2010 Vol. 34, No. 3
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2010, 34(3): 129-134.
doi: 10.3760/cma.j.issn.1673-4114.2010.03.001
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Abstract:
Nuclear medical molecular imaging is developing toward a multimodality and multitracer future. Abundant complementary data generated from different tracers in different modalities are successfully serving the biological research and clinical treatment. Among the others, PET-MRI has the greatest potential and will be a research of interest in the near future. This article focused on the evolution history of nuclear medicine from single modality to multimodality, single tracer to multitracer. It also gave a brief summary to the identifications, differences, pros and consofmultimodality, multitracer, multiparametric molecular imaging. Issues, problems and challenges concerned with her development and recognition are also discussed.
Nuclear medical molecular imaging is developing toward a multimodality and multitracer future. Abundant complementary data generated from different tracers in different modalities are successfully serving the biological research and clinical treatment. Among the others, PET-MRI has the greatest potential and will be a research of interest in the near future. This article focused on the evolution history of nuclear medicine from single modality to multimodality, single tracer to multitracer. It also gave a brief summary to the identifications, differences, pros and consofmultimodality, multitracer, multiparametric molecular imaging. Issues, problems and challenges concerned with her development and recognition are also discussed.
2010, 34(3): 135-138.
doi: 10.3760/cma.j.issn.1673-4114.2010.03.002
Abstract:
Objective To screen in vivo lung cancer specific binding 7-peptide from T7 phage display random peptide library and prepare peptide imaging agent in early diagnosis of lung cancer. Methods Used phage display in vivo technology to get the 7-peptide phage that can bind the lung cancer specifically, then sequenced and synthesized 7-peptide. After being labeled by 125I, this 7-peptide was injected into mice via vein and the distribution in the mice tumor mold was observed. Results One 7-peptide was obtained after four rounds of screening, and the peptide could bind lung cancer tissue specifically. Metabolism of this peptide in mice was fast and imaging of lung cancer was best two hours later after injection. The distribution in vivo decreased and almost disappeared after six hours. Conclusion This 7-peptide could be used to image and diagnose of lung cancer effectively.
2010, 34(3): 139-142.
doi: 10.3760/cma.j.issn.1673-4114.2010.03.003
Abstract:
Objective To evaluate and compare the suitability of 11C-choline and 18F-FDG PET-CT for reflecting tumors angiogenesis. Methods Fifty-four New Zealand white rabbits which weighted 2.5~3.0 kg were used in the experiment. Under general anesthesia, a needle was transthoracically inserted into the right lung, 0.5 ml viable VX2 tumor cell suspension was slowly injected through the needle to establish the model. 11C-choline and 18F-FDG PET-CT were performed after 10~11 d. The tumors SUVmax were calculated. The sections were stained with hematoxylin and eosin, and immunostained for CD34. Assessment of microvessel density (MVD) was performed by computer-assisted image analysis. The relationship 11C-choline SUVmax and 18F-FDG SUVmax with tumor size and MVD were statistically analyzed. Results Thirty-three rabbits successfully completed all imaging examinations. 11C-choline and 18F-FDG differently accumulated in all lung VX2 tumors. The mean of 11C-choline SUVmax was 4.02±3.07 (1.4~12.2), and the mean of 18F-FDG SUVmax was 5.70±3.45 (1.0~13.0). The mean size of tumor was(1.68±1.61)cm3 (0.13~8.00 cm3). Under high power microscope field of vision (200×, 0.739 mm2), the mean of MVD was 35.8±13.6(13~64). 11C-choline SUVmax did not correlate with tumor size and MVD. 18F-FDG SUVmax significantly and positively related to MVD (r=0.525, P=0.002). There was a critical positive correlation between 18F-FDG SUVmax and tumor size (r=0.335, P=0.057). Conclusions In the rabbit VX2 lung tumor model, 18F-FDG SUVmax correlated with MVD, so 18F-FDG PET-CT could reflect tumor angiogenesis. 11C-choline SUVmax did not statistically correlate with MVD, and 11C-choline PET-CT could not reflect tumor angiogenesis.
2010, 34(3): 143-147.
doi: 10.3760/cma.j.issn.1673-4114.2010.03.004
Abstract:
The patients with Graves disease hyperthyroidism are often accompanied by disorder of glycometabolism.β-cell dysfunction and insulin resistance play a main role in this disease, while the immune and genetic factors are also relevant with the disease. The blood glycose level can become normal gradually with the recovery of thyroid hormone after 131I and antithyroid drug treatment. Therefore, the blood glycose level could be improved and complications could be prevented by early treatment in the patients with Graves disease hyperthyroidism accompanied with glycometabolism disorder is helpful for improving the blood glycose level.
The patients with Graves disease hyperthyroidism are often accompanied by disorder of glycometabolism.β-cell dysfunction and insulin resistance play a main role in this disease, while the immune and genetic factors are also relevant with the disease. The blood glycose level can become normal gradually with the recovery of thyroid hormone after 131I and antithyroid drug treatment. Therefore, the blood glycose level could be improved and complications could be prevented by early treatment in the patients with Graves disease hyperthyroidism accompanied with glycometabolism disorder is helpful for improving the blood glycose level.
2010, 34(3): 147-151.
doi: 10.3760/cma.j.issn.1673-4114.2010.03.005
Abstract:
As a kind of membrane protein that mainly mediates iodide transport into thyroid follicular cells, sodium iodide symporter(NIS) plays a key role in radioiodine therapy of both thyroid and other cancers. Studies show that decreased NIS expression level or intracellular localization in thyroid carcinomas lead to low iodine uptake. So NIS gene therapy is a new method to overcome this problem. To be therapeutically effective, radioiodine has to be remained in the tumor cells for sufficient long time; this is still a problem which reduces therapeutic effect. It should increase iodide retention and decrease iodide efflux in tumor cells to optimize therapeutic scheme. This article reviews the studies on advances of radioiodine therapy of tumor induced by sodium iodide symporter gene.
As a kind of membrane protein that mainly mediates iodide transport into thyroid follicular cells, sodium iodide symporter(NIS) plays a key role in radioiodine therapy of both thyroid and other cancers. Studies show that decreased NIS expression level or intracellular localization in thyroid carcinomas lead to low iodine uptake. So NIS gene therapy is a new method to overcome this problem. To be therapeutically effective, radioiodine has to be remained in the tumor cells for sufficient long time; this is still a problem which reduces therapeutic effect. It should increase iodide retention and decrease iodide efflux in tumor cells to optimize therapeutic scheme. This article reviews the studies on advances of radioiodine therapy of tumor induced by sodium iodide symporter gene.
2010, 34(3): 152-155.
doi: 10.3760/cma.j.issn.1673-4114.2010.03.006
Abstract:
Objective To analyses the clinical data of 131I in treating youngsters with Graves disease, and to explore the effective dose range which is appropriate for Chinese youngsters with Graves disease. Methods Two hundred and thirty-four youngsters with Graves disease were selected in this study, their ages were between 8 and 17, the average quality of their thyroids was (59.0±16.5)g. According to the absorbed dose of 131I per gram of thyroid gland, 234 patients were divided into five groups: A: 1.11- < 1.48 MBq/g, B: 1.48- < 1.85 MBq/g, C: 1.85- < 2.22 MBq/g, D: 2.22-2.59 MBq/g, E: >2.59 MBq/g. The therapeutic effect was evaluated by observing after treatment. And calculate the recovery rate, the improvement rate and the incidence rate of hypothyroidism. Results ① One hundred and fifty-two(64.95%) patients were cured, 56(23.93%) were much better than before and 26(11.11%) were hypothyroid. The therapeutic effect of group B was the best in all groups. ②The recovery rate: there was no significant difference between group B, group C and group D(χ2=2.68, P>0.05). The recovery rate of group B was better than group A and group E(χ2=10.20 and χ2=5.49, P < 0.05). The recovery rate of group A was the lowest. ③The improvement rate: There was no significant difference between group B, group C, group D and group E (χ2=1.94, P>0.05). The improvement rate of group A was the highest (χ2=8.74, χ2=6.68, χ2=7.01 and χ2=11.12, P < 0.05). ④The incidence rate of hypothyroidism: There was no significant difference between group A, group B, group C and group D (χ2=2.71, P>0.05). Group E had the highest incidence rate of hypothyroidism(χ2=12.36, χ2=11.58, χ2=9.37 and χ2=4.36, P < 0.05). Conclusions Using 131I is a safe and effective therapeutic approach for youngsters with Graves disease. We suggest the absorbed dose range of 131I per gram of thyroid gland is 1.48-2.59 MBq/g, which can obtain the better therapeutic effect and can't increase the incidence rate of hypothyroidism.
2010, 34(3): 155-158.
doi: 10.3760/cma.j.issn.1673-4114.2010.03.007
Abstract:
Objective To evaluate the value of 18F-fluorodeoxyglucose(18F-FDG)SPECT-CT in detecting recurrence and(or) metastasis of cervical cancer. Methods Retrospective analysis of 62 patients who underwent 18F-FDG SPECT-CT to evaluate recurrence and/or metastasis of cervical cancer at Fujian Tumor Hospital. The diagnostic results were confirmed by second surgery, biopsy or clinical follow-up, and also compared with the coincidence images obtained by CT scan and the serum squamous cell carcinoma related antigen(SCCA) levels. Results It is confirmed that 36 of 62 patients had recurrence and(or) meta-stasis of cervical cancer by biopsy or clinical follow-up. The sensitivity, specificity, positivity predicitive value (PPV), negative predictive value (NPV), and accuracy of 18F-FDG SPECT-CT were 94.4%, 92.3, 94.4%, 92.3%and 93.5%. Those of CT scan were 69.4%, 80.8%, 83.3%, 65.6% and 74.2%. Those of SCCA measurement were 66.7%, 46.2%, 63.2%, 50.0% and 58.1%. Conclusions 18F-FDG SPECT-CT has greater clinical value to monitor recurrence and(or) metastasis of cervical cancer.
2010, 34(3): 158-160.
doi: 10.3760/cma.j.issn.1673-4114.2010.03.008
Abstract:
Studies show that high expression of bombesin exist in the face of many kind of tumors such as prostate cancer, so bombesin and its receptor can be used as target in radionuclide receptor imaging and targeted therapy of tumor, and become the focus of prostate cancer research. This article reviews the progress of radiolabelled bombesin in prostate cancer imaging and therapy.
Studies show that high expression of bombesin exist in the face of many kind of tumors such as prostate cancer, so bombesin and its receptor can be used as target in radionuclide receptor imaging and targeted therapy of tumor, and become the focus of prostate cancer research. This article reviews the progress of radiolabelled bombesin in prostate cancer imaging and therapy.
2010, 34(3): 161-164.
doi: 10.3760/cma.j.issn.1673-4114.2010.03.009
Abstract:
Objective To explore the clinical valuation of serum free prostate-specific antigen/total prostate-specific antigen(FPSA/TPSA) ratio in the diagnosis of prostate cancer with time-resolved fluoroim-munoassay. Methods Selected randomly 115 patients with benign prostatic hyperplasia and 58 patients with prostate cancer, sixty healthy physical examinees were chosen as normal control. Serum TPSA, FPSA and FPSA/TPSA ratio were measured with time-resolved fluoroimmunoassay. Results When TPSA was between 4.0- 45.5 μg/L, there was the rang of overlapping of TPSA in benign prostatic hyperplasia and prostate cancer patients. TPSA couldn't be a differential mark for the two conditions(t=1.76, P>0.05). But there were significant differences in the FPSA/TPSA ratio between the two conditions(t=2.74, P < 0.05). When the reference value was FPSA/TPSA≤0.15 in differential diagnosis of prostate cancer, it maintained a high sensitivity(91.5%), improved specificity(78.6%) and reliability(79.8%). It also improved positive predictive value(82.5%) and negative predictive value(96.5%) to a certain extent. Conclusions FPSA/TPSA ratio could make up for the shortage of only TPSA and improved the early detection rate of prostate cancer. It also reduced unnecessary biopsy and worth popularizing.
2010, 34(3): 164-167, 178.
doi: 10.3760/cma.j.issn.1673-4114.2010.03.010
Abstract:
Lung cancer has become the leading cause of cancer-related death in the world, chemotherapy plays an important role in the treatment of advanced non-small cell lung cancer (NSCLC) and small cell lung carcinoma(SCLC), and now is gradually applied in the early and middle stage of NSCLC. With the development of new technology, 18F-FDG PET-CT is applied in evaluation of chemotherapy effect and prognosis in patients with lung cancer. The application of 18F-FDG PET-CT in the lung cancer chemotherapy are reviewed in this paper.
Lung cancer has become the leading cause of cancer-related death in the world, chemotherapy plays an important role in the treatment of advanced non-small cell lung cancer (NSCLC) and small cell lung carcinoma(SCLC), and now is gradually applied in the early and middle stage of NSCLC. With the development of new technology, 18F-FDG PET-CT is applied in evaluation of chemotherapy effect and prognosis in patients with lung cancer. The application of 18F-FDG PET-CT in the lung cancer chemotherapy are reviewed in this paper.
2010, 34(3): 168-170.
doi: 10.3760/cma.j.issn.1673-4114.2010.03.011
Abstract:
Objective Because of the limited of 99Tcm-diethyl iminodiacetic acid(99Tcm-EHIDA) hepatobiliary scintigraphy in the diagnosis of severe cholestatic infant hepatitis syndrome, trial use 99Tcm-methoxy isobutyl isonitrile(99Tcm-MIBI) as a new hepatobiliary scintigraphy imaging agent to understand its applied basis and primary evaluate value in diagnosis of severe cholestatic infant hepatitis syndrome. Methods Constructed choledochal atresia animal model and investigated the application basis of 99Tcm-MIBI hepatobiliary scintigraphy. Twenty-seven children patients of severe cholestatic who finally confirmed infant hepatitis syndrome were underwent firstly 99Tcm-EHIDA hepatobiliary scintigraphy. After 24 h delay imaging next day, 99Tcm-MIBI hepatobiliary scintigraphy was underwent after 1 h. Two imaging agents of value in the diagnosis of severe cholestatic infant hepatitis syndrome were compared. Results It was proved that 99Tcm-MIBI was surely excreted by hepatobiliary and had no intestinal autocrine phenomenon in animal test. So 99Tcm-MIBI can be used to undergo hepatobiliary scintigraphy. The sensitivity of 99Tcm-MIBI hepatobiliary scintigraphy in the diagnosis of severe cholestatic infant hepatitis syndrome was 100% in our primary clinical study. Its sensitivity was higher than which of 99Tcm-EHIDA hepatobiliary scintigraphy (66.67%) by far. Conclusions With regard to those children patients who suspected highly severe cholestatic infant hepatitis syndrome in clinical, the sensitivity of 99Tcm-MIBI hepatobiliary scintigraphy is obviously superior to conventional 99Tcm-EHIDA hepatobiliary scintigraphy.
2010, 34(3): 171-173.
doi: 10.3760/cma.j.issn.1673-4114.2010.03.012
Abstract:
Objective To explore the clinical value of 99Tcm-DTPA renal dynamic imaging in evaluating renal function of the patients with upper urinary tract calculi. Methods The results of 99Tcm-DTPA renal dynamic imaging,glomerular filtration rate(GFR),intravenous pyelography(IVP),blood urea nitrogen(BUN)and serum creatinine(SCr)in 346 patients with upper urinary tract calculi diseases were analyzed retrospectively. These 346 patients were divided into four groups according to their total GFR value. Results ① The renal dynamic imaging in 346 patients could accurately reflect the function of the two kidneys. GFR was negatively related to the serum BUN and SCr levels(r=-0.458,P=0.000 and r=-0.542,P=0.000). ② The BUN and SCr levels showed significant difference among the four groups(F=49.23,P=0.000 and F=80.66,P=0.000). There were no significant difference of the BUN and SCr levels found between group 1 and group 2(P=0.119,P=0.088,respectively),while significant difference of the BUN and SCr levels found among the other groups (P < 0.05 for all situations). ③ Forty-three kidneys of the 346 patients were not visualized by IVP,while 18 of them(41.9%)had shown residual function(GFR≥10ml/min)with 99Tcm-DTPA renal dynamic imaging,the mean GFR was (21.89±12.81)ml/min. Conclusion 99Tcm-DTPA renal dynamic imaging is valuable to early evaluate the renal function,especially for the sick renal function in IVP detection failed patients.
2010, 34(3): 174-176.
doi: 10.3760/cma.j.issn.1673-4114.2010.03.013
Abstract:
Objective To study the value of 99Tcm-MIBI dynamic blood flow perfusion imaging and double-phase radionuclide imaging in benign and malignant cold thyroid nodules. Methods Retrospective analysis of surgical treatment of cold thyroid nodules of 28 patients. Use dual-head SPECT with low energy and high resolution collimator to get dynamic 99Tcm-MIBI blood flow perfusion imaging, 30 min early-phase and 120 min delayed-phase static planar imaging. The images are comprehensive analysed by T/NT and other methods. Results Nine cases of thyroid cancer in the dynamic blood flow perfusion, 30 min early-phase and 120 min delayed-phase static planar imaging, contain positive imaging 5, 6 and 7 cases respectively. 19 cases of benign lesions contain negative imaging 14, 11 and16 cases respectively. Sensitivity of 99Tcm-MIBI dynamic perfusion imaging in the diagnosis of thyroid cancer is 55.56%, specificity is 73.68%, accuracy is 67.85%. Sensitivity of 30 min early-phase static planar in the diagnosis of thyroid cancer is 66.67%, speci-ficity is 57.89%, accuracy is 67.85%. Sensitivity of 120 min delayed-phase static planar imaging in the diagnosis of thyroid cancer is 77.78%, specificity is 84.21%, accuracy is 82.14%. Conclusions 99Tcm-MIBI dual-phase imaging in the diagnosis and differential diagnosis of cold thyroid nodules has some value, comprehensive analysis of the blood perfusion and the T/NT of 99Tcm-MIBI dual-phase imaging can reduce the occurrence of false positive and false negative cases.
2010, 34(3): 179-182.
doi: 10.3760/cma.j.issn.1673-4114.2010.03.015
Abstract:
When people are exposed to ionising radiation, a series of molecules changing rapidly followed. Protein biomarkers of radiation injury are critical for triage, treatment, and follow-up of patients. This article reviews the application value of the definitive protein biomarkers with potential function, and introduces the progress in latest research of the multiparametric protein biomarkers analysis for diagnosis and therapy of radiation injury.
When people are exposed to ionising radiation, a series of molecules changing rapidly followed. Protein biomarkers of radiation injury are critical for triage, treatment, and follow-up of patients. This article reviews the application value of the definitive protein biomarkers with potential function, and introduces the progress in latest research of the multiparametric protein biomarkers analysis for diagnosis and therapy of radiation injury.
2010, 34(3): 183-185, 193.
doi: 10.3760/cma.j.issn.1673-4114.2010.03.016
Abstract:
Nuclear and radiation technology have a breakthrough development in the application of medical clinics. Some new radiological diagnosis and radiotherapy technologies have brought tremendous interest for human. Radiological intervention is the most representative of this type of radiation therapy technology. Large doses can cause possible skin and eye lens radiation damage, and is one of the most difficult occupational radiation protection. Because about 60 percent of surgical intervention is used in the treatment of cardiovascular diseases, the issue of radiation protection of patients in cardiovascular interventional has aroused widely attention both at home and abroad and carried out more extensive research. A large number of studies have shown that, cardiovascular intervention may cause high exposure doses to the patients that should be paid more attention. Surface dose is not enough to evaluate how much risk the patients suffering. When the human body suffer strongly penetrating power of radiation (X ray, γ ray, neutron) and the dose achieve a certain quantity, deep tissue and organ damage will happen. So when studying the surface dose, it is important to research the dose of the tissues and organs. Radiation intervention can result in stochastic effects such as oncology and genetic damage, therefore it is necessary to estimate the effective dose.
Nuclear and radiation technology have a breakthrough development in the application of medical clinics. Some new radiological diagnosis and radiotherapy technologies have brought tremendous interest for human. Radiological intervention is the most representative of this type of radiation therapy technology. Large doses can cause possible skin and eye lens radiation damage, and is one of the most difficult occupational radiation protection. Because about 60 percent of surgical intervention is used in the treatment of cardiovascular diseases, the issue of radiation protection of patients in cardiovascular interventional has aroused widely attention both at home and abroad and carried out more extensive research. A large number of studies have shown that, cardiovascular intervention may cause high exposure doses to the patients that should be paid more attention. Surface dose is not enough to evaluate how much risk the patients suffering. When the human body suffer strongly penetrating power of radiation (X ray, γ ray, neutron) and the dose achieve a certain quantity, deep tissue and organ damage will happen. So when studying the surface dose, it is important to research the dose of the tissues and organs. Radiation intervention can result in stochastic effects such as oncology and genetic damage, therefore it is necessary to estimate the effective dose.
2010, 34(3): 186-189.
doi: 10.3760/cma.j.issn.1673-4114.2010.03.017
Abstract:
Magnetic iron oxide nanoparticles are iron oxide particles of nanometer diameter with the characters of steady chemical property, long blood retention time, low toxicity, paramagnetism and biodegradability. Due to the cross-linking to tumor-targeting ligands through electrostatic interaction or chemical coupling such as peptides, monoclonal antibodies, chemotherapeutic drugs, gene segments. They are widely used for clinical oncology imaging, therapy and investigation. This article focuses on the applications and recent developments of magnetic iron oxide nanoparticles for tumor imaging and therapy.
Magnetic iron oxide nanoparticles are iron oxide particles of nanometer diameter with the characters of steady chemical property, long blood retention time, low toxicity, paramagnetism and biodegradability. Due to the cross-linking to tumor-targeting ligands through electrostatic interaction or chemical coupling such as peptides, monoclonal antibodies, chemotherapeutic drugs, gene segments. They are widely used for clinical oncology imaging, therapy and investigation. This article focuses on the applications and recent developments of magnetic iron oxide nanoparticles for tumor imaging and therapy.
2010, 34(3): 190-193.
doi: 10.3760/cma.j.issn.1673-4114.2010.03.018
Abstract:
Objective To explore the image correction of fracture displacement by conventional X-ray photography(orthotropic and lateral) and test by computed tomgraphy(CT). Methods The correction method of fracture displacement was designed according to geometry principles of X-ray photography. Selected one midhumeral fracture specimen which designed with lateral shift and angular displacement, and scanned from anteroposterior and lateral position respectively, and also volume scanned using CT, the data obtained from volume scan were processed using multiplanar reconstruction (MPR) and shaded surface display(SSD). The displacement data relied on X-ray image, CT with MPR and SSD processing, actual design of specimens were compared respectively. Result The direction and degree of displacement among correction data of X-ray im-ages and the data from MPR and SSD, actual design of specimen were little difference, location difference < 1.5 mm, degree difference < 1.5°. Conclusion It is really reliable for fracture displacement by conventional X-ray photography with coordinate correction, and it is helpful to obviously improve the diagnostic accuracy of the degree of fracture displacement.
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