2013 Vol. 37, No. 4
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2013, 37(4): 193-195.
doi: 10.3760/cma.j.issn.1673-4114.2013.04.001
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Abstract:
Objective To study the value of PET/CT using 11C-choline and that of PET/CT using 18F-FDG for the diagnosis of brain glioma. Methods Twenty-one cases of suspected brain glioma were examined. 11C-choline PET/CT and 18F-FDGPET/CT were performed on each patient to analyze the relevance of maximum standardized uptake value(SUVmax) of 11C-choline and 18F-FDG to the age and pathological types of patients with glioma. Results Of 21 patients, there was no significant correlation between SUVmax of 11C-choline and 18F-FDG and their age, and between SUVmax of 18F-FDG and benign and malignant tumors among patients, whereas there was certain correlation between SUVmax of 11C-choline and benign and malignant tumors among patients. Conclusion 11C-choline PET/CT is of great clinical value in diagnosing and differentiating brain glioma.
2013, 37(4): 196-198, 220.
doi: 10.3760/cma.j.issn.1673-4114.2013.04.002
Abstract:
Objective To study the protective effect of keratinocyte growth factor (KGF) in genetics damage induced by radiation using the methods of single cell gel electrophoresis (SCGE) and micronuclei assay. Methods The C57BL/6J mice were randomly divided into five groups:control group, radiation group and low, middle, high dose groups of KGF(1, 2, 4 mg/kg). Drugs were administrated by intraperitoneal injection. Then control group was given sham-irradiated, and other groups were given a whole body irradiation at the dose of 7.2 Gy with γ-rays. DNA damage of different groups were detected by SCGE and micronuclei assay. Results Compared with radiation group, pretreatment with KGF can significantly decrease the tail moment and micronucleus formation. Conclusion Pretreatment with KGF can effectively protect the radiation-induced genetics damage in mouse model.
2013, 37(4): 199-202.
doi: 10.3760/cma.j.issn.1673-4114.2013.04.003
Abstract:
Objective To explore the diagnosis value of 18F-FDG PET/CT and 3.0T MR combined imaging in detecting the primary focus of breast cancer. Methods Thirty eight female patients with highly suspected breast cancer were selected, 18F-FDG PET/CT and 3.0T MRI imaging were performed and their pathological results were gotten within 7 days. Results Twenty four malignant cases and 14 benign cases of the 38 patients were proved by pathology. The sensitivity, specificity and accuracy rate obtained by 3.0T MRI were 91.7%, 78.6% and 86.8%, respectively; they were 87.5%, 92.9% and 89.5% for 18F-FDG PET/CT; and which were 100.0%, 92.9% and 97.4% with 18F-FDG PET/CT and 3.0T MRI combined imaging. There were no significant difference among the three methods in the diagnostic ability(χ2=2.987, 1.612 and 2.955, all P > 0.05). Conclusions The combination of 18F-FDG PET/CT imaging and 3.0T MRI imaging in detecting the primary focus of breast cancer has important value, and comparison with separate 18F-FDG PET/CT imaging or 3.0T MRI imaging, the diagnosis efficiency of three imaging methods in breast cancer without statistics difference.
2013, 37(4): 203-206.
doi: 10.3760/cma.j.issn.1673-4114.2013.04.004
Abstract:
Objective To investigate the feasibility, efficacy and complications of CT guided radio-active 125I seed implantation in the treatment of lung cancer. Methods According to the different treatment methods, 65 patients with lung cancer were divided into two groups, 37 cases in the implantation alone group received CT guided 125I seeds interstitial implantation, the other 28 cases in the combination treatment group received interstitial 125I seeds implantation combined with chemotherapy. All the patients were examined by posologic validation, and were followed up termly. Results The total effictive rate of 65 patients was 80.0%, 1-year survival rate was 90.8%. The effictive rates of implantation alone group and combination treatment group were 67.6% and 96.4% respectively. There was a significant difference between the two groups(χ2=8.298, P < 0.01). Before treatment, all the patients′ mean diameter of the tumor was 5.48 cm; while it was 3.77 cm after treatment(t=7.764, P < 0.01). Complications included pneumothorax(36 cases), bloody sputum(7 cases), fever (4 cases) which improved after treatment in 65 patients, but without radiation pneumonia. Conclusion 125I seed implantation is a highly effective treatment without severe complications in the treatment of lung cancer.
2013, 37(4): 207-210.
doi: 10.3760/cma.j.issn.1673-4114.2013.04.005
Abstract:
Objective To evaluate monoenergetic imaging of dual energy CT in the visualization of metal implants(stainless steel implants). Methods Two different data(80 and 140 kV)of water phantom which contained metal implants were collected in one-time scanning using dual-energy scanning sequence. Monoenergetic technique which two different imaging at 80 kV and 140 kV were used for subtraction to removing metal artifacts was applied to generate the new imaging. The CT value of water surrounding metal implants were measured and compared. Results In the three images(80 kV, 140 kV, spectrum image fusion), the latter quality is the highest and the 80 kV scanning images′ quality was the worst. The difference between CT values of 80 kV images(140 kV images) and energy spectrum images along the right direction 0.1, 0.5, 1, 1.5, 2.0, 2.5, 3.0 cm of the metal basically was significant assessed by the SAS9.1 software. Conclusions Dual energy CT can effectively reduce artifacts of metal implants and will provide high image quality in the area with metal implants.
2013, 37(4): 211-215.
doi: 10.3760/cma.j.issn.1673-4114.2013.04.006
Abstract:
Objective To study the effects of lung cancer patients′ weight, blood glucose concentration and lesion size of lung cancer on 18F-FDG PET/CT lesions SUV results. Methods Fifty cases of lung cancer patients without a history of diabetes mellitus were enrolled in this study. Among them, 21 patients with mediastinal metastases were detected. According to clinical routine 18F-FDG PET/CT scanning, automatic extraction of lung cancer SUV, weight and size correction SUV were obtained using the GE Advantage Workstation image processing workstation. Liver reference background SUV was obtained using semi-automatic extraction method of extraction. Lung cancer primary tumors and metastatic lesions diagnosis reference standards were accordant with the liver reference background SUV or SUV shape correction×1.5+2×standard deviation. Results Fifty cases of lung cancer in patients with blood sugar concentration and liver reference background SUV had positive correlation with lung cancer, SUV of primary lung cancer was negatively correlated with blood sugar, but it showed a positive correlation between blood sugar and lung metastases. According to the reference criteria for the diagnosis of 50 primary lung cancer cases and 21 metastatic lung cancer cases before and after the clinical diagnosis, the glucose concentration, lesion size correction accuracies were 90.00%, 71.43% and 100%, 95.24% respectively. Conclusions Patients′ body weight, blood glucose concentration and lesion size significantly affect the accuracy of clinical diagnosis of lung cancer. After correction accuracy, it remarkably improved the clinical diagnosis of lung cancer. The results suggest that when using 18F-FDG PET/CT for lung cancer diagnosis, the effects of body weight, blood glucose concentration and lesion size should be concerned.
2013, 37(4): 216-220.
doi: 10.3760/cma.j.issn.1673-4114.2013.04.007
Abstract:
Objective To evaluate the role of 16α-[18F]fluoro-17β-oestradiol(18F-FES)PET/CT in the diagnosis and management of breast cancer. Methods Nineteen pre-operation cases with breast cancer and 7 post-operation cases with metastatic breast cancer underwent 18F-FES PET/CT and 18F-FDG PET/CT, and comparative analysis with the expression of estrogen receptor(ER)was performed. Results Of the primary lesions, the ER was positive in 9 patients(10 lesions), negative in 10 patients(11 lesions). The maximum standardized uptake value(SUVmax) for FES uptake was positively related to the lesion size and ER expression. The mean SUVmax for FES uptake was 3.45±2.34 in the 10 ER positive tumors, and 0.74±0.12 in the 11 ER negative tumors, which showed significant differences between the two groups(t=3.782, P < 0.01). The sensitivity, specificity and accuracy of FES PET for diagnosis ER positive patients were 100%, 90.90% and 95.23% respectively. Sixty-four 18F-FES positive metastases were found in the three ER positive metastatic patients, whereas only 47 18F-FDG positive metastases were found. Conclusion 18F-FES PET/CT will be useful for diagnosis, individualized medicine and detecting therapeutic changes in patients with ER positive breast cancer.
2013, 37(4): 221-224.
doi: 10.3760/cma.j.issn.1673-4114.2013.04.008
Abstract:
Objective To evaluate the clinical value of SPECT/CT fusion imaging in the diagnosis and differential diagnosis the characteristic of the whole body bone scan radioactive hot lesions in patients with breast cancer. Methods The abnormal radioactive hot lesions of whole body bone scan in 25 patients with breast cancer underwent SPECT/CT fusion imaging immediately. Another whole body bone scan and SPECT/CT fusion imaging were carried out 4 to 8 months later in all these patients. The whole body bone scan images, SPECT/CT images and fusion images were analyzed independently by two experienced nuclear medicine physicians and some of the equivocal CT images were analyzed by an experienced radiologist. Results Among all the 37 abnormal radioactive hot bone lesions, 29(29/37, 78. 38%) lesions were confirmed metastatic lesions, including 2 vertebral lesions classified as benign lesions on the basis of the first examinations data; and 8 lesions were benign, including a rib lesion classified as benign lesion according to the first examinations data. The difference between whole body bone scan and SPECT/CT examination was statistically significant(χ2=6. 975, P < 0. 05). The bone metastases are located mainly in spine and ribs. The sensitivity, specificity, positive and negative predictive values, and accuracy of whole-body bone scan and SPECT/CT fusion imaging were 82.76%, 75.00%, 92.31%, 54.55%, 81.08% and 93.10%, 87.50%, 96.43%, 77.78%, 91.89%, respectively. The area under the receiver operating characteristics curve was 0. 860±0. 056 for whole body bone scan and 0. 974±0. 020 for SPECT/CT. The area under the curve for SPECT/CT was significantly larger compared with the whole body bone scan(χ2=9. 924, P < 0. 001). Conclusions SPECT/CT fusion imaging is better than whole body bone scan alone to characterize the abnormal bone radioactive hot lesions and it can improve the accuracy of diagnosis. The patients should repeat the modality 4 to 8 months later if necessary.
2013, 37(4): 225-229.
doi: 10.3760/cma.j.issn.1673-4114.2013.04.009
Abstract:
Toll-like receptor 4(TLR4)is an important group of pattern recognition receptors, which is expressed not only on immune cells widely, but also on a variety of tumor cells. TLR4 can promote the development and progression, immune escape, apoptosis resistance, metastasis and invasion of tumors through different signal transduction mechanisms. Activated TLR4 plays an important role in the tumor microenvironment, and its influence on the radiosensitivity of tumor cells reduces the effect of radiation therapy severely. The study of these mechanisms can further identify the target for cancer radiotherapy, which will undoubtedly provide a new method for the treatment of malignant tumor.
Toll-like receptor 4(TLR4)is an important group of pattern recognition receptors, which is expressed not only on immune cells widely, but also on a variety of tumor cells. TLR4 can promote the development and progression, immune escape, apoptosis resistance, metastasis and invasion of tumors through different signal transduction mechanisms. Activated TLR4 plays an important role in the tumor microenvironment, and its influence on the radiosensitivity of tumor cells reduces the effect of radiation therapy severely. The study of these mechanisms can further identify the target for cancer radiotherapy, which will undoubtedly provide a new method for the treatment of malignant tumor.
2013, 37(4): 230-232, 238.
doi: 10.3760/cma.j.issn.1673-4114.2013.04.010
Abstract:
Lymphoma is one of the most common malignant tumors in clinic. But primary extranodal lymphomas is not frequently encountered clinically especially for the lymphomas which stem from urinary system. Kidney was the most common affecting area, followed by bladder and ureter. Palpable masses, abdominal pain, renal insufficiency, hematuria and difficult urination are the main clinical symptoms of primary extranodal lymphoma of the urinary system. Familiarity with the imaging features will be helpful to the accurate diagnosis and therapy.
Lymphoma is one of the most common malignant tumors in clinic. But primary extranodal lymphomas is not frequently encountered clinically especially for the lymphomas which stem from urinary system. Kidney was the most common affecting area, followed by bladder and ureter. Palpable masses, abdominal pain, renal insufficiency, hematuria and difficult urination are the main clinical symptoms of primary extranodal lymphoma of the urinary system. Familiarity with the imaging features will be helpful to the accurate diagnosis and therapy.
2013, 37(4): 233-238.
doi: 10.3760/cma.j.issn.1673-4114.2013.04.011
Abstract:
Except for the traditional radiotherapy sensitization agents such as nitro imidazoles and nitrobenzene, some chemotherapeutics also showed sensitization effect. Molecular targeted drug research is in the ascendant, respectively interacting with histone deacetylase, signal transducer and activator of transcription 3, poly(adenosine diphosphate-ribose)polymerase, prostaglandin H synthase-2, (hypoxia inducible factor-1, nuclear factor kappa-light-chain-enhancer of activated B cells, heat shock protein, ataxia-telangiectasia mutated gene and so on, through various ways such as interfering DNA repair, inhibiting tumor cell proliferation, promoting tumor cell apoptosis and inhibiting angiogenesis to improve the sensitivity of cancer cells to iron radiation.
Except for the traditional radiotherapy sensitization agents such as nitro imidazoles and nitrobenzene, some chemotherapeutics also showed sensitization effect. Molecular targeted drug research is in the ascendant, respectively interacting with histone deacetylase, signal transducer and activator of transcription 3, poly(adenosine diphosphate-ribose)polymerase, prostaglandin H synthase-2, (hypoxia inducible factor-1, nuclear factor kappa-light-chain-enhancer of activated B cells, heat shock protein, ataxia-telangiectasia mutated gene and so on, through various ways such as interfering DNA repair, inhibiting tumor cell proliferation, promoting tumor cell apoptosis and inhibiting angiogenesis to improve the sensitivity of cancer cells to iron radiation.
2013, 37(4): 239-242.
doi: 10.3760/cma.j.issn.1673-4114.2013.04.012
Abstract:
Preoperative neoadjuvant chemotherapy has become the standardized treatment for patients with locally advanced breast cancer. With the wide application of neoadjuvant chemotherapy in clinic, evaluation of response to neoadjuvant chemotherapy seems increasingly important. How to evaluate the curative effect of chemotherapy timely, accurately, effectively and noninvasively has become the focus of clinical research. At present, clinical palpation, radiographic measurement and pathological examination are usually used in clinic, and the study of breast cancer biology factor is also rapidly spread. The application status of different evaluation methods of neoadjuvant chemotherapy were reviewed in this article.
Preoperative neoadjuvant chemotherapy has become the standardized treatment for patients with locally advanced breast cancer. With the wide application of neoadjuvant chemotherapy in clinic, evaluation of response to neoadjuvant chemotherapy seems increasingly important. How to evaluate the curative effect of chemotherapy timely, accurately, effectively and noninvasively has become the focus of clinical research. At present, clinical palpation, radiographic measurement and pathological examination are usually used in clinic, and the study of breast cancer biology factor is also rapidly spread. The application status of different evaluation methods of neoadjuvant chemotherapy were reviewed in this article.
2013, 37(4): 243-246.
doi: 10.3760/cma.j.issn.1673-4114.2013.04.013
Abstract:
18F-FDG is currently the most widely used PET tracer. However, its application in the fields of brain tumor, prostate cancer, head and neck cancer, hepatocellular carcinoma, urinary tumor and well differentiated lung cancer exists limitation. Tumor uptake 11C-acetate is based on accelerated lipid synthesis and impaired oxidative metabolism. 11C-acetate PET may overcome the insufficiency of 18F-FDG PET. Uptake mechanism, application of the above tumors and the newest progress of 11C-acetate PET and PET/CT are reviewed in this article.
18F-FDG is currently the most widely used PET tracer. However, its application in the fields of brain tumor, prostate cancer, head and neck cancer, hepatocellular carcinoma, urinary tumor and well differentiated lung cancer exists limitation. Tumor uptake 11C-acetate is based on accelerated lipid synthesis and impaired oxidative metabolism. 11C-acetate PET may overcome the insufficiency of 18F-FDG PET. Uptake mechanism, application of the above tumors and the newest progress of 11C-acetate PET and PET/CT are reviewed in this article.
2013, 37(4): 247-252.
doi: 10.3760/cma.j.issn.1673-4114.2013.04.014
Abstract:
Left ventricular mechanical dyssynchrony is closely related to the severity of cardiovascular disease, it is essential to assess left ventricular mechanical dyssynchrony accurately for early prediction of adverse cardiac events and prognosis assessment of the cardiac resynchronization therapy. As a new technology to assess left ventricular mechanical dyssynchrony, the phase analysis of gated myocardial perfusion imaging(GMPI) can get both quantitative indicators of regional myocardial perfusion, evaluation of regional myocardial viability and scar tissue, as well as quantitative analysis of left ventricular function and left ventricular mechanical synchrony, it has broad application prospects in cardiovascular disease to assess left ventricular mechanical dyssynchrony and prognosis assessment. This review mainly described the applications of GMPI phase analysis in the cardiovascular disease.
Left ventricular mechanical dyssynchrony is closely related to the severity of cardiovascular disease, it is essential to assess left ventricular mechanical dyssynchrony accurately for early prediction of adverse cardiac events and prognosis assessment of the cardiac resynchronization therapy. As a new technology to assess left ventricular mechanical dyssynchrony, the phase analysis of gated myocardial perfusion imaging(GMPI) can get both quantitative indicators of regional myocardial perfusion, evaluation of regional myocardial viability and scar tissue, as well as quantitative analysis of left ventricular function and left ventricular mechanical synchrony, it has broad application prospects in cardiovascular disease to assess left ventricular mechanical dyssynchrony and prognosis assessment. This review mainly described the applications of GMPI phase analysis in the cardiovascular disease.
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