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BACKGROUND:The clinical manifestation of acute radiation skin injury is recurrent necrotic ulcers,and its pathogenesis is still not fully understood.The establishment of a suitable animal model will have important clinical implications for the study of its pathogenesis,prevention and treatment. OBJECTIVE:To establish a model of acute β-ray radiation skin injury and to investigate the mechanism of injury. METHODS:Sixty-nine Sprague-Dawley rats were randomly divided into 30,45,60 Gy 32P-β-ray groups(n=21 per group)and control group(n=6).A single local irradiation of the back of the rats was performed using 32P radionuclide.The control group was operated in the same way as the irradiated groups except that it was not irradiated.The body mass and skin appearance of the rats were measured at 7,15,30,45,and 60 days after irradiation.Three rats from each group were selected at each observation time point.The skin injury was observed by hematoxylin-eosin staining,Masson staining,transmission electron microscopy,and TUNEL assay.P53,Bcl-2 and Bax protein levels in the skin were measured by immunohistochemistry and western blot assay. RESULTS AND CONCLUSION:There was no accidental death after irradiation,and the body mass of rats showed a gradual increase.The rats showed different degrees of epidermal necrosis,inflammatory cell infiltration,reduction of hair follicles and appendages,and collagen fibrillation,which were evident at 60 and 45 Gy.The levels of serum inflammatory factors,interleukin-6 and tumor necrosis factor-α,were significantly increased in a dose-dependent manner.Under the electron microscope,there are varying degrees of mitochondrial reduction,vacuolization and nuclear pyknosis in the cells.The degree of cell apoptosis showed a certain dose-dependence.Immunohistochemistry and western blot results showed an increase in the expression of P53 and Bax proteins and a decrease in the expression of Bcl-2 protein in the skin after irradiation.There were significant differences between the 60 Gy group and the 45 Gy and 30 Gy groups(P＜0.05).To conclude,irradiation with 60 Gy and 45 Gy 32P radionuclide on the back of rats could successfully establish a practically pre-clinical animal model,and the mechanism is related to the up-regulation of P53 and Bax and the down-regulation of Bcl-2.This model can provide a reference for the establishment of animal models for the study of the mechanism of radiation skin injury and its prevention and treatment.
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OBJECTIVE:Percutaneous sacroiliac screw internal fixation has become the main surgical procedure for the treatment of posterior pelvic ring fractures;however,the unassisted closure operation requires high operator experience and repeated fluoroscopy increases the radiation hazard for patients and medical personnel.This article compares the clinical efficacy of robot-assisted versus unassisted percutaneous sacroiliac screw placement for posterior pelvic ring fractures by meta-analysis. METHODS:Computer searches of CNKI,WanFang,VIP,CBM,PubMed,Embase,Cochrane Library and ClinicalTrials.gov were conducted from the time of database inception to December 2022.The literature on the clinical efficacy of robot-assisted versus freehand percutaneous sacroiliac screw placement in the treatment of posterior pelvic ring fractures was collected in and outside China.The data were independently screened and extracted by two investigators according to the inclusion and exclusion criteria,respectively.The quality of randomized controlled trials was evaluated using Cochrane risk assessment criteria.The quality of included cohort studies was assessed using the Newcastle-Ottawa Scale.Meta-analysis was performed using RevMan 5.4 software for inclusion metrics.Outcome metrics included operative time,intraoperative bleeding,fluoroscopy time,fluoroscopy frequency,number of holes drilled,Majeed postoperative function score,the excellent and good rates of Matta fracture reduction,the excellent and good rates of Gras screw position,fracture healing time and complications. RESULTS:(1)A total of 13 publications were included,2 were randomized controlled trials both referring to randomized methods,11 non-randomized controlled studies were evaluated for quality of literature according to the Newcastle-Ottawa Scale,1 scored 8,9 scored 7;and 1 scored 6;the quality of literature was good.A total of 748 patients were included,including 430 in the robot-assisted group and 318 in the freehand group.(2)The results of the meta-analysis showed that the operative time(MD=-28.30,95%CI:-40.20 to-16.40),intraoperative bleeding(MD=-6.36,95%CI:-10.06 to-2.66),intraoperative fluoroscopy time(MD=-12.13,95%CI:-19.54 to-4.72),intraoperative fluoroscopy frequency(MD=-17.39,95%CI:-29.00 to-5.78),number of intraoperative needle drillings(SMD=-9.50,95%CI:-14.27 to-4.73)and the excellent and good rates of Gras screw position(OR=8.65,95%Cl:3.26-22.92)in the robot-assisted group were significantly better than those in the freehand group(P<0.05).(3)In the robot-assisted group,the overall postoperative complication rate was significantly reduced(OR=0.10,95%Cl:0.02-0.48,P<0.05).(4)No significant difference was detected in fracture healing time(MD=-0.08,95%CI:-0.21,0.06),the excellent and good rates of Matta fracture repositioning rate(OR=2.06,95%Cl:0.97-4.39),and Majeed functional score(MD=0.91,95%CI:-0.31-2.13)between both groups(P>0.05). CONCLUSION:Compared with freehand sacroiliac joint nailing,robotic assistance shortens the operative time,reduces intraoperative bleeding,decreases radiation damage to patients and medical staff,improves the excellent and good rate of screw position,and reduces the overall incidence of postoperative complications in patients,but there was no significant improvement in fracture reduction quality,fracture healing time,and postoperative function.In the future,more large-sample,multicenter,and high-quality randomized controlled trials are still needed to verify.
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Objective:To explore the clinical efficacy of 125I seeds implantation combined with transcatheter arterial chemoembolization (TACE) in the treatment of primary liver cancer. Methods:A retrospective analysis of data from 40 patients with primary liver cancer at the Northern Theater General Hospital from January 2018 to December 2020 (26 males, 14 females, age 41 to 82 years) was performed. Among them, 21 patients were in treatment group and underwent 125I seeds implantation combined with TACE treatment, while 19 patients were in control group and received TACE treatment. Alpha-fetoprotein (AFP) levels between the two groups were compared, effective rate and disease control rate (DCR) of the two groups were analyzed, and overall survival (OS) and progression-free survival (PFS) were observed. Data were analyzed by using Mann-Whitney U test, χ2 test, Kaplan-Meier method and log-rank test. Results:Two months after 125I seeds implantation, the effective rates of treatment group and control group were 76.19%(16/21) and 8/19, respectively ( χ2=4.83, P=0.028); the DCRs were 90.48%(19/21) and 11/19, respectively ( χ2=4.21, P=0.040). AFP levels in both groups decreased significantly, with treatment group showing a greater decrease rate (0.87(0.84, 0.90) and 0.66(0.65, 0.67); z=5.42, P<0.001). No serious adverse reaction was observed in either group. The median OS of treatment group and control group were 18.2 and 10.6 months, respectively ( χ2=10.98, P=0.037); the median PFS of the two groups were 8.4 and 6.1 months, respectively ( χ2=7.54, P=0.041). Conclusion:125I seeds implantation combined with TACE treatment can exert a synergistic and enhancing effect in the treatment of primary liver cancer.
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Objective:To evaluate the clinical value of CT-guided 125I seeds implantation combining with 89SrCl 2 to relieve pain after failure of external irradiation in patients with bone metastases from prostate cancer. Methods:Clinical data of 48 patients (age 56-85 years) with bone metastases from prostate cancer admitted to General Hospital of the Northern Theater Command from January 2019 to June 2021 were retrospectively analyzed. Patients were treated with 125I seeds implantation combining with 89SrCl 2 (group A) and 89SrCl 2 alone (group B), respectively. Independent-sample t test and repeated measures analysis of variance were used to evaluate the differences of pain level (most severe pain, least pain, mean pain and current pain) scores and bone pain interference scores between 2 groups before and after treatment (before treatment, 3 d, 4 weeks, 8 weeks and 12 weeks after treatment). Prostate specific antigen (PSA), free PSA (fPSA) and alkaline phosphatase (ALP) 12 weeks after treatment of 2 groups were also compared by using independent-sample t test. Results:In group A, a total of 722 seeds were implanted in 39 bone metastases in 23 patients, and the implantation successful rate was 97.44%(38/39). There were 25 patients in group B. In group A, the most severe pain, mean pain and current pain scores decreased with time ( F values: 3.71-22.47, all P<0.05). Except for the scores at 3 d posttreatment, most severe pain, mean pain, and current pain scores at different times showed significant differences with those before treatment (all P<0.05). There were also differences in the most severe pain, mean pain, and current pain scores in group B before and after treatment ( F values: 2.45-2.52, P values: 0.044-0.049), with scores decreasing first (till 8 weeks after treatment) and increasing later. The most severe pain, mean pain, and current pain scores 8 week after treatment were lower than those before treatment (all P<0.05), but all the four scores at 12 weeks were not significantly different from those before treatment ( P values: 0.057-0.693). At 12 weeks after treatment, the differences in the most severe pain, mean pain and current pain scores between 2 groups were statistically significant ( t values: 2.04-3.41, P values: 0.001-0.047). Bone pain interference scores 12 weeks after treatment in group A were higher than those in group B ( t values: 2.04-3.16, P values: 0.022-0.047), and PSA, fPSA and ALP 12 weeks after treatment in group A were significantly lower than those in group B ( t values: 4.38-6.82, P values: 0.012-0.042). Conclusion:CT-guided 125I seeds implantation combined with 89SrCl 2 is feasible and effective for the treatment of bone pain after failed external irradiation in patients with prostate cancer bone metastases, especially for the combination of fulminant pain.
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Objective:To evaluate the diagnostic value of 11C-choline PET/CT brain imaging for localization of epileptogenic foci in hippocampal sclerosis-refractory temporal lobe epilepsy (HS-RTLE), and compare it with 18F-FDG and 11C-flumazeni (FMZ) PET/CT. Methods:From March 2017 and June 2020, a total of 62 patients (39 males, 23 females, age (30.3±11.2) years) with pathologically confirmed HS-RTLE in General Hospital of Northern Theater Command were retrospectively analyzed. All patients were preoperatively treated with multiple radionuclide ( 18F-FDG, 11C-FMZ, 11C-choline) PET/CT brain imaging. 11C-choline PET imaging was used to acquire dynamic imaging data and time-activity curve (TAC) of 11C-choline in bilateral hippocampal regions were drawn. With postoperative pathology as the " gold standard" , the positive detection rates and localization diagnostic efficacies of three radionuclide imaging agents for epileptogenic foci were analyzed. Then a prospective study including 46 patients (27 males, 19 females; age (32.9±11.9) years; between May 2019 and August 2020; General Hospital of Northern Theater Command) with drug-refractory epilepsy caused by clinically suspected hippocampal sclerosis was performed. The examination method was the same as that of retrospective study. Using intracranial electrode implantation or postoperative pathology as " gold standard" , the diagnostic efficacy of 11C-choline TAC for localization of epileptogenic foci was verified, and ROC curve was drawn to evaluate the diagnostic value of three imaging agents for HS-RTLE epileptogenic foci. χ 2 test and Fisher exact probability method, Delong test were used to analyze the data. Results:In the retrospective study, the positive detection rate of 18F-FDG PET/CT was higher than that of 11C-choline PET/CT (100%(62/62) vs 85.48%(53/62); P=0.003), and the localization accuracies of 11C-choline and 11C-FMZ PET/CT were both higher than that of 18F-FDG PET/CT (100%(53/53), 96.61%(57/59) vs 33.87%(21/62); both P<0.001). In the prospective study, 25 of 46 patients were diagnosed as HS-RTLE and 21 were non-HS induced epilepsy. The specificities of 11C-choline, 11C-FMZ and 18F-FDG PET/CT were 100%(21/21), 90.48%(19/21), 33.33%(7/21), respectively. The AUCs of 11C-choline and 11C-FMZ PET/CT were significantly higher than that of 18F-FDG PET/CT (0.920, 0.912, 0.627; z values: 4.93, 5.16, both P<0.01). Conclusions:11C-choline PET/CT can be used in the preoperative localization of epileptic foci. Compared with 18F-FDG and 11C-FMZ PET/CT, the specificity of 11C-choline PET/CT is higher, and the negative imaging of 11C-choline is more significant for exclusion.
摘要
Objective To optimize the synthesis method of 18F-T807 and study preliminary biodistribution. Methods 18F-T807 was synthesized using an optimized method in TRACERlab FXFN synthesizer with a t-BOC（t-Butyloxy carbonyl）-protected 18F-T807 precursor NPPI-9 as starting material, improving experimental conditions for synthesis, then QC and biodistribution study in Wistar rats conducted. Results The improved synthesis conditions increased the synthesis yield from 20.5%±6.1% to 25.7%±5.8%. QC met the standard. Wistar rats had higher intake in kidney, liver, blood and lowest intake in brain, heart, lung. Conclusion The optimized synthesis method to synthesize 18F-T807 is simple and easy, and high yield, which can meet the needs of scientific research and clinical practice.
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Objective:To evaluate the efficacy and safety of 125I seeds implantation for lymph nodes metastasis (LNM) from radioactive iodine-refractory differentiated thyroid carcinoma (RAIR-DTC), and to verify the computer three-dimensional treatment planning system (TPS) from the dosimetry accuracy in assisting seeds implantation to treat LNM. Methods:Retrospective analysis was performed on 17 RAIR-DTC patients with LNM admitted to the General Hospital of Northern Theater Command from December 2016 to January 2019 (8 males, 9 females, median age 58 years). All patients underwent preoperative TPS planning design, CT-guided puncture and 125I seeds implantation (seed activity 14.8-25.9 MBq). The dosimetric results of postoperative validation were compared with those of preoperative planning, including the dosimetric parameters such as target volume before and after surgery and the dose received by 90% and 100% gross tumor volume (GTV) ( D90, D100), the percentage received by 100% and 150% of the prescription dose ( V100, V150), homogeneity index (HI). All patients underwent CT after 6 months to compare the LNM size, serum thyroglobulin (Tg) level, and the improvement of complications before and after treatment. Efficacies were divided into complete remission (CR), partial remission (PR), stable disease (SD), and progressive disease (PD). Paired t test or Wilcoxon signed rank test were used to analyze the data. Results:Among 17 patients, a total of 226 125I radioactive seeds were implanted. Among them, 1 achieved CR, 10 achieved PR, 4 were with SD, and 2 were with PD. The diameter of LNM was 1.40(0.65, 3.05) cm before treatment and was 0.40(0.21, 0.91) cm 6 months after treatment ( z=-3.95, P<0.05). The Tg before treatment was 23.50(20.94, 72.92) μg/L and was 8.90(3.20, 40.22) μg/L 6 months after treatment ( z=-5.009, P<0.001). Tg antibody were all negative. There were 90.90% (20/22) of patients had slightly lower D90 than the prescribed dose ((12 378.8±3 182.0) vs (12 497.8±1 686.4) cGy; t=0.251, P>0.05). The postoperative dose parameters D100 and V150 ((6 881.5±1 381.8) cGy, (58.5±18.4)%) were both lower than those of preoperative plan ((8 085.8±2 330.0) cGy, (66.5±17.7)%; t values: 8.913, 3.032, both P<0.05), and the remaining indicators were not significantly different from those of the preoperative plan ( t values: 0.251, 1.493, z values: from -1.604 to -0.593, all P>0.05). Conclusions:According to the TPS preoperative plan, 125I seeds implantation for treating RAIR-DTC LNM can achieve the expected dose distribution, and the short-term tumor local control is effective. It is a safe and effective treatment method.
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Objective To analyze the metabolic differences of 11C-flumazenil (11C-FMZ) with different specific radioactivity by detecting the percentage proportion of the main metabolites in vivo. Methods 5 male and 5 female volunteers with average age of (41.7±4.7) years and weight of (69.3±6.8) kg were selected from May to October 2019. 11C-FMZ with high and low specific radioactivity (268.3±57.2)×103 and (57.8±11.4)×103 Ci/mol was injected successively. The percentage of injected dose/liter of 11C-FMZ and its metabolites in the plasma at 1, 2, 3, 4, 5, 10, 15, 20, 30, 40 and 60 min after the injection was measured. Paired sample mean t test was used to calculate and compare the percentage of metabolites in the two groups. Results The percentage proportion of metabolites increased gradually with time, and reached the stable level after 15 min. The percentage proportion of low specific radioactivity group was higher than that of high specific radioactivity group with a significant statistical difference between 15 min and 60 min (P<0.05). Conclusion The metabolic rate of 11C-FMZ with different specific radioactivity was significantly different after injection and the specific radioactivity difference should be avoided if possible in clinical application.
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Objective To study the diagnostic values of pulmonary ventilation-perfusion (V/Q)planar imaging,pulmonary ventilation/perfusion SPECT/CT (V/Q SPECT/CT) imaging and CT pulmonary angiography (CTPA) for pulmonary embolism (PE).Methods From October 2016 to June 2018,54 patients (27 males,27 females,age:(62.0± 12.8) years) with suspected PE underwent V/Q planar imaging,V/Q SPECT/CT imaging and CTPA in the General Hospital of Northern Theater Command.The results of the above imaging methods were classified as definite PE,no PE and uncertain diagnosis according to the refined modified prospective investigation of pulmonary embolism diagnosis (PIOPED Ⅱ) criteria,European Association of Nuclear Medicine (EANM) diagnosis criteria (2009) and the direct and indirect signs of PE,respectively.Based on the final clinical diagnosis,receiver operating characteristic (ROC)curves were drawn and the area under curves (AUCs) were compared to assess the diagnostic efficacies for PE.Kruskal-Wallis test and Wilcoxon rank sum test were used to analyze the difference of pulmonary segment and subsegment number detected by the above methods.Results Among 54 patients,26 were definitely diagnosed as PE,and 28 were excluded.Patient numbers of uncertain diagnosis in V/Q planar imaging,V/Q SPECT/CT imaging and CTPA were 5,1 and 4,respectively.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of the above imaging methods were 66.67％ (16/24),88.00％(22/25),77.55％(38/49),16/19,73.33％(22/30);92.31％(24/26),92.59％ (25/27),92.45％(49/53),92.31％ (24/26),92.59％ (25/27);69.57％ (16/23),96.30％ (26/27),84.00％(42/50),16/17,78.79％(26/33),respectively.The AUCs were 0.757,0.926,and 0.809,respectively,there was a significant difference between the AUC of V/Q planar imaging and V/Q SPECT/CT (z =2.641,P＜0.05).There was no significant difference of cumulative number of pulmonary segments detected by the three methods (H=1.637,P＞0.05).Numbers of subsegments detected by V/Q planar imaging,V/Q SPECT/CT imaging and CTPA were 2.00(0.00,5.25),4.00(2.75,7.00) and 0.50(0.00,3.25),respectively,and V/Q SPECT/CT detected more than others (z values:-3.700,-3.570,both P＜0.05).Conclusion Pulmonary V/Q SPECT/CT imaging has a higher diagnostic efficacy in PE,especially in subsegmental PE.
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To evaluate the long term cardiopulmonary function after Fontan operation. Methods 10 patients who received Fontan operation were followed for(26 ±4) years in our hospital. 7 males and 3 females,(30. 7 ± 13. 2) years old(20 -60 years). All patients were diagnosed by echocardiography, CTA, 24 h ECG, cardiac catheterization, pulmonary angiography, radionuclide pulmonary blood perfusion and cardiopulmonary exercise test. Results Echocardiography shows: LVEF(0. 49 ± 0. 04), more than moderate atrioventricular valve regurgitation in 7 cases. CTA shows: there was no anastomotic stenosis, arteriovenous fistula in 4 cases. 24 h ECG shows: sinus rhythm in 7 cases, frequent paroxysmal atrial tachycardia in 1 case, atrial flutter in one and atrial fibrillation in one. Cardiac catheterization and pulmonary angiography show: the average pulmonary artery pressure(17. 8 ±2. 0)mmHg, average pulmonary resistance(4. 17 ±0. 56) woods. Radionuclide pulmonary blood perfusion shows: pulmonary blood of upper lung was reduced significantly with unbalanced distribution. Cardiopulmonary exercise test shows: both of lung ventilation function and heart reserve function decreased moderately or severely. Protein losing enteropathy was found in 1 case. Conclusion The decrease of cardiopulmonary function is found after Fontan operation during the long-term follow up for 20 years, especially for cardiac function. More attention should be paid to the early postoperative atrioventricular valve regurgitation. Unbalanced distribution of pulmonary blood is Found in long term. The incidence of arrhythmia after extra conduit Fontan operation is lower than other methods.
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Objective To compare the lateralization accuracy and localization accuracy of MRI, interictal 18 F-fluorodeoxyglucose(FDG)and 11 C-flumazenil(FMZ)PET/CT imaging for refractory epilepsy (REP)in patients with hippocampal sclerosis(HS).Methods A total of 41 classical HS patients (25 males,16 females;age:15-61 years)with REP from General Hospital of Northern Theater Command of PLA between January 2017 and October 2018 were retrospectively analyzed.All patients underwent MRI, interictal 18 F-FDG and 11 C-FMZ PET/CT imaging,followed by the resection of epileptogenic foci.The path-ological diagnosis was taken as the gold standard.Visual and semi-quantitative analyses were used to analyze the images.The lateralization accuracy and localization accuracy of the three imaging methods for epilepto-genic foci were calculated and compared(χ2 test).Results The lateral accuracy and localization accuracy of MRI were 70.73％(29 /41)and 60.98％(25 /41),those of interictal 18 F-FDG PET/CT imaging were 78.05％(32 /41)and 70.73％(29 /41),and those of interictal 11 C-FMZ PET/CT imaging were 100％(41 /41)and 100％(41 /41),respectively.The interictal 11 C-FMZ PET/CT imaging was the best among 3 ima-ging methods(χ2 values:1.976-12.902,all P<0.01).Conclusions All 3 imaging methods have their ad-vantages and limitations.The interictal 11 C-FMZ PET/CT imaging has a high value in the localization of classical HSREP,which can significantly improve the diagnostic accuracy of classical HSREP and guide clinical operation.
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A multi-label based level set model for multiple sclerosis lesion segmentation is proposed based on the shape, position and other information of lesions from magnetic resonance image. First, fuzzy c-means model is applied to extract the initial lesion region. Second, an intensity prior information term and a label fusion term are constructed using intensity information of the initial lesion region, the above two terms are integrated into a region-based level set model. The final lesion segmentation is achieved by evolving the level set contour. The experimental results show that the proposed method can accurately and robustly extract brain lesions from magnetic resonance images. The proposed method helps to reduce the work of radiologists significantly, which is useful in clinical application.
Subject(s)
Humans , Algorithms , Magnetic Resonance Imaging , Multiple Sclerosis , Diagnostic Imaging摘要
Objective@#To compare the lateralization accuracy and localization accuracy of MRI, interictal 18F-fluorodeoxyglucose(FDG) and 11C-flumazenil(FMZ) PET/CT imaging for refractory epilepsy(REP) in patients with hippocampal sclerosis(HS).@*Methods@#A total of 41 classical HS patients (25 males, 16 females; age: 15-61 years) with REP from General Hospital of Northern Theater Command of PLA between January 2017 and October 2018 were retrospectively analyzed. All patients underwent MRI, interictal 18F-FDG and 11C-FMZ PET/CT imaging, followed by the resection of epileptogenic foci. The pathological diagnosis was taken as the gold standard. Visual and semi-quantitative analyses were used to analyze the images. The lateralization accuracy and localization accuracy of the three imaging methods for epileptogenic foci were calculated and compared(χ2 test).@*Results@#The lateral accuracy and localization accuracy of MRI were 70.73%(29/41) and 60.98%(25/41), those of interictal 18F-FDG PET/CT imaging were 78.05%(32/41) and 70.73%(29/41), and those of interictal 11C-FMZ PET/CT imaging were 100%(41/41) and 100%(41/41), respectively. The interictal 11C-FMZ PET/CT imaging was the best among 3 imaging methods(χ2 values: 1.976-12.902, all P<0.01).@*Conclusions@#All 3 imaging methods have their advantages and limitations. The interictal 11C-FMZ PET/CT imaging has a high value in the localization of classical HSREP, which can significantly improve the diagnostic accuracy of classical HSREP and guide clinical operation.
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Objective To evaluate the clinical value of 125I seeds implantation (RSI) for treatment of lymph nodes metastases (LNM) in patients with 131I refractory differentiated thyroid carcinoma (RAIR-DTC).Methods A total of 42 RAIR-DTC patients with LNM (14 males,28 females,median age 49 years) who underwent RSI guided by CT from January 2015 to June 2016 were retrospectively analyzed.All patients underwent CT and their serum thyroglobulin (Tg) levels were measured 2,4 and 6 months post-treatment.The LNM size and serum Tg levels before and after treatment were compared,and the curative effect of RSI for complications was observed.Paired t test,x2 test,repeated measurement analysis of variance,Spearman correlation analysis were used to analyze the data.Results Two patients (4.76％) achieved complete remission,9(21.43％) achieved partial remission,29(69.05％) had no change,2(4.76％) were with progressive disease in all 42 patients.Thetotal effective rate was 95.24％ (40/42).The LNM diameter post-treatment was (1.39±0.75) cm,significantly lower than that before treatment ((1.99±0.38) cm;t=5.557,P＜0.01).The Tg level 2,4 and 6 months posttreatment was (53.24± 14.05),(33.17±7.61) and (25.93± 10.91) μg/L,respectively,which was significantly lower than that before treatment ((57.72± 15.23) μg/L;F =23.612,all P＜0.05).The age,sex,metastatic site,and the number of seeds implanted in each lesion were not the influencing factors on RSI (x2 values:0.569-15.884,rs =0.277,all P＞0.05).The LNM size was the influencing factor on RSI (x2=4.524,P＜0.05).Conclusions 125I RSI can significantly alleviate the clinical symptoms of RAIR-DTC patients with LNM,and the LNM size has relevance for the treatment effect.The clinical follow-up time of serum Tg level can be extended to 6 months or even longer.
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Objective The objective of this study was to evaluate the correlation between maximum standard uptake values( SUVmax ) of 18 F-FDG PET/CT and BRAF mutation in patients with papillary thyroid car-cinoma(PTC).Methods Atotalof51patients(meanageof49.3±12.9years)whounderwent18F-FDGPET/CT imaging and biopsy before thyroidectomy were retrospectively analyzed. Based on the pathological results, there were 48 patients with PTC and 3 patients with follicular thyroid carcinoma(FTC). The SUVmax of thyroid nodule was measured by semi-quantitative analysis. The correlation between clinical data( gender,age,tumor size and thyroglobulin concentration) and SUVmax was also analyzed. The difference of SUVmax between the two groups was analyzed by comparing the BRAF V600E mutation group and the non-mutation group. Results In patients with PTC,27 patients had BRAF V600E mutations and 11 patients had no tumor mutation. The SUVmax of BRAF V600E mutation group was significantly higher than that in the non-mutated group(5. 5 ± 3. 9 vs. 2. 2 ± 1. 2,P=0. 002). The SUVmax of patients with tumor diameter≥1 cm was significantly higher than that in patients with tumor <1 cm(P<0. 05). The SUVmax of patients with elevated thyroglobulin concentration was higher than that in normal patients(P<0. 05). No BRAF V600E mutation was observed in the FTC group. Conclusion The BRAF V600E mutant gene has a high SUVmax value in patients with PTC. There were significant difference in SUVmax among different tumor size and serum thyroglobulin concentration.
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Objective:To detect the interleukin-6 (IL-6) levels and expressions of applipoprotein E (ApoE) in the Alzheimer's disease (AD) patients with different body-mass indexes (BMI),and to explore the diagnotic value of 11Pittsburgh comound-B (11C-PIB) combined with 18F-fluorodeoxyglucose (18F-FDG) PET/CT imaging in AD.Methods:A total of 58 AD patients were divided into four groups according to their BMI:low BMI group(BMI <18.5 kg·m-2,n=18),normal BMI group(18.5 kg·m-2≤BMI <24.9 kg·m-2,n=13),high BMI group(24.9 kg·m-2≤BMI <29.9 kg·m-2,n=12)and obese group(BMI ≥29.9 kg·m-2,n=15).All the patients underwent PET/CT imaging (11C-PIB and 18F-FDG).The sensitivity,specificity and accuracy rate,the expression rates of ApoE (ε2,ε3,and ε4) and the levels of serum IL-6 were detected.The relationship between BMI and the expression rates of ApoE and the serum levels of IL-6 were analyzed by Spearman analysis.Results:The sensitivity,specificity,and accuracy rate of the patients in low BMI group diagnosed by 11C-PIB and 18F-FDG PET/CT were 87.5%,80.0%,and 84.6%,which were higher than those diagnosed by 11C-PIB (55.6%,50.0%,and 53.8%) or 18F-FDG (42.9%,50.0%,and 46.2%)alone (P<0.05).The serum levels of IL-6 and BMI of the AD patients had a negative correlation(r=-0.407,P=0.002).The expression rate of ApoE ε4 allelic gene(60.3%) of the AD patients was higher than those of ε2(18.9%) and ε3 allelic genes(20.7%),but there was no correlation between the BMI and the expression rates of different ApoE allelic genes of the AD patients(r=-0.028,P=0.833).Conclusion:11C-PIB and 18F-FDG PET/CT has a high diagnotic value in the AD patients.11C-PIB and 18F-FDG combinated with serum IL-6 level and BMI could diagnose and evaluate AD more exactly.
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Objective To evaluate the value of multi-modality imaging (PET/CT+CAG+CMRI) in post myocardial infract (MI) patients followed coronary artery bypass graft (CABG) and autologous bone marrow stem cell (BMSC) therapy.Methods A total of 43 patients with MI (27 males, 16 females, age range: 47-72 years) were prospectively enrolled in the year 2012 between January and December.All patients underwent CABG+BMSC transplantation and were divided into 3 groups according to the time interval between two treatments (group 1: 0-3 d;group 2: 4-14 d;group 3: 15-30 d).All patients were orderly scanned with CMRI, PET/CT (13N-NH3·H2O/18F-FDG) and CAG at different time-points pre-/post-treatment.The quantitative parameters included vascular stenosis degree(VSD), LVEF, percentage size of infarction (PSI), the number of segments in mismatched myocardial perfusion/metabolic and the K value for radioactive distribution grading.One-way analysis of variance and the least significant difference t test were used to compare parameters before and after treatment in the same group and among three different groups.Results Regarding PET/CT diagnostic efficacy of abnormal myocardial segments, the sensitivity, specificity, positive predictive value and negative predictive value were 95.4%(540/566), 87.3%(144/165), 96.3%(540/561) and 84.7%(144/170), respectively.After CABG and BMSC transplantation treatments for 12 months, VSD decreased significantly((69.1±9.5)%;F=12.854, P0.05).PSI of patients in group 2 decreased greatly after 12 months treatment ((35.70±12.59)%;F=3.792, t values:-2.916-4.059, all P0.05).Conclusions Multi-modality imaging may be used for accurately detecting abnormal myocardium and predicting prognosis.CABG+BMSC therapy during day 4-14 post-MI may temporarily improve perfusion and metabolism in viable myocardium, but the long term prognosis seemed not be improved.
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Objective To assess the diagnostic value of 18 F?FDG PET/CT imaging for primary pul?monary lymphoepithelioma?like carcinoma (LELC). Methods A total of 19 patients (10 males, 9 fe?males;average age 56.4 years) with suspected primary pulmonary LELC undergone whole?body 18F?FDG PET/CT and chest contrast CT scan were enrolled in this retrospective study. The SUVmax and uptake pat?terns of FDG, the histological types and the clinical stages were recorded. Image characteristics of contrast CT and FDG PET/CT were observed, and the diagnostic efficiency was calculated. Two?sample t test and one?way analysis of variance were used to analyze the results. Results The diagnostic sensitivity and spe?cificity of LELC were 12/13 and 4/6 for FDG PET/CT. The SUVmax of LELC lesions was significantly differ?ent from that of other lung malignant tumors or lung benign lesions (F=3.67, P<0?05). The lesion had longer diameter, lower CT density, higher SUVmax in stage Ⅳ patients, compared with that in stageⅠ-Ⅲpatients ( F=7.01, P<0.05) . The significant difference of SUVmax was found between lesions with ring up?take and lesions with other uptake types (3.94±0.67 vs 2.86±0.35; t=4.07, P<0?05). The SUVmax was higher in Schmincke tumors when compared with that in tumors of Regaud subtype ( 3. 61 ± 0. 71 vs 2. 76 ± 0?29; t=2.99, P<0.05) . Conclusion 18 F?FDG PET/CT could be an accurate method in differential diag?noses of primary pulmonary LELC.
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Objective To evaluate the clinical application of Hawkeye VG SPECT/CT imaging on diagnosing and locating lower gastrointestinal bleeding using in vivo labeling 99Tcm-RBC.Methods Fiftysix patients (42 males,14 females,age ranging from 10 to 76 years) who had definite lower gastrointestinal bleeding were studied retrospectively.All patients had intravenous injection with 370 MBq 99Tcm-RBC and then underwent planar,SPECT,and CT imaging respectively in the abdomen before exploratory laparotomy.Images from SPECT and CT were fused thereafter to locate the active bleeder,if any.x2 test was performed to show the differences of diagnostic sensitivity and accuracy between planar and SPECT/CT imaging.Results In 56 patients with lower gastrointestinal bleeding,50 patients showed abnormally concentrated radionuclide activity with planar images and 52 patients showed the similar imaging pattern with SPECT/CT.Among these patients,concordant bleeding with operation findings was found in 31 patients with planar images and 48 patients with SPECT/CT images.The sensitivity and accuracy were 89.3％ (50/56) and 73.8％ (31/42) in planar images,and 92.9％ (52/56) and 92.3％ (48/52) in SPECT/CT images (x2 =0.11,P＞0.05 ;x2 =4.63,P＜0.05).Conclusion Hawkeye VG SPECT/CT imaging shows an effective,simple and accurate method and could be used for diagnosing and locating lower gastrointestinal bleeding.
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BACKGROUND: For patients with myocardial infarction occupied most of the heart, the effect of coronary artery bridge is not obvious. Currently, myocardial and vascular regeneration by stem cells has become a focus of ischemic cardiovascular disease. Myocardial survival directly correlates with improvement of blood perfusion following stem cell transplantation.OBJECTIVE: To investigate the feasibility of ~(18)F-FDG and ~(99)Tc~m-MIBI single photon emission computed tomography imaging in assessing myocardial glucose metabolism and perfusion with old myocardial infarction after coronary artery bypass grafting (CABG) and CD34~+ stem cell transplanting. METHODS: Bone marrow was extracted from the anterior superior iliac spine 1 day before surgery. Mononuclear cells were isolated by Ficoll density gradient centrifugation. CD34~+ cells were isolated and purified by immunomagnetic bead system. Coronary artery pathological changes were examined under general anesthesia. The end-to-side anastomosis of graft vessel and coronary artery was performed. 1×10~(11)/L CD34~+ cell suspension was extracted, and injected into the surrounding and center of the infarct (blood flow/metabolism matching depletion) at 6 points, with 0.2 mL in each point. According to preoperative perfusion/metabolism imaging, myocardium segments were divided into two groups: match group: blood perfusion and metabolism images were sparse or normal, i.e. infarction or normal myocardium; mismatch group: blood perfusion image displayed depletion, but metabolism images were normal or radially distributed, i.e. surviving myocardium. ~(18)F-FDG and ~(99)Tc~m-MIBI dual-isotopic imaging were performed before and 4 months after CABG. Circumferential count profiles from ~(18)F-FDG and ~(99)Tc~m-MIBI short axis slices were generated to assess myocardial blood perfusion and glucose metabolism. RESULTS AND CONCLUSION: The 31 patients were divided into 279 segments, and 145 segments were in myocardial perfusion-metabolism mismatch (MM). ~(99)Tc~m-MIBI and ~(18)F-FDG uptake fraction was significantly increased 4 months before operation (P < 0.01); match group without transplanting had 81 segments, and the ~(99)Tc~m-MIBI and ~(18)F-FDG uptake fraction remained unchanged after operation (P > 0.05). Match group undergoing transplanting had 54 segments, and their ~(99)Tc~m-MIBI and ~(18)F-FDG uptake fraction increased remarkably 4 months after operation (P < 0.01). CABG can improve the function of survival myocardial segments, but it is helpless to infraction myocardium. The autologous CD34~+ stem cell transplantation can improve myocardial blood perfusion and glucose metabolism of the distributions of infract myocardium.