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Neuroblastoma is the most common extracranial solid tumor in children. The prognosis of different stages varies greatly, and its risk staging system is completely based on imaging. Radionuclide imaging plays an important role in the diagnosis and staging of various tumors, and it is also of great significance in the early diagnosis and staging of neuroblastoma. At present, imaging agents used for neuroblastoma mainly include catecholamine receptor, glucose metabolism, somatostatin receptor, etc. This article mainly discusses the application value and research progress of these imaging agents in the diagnosis of neuroblastoma.
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Objective:To compare and choose the best method for measuring metabolic tumor volume (MTV) of nasal extranodal natural killer/T-cell lymphoma (ENKTL), evaluate the prognostic value of 18F-FDG PET/CT metabolic parameters and clinical staging/scoring systems for patients with nasal ENKTL, and explore the added value of the two combinations for prognostic prediction. Methods:From January 2016 to September 2022, 44 patients (26 males, 18 females; age (47.5±13.6) years) pathologically diagnosed with nasal ENKTL who underwent 18F-FDG PET/CT imaging before treatment in Union Hospital, Tongji Medical College, Huazhong University of Science and Technology were retrospectively collected. SUV 2.5, SUV 4.0 and 41%SUV max were used as thresholds to measure MTV and total lesion glycolysis (TLG), and the consistency was analyzed by Bland-Altman analysis. The ROC curve analysis was used to compare the prognostic efficiency of different methods and determine the best method. The prognostic values of different clinical factors and clinical staging/scoring systems between groups were evaluated by corrected χ2 test. The independent factors were screened by Cox-regression model, and the combined diagnosis model was constructed by logistic regression. Results:Of 44 patients, 6(13.6%) were dead, with the overall survival (OS) of 32.05(11.77, 64.43) months, and the 2-year and 5-year OS rates of 86.6% and 82.5%, respectively. The mortality of different groups in age (≥60 and <60 years), prognostic index of natural killer cell lymphoma (PINK) score (low- and high-risk), and international prognostic index (IPI) score (low- and high-risk) were significantly different ( χ2 values: 5.02, 4.12, 3.88, all P<0.05). The consistency of MTV measured by different thresholds was good. Among them, the MTV measured by threshold of SUV 2.5 had the highest predictive efficiency with the AUC of 0.737. Multivariate analysis showed that MTV (hazard ratio ( HR)=10.488, 95% CI: 1.864-59.026, P=0.008) was the independent influencing factor of OS. By removing other factors, minimization model was obtained, including MTV and PINK score ( P values: 0.006, 0.048). The prediction model of MTV combined with PINK score improved prognostic efficacy with the AUCs of MTV, PINK score and the combination model of 0.781, 0.741 and 0.912, respectively. Conclusions:MTV measured by threshold of SUV 2.5 has better prognostic predictive value. MTV is the independent prognostic factor for OS in nasal ENKTL patients. MTV combined with PINK score has better prognostic value.
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Objective To establish a mice model of atopic dermatitis with acute itching and investigate the antipruritic effect and its mechanism of Xiaofeng Zhiyang granules（XFZYG）. Methods A mice model of atopic dermatitis was prepared by induction method. Mice were sensitized by calcipotriol and ovalbumin (OVA) applying to the right ear daily for 10 days, and then stimulated by OVA injected intradermally into the right cheek to resulting in acute itching. These mice were divided into 5 groups: blank control group, model group, low dose (7.2 g/kg) and high dose (14.4 g/kg) of XFZYG, and positive control group (montelukast 5 mg/kg). Drugs were administered by gavage at 12 h and 30 min before stimulation. The leukotriene levels in the serum of the mice were measured by Elisa and the basophil ratio and activation status in the blood were measured by flow cytometry. Results The mean number of scratches in the model group was 56 between 30 min and 60 min after stimulation, while the mean number of scratches in the low and high dose of XFZYG groups were 42 and 23 respectively, which were significantly lower than those in the model group （P<0.05）. The serum leukotriene levels and the proportion of basophils in the low and high dose of XFZYG groups were significantly lower than those in the model group (P<0.05). Conclusion XFZYG had certain therapeutic effect on acute itching of atopic dermatitis in mice, and the mechanism of its action was related to the reduction of leukotriene level and basophil ratio in serum of mice with atopic dermatitis .
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Fibroblast activation protein(FAP)can overexpress in activated fibroblasts.In recent years,radiolabeled FAP inhibitor(FAPI)had become important new positron imaging agents in nuclear medicine following 18F-FDG,and increasingly used for non-malignant diseases.The research progresses of FAPI PET imaging for diagnosis of non-malignant diseases were reviewed in this article.
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Objective:To investigate the diagnostic and prognostic value of 68Ga-fibroblast activation protein inhibitor (FAPI) PET for hepatobiliary malignancies. Methods:From July 2020 to February 2023, 33 patients (23 males, 10 females; age (55.4±13.5) years) with suspected or confirmed liver or biliary tract malignancies who underwent 68Ga-FAPI PET in Union Hospital, Tongji Medical College, Huazhong University of Science and Technology were retrospectively analyzed. PET images were evaluated by 3 experienced nuclear medicine physicians, and the results of biopsy or postoperative pathology, clinical and imaging follow-up were used as the gold standard. One-way analysis of variance and least significant difference t test were used to compare the differences among groups. Survival analysis was performed using Kaplan-Meier curves and the log-rank test. Results:Of 33 patients, 14 performed PET for initial diagnosis and staging, and 19 for restaging. There were 14 patients with hepatocellular carcinoma (HCC), 13 patients with cholangiocarcinoma (CCA), and 6 patients with gallbladder carcinoma (GBC). The primary tumor of HCC, CCA and GBC all showed significant 68Ga-FAPI uptake, with no statistically significant difference in SUV max among groups ( F=1.58, P=0.250). The sensitivities of 68Ga-FAPI PET for initial diagnosis and restaging of hepatobiliary malignancies were 14/14 and 15/15, respectively. Compared with conventional imaging, 68Ga-FAPI PET changed the diagnosis and staging in 29.2%(7/24) patients. The treatment strategy was changed in 30.3%(10/33) patients with malignant tumors due to 68Ga-FAPI PET findings. Follow-up showed 22 cases survived and 11 cases died, with the overall survival of 355.56(80.00, 516.97) d, and 1- and 2-year survival rates were 68.2% and 57.9%, respectively. Semi-quantitative 68Ga-FAPI PET parameters such as SUV max, target-liver ratio (TLR), and target-blood ratio (TBR) had no significant prognostic value, but the prognosis of the group without distant metastases diagnosed by 68Ga-FAPI PET was significantly better than that of the group with distant metastasis ( P=0.032). Conclusion:68Ga-FAPI PET has high sensitivity for the diagnosis of hepatobiliary malignancies, which can help guide treatment decisions and prognosis evaluation.
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Massive open online course (MOOC), as an online teaching mode, has attracted widespread attention in the education field. It realizes the integration of online teaching and learning in medical education and brings profound changes in concepts and methods of medical education. It has proposed a new development direction for modern medical education. The first Nuclear Medicine online MOOC resource is not only a supplement to direct face-to-face courses in a special period, but also a strong support for the realization of online and offline hybrid teaching, thereby promoting the " student-centered" undergraduates′ autonomous learning ability. The students can achieve the goal of the development of learning ability. Based on the results of applying the Nuclear Medicine MOOC to the teaching of undergraduates in multiple schools, this article further explains the obvious advantages of MOOC as an online teaching resource library for students′ knowledge internalization. The foundation of the new teaching method ensures the effective implementation of the above teaching methods and provides ideas for further deepening the reform of undergraduate medical education.
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Objective:To explore the diagnostic value of 68Ga-fibroblast activation protein inhibitor (FAPI) PET for the restaging of patients with colorectal cancer and its impact on treatment strategy. Methods:Patients with colorectal cancer who underwent 68Ga-FAPI PET imaging in the PET Center of Union Hospital, Tongji Medical College, Huazhong University of Science and Technology from June 2020 to June 2021 were retrospectively analyzed. PET images were evaluated by 3 experienced imaging physicians. Biopsy or postoperative pathology, clinical and imaging follow-up results were as the gold standard. The diagnostic value of PET was compared with conventional imaging (CT/MR), and the impact of 68Ga-FAPI PET on guiding treatment was evaluated. χ2 test and Fisher exact test were used to compare the differences between groups. Results:A total of 33 patients were included (17 males, 16 females, age (52.8±12.3) years), of which 24 were finally diagnosed as recurrence/metastases/progression. The accuracy, sensitivity, specificity, positive predictive value and negative predictive value of 68Ga-FAPI PET in detecting recurrence/metastases/progression of colorectal cancer were 93.9%(31/33), 100%(24/24), 7/9, 92.3%(24/26) and 7/7, respectively. Its accuracy, sensitivity and negative predictive value were significantly higher than those of conventional imaging (64.5%(20/31), 56.5%(13/23) and 7/17; χ2 values: 8.549 and 10.786, all P<0.05). Compared with the clinical or pathological stage before examination, 68Ga-FAPI PET led upstaging to stage Ⅳ in 12 patients (50.0%, 12/24). Of the 31 patients who were correctly diagnosed by 68Ga-FAPI PET, the treatment regimen of 22 patients (71.0%) was changed because of 68Ga-FAPI PET imaging. Conclusion:68Ga-FAPI PET has good diagnostic performance in the restaging of colorectal cancer, which is helpful to further guide clinical treatment strategy.
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At the end of December 2019, acute respiratory infectious diseases caused by a new type of coronavirus were prevalent in Wuhan and other cities of China. Different from radiology examinations, the protocols of nuclear medical imaging examinations are complicated, in which more workplaces and staff are needed, resulting more complex management of patients and higher protection requirements. Combined with the characteristics of SPECT and PET imaging procedures, this paper puts forward some suggestions on the protective process of imaging examinations for patients with confirmed or suspected noval coronavirus infec- tion. The main purpose is to protect medical staff from virus infection, effectively reduce the risk of virus transmission during the examination process, and ensure the medical quality and safety.
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At the end of December 2019,acute respiratory infectious diseases caused by a new type of coronavirus were prevalent in Wuhan and other cities of China.Different from radiology examinations,the protocols of nuclear medical imaging examinations are complicated,in which more workplaces and staff are needed,resulting more complex management of patients and higher protection requirements.Combined with the characteristics of SPECT and PET imaging procedures,this paper puts forward some suggestions on the protective process of imaging examinations for patients with confirmed or suspected novel coronavirus infection.The main purpose is to protect medical staff from virus infection,effectively reduce the risk of virus transmission during the examination process,and ensure the medical quality and safety.
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At the end of December 2019, acute respiratory infectious diseases caused by a new type of coronavirus were prevalent in Wuhan and other cities of China. Different from radiology examinations, the protocols of nuclear medical imaging examinations are complicated, in which more workplaces and staff are needed, resulting more complex management of patients and higher protection requirements. Combined with the characteristics of SPECT and PET imaging procedures, this paper puts forward some suggestions on the protective process of imaging examinations for patients with confirmed or suspected novel coronavirus infection. The main purpose is to protect medical staff from virus infection, effectively reduce the risk of virus transmission during the examination process, and ensure the medical quality and safety.
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Objective To establish a high-throughput in-vitro screening cell model for anti-atherosclerosis leading compounds.Methods Hypoxia response element (HRE) was cloned into a luciferase reporter vector, pGL3-Enhancer, to construct pGL3-HIF-1α-HRE.The THP-1human monocyte cell line was infected with the pGL3-HIF-1α-HRE and a stable cell line, THP-1-HIF-1α-HRE, was screened.Results Real-time PCR assay showed that HIF-1αexpression and luciferase activity in THP-1-HIF-1α-HRE cells was effectively upregulated by hypoxia.The increase of HIF-1αexpression and luciferase activity induced by hypoxia was significantly inhibited by lovastatin or curcumin.Conclusion THP1-HIF-1α-HRE, an in-vitro cell model for high-throughput screening lead compounds for anti-atherosclerosis (AS) was successfully established.
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Objective To study the extraction technology and optimize the extraction process of Fuyuan Xingnao gran-ule.Methods The preliminary extraction process was designed by routine extraction method combined with the results of pharmacological activity experiment.The extraction process was optimized with orthogonal test.Results The extract was ob-tained by ethanol reflux extraction,water decoction extraction or ethanol precipitation followed by filtration and concentration. The optimal process for ethanol reflux extraction was extracting twice with 50% ethanol.The ratio of liquor to dry material was 8∶1 for the first time and 6∶1 for the second time.The extraction time was 120 minutes for the first time and 80 minutes for the second time.The optimal process for water decoction extraction was extracting twice with 120 minutes and 80 minutes each time.The ratio of liquor to dry material was 10∶1 for the first time and 8∶1 for the second time.The extraction temper-ature was100 ℃.The best ethanol precipitation process was 16 hour extraction with 80% ethanol.The ratio of ethanol to dry material was 2∶1.Conclusion The quality of Fuyuan Xingnao granule extract with this optimized extraction process was in line with requirements of Pharmacopoeiaof the People's Republic of China 2015,4 Volumes(0104 granule).
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Objective To evaluate the diagnostic value of quantitative rest and stress 13N-NH3 PET myocardial perfusion imaging (MPI) on coronary microvascular disease (CMVD),and provide basis for accurate classification.Methods From July 2016 to September 2017,a total of 23 patients (16 males,7 females;27-70 years) who were suspected of CMVD were prospectively enrolled in this study.Rest and ATPstress MPI were acquired using 13N-NH3 PET and analyzed using Heartsee software.Rest and stress relative uptake,absolute myocardial blood flow (MBF) and coronary flow reserve (CFR) were obtained and present on sectional images and cup maps.Based on the information,CMVD was diagnosed or excluded.Combined with myocardial enzymes,echocardiography,cardiac MRI,coronary angiography,CT angiography (CTA),CMVD was further divided into CMVD without (type 1) or with obstructive coronary disease (type 2),and other CMVD (type 3).Two-sample t test and one-way analysis of variance were used to analyze the data.Results In 23 patients,17 cases were diagnosed as CMVD (including 10 cases with type 1,3 cases with type 2 and 4 cases with type 3),and 6 cases were excluded.There were no significant differences in the age,gender and risk factors between CMVD group and exclusion group (all P＞0.05).The relative uptake results,including average uptake of whole left ventricle in rest and stress states,rest minimum quadrant,and area of stress uptake less than 60％ of maximum were significantly different between the two groups (t values:from -3.249 to 2.469,all P＜0.05).All the absolute blood flow parameters,including rest and stress whole MBF and CFR,rest and stress minimum quadrant MBF and CFR,were significantly different between CMVD group and exclusion group (t values:from-8.278 to-3.258,all P＜0.05).There was no statistically significant difference for relative uptake data among three types of CMVD (F values:from 0.002 to 1.440,all P＞0.05).For absolute quantitative values of whole MBF and minimum quadrant MBF in both rest and stress states,difference was statistically significant among groups (F values:from 3.885 to 8.452,all P＜0.05).Conclusion Quantitative PET MPI could provide a noninvasive,safe and accurate method for the diagnosis and classification of CMVD.
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Objective To evaluate the efficacy of Scrophularia ningpoensis granules combined with fosinopril in treatment of congestive heart failure.Methods 60 congestive heart failure patients were randomly divided into 2 groups, 30 patients in the treatment group and 30 patients in the control group.Besides the conventional therapy, the control group was treated with fosinopril and the treatment group received Scrophularia ningpoensis granules plus fosinopril for 90 days.Left ventricular end diastolic diameter (LVEDD), left ventricular end systolic diameter (LVESD), left ventricular ejection fraction (LVEF) and serum B-type brain natriuretic peptide (BNP) were measured before and after treatment.Results The total effective rate in the treatment group and the control group were 90%, but significantly effective number in the treatment group was higher than the control group.The levels of BNP, LVEDD and LVESD in both groups were decreased, while LVEF was increased after the treatment.The difference was statistically significant (P<0.01).The degree of improvement of heart function in the treatment group was better than that in the control group (P<0.05).Conclusion The combination therapy of Scrophularia ningpoensis granules and fosinopril is efficacious in treating CHF.
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Objective To prepare a kind of 99Tcm-labeled estrogen receptor (ER) SPECT imaging agent,and evaluate its binding characteristics with ER by in vitro and in vivo studies.Methods EDL was prepared from estrone and then reacted with GAP to synthesize GAP-EDL.Then,GAP-EDL was labeled with 99Tcm to obtain 99Tcm-GAP-EDL.Cell uptake and blocking assays were performed in vitro on MCF-7and MDA-MB-231 cells.The biodistribution study of 99Tcm-GAP-EDL was performed on normal BALB/c mice at 30,60,120,180 and 240 min post injection.Nude mice bearing either MCF-7 or MDA-MB-231derived tumors were injected with 99Tcm-GAP-EDL,and subjected to γimaging at 1,2,4 h post injection.The mice injected with excess unlabeled GAP-EDL or estradiol were used as the blocking control.Two-sample t test was used for data analysis.Results The radiolabeling yield of 99Tcm-GAP-EDL was (98.8 ±0.5) ％ and the radiochemical purity after 24 h was over 90％.The cell uptake rate of MCF-7 cells at 240min was (4.84± 0.21) ％,which was significantly higher than that of MDA-MB-231 cells ((2.11±0.21) ％;t =15.96,P＜0.05).99 Tcm-GAP-EDL uptake rate of MCF-7 cells in blocking groups ((2.31 ± 0.28) ％ and (2.05±0.35) ％) decreased significantly compared to that of non-blocking group(t=11.52,11.16,both P＜0.05).Biodistribution studies showed that 99Tcm-GAP-EDL was mainly metabolized by the liver and kidneys,and exhibited quick blood clearance.Gamma imaging showed high uptake in MCF-7 tumors 1 h post injection and the uptake reached the highest at 4 h,while there was little 99Tcm-GAP-EDL uptake in MDA-MB231 tumors and blocked MCF-7 tumors.Conclusions 99Tcm-GAP-EDL may be prepared under mild conditions with high labeling purity and stability.The in vitro and in vivo characteristics of 99Tcm-GAP-EDL suggest that it may be a promising probe for ER positive tumor imaging.
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In this study, a novel technique for the preparation of (125)I-5-trimethylstannyl-1-(2-deoxy-2-fluoro-beta-D-arabinofuranosyl) urail (FIAU) was developed, (125)I-FIAU biodistribution profile was detected in Kunming mice and the possibility of using FTAU radio-labeling for reporter gene imaging was explored. 5-trimethylstannyl-1-(2-deoxy-2-fluoro-beta-D-arabinofuranosyl) urail (FTAU) was labeled with radioiodine ((125)I). A rotary evaporation method was used to remove excess methanol. The reactant was purified through a Sep-Pak C18 reversal phase column. The radiochemical purity and in vivo stability were determined using silica gel thin layer chromatography (TLC). The biodistribution of (125)I-FIAU in Kunming mice was also detected. The results showed that (125)I-FIAU could be radiolabeled effectively with FTAU, with mean labeling rate being (81±0.38)% (n =5). The mean radiochemical purity of (98.01±0.40)% (n=5) was achieved after a reversal phase Sep-park column purification. (125)I-FIAU was stable when incubated in normal human serum or in saline at 37°C, with a radiochemical purity >96% during a 0.5-24 h time period. Biological experiments exhibited rapid clearance of (125)I-FIAU from the blood pool. (125)I-FIAU was mostly excreted by kidneys. (125)I-FIAU in myocardium dropped conspicuously after 8 h and there was hardly retention at 24 h. We were led to concluded that the new method of radioiodinization of FTAU for the preparation of (125)I-FIAU is easy, highly effective and stable in vivo. The biodistribution of (125)I-FIAU in Kunming mice showed it can serve as an imaging probe for myocardial reporter genes.