2019 Vol. 43, No. 5
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2019, 43(5): 405-410.
doi: 10.3760/cma.j.issn.1673-4114.2019.05.004
Abstract:
Objective To evaluate the dose–response relationship of thyroid remnants and differentiated thyroid carcinoma (DTC) cervical metastases in the radioiodine treatment of DTC. Methods Post-therapeutic iodine-131 whole-body scintigraphy and SPECT/CT imaging were performed in 22 patients with DTC, including 10 males and 12 females, of the Nuclear Department of Third Affiliated Hospital of Sun Yat-Sen University. The ages of the patients were between 21 and 59 years, with a median of 39.5 years. Images were acquired from iodine-131 whole-body scintigraphy and SPECT/CT at multiple time points after treatment. The absorbed doses (ADs) of thyroid remnants and DTC metastases and the mean individual ADs were calculated using these images. Lesion response was determined using the 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer. The differences in lesion AD of each observed group were analyzed using the Mann–Whitney U test. Moreover, the receiver operating characteristic (ROC) curves were used to test the performance of the estimated AD for prognostic assessment. Results All (28/28) thyroid remnants and 34.8% (8/23) of DTC metastases responded completely. The lesion ADs of the completely responded DTC metastases (M=79.3 Gy) were significantly higher than that of the incompletely responded lesions (M=29.8 Gy) (Z=−2.195, P=0.028). The ROC curve analysis indicated that the estimation of lesion AD, which had an area under the curve of 0.783 (Z=−2.195, P=0.028) for DTC metastases, may be a prognostic factor for the prediction of lesion-based iodine-131 therapy response. The corresponding lesion AD threshold value for correctly predicting the complete response of metastatic lesions was 70.6 Gy. The mean individual ADs of clinically relieved patients, which had an area under the curve of 0.823 (Z=−2.285, P=0.022), were also significantly higher than that of the clinically nonrelieved patients. Conclusion Completely responded metastases demonstrated higher AD than the incompletely responded ones. The AD of iodine uptake tissue and the average AD of patients are possibly valuable to predict the response to iodine therapy.
2019, 43(5): 397-399.
doi: 10.3760/cma.j.issn.1673-4114.2019.05.002
Abstract:
The decision to hospitalize or release patients should be determined on an individual basis and should not be based solely on their residual activity according to ICRP publication 94. Based on high-end scientific research, ICRP publication 94 analyzed and compared the advantages and disadvantages of hospitalization and non-hospitalization. To help scientific studies weigh the pros and cons of hospitalization and release, this report aims to achieve a uniform understanding and practical implementation of these practices.
The decision to hospitalize or release patients should be determined on an individual basis and should not be based solely on their residual activity according to ICRP publication 94. Based on high-end scientific research, ICRP publication 94 analyzed and compared the advantages and disadvantages of hospitalization and non-hospitalization. To help scientific studies weigh the pros and cons of hospitalization and release, this report aims to achieve a uniform understanding and practical implementation of these practices.
2019, 43(5): 400-404.
doi: 10.3760/cma.j.issn.1673-4114.2019.05.003
Abstract:
Objective To evaluate how long after iodine-131 treatment of hospitalized patients with differentiated thyroid cancer (DTC), the radiation dose in patients fit the discharged requirements, as well as the radiation levels in wards and facilities in which the patients lived. Methods A total of 143 patients with DTC were hospitalized and treated with iodine-131 from January 2015 to March 2017 in the department of nuclear medicine, third affiliated hospital of Sun Yat-sen university. The participants consisted of 46 males and 97 females aged 37.6±12.4 years. The patients were divided into three groups according to the radiation dose of iodine-131. Groups 1, 2, and 3 were administered with 3.70, 5.55, and 7.40 GBq, respectively. After the administration of iodine-131 for 0.5, 2, 4, 8, 12, 24, 36, 48, 72, and 80 h, the radiation dose rate was measured at 1 m in front of the patients by using a real-time radiation monitor, and the changes in radioactivity in the patients were estimated. On the day after the patients were discharged, the radiation doses on the patients' clothes, bed sheets, ward floor, and ground at the bathroom door were monitored using a surface radiation monitor. Data were subjected to variance analysis, and a P<0.05 was considered statistically significant. Results Groups 1 [(597.5±196.3) μsv/h], 2 [(794.5±254.2) μsv/h], and 3 [(1114.1±258.5) μsv/h] had significantly different radiation dose rates (F=62.757, P<0.01) after 0.5 h of iodine-131 administration. Prolonged radiation exposure resulted in rapid exponential decrease in the radiation dose rate and gradual reduction in the differences among the data. The radiation dose rates of groups 1, 2, and 3 [(13.3±10.7), (16.1±9.7), and (21.9±14.5) μsv/h, respectively] after 72 h of iodine-131 administration were not significantly different (F=2.313, P>0.05). The dose rate in 95.8% of the patients (137 out of 143 patients) was less than 23.3 μSv/h after approximately 80 h of iodine-131 administration. After the patients were discharged from the hospital, the surface dose rates on the bed sheets, patients' clothes, ward floor, and ground at the bathroom door were (3.9±1.2), (4.1±1.9), (3.8±1.6), and (6.2±2.6) μsv/h, respectively. These values were lower than the corresponding radiation limit levels. Conclusions After 80 h of treatment with no more than 7.40 GBq iodine-131, the residual dose of iodine-131 in most patients was lower than its restricted value in China. The radiation pollution level of the patients' ward grounds, bed sheets, and clothes were also lower than the radiation limit. Thus, these materials and facilities require no special treatment.
2019, 43(5): 411-415.
doi: 10.3760/cma.j.issn.1673-4114.2019.05.005
Abstract:
According to the current management policy in China, the regulations and workflow, to briefly discuss the relative problem about the site selection, layout design, waste treatment, radiation protection and the management of radionuclide treatment ward. To provide the proposal of the radionuclide treatment ward about establishment and radiation protection, as well as preliminary opinions on the management of ward. Then provide references and suggestions for establishing a radionuclide treatment ward in department of nuclear medicine of hospital.
According to the current management policy in China, the regulations and workflow, to briefly discuss the relative problem about the site selection, layout design, waste treatment, radiation protection and the management of radionuclide treatment ward. To provide the proposal of the radionuclide treatment ward about establishment and radiation protection, as well as preliminary opinions on the management of ward. Then provide references and suggestions for establishing a radionuclide treatment ward in department of nuclear medicine of hospital.
2019, 43(5): 416-421.
doi: 10.3760/cma.j.issn.1673-4114.2019.05.006
Abstract:
Objective To determine the value of 99Tcm-DTPA orbit SPECT/CT in evaluating the activity of thyroid-associated ophthalmopathy (TAO). Methods The 99Tcm-DTPA orbit SPECT/CT imaging data of 66 orbits of 33 patients [13 men and 20 women, age (45.36±13.44) years old] were retrospectively analyzed, along with the clinical activity score (CAS) and MRI of the 21 patients (42 orbits) . The orbit/occipital area's uptake ratio (UR) was calculated by the ROI. The activity of each extraocular muscle (EOM) on the SPECT/ CT and MRI images was assessed by visual analysis. MRI score of every orbit was obtained according to the number of active EOM, the range of which was 0−4 . As for the CAS, ≥3 represented the active stage, and the others denote the inactive stage. The UR between the active TAO and inactive TAO was compared using t test, the correlation between the UR and CAS/MRI score was calculated by Spearman analysis, and the consistency of the activity of every EOM assessed by SPECT/CT and MRI was evaluated by Kappa test. The receiver operating characteristic (ROC) curve was depicted to determine the diagnostic efficiency of SPECT/CT using CAS as the gold standard. Results ① CAS was moderately correlated with the UR of all the 66 orbits (r=0.441, P=0.000). The UR of the inactive group (1.20±0.58) was significantly lower than that of the active group (1.56±0.57) (t=−2.476, P=0.016). The area under the curve of the ROC was 0.679. The threshold differentiating the inactive phase from the active one was 1.20, with the sensitivity of 79.5% and with the specificity being 55.6%. ② The MRI score of the 42 orbits was significantly correlated with UR (r=0.515, P=0.000). The UR of the inactive group (1.00±0.60) was significantly lower than that of the active group (1.72±0.45) according to the MRI score (t=−4.438, P=0.000). ③The activity of the 168 muscles assessed by 99Tcm-DTPA SPECT/CT was moderately consistent with that assessed by MRI (kappa=0.569, P=0.000). Conclusions 99Tcm-DTPA orbit SPECT/CT is a reliable and objective method to evaluate the activity of TAO, and it will be helpful in clinical practice.
2019, 43(5): 422-426.
doi: 10.3760/cma.j.issn.1673-4114.2019.05.007
Abstract:
Objective To explore the recent effect of 99Tcm-methoxyisobutylisonitrile myocardial perfusion imaging (99Tcm -MIBI) in coronary heart disease (CHD) patients with percutaneous coronary intervention (PCI). Methods From October 2014 to March 2017, a total of 124 patients [including 68 males and 56 females, aged 43~79 (61.89±17.21)] with CHD undergoing PCI in Fuling central hospital were used as research objects and underwent adenosine-loading myocardial perfusion imaging (99Tcm -MIBI-SMPI) and 99Tcm MIBI rest myocardial perfusion imaging (99Tcm-MIBI-RMPI) within 3 days before PCI and 99Tcm-MIBI-SMPI within 3 days after PCI. All patients were followed up for 1 year via telephone calls. According to complete improvement, partial improvement and no improvement of ischemia, they were divided into three groups. The cases of general cardiovascular events and serious cardiovascular events were calculated. Student-t test was used to compare the measurement data between the two groups, and χ2 test was used to compare the count data. Results In the 124 patients, 99Tcm-MIBI-SMPI examination before PCI showed 272 reversible defect sections and 360 irreversible defect sections. The summed stress score was 1598 points. 99Tcm-MIBI-SMPI examination after PCI showed 25 reversible defect sections, 247 sections (247/272=90.81%) improved, 198 irreversible defect sections, and 162 sections (162/360=45.00%) improved. The summed stress score was 636 points. After PCI, the left ventricular ejection fraction, end diastolic velocity, and end systolic volume of patients showed significant improvement. The differences were statistically significant (t=−7.450, 4.304, 12.144, all P<0.01). Postoperative 99Tcm MIBI-SMPI indicated the completely improved, improved, and partly improved status of the three groups of ischemia patients, and the improvement showed an significantly increased trend in both half year and 1 year total incidence of cardiovascular events (χ2=142.668, 106.225, both P<0.05). Conclusion 99Tcm-MIBI has good effect on CHD patients with PCI and on their long-term prognosis.
2019, 43(5): 427-431.
doi: 10.3760/cma.j.issn.1673-4114.2019.05.008
Abstract:
Objective To investigate the prognostic stratification value of an enhanced international prognostic index (NCCN-IPI) in patients with diffuse large B-cell lymphoma (DLBCL) who are negative at the end of treatment with positron emission tomography computed tomography (PET/CT). Methods A retrospective analysis was conducted on 60 patients with DLBCL from April 2013 to August 2017 in the first affiliated hospital of Soochow university. There were 28 males and 32 females, with a median age of 51 years (16−81 years). Baseline characteristics were collected from all the patients who underwent six- to eight-cycle R-CHOP regimen chemotherapy and were negative by 18F-FDG PET/CT. The risk stratification was performed by NCCN-IPI, Log-rank test was used for comparison of the differences in progression-free survival (PFS) and overall survival (OS) between groups. Results The patients featured a median follow-up of 34 months (14–69 months). The two-year PFS and OS rates reached 83.33% (50/60) and 96.67% (58/60), respectively. On the basis of NCCN-IPI risk categorization, 35.0% (21/60), 41.7% (25/60), 18.3% (11/60) and 5.0% (3/60) patients belonged to the low-, low–intermediate-, high–intermediate-, and high-risk subgroups, respectively. A statistically significant difference was observed in the PFS between the low-risk group and the other groups (P=0.0272, 0.0143, <0.0001) and in the OS between the high-risk group and the other groups (P=0.0098, 0.0166, 0.0045). The difference between the PFS and OS of other components showed no statistical significance (all P>0.05). Conclusion Further prognostic stratification can be performed by NCCN-IPI in patients with DLBCL who are negative at the end of treatment by PET/CT.
2019, 43(5): 432-436.
doi: 10.3760/cma.j.issn.1673-4114.2019.05.009
Abstract:
Objectives To evalute treatment effect of differentiated thyroid cancer (DTC) in primary hospitals while observing the standardized treatment process and status quo of DTC in Anqing Province, China. Methods A total of 219 DTC patients [48 males and 17 females, aged between 22 to 68 (44.6±5.4) years old] admitted to our hospital from July 2015 to July 2018 received 131I treatment. Specifically, these patients stopped taking levothyroxine 3 to 4 weeks before treatment, were given an iodine-free diet, and were administered oral 131I by DTC individualized dose after examining and excluding any contraindication of the treatment. The clinical treatment effect on patients with different pathological types was then examined, and each patient was checked for metastatic lesions to ensure that no non-standard phenomenon occurred during the treatment. The nuclear medicine discipline and status quo of standardized DTC treatment in primary hospitals and the degree of related knowledge of primary doctors were also examined by conducting a questionnaire survey. The questionnaires were distributed to the participants in the Standardized Treatment and Diagnosis of Nuclear Medicine seminar in Southwest Anhui. Tg was monitored among the follow-up outpatients, and their thyroid function, thyroid iodine uptake rate, and imaging examination results were used to determine the key points. Results The 131I treatment achieved an effective rate of 98.6% (216/219) among the DTC patients. A total of 57 cases demonstrated non-standard phenomena, among which 38 cases were cured by 131I in a secondary operation, 7 were cured via radiotherapy or 131I treatment after radiotherapy, 8 cases developed cervical lymph node metastases after a partial thyroidectomy operation, 2 cases developed DTC metastases due to limited TSH inhibition, and 2 cases (in other hospitals) developed metastases due to irregular monitoring of Tg or TgAb. The survey results showed that Anqing only has two medical hospitals, and our hospital is the only institution that can administer the 131I treatment. The number of medical staff in primary hospitals who mastered standardized DTC treatment knowledge was less than 30% (62 of 219). A total of 187 follow-up patients were Tg negative, whereas 32 were Tg positive, thereby indicating a satisfactory control level of TSH among these patients. The thyroid iodine uptake rate of the outpatients was less than 1%, and the imaging examination results of most outpatients were negative. Conclusions The observation results highlighted a positive standard treatment effect. Although some abnormal phenomena were observed during the course of the treatment, they can be avoided or reduced by strictly implementing the treatment system and strengthening the standardized treatment knowledge of the medical staff.
2019, 43(5): 437-441.
doi: 10.3760/cma.j.issn.1673-4114.2019.05.010
Abstract:
Objective To investigate the effects of stereotactic radiotherapy on the expression of serum carcinoembryonic antigen (CEA), glycoprotein antigen-125 (CA125), glycoprotein antigen-125 (CA153), and tumor specific growth factor (TSGF) in patients with advanced lung adenocarcinoma. Methods Ninety-two patients with advanced lung adenocarcinoma admitted to Yantai Yantai m ountain hospital from January 2015 to May 2017 were equally and randomly divided into a control [46 cases: 28 males and 18 females with the average of (57.6±7.4)] and an observation group [46 cases: 30 males and 16 females with the average of (58.2±8.1)]. The control group was treated with paclitaxel and cisplatin chemotherapy. Stereotactic radiotherapy was given on the basis of the group. The therapeutic effects; serum CEA, CA125, CA153, and TSGF expression levels; complications; and prognosis of the two groups were compared. χ2 test and t test were used for the comparison among groups, and Kaplan Meier survival curve was used to analyze the survival rate. Results The effective rates were 37.0% (17/46) and 17.4% (8/46) in the observation and the control group, respectively. The difference was significant (χ2=4.449, P=0.035). The expression levels of serum CEA, CA125, CA153, and TSGF in the observation group were significantly lower than those in the control group (t=6.987–13.575, all P=0.000). No significant difference was observed in terms of complications (χ2=0.562, P=0.337). The median survival times were 13.6 and 10.2 months in the observation and the control group, respectively. The difference was significant (U=126.0, P<0.01). Conclusion Stereotactic radiography can promote lung adenocarcinoma therapy, reduce the level of serum tumor markers, and prolong the survival period of patients. Therefore, stereotactic radiography is worthy of clinical application.
2019, 43(5): 442-449.
doi: 10.3760/cma.j.issn.1673-4114.2019.05.011
Abstract:
Objective To observe and compare the effects of radiation on the damage and recovery of hematopoietic system in mice of different ages (juvenile, adult, and aged mice). Methods Sixty male C57BL/6 mice of various ages were randomly divided into control, 2 Gy irradiation, and 4 Gy irradiation groups. The control group received sham irradiation, and the other two were administered with 137Cs γ total body irradiation. On the 3rd, 7th, 14th, and 28th days after irradiation, peripheral blood was collected, white blood cells, red blood cells and platelets were counted, unilateral femur bone marrow nucleated cell counts were determined, and percentages of hematopoietic stem cell (HSC), hematopoietic progenitor cell (HPC) and colony forming unit-granulocyte macrophage were calculated. One way ANOVA was used for comparison among groups, while t test was used for comparison between two groups. Results White blood cell count, unilateral femur bone marrow nucleated cell count, hematopoietic stem cell and progenitor cell count of irradiated mice were reduced to the lowest values on the 3rd day. Compared with the control group, the white blood cell count of juvenile mice decreased to 34.8% (2 Gy irradiation) (t=6.129, P<0.05) and 19.6% (4 Gy irradiation) (t=7.084, P<0.05), while adult mice decreased to 43.8% (2 Gy irradiation) (t=3.043, P<0.05) and 20.0% (4 Gy irradiation) (t=7.084, P<0.05), aged mice decreased to 19.0% (2 Gy irradiation) (t=22.080, P<0.05) and 8.4% (4 Gy irradiation) (t=24.590, P<0.05). The decrease in 4 Gy group was more serious than that in 2 Gy group in a dose-dependent manner. At 28th day after irradiation, unilateral femur bone marrow nucleated cell count in irradiated juvenile mice did not return to normal, the HSC percentage in the juvenile mice of 4 Gy group was still lower than 50%, and the HPC percentage of irradiated juvenile mice recovered to approximately 50% of that of the control group. At 28th day after irradiation, the percentage of colony forming unit-granulocyte macrophage returned to normal for the irradiated adult mice, however, the irradiated juvenile mice (2 Gy irradiation: t=2.067, P<0.05; 4 Gy irradiation: t=3.358, P<0.05) and aged mice (2 Gy irradiation: t=2.586, P<0.05; 4 Gy irradiation: t=4.772, P<0.05) were significantly lower than those of adult mice, which did not return to normal level. Conclusions After irradiation, majority of the hematopoietic system of the irradiated group showed acute, dose-dependent inhibition on the 3rd day. After the recovery period, most of the indicators returned to normal values on the 28th day. The results suggest that the hematopoietic stem cell functions in juvenile mice are more sensitive to radiation injury and poorly recover after radiation compared with those in adult mice. In addition, the recovery for bone marrow cell proliferation was decreased in aged mice.
2019, 43(5): 450-455.
doi: 10.3760/cma.j.issn.1673-4114.2019.05.012
Abstract:
The development and progression of tumor is a complex biological process, involving many factors. Hypoxia is one of the prominent features of the microenvironment of solid tumors. Hypoxic microenvironment can contribute to tumors with stronger adaptability, higher malignancy and drug-resistance. The study found that exosomes are important factors in mediating tumor biological processes, while hypoxic-derived exosomes play a more prominent role in some biological processes. Therefore, researches on hypoxic-derived exosomes are of great importance in understanding the development and growth control of tumors. This article briefly outlines the role of exosomes in tumor hypoxic microenvironment, in order to provide a theoretical basis for the researches of tumor biology.
The development and progression of tumor is a complex biological process, involving many factors. Hypoxia is one of the prominent features of the microenvironment of solid tumors. Hypoxic microenvironment can contribute to tumors with stronger adaptability, higher malignancy and drug-resistance. The study found that exosomes are important factors in mediating tumor biological processes, while hypoxic-derived exosomes play a more prominent role in some biological processes. Therefore, researches on hypoxic-derived exosomes are of great importance in understanding the development and growth control of tumors. This article briefly outlines the role of exosomes in tumor hypoxic microenvironment, in order to provide a theoretical basis for the researches of tumor biology.
2019, 43(5): 456-461.
doi: 10.3760/cma.j.issn.1673-4114.2019.05.013
Abstract:
Primary aldosteronism (PA) is a clinical syndrome in which excess production of the hormone aldosterone from the adrenal glands, leads to activation of the renin-angiotensin system, causing a series of pathophysiological changes in the body. PA is divided into unilateral or bilateral adrenal aldosterone secretion, and their treatment methods are essentially different. The former is mostly treated by operation, while the latter is mainly treated with drugs. It's very important to early identify the type of PA in clinical implication. Radionuclide imaging including positron emission tomography (PET) and single photon emission computed tomography (SPECT), which are characterized by molecular probes, functional imaging, and non-invasiveness, are playing an increasingly important role in the classification of PA patients. The author reviews the research progress of radionuclide imaging in PA.
Primary aldosteronism (PA) is a clinical syndrome in which excess production of the hormone aldosterone from the adrenal glands, leads to activation of the renin-angiotensin system, causing a series of pathophysiological changes in the body. PA is divided into unilateral or bilateral adrenal aldosterone secretion, and their treatment methods are essentially different. The former is mostly treated by operation, while the latter is mainly treated with drugs. It's very important to early identify the type of PA in clinical implication. Radionuclide imaging including positron emission tomography (PET) and single photon emission computed tomography (SPECT), which are characterized by molecular probes, functional imaging, and non-invasiveness, are playing an increasingly important role in the classification of PA patients. The author reviews the research progress of radionuclide imaging in PA.
2019, 43(5): 462-467.
doi: 10.3760/cma.j.issn.1673-4114.2019.05.014
Abstract:
Assessing physiological function of coronary arteries is helpful to objectively assess the risk stratification of coronary artery disease (CAD) and select appropriate treatment strategies for improving the prognosis of patients with CAD. Current clinical indicators used to evaluate the physiological function of coronary arteries include fractional flow reserve (FFR), myocardial flow reserve (MFR) and index of microciculatory resistance (IMR), which can be obtained by noninvasive or invasive methods. This article review the clinical values of FFR, MFR and IMR in patients with CAD.
Assessing physiological function of coronary arteries is helpful to objectively assess the risk stratification of coronary artery disease (CAD) and select appropriate treatment strategies for improving the prognosis of patients with CAD. Current clinical indicators used to evaluate the physiological function of coronary arteries include fractional flow reserve (FFR), myocardial flow reserve (MFR) and index of microciculatory resistance (IMR), which can be obtained by noninvasive or invasive methods. This article review the clinical values of FFR, MFR and IMR in patients with CAD.
2019, 43(5): 468-471.
doi: 10.3760/cma.j.issn.1673-4114.2019.05.015
Abstract:
Atherosclerotic vulnerable plaque refers to the plaque with poor stability and tendency of thrombosis, and acute cardiovascular and cerebrovascular ischemia evens are mainly caused by the rupture of vulnerable plaque and secondary thrombosis. Studies have shown that coronary atherosclerosis is closed related to and often occurs simultaneously with head and neck atherosclerosis, and some inflammatory factors can be detected in peripheral blood at the early stage of the disease. There are many clinical method for the diagnosis of vulnerable plaque. In this paper, the imaging diagnosis of atherosclerotic plaque of coronary arteries and head and neck as well as the research status and prospects of related inflammatory factors are summarized as follows.
Atherosclerotic vulnerable plaque refers to the plaque with poor stability and tendency of thrombosis, and acute cardiovascular and cerebrovascular ischemia evens are mainly caused by the rupture of vulnerable plaque and secondary thrombosis. Studies have shown that coronary atherosclerosis is closed related to and often occurs simultaneously with head and neck atherosclerosis, and some inflammatory factors can be detected in peripheral blood at the early stage of the disease. There are many clinical method for the diagnosis of vulnerable plaque. In this paper, the imaging diagnosis of atherosclerotic plaque of coronary arteries and head and neck as well as the research status and prospects of related inflammatory factors are summarized as follows.
2019, 43(5): 472-478.
doi: 10.3760/cma.j.issn.1673-4114.2019.05.016
Abstract:
Radiotherapy and chemotherapy are important methods in the treatment of esophageal cancer. The evaluation of response after treatment has considerable importance for individualized treatment. The conventional imaging technology used to evaluate the response after therapy is only based on morphological changes, which cannot accurately reflect the early changes in tumor size. By contrast, the molecular imaging technology, PET/CT, can use different types of imaging agents to evaluate treatment response in terms of metabolism, proliferation, hypoxia, and apoptosis, which improves the diagnosis' sensitivity and specificity. Therefore, molecular imaging using multiple PET tracers is a promising new method for the evaluation of therapy response in esophageal cancer. The article reviews the PET/CT imaging agents used to examine the non-operation treatment response of esophageal cancer in recent years.
Radiotherapy and chemotherapy are important methods in the treatment of esophageal cancer. The evaluation of response after treatment has considerable importance for individualized treatment. The conventional imaging technology used to evaluate the response after therapy is only based on morphological changes, which cannot accurately reflect the early changes in tumor size. By contrast, the molecular imaging technology, PET/CT, can use different types of imaging agents to evaluate treatment response in terms of metabolism, proliferation, hypoxia, and apoptosis, which improves the diagnosis' sensitivity and specificity. Therefore, molecular imaging using multiple PET tracers is a promising new method for the evaluation of therapy response in esophageal cancer. The article reviews the PET/CT imaging agents used to examine the non-operation treatment response of esophageal cancer in recent years.
2019, 43(5): 479-483.
doi: 10.3760/cma.j.issn.1673-4114.2019.05.017
Abstract:
Although maximal safe surgery and adjuvant Stupp protocols are the first line treatment of glioblastoma (GBM) recommended by several guidelines, patients >70 years old are excluded from this protocol. No identical treatment exists for elderly patients who account for nearly 50% of all cases. Elderly patients do not receive standard treatment because of certain reasons, including low physical fitness score, multiple comorbidities, and social and family factors. Hence, the prognosis of the elderly is poor. Many clinical trials have emerged to analyze GBM in elderly patients. This review describes the molecular features and new clinical trials of elderly GBM to provide medical evidence for the individualized treatment of elderly patients.
Although maximal safe surgery and adjuvant Stupp protocols are the first line treatment of glioblastoma (GBM) recommended by several guidelines, patients >70 years old are excluded from this protocol. No identical treatment exists for elderly patients who account for nearly 50% of all cases. Elderly patients do not receive standard treatment because of certain reasons, including low physical fitness score, multiple comorbidities, and social and family factors. Hence, the prognosis of the elderly is poor. Many clinical trials have emerged to analyze GBM in elderly patients. This review describes the molecular features and new clinical trials of elderly GBM to provide medical evidence for the individualized treatment of elderly patients.
2019, 43(5): 484-489.
doi: 10.3760/cma.j.issn.1673-4114.2019.05.018
Abstract:
The important clinical value in bone health diagnosis and treatment has been documented of the standardized dual energy X-ray absorptiometry (DXA) on bone mineral density diagnostic report. Based on the official position of the international society for clinical densitometry (ISCD) combined with China national conditions, China Health Promotion Foundation Expert Committee on Bone Density Measurement and Osteoporosis Diagnosis has formed a standardized opinion about the diagnosis report of DXA bone mineral density measurement. The intention is to make the DXA diagnostic report accurately reflect the important clinical value of DXA and better apply it in clinical diagnosis and treatment.
The important clinical value in bone health diagnosis and treatment has been documented of the standardized dual energy X-ray absorptiometry (DXA) on bone mineral density diagnostic report. Based on the official position of the international society for clinical densitometry (ISCD) combined with China national conditions, China Health Promotion Foundation Expert Committee on Bone Density Measurement and Osteoporosis Diagnosis has formed a standardized opinion about the diagnosis report of DXA bone mineral density measurement. The intention is to make the DXA diagnostic report accurately reflect the important clinical value of DXA and better apply it in clinical diagnosis and treatment.
2019, 43(5): 490-493.
doi: 10.3760/cma.j.issn.1673-4114.2019.05.019
Abstract:
Neurogenic tumors account for approximately 10%–20% of retroperitoneal lesions and are mostly located in the paraspinal sympathetic chain (kidney-level paravertebral). Paraganglioma is a pheochromocytoma outside the adrenal gland. It originates from ganglionic crest cells and can be seen all over the body. Paraganglioma is most common at the front of the branches of the abdominal aorta and the inferior mesenteric artery. Given that paraganglioma does not have typical imaging features and clinical manifestations, it is often difficult to identify from other various retroperitoneal lesions. In this study, two paraganglioma cases, which were not easy to differentiate from other retroperitoneal lesions in 18F-FDGPET/CT imaging, were selected. A differential diagnosis was also made from their clinical and imaging features. The diagnostic ideas were summarized and analyzed as a reference for accurate imaging diagnosis in clinical work.
Neurogenic tumors account for approximately 10%–20% of retroperitoneal lesions and are mostly located in the paraspinal sympathetic chain (kidney-level paravertebral). Paraganglioma is a pheochromocytoma outside the adrenal gland. It originates from ganglionic crest cells and can be seen all over the body. Paraganglioma is most common at the front of the branches of the abdominal aorta and the inferior mesenteric artery. Given that paraganglioma does not have typical imaging features and clinical manifestations, it is often difficult to identify from other various retroperitoneal lesions. In this study, two paraganglioma cases, which were not easy to differentiate from other retroperitoneal lesions in 18F-FDGPET/CT imaging, were selected. A differential diagnosis was also made from their clinical and imaging features. The diagnostic ideas were summarized and analyzed as a reference for accurate imaging diagnosis in clinical work.
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