2014 Vol. 38, No. 3
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2014, 38(3): 141-147.
doi: 10.3760/cma.j.issn.1673-4114.2014.03.001
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Abstract:
Objective To investigate the damaged characteristics of cerebral glucose metabolism(CGM)and cerebral blood flow(CBF)in ischemic cerebrovascular disease(ICVD)patients with severe cerebral artery stenosis or occlusion. Methods Thirty-three cases of ICVD patients were examined by 18F- FDG PET and 13N-Ammonia PET, obtaining the same stages of cerebral blood perfusion and glucose metabolism image. According to the semi-quantitative analysis, the rate of reductions in CGM and CBF, and the ratio of CGM/CBF were figured out. Results ① There were 121 foci in total, positive rate of 18F-FDG imaging was 91.7%, and 13N-Ammonia imaging was 78.5%. ②ICVD foci were mostly characterized with multifocal and asymmetric distribution. ③Based on visual analysis to the relationship of FDG images and Ammonia images, 121 foci were divided into two types: matched damage in 66 foci(54.5%, type Ⅰ)and mismatched damage in 55 foci(45.5%, type Ⅱ-type Ⅴ). ④Based on semi-quantitative study to matched and mismatched group, the ratio of CGM/ CBF with 1.1-1.3 may be considered as the parameter in evaluation. ⑤Based on the rate of reductions in CGM and CBF, 66 matched foci were divided into mild(27 foci, 40.9%), moderate(15 foci, 22.7%)and severe(24 foci, 36.4%) damage group. ⑥4 cases with unilateral foci appeared crossed cerebellar diaschisis. Conclusions The matched relationship of CGM and CBF was markedly damaged in IVCD patients with sever cerebral artery stenosis but different degrees of injury on metabolism and blood flow were also found. The application of combined imaging with 18F-FDG and 13N-Ammonia brain PET is able to greatly improve ICVD diagnosis and management.
2014, 38(3): 148-151.
doi: 10.3760/cma.j.issn.1673-4114.2014.03.002
Abstract:
Objective To observe the incidence of pulmonary metastasis in osteosarcoma and evaluate the diagnostic efficiency of bone scintigraphy and chest CT in detection of pulmonary metastases and its influential factors. Methods A retrospective study was performed in 178 consecutive patients with osteosarcoma who underwent both bone scintigraphy and chest CT examination simultaneously by using a SPECT/CT instrument. Based on the final clinical diagnosis, incidence of pulmonary metastasis in the group was calculated, and the diagnostic efficacy of bone scintigraphy and chest CT was evaluated, respectively. Detection rate of bone scintigraphy was correlated to the status of calcification in metastatic lesions. Serum alkaline phosphatase (ALP) levels was correlated to the occurrence of pulmonary metastasis, calcification status in metastatic lesions and scintigraphic detections. Results Pulmonary metastasis occurred in 24.2% patients of all the patients. In the detection of pulmonary metastasis, sensitivity of bone scintigraphy and chest CT was 44.2% and 100%, respectively, and specificity was 100% and 89.6%, respectively. Lesion detection on bone scintigraphy was affected by the status of calcification in metastatic tumors(χ2=8.4, P < 0.01). It was found that the serum ALP levels was correlated to the occurrence of pulmonary metastasis, but not to the calcification or scintigraphic detections. Conclusions The risk of pulmonary metastasis in patients with osteosarcoma is higher. Using SPECT/CT to obtain bone scintigraphy and chest CT simultaneously will have a higher diagnostic value for detection of pulmonary metastasis, especially for those patients who with elevated serum ALP.
2014, 38(3): 152-156, 170.
doi: 10.3760/cma.j.issn.1673-4114.2014.03.003
Abstract:
Objective To assess the effects of two different doses of 131I(3700 MBq vs. 1110 MBq)for ablation of thyroid remnant in patients with differentiated thyroid carcinoma(DTC) by using meta analysis. Methods Collected the eligible trials by searching the Cochrane Library, MEDLINE, OVID, EMBASE, EBSCO and SpringerLink from January 1980 to August 2013. All relevant studies were screened according to inclusion and exclusion criteria. A modified Jadad scale was used for quality evaluation of selected literatures. RveMan 5.1 software was used for statistical analysis. Results Twelve randomized controlled trails involving 2290 patients were included in accordance with the inclusion and exclusion criteria. According to the criteria of successful thyroid remnant ablation reported in each literature, no statistical difference was noted in the rate of successful remnant ablation between low- and high-dose 131I group(Z=1.80, P > 0.05). Both the low- or high-dose of 131I ablation showed no significant difference in the rate of successful remnant ablation between the two methods(recombinant human thyrotropin vs. steroid withdrawal)of preparing therapy(Z=0.98 and 0.33, P > 0.05). Also, no significant differences existed in quality-of-life scores on the SF-36 between different 131I-dose groups(Z=0.37, P > 0.05). The low-dose group showed lower incidence of adverse events(Z=5.15, P < 0.01) and shorter hospital isolation time than that in high-dose 131I group. Conclusions Two different doses of 131I treatment and two different preparation methods have similar efficacy in ablation of residual thyroid tissue in patients with low risk DTC, but the incidence of adverse effects in low-dose 131I group is less.
2014, 38(3): 157-160, 189.
doi: 10.3760/cma.j.issn.1673-4114.2014.03.004
Abstract:
Objective Au nanoparticles(AuNPs)was chemically modified with sulfhydryl-polyethylene glycol(SH-PEG) and its effects on liver cancer cell survival and radiation damage were assessed. Methods PEG-AuNPs were chemically fabricated with SH-PEG and AuNPs. The size of PEG-AuNPs and uptake by liver cancer cell were observed by field-emission transmission electron microscopy(TEM). The Cell Titer-Glo luminescent cell viability assay and cell colonies were used to examine effect of PEG-AuNPs on liver cancer cells′ survival and radiation damage. Results 14.4 nm and 30.5 nm PEG-AuNPs were obtained by above fabrication. 30.5 nm PEG-AuNPs were presented more absorption, inhibition the survival and enhance radiation effect to liver cancer cell. Conclusions After modification with SH-PEG, larger PEG-AuNPs with 30.5 nm showed stronger inhibition in liver cancer cellular survival and promoted liver cancer cells sensitive to radiation.
2014, 38(3): 164-166, 178.
doi: 10.3760/cma.j.issn.1673-4114.2014.03.006
Abstract:
Objective To observe the protective function of dehydroepiandrosterone(DHEA) on hematopoietic in C57BL/6 mouse induced by radiotherapy and chemotherapy. Methods Constructing the animal models with hematopoietic injury by 8.0 Gy 137Cs γ ray and cyclophosphamide respectively. Observe the changes of colony-forming unit-spleen(CFU-S), populations of peripheral WBC and bone marrow nucleated cells and index of spleen in all DHEA treated groups. Results DHEA can reduce injury of 137Cs γ ray and cyclophosphamide induced hematopoietic function injury of C57BL/6 mouse. Compared with the blank control group, the DHEA group can significantly increase the number of peripheral blood leukocyte, bone marrow nucleated cells and CFU-S, and there is statistically difference between DHEA treated group and the blank control group. Index of spleen in the high dose group is higher than that in the blank control group. Conclusion DHEA have protection function on hematopoietic in C57BL/6 mouse induced by radiotherapy and chemotherapy.
2014, 38(3): 167-170.
doi: 10.3760/cma.j.issn.1673-4114.2014.03.007
Abstract:
Objective To explore the application value of angiotensin Ⅱ(ATⅡ), neuropeptide Y(NPY), insulin-like growth factor 1(IGF-1) and high sensitive C-reaction protein(hs-CRP) levels in evaluation of the severity of coronary heart disease(CHD). Methods The plasma ATⅡ, NPY, IGF-1 and hs-CRP levels in 157 patients with CHD [including 51 cases with stable angina(SA), 45 cases with unstable angina(USA) and 61 cases with acute myocardial infraction(AMI)] were measured by radioimmunoassay, enzyme immunoassay and high sensitive enzyme immunoassay and were compared with 60 health controls. Results The plasma ATⅡ level in 157 patients with CHD was significantly higher than those in 60 controls(tSA ATⅡ=2.257, P < 0.05;tUSA ATⅡ=3.018, P < 0.01;tAMI ATⅡ=4.143, P < 0.001). The plasma NPY level in 157 patients with CHD was higher than those in 60 controls(tSA NPY=1.413, P > 0.05;tUSA NPY=2.148, P < 0.05;tAMI NPY=3.068, P < 0.01), but there were no significant difference between SA patients and the 60 conrols. The plasma IGF-1 level in 157 patients with CHD was significantly higher than those in 60 controls(tSA IGF-1=2.121, P < 0.05;tUSA IGF-1=2.937, P < 0.01;tAMI IGF-1=4.217, P < 0.001). The plasma hs-CRP level in 157 patients with CHD was significantly higher than those in 60 controls(tSA hs-CRP=2.095, P < 0.05;tUSA hs-CRP=2.867, P < 0.01;tAMI hs-CRP=4.349, P < 0.001). The four plasma biomarkers were increased with severity of CHD. Conclusion The plasma ATⅡ, NPY, IGF-1 and hs-CRP levels were valuable indexes for judging the severity of patients with CHD, and could be used for follow-up.
2014, 38(3): 171-174.
doi: 10.3760/cma.j.issn.1673-4114.2014.03.008
Abstract:
Objective To research the automation synthesis and quality control of [18F]fluoromethyl choline(18F-FCH) by automatic synthesis module from Japanese sumitomo corporation. Methods Intermediate product 18FCH2Br was produced by the reaction of CH2Br2 with 18F- which was made by sumitomo cyclotron. 18FC2H4SO3CF3 with a higher activity was generated by modifying the activities of 18FCH2Br through the Ag-Triflate/C column at high temperature. 18FC2H4SO3CF3 reacted with N, N-dimethyl ethanolamine on Sep-Pak C-18 column at room temperature and the products were purified through washing the Sep-Pak C-18 column and Sep-Pak CM column in series with alcohol, water and physiological saline injector respectively. The purity of the final products was detected by high performance liquid chromatography. Results The radiochemical purity of 18F-FCH was above 97%, the uncorrected radiochemical yield was 27%, and the synthesis process last for 38 min. Conclusion This synthesis method has more advantages, such as easier operation, higher yields, shorter synthesis time, more stable products with a higher radiochemical purity.
2014, 38(3): 175-178.
doi: 10.3760/cma.j.issn.1673-4114.2014.03.009
Abstract:
Among non-invasive methods for the assessment of ischaemic heart disease, myocardial perfusion imaging(MPI) using SPECT tracers is firmly established and well-known by physician and patients. However, MPI is still affected by several drawbacks such as attenuation due to non-uniform tissue, motion artefacts due to time-consuming scan and radiation exposure. The dedicated solid-state cardiac camera using cadmium zinc telluride(CZT) solid-state detectors emerged in recent years. The camera has gotten more and more attention. The camera has advanced CZT detector, acquisition and reconstruction method. The count rate, spatial resolution and energy resolution of the CZT SPECT have been enhanced significantly. This paper would review the clinical application progress of CZT SPECT.
Among non-invasive methods for the assessment of ischaemic heart disease, myocardial perfusion imaging(MPI) using SPECT tracers is firmly established and well-known by physician and patients. However, MPI is still affected by several drawbacks such as attenuation due to non-uniform tissue, motion artefacts due to time-consuming scan and radiation exposure. The dedicated solid-state cardiac camera using cadmium zinc telluride(CZT) solid-state detectors emerged in recent years. The camera has gotten more and more attention. The camera has advanced CZT detector, acquisition and reconstruction method. The count rate, spatial resolution and energy resolution of the CZT SPECT have been enhanced significantly. This paper would review the clinical application progress of CZT SPECT.
2014, 38(3): 179-184.
doi: 10.3760/cma.j.issn.1673-4114.2014.03.010
Abstract:
Malignant tumors′ growth and metastasis depend on tumor angiogenesis. Recent studies had found that the integrin αvβ3 had a high expression on the surface of tumor angiogenesis endothelial cells and parts of the tumor cells, it can regulate tumor angiogenesis by cell adhesion, but it does not express on the surface of normal blood vessels or the normal organizations, or only had a low level expression. Thus it can be used as a new target for the tumor angiogenesis imaging and treatment. Recent years, there is a great progress on the design of the integrin αvβ3 targeting agents, the selection of radionuclides, and the latest research on the agents at home and abroad. This article will made a review on how to better design the integrin αvβ3 agents, choose the appropriate radionuclides, and the research direction of these agents.
Malignant tumors′ growth and metastasis depend on tumor angiogenesis. Recent studies had found that the integrin αvβ3 had a high expression on the surface of tumor angiogenesis endothelial cells and parts of the tumor cells, it can regulate tumor angiogenesis by cell adhesion, but it does not express on the surface of normal blood vessels or the normal organizations, or only had a low level expression. Thus it can be used as a new target for the tumor angiogenesis imaging and treatment. Recent years, there is a great progress on the design of the integrin αvβ3 targeting agents, the selection of radionuclides, and the latest research on the agents at home and abroad. This article will made a review on how to better design the integrin αvβ3 agents, choose the appropriate radionuclides, and the research direction of these agents.
2014, 38(3): 185-189.
doi: 10.3760/cma.j.issn.1673-4114.2014.03.011
Abstract:
Cancer gene therapy is a way to treat cancer at the gene level which is one of the effective methods for cancer therapy. But, there are still some outstanding problems, for example, the targeting of gene expression. Recent researches confirm that the specific promoter can improve the targeting in gene therapy. The promoter is a region of DNA which can initiates transcription of a particular gene. The specific promoter only can be activated in certain tissue or tumor. Based on the recent studies in this field, this article will introduce types and functions of specific promoters, which has been investigated in cancer gene therapy.
Cancer gene therapy is a way to treat cancer at the gene level which is one of the effective methods for cancer therapy. But, there are still some outstanding problems, for example, the targeting of gene expression. Recent researches confirm that the specific promoter can improve the targeting in gene therapy. The promoter is a region of DNA which can initiates transcription of a particular gene. The specific promoter only can be activated in certain tissue or tumor. Based on the recent studies in this field, this article will introduce types and functions of specific promoters, which has been investigated in cancer gene therapy.
2014, 38(3): 190-196.
doi: 10.3760/cma.j.issn.1673-4114.2014.03.012
Abstract:
CXC chemokine receptor type 4(CXCR4) and its ligand(CXCL12) exerts crucial influence in regulating tumor growth, angiogenesis and metastasis. Studies show that the downstream signaling pathway can be activated by interaction of the chemokine receptor and its ligand to promote tumor growth and angiogenesis. Additional observation suggests that neoplastic tissue expresses high levels of CXCR4, and the site of tumor metastasis over expresses CXCL12, through which this specific binding ability can induce tumor metastasis. Thus, the CXCR4 levels could be used as a predictive marker of metastatic potential. Hopefully, the non-invasive imaging methods, such as SPECT/CT, PET, are employed in the imaging of the chemokine receptors to diagnose and treat the tumors in the early stage.
CXC chemokine receptor type 4(CXCR4) and its ligand(CXCL12) exerts crucial influence in regulating tumor growth, angiogenesis and metastasis. Studies show that the downstream signaling pathway can be activated by interaction of the chemokine receptor and its ligand to promote tumor growth and angiogenesis. Additional observation suggests that neoplastic tissue expresses high levels of CXCR4, and the site of tumor metastasis over expresses CXCL12, through which this specific binding ability can induce tumor metastasis. Thus, the CXCR4 levels could be used as a predictive marker of metastatic potential. Hopefully, the non-invasive imaging methods, such as SPECT/CT, PET, are employed in the imaging of the chemokine receptors to diagnose and treat the tumors in the early stage.
2014, 38(3): 197-201.
doi: 10.3760/cma.j.issn.1673-4114.2014.03.013
Abstract:
Triple-negative breast cancer(TNBC)is a distinctive sub-group of breast cancers that do not express estrogen receptors(ER), progesterone receptors(PR) and human epidermal growth factor receptor 2(HER2). TNBC often happens to premenopausal women, and having special features such as poor prognosis, short 5-year survival, strong tumor invasion, high incidence of local recurrence and distant metastasis. Chemotherapy and surgery are mainly available systemic treatments of TNBC, and neoadjuvant chemotherapy(NAC)has become a widely used systemic treatment. Recently, the value of 18F-FDG PET/CT in breast cancer has been extensively studied, the role of PET/CT monitoring the efficacy of NAC has been a positive result. In this paper, the research progress of assessment with 18F-FDG PET/CT in TNBC during neoadjuvant chemotherapy was reviewed.
Triple-negative breast cancer(TNBC)is a distinctive sub-group of breast cancers that do not express estrogen receptors(ER), progesterone receptors(PR) and human epidermal growth factor receptor 2(HER2). TNBC often happens to premenopausal women, and having special features such as poor prognosis, short 5-year survival, strong tumor invasion, high incidence of local recurrence and distant metastasis. Chemotherapy and surgery are mainly available systemic treatments of TNBC, and neoadjuvant chemotherapy(NAC)has become a widely used systemic treatment. Recently, the value of 18F-FDG PET/CT in breast cancer has been extensively studied, the role of PET/CT monitoring the efficacy of NAC has been a positive result. In this paper, the research progress of assessment with 18F-FDG PET/CT in TNBC during neoadjuvant chemotherapy was reviewed.
2014, 38(3): 202-206.
doi: 10.3760/cma.j.issn.1673-4114.2014.03.014
Abstract:
Gastroesophageal reflux(GER) is a common digestive system disease with high incidence in infants and children. The long-term serious GER may provoke serious complications, early accurate detection of GER is crucial for its treatment. Milk scan gastroesophageal imaging is a kind of examination method which is mainly used for GER, gastric emptying, aspiration and the research on pathogenesis of GER. The clinical application is wide, but its specificity and sensitivity is low. At present, the application and research about milk scan is less in our country. This article mainly summarized the technology and clinical application and progression of milk scan.
Gastroesophageal reflux(GER) is a common digestive system disease with high incidence in infants and children. The long-term serious GER may provoke serious complications, early accurate detection of GER is crucial for its treatment. Milk scan gastroesophageal imaging is a kind of examination method which is mainly used for GER, gastric emptying, aspiration and the research on pathogenesis of GER. The clinical application is wide, but its specificity and sensitivity is low. At present, the application and research about milk scan is less in our country. This article mainly summarized the technology and clinical application and progression of milk scan.
2014, 38(3): 207-210.
doi: 10.3760/cma.j.issn.1673-4114.2014.03.015
Abstract:
Most of the cirrhosis and hepatic carcinoma patients have reached an advanced stage as they are diagnosed, the prognosis is poor, and its early diagnosis and treatment are essential for the patient's prognosis. With medical diagnostic imaging technology advanced, more and more MRI technology is used to the diagnosis, such as diffusion-weighted imaging, perfusion-weighted imaging, new hepatocellular specific contrast agent enhanced MRI can provide more extensive diagnostic information from a plurality of the molecular level, cellular functions, and improve the accuracy of diagnosis of cirrhosis and hepatic carcinoma. This is of great significance to improve cirrhosis and hepatic carcinoma's diagnostic accuracy and improve patient's prognosis.
Most of the cirrhosis and hepatic carcinoma patients have reached an advanced stage as they are diagnosed, the prognosis is poor, and its early diagnosis and treatment are essential for the patient's prognosis. With medical diagnostic imaging technology advanced, more and more MRI technology is used to the diagnosis, such as diffusion-weighted imaging, perfusion-weighted imaging, new hepatocellular specific contrast agent enhanced MRI can provide more extensive diagnostic information from a plurality of the molecular level, cellular functions, and improve the accuracy of diagnosis of cirrhosis and hepatic carcinoma. This is of great significance to improve cirrhosis and hepatic carcinoma's diagnostic accuracy and improve patient's prognosis.
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