RESUMO
Multiple myeloma (MM) is a malignant tumor of the blood system that is more common in the elderly with abnormal proliferation of bone marrow plasma cells. The current diagnostic methods mainly rely on the detection of M protein and invasive bone marrow aspiration biopsy. The sensitivity and specificity of conventional imaging tests are low. Molecular imaging technology provides new options and methods for the noninvasive diagnosis of MM. Whole-body MRI (WB-MRI) has good soft tissue contrast and spatial resolution, which can show bone marrow infiltration and vascular conditions. Metabolic imaging such as 18F-FDG, acetate, choline, and methionine are highly sensitive. ImmunoPET imaging screens specific targets for targeted therapy or immunotherapy and evaluates the efficacy. This article reviews the progress of molecular imaging in MM, especially immunoPET imaging.
RESUMO
Objective@#To investigate the value of ATP stress cerebral blood flow perfusion imaging (CBFPI) in diagnosis of ischemic cerebrovascular disease.@*Methods@#Thirty-two patients with cerebral ischemia and ischemic cerebral infarction (26 males, 6 females, average age: (63.0±8.7) years) in China-Japan Friendship Hospital from November 2016 to February 2017 were enrolled. All subjects underwent 99Tcm-ethylcysteinate dimer (ECD) rest and ATP stress CBFPI. Region of interest (ROI) was drawn in the symmetrical parts of the bilateral frontal lobe, parietal lobe, temporal lobe, occipital lobe and basal ganglia region, and the regional cerebral blood flow (rCBF) was automatically calculated. The images and rCBF of post- and pre-ATP stress CBFPI were analyzed and compared. Paired t test was used for statistical analysis.@*Results@#The positive rates of rest CBFPI, ATP stress CBFPI, and combination of both imaging were 53.1%(17/32), 65.6%(21/32), and 100%(32/32), respectively. In 16 cases with unilateral vascular stenosis, the average rCBF of diseased hemisphere was lower in stress imaging (62.7±13.3) ml·100 g-1·min-1 than that in rest imaging ((65.8±13.2) ml·100 g-1·min-1; t=3.07, P<0.05). While the average rCBF of the contralateral hemisphere in rest and stress imaging showed no significant difference ((67.4±13.3) vs (65.9±13.0) ml·100 g-1·min-1; t=1.90, P>0.05). In the other 16 patients with bilateral multivessel disease, the average rCBF of whole brain in rest imaging was higher than that in stress imaging: (62.5±13.9) vs (57.5±11.6) ml·100 g-1·min-1; t=3.50, P<0.05. There were 21 out of the 32 patients presented with a decreased cerebrovascular reserve.@*Conclusion@#ATP stress combined with rest CBFPI may improve positive rate remarkably and help to evaluate the cerebrovascular reserve.
RESUMO
Objective To explore the value of 18F-FDG PET/CT in diagnosis of retroperitoneal fibrosis (RPF).Methods Totally 12 RPF patients underwent 18 F-FDG PET/CT scanning,and the characteristics of metabolic activity,distribution of retroperitoneal lesions and maximum standardized uptake value (SUVmax) were analyzed retrospectively.Results Among 12 patients,7 were initial evaluation patients,5 were post-treatment patients.Of 7 initial evaluation patients,there were 4 patients with secondary RPF,including prostate carcinoma,breast cancer and IgG4-related disease.Retroperitoneal mass isodense with muscle surrounding the abdominal aorta or the iliac arteries were found in 12 patients,and ureteral involvement were found in 11 paients (11/12,91.67％).SUVmax in initial evaluation patients (4.21±1.76) was higher than that in patients after treatment (1.46±0.25,P＜0.05).According to PET/CT,3 idiopathic RPF patients as initial evaluation with high metabolic activity lesions received immunosuppressive therapy including corticosteroids and tamoxifen,and 4 secondary RPF patients with high metabolic activity lesions received treatment based on causes.Among 5 post-treatment patients,3 continued to accept current corticosteroids maintenance dose,while 2 did not receive any other treatment.Conclusion PET/CT may be used to evaluate the activity and extension of lesions in patients with RPF.
RESUMO
Objective To investigate the characteristics of metabolic foci on 18F-fluorodeoxyglucose (FDG) PET/CT scan in pediatric patients with epilepsy.Methods Twenty-three pediatric patients (15 males,8 females,age range:0.5-13.3 years) with epilepsy were retrospectively reviewed from March 2014 to December 2016.All patients underwent 18F-FDG PET/CT and metabolic foci were found.The visual method and semi-quantitative analysis were used to analyze images.Fourteen of them underwent surgery and were followed up for 3-24 months.Results Glucose hypermetabolism were observed most frequently in the frontal and parietal lobes,with or without surrounding/remote hypometabolism.On the day of PET/CT imaging,8 patients had no seizures,14 patients had seizures,and 1 patient was uncertain.The sites of resection were consistent with the regions of hypermetabolism in 9 patients,among whom the pathological results showed 8 cortical malformations and 1 Rasmussen's syndrome.Follow-up results for the above 9 patients showed that there was 7 Engel class Ⅰ patients and 2 Engel class Ⅲ patients.Conclusion The hypermetabolism may mostly appear in the frontal and parietal lobes of pediatric patients with epilepsy,and malformations of cortical development seem to be the most common pathology results.
RESUMO
Objective To investigate whether quality assurance and quality control using multimodal image guidance and radiation dosimetry optimization could ensure and improve the targeting of 125I seeds brachytherapy.Methods A total of 287 patients (184 males,103 females,average age 61.9 years) with non-small-cell lung cancer (NSCLC) and 122 patients (average age 65.5 years) with prostate cancer who were diagnosed by pathology or imaging methods (coincidence imaging,CT,flexible fiberoptic bronchoscopy,ultrasonography) from October 2002 to October 2016 were retrospectively enrolled.All imaging methods were used to locate the target area.Optimization of radiation dosimetry was made according to treatment planning system (TPS) and evaluated by dose-volume histogram (DVH).125I seeds implantation was performed under the imaging guidance,followed by real-time location verification,dosimetric verification.Therapeutic efficacy was evaluated.Paired t test was used to analyze the data.Results The prescribed dose (PD) of planning target volume (PTV) was above 140 Gy.Immediate dosimetric verification was performed in 59 patients with NSCLC and 31 patients with pulmonary metastases.The radiation dose before and after the implantation was coincident in 93.2％ (55/59) of NSCLC and 93.5％ (29/31) of pulmonary metastases.The coincident rate of patients with dose delivered to 90％ GTV (D90)＞matched peripheral dose (MPD) was 93.2％ (55/59) and 87.1％ (27/31) respectively in NSCLC and pulmonary metastases.There was no significant difference in MPD,D90 and conformity index (CI) before and after implantation (t values:2.11-9.71,all P＞0.05).The average dose of the risk organs was significantly lower than the tolerance dose of the normal tissue.The incidence of radiation pneumonitis was 1.05％ (3/287).No other serious complications were found.Conclusion Targeted diagnosis and therapy of multimodal image guidance could be optimized to improve the effect of targeting and therapeutic gain ratio of 125I seeds brachytherapy.
RESUMO
Objective To observe the metabolic changes of subcortical structures in children with intractable epilepsy using 18 F-FDG PET/CT,and to investigate the mechanism of subcortical structure involvement in epileptic seizures and its clinical significance.Methods Features of 18F-FDG PET/CT imaging in 611 intractable epilepsy children were analyzed.The metabolic changes of cortex and subcortical structures (basal ganglia,thalamus and cerebellum) were observed.The children were divided into three groups (young,middle and older groups) according to age,also mild group and severe group according to the number of involved lobar,respectively.The incidence of metabolic abnormalities in subcortical structures of different groups were analyzed.Results Among 611 children,unilateral cortical metabolic abnormality was found in 525,and bilateral cortical metabolic abnormalities were found in 86 children.The involvement of subcortical structures was detected in 190 children,including basal ganglia (n=64),thalamus (n=113) and cerebellum (n=105).The incidence of metabolic abnormality in subcortical structures under different age groups was not statistically different (all P＞ 0.05),while the incidence of metabolic abnormality in subcortical structures of severe group was significantly higher than that of mild group (all P＜0.001).Conclusion 18 F-FDG PET/CT might be able to detect the metabolic abnormalities of subcortical structures,therefore indicating the involvement of cerebral cortex.
RESUMO
Single nuclear medicine functional imaging (including SPECT and PET) couldn't fully meet the demand of clinical diagnosis because of its own limits, thus the multimodality imaging equipment integrated anatomical and functional images has became the development trend of the nuclear medicine and even the entire medical imaging. Following the earliest SPECT-CT and PET-CT which having been widely used in clinic, the newest PET-MR has also been applied to clinical practice. PET-MR combined MR images with PET function image is substantial to the clinical diagnosis of cerebral nervous system diseases, cardiovascular system diseases and tumor, etc. In this paper, we reviewed the current application situation and prospects of PET-MR in cerebral nervous system diseases.
RESUMO
The radioactive iodine uptake(RAIU) has great value in determining the 131I treatment dosage of patients suffered from hyperthyroidism and judging thyroid function. Many factors which could interfere the results of RAIU were as follows: instrumental factors, thyroid radioactivity counts measurement, counts of a calibrated standard in a neck phantom and counts of room background, iodinated drugs and food, anti-thyroid medication, among other causes, have shown to induce varying degrees of errors in RAIU measurements. Irregular measurements which may interfere with radioactive iodine uptake are commonly seen in clinical practice, yet its actual influence has not been reported. Optimization, regularization and quality control of the radioiodine uptake measurement are essentials for clinical routine practice to guarantee appropriate values for clinical hyperthyroidism diagnosis and treatment. All the above factors affecting the measurement of thyroid function instrument for radioactive iodine uptake are analyzed and then put forward the corresponding solutions.
RESUMO
Even though multimodal imaging system has already been applied in clinic, the PET-MRI still is a revolutionary progress of medical imaging, and it is a landmark after PET-CT imaging equipment. MRI not only can solve the limitations of CT, but also can provide abundant morphology and function information; at the same time, PET also play important role in the diagnosis of tumor, nervous system diseases and cardiovascular disease; and in the treatment decision, treatment effect evaluation and prognosis evaluation when it is applied in research of physiological and disease state at the levels of molecular activity and metabolism of human body. With the rapid development of science and technology, this article has summarized the imaging technology and clinical application of PET-MRI in recent years.
RESUMO
To explore the effectiveness of positron emission tomography (PET) respiratory gating based on time and amplitude to improve the reconstructed image artifacts. It is necessary to appropriately select acquisition and processing methods which ensure the readability of myocardial imaging images in radionuclide medicine myocardial imaging. This summary mainly discusses the identification method and how to avoid adverse effect for images from myocardial imaging process, and includes similarities and differences of varieties methods: identification for image artifacts of myocardial imaging, image reconstruction algorithms and software processing and so on. It should be significant to choose the appropriate method to identify myocardial imaging artifacts in image collection. The pros and cons of myocardial imaging image reconstruction algorithm and various software processing methods still remain unknown. How to choose better appropriate acquisition, image reconstruction and software processing methods for myocardial imaging need further study.
RESUMO
How to study a method that can significantly improve the therapeutic gain ratio of malignant tumor is one of the problems must be solved in the field of cancer therapy. However, how can effectively treat malignancy patients with contraindications of operation, radiotherapy and chemotherapy has been a difficult problem in cancer therapy. The 125I brachytherapy was suitable for malignancy patients with contraindications of operation, radiotherapy and chemotherapy. The guidance of multimodal imaging could contribute to the definitions of tissue density imaging target and biological target, and could ensure the targeting and conformity of treatment. Using the quality assurance and quality control measurements (QA/QC) optimized by radiation dosimetry; using therapy planning system (TPS) to make plan, and adopt optimizing radiation dosimetry and dose volume histogram (DVH) to evaluate TPS, and using image to guide particle implantation and adopt series of methods, such as real-time location verification, dosimetry verification post-implantation, therapy efficacy determination, follow-up and so on, to improve therapeutic gain ratio and partially control therapy efficacy, and then significantly reduce adverse reaction. All of these have important clinical value for increasing survival rate and quality of life.
RESUMO
Early diagnosis and precision medicine generally show significant differences in the prognosis of patients with carcinoma. Angiogenesis not only plays a key role in tumor pathophysiology but also acts as an important drug target. Peptides with specific se-quences can target specific molecules on the endothelial cellular membrane during tumor angiogenesis. Radionuclide-labeled molecu-lar probes exhibit many advantages in oncotherapy. This article focuses on the progress of radionuclide-labeled RGD and RRL in radio-immunoimaging and radioimmunotherapy targeting tumor angiogenesis.
RESUMO
Objective To investigate the clinical value of 18 F?FDG PET/CT in staging multiple myeloma ( MM) and evaluating the glucose metabolic activity of MM. Methods A total of 25 MM patients ( 13 males, 12 females, age:39-67 years) from May 2010 to April 2015 were enrolled in this retrospective study. The SUVmax of each patient was recorded. D?S plus staging according to 18 F?FDG PET/CT was com?pared with the traditional D?S staging. The SUVmax and the percentage of plasmacytes of bone marrow of phase Ⅲ and non?phase Ⅲ ( phaseⅠand Ⅱ) according to D?S plus staging were compared. Two?sample t test and Wilcoxon rank sum test were used to analyze the data. Results In 25 MM patients, the range of SUVmax of lesions was 1.8-12?0 and the mean value was 5.15±2.74. According to D?S staging, the numbers of patients with phase Ⅰ,Ⅱ andⅢwere 7, 4 and 14, respectively. While the numbers were 3, 1 and 21 by D?S plus staging. Based on the D?S plus staging system, stages of 7 patients ( 28%, 7/25 ) were changed. According to the D?S plus staging system, the SUVmax between phaseⅢand non?phaseⅢpatients was significantly different (5.75±2.54 vs 3.00±0?70; t=2.12, P0.05). Conclusion 18F?FDG PET/CT is of clinical importance for MM staging and metabolic activity assessment of MM.
RESUMO
AIM:ToinvestigatetheeffectofP21-activatedkinase1(PAK1)andlymphoidenhancer-binding factor 1(LEF1) on the proliferation of esophagus cancer cells .METHODS:Real-time PCR was applied to detect the mR-NA expression of PAK1 and LEF1 in the esophagus cancer tissues .MTT assay were used to measure the proliferation of hu-man esophagus cancer cell line KYSE transfected with PAK 1 and LEF1.RESULTS: The mRNA expression of PAK1 in the esophagus cancer tissues was lower than that in control group (P<0.05).The mRNA expression of LEF1 and tran-scription factor 4 (TCF4) in the esophagus cancer tissues was higher than that in control group (P<0.05).The prolifera-tion of KYSE cells with over-expression of PAK1 and LEF1 was higher than that in control group .No significant change of apoptosis between the KYSE cells with over-expression of PAK1 and LEF1 and control group was observed .CONCLU-SION:The expression of PAK1 decreases and the expression of LEF 1 increases in esophagus cancer tissues .LEF1 domi-nantly regulates the proliferation of esophagus cancer cells .
RESUMO
Objective: To evaluate the diagnostic value of fluorine-18 fluorodeoxyglucose ( 18 F-FDG) positron emission tomography/computed tomography ( PET/CT) in fever of unknown origin ( FUO) in a Chinese hospital .Methods:The records of 51 patients with FUO (32 men and 19 women;mean age 54 years with a range between 3 and 81 years) were analyzed retrospectively .All the patients were examined by 18 F-FDG PET/CT scan and the results were compared with the final diagnosis which was established by additional procedures including pathology , laboratory examination , and clinical follow-up for more than 3 months.The t test was used for statistical analysis .Results: A final diagnosis was established for 48 patients , including 32 patients with infectious diseases , 9 with malignancies , and 7 with non-infectious inflammatory diseases .By FDG PET scan alone , the rates of true positive , false positive , false negative, and true negative were 52.9%, 27.5%, 17.6%, and 2.0%, respectively.By FDG PET/CT scan, the rates of true positive, false positive, false negative, and true negative were 70.6%, 27.5%, 2.0%, and 0, respectively.18F-PET/CT had a sensitivity of 97.3%(36/37), specificity of 0 (0/14), and accuracy of 70.6%(36/51) in FUO, especially a high sensitivity and accuracy of 100%(9/9) in the diagnosis of malignant tumor .Moreover , the maximum standardized uptake value ( SUVmax ) in tumor was significant higher than that in infection (3.7 ±2.7 vs.7.7 ±3.5, P=0.001, t=3.6), which implied that SUVmax might be useful in differential diagnosis in FUO .Conclusion:FDG PET/CT is a valuable imaging tool for the identification and location of the potential lesion in FUO and is helpful for the etiological diagnosis , especially in the diagnosis of malignant lesions .
RESUMO
Para-neoplastic neurological syndrome (PNS) is a series of rare illnesses affecting the nervous system and associated with several malignant tumors. PNS is manifested by various clinical symptoms, which conventionally precede the diagnosis of tumors in months or even years. Although anti-neuronal antibodies can indicate the presence of cancer, numerous false positive and false nega-tive cases are detected. Therefore, the clinical diagnosis of PNS has become a challenge. Position emission tomography/computed to-mography (PET/CT) is an image-fusion method containing anatomical and functional information and can be used to obtain whole-body images by a single scan. Fluoro-deoxy-glucose (FDG) PET/CT imaging can reveal potential malignant lesions in the whole body and diagnose specific types of cancer. This technology can also be applied to assess functional abnormality in the brain and moni-tor its response to treatment. Furthermore, the mechanism, clinical manifestation, and diagnosis of PNS are introduced in this study. Re-cent applications of FDG PET/CT in the diagnosis of PNS are reviewed to improve diagnostic accuracy.
RESUMO
Objective To evaluate the usefulness of delayed parenchymal transit time (PTT) on 99TcmDTPA diuretic renography as a predictor for functional improvement after Anderson-Hynes dismembered pyeloplasty in patients with ureteropelvic junction obstruction (UPJO).Methods Forty-seven patients (37males,10 females,age (29.7± 10.8) years) with unilateral U PJO were retrospectively analyzed.All patients underwent 99Tcm-DTPA diuretic renography before and after the surgery.Patient age,sex,UPJO location,surgical methods,relative renal function (RRF) of the diseased kidney (uptake ratio of UPJO kidney to both kidneys),and PTT were recorded.Delayed PTT was defined as having one of the following criteria: (1) photopenic pelvis between the second and seventh frame; (2) relatively stable tracer distribution within the kidney between the second to ninth frame with nearly unchanged kidney shape and size; (3) ever increasing activity in the parenchyma; (4) slower clearance from the parenchyma into the pelvis since the second frame compared with the contralateral healthy kidney.The relationship between the above-mentioned factors and RRF improvement (RRFpvst-surgery,-RRFpre-sugery) was analyzed.Paired t test,Kruskal-Wallis and Mann-Whitney rank sum tests and Pearson correlation analysis were used.Results The average RRF of pre-and post-surgery was (40.70± 13.30) ％ and (44.96 ± 12.60) ％,respectively (t =4.19,P ＜ 0.01).RRF improvement between the delayed group (n=16) and normal timely PTT group (n=27) was significantly different: ((11.69±6.52) ％ vs (0.48±2.98) ％,Z=-5.13,P＜0.01).The assessment of delayed or normal PTT could not be determined in 4 patients.No statistically significant differences of RRF improvement were found between pre-surgery RRF ＜ 40％ and RRF ≥ 40％ groups,between left and right UPJO groups,between open surgery and laparoscope groups,between male and female patients (Z =-1.93 to 1.25,all P＞0.05).There was no significant correlation between RRF improvement and patient age (r =0.01,P＞0.05).Conclusion Delayed PTT on 99Tcm-DTPA diuretic renography might be the predictor for functional improvement post surgery in UPJO patients.
RESUMO
The microRNA (miRNA) is a novel class of small noncoding RNA that regulate gene expression by targeting mRNA.It has been shown to play important roles in a broad range of biological processes,especially in the occurrence,development,invasion and metastasis of malignant tumors.Conventional detection methods,such as Northern blot and realtime PCR have been used to assess endogenous miRNA expression.However,these techniques are invasive and cannot be used repetitively in living animals.Recent remarkable advances of in vivo imaging techniques have provided the capability of noninvasive imaging of miRNA in vivo.The recent progress about the reporter gene,antisense luminescence,nanoparticle and multimodal imaging for visualizing miRNA expression in vivo was reviewed.
RESUMO
Objective To assess the value of 18F-FDG PET/CT in clinical classification,monitoring of chemotherapeutic response and surveillance of histopathological transformation of Castleman's disease (CD).Methods Fourteen pathologically diagnosed CD patients (7 males,7 females; mean age:(45.64±14.30) years) were retrospectively reviewed.18F-FDG PET/CT was performed before chemotherapy in all patients and 4 of 14 patients were reexamined after the treatment.The study parameters included histopathological results,sites,number and highest SUVmax of the lesions.Mann-Whitney and Kruskal-Wallis tests were used for data analysis.Results Of all the 12 patients without histopathological transformation,one or more enlarged and metabolically active lymph nodes were found in each patient (SUVmax =3.94± 1.44,range:1.9-6.8),including 2 unicentric CD (UCD) and 10 multicentric CD (MCD).There was no statistically significant difference of SUVmam between UCD and MCD (4.55±3.18 vs 3.82±1.14; Z=0.22,P＞0.05).There was also no significant difference of SUVmax among different pathological types (hyaline-vascular CD (4/12):3.56±0.96,plasma cell CD (6/12):4.73±1.41,mixed CD (2/12):2.30±0.57; x2 =4.74,P＞0.05).For the 4 patients with follow-up PET/CT after chemotherapy,the lesion activity was normalized in 3 patients and clearly reduced in 1 patient.The SUVmax of 2 patients with histopathological transformation (10.85±2.05) was significantly higher than that without transformation (3.94± 1.44; Z=-2.19,P＜0.05).Conclusion 18F-FDG PET/CT may play an important role in clinical classification,monitoring of chemotherapeutic response and surveillance of histopathological transformation of CD.
