2020 Vol. 44, No. 7
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2020, 44(7): 405-410.
doi: 10.3760/cma.j.cn121381-201903062-00054
Abstract:
Objective To evaluate the impact of CT attenuation correction (CTAC) on intelligence quotient (IQ)-SPECT/CT and low energy high resolution (LEHR)- SPECT/CT myocardial perfusion imaging (MPI). Methods Thirty-one patients (21 males and 10 females, aged 49.4 ± 12.01 years) with confirmed or suspected coronary heart disease were subjected to resting MPI from May 2018 to Octorber 2018 in the First Hospital of Shanxi Medical University. All patients were subjected to IQ-SPECT/CT+CTAC and LEHR-SPECT/CT+CTAC on the same day. The visual analysis and myocardial uptake of five myocardial segments (apical, anterior, lateral, inferior, and septal walls) were compared before and after IQ-SPECT/CT CTAC and after manual coordination, as well as before and after LEHR-SPECT/CT CTAC. Paired t test was used for comparison between the two groups. Chi-square test was used to compare the rate. Kappa test was used for consistency analysis. Results (1) Visual analysis results were as follows. The IQ group was compared with the LEHR group without CTAC. Two nuclear medicine physicians were double blind and had high agreement (Kappa value = 0.795, P<0.001). The sparse rate of myocardial segments of the IQ group was 77% (24/31), which was much higher than that of the LEHR group by 23% (7/31) ( χ2=16.52, P<0.001). Owing to the high sparse rate myocardial segments of IQ, the original image and manual reregistration the MPI and CT images were analyzed. After re-coordination, the distribution of apical in the IQ group was found to be sparse (16%, 5/31), and the difference between the LEHR group (23%, 7/31) was not statistically significant (χ2=0.103, P=0.748). (2) Results of myocardial uptake were as follows. Compared with the previous IQ-CTAC, the myocardial uptake values of the apical wall [(65.71±25.69)% vs.(58.68±20.39)%], anterior wall[ (204.23±43.24)% vs.(184.66±41.22)%], and septal wall [ (316.19±47.43)% vs. (270.03±65.33)% ] significantly decreased after CTAC(t=4.014, 4.232, and 5.473, respectively; all P<0.05). Meanwhile, myocardial uptake increased in anterior wall [ (204.68±41.14) % vs. (211.81±35.04)%], septal wall[ (319.13±44.90)% vs.( 350.87±44.24)%], and inferior wall [(185.48±31.06)% vs.( 228.67±29.45)% ] of the LEHR group after CTAC(t=−2.471, P=0.019; t=−5.968, P<0.001; and t=−11.311, P<0.001, respectively). After IQ registration, compared with previous CTAC, the myocardial uptake values of anterior wall [(212.06±33.59)% vs. (204.23±43.24)%], lateral wall [(372.84±39.37)% vs. (355.81±46.79)%], inferior wall [(219.13±25.10)% vs. (191.58±33.06)%], and septal wall [(335.00±36.84)% vs. (316.19±47.43)%] obviously increased (t=−2.497, P=0.018; t=2.672, P=0.012; t=−7.632, P<0.001 and t=−3.557, P<0.001, respectively). Conclusions The distribution of inferior and inferior walls of LEHR-SPECT/CT CTAC was compensated, whereas the distribution of apical, anterior, and septal walls became sparse after IQ-SPECT/CT CTAC. In the IQ-SPECT/CT acquisition mode, overcorrection likely occurred after CTAC, and this situation was significantly improved after re-coordination.
2020, 44(7): 411-415.
doi: 10.3760/cma.j.cn121381-201903010-00049
Abstract:
Objective To investigate the diagnostic value of 99Tcm-MDP SPECT whole-body bone scan and local SPECT/CT tomography fusion imaging for insufficiency fracture (IF). Methods Ninety patients (including 32 males and 58 females, aged 67.56±7.68, 22 cases with suspected IF, 68 cases with confirmed local IF) who were either diagnosed with IF in their partial skeleton or suspected to suffer from IF were enrolled in this study. The diagnostic value of 99Tcm-MDP SPECT whole-body bone scan and local SPECT/CT tomography fusion imaging for IF were retrospectively analyzed. The correct diagnosis were confirmed by clinical assessment and over 6 months of imaging follow-up. Results A total of 234 lesions were detected in 90 patients by 99Tcm-MDP SPECT whole-body bone scan, which showed high radioactivity in all lesions. The common sites of the lesions were the pelvis (78 lesions), lumbar vertebrae (49 lesions), thoracic vertebrae (46 lesions), ribs (45 lesions), femur (8 lesions), tibia (4 lesions), calcaneus (3 lesions), and sternus (1 lesion). The sensitivity of 99Tcm-MDP whole-body bone scan and local SPECT/CT tomography fusion imaging for IF was 100% (234/234). A greater number of lesions were determined in approximately 68.89% (62/90) of the patients by combined imaging than the lesions which were confirmed as IF before combined imaging. A total of 293 fractures were identified in the scope of CT examination; of these, 234 were diagnosed as acute fractures and 59 were diagnosed as chronic fractures by SPECT/CT. The diagnostic sensitivity of SPECT/CT toward acute IF was 100% (234/234). Conclusion 99Tcm-MDP SPECT whole body-bone scan and local SPECT/CT fusion imaging has high clinical value in the systemic display and diagnosis of IF in patients with osteoporosis.
2020, 44(7): 416-421.
doi: 10.3760/cma.j.cn121381-201904020-00053
Abstract:
Objective To investigate the correlations among standardized uptake value (SUV), CT value, maximum transverse diameter of normal prostate, and patient age through 18F-fluorodeoxyglucose (FDG) PET/CT. Methods Retrospective analysis of 181 male patients aged 19–94 (60.6±14.5) years who underwent 18F-FDG PET/CT in the Second Hospital of Anhui Medical University from June 2018 to February 2019 was performed. The patients were divided into four groups by age group (19–39 years, 16 cases; 40–59 years, 57 cases; 60–79 years, 94 cases; and 80–99 years, 14 cases). The maximum standardized uptake value (SUVmax), mean standardized uptake value (SUVmean), and mean CT value (CTmean) of prostate 18F-FDG were measured through a delineated region of interest method, and the maximum transverse diameter of the prostate was measured at the maximum transverse plane of the prostate. SPSS 16.0 statistical software was used in analyzing the correlations among the maximum transverse diameter of the prostate, SUVmax, SUVmean, CTmean, and age on the basis of the Pearson correlation coefficient, scatter plot, and linear regression trend line. One-way ANOVA and LSD-t test were used for each parameter. Results The maximum transverse diameter of the normal prostate was 3.4–6.5(4.66±0.59) cm, SUVmax was 1.0–4.2 (2.44±0.49), SUVmean was 0.7–3.4(1.97±0.44), CTmean was 25–46(34.5±3.72) HU. The maximum transverse diameter of the prostate was positively correlated with age (r=0.465, P<0.001). No significant correlation between prostate SUVmax, SUVmean and age, the maximum transverse diameter of the prostate (r=0.047, 0.071, 0.040, 0.035, all P>0.05). Prostate CTmean increased with age, and an extremely weak correlation or no correlation was observed between them (r=0.126, P=0.091). The maximum transverse diameters of all the age groups (19–39, 40–59, 60–79, and 80–99 years) were (4.04±0.27), (4.52±0.53), (4.77±0.54), and (5.24±0.65) cm, respectively, the SUVmax were 2.48±0.65, 2.38±0.50, 2.46±0.47, 2.48±0.42, respetively; the SUVmean were 2.03±0.51, 1.90±0.44, 2.00±0.42, and 2.05±0.41, respectively; and the CTmean were (33.25±3.59), (34.19±3.76), (34.76±3.80), and (35.29±2.97) HU, respectively. Significant differences were found among the maximum transverse diameters of the age groups (F=16.278, P<0.001), whereas no significant difference was found among SUVmax, SUVmean, and CTmean. Conclusion The maximum transverse diameter of the prostate increases with age, but age does not significantly affect the glucose metabolism and CT density of the prostate.
2020, 44(7): 422-428.
doi: 10.3760/cma.j.cn121381-201906010-00058
Abstract:
Objective To investigate the correlation between tumor uptake target to normal tissue ratio (TNR) obtained from breast-specific gamma imaging (BSGI) and the pathology of breast cancer. Methods A total of 84 female patients aged 30−76(53.2±13.1) years who had visited Guizhou Provincial People's Hospital with a diagnosis of invasive ductal carcinoma and who underwent preoperative BSGI were retrospectively enrolled from April 2016 to August 2017. The BSGI images of these patients were visually scored from 1 to 5 according to a breast imaging reporting and data system (BIRADS). The TNR results obtained from positive BSGI images were compared in terms of breast cancer pathology. T test and chi-square test were used for the comparison of positive and negative results, and analysis of variance was used for the comparison of pathological subtypes among multiple groups.Multiple regression analysis was performed using histologic factors; significant, independent factors were determined by P values less than 0.05 in the univariate analysis. The correlations between TNR and histopathologic factors were analyzed by Pearson’s correlation coefficient. Results Among 84 images, 75 were classified with positive findings (sensitivity 89.3%, 75/84). A higher TNR value was significantly correlated with tumor size (t=4.13, P<0.01), axillary lymph node metastasis (χ2=5.04, P=0.005), histologic grade(HG) (F=11.05, P=0.034), progestrone receptor(PR) status (χ2=3.12, P=0.041), and Ki-67 (χ2=16.20, P=0.008). Multivariate analysis revealed that the pathological risk factors of breast cancer are related to tumor size tumor size≥2 cm, axillary lymph node metastasis, and negative PR status ( Conclusion High TNRs in BSGI imaging may be associated with the adverse pathological factors of breast cancer.This parameter may could be a valuable prognostic indicator of breast cancer.
2020, 44(7): 429-434.
doi: 10.3760/cma.j.cn121381-202001026-00044
Abstract:
Objective To analysis the changes in the magnetic susceptibility of substantia nigra(SN) and red nucleus(RN) in midbrain in Parkinson disease (PD), and determine the value of MR quantitative susceptibility mapping (QSM) in the clinical diagnosis of PD. Methods A total of 39 PD patients (PD group) who were hospitalized in the First People's Hospital of Foshan from February 2017 to August 2019, including 17 males and 22 females, aged 47−80 (65.44±9.78) years old, were divided into early PD group (n=23) and progress PD group (n=16) according to improved Hoehn-Yahr classification. And 20 normal controls were selected. All were scanned by QSM technique, and the magnetic susceptibility of SN and RN were measured. The independent sample t test was used to analyze the change of magnetic susceptibility of SN and RN in PD patients, which were analysis with the clinical diagnosis, grading and course of PD perform with Pearson correlation analysis. Univariate analysis was used to analyze the relationship between the magnetic susceptibility of bilateral SN and RN with the symptom of physical movement disorder. Results The magnetic susceptibility value of the SN and RN in the PD group are significantly increase compared with control group ((0.073±0.017) ×10−3 vs. (0.058±0.028) ×10−3; (0.094±0.020) ×10−3 vs. (0.072±0.035) ×10−3), the difference is statistically significant (t=−2.125, P=0043; t=−2.605, P=0.015). No significant correlation among the magnetic susceptibility of SN and RN and the Hoehn-Yahr classification (r=0.051, P=0.759; r=0.045, P=0.788), but the magnetic susceptibility of SN was positively correlated with the course of the disease (r=0.420, P=0.008), while not the RN (r=0.241, P=0.130). There was no significant difference among the magnetic susceptibility of SN and RN on the left or right sides of the midbrain in the PD group, and the symptoms of limb movement disorder during clinical onset (SN: FL=0.661, PL=0.421; FR=1.153, PR=0.290. RN: FL=0.006, PL=0.940; FR=0.109, PR=0.743). Conclusions QSM technology can indirectly reflect the iron deposition in the brain by measure the magnetic susceptibility of SN and RN in midbrain. It is valuable for the diagnosis and assessing the course of PD.
2020, 44(7): 435-440.
doi: 10.3760/cma.j.cn121381−201903036−00057
Abstract:
Objective To explore the expression of long non-coding RNA (lncRNA) urothelial carcinoembryonic antigen 1 (UCA1) in lung adenocarcinoma A549 cells and its influence on key enzymes involved in sugar metabolism, cell invasion, and metastasis. Methods The lncRNA UCA1 silencing and its control stable transfected lung adenocarcinoma A549 cells were constructed, the small interfering RNA (siRNA) transfected cells were divided into NC group (negative control group, transfected with siRNA-UCA1 sequence) and siRNA-UCA1 group (transfected with siRNA-UCA1 knockdown sequence). Quantitative real-time PCR and Western blot analyses were used to detect changes in the levels of glucose transporter protein (GLUT)1, hexokinase (HK)2 and pyruvate kinase isozymes M (PKM)2 related to glucose metabolism. Transwell and scratch tests were conducted to detect the invasion and migration ability of siRNA-UCA1. 18F-Fluorodeoxyglucose (FDG) uptake experiment was used to detect the uptake rate of siRNA-UCA1. T test was used to compare the measurement data. Results UCA1 was highly expressed in lung adenocarcinoma A549 cell line. Compared with the NC group, the siRNA-UCA1 group can inhibit the expression of GLUT1, HK2, and PKM2 in lung adenocarcinoma A549 cells (t=19.66, 5.81, 11.98; all P<0.001), and the protein expression levels of the three significantly decreased (t=61.35, 145.90, 88.19; all P<0.001). Compared with the NC group, the siRNA-UCA1 group's migration ability and 18F-FDG uptake rate of A549 cells were significantly reduced (t=19.43, 7.71, 5.79; all P<0.05). Conclusions LncRNA UCA1 can affected the key enzymes of glucose metabolism and promoted the metastasis ability of lung adenocarcinoma. Thus, lncRNA UCA1 may be a new diagnostic index and therapeutic target for lung cancer.
2020, 44(7): 441-446.
doi: 10.3760/cma.j.cn121381-202003014-00051
Abstract:
Radionuclides produced by nuclear medical experiments, nuclear medicine treatment and nuclear accidents are inevitably released into the natural environment such as water and soil, causing great damage to the environment and the genetic, immune, skeletal and nervous systems of the human body. With excellent surface properties and magnetic responsiveness, magnetic nano-adsorption materials are widely used in the removal of radionuclides from water. In this paper, the research progress of the magnetic nanomaterials for removing radionuclides from water is reviewed.
Radionuclides produced by nuclear medical experiments, nuclear medicine treatment and nuclear accidents are inevitably released into the natural environment such as water and soil, causing great damage to the environment and the genetic, immune, skeletal and nervous systems of the human body. With excellent surface properties and magnetic responsiveness, magnetic nano-adsorption materials are widely used in the removal of radionuclides from water. In this paper, the research progress of the magnetic nanomaterials for removing radionuclides from water is reviewed.
2020, 44(7): 447-452.
doi: 10.3760/cma.j.cn121381-201904034-00047
Abstract:
As a new multimodal imaging technology, PET/MR combines the ability of MRI and its various functional imaging parameters to obtain excellent and highly sensitive soft tissue contrast and the capability of PET to quantify radiotracer metabolism. Via simultaneous scanning, this combined method achieves PET images and allows the examination of fine anatomical structures through MRI. The effectiveness of this combined method is increasingly explored in diagnosing cardiovascular diseases. This review summarizes the advantages and limitations of PET/MR in diagnosing cardiovascular diseases and discusses its potential clinical applications.
As a new multimodal imaging technology, PET/MR combines the ability of MRI and its various functional imaging parameters to obtain excellent and highly sensitive soft tissue contrast and the capability of PET to quantify radiotracer metabolism. Via simultaneous scanning, this combined method achieves PET images and allows the examination of fine anatomical structures through MRI. The effectiveness of this combined method is increasingly explored in diagnosing cardiovascular diseases. This review summarizes the advantages and limitations of PET/MR in diagnosing cardiovascular diseases and discusses its potential clinical applications.
2020, 44(7): 453-458.
doi: 10.3760/cma.j.cn121381-201907022-00045
Abstract:
18F-FDG PET/CT has been widely used as a powerful tool for the diagnosis and differential diagnosis of cardiac tumors. This article focuses on the research evidence of 18F-FDG PET/CT applied in cardiac tumors from four aspects: positioning diagnosis, qualitative diagnosis, efficacy evaluation and imaging technology optimization, achieving the goal of systematical evaluation of the method.
18F-FDG PET/CT has been widely used as a powerful tool for the diagnosis and differential diagnosis of cardiac tumors. This article focuses on the research evidence of 18F-FDG PET/CT applied in cardiac tumors from four aspects: positioning diagnosis, qualitative diagnosis, efficacy evaluation and imaging technology optimization, achieving the goal of systematical evaluation of the method.
2020, 44(7): 459-464.
doi: 10.3760/cma.j.cn121381-202003014-00055
Abstract:
With the increasing use of nuclear and radiation in people's daily life, the harm caused by radiation has also received much attention. Dose estimation is an important part of the application of radiation technology. Estimating the radiation dose received by the human body plays an important role in determining the deterministic and random effects of radiation. Monte Carlo simulation combined with the human reference model can estimate radiation doses of nuclear accidents, medical exposures and environmental radiation. It is a fast and low-hardware dose estimation method. Currently, it faces bottlenecks in model development and calculation. This artical reviews the research progress.
With the increasing use of nuclear and radiation in people's daily life, the harm caused by radiation has also received much attention. Dose estimation is an important part of the application of radiation technology. Estimating the radiation dose received by the human body plays an important role in determining the deterministic and random effects of radiation. Monte Carlo simulation combined with the human reference model can estimate radiation doses of nuclear accidents, medical exposures and environmental radiation. It is a fast and low-hardware dose estimation method. Currently, it faces bottlenecks in model development and calculation. This artical reviews the research progress.
2020, 44(7): 465-469.
doi: 10.3760/cma.j.cn121381-201905022-00052
Abstract:
A special feature of the case reported in this paper is that no definite primary lesion was found by pathology after total thyroidectomy and neck lymph-node dissection. PET/CT examination and whole-body 131I scan after radioiodine therapy revealed a left iliac bone lesion, which was resected accordingly. In addition to the pathological confirmation of another bone metastasis of papillary thyroid carcinoma, 131I therapy and regular thyroid-stimulating hormone-suppression therapy were performed again. Regarding the diagnosis and treatment process, the diagnosis was constantly updated and the targeted treatment plan was prepared. Finally, effectively treatment on the patients was achieved.
A special feature of the case reported in this paper is that no definite primary lesion was found by pathology after total thyroidectomy and neck lymph-node dissection. PET/CT examination and whole-body 131I scan after radioiodine therapy revealed a left iliac bone lesion, which was resected accordingly. In addition to the pathological confirmation of another bone metastasis of papillary thyroid carcinoma, 131I therapy and regular thyroid-stimulating hormone-suppression therapy were performed again. Regarding the diagnosis and treatment process, the diagnosis was constantly updated and the targeted treatment plan was prepared. Finally, effectively treatment on the patients was achieved.
2020, 44(7): 470-472.
doi: 10.3760/cma.j.cn121381-202001017-00048
Abstract:
This paper reports a case of recurrent endolymphatic sac tumor after subtotal resection, which was initially diagnosed as papillary sweat adenoma. The CT and MRI characteristics, clinical manifestations and pathological morphology of the tumor were analyzed, and the relevant literature was reviewed. The imaging manifestations were mainly summarized in order to improve the understanding of the tumor by radiologists and clinicians.
This paper reports a case of recurrent endolymphatic sac tumor after subtotal resection, which was initially diagnosed as papillary sweat adenoma. The CT and MRI characteristics, clinical manifestations and pathological morphology of the tumor were analyzed, and the relevant literature was reviewed. The imaging manifestations were mainly summarized in order to improve the understanding of the tumor by radiologists and clinicians.
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