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A 56-year-old man presented with vague upper abdominal pain for more than 4 months. His abdominal ultrasound and MRI showed thickening of the neck and base of the gallbladder and nodule formation at the base of the gallbladder. 18F-FDG PET/CT revealed intense FDG uptake in the base of the gallbladder and multiple lymph nodes. 68Ga-FAPI-04 PET/CT not only showed intense FAPI uptake in the above mentioned FDG-avid lesions but also showed intense FAPI uptake in the neck lesion of the gallbladder and some other additional lymph nodes. Finally, histopathological examination confirmed poorly differentiated tubular adenocarcinoma of the neck and base of the gallbladder. Our case illustrated that 68Ga-FAPI-04 PET/CT may outperform 18F-FDG PET/CT in the detection of gallbladder cancer primary and metastatic lesions.
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Objective@#To investigate the possibility and diagnostic efficiency of 18F-NaF PET/CT bone scan after oral administration (PO) by comparing with that of intravenous injection (IV).@*Methods@#Fifty patients (19 males, 31 females; average age: (52.8±11.7) years) with cancer who underwent PET/CT scans after oral and intravenous administration of 18F-NaF respectively with an interval of 2-7 d from June 2015 to September 2016 were prospectively enrolled. Single-phase 18F-NaF PET/CT was performed 60 min after IV, and dual-phase 18F-NaF PET/CT was performed 60 and 120 min after PO. All PET/CT images were reviewed, lesions were counted, and maximum standardized uptake value (SUVmax) and target/non-target (T/NT) ratios were calculated and compared. Paired t test was used.@*Results@#Forty-one patients (15 males, 26 females; average age: (53.5±10.4) years) who finished all PET/CT scans were enrolled. The images at 120 min after PO was visually similar to the images at 60 min after IV. Three modalities detected the same cases and lesions (35 positive cases: 25 malignant, 8 benign, 2 cases with indefinite diagnosis; 302 lesions: 172 malignant, 108 benign, 22 ambiguous lesions). The SUVmax-PO60 min and SUVmax-PO120 min were lower than the SUVmax-IV60 min in the same lesion (18.22±12.64, 26.60±19.49 vs 28.07±16.34; t values: -12.36 and -3.59, both P<0.05). A total of 194 lesions were included for T/NT ratio analysis. T/NTIV60 min, T/NTPO60 min and T/NTPO120 min were 2.76±1.30, 2.87±1.50, 2.98±1.42, respectively, and T/NTPO120 min was higher than T/NTIV60 min (t=3.18, P<0.05).@*Conclusion@#18F-NaF PET/CT images after PO, especially at 120 min post-PO, has similar diagnostic power of lesion-detection and SUVmax-measurement with IV.
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Purpose The clinical manifestation of insufficiency fracture (IF) is in lack of specificity,thus it is prone to misdiagnosis.This paper aims explore imaging characteristics of 99Tcm-MDP whole-body bone scan and local SPECT/CT tomography for IF in the anticipation to improve its cognition and diagnosis capability to imaging manifestations.Materials and Methods Thirty patients who were diagnosed as IF by follow-up or imaging in Affiliated Hospital of Southwest Medical University from September 2015 to September 2016 were enrolled.The imaging features of their whole-body bone scan and local S PECT/CT tomography were retrospectively analyzed.Results For 30 patients,20 cases were single bone lesion,and 10 cases were multiple bone lesions.Lesions on the whole-body scan were represented as developer concentration of different level.Fracture line,sclerosis rim/line,soft tissue swelling,wedge-shaped or concave deformity of the vertebra could be observed on the images of SPECT/CT scan.Osteoporosis of different level could be seen on all the 30 patients.No bone destruction could be seen on the lesions and no obvious soft tissue mass around the lesions were formed.Conclusion Manifestation of whole-body bone scan and local SPECT/CT scan of IF is with certain specificity and is of significance in the early-stage diagnosis and differential diagnosis of IF.
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Objective To systematically evaluate the consistency of sensitivity (SEN) and specificity (SPE) between positron-emission tomography (PET) /magnetic resonance imaging (MRI) and PET/CT in the diagnosis of lymphoma.Methods The databases,including PubMed,Cochrane Library,Chinese Biomedical Literature Database (CBM),CNKI,Wanfang and VIP,were retrieved till October 2016.The studies published the SEN and SPE of PET/MRI and PET/CT in the diagnosis of lymphoma were collected and selected based on inclusion and exclusion criteria by two reviewers independently.Then,data extraction and analysis were performed by two independent reviewers.Resnlts A total of 6 studies,including 221 cases of patients with lymphoma,wereincluded.Among the 6 studies,4 of them provided patients-based and site-based data (including one provided data about staging ofdisease),and 2 studies only provided site-based data (including one provided data about staging of disease).The results indicated thatboth PET/MRI and PET/CT can accurately detect the lesions in patients with lymphoma,and the locations and numbers of lesions found bythe two methods were almost the same.Additionally,PET/MRI and PET/CT had high SEN and SPE for detection of lesions in patientswith lymphoma.and had high consistency in the diagnosis of lymphoma.Condusion The SEN and SPE of PET/MRI were similar to those of PET/CT in the diagnosis of lymphoma.PET/MRI may become a significant method for diagnosing lymphoma.
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Objective To evaluate the value of 99Tcm-EHIDA SPECT combined with planar hepatobiliary scintigraphy (combined scintigraphy) in the differentiation of infant biliary atresia (BA) from neonatal hepatitis (NH).Methods This is a retrospective study on 32 infants with cholestasis (18 males,14 females;age:28-83 d) from June 2013 to June 2014.All infants underwent sequential 99Tcm-EHIDA hepatobiliary planar scintigraphy and combined scintigraphy,and the diagnostic efficacy of the 2 methods for differentiating infant BA from NH was analyzed by x2 test.Results In sequential planar scintigraphy,the diagnostic sensitivity,specificity,accuracy,positive predictive value and negative predictive value were 76.2％ (16/21),6/11,68.8％ (22/32),76.2％ (16/21) and 6/11,respectively.In combined scintigraphy,the diagnostic parameters were 95.2％ (20/21),8/11,87.5％ (28/32),87.0％ (20/23) and 8/9,respectively.Combined scintigraphy correctly identified 4 BA cases that were misdiagnosed as NH by planar scintigraphy.The sensitivity of combined scintigraphy was significantly higher than that of planar scintigraphy (x2 =4.285,P＜0.05),while no significant difference was found in the other diagnostic parameters (x2 =0.061-0.405,all P＞0.05).Conclusions Combined scintigraphy has incremental value for the differentiation of infant BA from NH.
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Objective To evaluate the diagnostic value of radionuclide salivagram in children with pulmonary aspiration.Methods From March 2012 to June 2015,a total of 62 patients (37 males,25 females;age range:2 d-14 years) with suspected pediatric aspiration pneumonia were enrolled in this retrospective study.All patients underwent gastroesophageal reflux (GER) imaging and(or) radionuclide salivagram.Detection rate of pulmonary aspiration by the two imaging techniques was compared with x2 test.Results Of 62 patients,14 were diagnosed as pulmonary aspiration,including 1 detected by GER imaging,and 13 detected by salivagram.The detection rate for pulmonary aspiration by radionuclide salivagram (26.0％,13/50) was significantly higher than that by GER imaging (3.1％,1/32;x2=7.211,P＜0.05).Eight of the 13 cases with pulmonary aspiration diagnosed by radionuclide salivagram underwent upper gastrointestinal radiography,and 5 cases had visible contrast agent in the airway.Conclusion Radionuclide salivagram has a higher detection rate for pulmonary aspiration compared to GER imaging,and has good concordance with the traditional upper gastrointestinal radiography.
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Objective To evaluate the value of 18 F?NaF PET/CT and MRI in the diagnosis of skull?base bone invasion ( SBBI) in patients with nasopharyngeal carcinoma( NPC) . Methods Sixty?three NPC patients (45 males, 18 females;age range 23-72 years) were enrolled in this prospective study. Pa?tients underwent 18 F?NaF PET/CT and MRI to confirm whether the skull base was invaded. The reference standard was based on the follow?up imaging in 6 months. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of the two imaging modalities were calculated. χ2 test was used to analyze their difference. The SBBI foci and their distribution detected by the two imaging modalities were compared. Results Thirty?four NPC patients demonstrated SBBI in follow?up imaging. The diagnostic sen?sitivity, specificity, positive predictive value, negative predictive value, and accuracy of 18 F?NaF PET/CT were 97.1%(33/34), 89.7%(26/29), 91.7%(33/36), 96.3%(26/27) and 93.7%(59/63), respective?ly. For MRI, the parameters were 91.2%(31/34), 86.2%(25/29), 88.6%(31/35), 89.3%(25/28) and 88.9%(56/63), respectively. The diagnostic efficiency of the two imaging modalities had no significant difference (χ2=0.162-1.062, all P>0.05) . 18 F?NaF PET/CT detected 133 lesions and MRI detected 97 le? sions, and the clivus was the most common site of SBBI. Conclusions 18 F?NaF PET/CT and MRI have similar diagnostic efficiency in detecting SBBI. 18 F?NaF PET/CT can detect more lesions than MRI do, and has potential advantage for detecting tiny bone lesions in skull base.
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Here we report a case of 41-year-old man with a soft tissue density mass at right upper lung and palpable abscesses at right upper backside and right wrist. ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography demonstrated a 7.8 × 5.0 cm mass with soft-tissue density in the upper lobe of the right lung with high metabolic activity. The infiltrative mass extended to adjacent chest wall soft tissue. Final diagnosis of pulmonary actinomycosis with multiple abscesses was made. The patient responded well to antibiotics treatment.
Subject(s)
Adult , Humans , Male , Abscess , Actinomycosis/diagnosis , Anti-Bacterial Agents/therapeutic use , Diagnosis, Differential , Fluorodeoxyglucose F18/chemistry , Lung Diseases/diagnosis , Lung Neoplasms/pathology , Positron-Emission Tomography , Tomography, X-Ray ComputedABSTRACT
AIM: To establish a HPLC method for determining notoginsenoside R_1, ginsenoside Rg_1, Rb_1 and Rd in Suxiong Pill (Radix et Rhizoma Notoginseng, Flos Carthami, Rhizoma Chuanxiong). METHODS: A Kromasil C_ 18 column was used. The mobile phase was acetonitrile-water in linear gradient elution. The detection wavelength was 203 nm. RESULTS: The linear range was at 1.20-6.02 ?g(r= 0.999 6 ) for notoginsenoside R_1, 5.60-27.99 ?g(r= 0.999 9 ) for ginsenoside Rg_1, 2.84-14.20 ?g(r= 0.999 9 )for ginsenoside Rb_1, 0.51-2.55 ?g(r= 0.999 7 ) for ginsenoside Rd. The average recoveries (n=6) were 96.4% (RSD= 1.9% ) , 103.7% (RSD= 0.8% ), 106.6% (RSD= 1.3% ), 98.5% (RSD= 1.1% ), respectively. CONCLUSION: The method is simple, reliable, accurate and can be applied to the quality control of the preparation.