Application of 68Ga-NOTA-3P-TATE-RGD PET/CT in the evaluation of neuroendocrine neoplasms / 中华核医学与分子影像杂志

Objective:To investigate the value of PET/CT imaging with 68Ga-1, 4, 7-triazacyclononane-1, 4, 7-triacetic acid-3 polyethylene glycol- D-Phe1-Tyr3-Thr8-octreotide Arg-Gly-Asp (NOTA-3P-TATE-RGD), a dual somatostatin receptor 2- and integrin α vβ 3- targeting tracer, in the evaluation of neuroendocrine neoplasms (NEN). Methods:From April 2021 to February 2022, 35 patients (19 males, 16 females; median age 54(41, 61) years) with histologically confirmed NEN in Peking Union Medical College Hospital were prospectively enrolled. All patients were scanned with both 68Ga-NOTA-3P-TATE-RGD and 68Ga-1, 4, 7, 1 0-tetraazacyclododecane-1, 4, 7, 10-tetraacetic acid- D-Phe1-Tyr3-Thr8-octreotide (DOTATATE) PET/CT imaging within one week. The differences of the numbers of detected lesions, SUV max and tumor-to-background ratio (TBR) between the two imaging methods were compared by Wilcoxon signed-rank test. Results:Of the 35 patients, the total numbers of lesions detected by 68Ga-NOTA-3P-TATE-RGD and 68Ga-DOTATATE were 1 190 and 1 106, respectively. 68Ga-NOTA-3P-TATE-RGD and 68Ga-DOTATATE both detected 35 primary tumors and performed comparably in detecting lymph node metastases (4(1, 8) vs 4(1, 8); z=-0.45, P=0.655) and bone metastases (5(2, 60) vs 5(2, 66); z=-1.11, P=0.244). However, the number of liver lesions detected by 68Ga-NOTA-3P-TATE-RGD was significantly higher than that by 68Ga-DOTATATE (17(6, 27) vs 8(3, 26); z=-2.31, P=0.021). 68Ga-DOTATATE demonstrated higher SUV max than 68Ga-NOTA-3P-TATE-RGD (15.6(9.9, 24.9) vs 12.7(8.0, 18.4); z=-7.19, P<0.001), while the TBR of liver metastases was significantly lower (3.4(1.8, 5.5) vs 6.1(3.8, 10.8); z=-7.56, P<0.001). Conclusion:68Ga-NOTA-3P-TATE-RGD performs better than 68Ga-DOTATATE in the detection of liver metastases, while is comparable to 68Ga-DOTATATE in detecting lesions of other sites.

Application of 99Tc m-MIBI SPECT/CT imaging in patients with primary cervical dystonia / 中华核医学与分子影像杂志

Objective:To evaluate the value of 99Tc m-methoxyisobutylisonitrile(MIBI) SPECT/CT imaging for the identification of dystonic muscles in patients with primary cervical dystonia (PCD). Methods:A total of 10 patients with PCD (3 males, 7 females, age (47.3±9.9) years) and 10 healthy subjects (4 males, 6 females, age (43.5±9.4) years; control group) between August 2019 and October 2021 in China-Japan Friendship Hospital were enrolled prospectively. All subjects underwent 99Tc m-MIBI SPECT/CT scan. The SUV max of 8 bilateral representative muscles, including rectus capitis posterior major, obliquus capitis inferior, splenius capitis, semispinalis, sternocleidomastoid, trapezius, musculus scalenus muscle and levator scapulae were evaluated in control group. In PCD group, muscles with abnormal uptake were determined. ROI was drawn and SUV max was measured. Independent-sample t test was used to analyze the differences of SUV max between normal and abnormal muscles. The detecting rates of neck MRI and SPECT/CT for abnormal muscles were analyzed by χ2 test. Results:Normal muscles of healthy subjects showed mild symmetrical radioactivity distribution, with the SUV max of 1.10±0.19. A total of 60 muscles with abnormal uptake in 10 patients were found, including 7 rectus capitis posterior major, 10 obliquus capitis inferior, 8 splenius capitis, 8 semispinalis, 10 sternocleidomastoid, 5 trapezius, 3 musculus scalenus muscle and 9 levator scapulae. The SUV max of muscles with abnormal uptake was 1.81±0.43, which was higher than that of normal muscles ( t=17.05, P<0.001). Only 30 pieces abnormal hypertrophy muscle were found by neck MRI, and the detecting rate was much lower than that of SPECT/CT (18.75%(30/160) vs 37.50%(60/160); χ2=28.03, P<0.001). Conclusion:99Tc m-MIBI SPECT/CT may be a useful method for identifying dystonic muscles and a guide to precision therapy in patients with PCD.

IgG4-related spinal pachymeningitis.

The aim of this study is to study the clinical, laboratory, imaging pathology, and prognosis features of IgG4-related spinal pachymeningitis. We worked with a 55-year-old man suffering from IgG4-related spinal pachymeningitis who had the most widespread lesion in his dura mater. We also review previous related studies and discuss the clinical characteristics of this rare disease. In total, eight IgG4-related spinal pachymeningitis patients have been reported in the literature since 2009. They were mostly male patients, 51.7 ± 11.9 years old on average. Cervical and thoracic vertebrae were the most common sites for lesions. The most prominent symptom was varying numbness and weakness of the limbs and/or body associated with spinal cord compression. There was one patient (1/5) with elevated serum IgG4 levels and three patients (3/3) with increased cerebrospinal fluid (CSF) IgG4 index. Positive histopathologic findings are the strongest basis for a diagnosis. All the patients with IgG4-related spinal pachymeningitis responded well to glucocorticoid therapy. IgG4-related spinal pachymeningitis is an orphan disease that mainly occurs in cervical and thoracic vertebrae. Older males are the most susceptible group. Serum IgG4 levels were consistently normal in these cases, so analysis of CSF for IgG4 production (IgG4 index) could become a useful tool. Pathological findings remain the gold standard for diagnosis. Most patients responded favorably to glucocorticoid treatment.

Cerebral blood flow perfusion imaging in patients with laughing gas abuse / 中华核医学与分子影像杂志

Objective:To explore the changes of cerebral blood flow (CBF) perfusion caused by N 2O (laughing gas) abuse. Methods:From December 2017 to October 2018, the CBF perfusion images of 24 patients with laughing gas abuse (9 males, 15 females; age: 18-32(24.0±8.9) years) from China-Japan Friendship Hospital were analyzed retrospectively. The region uptake statistics of different brain regions of interest (ROI) (basal ganglia, central region, cerebellum, cingulate gyrus, frontal lobe, medial temporal lobe, occipital lobe, parietal lobe, temporal lobe) between patients with laughing gas abuse and normal people of the same age group from background software database were calculated automatically. Statistic>1.68 indicated the increase of local CBF perfusion, while statistic < -1.68 indicated the decrease of local CBF perfusion. The correlation between the statistics of bilateral brain regions and the correlation between statistical values and clinical indicators were analyzed by Pearson and Spearman correlation analyses.Results:The correlation of the statistics between bilateral regions of each brain area was significant( r values: 0.503-0.892, all P<0.05). The decreased CBF proportions of frontal and temporal lobes were 62.5%(15/24) and 70.8%(17/24), respectively. The highest proportion of increased CBF was cingulate gyrus (33.3%, 8/24). There were significant correlations between frontal lobe, central brain area and duration of laughing gas abuse ( rs values: 0.375, 0.305, both P<0.05). Conclusion:CBF perfusion imaging is helpful for understanding the changes of CBF in patients with laughing gas abuse.

Triple fusion PET/MRI in location of epileptogenic focus in patients with focal cortical dysplasia / 中华神经医学杂志

Objective:To explore the value of triple fusion positron emission tomography (PET)/MRI in location of epileptogenic focus in patients with focal cortical dysplasia (FCD).Methods:Three patients with refractory partial epilepsy, admitted to our hospital from December 2016 to June 2017, were chosen in our study. The raw MRI and PET images of these patients were processed using Freesurfer and FSL image processing softwares. After extraction and coregistration, precise PET/MRI fusion images were obtained; and the grey-white matter dividing line was highlighted on this fusion image to form triple-fusion images to observe the hypometabolic area and clarify the location.Results:Triple-fusion images of these 3 patients were acquired. In patient 1, a marked decrease in metabolism was noted in the gyrus region delineated by the gray-white matter boundary in the right cingulate gyrus. In patient 2, the area with slightly increased local signal in the right superior frontal gyrus (MRI FLAIR sequence) was the area with reduced metabolism. In patient 3, an area of local decreased metabolism was noted in the right cingulate gyrus. The preoperative evaluation of all 3 patients showed that the above areas were epileptic foci; the patients were followed up for 2 years after surgical resection, no clinical seizures occurred in all patients, and antiepileptic drugs were gradually stopped. All 3 patients were diagnosed as having FCD by postoperative pathology.Conclusion:Triple fusion PET/MRI is a powerful way to assist FCD diagnosis, especially for those FCD cases which are difficult to be diagnosed by other imaging methods, and has a potential clinical application value in epilepsy patients.

Characteristics of cerebral blood flow in patients with psychiatric symptoms caused by nitrous oxide abuse / 中华行为医学与脑科学杂志

Objective:To investigate the clinical, neuropsychological and regional cerebral blood flow (rCBF) characteristics in patients with psychiatric symptoms caused by nitrous oxide abuse.Methods:Twelve patients with psychiatric symptoms caused by nitrous oxide abuse were enrolled from February 2018 to February 2020 in the Department of Neurology, China-Japan Friendship Hospital and the First Hospital of Tsinghua University.All patients were scored with the brief psychiatric rating scale (BPRS), Hamilton depression scale (HAMD), Hamilton anxiety scale (HAMA), mini-mental state examination (MMSE) and Montreal cognitive assessment (MoCA). The SPECT/CT images were collected with low-energy and high-resolution collimator.After the pictures were reconstructed, 18 brain regions were automatically sketched and calculated by Database Comparison software.The statistical value of the difference between the general mean value of each brain region and that of the corresponding region of interest in the same age group was estimated.Results:(1)The clinical manifestations of 12 patients were anxiety, depression, hallucination, delusion, and 7 patients were accompanied by cognitive decline.(2)Neuropsychological examination: BPRS score was 57.83±11.15 (anxiety depression factor was 3.94±0.47; lacking active factor was 3.25±0.85; thinking disturbance factor was 3.21±1.27; activity factor was 2.28±0.56; hostility factor was 3.14±1.24). The score of self-knowledge impairment was 2.92±1.08, the score of inability to work was 4.50±1.17, the score of HAMD was 32.75±10.13, the score of HAMA was 18.67±5.80, the score of MMSE was 27.67±2.50, and the score of MoCA was 24.58±3.78.(3)SPECT showed that compared with the general mean value of the corresponding regions of interest of normal people, the patients showed hypoperfusion in the frontal lobe (7 patients, 58.30%) and the temporal lobe (8 patients, 66.70%).Conclusion:Nitrous oxide abuse has an obvious effect on rCBF.The psychiatric symptoms include anxiety, depression, hallucination, delusion and so on, which affect the ability to work and learn.SPECT has important value in the diagnosis of nitrous oxide abuse, and indicates changes in local brain functional activity.

Application of lung V/Q SPECT imaging in fibrosing mediastinitis / 中华核医学与分子影像杂志

Objective@#To investigate the value of pulmonary ventilation/perfusion (V/Q) SPECT imaging in fibrosing mediastinitis (FM).@*Methods@#From January 2015 to July 2018, 14 FM patients (6 males, 8 females, average age 74 years) who underwent V/Q SPECT imaging in China-Japan Friendship Hospital were retrospectively studied. The data of V/Q SPECT imaging were analyzed and the defect extent was classified as mild (<20%), moderate (20%-50%) and severe (>50%) according to the percentage of pulmonary perfusion and ventilation defect in total lung volume (%). χ2 test was used to analyze the incidence rates of the impaired blood perfusion of each lung lobe.@*Results@#According to the results of Q SPECT imaging, all 14 patients had impaired blood perfusion in the superior lobe of left lung, and the number of patients with/without impaired blood perfusion in the inferior lobe of left lung, superior lobe of right lung, middle lobe of right lung, inferior lobe of right lung were 11/3, 14/0, 13/1, 12/2, respectively. The incidence rates of impaired blood perfusion in different lobes were not significantly different (χ2=6.198, P=0.185). The range of lung perfusion defect was mild in 1, moderate in 7 and severe in 6 patients. The incidence rates of impaired blood ventilation in different lobes were not significantly different (χ2=1.587, P=0.811). The range of lung ventilation defeat was mild in 11, moderate in 2 and severe in 1 patients. The defect extent of lung segments and subsegments in Q SPECT imaging and V SPECT imaging were 119 and 41, respectively (χ2=28.42, P<0.05). There was more defect in Q SPECT imaging, but both methods showed segmental or subsegmental distribution.@*Conclusions@#The defect of V/Q SPECT imaging in FM patients is segmental in distribution, and more is observed in Q SPECT imaging. Pulmonary V/Q SPECT imaging can evaluate the defect range and extent of pulmonary perfusion and ventilation in FM patients.

Application of lung V/Q SPECT imaging in fibrosing mediastinitis / 中华核医学与分子影像杂志

Objective To investigate the value of pulmonary ventilation/perfusion (V/Q) SPECT imaging in fibrosing mediastinitis (FM).Methods From January 2015 to July 2018,14 FM patients (6 males,8 females,average age 74 years) who underwent V/Q SPECT imaging in China-Japan Friendship Hospital were retrospectively studied.The data of V/Q SPECT imaging were analyzed and the defect extent was classified as mild (＜20％),moderate (20％-50％) and severe (＞50％) according to the percentage of pulmonary perfusion and ventilation defect in total lung volume (％).x2 test was used to analyze the incidence rates of the impaired blood perfusion of each lung lobe.Results According to the results of Q SPECT imaging,all 14 patients had impaired blood perfusion in the superior lobe of left lung,and the number of patients with/without impaired blood perfusion in the inferior lobe of left lung,superior lobe of right lung,middle lobe of right lung,inferior lobe of right lung were 11/3,14/0,13/1,12/2,respectively.The incidence rates of impaired blood perfusion in different lobes were not significantly different (x2=6.198,P=0.185).The range of lung perfusion defect was mild in 1,moderate in 7 and severe in 6 patients.The incidence rates of impaired blood ventilation in different lobes were not significantly different (x2 =1.587,P=0.811).The range of lung ventilation defeat was mild in 11,moderate in 2 and severe in 1 patients.The defect extent of lung segments and subsegments in Q SPECT imaging and V SPECT imaging were 119 and 41,respectively (x2=28.42,P＜0.05).There was more defect in Q SPECT imaging,but both methods showed segmental or subsegmental distribution.Conclusions The defect of V/Q SPECT imaging in FM patients is segmental in distribution,and more is observed in Q SPECT imaging.Pulmonary V/Q SPECT imaging can evaluate the defect range and extent of pulmonary perfusion and ventilation in FM patients.

Protease activated receptor-1 targeted 99Tcm-(HYNIC-BMS-200261) (tricine) (TPPTS) imaging on nude mice bearing human breast cancer / 中华核医学与分子影像杂志

Objective To study the reliability of 99Tcm-(hydrazinonicotinamide (HYNIC)-BMS-200261) (tricine) (trisodium triphenylphosphine-3,3',3"-trisulfonate (TPPTS)) as a radiotracer for protease activated receptor-1 (PAR-1) expression in breast cancer.Methods Fifteen nude mice bearing MDA-MB-435,MDA-MB-231 and MCF-7 human breast cancer xenografts (5 mice for each cell line) with different PAR-1 expression were used for 99Tcm-(HYNIC-BMS-200261) (tricine) (TPPTS) γ imaging,and tumor/non-tumor (T/NT) ratios were obtained with region of interest (ROI) technique.Afterwards,the biodistribution of 99Tcm-(HYNIC-BMS-200261) (tricine) (TPPTS) was analyzed in tumor-bearing nude mice,and the radioactivity in tumor (percentage activity of injection dose per gram of tissue,％ID/g) was calculated.The immunostaining was performed to examine PAR-1 expression in tumor tissue and semi-quantitative analysis was used.One-way analysis of variance and Pearson correlation analysis were used to analyze data.Results At 2 h postinjection,the T/NT ratios were 3.03±0.32,2.27±0.25 and 1.51±0.13 respectively in nude mice bearing MDA-MB-435,MDA-MB-231 and MCF-7 xenografts;the tumor uptakes of 99Tcm-(HYNIC-BMS-200261)(tricine)(TPPTS) were (1.03±0.15),(0.56±0.14) and (0.30±0.06) ％ID/g;PAR-1 expression levels were (17.22±2.71) ％,(10.78± 1.95) ％ and (2.80± 1.18) ％,respectively (F values:47.66,46.36,62.35,all P＜0.05).The T/NT ratios and tumor uptake of 99Tcm-(HYNIC-BMS-200261) (tricine) (TPPTS) at 2 h post-injection were correlated with PAR-1 expression (r values:0.934 and 0.929,both P＜0.05).Conclusions 99Tcm-(HYNIC-BMS-200261) (tricine) (TPPTS) imaging could be a noninvasive and effective method for monitoring PAR-1 expression in human breast cancer.

CT and 18F-FDG PET/CT features of pulmonary sclerosing hemangioma / 中华核医学与分子影像杂志

Objective To evaluate characteristics of CT and 18F-FDG PET/CT in pulmonary sclerosing hemangioma (PSH).Methods A retrospective study involving 12 patients (2 males,10 females;24-80 years old) confirmed as PSH by pathology from May 2012 to July 2014 was investigated.All patients underwent chest CT scan,including enhanced CT;and 5 cases underwent whole-body 18F-FDG PET/CT.All imaging data were collected and analyzed to find out a more effective diagnostic method.Results In 12 PSH patients,9 had single lesion,of which 4 involved left lung and 5 right lung.The rest 3 patients including 1 with two nodules located in the right lower lobe,and 2 with multiple nodules scattered in several lobes.Plain CT showed all lesions had uniformly isodensity,4 with calcification,3 with air meniscus sign.Contrast-enhanced CT examinations showed that the majority lesions were prominent enhancement and few moderate enhancement,all lesions showed vessel marginating sign and 6 with cystic and necrosis area.18F-FDG PET/CT examinations showed that the lesions displayed patchy pattern of mild to moderate uptake with SUVmax 2.2--4.0.Conclusions The characteristic CT features of PSH,especially the contrast-enhanced CT imaging,are important for diagnosis.18F-FDG PET/CT findings are extremely helpful in differentiating PSH from malignant lesions.

Associations of psychological resilience with family cohesion and non-suicidal self-injury of middle school students in Fujian Province / 中国学校卫生

Objective@#To explore the relationship between family cohesion, psychological resilience and non-suicidal self-injury among middle school students.@*Methods@#By using the stratified random cluster sampling method, 2 065 students from 4 middle school from Fujian province were investigated with family cohesion scale, adolescent psychological resilience scale and adolescent self-injury behavior questionnaire.@*Results@#The report rate of self-injury was 40.34%, which differed by childhood migration experiences, parenting style as well as academic pressure (χ2=11.66，29.45，12.48，P<0.01). Total scores and dimensional scales in family cohesion and psychological resilience showed significant differences in students with or without self-injury (t=-8.33，-12.08，-7.29，-11.53，-3.38，-7.37，-7.68，P<0.01). The family cohesion was positively correlated with the psychological resilience and each dimension (r=0.27-0.56, P<0.01), but negatively correlated with non-suicidal self-injury (r=-0.18, P<0.01). The psychological resilience and each dimension were negatively correlated with non-suicidal self-injury (r=-0.24--0.14, P<0.01). Psychological resilience had a partial mediating effect between family cohesion and non-suicidal self-injury, with mediating effect accounting for 61.11% of the total effect.@*Conclusion@#Psychological resilience played a mediating role between family cohesion and non-suicidal self-injury. By promoting family cohesion to improve psychological resilience, it is helpful to prevent non-suicidal self-injury among middle school students.