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Objective:To investigate the prognostic value of metabolic tumor volume (MTV) and total lesion glycolysis (TLG) in patients with extensive-stage small cell lung cancer (ES-SCLC).Methods:From March 2019 to June 2020, 69 patients (55 males, 14 females, age: 38-87 years) with ES-SCLC who underwent pretreatment 18F-FDG PET/CT in First Affiliated Hospital of Zhengzhou University were retrospectively enrolled. The variables including gender, age, smoking, weight loss, liver metastasis, bone metastasis, malignant effusion, SUV max of the primary tumor, whole-body MTV (wbMTV) and whole-body TLG (wbTLG) (including wbMTV 40%, wbTLG 40%, wbMTV 2.5 and wbTLG 2.5) were analyzed. The predictors of overall survival (OS) were analyzed by using Kaplan-Meier method (log-rank test). Results:Of 69 ES-SCLC patients, 43(62%) died and 26(38%) were still alive by the end of follow-up, with a median survival time of 15.0(95% CI: 11.7-18.3) months. Univariate analysis revealed that age ( χ2=4.53, P=0.033), bone metastasis ( χ2=18.05, P<0.001), liver metastasis ( χ2=27.94, P<0.001), wbMTV 2.5 ( χ2=3.98, P=0.046), and wbTLG 2.5( χ2=5.80, P=0.016) were significant predictors of OS. Conclusion:wbMTV 2.5 and wbTLG 2.5 are assosciated with OS and may provide some reference value for predicting the prognosis of ES-SCLC patients.
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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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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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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 investigate the diagnostic value of 99Tc m-human serum albumin (HSA) SPECT/CT imaging for protein-losing enteropathy. Methods:Retrospective analysis was performed on 55 patients (21 males, 34 females, age: 5-78 (46.7±13.5) years) who had hypoproteinemia and underwent 99Tc m-HSA SPECT/CT imaging in the First Affiliated Hospital of Zhengzhou University between August 2016 and August 2019. The diagnostic efficiencies of dynamic planar imaging and SPECT/CT imaging for protein-losing enteropathy were evaluated according to the clinical final diagnosis. χ2 test was used for data analysis. Results:The final clinical diagnosis confirmed 46/52 patients were with protein-losing enteropathy. The sensitivities, specificities and accuracies of 99Tc m-HSA planar imaging and SPECT/CT imaging for the diagnosis of protein-losing enteropathy were 91.30% (42/46) vs 100% (46/46), 6/9 vs 8/9, and 87.27% (48/55) vs 98.18%(54/55), respectively. The differences in sensitivity, specificity and accuracy were all statistically significant ( χ2 values: 5.73, 4.27, 5.42, all P<0.05). Conclusion:Based on 99Tc m-HSA planar dynamic imaging, SPECT/CT imaging has good diagnostic ability for intestinal protein loss and high diagnostic efficiency for protein-losing enteropathy.
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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 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.
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Objective To investigate the differential diagnostic value of 18 F‐DG PET/CT imaging on gastric malignancies and primary gastric lymphoma(PGL) .Methods A total of 93 cases of gastric cancer (23 cases of mucinous adenocarcinoma and 70 ca‐ses of non mucinous adenocarcinoma ) ,58 cases of PGL and 31 cases of Diffuse Large b Cell Lymphoma (DLBCL ) and 27 cases of Mucosa associated tissue lymphoma (MALT) treated in our hospital from Jun 2012 to Jun 2015 were involved in this study .Their clinical data ,SUVmax ,maximum lesions thickness ,CT value ,lesion shape ,merge splenomegaly and lymph node metastasis were compared .The relation between SUVmax and maximum lesions thickness were analyzed with Pearson analysis .Results The aver‐age age and the lesions involve cardiac orifice rate of the gastric cancer group were significantly higher than that of PGL group (P0 .05) .Conclusion The diagnostic value of 18 F‐FDG PET/CT in gastric malignancies was high ,and patients with different cancer and pathological type were different in SUVmax ,maximum le‐sions thickness and lesion shape .
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Hypoxia is the combined result of tumor over-growth and vascular structural abnormalities.Hypoxia is related to tumor invasiveness,radioresistance,and chemoresistance.18F-fluoromisoni-dzole (18F-FMISO) can selectively bind to hypoxic tissues of malignant tumors,and is thus useful for imaging of tumor hypoxia in cancer diagnosis and treatment.This review summarizes the state-of-art research of 18F-FMISO in comparison with other hypoxic agents when applied to animals and clinical studies.
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Objective To evaluate the value of 18F-FDG and 18F-FLT PET/CT for the detection of primary and regional lymph node metastasis of gastric cancer.Methods Thirty-seven patients with gastric cancer underwent preoperative 18F-FLT and 18F-FDG PET/CT within one week from March 2011 to April 2013.Postoperative histopathology confirmation was obtained in all patients.The PET/CT images were assessed visually and semi-quantitatively.Two-sample t and x2 tests were analyzed using SPSS 13.0.Results For the detection of primary gastric cancer,the sensitivities of 18 F-FLT and 18 F-FDG PET were 89.2％ (33/ 37) vs 91.9％(34/37),respectively (x2=0.158,P＞0.05).The 18F-FLT SUVmax of 16/37 cases with diffuse-type gastric cancer was significantly higher than that of 21/37 cases with intestinal-type gastric cancer (6.89±1.38 vs 3.79±2.45,t=4.533,P＜0.05) ; while 18F-FDG SUVmaxwas not significantly different between the two subgroups (7.13± 1.97 vs 6.36±2.32,t =1.066,P＞0.05).For the detection of regional lymph node metastasis,the sensitivity,specificity and accuracy of 18F-FLT and 18F-FDG were 64.8％(35/54) vs 88.9％(48/54),97.6％(246/252) vs 82.9％(209/252),91.8％(281/306) vs 84.0％(257/306),respectively (x2 =8.796,30.948,8.854,all P＜0.05).The overall sensitivity,specificity and accuracy by both tracers were 92.6％(50/54),98.8％(249/252) and 97.7％(299/306).Conclusions 18F-FLT might be a better or complementary tracer to 18F-FDG for the detection of diffuse-type gastric cancer.Compared with 18FFDG PET/CT,18F-FLT PET/CT may be less sensitive but more specific and accurate for the detection of regional lymph node metastasis.The overall diagnostic accuracy can be improved by using both tracers.
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@# Objective To explore the effect of psychological intervention on the rehabilitation of depressive patients.Methods 183 depressive patients were randomly divided into study group (n=93) and control group (n=90). The study group was given systemic psychological intervention additional to routine medicine for 12 weeks and the control group was given only medication. The efficacy was measured by Brief Psychiatric Rating Scale (BPRS), Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS).Results There is no significant difference in SDS, SAS and BPRS ratings between two groups before the intervention (P>0.05). The scores of anxiety-depression, lacking-activity, thinking-disturbance, SAS and SDS were significantly lower in the study group than in the control group 12 weeks after the intervention(P<0.05). Conclusion Psychological intervention can positively improve the rehabilitation of depressive patients.