2017 Vol. 41, No. 1
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2017, 41(1): 1-7.
doi: 10.3760/cma.j.issn.1673-4114.2017.01.001
Abstract:
Objective To evaluate the value of 99Tcm-3PRGD2 integrin receptor imaging in qualitative diagnosis of breast cancer and then compare this technique with mammography. Methods A total of 84 female patients with established breast lesions were recruited. All patients were examined using 99Tcm-3PRGD2 integrin receptor imaging and mammography. Diagnosis of breast(especially dense breast) lesion by using these two techniques was analyzed and compared with postoperative pathology as the gold standard. T test and χ2 test were used for data statistical analysis by using SPSS22.0 software. Results The diagnostic efficiency of SPECT/CT imaging was higher than that of whole-body imaging. The intake rates of Tmax, Tmean, Tmean/B, and Tmax/B were significantly higher in breast cancer than in benign nodules(t=2.09~3.19, all P＜0.05), and their difference in intake of Tmax/B was obvious(t=3.19, P＜0.01). The difference between 2 and 4 h imaging was not significant(t=0.63~1.25, all P>0.05). The sensitivity of SPECT/CT in diagnosis of breast cancer was more than 95.0%, which could be increased to 98.4% when this technique was combined with mammography. For dense mammary gland, the sensitivity, specificity, and accuracy of 99Tcm-3PRGD2 SPECT/CT and mammography were 95.2%, 83.3%, and 91.7% and 78.6%, 76.2%, and 77.8%, respectively, 99Tcm-3PRGD2 SPECT/CT had a higher accuracy(χ2=4.341, P＜0.05). Conclusions 99Tcm-3PRGD2 SPECT/CT had high sensitivity and was a useful complement to mammography. This technique demonstrated a higher diagnostic value than mammography for qualitative diagnosis of dense mammary gland.
2017, 41(1): 8-14.
doi: 10.3760/cma.j.issn.1673-4114.2017.01.002
Abstract:
Objective To explore a quantitative scoring system based on PET/CT and high-resolution computed tomography(HRCT) characteristics for differentiating benign and malignant solitary pulmonary lesions. Methods A total of 112 patients with solitary pulmonary lesions detected by 18F-FDG PET/CT were enrolled and reviewed retrospectively. Of these cases, 44 were benign lesions and 68 were malignant. PET/CT and HRCT imaging features were recorded and evaluated. A quantitative scoring system was established. The best cut-off score was calculated by analysis of receiver operating characteristics(ROC) in differentiating benign and malignant lesions. Results The indicators of malignant solitary pulmonary lesions by PET/CT and HRCT included age≥60 years(2 points), diameter of the lesion≥1 cm(2 points), heterogeneous density(2 points), clear boundary(1 point), SUVmax≥2.5(2 points), ΔSUVmax≥1.0(2 points), retention index(RI)≥15%(2 points), lobular sign(3 points), spiculation sign(3 points), pleural traction sign(3 points), and vacuole sign(3 points). A quantitative scoring system was established according to risk factors. Moreover, score 12 was the best cut-off by ROC analysis in differentiating benign and malignant lesions. The sensitivity and specificity rates were 92.6% and 81.8%, respectively. Conclusion The quantitative scoring system based on PET/CT and HRCT features exhibited a good capacity for differentiating malignant lesions from benign solitary pulmonary lesions.
2017, 41(1): 15-18.
doi: 10.3760/cma.j.issn.1673-4114.2017.01.003
Abstract:
Objective To analyze the possible causes of liver uptake in 99Tcm-MDP bone scan. Methods A retrospective analysis was performed on 20 cases of abnormal liver uptake in bone scan in our hospital from January 2013 to July 2015. The results were compared with other imaging examinations and/or pathological findings and laboratory examinations. Results Twenty patients were found to have abnormal liver uptake of the imaging agent, including 3 cases with primary liver injury, 17 cases with secondary liver injury, which include 1 case with multiple myeloma and 7 cases with liver metastasis(5 cases with colorectal cancer, 1 with from hepatocellular carcinoma, 1 case with lung cancer), and 1 case of liver uptake after iron treatment. Conclusion Abnormal liver uptake of 99Tcm-MDP in bone imaging is associated with several reasons; barring technical reasons, we should be alert to the liver injury caused by various reasons to provide reference for patients prior to clinical intervention.
2017, 41(1): 19-22,32.
doi: 10.3760/cma.j.issn.1673-4114.2017.01.004
Abstract:
Objective To study the protective effects of 5-methoxytryptamine-α-lipoic acid salt(MLA), a new synthetized compound, on the hematopoietic system of mice exposed to sublethal dose of total body irradiation(TBI). Methods Fifteen C57BL/6 mice were randomly assigned into three groups:control, irradiation, and MLA+irradiation. The mice in the control group received sham TBI, whereas the mice in the other groups underwent exposure to 6.0 Gy 137Cs γ-ray TBI. The mice in the MLA group were first administered with 10 mg/kg MLA after exposure to 6.0 Gy TBI for 2 h. The MLA was administered successively for 3 d. The peripheral blood and bone marrow nucleated cells(BMNCs) were then counted after the mice were exposed to TBI for 30 d. The CFU-GM ability, reactive oxygen species(ROS) levels, and nicotinamide adenine dinucleotide phosphate oxidase 4(NOX4) expression in the hematopoietic cells were also detected. Results In contrast to those of the control group, the number of BMNCs and the number CFU-GM in the irradiated groups decreased significantly(t=9.304, 7.493, both P＜0.05), and the ROS levels and the NOX4 expression in the bone marrow cells of the irradiated groups increased(t=14.74, 53.12, both P＜0.05). Compared with those of the irradiation group, the number of white blood cells and the number of BMNCs were elevated by MLA(t=4.858, 3.947, both P＜0.05). The ROS levels and NOX4 expression in the bone marrow cells were inhibited by MLA(t=11.21, 33.93, both P＜0.05). Conclusion MLA can protect mice from hematopoietic injury induced by irradiation.
2017, 41(1): 23-28.
doi: 10.3760/cma.j.issn.1673-4114.2017.01.005
Abstract:
Objective To observe the variation of apparent diffusion coefficient(ADC) and sum up the feasibility of diffusion weighted imaging(DWI) after enhancement by employing the multi-b value model of liver DWI before and after injection of gadolinium-ethoxibenzyl-diethylene triaminepentaacetic acid(Gd-EOB-DTPA). Methods Data from 126 patients with Gd-EOB-DTPA were collected. Among these patients, 30 had normal liver, 25 had liver cancer, 20 had metastatic carcinoma, 28 had hemangioma, and 23 had cysts, as confirmed by clinical and pathological examination. Philips Achieva 1.5T dual-gradient superconducting magnetic resonance scanner was used for in-phase, in-and-out phase T1 weighted breath hold axial scan, and axial respiratory gated DWI. 0.025 mmol/kg dose of Gd-EOB-DTPA was injected into the patients, temporal high resolution isotropic volume examination(THRIVE) and T1 weighted breath hold axial scan were conducted at arterial phase, venous phase and 3, 10, 20, and 30 min phases. Axial T2 weighted fat saturation respiratory gated scan was conducted at 5 min phase. Axial respiratory gated DWI was conducted at 15 min phase, followed by coronal T2 weighted breath hold scan. Axial respiratory gated DWI was conducted at 25 min phase. The plain, 15 min phase and 25 min phase scan had the same DWI parameter which was single-excitation spin echo-echo planar imaging sequence, the b value was 0, 50, 300, 600 s/mm2, respectively, with a scan time of 196 s. The b=50, 300, and 600 s/mm2 ADC diagram of plain scan, 15 and 25 min scan were generated on an EWS workstation by ADC analysis function. The ADC values of normal liver, liver cancer, metastasis, hemangioma, and cyst were measured. At the same b values, the ADC values of the same type of disease were statistically analyzed by t test at plain scan, 15 and 25 min scan. Results For the same b value and disease, the ADC values of the plain scan were the largest. The ADC values began to decrease and finally increase with the injection of Gd-EOB-DTPA. These values at the 25 min scan were consistent with the result of the plain scan, and the 15 min scan were the lowest. The ADC values had no significant difference in the plain scan, 15 min scan and 25 min scan(t=0.25~1.29, all P>0.05). For the DWI of the same disease and phase, the b value increased and the ADC values decreased; the smaller the b value, the greater the ADC values. Conclusion After intravenous injection of Gd-EOB-DTPA, the decrease of the ADC values in the liver was minimal, and DWI was feasible after enhancement.
2017, 41(1): 29-32.
doi: 10.3760/cma.j.issn.1673-4114.2017.01.006
Abstract:
Objective To analyze the dose and the duration that medical staff can take during operation with or without lead screen protection in PET-enhanced CT and to evaluate the practical application value of lead screen on radioprotection. Methods According to a certain set of conditions, 40 patients were selected, and randomly and equally divided into experimental group(with lead screen protection) and control group(without lead screen protection). A personal meter was used to measure personal radiation rate and cumulative dose equivalent. The time required for the operator was recorded. The analysis of these statistics adopted t-text by SPSS17.0 and conclusion on the radiation dose and operation convenience was drawn. Results The average dose equivalent rate and the median dose equivalent rate of the operator group was remarkably less than that of the control group(t=3.390, 3.392, both P＜0.05). On the average cumulative dose equivalent and the median cumulative dose equivalent, the value for the experimental group was also less than that for the control group(t=1.182, 1.182, both P＜0.05). The more the operator used the lead screen, the shorter the time could take. So the time the experimental group took was decreased with the increasing proficiency, and the time was closed to the control group. Conclusions When using lead screen, the radiation equivalent rate of operation personnel was low. The cumulative dose equivalent decreased, and all such changes were due to the time used in the operation. Lead screen exhibited its practical application value on radioprotection.
2017, 41(1): 33-39,44.
doi: 10.3760/cma.j.issn.1673-4114.2017.01.007
Abstract:
Radiation-induced intestinal injuries, a devastating adverse effect of radiation therapy, can lead to local ischemia and fibrosis with the development of ulcers, strictures and lower gastrointestinal bleeding. As the complex causes of radiation-induced intestinal injuries, diverse evaluating methods and animal model had been established. In this context, the present review will focus on the evaluating and establishing methods of radiation-induced intestinal injuries animal model, what would provide ideas for related basic research.
Radiation-induced intestinal injuries, a devastating adverse effect of radiation therapy, can lead to local ischemia and fibrosis with the development of ulcers, strictures and lower gastrointestinal bleeding. As the complex causes of radiation-induced intestinal injuries, diverse evaluating methods and animal model had been established. In this context, the present review will focus on the evaluating and establishing methods of radiation-induced intestinal injuries animal model, what would provide ideas for related basic research.
2017, 41(1): 40-44.
doi: 10.3760/cma.j.issn.1673-4114.2017.01.008
Abstract:
Pelvic cancer is among the most commonly diagnosed cancers, and radiotherapy is frequently conducted as a part of tumor comprehensive treatment. Radiotherapy can improve tumor control rate but can also damage surrounding normal tissue. Pelvic radiation disease is the most common complication that results from radiotherapy to a tumor of pelvic origin, thereby seriously affecting the quality of life of a patient. If early intervention can be achieved, the patient will benefit by reducing the incidence of the disease. This article reviews domestic and foreign literature on the prevention of pelvic radiation disease.
Pelvic cancer is among the most commonly diagnosed cancers, and radiotherapy is frequently conducted as a part of tumor comprehensive treatment. Radiotherapy can improve tumor control rate but can also damage surrounding normal tissue. Pelvic radiation disease is the most common complication that results from radiotherapy to a tumor of pelvic origin, thereby seriously affecting the quality of life of a patient. If early intervention can be achieved, the patient will benefit by reducing the incidence of the disease. This article reviews domestic and foreign literature on the prevention of pelvic radiation disease.
2017, 41(1): 45-49.
doi: 10.3760/cma.j.issn.1673-4114.2017.01.009
Abstract:
Deinococcus radiodurans(DR) has strong resistance to radiation and comprises a series of mechanisms that allow it to survive under various extreme conditions. Some of the genes existing in DR particularly contribute to its robust viability. Two-component system(TCS) is a signal transduction system that widely exists in bacteria. This system can assist the bacteria in coping with the change in external environment and is vital for various life activities. Given that TCS plays an important role in resistance mechanism as a stress response system, this article reviewed the resistant mechanism and the TCS in DR.
Deinococcus radiodurans(DR) has strong resistance to radiation and comprises a series of mechanisms that allow it to survive under various extreme conditions. Some of the genes existing in DR particularly contribute to its robust viability. Two-component system(TCS) is a signal transduction system that widely exists in bacteria. This system can assist the bacteria in coping with the change in external environment and is vital for various life activities. Given that TCS plays an important role in resistance mechanism as a stress response system, this article reviewed the resistant mechanism and the TCS in DR.
2017, 41(1): 50-58.
doi: 10.3760/cma.j.issn.1673-4114.2017.01.010
Abstract:
Epithelial growth factor receptor(EGFR) plays an important role in numerous cancers and many types of targeting EGFR drugs have been approved by the Food and Drug Administration. However, the individual sensitivity and efficiency rates of these targeting EGFR medicines are low. Many studies have shown that patients with high EGFR expression or mutation are responsive to targeting drugs. Therefore, clearing the EGFR expression and mutation status is significant for clinical medication. PET is a noninvasive in vivo imaging technique that enables the visualization and quantification of the distribution of molecules labeled with positron-emitting isotopes at a picomolar level. PET can guide the precision medicine for these targeting EGFR drugs. This review summarizes the small-molecule PET probes for targeting EGFR.
Epithelial growth factor receptor(EGFR) plays an important role in numerous cancers and many types of targeting EGFR drugs have been approved by the Food and Drug Administration. However, the individual sensitivity and efficiency rates of these targeting EGFR medicines are low. Many studies have shown that patients with high EGFR expression or mutation are responsive to targeting drugs. Therefore, clearing the EGFR expression and mutation status is significant for clinical medication. PET is a noninvasive in vivo imaging technique that enables the visualization and quantification of the distribution of molecules labeled with positron-emitting isotopes at a picomolar level. PET can guide the precision medicine for these targeting EGFR drugs. This review summarizes the small-molecule PET probes for targeting EGFR.
2017, 41(1): 59-62,73.
doi: 10.3760/cma.j.issn.1673-4114.2017.01.011
Abstract:
Papillary thyroid carcinoma(PTC) is one of the most common malignant tumors in the endocrine and head-neck system. Surgical resection is the mainly treatment used in advanced PTC patients, and 131I is used as adjuvant treatment. However, nearly 30% of patients suffering from tumor dedifferentiation fail to uptake iodine after thyroid cancer surgery; thus, these patients lose the opportunity to undergo postoperative 131I treatment. Recently, with the rapid increase in the incidence of thyroid cancer, the number of such patients has increased dramatically, and radiation therapy gradually plays an important role in the adjuvant therapy. Although radiotherapy has been limited for advanced PTC patients in the past, with the development of radiotherapy technology, external-beam radiotherapy(EBRT) has slowly displayed its greatest superiority for these patients.
Papillary thyroid carcinoma(PTC) is one of the most common malignant tumors in the endocrine and head-neck system. Surgical resection is the mainly treatment used in advanced PTC patients, and 131I is used as adjuvant treatment. However, nearly 30% of patients suffering from tumor dedifferentiation fail to uptake iodine after thyroid cancer surgery; thus, these patients lose the opportunity to undergo postoperative 131I treatment. Recently, with the rapid increase in the incidence of thyroid cancer, the number of such patients has increased dramatically, and radiation therapy gradually plays an important role in the adjuvant therapy. Although radiotherapy has been limited for advanced PTC patients in the past, with the development of radiotherapy technology, external-beam radiotherapy(EBRT) has slowly displayed its greatest superiority for these patients.
2017, 41(1): 63-67.
doi: 10.3760/cma.j.issn.1673-4114.2017.01.012
Abstract:
Radiation therapy is a potent physical entity with dramatic effects in both malignant and surrounding normal tissues. Untoward reactions to radiation therapy in normal tissues are most frequently classified as either acute or delayed reactions. They are often progressive and serious and occasionally even lethal. These injuries effectively limit the clinical dose of radiation. This article mainly provides an overview of the use of hyperbaric oxygen therapy for delayed radiation injuries.
Radiation therapy is a potent physical entity with dramatic effects in both malignant and surrounding normal tissues. Untoward reactions to radiation therapy in normal tissues are most frequently classified as either acute or delayed reactions. They are often progressive and serious and occasionally even lethal. These injuries effectively limit the clinical dose of radiation. This article mainly provides an overview of the use of hyperbaric oxygen therapy for delayed radiation injuries.
2017, 41(1): 68-73.
doi: 10.3760/cma.j.issn.1673-4114.2017.01.013
Abstract:
From the following aspects-duodenal low X-ray imaging, ultrasonography, endoscopic retrograde cholangiopancreatography(ERCP), CT, MRI and magnetic resonance cholangiopancretography(MRCP), this paper will analyze important progress of imaging diagnosis of duodenal papillary carcinoma, as well as advantages and disadvantages of the methods mentioned above. This paper believes that on the basis of using conventional imaging methods, some new methods such as ultrasonography, MRI, CT, ERCP, and endoscopic ultrasonography(EUS) ect. will greatly improve accuracy in the comprehensive treatment on duodenal papillary carcinoma.
From the following aspects-duodenal low X-ray imaging, ultrasonography, endoscopic retrograde cholangiopancreatography(ERCP), CT, MRI and magnetic resonance cholangiopancretography(MRCP), this paper will analyze important progress of imaging diagnosis of duodenal papillary carcinoma, as well as advantages and disadvantages of the methods mentioned above. This paper believes that on the basis of using conventional imaging methods, some new methods such as ultrasonography, MRI, CT, ERCP, and endoscopic ultrasonography(EUS) ect. will greatly improve accuracy in the comprehensive treatment on duodenal papillary carcinoma.
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