2011 Vol. 35, No. 2
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2011, 35(2): 65-68.
doi: 10.3760/cma.j.issn.1673-4114.2011.02.001
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Abstract:
Mitochondria play a major role in normal metabolism of the body. Therefore, mitochondrial dysfunction inevitably participates in or even determines the onset and progression of many diseases. Methods for in vivo assessment of mitochondrial function would help understand the biological function of mitochondria. This review focuses on the methods to assess mitochondrial function in vivo.
Mitochondria play a major role in normal metabolism of the body. Therefore, mitochondrial dysfunction inevitably participates in or even determines the onset and progression of many diseases. Methods for in vivo assessment of mitochondrial function would help understand the biological function of mitochondria. This review focuses on the methods to assess mitochondrial function in vivo.
2011, 35(2): 69-72.
doi: 10.3760/cma.j.issn.1673-4114.2011.02.002
Abstract:
PET is an important functional neuroimaging technique that can be used to assessment of cerebral metabolic activity and blood flow and identifies the distribution of important neurotransmitters in the human brain. Compared with other conventional imaging techniques, PET enables regional cerebral glucose metabolism, blood flow, dopaminergic and serotonergic receptor function to be assessed qualitatively and quantitatively. In recent years, PET increasingly being used greatly to advance our understanding of the neurobiology and pathophysiology of schizophrenia. This review focuses on the use of PET tracers in identifying regional brain abnormalities and regions associated with cognitive functioning in schizophrenia.
PET is an important functional neuroimaging technique that can be used to assessment of cerebral metabolic activity and blood flow and identifies the distribution of important neurotransmitters in the human brain. Compared with other conventional imaging techniques, PET enables regional cerebral glucose metabolism, blood flow, dopaminergic and serotonergic receptor function to be assessed qualitatively and quantitatively. In recent years, PET increasingly being used greatly to advance our understanding of the neurobiology and pathophysiology of schizophrenia. This review focuses on the use of PET tracers in identifying regional brain abnormalities and regions associated with cognitive functioning in schizophrenia.
2011, 35(2): 73-80, 127.
doi: 10.3760/cma.j.issn.1673-4114.2011.02.003
Abstract:
In the central nervous system, the widely distributed 5-hydroxytryptamine(5-HT)receptors are involved in regulating a large number of psychological and physiological functions, including mood, sleep, endocrine and autonomic nervous system. Abnormal 5-HT transmission has been implicated in a variety of neuropsychiatric disorders, such as pain, depression and epilepsy. With the development of radioligands, non-invasive nuclear imaging technique with exquisite sensitivity and specificity has been applied for delineation of neurotransmitter function in vivo. It does great benefit for researches of these diseases and development of drugs. This review provided an overview of 5-HT receptors radioligands and recent findings.
In the central nervous system, the widely distributed 5-hydroxytryptamine(5-HT)receptors are involved in regulating a large number of psychological and physiological functions, including mood, sleep, endocrine and autonomic nervous system. Abnormal 5-HT transmission has been implicated in a variety of neuropsychiatric disorders, such as pain, depression and epilepsy. With the development of radioligands, non-invasive nuclear imaging technique with exquisite sensitivity and specificity has been applied for delineation of neurotransmitter function in vivo. It does great benefit for researches of these diseases and development of drugs. This review provided an overview of 5-HT receptors radioligands and recent findings.
2011, 35(2): 81-84.
doi: 10.3760/cma.j.issn.1673-4114.2011.02.004
Abstract:
Objective To investigate the value of 18F-FDG PET-CT on patients with suspected prostate cancer recurrence and metastasis. Methods Retrospective analysis 23 patients with prostate cancer who were suspected to have tumor recurrence and metastasis during follow-up, underwent 18F-FDG PET-CT examination. 18F-FDG PET-CT results were compared with those of conventional images, as referred to histopathology or clinical follow-up. Results In total, 19 patients with recurrence and metastasis were confirmed by histopathology or clinical follow-up. Twenty patients were found to have positive lesion by 18F-FDG PET-CT, including the pelic abscess (1case), prostate cancer local recurrence(5cases), lymph node metastases(8cases), multiple systemic lymph node metastasis(1case)and bone metastases(5cases). The sensitivity of 18F-FDG PET-CT was 100%(19/19)in diagnosis carcinoma recurrence and metastasis, and the specificity and accuracy were 75%(3/4)and 95%(22/23). The levels of prostate specific antigen in 12 patients gradually increased after endocrine theraphy, and PET-CT could dipit this accurately. Compared with conventional images such as B mode ultrasonic, CT, bone imaging, 18F-FDG PET-CT could find more focus. Conclusion 18F-FDG PET-CT imaging is valuable in diagnosing recurrent and metastatic prostate cancer.
2011, 35(2): 84-88.
doi: 10.3760/cma.j.issn.1673-4114.2011.02.005
Abstract:
18F-FDG PET-CT has widely used in nasopharyngeal carcinoma diagnosis and staging in recent years, it's effecten target volume delineation has received great attention. The article lays stress on the clinical research progress of 18F-FDG PET-CT in the radiotherapy of nasopharyngeal carcinoma improve the accuracy of target delineation, reduce the difference of target delineation, guide the dose painting and boost.
18F-FDG PET-CT has widely used in nasopharyngeal carcinoma diagnosis and staging in recent years, it's effecten target volume delineation has received great attention. The article lays stress on the clinical research progress of 18F-FDG PET-CT in the radiotherapy of nasopharyngeal carcinoma improve the accuracy of target delineation, reduce the difference of target delineation, guide the dose painting and boost.
2011, 35(2): 89-92.
doi: 10.3760/cma.j.issn.1673-4114.2011.02.006
Abstract:
Objective To compare the value of 99Tcm-methylene diphosphonate(99Tcm-MDP)bone scintigraphy, 99Tcm-MDP SPECT-CT and 18F-FDG in detecting bone metastases of spine. Methods Retro-spective analysis of 88 tumor patients who underwent 99Tcm-MDP planar bone scintigraphy, then performed 99Tcm-MDP SPECT-CT immediately, and then underwent 18F-FDG SPECT-CT within 2 weeks apart. The diagnostic results were confirmed by biopsy, MRI/CT and clinical follow-up. Results Fouty-eight of 88 patients were comfirmed to be spine bone metastases, 19 to be spine benigns, 21 to be non-metastases. The sensitivity, specificity, positivity predicitive value, negative predictive value, and accuracy of 99Tcm-MDP bone scintigraphy were 89.6%(43/48), 62.5%(25/40), 74.1%(43/58), 83.3%(25/30)and 63.4%(68/88). Those of 99Tcm-MDP SPECT-CT were 93.8%(45/48), 92.5%(35/40), 90.0%(45/50), 92.1%(35/38)and 81.6%(80/88). Those of 18F-FDG SPECT-CT were 97.9%(47/48), 97.5%(39/40), 97.9%(48/49), 97.5%(39/40)and 87.8%(86/88). SPECT-CT is resolving the problem in conventional bone scintigraphy on anatomical localization of the positive lesions on bone, and reducing the false positive rate. 18F-FDG SPECT-CT is more specific than 99Tcm-MDP bone scintigraphy to the bone metastases of spine, and increasing the ability to identify bone lesion malignant or benign, and increasing the specificity(χ2=15.313, P < 0.001) and accuracy(χ2=16.831, P < 0.001). Conclusion The dia-gnostic accuracy of 99Tcm-MDP SPECT-CT and 18F-FDG SPECT-CT in detecting bone metastases of spine are both better than 99Tcm-MDP BS.They are valuable for detecting bone metastases of spine.
2011, 35(2): 93-99.
doi: 10.3760/cma.j.issn.1673-4114.2011.02.007
Abstract:
Effectiveness of radioiodine for Graves' hyperthyroidism depends on retention time of 131I in the thyroid, and may be effected by several factors, including previous treatment with antithyroid drugs, goiter volume, 24 h thyroidal radioactive iodine uptake and so on. A short course of therapy with low dose of lithium carbonate increased retention of 131I in the thyroid and prolong the intrathyroidal effective half-life of 131I before and after 131I therapy in patients with Graves'disease, because of the actions that lithium blocks the release of organic iodine and thyroid hormone from the thyroid gland without affecting thyroidal radioactive iodine uptake. Therefore, using lithium as adjunct to radioiodine therapy increases the radiation dose delivered to the thyroid, to result in reduced the activity required and whole-body radiation dose in patients with very short effective half-life, and so improve the cure rate of hyperthyroidism. A short course of lithium carbonate therapy can be considered a useful adjunct to 131I therapy for obtaining a more rapid control of thyrotoxicosis and avoiding its transient exacerbation because of methimazole withdrawal prior to 131I administration or in patients who cannot tolerate or do not respond to antithyroid drugs, and for helping to prevent the radioiodine-associated increase in serum free thyroid hormone concentrations. In addition, lithium carbonate enhances the effectiveness of 131I therapy, in terms of prompter control of hyperthyroidism in patients with small or large goiters. At the same time, lithium also may increases the rate of permanent control of hyperthyroidism in patients with large goiters. In summary, in the short-term lithium plays an important role as an adjunct to 131I, since it helps to prevent the 131I-associated increase in serum free thyroid hormone concentrations and allows a more prompt control of thyrotoxicosis. This is of particular importance in highrisk patients, such as the elderly, those with severe hyperthyroidism, underlying cardiovascular disorders, or other severe nonthyroidal illness for whom even a transient exacerbation of the thyrotoxicosis may be dangerous. Treatment with a relatively low dose of lithium before and after 131I therapy offers a safe and effective alternative means of controlling thyrotoxicosis in patients with Graves disease.
Effectiveness of radioiodine for Graves' hyperthyroidism depends on retention time of 131I in the thyroid, and may be effected by several factors, including previous treatment with antithyroid drugs, goiter volume, 24 h thyroidal radioactive iodine uptake and so on. A short course of therapy with low dose of lithium carbonate increased retention of 131I in the thyroid and prolong the intrathyroidal effective half-life of 131I before and after 131I therapy in patients with Graves'disease, because of the actions that lithium blocks the release of organic iodine and thyroid hormone from the thyroid gland without affecting thyroidal radioactive iodine uptake. Therefore, using lithium as adjunct to radioiodine therapy increases the radiation dose delivered to the thyroid, to result in reduced the activity required and whole-body radiation dose in patients with very short effective half-life, and so improve the cure rate of hyperthyroidism. A short course of lithium carbonate therapy can be considered a useful adjunct to 131I therapy for obtaining a more rapid control of thyrotoxicosis and avoiding its transient exacerbation because of methimazole withdrawal prior to 131I administration or in patients who cannot tolerate or do not respond to antithyroid drugs, and for helping to prevent the radioiodine-associated increase in serum free thyroid hormone concentrations. In addition, lithium carbonate enhances the effectiveness of 131I therapy, in terms of prompter control of hyperthyroidism in patients with small or large goiters. At the same time, lithium also may increases the rate of permanent control of hyperthyroidism in patients with large goiters. In summary, in the short-term lithium plays an important role as an adjunct to 131I, since it helps to prevent the 131I-associated increase in serum free thyroid hormone concentrations and allows a more prompt control of thyrotoxicosis. This is of particular importance in highrisk patients, such as the elderly, those with severe hyperthyroidism, underlying cardiovascular disorders, or other severe nonthyroidal illness for whom even a transient exacerbation of the thyrotoxicosis may be dangerous. Treatment with a relatively low dose of lithium before and after 131I therapy offers a safe and effective alternative means of controlling thyrotoxicosis in patients with Graves disease.
2011, 35(2): 99-103.
doi: 10.3760/cma.j.issn.1673-4114.2011.02.008
Abstract:
Coronary heart disease(CHD) is a common and frequently occurring disease which seriously threaten the health of human beings. So diagnosing CHD early and assessing the cardiac risk accurately and non-invasively that is a clinical problem which is urgent need for solving. Although the effectiveness of risk assessment algorithms have been proved by lots of clinical trials, but still has some limitations. The combination of myocardial perfusion imaging and coronary artery calcium score is promising in CHD diagnosis and cardiac risk assessment.
Coronary heart disease(CHD) is a common and frequently occurring disease which seriously threaten the health of human beings. So diagnosing CHD early and assessing the cardiac risk accurately and non-invasively that is a clinical problem which is urgent need for solving. Although the effectiveness of risk assessment algorithms have been proved by lots of clinical trials, but still has some limitations. The combination of myocardial perfusion imaging and coronary artery calcium score is promising in CHD diagnosis and cardiac risk assessment.
2011, 35(2): 104-107.
doi: 10.3760/cma.j.issn.1673-4114.2011.02.009
Abstract:
Objective To investigate the effects of laparoscopic cholecystectomy on the plasma levels of endothelin and calcitonin gene-related peptide(CGRP)in elderly patients. Methods Sixty patients undergoing elective laoaroscopic cholecystectomy were divided into < 65 years old group and > 65 years old group according to their ages(30 cases in each group). The plasma levels of endothelin and CGRP were measured before surgery, after intubation, at the time of gallbladder removal, immediately after surgery and 24 hours after surgery by radioimmunoassay. Results There was no significant difference in endothelin levels between the two groups before the surgery (t=0.971, P > 0.05). The endothelin levels in both groups gradually increased after the intubation, but more significantly in the > 65 years old group(t=4.258, P < 0.05). The increased endothelin levels were maintained during the surgery in both groups, but they were higher in the > 65 years old group(t=5.134, P < 0.01). When the surgery was completed, the level of endothelin in the > 65 years old group continued to increase, but it decreased in the < 65 years old group, and there was significantly difference between the two groups(t=6.627, P < 0.01). Endothelin levels in both groups at 24 hours after the surgery returned to the levels before surgery, and there was no significant difference between the two groups (t=1.917, P > 0.05). The CGRP levels had not significantly changed during the perioperative period in the < 65 years old group. In the > 65 years old group, CGRP levels decreased after anaesthesia, but increased during the surgery, and then reached the highest level at the time of the surgery completed. CGRP levels were significant difference between the two groups after intubation and immediately after surgery(t=4.084 and t=4.085, P < 0.05). Conclusion The levels of endothelin and CGRP had significantly changed elderly patients than those in young patients, especially for endothelin.
2011, 35(2): 107-110.
doi: 10.3760/cma.j.issn.1673-4114.2011.02.010
Abstract:
Objective To explore the value of combined examination of serum tumormarkers carbohydrate antigen 15-3 (CA15-3), carcinoembryonic antigen (CEA) and whole body bone scan in the diagnosis of bone metastasis in breast cancer. Methods Whole body bone scan and serum CA15-3 and CEA levels with a electrochemical luminescence assay were performed in 97 patients with breast cancer (46 cases with bone metastasis and 51 cases without bone metastasis) and 45 patients with benign breast diseases. As for the negative cases who had significant pains in bones, CT or MRI was performed to make sure. Results The serum level of CA15-3 and CEA were significantly higher in patients with bone metastasis than those in patients without bone metastasis and the benign lesions. The positive predicting values were 76.09% and 80.43%. Most patients with bone metastasis had positive results in bone scan(95.65%), only 2 cases had negative results (4.35%), which is positive by CT or MRI Seven. Seven patients without bone metastasis and Three patients with the benign lesions had positive results in bone scan, that may be caused by previous operation or injury. The combined determination of CA15-3, CEA and whole body bone scan had a better performance in sensitivity, specificity and accuracy than each single way. Conclusion The combined determination of CA15-3, CEA and whole body bone scan were valuable in the diagnosis of bone metastasis in breast cancer.
2011, 35(2): 110-113.
doi: 10.3760/cma.j.issn.1673-4114.2011.02.011
Abstract:
Objective To study the changes of serum thyrotrophin receptor antibody(TRAb) in patients of Graves' hyperthyroidism after 131I radiotherapy and explore its clinical significances. Methods A total of 128 patients and 45 nomal controls were included in the study. Serum concentration of TRAb was measured by radioreceptor assay before and at 3, 6, 12 and 18 months after 131I radiotherapy. Results The TRAb level of 45 nomal controls was (2.95±1.48) U/L. Abnormally higher TRAb level[(81.52±36.15)U/L)]was noted in patients before 131I treatment(t=8.17, P < 0.01). The TRAb titer increased further to(127.13±49.05)U/L at 3 months after therapy(t=4.92, P < 0.01), before it dropped to (59.82±28.51)U/L and (12.53±9.26)U/L at 6 and 12 months respectively(t=6.89 and t=2.29, P < 0.01). At 18 months after 131I radiotherapy, the level of TRAb [(4.29±2.56)U/L)]was back to normal with no difference to that of controls(t=1.53, P > 0.05). Conclusion It is of great significance to measure serum concentrations of TRAb after 131I radiotherapy, which is of important clinical value for therapy guidance, efficacy assessment, recurrence prediction and hypothyroidism identification.
2011, 35(2): 114-117.
doi: 10.3760/cma.j.issn.1673-4114.2011.02.012
Abstract:
Objective To evaluate the clinical value of CT guided interstitial 125I seed implantation treatment of refractory lung cancer. Methods A total of 35 cases of refractory lung cancer patients underwent 125I seed implantation treatment. Preoperative treatment planning system was used to calculate the distribution of radioactive source, then 2.855-3.087 MBq 125I seeds were implanted into the tumor tissues intraoperatively. Plane implantation of the particles were made every 0.5-1.0 cm. Matched peripheral dose was 150-180 Gy, and 10-120 particles were implanted for each patient, who would be followed up by CT to explore their efficacies two months later. Results Of the 35 patients, there were complete remission 4 cases, partial remission 27 cases, stable disease 3 cases, and progressive disease 1 cases. The objective response rate was 88.57%. Serious intraoperative and postoperative pneumothorax occurred in 5 patients, among whom transference cure was found 3-10 days later after their closed thoracic drainage, and 7 mild pneumothorax patients healed without more treatment. After follow-up it was found that most toxic reactions were mild and tolerable, and no severe complications were reported like hemoptysis or radiation pneumonia. Conclusion It is effective, less inasie and of low complication rate in CT guided interstitial 125I seed implantation treatment of advanced refractory lung cancer.
2011, 35(2): 117-124.
doi: 10.3760/cma.j.issn.1673-4114.2011.02.013
Abstract:
Radiation-induced heart disease(RIHD) is one of common late side effects derived by thoracic radiotherapy. RIHD is often subclinical and there is an extremely long clinical latent period between radiation therapy and the first clinical presentation of radiation injury, and it did not cause clinical attention for a long time. Until the 1990s, epidemiologic investigations demonstrate that thoracic cancer radiotherapy increased rates of cardiac mortality, RIHD has partly offset the survival benefit provided by adjuvant RT. Radiotherapy techniques has undergone many improvements over the last decades, these improvements decreased both the volume and dose of radiation delivered to the heart, seem to have decreased the incidence of RIHD. Nonetheless, recent studies indicate that the problem of RIHD may persist. For instance, patients with Hodgkin's Disease, lung cancer, and esophageal may still receive either a high dose of radiation to a small part of the heart or a lower dose to the whole heart in radiotherapy. Therefore, long-term cardiac follow-up of these patients is essential. This article briefly review the clinical presentations, influence factors, prevention and managements, diagnosis and study advances of RIHD.
Radiation-induced heart disease(RIHD) is one of common late side effects derived by thoracic radiotherapy. RIHD is often subclinical and there is an extremely long clinical latent period between radiation therapy and the first clinical presentation of radiation injury, and it did not cause clinical attention for a long time. Until the 1990s, epidemiologic investigations demonstrate that thoracic cancer radiotherapy increased rates of cardiac mortality, RIHD has partly offset the survival benefit provided by adjuvant RT. Radiotherapy techniques has undergone many improvements over the last decades, these improvements decreased both the volume and dose of radiation delivered to the heart, seem to have decreased the incidence of RIHD. Nonetheless, recent studies indicate that the problem of RIHD may persist. For instance, patients with Hodgkin's Disease, lung cancer, and esophageal may still receive either a high dose of radiation to a small part of the heart or a lower dose to the whole heart in radiotherapy. Therefore, long-term cardiac follow-up of these patients is essential. This article briefly review the clinical presentations, influence factors, prevention and managements, diagnosis and study advances of RIHD.
2011, 35(2): 124-127.
doi: 10.3760/cma.j.issn.1673-4114.2011.02.014
Abstract:
Hepatic adenoma is a rare benign tumor, which is quite easily misdiagnosed for its non-specific appearance. The great advances in imaging technology have led an increase in the detection rate of hepatic adenoma. This article reviews the recent advances at home and abroad in imaging diagnostic characteristic of hepatic adenoma, in order to raise awareness of clinicians and make accurate judgment.
Hepatic adenoma is a rare benign tumor, which is quite easily misdiagnosed for its non-specific appearance. The great advances in imaging technology have led an increase in the detection rate of hepatic adenoma. This article reviews the recent advances at home and abroad in imaging diagnostic characteristic of hepatic adenoma, in order to raise awareness of clinicians and make accurate judgment.
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