2010 Vol. 34, No. 5
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2010, 34(5): 257-261.
doi: 10.3760/cma.j.issn.1673-4114.2010.05.001
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Abstract:
PET is an advanced imaging technology to obtain biological, physiological or pharmacological function.The PET signal comprises the sum of a radio-probe and its radioactive metabolites from intracellular, extracellular and intravascular compartments of a given tissue, it cannot provide the chemical composition of the radioactivity or compartments of radio-labeled substances present.On the other hand, in vivo microdialysis is a powerful sampling technique wherein regional chemical information is obtained by implantinga probe into the extracellular fluid of interest tissue.Combined PET and microdialysis may potentially play an important role in pathophysiology, pharmacology, pharmacokinetics and drug metabolism.
PET is an advanced imaging technology to obtain biological, physiological or pharmacological function.The PET signal comprises the sum of a radio-probe and its radioactive metabolites from intracellular, extracellular and intravascular compartments of a given tissue, it cannot provide the chemical composition of the radioactivity or compartments of radio-labeled substances present.On the other hand, in vivo microdialysis is a powerful sampling technique wherein regional chemical information is obtained by implantinga probe into the extracellular fluid of interest tissue.Combined PET and microdialysis may potentially play an important role in pathophysiology, pharmacology, pharmacokinetics and drug metabolism.
2010, 34(5): 262-265.
doi: 10.3760/cma.j.issn.1673-4114.2010.05.002
Abstract:
Stem cell therapy research has made great progress, demonstrating a broad application prospects.However, stem cell therapy as a new disease treatment, there are still many problems to be solved. Reporter gene imaging is a rapid development in recent years, a non-invasive, sensitive method of monitoring of stem cells, in particular radionuclide reporter gene imaging has high sensitivity and specificity of the advantages of strong and can carry out imaging of deep tissue and repeat imaging, is a tracer in vivo conditions, the most promising stem cell transplantation technique, showing good prospects for development.
Stem cell therapy research has made great progress, demonstrating a broad application prospects.However, stem cell therapy as a new disease treatment, there are still many problems to be solved. Reporter gene imaging is a rapid development in recent years, a non-invasive, sensitive method of monitoring of stem cells, in particular radionuclide reporter gene imaging has high sensitivity and specificity of the advantages of strong and can carry out imaging of deep tissue and repeat imaging, is a tracer in vivo conditions, the most promising stem cell transplantation technique, showing good prospects for development.
2010, 34(5): 266-268.
doi: 10.3760/cma.j.issn.1673-4114.2010.05.003
Abstract:
Epidermal growth factor receptor (EGFR) is a promising therapeutic target for cancer patients.Its activity can be reflected by PET-CTEGFR imaging which became a more reliable indicator to measure EGFR.In recent years, PET-CTEGFR imaging was adopted to screen targeted drugs, which became a hot topic in the clinical application of PET-CT.
Epidermal growth factor receptor (EGFR) is a promising therapeutic target for cancer patients.Its activity can be reflected by PET-CTEGFR imaging which became a more reliable indicator to measure EGFR.In recent years, PET-CTEGFR imaging was adopted to screen targeted drugs, which became a hot topic in the clinical application of PET-CT.
2010, 34(5): 269-273.
doi: 10.3760/cma.j.issn.1673-4114.2010.05.004
Abstract:
The molecular imaging and targeted therapy with radiolabeled anti-CD20 monoclonal antibody or recombinant anti-CD20 monoclonal antibody fragments is the effective methods to improve the survival rate for non-Hodgkin's lymphoma(NHL).This article reviews the biological characteristics of CD20 and the immunotherapy, radioimmunotherapy, radioimmunoimaging with anti-CD20 monoclonal antibody for NHL.
The molecular imaging and targeted therapy with radiolabeled anti-CD20 monoclonal antibody or recombinant anti-CD20 monoclonal antibody fragments is the effective methods to improve the survival rate for non-Hodgkin's lymphoma(NHL).This article reviews the biological characteristics of CD20 and the immunotherapy, radioimmunotherapy, radioimmunoimaging with anti-CD20 monoclonal antibody for NHL.
2010, 34(5): 274-277.
doi: 10.3760/cma.j.issn.1673-4114.2010.05.005
Abstract:
PET-CT is a useful noninvasive method for the diagnosis of coronary artery disease (CAD), and can assessment the nature of the atherosclerosis plaque.It plays an important role in the diagnosis of CAD and is useful for the selection of surgical approaches, and for the evaluation of prognosis. The clinical application of PET-CTand its new progress are introduced in this paper.
PET-CT is a useful noninvasive method for the diagnosis of coronary artery disease (CAD), and can assessment the nature of the atherosclerosis plaque.It plays an important role in the diagnosis of CAD and is useful for the selection of surgical approaches, and for the evaluation of prognosis. The clinical application of PET-CTand its new progress are introduced in this paper.
2010, 34(5): 277-281.
doi: 10.3760/cma.j.issn.1673-4114.2010.05.006
Abstract:
Objective To quantitatively investigate the effectof age on the glomerular filtration rate (GFR)in living-related kidney donors, to analyze the clinicalvalue and the dependence ofGFR on age and toprovide an Objective basis for the selection of the living kidney donor.M ethods One hundred and sixtyone living-related kidney donorswere divided into four age groups, namely 20－29 years(n=52), 30－39 years (n=44), 40－49 years(n=38)and≥50 years(n=27).On theotherhand, the totaldonorswere divided into the groupsolder than 55 years(n=24)and younger than 55 years(n=137).To quantify GFR in all the subjects using the99Tcm-diethylenetriamine pentaacetic acid(99Tcm-DTPA)renography according to standard procedure and to evaluate the effects of age on renal function. Results The total GFR in living-related kidney donorswas calculated as(89.55±12.87)ml·min－1·(1.73m2)－1.The GFR in the first to the four age groups were(88.27±12.29)ml·min－1·(1.73m2)－1, (91.85±14.51)ml·min－1·(1.73m2)－1, (89.25±11.26)ml·min－1· (1.73m2)－1and(88.24±13.20)ml·min－1·(1.73m2)－1.The difference ofGFRwere notsignificant between the fouragegroups(F=2.09, P=0.10).The GFR in the donorsolder than 55 yearsand younger than 55 years were(88.57±13.14)ml·min－1·(1.73m2)－1and(89.44±10.34)m l·min－1·(1.73m2)－1, therewere no significant difference in GFR between the two groups(F=1.31, P=0.25).When relating GFR to age in all the livingrelated kidneydonors, there was nosignificant correlation(r=－0.033, P=0.69).No serious complications occurred after living kidney transplantation, serum creatinine values and blood urea nitrogen recovered to the normal levels in a shortperiod, hepatic and renal functionswere normal. Conclusion This study indicated that the GFR valueswere not correlated with the change of age in living-related kidney donors, and the Results were helpful for the selection of living donors.
2010, 34(5): 281-284.
doi: 10.3760/cma.j.issn.1673-4114.2010.05.007
Abstract:
Objective To detect the changes and clinical influence elements of radionuclide renal dynamic imaging to measure glomerular filtration rate(GFR)and effective renal plasma flow(ERPF)in patients with type 2 diabetes mellitus(T2DM). Methods One hundred and eight patients with T2DM were divided into 4 groups according to the values of urinary albumin excretion rate(UAER): GroupⅠ: UAER < 20μg·min－1, 31 cases.GroupⅡ: UAER 20~200μg·min－1, 28 cases.GroupⅢ: UAER > 200μg·min－1, serum creatinine(SCr) < 105μmol/L, 26 cases.GroupⅣ: UAER > 200μg·min－1, SCr≥105μmol/L, 23 cases.99Tcm-diethylenetriamine pentaacetic acid and99Tcm-ethylenedicysteine renal dynamic imaging were performed in all patients.GFR, ERPF and renogram were derived simultaneously.The levels of blood creatinine, blood urea nitrogen, urine albumin, blood press, fasting blood insulin, glycosylated hemoglobin, fasting blood glucousewere measured in the four groups. Results With the evolvement of diabetes nephropathy(DN), UAERs were gradually ascended and the values of GFR and ERPF was gradually descended, the former offered remarkable inverse correlation with the two latters(r1=－0.497, P < 0.05;r2=－0.215, P < 0.05).The values ofGFR and ERPF in four groups patientswith hypertension was lower than with out hypertension(t1= 1.8, t2=2.1, t3=1.9, P < 0.05;t4=3.2, P < 0.01).Multielement stepwise regression analyses assumed that age, systolic pressure, glycosylated hemoglobin and insulin resistance index offered inverse correlation with GFR and ERPF(coefficient of regression factor: －0.507、－0.874, －0.528、－0.587, －0.336、－0.697, －0.348、－0.371, P < 0.01). Conclusion GFR and ERPFwere sensitive index reflecting the changes of DN.Hypertension and insulin resistance were independence risk factors to make the value of GFR and ERPF decreased in patients with DN.
2010, 34(5): 285-288.
doi: 10.3760/cma.j.issn.1673-4114.2010.05.008
Abstract:
The main ingredient of 99Tc-methylenediphosphonate(99Tc-MDP) is chelates which formed by the technetium 99Tc after stannous reduction and methylenediphosphonate.Studies have shown that 99Tc-MDP can inhibit the inflammatory response, play anti-inflammatory, anti-rheumatic effect, it also have significant analgesic effect by inhibit prostaglandin synthesis.In addition, 99Tc-MDP also can regulate the body's own immune and bone metabolism to treat the corresponding diseases.Treating rheumatoid arthritis, ankylosing spondylitis, Graves'ophthalmopathy and other autoimmune diseases.Italso has a good effect on pain which is caused by cancer, femoral head necrosis and osteoporosis.Review progress of 99Tc-MDP in clinical applications.
The main ingredient of 99Tc-methylenediphosphonate(99Tc-MDP) is chelates which formed by the technetium 99Tc after stannous reduction and methylenediphosphonate.Studies have shown that 99Tc-MDP can inhibit the inflammatory response, play anti-inflammatory, anti-rheumatic effect, it also have significant analgesic effect by inhibit prostaglandin synthesis.In addition, 99Tc-MDP also can regulate the body's own immune and bone metabolism to treat the corresponding diseases.Treating rheumatoid arthritis, ankylosing spondylitis, Graves'ophthalmopathy and other autoimmune diseases.Italso has a good effect on pain which is caused by cancer, femoral head necrosis and osteoporosis.Review progress of 99Tc-MDP in clinical applications.
2010, 34(5): 288-290.
doi: 10.3760/cma.j.issn.1673-4114.2010.05.009
Abstract:
Objective To evaluate clinicalvalue of radioactive iodineuptake and thyroid imaging in diagnosisofpainless thyroiditis(PT). Methods Seventy casesof PT patients, 50 casesofGD patientsand 50 cases of healthy personswere retrospectively analyzed by using radioactive iodine uptake, thyroid imaging and serological examination. Results PT group radioactive iodine uptake ratewas significantly lower than the control group, GD group was significantly higher than the control group, PT group and the GD group differencewas significant(F=64.88, P < 0.01).Thyroid image of PTgroup isnotclear, orno to be seen, thyroid image of GD group can be clearly visible. Conclusion Radioactive iodine uptake and thyroid imaging play an irreplaceable role in the identification of PTand GD, and themethod issimpleand effective too.
2010, 34(5): 291-294.
doi: 10.370/cma.j.issn.1673-4114.2010.05.010
Abstract:
Objective To study clinical application of the changes of serum cytokines andhypersensitive C. reactive protein(hs, CRP)in patients with coronary heart disease. Methods The levels of interleukin-1β(IL-1β), interleukin-6(IL-6), interleukin-8(IL-8), hs-CRP(with high-sensitive enzyme immunoassay) and tumor necrosis factor α(TNF-α)(with radioimmunoassay)in blood serum were determined in 124 patients with coronary heart disease(including 41 patients with stable angina pectoris (SA), 38 patients with unstable angina(USA)and 45 patients with acute myocardial infarction(AMI))and 54 normal controls, and then comparatively analysed all the data. Results The levels of IL-1β, IL-6, IL-8 and TNF-α in 124 patients with coronary heart disease were significantly higher than those in 54 normal controls(tIL-1β=3.145, tIL-6=3.627, tIL-8= 3.054, tTNF-α=3.301, P < 0.01).The levels of IL-1β, IL-6, IL-8 and TNF-α in 41 patients with SA were no significantly than those in 54 normal controls(tIL-1β=1.431, tIL-6=1.587, tIL-8=1.745, tTNF-α=1.461, P > 0.05).The levels of IL-1β, IL-6, IL-8 and TNF-α in 38 patients with USA and in 45 patients with AMI were significantly higher than those of in 54 normal controls(USA: tIL-1β=2.871, tIL-6=2.748, tIL-8=2.687, tTNF-α=3.145, P < 0.01; AMI: tIL-1β=2.776, tIL-6=2.874, tIL-8=2.689, tTNF-α=3.212, P < 0.01).The level of hs-CRP in SA, USA and AMI groups were higher than thoes in normal controls(tSA=2.617, P < 0.05; tUSA=3.018, P < 0.01; tAMI=3.189, P < 0.01).The levels of IL-1β, IL-6, IL-8, TNF-α and hs-CRP had increasing tendency follow up the severity degree of patients with SA or USA or AMI and the levels of IL-1β, IL-6, IL-8, TNF-α and hs-CRP in patients with AMI were highest in 124 patients with coronary heart disease. Conclusion In the diagnosis of the patients with SA, USA and AMI, the determination of the levels of IL-1β, IL-6, IL-8, TNF-α and hs-CRP in blood serum were important index, and they were references for cardiovascular happened.
2010, 34(5): 294-296.
doi: 10.3760/cma.j.issn.1673-4114.2010.05.011
Abstract:
Objective To study the clinical application of determination of plasma renin activity(PRA), Angiotensin Ⅱ (Ang Ⅱ)and insulin-like growth factor-1(IGF-1)levels in typing of essential hypertension(EH). Methods Determined the levels of PRA and Ang Ⅱ in 256 patients with EH and 70 healthy volunteers(as control group)by radioimmunoassay, and measured IGF-1 level by enzyme immunoassay.Research on the typing of EH and the difference between the groups. Results The PRA and Ang Ⅱ in control group was(0.432±0.236)μg·L-1·h-1 and (31.7±7.4)μg/L respectively.In 256 patients with EH,PRA was increased, normal and decreased in 18.0%, 71.8% and 10.2% respectively, while the level of Ang Ⅱ was increased, normal and decreased in 12.9%, 76.2% and 10.9% respectively.The IGF-1 levels in 256 patients with EH were increased following the increase of blood pressure. Conclusion Typing of EH patients with PRA and Ang Ⅱ as well as the determination of IGF-1 were useful in treating and following up the patients with EH.
2010, 34(5): 297-299.
doi: 10.3760/cma.j.issn.1673-4114.2010.05.012
Abstract:
Objective To investigate the diagnotic value of tumor positive delay tomogram imaging with 99Tcm-methoxyisobutylisonitrile (MIBI) for pulmonary neoplasm. Methods Twenty-eight cases pulmonary neoplasms traded by 99Tcm-MIBI imaging, then performed tomogram imaging after 1h.By the uptake ratio value exceeding 1.31 between pulmonary neoplasm(T)and normal tissue on the opposite side or vicinity tissue(N), benign or malignant was diagnosted. Results The malignant pulmonary neoplasm had abnormal high uptake, but benign pulmonary neoplasm had light uptake.The sensitivity and specificity of 99Tcm-MIBI imaging for the malignant pulmonary neoplasm were 76.9% and 86.7% respectively, the false positive and false negative rate were 13.3% and 23.1% respectively. Conclusions Tumor positive delay tomogram imaging with 99Tcm-MIBI for pulmonary neoplasm is an important detection in differentiating benign and malignant, it has high sensitivity, specificity, picture quanlity and no wound again.
2010, 34(5): 299-301.
doi: 10.3760/cma.j.issn.1673-4114.2010.05.013
Abstract:
Objective To study the feasibility and curative effect of 131Ⅰ therapy for youngsters with Graves' disease. Methods Retrospective analyzed 58 youngsters with Graves' disease, to compare the serum free triiodthyroine (FT3), free thyroxine(FT4)and thyroid-stimulating hormone(TSH)levels with chemiluminescent immunoassay and to measure the thyroid gland size with color Doppler diagnostic apparatus before and after six months of 131Ⅰ(148-240.5 MBq)therapy, then followed up for 2－7 years, and clinical efficacy was evaluated according to the Results. Results After 6 months of therapy, the levels of FT3and FT4 were significantly decreased(t=12.43, t=21.21, P < 0.01), the level of TSH was significantly increased(t=10.34, P < 0.01), and thyroid volume was decreased obviously. Of the 58 patients, 31(53.45%) patients were cured, 16(27.59%) were much better than before, and 7(12.1%) were invalid, 3(5.17%)were temporary hypothyroid, 1(1.72%) recrudesced. Conclusion 131Ⅰ is an effective therapy which is safe and economical to youngsters with Graves' disease.
2010, 34(5): 303-307.
doi: 10.3760/cma.j.issn.1673-4114.2010.05.015
Abstract:
Alzheimer's disease(AD), dementia with Lewy bodies(DLB)and frontotemporal dementia (FTD)are the main type of neurodegenerative diseases, but the FTD and DLB are always confused with AD.Structural MRI, diffusion-weighted imaging and proton magnetic resonance spectroscopy have the potential to support the diagnosis of AD and the relative disease.Brain atrophy pattern, apparent diffusion coefficient and fractional anisotropy pattern, the distribution mode of N-acetylaspartate and myo-inositol in temporal lobe, hippocampus, pariet al lobe, frontal lobe could help to differentiate AD from FTD, DLB and those patterns are in accordance with the pathological changes.
Alzheimer's disease(AD), dementia with Lewy bodies(DLB)and frontotemporal dementia (FTD)are the main type of neurodegenerative diseases, but the FTD and DLB are always confused with AD.Structural MRI, diffusion-weighted imaging and proton magnetic resonance spectroscopy have the potential to support the diagnosis of AD and the relative disease.Brain atrophy pattern, apparent diffusion coefficient and fractional anisotropy pattern, the distribution mode of N-acetylaspartate and myo-inositol in temporal lobe, hippocampus, pariet al lobe, frontal lobe could help to differentiate AD from FTD, DLB and those patterns are in accordance with the pathological changes.
2010, 34(5): 308-312.
doi: 10.3760/cma.j.issn.1673-4114.2010.05.016
Abstract:
Recently spiral CT cholargiography with technique of combine minimum intensity projection with curved planar reformation(MinP+CPR)is less studying but more important, which is basic on contrast-enhanced scan, by defining properly thickness for MinP processing and transferring the processed data sets to CPR soft for further reconstruction. Using this technique can obtain a overview of obstructed segment of bile duct and expanded segment of bile duct at same time. The quality of the data sets is good as or even better than that of other imaging method of bile duct and other Bile duct pre-processed techniques.For no invasion and complication, it is consider as a new alternative imaging method which is no limitation of serum bilirubin level, pacemaker and surgical clips.
Recently spiral CT cholargiography with technique of combine minimum intensity projection with curved planar reformation(MinP+CPR)is less studying but more important, which is basic on contrast-enhanced scan, by defining properly thickness for MinP processing and transferring the processed data sets to CPR soft for further reconstruction. Using this technique can obtain a overview of obstructed segment of bile duct and expanded segment of bile duct at same time. The quality of the data sets is good as or even better than that of other imaging method of bile duct and other Bile duct pre-processed techniques.For no invasion and complication, it is consider as a new alternative imaging method which is no limitation of serum bilirubin level, pacemaker and surgical clips.
Imaging and pathologic features of eosinophilic hyperplastic lymphogranuloma in head and neck region
2010, 34(5): 313-317.
doi: 10.3760/cma.j.issn.1673-4114.2010.05.017
Abstract:
Objective To study the pathological and imaging features of eosinophilic hyperplastic lymphogranuloma (Kimura disease, KD) and improve the diagnosis of the KD. Methods The clinical, imaging and pathological features of 8 cases with KD in head and neck region were retrospectively analyzed. Results In 8 cases with KD, 4 cases had solitary nodule and 4 had multiple masses. 6 patients had soft-tissue masses related to parotid glands, whereas other 2 cases were in relation to the submandibular and eyelid separately.CT and MRI findings: ① Extensive swelling of the involved parotid glands and face were depicted in KD patients. Both well-defined, nodular masses, as well as ill-defined plaque-like infiltrative masses were seen in the KD. The masses were slightly hyper-density on CT scan. They were iso-intensity in T1-weighted sequence and iso- or hypo-intensity in T2-weighted sequence mostly, with different enhancement after administration of contrast medium. ②The masses of KD in other location might involve surrounding structures, such as bone involvement, however they had the similar density, intensity and enhancement pattern with parotid gland. ③All 8 cases had associated lymphadenopathy, which with homogeneous density without necrosis and cyst. Most of their adjacent skin was thicker and subcutaneous fat overlying the subcutaneous masses. Histologic examination demonstrated lymphoid hyperplasia with vascular proliferation and eosinophilic infiltration in the different proportion. Conclusion The position and clinical findings of KD have some characteristic features,with CT, MRI examinations and pathological feature, the accuracy in the diagnosis of KD before operation can be increased.
Objective To study the pathological and imaging features of eosinophilic hyperplastic lymphogranuloma (Kimura disease, KD) and improve the diagnosis of the KD. Methods The clinical, imaging and pathological features of 8 cases with KD in head and neck region were retrospectively analyzed. Results In 8 cases with KD, 4 cases had solitary nodule and 4 had multiple masses. 6 patients had soft-tissue masses related to parotid glands, whereas other 2 cases were in relation to the submandibular and eyelid separately.CT and MRI findings: ① Extensive swelling of the involved parotid glands and face were depicted in KD patients. Both well-defined, nodular masses, as well as ill-defined plaque-like infiltrative masses were seen in the KD. The masses were slightly hyper-density on CT scan. They were iso-intensity in T1-weighted sequence and iso- or hypo-intensity in T2-weighted sequence mostly, with different enhancement after administration of contrast medium. ②The masses of KD in other location might involve surrounding structures, such as bone involvement, however they had the similar density, intensity and enhancement pattern with parotid gland. ③All 8 cases had associated lymphadenopathy, which with homogeneous density without necrosis and cyst. Most of their adjacent skin was thicker and subcutaneous fat overlying the subcutaneous masses. Histologic examination demonstrated lymphoid hyperplasia with vascular proliferation and eosinophilic infiltration in the different proportion. Conclusion The position and clinical findings of KD have some characteristic features,with CT, MRI examinations and pathological feature, the accuracy in the diagnosis of KD before operation can be increased.
2010, 34(5): 318-320.
doi: 10.3760/cma.j.issn.1673-4114.2010.05.018
Abstract:
This paper describes a novel treatment: based on nanoparticles that combines radiotherapy and photodynamic therapy. With this approach, the application of traditional photodynamic therapies only to surface treatment can be solved, so that the therapeutic effect can be improved; the approach also could guarantee the effectiveness of treatment and reduce radiation doses, so it can effectively control the complications of radiotherapy, This new modality will open a new chapter for cancer therapy.
This paper describes a novel treatment: based on nanoparticles that combines radiotherapy and photodynamic therapy. With this approach, the application of traditional photodynamic therapies only to surface treatment can be solved, so that the therapeutic effect can be improved; the approach also could guarantee the effectiveness of treatment and reduce radiation doses, so it can effectively control the complications of radiotherapy, This new modality will open a new chapter for cancer therapy.
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