2017 Vol. 41, No. 4
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2017, 41(4): 233-240.
doi: 10.3760/cma.j.issn.1673-4114.2017.04.001
Abstract:
ObjectiveArg-Gly-Asp (RGD) or Ala-Thr-Trp-Leu-Pro-Pro-Arg (ATWLPPR) peptide binds specifically to integrin αvβ3 or neuropilin-1(NRP-1) receptor, respectively.In this study, a novel heterodimer peptide probe containing both RGD and ATWLPPR was designed in one molecule.The in vitro and in vivo biological behavior of the dual-targeted imaging probe RGD-ATWLPPR was compared with its corresponding counterparts. Methods18F labeling was conducted through 18F-FAl approach.In the integrin αvβ3-positive U87MG human glioma cell line, the αvβ3/NRP-1 receptor binding affinity of RGD-ATWLPPR was tested and compared with its counterparts RGD and ATWLPPR.The tumor uptake and distribution pattern of 18F-labeled RGD-ATWLPPR through PET imaging was evaluated and compared with those of RGD and ATWLPPR.The means were compared using one-way ANOVA and t test. ResultsBoth integrin αvβ3 and NRP-1 showed high expression in U87MG glioma cells and tumor tissues.RGD-ATWLPPR exhibited similar in vitro receptor binding affinity to those of RGD and ATWLPPR.Based on the PET imaging study, 18F-labeled RGD-ATWLPPR (denoted as 18F-FAl-NOTA-RGD-ATWLPPR) demonstrated significantly higher tumor uptake than RGD[(4.86±0.48)% ID/g vs.(3.33±0.15)% ID/g, t=10.21, P < 0.05]and ATWLPPR[(4.86±0.48)% ID/g vs.(2.28±0.41)% ID/g, t=32.16, P < 0.05].In the blocking study, 18F-FAl-NOTA-RGD-ATWLPPR showed positive imaging result in the presence of excess unlabeled RGD or ATWLPPR.The tumor uptake decreased to the background level when unlabeled RGD and ATWLPPR were co-injected before administration of 18F-FAl-NOTA-RGD-ATWLPPR. ConclusionsThe dual-targeted PET probe 18F-FAl-NOTA-RGD-ATWLPPR specifically binds to either integrin αvβ3 or NRP-1 receptor and could be a promising PET imaging agent for NRP-1-/αvβ3+and NRP-1+/αvβ3-tumors.The receptor-binding affinity of RGD-ATWLPPR must be further improved.
2017, 41(4): 241-246.
doi: 10.3760/cma.j.issn.1673-4114.2017.04.002
Abstract:
ObjectiveTo investigate the value of 18F-FDG PET/CT combined with the same scanner high resolution CT (HRCT) in the diagnosis of pulmonary ground-glass nodules (GGNs). MethodsA total of 72 patients with pulmonary GGNs (40 cases were malignant, 32 presented benign lesions) were retrospectively analyzed and confirmed by surgical pathology or clinical follow-up.The clinical data, imaging features, maximum standardized uptake value (SUVmax) were analyzed statistically. ResultsUnivariate analysis showed significant differences in diameter (t=4.932, P < 0.001), density type (χ2=29.425, P < 0.001), lobular sign (χ2=9.626, P=0.002), spiculation sign (χ2=7.605, P=0.006), pleural indentation (χ2=4.585, P=0.032), vascular convergence (χ2=7.605, P=0.006), and SUVmax(t=3.884, P < 0.001).By contrast, no differences in gender (χ2=0.026, P=0.873), age (t=1.417, P=0.161), vacuole sign (χ2=3.214, P=0.073), and air bronchus sign (χ2=1.664, P=0.197) were observed between the two groups in HRCT.Multivariate analysis showed that mixed density was a notable predictor of malignancy (χ2=10.261, OR=23.515, P < 0.05).The receiver operating characteristic curve showed the diameter ≥ 11 mm and SUVmax ≥ 0.9 as the standard reference indexes that yielded good identification accuracy.The sensitivity of HRCT, PET/CT, and PET/CT combined with the same scanner HRCT in the diagnosis of GGNs were 75.0%, 82.5%, and 90.0%, with specificity values of 81.3%, 78.1%, and 68.8% and accuracy of 77.8%, 80.6%, and 80.6%, respectively. Conclusions18F-FDG PET/CT combined with the same scanner HRCT present certain clinical value in the differential diagnosis of GGNs by analyzing the metabolic condition and imaging characteristics.This approach can improve diagnostic sensitivity.
2017, 41(4): 247-251.
doi: 10.3760/cma.j.issn.1673-4114.2017.04.003
Abstract:
ObjectiveTo evaluate the clinical curative effect of zoledronic acid combined with 89Sr for the treatment of prostate cancer patients with bone metastases. MethodsA total of 74 prostate cancer patients were randomly divided into three groups according to treatment, as follows:Group A (n=25;median age, 66 years; age range, 46-87 years), zoledronic acid with 89Sr; Group B (n=25;median age, 65 years; age range, 43-89 years), zoledronic acid; and Group C (n=24;median age, 66 years; age range, 47-85 years), 89Sr.Groups B and C were the control groups.All patients were followed up for 6 months, during which the status of bone pain relief and improvement in the number of bone metastatic lesions were observed. ResultsThe three groups showed similar baseline characteristics.Total pain relief efficiency in group A was 88.0%, while those of the control groups were 72.0%(group B) and 79.2%(group C).Pain palliation of group A significantly differed from those of groups B and C (χ2=8.959, P < 0.05).Regression of bone metastatic lesions in group A was 88.0%, while those of the control groups were 44.0%(group B) and 75.0%(group C).Significant difference was found between group A and the two control groups (χ2=9.096, P < 0.05). ConclusionCombined therapy of zoledronic acid and 89Sr in prostate cancer patients with painful bone metastases was more effective in treating pain and improving the quality of life than separate administration of zoledronic acid or 89Sr.
2017, 41(4): 252-257.
doi: 10.3760/cma.j.issn.1673-4114.2017.04.004
Abstract:
ObjectiveTo investigate the changes in the thyroid hormone, serum creatase enzymes, lipids, and clinical manifestations of differentiated thyroid cancer patients with levothyroxine withdrawal. MethodsForty-six differentiated thyroid carcinoma (DTC) patients were enrolled.The serial thyroid function[free triiodothyronine (FT3), free thyroxine (FT4), and thyroid stimulating hormone (TSH)], serum creatase enzymes[aspartate aminotransferase (AST), lactate dehydrogenase (LDH), alpha-hydroxybutyric dehydrogenase (α-HBD), creatine kinase (CK), and isoenzymes of creatine kinase (CKMB)], lipids[triglyceride (TG), total cholesterol (TC), high density lipoprotein (HDL), and low density lipoprotein (LDL)]levels of these patients were tested during a four-week levothyroxine withdrawal.These levels were then retested after 4, 8, and 12 weeks.The time-change curve was acquired and the clinical symptoms were recorded.Fifty patients with a normal thyroid function were included in the control group.A rank-sum test and a correlation analysis were performed to analyze the relationship among the FT3, FT4, and serum creatase enzymes of patients undergoing a four-week levothyroxine withdrawal. Results① A statistically significant relationship was observed between those patients with DTC withdrawal and those in the control group in terms of their serum creatase enzymes and lipids[AST (t=3.888, P < 0.05), LDH (Z=-3.372, P < 0.05), CK (Z=-5.913, P < 0.05), TG (Z=-2.787, P < 0.05), TC (t=6.166, P < 0.05), HDL (t=3.041, P < 0.05), LDL (t=5.372, P < 0.05)].② CK, TG, TC, and LDL returned to their normal levels after reusing levothyroxine for four weeks.③ FT3 is negatively related to CK and TC, while FT4 is negatively related to LDH, α-HBD, CK, CKMB, and TG.④ 86.96 percent of the major clinical manifestation are muscular soreness, hypodynamia and tumidness in DTC patients undergoing a four-week levothyroxine withdrawal. Conclusions① Levothyroxine withdrawal can lead to abnormal AST, LDH, CK, TG, TC, HDL, and LDL levels.② The changes in the serum creatase enzymes and lipids of patients with DTC withdrawal were reversible.③ The FT3 and FT4 levels influenced CK abnormality.④ Hypothyroid myopathy occurred in DTC patients undergoing a four-week levothyroxine withdrawal, and the clinical manifestation was improved by reusing levothyroxine.
2017, 41(4): 258-264.
doi: 10.3760/cma.j.issn.1673-4114.2017.04.005
Abstract:
ObjectiveTo explore the imaging findings in and clinical value of multiple-slice computed tomography angiography (MSCTA) in acute aortic intramural hematoma (AAIH). MethodsA total of 76 AAIH cases with complete clinical information were recruited and subjected to MSCTA examinations.The patients were divided into progressive and stable groups according to the follow-up changes.Then, the clinical data and MSCTA features were compared.All outcomes were analyzed statistically.The quantitative data of normal distribution and abnormal distribution were tested by two independent samples and Mann-Whitney U test, respectively.The qualitative data were tested by chi-square test. ResultsA total of 27(35.5%) type A cases and 49(64.5%) type B cases were classified according to Stanford criteria.No significant difference in the maximum thickness of aortic hematoma, number of ulcer-like projections, degree of focal enhancement, and severity of pleural effusion was noted between the Stanford A and B groups (Z=-0.788, χ2=0.441, χ2=0.383, χ2=0.338, all P > 0.05).The ulcer depths in the Stanford A and B groups were (2.8±2.9) and (2.5±3.3) mm, respectively (Z=-2.345, P=0.019).Meanwhile, 15(19.7%) cases (12 type A cases and 3 type B cases) were accompanied by pericardial effusion (χ2=16.138, P < 0.001).Twenty cases belonged to the progressive group, whereas 21 cases were included in the stable group.Univariate statistical analysis showed significant differences in ulcer-like projection, ulcer depth, and pleural effusion between the progressive and stable groups (χ2=9.227, Z=-2.689, χ2=4.111, all P < 0.05).By contrast, no significant difference in Stanford subtype, maximum aortic thickness, maximum aortic hematoma thickness, focal enhancement, and pleural effusion was noted between the Stanford A and B groups (χ2=1.453, Z=-0.874, χ2=0.006, χ2=1.733, all P > 0.05).Multivariate analysis revealed that the amount of ulcer-like projections was the independent risk factor for AAIH progression. ConclusionsAAIH manifested as annular and/or crescent thickening aortic wall with higher density in plain scan and non enhancement in enhanced scan using MSCTA technique.MSCTA plays an important role in the correct diagnosis of AAIH patients.The number of ulcer-like projections is the independent risk factor for disease progression.Close follow up is hence recommended during the early stage of AAIH using MSCTA.
2017, 41(4): 265-270.
doi: 10.3760/cma.j.issn.1673-4114.2017.04.006
Abstract:
Hepatic fibrosis is a pathological process associated with chronic liver diseases, with significant morbidity and mortality.The current gold standard for the diagnosis of liver fibrosis is liver biopsy, but liver biopsy has many limitations.Currently, there is no noninvasive means of effective diagnosis of liver fibrosis.In the early stages of the disease, it can be reversed by active therapy.Thus, diagnosis and precise stages of liver fibrosis are important in controlling progression of the disease.Because of its noninvasive, high specificity and other advantages, molecular imaging has great potential use in liver fibrosis.This paper provides an overview of the latest advances in the diagnosis and stages of liver fibrosis using magnetic resonance imaging and nuclear medicine imaging.
Hepatic fibrosis is a pathological process associated with chronic liver diseases, with significant morbidity and mortality.The current gold standard for the diagnosis of liver fibrosis is liver biopsy, but liver biopsy has many limitations.Currently, there is no noninvasive means of effective diagnosis of liver fibrosis.In the early stages of the disease, it can be reversed by active therapy.Thus, diagnosis and precise stages of liver fibrosis are important in controlling progression of the disease.Because of its noninvasive, high specificity and other advantages, molecular imaging has great potential use in liver fibrosis.This paper provides an overview of the latest advances in the diagnosis and stages of liver fibrosis using magnetic resonance imaging and nuclear medicine imaging.
2017, 41(4): 271-277.
doi: 10.3760/cma.j.issn.1673-4114.2017.04.007
Abstract:
Apoptosis plays a key role in the development and treatment of tumors; thus, the invasive dynamic monitoring of apoptosis is of considerable interest in the management of cancer.At present, 99Tcm-BTAP-Annexin V, 99Tcm-HYNIC-Annexin V, 18F-ICMT-11, 18F-CP18, and 18F-ML-10 have achieved clinical application.Despite their limitations, these agents are superior to conventional imaging technique in the diagnosis and therapeutic monitoring of cancer and can exhibit potential in clinical applications.This review provides an overview of the recent development in apoptosis imaging by using radionuclide-labeled tracers in the management of cancer.
Apoptosis plays a key role in the development and treatment of tumors; thus, the invasive dynamic monitoring of apoptosis is of considerable interest in the management of cancer.At present, 99Tcm-BTAP-Annexin V, 99Tcm-HYNIC-Annexin V, 18F-ICMT-11, 18F-CP18, and 18F-ML-10 have achieved clinical application.Despite their limitations, these agents are superior to conventional imaging technique in the diagnosis and therapeutic monitoring of cancer and can exhibit potential in clinical applications.This review provides an overview of the recent development in apoptosis imaging by using radionuclide-labeled tracers in the management of cancer.
2017, 41(4): 278-282.
doi: 10.3760/cma.j.issn.1673-4114.2017.04.008
Abstract:
Breast cancer exhibits high risk to metastasize to bone.Skeletal-related events caused by bone metastases can significantly affect the quality of life and outcomes of patients with breast cancer.Therefore, such events play an important role in clinical staging and treatment protocols for early and accurate diagnosis of bone metastasis in breast cancer and for improving patient prognosis.The review summarizes the research status of imaging examination of bone metastasis in breast cancer and provides evidence for early diagnosis of bone metastasis.
Breast cancer exhibits high risk to metastasize to bone.Skeletal-related events caused by bone metastases can significantly affect the quality of life and outcomes of patients with breast cancer.Therefore, such events play an important role in clinical staging and treatment protocols for early and accurate diagnosis of bone metastasis in breast cancer and for improving patient prognosis.The review summarizes the research status of imaging examination of bone metastasis in breast cancer and provides evidence for early diagnosis of bone metastasis.
2017, 41(4): 283-287.
doi: 10.3760/cma.j.issn.1673-4114.2017.04.009
Abstract:
Glioma is one of the common diseases of the nervous system, and it poses hazards to human health.Prognosis of glioma depends on staging, surgical resection, histological classification, and pathological grading.Both 11C-L-methionine and 18F-fluoroethyl tyrosine are popular amino acid tracers used in PET imaging of brain tumors and reflect amino acid transport, metabolism, and protein synthesis in vivo.A literature overview on the role of amino acid PET in glioma is provided in terms of diagnostic accuracy, grading, differentiation of tumor recurrence and radiation necrosis, radiotherapy planning, and prognosis.
Glioma is one of the common diseases of the nervous system, and it poses hazards to human health.Prognosis of glioma depends on staging, surgical resection, histological classification, and pathological grading.Both 11C-L-methionine and 18F-fluoroethyl tyrosine are popular amino acid tracers used in PET imaging of brain tumors and reflect amino acid transport, metabolism, and protein synthesis in vivo.A literature overview on the role of amino acid PET in glioma is provided in terms of diagnostic accuracy, grading, differentiation of tumor recurrence and radiation necrosis, radiotherapy planning, and prognosis.
2017, 41(4): 288-293.
doi: 10.3760/cma.j.issn.1673-4114.2017.04.010
Abstract:
Patients who successfully complete treatment for prostate cancer face an almost 33% chance of disease recurrence in the next 10 to 15 years, during which the positioning of the lesion and its development stage should be precisely identified using PET/CT.PET imaging agents that are currently used to diagnose PCa are 18F-FDG, 11C-choline, 18F-choline, and 68Ga-prostate-specific membrane antigen (68Ga-PSMA).However, the diagnosis of PCa is insufficient due to the poor intake of 18F-FDG in PCa cells and the short half-life of 11C-choline.18F-fluorocyclobutane carboxylic acid (18F-FACBC) has the advantages of strong specificity of PCa cells, long half-life, and simple preparation requirements and can therefore be an imaging agent for PCa diagnosis.
Patients who successfully complete treatment for prostate cancer face an almost 33% chance of disease recurrence in the next 10 to 15 years, during which the positioning of the lesion and its development stage should be precisely identified using PET/CT.PET imaging agents that are currently used to diagnose PCa are 18F-FDG, 11C-choline, 18F-choline, and 68Ga-prostate-specific membrane antigen (68Ga-PSMA).However, the diagnosis of PCa is insufficient due to the poor intake of 18F-FDG in PCa cells and the short half-life of 11C-choline.18F-fluorocyclobutane carboxylic acid (18F-FACBC) has the advantages of strong specificity of PCa cells, long half-life, and simple preparation requirements and can therefore be an imaging agent for PCa diagnosis.
2017, 41(4): 294-297, 302.
doi: 10.3760/cma.j.issn.1673-4114.2017.04.011
Abstract:
The intracranial venous sinus thrombosis (CVST) is a special cerebrovascular disease with cerebral venous reflux obstruction as the core.Because of lacking the diversity and specificity of the disease, it is difficult to diagnose in the early stage of the disease.If the patient can not be diagnosed and treated in the early stage, the patients with mild symptoms present headache, and severe symptoms show paralysis or even death.Comprehensive imaging examination plays an important role in the diagnosis of the disease, and is helpful for the early diagnosis of the disease.This article reviews the progress of imaging findings of CVST.
The intracranial venous sinus thrombosis (CVST) is a special cerebrovascular disease with cerebral venous reflux obstruction as the core.Because of lacking the diversity and specificity of the disease, it is difficult to diagnose in the early stage of the disease.If the patient can not be diagnosed and treated in the early stage, the patients with mild symptoms present headache, and severe symptoms show paralysis or even death.Comprehensive imaging examination plays an important role in the diagnosis of the disease, and is helpful for the early diagnosis of the disease.This article reviews the progress of imaging findings of CVST.
2017, 41(4): 298-302.
doi: 10.3760/cma.j.issn.1673-4114.2017.04.012
Abstract:
In diagnostic nuclear medicine, the used of radioactive drugs with ionizing radiation effect and may place nuclear medicine workers and patients at risk of infection in terms of health.In this review the global trends in diagnostic nuclear medicine modalities applied in medical procedure were introduced at first.And then the exposure dose of nuclear medicine workers and patients in different examination items were analyzed emphatically.The radiation protection status was evaluated based on the analysis.In recent years, the researches in nuclear medicine radiation protection showed that the annual effective dose of workers was less than yearly dose limit of occupational exposure.The effective dose was mainly from single photon radiopharmaceuticals labeled by 99Tcm for patients undergoing SPECT examinations.However for PET/CT examinations, the effective dose was mainly from CT procedure.It could significantly reduce the effective dose to the patients when the activity of radioactive drugs and CT acquisition conditions were selected appropriately.
In diagnostic nuclear medicine, the used of radioactive drugs with ionizing radiation effect and may place nuclear medicine workers and patients at risk of infection in terms of health.In this review the global trends in diagnostic nuclear medicine modalities applied in medical procedure were introduced at first.And then the exposure dose of nuclear medicine workers and patients in different examination items were analyzed emphatically.The radiation protection status was evaluated based on the analysis.In recent years, the researches in nuclear medicine radiation protection showed that the annual effective dose of workers was less than yearly dose limit of occupational exposure.The effective dose was mainly from single photon radiopharmaceuticals labeled by 99Tcm for patients undergoing SPECT examinations.However for PET/CT examinations, the effective dose was mainly from CT procedure.It could significantly reduce the effective dose to the patients when the activity of radioactive drugs and CT acquisition conditions were selected appropriately.
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