bone imaging was performed according to technological process.The other 53 patients received bone imaging only were selected as control group.After injection of 99Tcm-MDP immediately and 30 min,1 h,2 h,4 h,6 h,and 24 h later,physiological response of all patients was observed,and image quality of bone imaging between the two groups was compared.Then the ratio of subjective excellent images of the two groups was calculated.Radioactivity counting of T12,L4,iliac crest,middle humerus,middle femur and soft tissue above 2 cm of ilium on posterior image was measured,and target/non target (T/NT) was calculated.Statistical analysis was performed on the two groups.Results Adverse reaction was not found in all patients in two groups.Subjective excellent rate was 90.57％ (48/53) in observation group,and 92.45％ (49/53) in control group (x2 =0.12,P＞0.05).T/NT of T12,L4,middle humerus and middle femur had no significant differences between two groups (all P＞0.05).The difference of T/NT of iliac crest was statistically significant between two groups (t=3.45,P＜0.05).Conclusion Radionuclide renal dynamic imaging on the same day has no significant impact on the image quality of whole body bone imaging.
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Objective Chronic heart failure ( CHF) is a disease with high morbidity, and mortality.The study was designed to explore the prognostic value of rest gated SPECT myocardial perfusion ( GSMPI) in patients with chronic heart failure. Methods This study was a prospective study, in which 142 CHF patients was included from January 1, 2011 to December 31, 2012.All patients underwent GSMPI, further, summed rest score ( SRS) , left ventricular ejection fraction ( LVEF) , end-diastolic volume ( EDV) , end-systolic volume ( ESV) and phase standard deviation ( PSD) were recorded.All the patients were followed up.Primary endpoint was the major adverse cardiac events ( MACE) .Additionally, we analyzed the independent predictive factor of MACE occurrence by using the Cox proportional hazard model. Results during the follow-up, MACE occurred in 65 cases.The median time to MACE occur-rence was 28(5-48) months.The 3-year MACE free survival rate was 64.3%.Multivariate Cox proportional hazards regression analysis showed that cardiac function grade[HR(95%CI):1.761(1.087~4.824), P=0.005], NT-proBNP[HR(95%CI):1.153(1.125~5.997), P =0.009], LVEF[HR(95%CI): 1.945(1.138 ~ 6.131), P=0.019], SRS[HR(95%CI):1.517(1.108~4.278), P=0.027] and PSD[HR(95%CI):1.442(1.156~5.339), P=0.032] were all independent predictors of MACE. Conclusion GSMPI may be a prognostic factor for the patients with chronic heart failure.