2010 Vol. 34, No. 1
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2010, 34(1): 1-5.
doi: 10.3760/cma.j.issn.1673-4114.2010.01.001
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Abstract:
Various imaging modalities have been exploited to investigate the anatomic or functional dissemination of tissues in the body.However, no single imaging modality allows overall structural, functional, and molecular information as each imaging modality has its own unique strengths and weaknesses.The combination of two imaging modalities that investigates the strengths of different methods might offer the prospect of improved diagnostic abilities.As more and more dual-modality imaging system have become clinically adopted, significant progress has been made toward the creation of dual-modality imaging probes, which can be used as novel tools for future multimodality systems.These all-in-one probes take full advantage of two different imaging modalities and could provide comprehensive information for clinical diagnostics.This review discusses the advantages and challenges in developing dual-modality imaging probes.
Various imaging modalities have been exploited to investigate the anatomic or functional dissemination of tissues in the body.However, no single imaging modality allows overall structural, functional, and molecular information as each imaging modality has its own unique strengths and weaknesses.The combination of two imaging modalities that investigates the strengths of different methods might offer the prospect of improved diagnostic abilities.As more and more dual-modality imaging system have become clinically adopted, significant progress has been made toward the creation of dual-modality imaging probes, which can be used as novel tools for future multimodality systems.These all-in-one probes take full advantage of two different imaging modalities and could provide comprehensive information for clinical diagnostics.This review discusses the advantages and challenges in developing dual-modality imaging probes.
2010, 34(1): 6-11.
doi: 10.3760/cma.j.issn.1673-4114.2010.01.002
Abstract:
Stroke is one of the leading causes of death and disability, especially for the old population in modern world.As one of ligand-gating ionotropic glutamate receptors, N-methyl-D-aspartate rece pto r(NMDAR)involves in excitatory synaptic transmission, synaptic plasticity and the cause and development of numerous neurological as well as psychiatric disorders.Since the distribution of NMDAR varies in different regions, certain brain regions such as hippocampus and cortex with the highest density of NMDAR, are especially sensitive to ischemia.Much emphasizes have been put on the changes of excitatory neurotransmission and NMDAR in central nervous system after ischemia, because the glutamate-mediated excitatory neurotoxicity play a key role in the development of stroke.It has been shown that neuronal death after ischemia results from excessive Ca2+ influx, which is due to the hyperactivity of NMDAR, Ca2+ permeable α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid receptor, kainic acid receptors and/or other ion channels permeable to Ca2+.The increase of intracellular Ca2+ triggers the cascades of cell death.With specific structure and pharmacology properties, this study of the tracer of NMDAR give the target for early diagnosis and developing of specific antagonist.Elucidating the changes in interneurons after ischemia/ hypoxia with tomography in vivo will help to understand the mechanisms underlying the neoroprotection of antagonist.
Stroke is one of the leading causes of death and disability, especially for the old population in modern world.As one of ligand-gating ionotropic glutamate receptors, N-methyl-D-aspartate rece pto r(NMDAR)involves in excitatory synaptic transmission, synaptic plasticity and the cause and development of numerous neurological as well as psychiatric disorders.Since the distribution of NMDAR varies in different regions, certain brain regions such as hippocampus and cortex with the highest density of NMDAR, are especially sensitive to ischemia.Much emphasizes have been put on the changes of excitatory neurotransmission and NMDAR in central nervous system after ischemia, because the glutamate-mediated excitatory neurotoxicity play a key role in the development of stroke.It has been shown that neuronal death after ischemia results from excessive Ca2+ influx, which is due to the hyperactivity of NMDAR, Ca2+ permeable α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid receptor, kainic acid receptors and/or other ion channels permeable to Ca2+.The increase of intracellular Ca2+ triggers the cascades of cell death.With specific structure and pharmacology properties, this study of the tracer of NMDAR give the target for early diagnosis and developing of specific antagonist.Elucidating the changes in interneurons after ischemia/ hypoxia with tomography in vivo will help to understand the mechanisms underlying the neoroprotection of antagonist.
2010, 34(1): 11-15.
doi: 10.3760/cma.j.issn.1673-4114.2010.01.003
Abstract:
Objective To investigate the value of 18F-FDG PET-CT scans on early assessing the therapeutic effects on human nasopharyngeal carcinoma(NPC)xenograft in nude mice after radiotherapy, and preliminarily analyze the relation of 18F-FDG PET-CT scans and the positive expression rate of Ki67, and provide a basis for further clinical studies. Methods Fifteen xenograft nude mice of NPC were randomly divided into three groups(5 nude mice per group).Control group: all mice immediately executed after the 18FFDG PET-CT scans and taken pathology; 6 Gy radiotherapy group: all mice took 18F-FDG PET-CT scans before and 1 d after receiving 6 Gy irradiation, and were killed immediately to take pathology; 12 Gy radiotherapy group: all mice received 12 Gy irradiation(6 Gy each time, totally 2 times).They took 18F-FDG PET-CT scans before radiotherapy, after receiving the first 6 Gy irradiation, 2 d and 6 d after receiving 12 Gy irradiation respectively, and then were executed to take pathology after the last scan. The expression of Ki67 in xenografts of different groups was detected and the relation between their changes and T/NT were analyzed. Results ① For 12 Gy radiotherapy group, the average T/NT ratios of the NPC xenograft of pre-radiotherapy, after the first 6 Gy irradiation, 2 d and 6 d after 12 Gy radiotherapy were 2.17±0.31, 1.68±0.42, 1.41±0.40, and 0.70±0.12, respectively. The average T/NT ratios were not statistically difference before and after the first 6 Gy irradiation. The average T/NT ratio of 2 d after radiotherapy decreased significantly than pre-radiotherapy (t=2.80, P < 0.05) and after the first 6 Gy irradiation(t=3.14, P < 0.05); The average T/NT ratio of 6d after radiotherapy was decreased seriously than 2 d after radiotherapy (t=3.49, P < 0.05, compared with pre-radiotherapy t=8.01, P < 0.01). ② The positive expression rates of Ki67 of NPC xenograft markedly decreased after receiving irradiation. There were significant differences in the positive expressions of Ki67 between different groups(F=21.95, P < 0.01).The positive expression of Ki67 in the 12 Gy radiotherapy group decreased significantly compared with the control group (t=7.145, P < 0.01) and the 6 Gy radiotherapy group (t=2.384, P < 0.05). The positive expression of Ki67 in the 6 Gy radiotherapy group was less than the control group, also have statistical significance(t=4.320, P < 0.01).③There was no correlation between the T/NT ratio of NPC xenograft and the positive expression of Ki67. ④Positive correlation was found between the variance of T/NT ratio and the variance of the positive expression of Ki67 of NPC xenograft (r=0.532, P < 0.05). Conclusions 18F-FDG PET-CT imaging has an important value on early assessing the therapeutic effects of NPC xenograft in nude mice after radiotherapy, and the 6th day after radiotherapy is an appropriate time point.18F-FDG PET-CT imaging can reflect the variance of the positive expression of Ki67 of NPC, and yet indirectly reflect the sensitivity of NPC to radiotheraphy.
2010, 34(1): 16-19.
doi: 10.3760/cma.j.issn.1673-4114.2010.01.004
Abstract:
With the rise of nano science and technology, more and more researchers will take attention to application of nano-drugs in the biomedical field.The current focus of concern is that a target of nano-drugs linked specificity immunoreactive substances combine to tumor cells for diagnosis and treatment by physical, chemical and biological synthesis methods in based on nano-drugs.This paper mainly reviewed the concept of nano-drug and development of nano-drug targeting research.
With the rise of nano science and technology, more and more researchers will take attention to application of nano-drugs in the biomedical field.The current focus of concern is that a target of nano-drugs linked specificity immunoreactive substances combine to tumor cells for diagnosis and treatment by physical, chemical and biological synthesis methods in based on nano-drugs.This paper mainly reviewed the concept of nano-drug and development of nano-drug targeting research.
2010, 34(1): 19-22.
doi: 10.3760/cma.j.issn.1673-4114.2010.01.005
Abstract:
Tumor angiogenesis is the foundation of tumor growth and metastasis.The vascular endothelial growth factor(VEGF)and VEGF receptor(VEGFR)plays a pivotal role in regulating tumor angiogenesis.VEGFR has become a common molecular target which has a potential value in angiogenesis diagnosis and therapy at present.Radionuclide receptor imaging has the advantage of high sensitivity and specificity, by which distribution density of VEGFR and its affinity with its ligand in tumor tissue can be revealed.VEGFR imaging is helpful in diagnosis, staging and detection of recurrence and metastasis of tumor and plays an instructive role in biological therapy of tumor mediated by VEGFR.
Tumor angiogenesis is the foundation of tumor growth and metastasis.The vascular endothelial growth factor(VEGF)and VEGF receptor(VEGFR)plays a pivotal role in regulating tumor angiogenesis.VEGFR has become a common molecular target which has a potential value in angiogenesis diagnosis and therapy at present.Radionuclide receptor imaging has the advantage of high sensitivity and specificity, by which distribution density of VEGFR and its affinity with its ligand in tumor tissue can be revealed.VEGFR imaging is helpful in diagnosis, staging and detection of recurrence and metastasis of tumor and plays an instructive role in biological therapy of tumor mediated by VEGFR.
2010, 34(1): 23-26.
doi: 10.3760/cma.j.issn.1673-4114.2010.01.006
Abstract:
Objective To investigate clinical significance of the 99Tcm-bis(N-ethoxy-N-ethyl-dithiocarbamato)nitridotechnetium(99Tcm-N-NOET)exercise and delayed myocardial perfusion imaging(MPI)in hypertensive patients. Methods Sixty patients with hypertension and 19 normal subjects were carried out 99Tcm-N-NOET exercise and delayed MPI, and analyzed the results of MPI, exercise electrocardiography(ECG), cardiac function parameters end-diastolic volume(EDV), end-systolic volume(ESV), left ventricular ejection fraction(LVEF), △LVEF(LVEF exercis-LVEF delay)and coronary angiography(CAG). Results ① Sixty patients with hypertension, 22 cases(36.7%)of exercise ECG were abnormal, 16 cases(26.7%)were the chest tightness in exercise, 13 cases(21.7%)were blood pressure excessive reaction in exercise; control group, 2 cases(10.5%)of exercise ECG were abnormal, 1 case(5.3%, 1/19)was chest tightness in exercise, no per-son was blood pressure response in excessive.②The positive rate of myocardial perfusion in hyper-tensive group was significantly higher than the control group(31.75%vs.5.30%, P < 0.05).③Cardial function parameters in hypertension group[exercise EDV=(79.75±29.10)ml, ESV=(28.82±15.73)ml, LVEF=(65.78± 1.27)%; delay EDV=(81.42±3.47)ml, ESV=(30.62±2.05)ml, LVEF=(64.20±9.70)%]and control group[exercise EDV=(79.63±21.65)ml, ESV=(27.37±10.71)ml, LVEF=(66.42±1.55)%; delay EDV=(82.89±4.96)ml, ESV=(31.42±3.06)ml, LVEF=(63.16±7.54)%]were no statistical difference(exercise EDV: t=0.161, ESV: t= 0.112, LVEF: t=0.261; delay EDV: t=0.276, ESV: t=0.197, LVEF: t=0.184, P > 0.05), △LVEF < 0%, 28 cases (46.7%)in hypertension group, 4 cases(21.1%)in control group, χ2=3.929, P < 0.05; 11 cases(57.9%)in MPI positive group, 12 cases(29.3%)in MPI negative group, χ2=4.501, P < 0.05.④Nineteen patients with hypertension underwent CAG, 11 cases were abnormal, 8 cases were normal.MPI results: 9 cases were ischemia, 10 cases were normal, and they were no statistical difference(χ2=0.25, P > 0.05).The sensitivity, specificity and accuracy of 99Tcm-N-NOET MPI were 72.7%, 87.5%and 78.9%. Conclusions ① 99Tcm-NNOET exercise and delayed MPI can diagnose whether hypertension patients with myocardial ischemia or not.②△LVEF of hypertensive patients reduced, △LVEF is lower in hypertensive patients of MPI-positive.
2010, 34(1): 27-31.
doi: 10.3760/cma.j.issn.1673-4114.2010.01.007
Abstract:
Radioiodine ablation of thyroid remnants after surgery is an important part of the treatment of differentiated thyroid carcinoma.The effect of ablation therapy is affected by many factors, such as the administration dose of radioiodine, mode of operation, amount of thyroid remnants, the serum level of thyroidstimulating hormone and thyroglobulin, whether lymph nodes or distant metastasis are existed, the period of time between the ablation treatment and the operation and so on.Relative high dose of radioiodine, total or near-total thyroidectomy, high level of thyroid-stimulating hormone, ablation treatment onset after surgery without delay would contributed to the success of thyroid ablation.If the patient's thyroglobulin levels are high or metastasis foci are existed, the dose of radioiodine should increase to some extent.While patient's gender, age and pathology are unrelated to the treating effect.
Radioiodine ablation of thyroid remnants after surgery is an important part of the treatment of differentiated thyroid carcinoma.The effect of ablation therapy is affected by many factors, such as the administration dose of radioiodine, mode of operation, amount of thyroid remnants, the serum level of thyroidstimulating hormone and thyroglobulin, whether lymph nodes or distant metastasis are existed, the period of time between the ablation treatment and the operation and so on.Relative high dose of radioiodine, total or near-total thyroidectomy, high level of thyroid-stimulating hormone, ablation treatment onset after surgery without delay would contributed to the success of thyroid ablation.If the patient's thyroglobulin levels are high or metastasis foci are existed, the dose of radioiodine should increase to some extent.While patient's gender, age and pathology are unrelated to the treating effect.
2010, 34(1): 31-34.
doi: 10.3760/cma.j.issn.1673-4114.2010.01.008
Abstract:
Hyperthyroidism is an autoimmune diseasein which excessive amounts of thyroid hormones circulate in the blood.The treatments for hyperthyroidism mainly include antithyroid drugs, 131I treatment, and surgery.131I had been verified as an effective, safe, simple method to treat adult and children hyperthyroidism.Current research trends of 131I treatment mainly are problems of 131I treatment of hyperthyroidism and its long-term security.
Hyperthyroidism is an autoimmune diseasein which excessive amounts of thyroid hormones circulate in the blood.The treatments for hyperthyroidism mainly include antithyroid drugs, 131I treatment, and surgery.131I had been verified as an effective, safe, simple method to treat adult and children hyperthyroidism.Current research trends of 131I treatment mainly are problems of 131I treatment of hyperthyroidism and its long-term security.
2010, 34(1): 35-37, 41.
doi: 10.3760/cma.j.issn.1673-4114.2010.01.009
Abstract:
Objective To evaluate the situation of nuclear medicine in Beijing 2008. Methods Staff, equipment, clinical applications and research of nuclear medicine in Beijing were evaluated by post questionnaires.The military hospitals were excluded from the survey. Results Thirty-five nuclear medicine departments and PET, PET-CT centers from 33 hospitals responded to our survey.In these departments and centers, there were 334 staff, doctors 42.8%, technicians 39.8%, nurses 9.3%, physical therapist and engineers 2.4%, chemists 2.1%, others 3.6%.Forty-nine imaging equipment included 2 gamma cameras, 42 SPECT, 2 PET, 3 PET-CT, were equipped in these hospitals before the end of 2008.During 2008, clinical studies consisted of 100 685 radionuclide imaging(96 857 for SPECT, 3758 for PET-CT), 7832 function measures (6980 for thyroid function, 852 for renal function), 6768 bone density measures, 632 491 for in vitro studies, and 3169 radionuclide therapies(the most for Graves'disease, followed bythyroid cancer and bone metastasis). One hundred and one papers were published as first author in 2008.State of the art imaging equipments conducted the daily quality control(QC), weekly QC, monthly QC and quarterly QC were 43.3%, 30.4%, 47.8%and 67.4%respectively. Conclusion Compared with 2005, high educated staff increased, the proportion of technicists and nurses enlarged, the cases of radionuclide imaging and treatment increased, QC procedures of the equipments were enhanced but not enough.
2010, 34(1): 38-41.
doi: 10.3760/cma.j.issn.1673-4114.2010.01.010
Abstract:
Cardiac resynchronization therapy(CRT)has shown benefits in patients with advanced heart failure.It has shown with ultrasound cardiogram(UCG)that the presence of left ventricular mechanical dyssynchrony is an important predictor for response to CRT.Therapy trial showed that under present conditions the current available UCG techniques including tissue Doppler imaging(TDI)and myocardial strain-rate imaging are not ready for routine clinical practice to assess left ventricular dyssynchrony.Research now shows that the advantages of gated myocardial perfusion SPECT over TDI are its automation, repeatability, and reproducibility that are very promising in improving prediction of CRT response in heart failure patients.
Cardiac resynchronization therapy(CRT)has shown benefits in patients with advanced heart failure.It has shown with ultrasound cardiogram(UCG)that the presence of left ventricular mechanical dyssynchrony is an important predictor for response to CRT.Therapy trial showed that under present conditions the current available UCG techniques including tissue Doppler imaging(TDI)and myocardial strain-rate imaging are not ready for routine clinical practice to assess left ventricular dyssynchrony.Research now shows that the advantages of gated myocardial perfusion SPECT over TDI are its automation, repeatability, and reproducibility that are very promising in improving prediction of CRT response in heart failure patients.
2010, 34(1): 42-46.
doi: 10.3760/cma.j.issn.1673-4114.2010.01.011
Abstract:
Objective To investigate the optimal program of 99Tcmlabeled radionuclide imaging in diagnosing coronary disease. Methods Four-thousand-two-hundred and thirty-six patients who were suspected or diagnosed with coronary disease were chosen.Eight-thousand-eight-hundred and seventy-three times 99Tcmlabeled radionuclide imaging were taken and analyzed.The optimal program of 99Tcmlabeled radionuclide imaging were drawn, compared and verified with their clinical information. Results The optimal program had high accuracy in diagnosing the patients of coronary disease, myocardial ischemia, myocardial infarction.It also was exact in special clinical needs of detecting myocardial viability, culprit vessel, ischemic cardiomyopathy and therapy effect. Conclusions The optimal program could satisfy many requirements of diagnosing coronary disease and overcome some defects of radionuclide imaging.So it was one highperforming, convenient and economical program and had significant clinical value.
2010, 34(1): 49-52.
doi: 10.3760/cma.j.issn.1673-4114.2010.01.013
Abstract:
Objective To investigate the efficacy and safety of transcatheter arterial chemoembolization (TACE)in combination with secondary resection in the treatment of massive extrahepatic growing hepatocellular carcinoma(E-HCC). Methods Five patients were involved in this study.CT reviewed after the first time of TACE treatment a month.If the lesion was not filled with satisfaction by chemotherapic agents lipiodol emulsion, arterial angiography and TACE were performed again.If failed to inject chemotherapic agents lipiodol emulsion into the lesions through the feeding arteries, the secondary resection was used. Results Five patients underwent TACE treatment 9 times, an average of 1.8 times.CT reviewed the iodized oil deposition in the tumor showed 3 types after all patient were treated first time of TACE a month: completely filled 1 case; dense filled 3 cases; spot or ring-type filled 1 case.After received the secondary resection, 3 cases of them were underwent curative resection successfully, the other 2 cases were used palliative resection due to surrounding tissue severe adhesion. Post-operative pathological specimen showed 35%~100% tumor necrosis (average 74.8%). During a follow-up of 13~27 months, 1 survived and 4 deaths, the median survival time was 22.2 months. No severe complications were observed. Conclusion TACE can induce obvious necrosis and shrinkage of E-HCC and increase the opportunities of secondary resection.
2010, 34(1): 53-55.
doi: 10.3760/cma.j.issn.1673-4114.2010.01.014
Abstract:
Objective To improve the accuracy of diagnosis by studying the imaging manifestation of renal angiomyolipoma(AML). Methods Cellected the ultrasonic, CT, MRI data of 36 cases renal AML, analysed the imaging manifestation characteristics of each case. Results Accuraus rate of ultrasonic was 63.8%, CT 86.1%and MRI 91.7%. Conclusions Ultrasonic, CT and MRI all could clear the size, shape, position and neighbouring relation of the renal AML, among which MRI could accurately diagnose the internal parts and bleeding.It could also distinguish the kidney lipoma, differentiated liposarcoma, and kidney cancer, thus greatly improve the diagnosis accuracy of this disease.
2010, 34(1): 56-58.
doi: 10.3760/cma.j.issn.1673-4114.2010.01.015
Abstract:
Objective The treatment results of cervical cancer in post stage stereotactic radiotherapy (SRT)after the whole pelvic cavity radiotherapy, was evaluated to explore the feasibility of this optimal method. Methods Forty-nine moderate or advanced cases of cervical cancer with the same clinical stages and pathologic types in our hospital were treated with the whole pelvic cavity radiotherapy and post stage SRT push doses radiotherapy.They were followed up for 3 to 12 months, the total effective rates, the tumor progressions after radiotherapy and no side effects after radiotherapy in patients were observed. Results After radiotherapy for 3 months, the patients'tumor total effective rates were 81.6%, tumor progression rates without intrauterine were 100%, rectum reaction rates were 18.4%and bladder reaction rates were 12.2%. Conclusions This optimization was feasible to the patients of cervical cancer with better tumors'local control and surviving time's prolongation.
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