2020 Vol. 44, No. 12
Display Method:
2020, 44(12): 0-0.
[PDF 7394KB]
Abstract:
2020, 44(12): 1-4.
Abstract:
2020, 44(12): 737-743.
doi: 10.3760/cma.j.cn121381-202004048-00101
Abstract:
Objective To analyze variations in the chest CT of different clinical outcomes of corona virus disease 2019 (COVID-19) based on deep learning and improve the understanding on COVID-19 imaging. Methods The chest CT of 42 cases (the clinical classification was common type) of COVID-19 in Inner Mongolia Autonomous Region collected from January 25, 2020 to March 29, 2020 were examined. The cases included 20 males and 22 females, with ages ranging from 17 months to 86 (48.74±17.18) years. The patients were divided into group A, which included those did not progress to severe disease (n=29), and group B, which included those who progressed to severe/critical disease (n=13). Differences in age, gender, lesion distribution, sides, number, volume, density (CT value), and proportion of lesion volume as detected by chest CT were compared between the two groups by deep learning. Two independent samples t test and Mann-Whitney U nonparametric tests were used to compare measurement data, and the χ2 and Fisher's exact tests were used to compare count data. Results No statistical difference in gender was noted between the two groups (χ2=0.016, P=1.000). The mean age of group B was higher than that of group A (65.62±11.24 years vs. 41.17±13.66 years), and a statistical difference was observed in each group (t=5.64, P<0.001). The number of infected pulmonary lobes, proportion of infection volume in each pulmonary lobe, and proportion of total infection volume were higher in group B than in group A, and a statistical difference was noted in each group (Z=2.505−3.605, all P<0.05). No statistical difference in total lung volume between the two groups was observed (Z=1.456, P=0.146). The size of infection in each lobe and the total volume of infection in both lungs in group B were greater than those in group A, and a statistical difference was found in each group (Z=2.301−3.254, all P<0.05). The proportion of lesions in group B within the threshold range of all CT values was higher than that in group A, and a statistical difference was observed in each group (Z=3.115−3.578, all P<0.05). The results of chest CT and artificial intelligence lesion recognition mapping revealed that lesions in serious cases are mainly characterized with ground glass opacity and consolidation. Moreover, the lesions frequently involved the lower lobes of the lungs and less commonly affected the middle lobe of the right lung. Conclusions The chest CT of patients with COVID-19 who progressed to severe disease and those who did not showed significant differences. Artificial intelligence based on deep learning can assess patients with a tendency to progress to severe/critical disease early and contribute to the improved management of severe COVID-19.
2020, 44(12): 744-749.
doi: 10.3760/cma.j.cn121381-202004004-00107
Abstract:
As a non-invasive method of image analysis, radiomics can deeply explore the clinical information hidden behind medical images. The development of deep learning technology has promoted radiomics research to a new level, and numerous studies have confirmed its application value in tumor radiotherapy. Based on the research background of radiomics, this paper reviews its research progress in tumor radiotherapy.
As a non-invasive method of image analysis, radiomics can deeply explore the clinical information hidden behind medical images. The development of deep learning technology has promoted radiomics research to a new level, and numerous studies have confirmed its application value in tumor radiotherapy. Based on the research background of radiomics, this paper reviews its research progress in tumor radiotherapy.
2020, 44(12): 750-754.
doi: 10.3760/cma.j.cn121381-202003036-00104
Abstract:
Artificial intelligence (AI) refers to the intelligence shown by machines made by human beings, and it is also a new science used to simulate, extend and expand the theories, methods, technologies and application systems of human intelligence. AI can be applied in many fields, and its combination with robotics is widely used, and it was early used in the field of medicine. However, the application in nuclear medicine wards is relatively late, and many problems need to be improved. Aimed at the application status of AI robotics in nuclear medicine wards, this review summarizes the four main functions of hospital admission propaganda, environmental monitoring, ward rounds and disinfection. Through discussing the urgently solved problems, this review points out the direction of further research and development, aiming to promot the rapid development of radionuclide diagnosis and treatment.
Artificial intelligence (AI) refers to the intelligence shown by machines made by human beings, and it is also a new science used to simulate, extend and expand the theories, methods, technologies and application systems of human intelligence. AI can be applied in many fields, and its combination with robotics is widely used, and it was early used in the field of medicine. However, the application in nuclear medicine wards is relatively late, and many problems need to be improved. Aimed at the application status of AI robotics in nuclear medicine wards, this review summarizes the four main functions of hospital admission propaganda, environmental monitoring, ward rounds and disinfection. Through discussing the urgently solved problems, this review points out the direction of further research and development, aiming to promot the rapid development of radionuclide diagnosis and treatment.
2020, 44(12): 755-762.
doi: 10.3760/cma.j.cn121381-201909050-00110
Abstract:
Objective To demonstrate whether 18F-FDG PET/CT metabolic parameters could predict prognosis in patients with metastatic maligant melanoma (MM). Methods A retrospective analysis was conducted on a dataset composed of 47 patients who were newly diagnosed with metastatic MM and currently undergoing pretreatment 18F-FDG PET/CT in the Affiliated Hospital of Nanjing University Medical School, Nanjing Drum Tower Hospital from August 2011 to December 2018. Of 47 patients, 20 were male, 27 were female and median age 59 (23−86) years. All patients were treated with chemotherapy, immunotherapy or targeted therapy and follow-up time was 0.5 to 53.6 months. Melanoma-specific survival (MSS) and progression-free survival (PFS) were defined as the time from 18F-FDG PET/CT imaging to the patient's death and the patient's death or progression of the disease, separately. All patients underwent 18F-FDG PET/CT imaging before treatment.The maximum standardized uptake value (SUVmax) was measured. Whole-body metabolic tumor volume (MTV) and whole-body total lesion glycolysis (TLG) were measured automatically and SUV>40% SUVmax voxel boundary was used as threshold. The optimal thresholds of PET parameters were obtained using the receiver operating characteristic (ROC) curve, and the patients were divided into two groups separately according to the optimal thresholds of SUVmax, whole-body MTV and whole-body TLG and six groups were obtained. The difference of MSS and PFS between the two groups were predicted by Kaplan-Meier method and Log-rank test. Univariate analysis was conducted to evaluate the prognostic value of PET parameters and clinical variables. The Cox proportional risk model multivariate analysis was used to determine whether the PET parameters can act as independent prognostic risk factors for MSS and PFS. Results The cut-off values for SUVmax, whole-body MTV, and whole-body TLG were 10.86, 8.12 cm3, and 91.45, respectively, as shown in the ROC curve analysis. The PFS was significantly different in two groups divided by optimal thresholds of whole-body MTV or whole-body TLG, separately (χ2=5.04, 5.02; both P<0.05). Similarly, the MSS was significantly different in two groups divided by optimal thresholds of SUVmax or whole-body TLG, separately (χ2=10.22, 4.38; both P<0.05). The univariate analysis results were as follows: the serum lactate dehydrogenase level≥245 U/L, lymphatic metastasis, SUVmax>10.86 and whole-body TLG>91.45, which were associated with predictors of MSS. M l stage, whole-body MTV>8.12 cm3 and whole-body TLG>91.45, which were associated with PFS. The multivariate analysis results showed that SUVmax>10.86, proving its potential as an independent prognostic risk factor for MSS. Conclusion The 18F-FDG PET/CT metabolic parameter SUVmax was the best predictive marker in metastatic MM patients, whole-body MTV and whole-body TLG helped for the prognosis of metastatic MM patients.
2020, 44(12): 763-769.
doi: 10.3760/cma.j.cn121381-202002049-00111
Abstract:
Objective To investigate the CT and pathological features of renal epithelioid angiomyolipoma (EAML) and epithelioid-like angiomyolipoma (AML). Methods Retrospectively collected data on 22 cases of EAML diagnosed by initial pathology in the Shunde Hospital of the Southern Medical University (the First People's Hospital of Shunde in Foshan City) and the First People's Hospital of Foshan from June 2008 to October 2018, including 4 males and 18 females with an average age of 48.9 years (ranging from 22 years to 72 years). The specimens of all lesions were resliced, stained, observed under microscope, and divided into the EAML and epithelioid-like AML groups according to their proportion of epithelioid components. A comparative analysis of CT signs, such as lesion diameter, morphology, liquid necrosis, hemorrhage, fat, and enhanced mode, on the CT images in both groups was performed. The CT values of each phase were measured, and the enhancement ratio of the cortical and medulla phases, which can reflect the degree of enhancement in each phase, was calculated. Independent sample t test, Mann-Whitney U test, and Fisher's exact probability method were used to compare the two groups. Results The epithelioid cells in the renal EAML group (15 cases) accounted for 86.7%, and the cells were round or polygonal, arranged in nests and sheets, and some nuclei were irregular and atypia. The epithelioid cells in the epithelioid-like AML group (7 cases) accounted for 23.6%, and the rest part were mostly spindle-shaped smooth muscle cells and adipocytes. The renal EAML group and the epithelioid-like AML group had significant differences in the lesion length ((8.40±4.26) cm vs. (4.90±1.84) cm), liquid necrosis (73.3%(11/15) vs. 14.3% (1/7)), fat (86.7%(13/15) vs. 14.3%(1/7)), and enhancement pattern (73.3%(11/15) vs. 14.3%(1/7)) (t=2.66; Fisher's exact probability method; all P<0.05). The cortical phase enhancement ratio was statistically significant (0.61 (0.56, 0.67) vs. 0.96 (0.92, 0.97), Z=−3.56, P<0.001), and the diagnosis efficiency was the highest when the cutoff value was ≤0.73 (area under curve =0.981 (0.813−1.000), Youden=0.87). Youden index of fat-free, "fast-in and slow-out" intensive mode, liquid necrosis, and tumor length >8 cm in order from high to low. Conclusions EAML has characteristic CT signs especially when the cortical phase enhancement ratio is ≤0.73. In this case, EAML is highly suspected to be possible.
2020, 44(12): 770-774.
doi: 10.3760/cma.j.cn121381-201911022-00109
Abstract:
Objective To explore the value of coronary CT angiography in evaluating the nature and prognosis of angina pectoris plaque. Methods A retrospective analysis of 139 patients with angina pectoris treated in Gaochun People's Hospital of Nanjing was conducted from 1 August 2018 to 31 July 2019. According to their clinical data, they were divided into stable angina pectoris (SAP, n=50) group and unstable angina pectoris (UAP, n=89) group. The plaque properties of the two groups were compared, and the relationship between their plaque properties and prognosis was analyzed. The measurement data of the two groups were compared by paired t test. The count data were compared by χ2 test. Results The rate of soft plaque detection in the UAP group was significantly higher than that in SAP group (41.99% (152/362) vs. 18.24% (31/170)), and the rate of calcified plaque detection was significantly lower than that in the SAP group (38.12% (138/362) vs. 61.76% (105/170)) (χ2=28.92 and 26.06, both P<0.01). Among the 89 patients in the UAP group, 25 patients had cardiovascular events, including 5 cases of heart failure, 5 cases of acute myocardial infarction, and 15 cases of recurrent UAP. The rate of soft plaque detection in patients with poor prognosis in the UAP group was significantly higher than that in patients with good prognosis (72.73% (80/110) vs. 28.57% (72/252), χ2=61.29, P<0.05), and the rate of calcified plaque detection was significantly lower than that in patients with good prognosis (7.27% (8/110) vs. 51.59% (130/252), χ2=63.75, P<0.05). Among the 50 patients in the SAP group, 5 patients had cardiovascular events, including 1 case of acute myocardial infarction and 4 cases of UAP. The rate of soft plaque detection in patients with poor prognosis in the SAP group was significantly higher than that in patients with good prognosis (57.89% (11/19) vs. 13.25% (20/151), χ2=22.57, P<0.05), and the rate of calcified plaque detection was significantly lower than that in patients with good prognosis (21.05% (4/19) vs. 66.89% (101/151), χ2=15.01, P<0.05). Conclusion Coronary CT angiography can effectively assess the nature of plaque and predict the prognosis of patients.
2020, 44(12): 775-779.
doi: 10.3760/cma.j.cn121381-201908004-00097
Abstract:
Gastric cancer is one of the commonest malignant tumors in the world. The application of 18F-fluorodeoxyglucose (FDG) PET/CT in gastric cancer has both advantages and limitations. 18F-FDG uptake in primary gastric cancer is closely related to cancer staging, histological classification and tumor size. Positive 18F-FDG uptake in early gastric cancer often indicates the incurability of endoscopic submucosal dissection. Maximum standardized uptake value (SUVmax) of advanced gastric cancer is significantly different between intestinal type and signet ring cell carcinoma (SRC) or diffuse type gastric cancer; SUVmax of SRC is negatively correlated with the overall survival time and disease-free survival time of patients. The sensitivity of 18F-FDG PET/CT for regional lymph node metastasis is low, but the specificity is high. Regional lymph nodes with positive 18F-FDG uptake indicate poor prognosis. 18F-FDG PET/CT can detect occult distant metastases (7.2%~10.0%), most of which (4.7%~8.8%) cannot be detected by laparoscopy. Routine application of 18F-FDG PET/CT combined with laparoscopy is of great significance in determining the staging of gastric cancer.
Gastric cancer is one of the commonest malignant tumors in the world. The application of 18F-fluorodeoxyglucose (FDG) PET/CT in gastric cancer has both advantages and limitations. 18F-FDG uptake in primary gastric cancer is closely related to cancer staging, histological classification and tumor size. Positive 18F-FDG uptake in early gastric cancer often indicates the incurability of endoscopic submucosal dissection. Maximum standardized uptake value (SUVmax) of advanced gastric cancer is significantly different between intestinal type and signet ring cell carcinoma (SRC) or diffuse type gastric cancer; SUVmax of SRC is negatively correlated with the overall survival time and disease-free survival time of patients. The sensitivity of 18F-FDG PET/CT for regional lymph node metastasis is low, but the specificity is high. Regional lymph nodes with positive 18F-FDG uptake indicate poor prognosis. 18F-FDG PET/CT can detect occult distant metastases (7.2%~10.0%), most of which (4.7%~8.8%) cannot be detected by laparoscopy. Routine application of 18F-FDG PET/CT combined with laparoscopy is of great significance in determining the staging of gastric cancer.
2020, 44(12): 780-785.
doi: 10.3760/cma.j.cn121381-201910002-00108
Abstract:
Autonomously functioning thyroid nodule (AFTN) is a predominantly benign neoplasm presenting in thyroid gland. AFTN can cause a range of functional abnormalities, from euthyroidism to subclinical hyperthyroidism (pre-toxic nodule stage) and overt hyperthyroidism (toxic nodule stage). The treatment methods include surgery treatment, 131I therapy, radiofrequency ablation treatment, etc. This paper reviews the progress in diagnosis and treatment of AFTN and the special clinical conditions (such as malignant nodules, Marine-Lenhart syndrome, Graves hyperthyroidism induced by 131I therapy, etc.) to provide a basis for further clinical application.
Autonomously functioning thyroid nodule (AFTN) is a predominantly benign neoplasm presenting in thyroid gland. AFTN can cause a range of functional abnormalities, from euthyroidism to subclinical hyperthyroidism (pre-toxic nodule stage) and overt hyperthyroidism (toxic nodule stage). The treatment methods include surgery treatment, 131I therapy, radiofrequency ablation treatment, etc. This paper reviews the progress in diagnosis and treatment of AFTN and the special clinical conditions (such as malignant nodules, Marine-Lenhart syndrome, Graves hyperthyroidism induced by 131I therapy, etc.) to provide a basis for further clinical application.
2020, 44(12): 786-795.
doi: 10.3760/cma.j.cn121381-201912038-00099
Abstract:
The small ubiquitin-like modifications regulated by small-like modifier specific protease (SENPs) plays an important role in the regulation of radiosensitivity, and inhibition of SENPs will increase the radiosensitivity of tumor cells. According to reports, SENPs regulates the radiosensitivity of tumor cells by participating in DNA damage repair, altering cell cycle distribution and regulating signal pathways. At present, SENP1-based SENPs inhibitors are mainly divided into several types including small hairpin RNA, peptides and peptidomimetics, synthetic small molecules, compounds derived from virtual screening and natural products. SENPs inhibitors can be used as new types of radiosensitizers, which need to be further optimized and developed. In this review, we discuss the potential mechanisms of SENPs regulating radiosensitivity and the research progress of its inhibitors to lay a theoretical foundation for the subsequent development of SENPs inhibitors as radiosensitizers.
The small ubiquitin-like modifications regulated by small-like modifier specific protease (SENPs) plays an important role in the regulation of radiosensitivity, and inhibition of SENPs will increase the radiosensitivity of tumor cells. According to reports, SENPs regulates the radiosensitivity of tumor cells by participating in DNA damage repair, altering cell cycle distribution and regulating signal pathways. At present, SENP1-based SENPs inhibitors are mainly divided into several types including small hairpin RNA, peptides and peptidomimetics, synthetic small molecules, compounds derived from virtual screening and natural products. SENPs inhibitors can be used as new types of radiosensitizers, which need to be further optimized and developed. In this review, we discuss the potential mechanisms of SENPs regulating radiosensitivity and the research progress of its inhibitors to lay a theoretical foundation for the subsequent development of SENPs inhibitors as radiosensitizers.
2020, 44(12): 796-798.
doi: 10.3760/cma.j.cn121381-201912037-00092
Abstract:
A case of hepatic epithelioid hemangioendothelioma with 18F-FDG PET/CT whole-body imaging was reported. The characteristics of the disease were analyzed from clinical symptoms, laboratory and pathological examination, and imaging, and were understood through literature review. The disease has an extremely low incidence and the clinical manifestations are lack of specificity. It is not easy to be found in the early stage. It is difficult to be distinguished from common liver tumors, and easy to be misdiagnosed. The prognosis of the disease is poor. It is recognized at present that the most effective treatment is liver transplantation or radical resection.
A case of hepatic epithelioid hemangioendothelioma with 18F-FDG PET/CT whole-body imaging was reported. The characteristics of the disease were analyzed from clinical symptoms, laboratory and pathological examination, and imaging, and were understood through literature review. The disease has an extremely low incidence and the clinical manifestations are lack of specificity. It is not easy to be found in the early stage. It is difficult to be distinguished from common liver tumors, and easy to be misdiagnosed. The prognosis of the disease is poor. It is recognized at present that the most effective treatment is liver transplantation or radical resection.
2020, 44(12): 799-802.
doi: 10.3760/cma.j.cn121381-201910012-00103
Abstract:
A case of triple hyperparathyroidism with giant parathyroid adenoma showed by 99Tcm-MIBI SPECT/CT imaging was reported. The characteristics of the disease were analyzed from clinical symptoms, laboratory examinations, and imaging tests. Triple hyperparathyroidism(HPT), which is common in dialysis patients with chronic renal insufficiency, was deeply analyzed through literature review. The parathyroid glands are stimulated by hypocalcemia for a long time, and some tissues proliferate and turn into adenomas with autocrine function. The incidence of triple HPT is low, and the effect of medical treatment is poor. Timely 99Tcm-MIBI SPECT/CT imaging can be further qualitative and localized to facilitate the selection of appropriate treatment options.
A case of triple hyperparathyroidism with giant parathyroid adenoma showed by 99Tcm-MIBI SPECT/CT imaging was reported. The characteristics of the disease were analyzed from clinical symptoms, laboratory examinations, and imaging tests. Triple hyperparathyroidism(HPT), which is common in dialysis patients with chronic renal insufficiency, was deeply analyzed through literature review. The parathyroid glands are stimulated by hypocalcemia for a long time, and some tissues proliferate and turn into adenomas with autocrine function. The incidence of triple HPT is low, and the effect of medical treatment is poor. Timely 99Tcm-MIBI SPECT/CT imaging can be further qualitative and localized to facilitate the selection of appropriate treatment options.
Submit
Author Login
Referees
Editor-in-Chief
Editor Center
Email alert
RSS
