2016 Vol. 40, No. 1
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2016, 40(1): 1-5, 21.
doi: 10.3760/cma.j.issn.1673-4114.2016.01.001
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Abstract:
Objective To explore a PET probe, 11C-GF120918 in the assessing of the function and significance of P-glycoprotein(P-gp) and breast cancer resistance protein(BCRP). Methods The mice were injected with chemically synthesized 11C-GF120918. An automatic gamma counter was used to measure the 11C-GF120918 radiation intensity of the various organs of the mice at different times and dosages. Simultaneously, HPLC was employed to detect the metabolism of 11C-GF120918 in the brain and blood of the mice. The four mice groups, namely, P-gp knockdown mice, BCRP knockdown mice, P-gp/BCRP knockdown mice, and wild mice, were manually injected with 11C-GF120918. The radiation intensity of 11C-GF120918 in the mice brain was detected by PET. Results After the 11C-GF120918 injection, the tissues and organs of mice were more widely distributed compared with those of the wild mice(χ2=8.14, P < 0.05). Thirty minutes after injection, the 11C-GF120918 radiation intensity in the brain and blood were still (99.3±0.5)% and (83.2±3.5)%, respectively, with better biochemistry and radiation stability. In PET studies, AUCbrain[0~60 min] in the P-gp knockout mice was nine times higher than that in the wild group(χ2=7.69, P < 0.05). The AUCbrain[0-60 min] of the BCPR knockout mice was three times higher than that in the wild group(χ2=8.24, P < 0.05). The evident effect of 11C-GF120918 was relatively stable. Conclusion 11C-GF120918 can be used as PET probes to evaluate the multi-drug resistance of P-gp and BCRP.
2016, 40(1): 6-12.
doi: 10.3760/cma.j.issn.1673-4114.2016.01.002
Abstract:
Objective To use Tracerlab FXC transformation to achieve a stable automated synthesis of 11C-acetate, while performing necessary quality control and analysis of key factors of production yield. Methods The devices that do not participate were short-circuited in the reaction of synthesis, adding external controllable valves or devices to control the external factors which may affect the synthesis yield.The active 11C-CO2 reacts with 500 μl of 0.5 mol/L methyl magnesium bromide and then quenched and diluted, and solid phase extraction was used to obtain 11C-acetate.Quality control is applied to the final product according to Chinese Pharmacopoeia Fourth General. Results The analysis of the key factors of yield was carried out to identify the major factors exerts the most considerable effect on the processing synthesis of 11C-acetate.All results qualified after testing according to Chinese Pharmacopoeia quality control guidelines with five times of consecutive synthesis. Conclusions Numerous factors affect the synthesis of 11C-acetate, and production yield is highly unstable, as well.The modified Tracerlab FXC is able to produce 11C-acetate in a faster, more stable, and secure approach, and the final product is also qualified according to the product standard.
2016, 40(1): 13-16, 34.
doi: 10.3760/cma.j.issn.1673-4114.2016.01.003
Abstract:
Objective To investigate and analyze the changes of early thyroid stimulating hormone receptor antibody(TRAb) and thyroid stimulating antibody(TSAb) after 131I treatment for Graves hyperthyroidism and their correlation. Methods Eighty-nine patients with Graves hyperthyroidism were randomly selected in this study.The patients were divided into two groups:Group 1(control group):47 patients who did not receive 131I treatment; Group 2(study group):the remaining 42 patients who received 131I treatment before 3 months.Serum FT3, FT4, TSH, TRAb, TSAb, and TSBAb values were measured for all patients in two groups.FT3, FT4, and TSH valued were determined by chemiluminescence method.TRAb values were determined by radiation receptor analysis.TSAb and TSBAb values were determined by enzyme-linked immunosorbent assay. Results The positive rates of TRAb values in study group and control group were 78.6% and 36.2% respectively.The positive rates of TSAb and TSBAb values in study group and control group were 38.1%(16/42), 0(0/42) and 53.2%(25/47), 6.4%(3/47), respectively; the number of patients with positive TSAb and TRAb simultaneously in the study and control groups were 13(16 cases with positive TSAb and 33 cases with positive TRAb) and 15 cases(25 cases with positive TSAb and 17 cases with positive TRAb), respectively; the number of patients with positive TSBAb in the study and control groups were 0 and 3 cases, respectively.Two of three patients with positive TSBAb were positive TSAb and TRAb, simultaneously, 1 of 3 patients with positive TSBAb were positive TSAb and negative TRAb. Conclusions The serum TRAb value in the majority of patients with Graves hyperthyroidism increased in 3 months after 131I treatment.The TSAb value in the part of patients with increased TRAb(39.4%, 13/33) were abnormally high, showing that increased serum TRAb in 3 months after 131I treatment could not perform the same function as TSAb.
2016, 40(1): 17-21.
doi: 10.3760/cma.j.issn.1673-4114.2016.01.004
Abstract:
Objective To identify the risk factors, level of exposure, and the population distribution in high-risk stroke people groups with age over 40 years in Hebei and Dongli Districts of Tianjin.To explore the level of serum homocystenine(Hcy) and its influencing factors. Methods A total of 834 high-risk cases were accepted and divided into groups A(40~49), B(50~59), C(60~69), and D(≥70) based on age.Data were analyzed using ANOVA, Chi-square test, and binary logistic regression. Results The serum Hcy values were(12.25±4.54), (14.01±6.67), (15.76±8.88), and(18.21±8.99)μmol/L for groups A to D, respectively.The level of serum Hcy increased with increasing age(F=15.476, P < 0.05).The rate of males with hyperhomocysteinemia(HHcy) was significantly higher than that of females(χ2=31.034, P < 0.05).The rates in the exposed group with previous stroke history and smoking were significantly higher than those of the non-exposed group(χ2=9.888 and 18.486, both P < 0.05).The rates in exposed group with transient ischemic attack(TIA), heart disease, high blood pressure, dyslipidemia, and lack of physical exercise showed no significant difference with the non-exposed group(χ2=0.688, 0.773, 2.042, 1.427 and 0.560, all P>0.05), but the rate in exposed group with diabetes was significantly lower than nonexposed group(χ2=30.345, P < 0.05).The independent risk factors of HHcy were male(OR=2.332), smoking(OR=1.537), and previous stroke history(OR=1.946) according to the logistic regression. Conclusions The detection of serum Hcy is extremely important in screening high-risk populations for stroke.HHcy is an independent risk factor of stroke.It's important to take measures to reduce the incidence of stroke.
2016, 40(1): 22-25.
doi: 10.3760/cma.j.issn.1673-4114.2016.01.005
Abstract:
Objective This study was performed to determine the feasibility of liver tumor motion prediction based on back propagation(BP) neural network. Methods A liver cancer patient was scanned using X-ray volume imaging, and all breath motion figures were recorded.The tumor was located using an iodized oil mark.The mark motion track was gathered through image processing.A BP model was established based on the marked track.This model was used for tumor prediction.The results were compared with the true mark track. Results Accurate prediction of liver tumor was achieved via BP neural network, with a deviation of less than 1 pixel.However, the predicted value was less accurate at the peak of the breath motion curve, with a deviation of less than 2 pixels. Conclusions BP neural network is proposed as a new approach for liver tumor motion prediction.This network is beneficial to enhance the accuracy of liver stereotactic body radiation therapy and real-time adaptive radiation therapy.The proposed approach could be applied clinically.
2016, 40(1): 26-30.
doi: 10.3760/cma.j.issn.1673-4114.2016.01.006
Abstract:
Objective To evaluate the value of the three dimensional multi-slice spiral CT in the diagnosis of coronary artery-pulmonary artery fistula(CPF). Methods Retrospectively analyzed the multi-slice spiral CT images of 20 CPF patients diagnosed by coronary CT angiography.All of the cases were used in volume rendering, multiplanar reformation, curved planar reformation, and maximum intensity projection.Moreover, the incidence, the features of the abnormal vessels revealed by multi-slice spiral CT, and the diagnostic significance of CPF were retrospectively summarized. Results The origin of CPF vessels was the branch of left coronary artery or left conus branch in 11 cases, the branch of left coronary artery and right conus branch in 7 cases, the right conus branch in 1 case, and the multi-branch of left and right coronary artery in 1 case.The abnormal vessels demonstrated a tortuous dilatation in 19 cases and a tubular dilatation in 1 case.CPF extended into the pulmonary artery wall in 20 cases; companied with aneurysm in 5 cases and fusiform aneurysm in 1 case.Moreover, the pulmonary artery fistulas were located in the left wall of the main pulmonary artery in 14 cases, in the left anterior wall in 1 case, in the anterior wall in 2 cases, in the left and anterior wall in 1 case, and in the anterior and right wall in 1 case; pulmonary artery fistulas were absent in 1 case.The CT features of the pulmonary artery fistula concluded a window sign in 17 cases, an ejection sign in 8 cases, a smoke sign in 3 cases, a streamer sign in 1 case, and an isodensity sign in 10 cases. Conclusion The 3D-MSCT can clearly visualize abnormal vessels and fistula.Thus, this method can be considered as the primary choice in CPF diagnosis and treatment.
2016, 40(1): 31-34.
doi: 10.3760/cma.j.issn.1673-4114.2016.01.007
Abstract:
Objective To improve the diagnostic accuracy rate of cystic thymoma and cystic teratoma by investigating their imaging features and differential diagnosis. Methods Retrospectively analyzed the X-ray and CT scanning images of 30 patients, including 12 cases of cystic teratoma and 18 cases of cystic thymoma, which were confirmed via surgery and pathology. Results All of the tumors were localized in the anterior mediastinum, except in one case wherein the tumor extended into the middle mediastinum.In addition, the majority of masses were biased on one side.The cystic thymoma cases showed obvious leaf and were cystic; several tumors also exhibited small mural nodules.Moreover, the adjacent vascular structures were pushed, the lung tissue was compressed by some lesions, and part of the tumor may be secondary to breast changes, such as pleural effusion.All of the teratoma cases were cystic, although no significant bone and fat components were found in the tumor.The density of cystic teratoma was also heterogeneous but not completely cystic. Conclusion Cystic thymoma and cystic teratoma exhibited certain pathological and imaging features, and can be accurately diagnosed based on their features and clinical manifestations.
The application of hypoxia imaging with PET in predicting tumor hypoxia and guiding clinical therapy
2016, 40(1): 35-43.
doi: 10.3760/cma.j.issn.1673-4114.2016.01.008
Abstract:
Assessing tumor hypoxia with metabolic imaging is an attractive alternative.Hypoxia tracers bind selectively to hypoxic cells, using PET with specific radiopharmaceuticals could visualize hypoxia noninvasively.Hypoxia PET imaging is a valuable tool in assessing oxygenation levels in tumors for the purpose of tumor diagnosis and also as a prognostic indicator.Meanwhile, hypoxia imaging can quantify hypoxic tumor subvolumes for dose painting and personalized treatment planning and delivery.This review summarizes the published literature on clinical studies and the experimental treatment of tumor hypoxia.
Assessing tumor hypoxia with metabolic imaging is an attractive alternative.Hypoxia tracers bind selectively to hypoxic cells, using PET with specific radiopharmaceuticals could visualize hypoxia noninvasively.Hypoxia PET imaging is a valuable tool in assessing oxygenation levels in tumors for the purpose of tumor diagnosis and also as a prognostic indicator.Meanwhile, hypoxia imaging can quantify hypoxic tumor subvolumes for dose painting and personalized treatment planning and delivery.This review summarizes the published literature on clinical studies and the experimental treatment of tumor hypoxia.
2016, 40(1): 44-49.
doi: 10.3760/cma.j.issn.1673-4114.2016.01.009
Abstract:
Alzheimer disease(AD) is considered a continuous and dynamic pathophysiological process.The disease is characterized by a series of neuronal degeneration reactions caused by amyloid plaque(i.e., amyloid-beta, A beta) aggregation leading to decreased neurons, reduced synaptic function, cognitive dysfunction, and, eventually, dementia.Besides the pathological process of A beta, numerous studies have shown that neuroinflammation performs a crucial function in the pathogenesis of AD.The in vivo use of PET to monitor the translocator protein(TSPO) upregulation of activated microglia during inflammation is helpful in diagnosing the disease and detecting treatment responses.This article will review the functions of microglia in neural inflammation and commonly used PET imaging agents.
Alzheimer disease(AD) is considered a continuous and dynamic pathophysiological process.The disease is characterized by a series of neuronal degeneration reactions caused by amyloid plaque(i.e., amyloid-beta, A beta) aggregation leading to decreased neurons, reduced synaptic function, cognitive dysfunction, and, eventually, dementia.Besides the pathological process of A beta, numerous studies have shown that neuroinflammation performs a crucial function in the pathogenesis of AD.The in vivo use of PET to monitor the translocator protein(TSPO) upregulation of activated microglia during inflammation is helpful in diagnosing the disease and detecting treatment responses.This article will review the functions of microglia in neural inflammation and commonly used PET imaging agents.
2016, 40(1): 50-54.
doi: 10.3760/cma.j.issn.1673-4114.2016.01.010
Abstract:
Lymphoma is a malignant tumor of the blood system.Bone marrow infiltration(BMI) advances the disease to stage IV and is a marker of disease progression and poor prognosis.Conventional bone marrow biopsy is a traumatic detection, and the rate is low.The emergence of PET/CT and whole-body MRI supplements the means of BMI detection.PET/CT and whole-body MRI both exhibit a high detection rate for lymphoma BMI, particularly for aggressive lymphoma BMI.However, both approaches to determine high and low is inconclusive, For red bone marrow, benign bone marrow lesions(inflammation and others), lymphoma BMI lesions, as well as bone marrow changes after tumor therapy and bone marrow residual or recurrent lesions, whole body MRI is difficult to distinguish.PET/CT can excellently identify these lesions.However, PET/CT uses ionizing radiation:false negative results can be present for inert lymphoma BMI lesions and lesions beyond the PET/CT resolution.Certain circumstances may limit the use of PET/CT, including normal tissue, whose 18F-FDG physiological uptake may change; inflammation, which is related to 18F-FDG uptake, changes in the distribution of 18F-FDG caused by high blood glucose or high blood insulin, bone marrow activation in tumor patients after treatment, and so on.In these cases, we can use whole-body MRI.Therefore, the two approaches are complementary.Neither PET/CT nor whole body MRI can replace BMB.BMB under the guidance of PET/CT or whole-body MRI considerably improves the detection rate of BMI for patients with negative BMB findings, but imaging findings are positive.In addition, whole-body MRI-positive patients may present poorer prognosis than whole-body MRI-negative patients.
Lymphoma is a malignant tumor of the blood system.Bone marrow infiltration(BMI) advances the disease to stage IV and is a marker of disease progression and poor prognosis.Conventional bone marrow biopsy is a traumatic detection, and the rate is low.The emergence of PET/CT and whole-body MRI supplements the means of BMI detection.PET/CT and whole-body MRI both exhibit a high detection rate for lymphoma BMI, particularly for aggressive lymphoma BMI.However, both approaches to determine high and low is inconclusive, For red bone marrow, benign bone marrow lesions(inflammation and others), lymphoma BMI lesions, as well as bone marrow changes after tumor therapy and bone marrow residual or recurrent lesions, whole body MRI is difficult to distinguish.PET/CT can excellently identify these lesions.However, PET/CT uses ionizing radiation:false negative results can be present for inert lymphoma BMI lesions and lesions beyond the PET/CT resolution.Certain circumstances may limit the use of PET/CT, including normal tissue, whose 18F-FDG physiological uptake may change; inflammation, which is related to 18F-FDG uptake, changes in the distribution of 18F-FDG caused by high blood glucose or high blood insulin, bone marrow activation in tumor patients after treatment, and so on.In these cases, we can use whole-body MRI.Therefore, the two approaches are complementary.Neither PET/CT nor whole body MRI can replace BMB.BMB under the guidance of PET/CT or whole-body MRI considerably improves the detection rate of BMI for patients with negative BMB findings, but imaging findings are positive.In addition, whole-body MRI-positive patients may present poorer prognosis than whole-body MRI-negative patients.
2016, 40(1): 55-59.
doi: 10.3760/cma.j.issn.1673-4114.2016.01.011
Abstract:
Pulmonary interstitial fibrosis(PIF) is a diffuse lung disease caused by different etiologies and affect interstitial tissue, alveoli and bronchiioles.PIF has the similar pathological process.Because of its diverse etiology, the complexity of the pathogenesis, treatment of difficult, PIF has became the research hotspot.Recently, PET/CT is widely used in tumor, cardiovascular disease and nervous disease, and has special advantages in earlydiagnosis, active estimate, efficacy monitoring and prognostic evaluation.This paper reviewed existing circumstances research of PET/CT in PIF at home and abroad.
Pulmonary interstitial fibrosis(PIF) is a diffuse lung disease caused by different etiologies and affect interstitial tissue, alveoli and bronchiioles.PIF has the similar pathological process.Because of its diverse etiology, the complexity of the pathogenesis, treatment of difficult, PIF has became the research hotspot.Recently, PET/CT is widely used in tumor, cardiovascular disease and nervous disease, and has special advantages in earlydiagnosis, active estimate, efficacy monitoring and prognostic evaluation.This paper reviewed existing circumstances research of PET/CT in PIF at home and abroad.
2016, 40(1): 60-64.
doi: 10.3760/cma.j.issn.1673-4114.2016.01.012
Abstract:
Ovarian cancer ranks first among gynecologic malignancy-related mortalities.Early stage of ovarian cancer does not show specific symptoms, and most cases are diagnosed in advanced stages.The major causes of death are relapse and metastasis, and circulating tumor cells play fundamental roles in these processes.These tumor cells have been widely used recently in detection and prognostic evaluation of many types of malignant tumors.This work reviews the progress in biological characteristics of circulating tumor cells and their clinical application in ovarian cancer.
Ovarian cancer ranks first among gynecologic malignancy-related mortalities.Early stage of ovarian cancer does not show specific symptoms, and most cases are diagnosed in advanced stages.The major causes of death are relapse and metastasis, and circulating tumor cells play fundamental roles in these processes.These tumor cells have been widely used recently in detection and prognostic evaluation of many types of malignant tumors.This work reviews the progress in biological characteristics of circulating tumor cells and their clinical application in ovarian cancer.
Recent advances in the application of mesenchymal stem cells for treatment of acute radiation injury
2016, 40(1): 65-69.
doi: 10.3760/cma.j.issn.1673-4114.2016.01.013
Abstract:
Mesenchymal stem cells(MSCs) are a source of various multipotent stromal cells with low inherent immunogenicity.These cells can undergo multi-directional differentiation, support hematopoiesis, and regulate immune responses.MSCs can be easily collected and amplified.These cells can also be transfected using an exogenous gene.MSCs have been extensively applied in clinical treatments, such as in the therapy for acute radiation injury.This study was primarily performed to investigate the effect and mechanism of MSCs in acute radiation injury.
Mesenchymal stem cells(MSCs) are a source of various multipotent stromal cells with low inherent immunogenicity.These cells can undergo multi-directional differentiation, support hematopoiesis, and regulate immune responses.MSCs can be easily collected and amplified.These cells can also be transfected using an exogenous gene.MSCs have been extensively applied in clinical treatments, such as in the therapy for acute radiation injury.This study was primarily performed to investigate the effect and mechanism of MSCs in acute radiation injury.
2016, 40(1): 70-76.
doi: 10.3760/cma.j.issn.1673-4114.2016.01.014
Abstract:
The advantages, limitations, and diagnosis value of various imaging examination methods in the diagnosis of breast disease are stated in this paper.Mammography and ultrasonic examination have been demonstrated as the "golden combination" in the screening of breast disease.MRI is an important complement for the diagnosis of breast disease.CT imaging is a method that will be used in the diagnosis of breast disease after the improvement of its technique.Finally, SPECT is extremely helpful for the diagnosis of breast disease, which cannot be diagnosed by mammography and ultrasonic examination.PET/CT is mainly applied in the diagnosis, differential diagnosis, and judgment of treatment results.None of the imaging methods can be replaced by any single method at present.These imaging methods supplement each other.The combination of several imaging methods can guarantee accurate diagnosis and treatment.
The advantages, limitations, and diagnosis value of various imaging examination methods in the diagnosis of breast disease are stated in this paper.Mammography and ultrasonic examination have been demonstrated as the "golden combination" in the screening of breast disease.MRI is an important complement for the diagnosis of breast disease.CT imaging is a method that will be used in the diagnosis of breast disease after the improvement of its technique.Finally, SPECT is extremely helpful for the diagnosis of breast disease, which cannot be diagnosed by mammography and ultrasonic examination.PET/CT is mainly applied in the diagnosis, differential diagnosis, and judgment of treatment results.None of the imaging methods can be replaced by any single method at present.These imaging methods supplement each other.The combination of several imaging methods can guarantee accurate diagnosis and treatment.
2016, 40(1): 77-81.
doi: 10.3760/cma.j.issn.1673-4114.2016.01.015
Abstract:
Spectral imaging is a new technique in the field of CT imaging in recent years, with many parameters, quantitative analysis of imaging characteristics, the main technology including material separation, single energy image, can measure the spectrum curve and the effective atomic number.Through the comprehensive application of various parameters and analysis tools, spectrum imaging can reflect the characteristics of lesions, and has potential value to determine the source and scope, differential diagnosis etc..The screening of lung cancer, the identifying of benign and malignant pulmonary nodules and other aspects of the study also achieved initial results.This article focuses on the spectrum technology and its application in diagnosis of lung cancer.
Spectral imaging is a new technique in the field of CT imaging in recent years, with many parameters, quantitative analysis of imaging characteristics, the main technology including material separation, single energy image, can measure the spectrum curve and the effective atomic number.Through the comprehensive application of various parameters and analysis tools, spectrum imaging can reflect the characteristics of lesions, and has potential value to determine the source and scope, differential diagnosis etc..The screening of lung cancer, the identifying of benign and malignant pulmonary nodules and other aspects of the study also achieved initial results.This article focuses on the spectrum technology and its application in diagnosis of lung cancer.
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