2020 Vol. 44, No. 8
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2020, 44(8): 0-0.
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2020, 44(8): 1-4.
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2020, 44(8): 475-479.
doi: 10.3760/cma.j.cn121381-201906023-00059
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Objective To investigate the relationship between the maximum standardized uptake value (SUVmax) of preoperative 18F-FDG PET/CT and the World Health Organization (WHO) pathological classification and Masaoka stage of thymic epithelial tumors. Methods A total of 40 patients (14 males and 26 females ranging in age from 32 years to 79 years) was retrospectively reviewed with histologically proven thymic epithelial tumors who underwent 18F-FDG PET/CT before surgical resection at the First Affiliated Hospital of Nanjing Medical University from September 2007 to March 2019. SUVmax was measured. The patients were divided into three groups in accordance with a simplified pathological classification scheme WHO (2015): low-risk thymomas (types A, AB, and B1), high-risk thymomas (types B2 and B3), and thymic carcinomas (type C). In addition, all tumors were divided into three groups on the basis of the Masaoka stage: stages Ⅰ, Ⅱ, and Ⅲ. The area under the curve (AUC) calculated via receiver operating characteristic (ROC) curve analysis was used to estimate the best value of SUVmax that was capable of discriminating thymomas from thymic carcinomas. Groups were compared by using the Mann-Whitney test or Kruskal-Wallis test. Results A total of 11 low-risk thymomas (1 type A, 4 type AB, and 6 type B1), 15 high-risk thymomas (10 type B2 and 5 type B3), and 14 thymic carcinomas were identified. Eight, 17, and 15 patients were in Masaoka stages Ⅰ, Ⅱ, and Ⅲ, respectively. The median SUVmax value was 3.78 for low-risk thymomas, 5.21 for high-risk thymomas, and 10.44 for thymic carcinomas and was significantly different among groups (Z=3.088, −3.928, 4.106; all P<0.01), the difference in SUVmax between the 3 groups is statistically significant (χ2=26.716, P<0.01). The values for Masaoka stages Ⅰ, Ⅱ, and Ⅲ were 3.74, 5.14, and 10.08, respectively, and showed significant differences when compared with each other (Z=2.680, 3.679, −3.644; all P<0.01), the difference in SUVmax between the 3 groups is statistically significant (χ2=22.295, P<0.01) . The results of ROC curve analysis showed that the AUC of SUVmax was 0.953 (95% confidence interval: 0.891–1.000, P<0.01). SUVmax=6.81 was the best threshold for the differential diagnosis of thymomas and thymic carcinomas. Conclusions SUVmax measured by 18F-FDG PET/CT had a good correlation with the pathological classification and Masaoka stage of thymic epithelial tumors. Therefore, it can provide reference value for planning clinical treatment.
2020, 44(8): 480-485.
doi: 10.3760/cma.j.cn121381-201905031-00063
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Objective To investigate the correlation between findings from 18F-fluorodeoxyglucose (FDG) PET/CT and pathology of gastric cancer. Methods A retrospective analysis was performed on data collected from 101 patients with gastric cancer, including 73 males and 28 females, aged 25−81 ( 59.74±11.39) years old, who underwent PET/CT examination and surgical treatment in Fujian Provincial Cancer Hospital from October 2011 to June 2016. Maximum standardized uptake value (SUVmax) in primary lesion, thickness of primary lesions, and lymph node metastasis in PET/CT were recorded. According to gender, age, location of primary lesion, length of primary lesion, pathological type and differentiation degree of primary lesion, TNM (tumor, node, metastasis) stage and clinical stage. Independent sample t test and one-way ANOVA were used to evaluate the difference in SUVmax between each group. Pearson correlation analysis was employed to examine the relationship between SUVmax and the size of primary lesion. Indices with statistical differences were included in multivariate Logistic regression analysis to evaluate the relationship between lymph node metastasis and each factor. Results Difference of SUVmax in length (<4 cm: 3.774±1.062, 4 cm≤D<8 cm: 6.552±3.695, ≥8 cm: 5.592±2.305), location (gastric fundus and cardia: 7.157±4.425, gastric body: 4.710±2.010, gastric antrum: 6.137±3.069), and pathological type of gastric cancer (signet ring cell carcinoma: 4.176±1.724, non-signet ring cell carcinoma: 5.998±3.295) were statistically significant (t=7.022, P=0.001; t=5.564, P=0.005; t=2.212, P=0.029). The results of Pearson correlation analysis showed that SUVmax was positively correlated with the length, width and thickness of gastric cancer (r=0.209, P=0.036; r=0.245, P=0.013; r=0.359, P<0.001). The sensitivity, specificity and accuracy of PET/CT in the diagnosis of lymph node metastasis of gastric cancer were 71.3% (57/80), 81.0% (17/21) and 73.3% (74/101), respectively. The result of multivariate Logistic regression analysis showed that T stage is an independent correlation factor for lymph node metastasis (OR=12.648, 95%CI=3.905−40.961, P<0.001). Conclusions The SUVmax of primary gastric cancer lesion is related to size, location, and pathological type. T stage is an independent predictor of lymph node metastasis.
2020, 44(8): 486-492.
doi: 10.3760/cma.j.cn121381-201903057-00064
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Objective To explore the relationship between comprehensive information of gliomas and O6-methylguanylmethyltransferase (MGMT) promoter methylation status non-invasively by analyzing radiomic features of multi-modality 18F-fluorodeoxyglucose (FDG) PET/CT images. The response to temozolomide (TMZ) was determined through the abovementioned method for the clinical management of glioma patients. Methods A retrospective study of 17 patients (13 males and 4 females) with glioma confirmed by histopathological results in the First Medical Center of General Hospital of Chinese PLA from January 2016 to September 2018 was conducted. Preoperative 18F-FDG PET/CT scanning was performed. Radiomic texture analysis was performed after manually delineating the volume of interest. MGMT promoter methylation was examined by pyrosequencing analysis. MGMT data were categorized according to the methylation status, i.e., methylated and unmethylated groups. Two independent sample t-tests were used to analyze the differences in imaging omics parameters between the two groups of data. Results Among the 17 patients with glioma, 9 (52.9%) had MGMT unmethylation and 8 (47.1%) had MGMT methylation. Between the methylated group and the unmethylated group, there was no significant difference in patient age or tumor grade (t=−0.251, −0.016, P=0.806, 0.198); The difference between genders was statistically significant Meaning (t=−1.426, P=0.031). Both the SUVmax and TNRmax values of the MGMT methylated group were significantly higher than those of the MGMT unmethylated group (SUVmax: 18.83±7.77 vs. 9.66±4.13; t=−3.095, Conclusion The features (SUVmax and TNRmax) of 18F-FDG PET/CT images are two key indicators in the detection of MGMT methylation status in gliomas and are valuable predictors of the clinical responses of patients scheduled to receive TMZ chemotherapeutics.
2020, 44(8): 493-498.
doi: 10.3760/cma.j.cn121381-201905011-00065
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Objective To investigate whether vitamin D deficiency is involved in Graves disease (GD) occurrence and development and whether vitamin D supplementation can improve the efficacy of 131I in GD treatment. Methods A retrospective analysis was conducted on 200 GD patients in the nuclear medicine department of Qingdao Municipal Hospital from January 2017 to June 2018. The study included 60 males and 140 females aged 13–78 (42.1±12.1) years old. Two hundred patients with GD were divided into two groups, namely, GD1 group (100 cases) and GD2 group (100 cases) by random remainder grouping method, and 200 normal healthy people were selected to serve as the control. The levels of thyroid stimulating hormone (TSH), free triiodothyronine (FT3), free thyroxine (FT4), thyrotrophin receptor antibody (TRAb), thyroglobulin antibody (TgAb), thyroid peroxidase antibody (TPOAb), and 25-(OH)D3 in GD group and control group were detected before treatment. After 12 months, the levels of TRAb, TgAb, TPOAb and 25-(OH)D3 were reexamined. Two independent samples were compared by t-test. Paired samples were compared by t-test. Spearman rank correlation analysis was used. The effective rates of GD1 and GD2 groups were compared by χ2 test. Results Before treatment, the level of 25-(OH)D3 in GD group was (29.32±12.43) nmol/L, and that of normal control group was (51.46±25.92) nmol/L. The vitamin D level of GD group was lower than that of normal control group, and the difference was statistically significant (t=−18.106, P<0.01). Serum 25-(OH)D3 level was negatively correlated with TRAb, FT3, FT4, TgAb, and TPOAb levels (r=−0.688~−0.219, all P<0.05), and positively correlated with TSH level (r=0.259, P<0.05). Twelve months after treatment, the serum 25-(OH)D3 level in GD2 group [(44.68±17.45) nmol/L] was higher than that in GD1 group [(29.86±12.78) nmol/L], and the difference between the two groups before and after treatment was statistically significant (t=−7.920, P<0.01). The levels of TRAb, TgAb, and TPOAb in GD2 group were (1.96±1.52) IU/L, (106.78±76.37) IU/mL, and (59.74±37.26) IU/mL, while in GD1 group were (3.12±1.80) IU/L, (146.33±103.81) IU/mL, and (100.41±63.11) IU/mL, respectively. The difference between the two groups before and after treatment was statistically significant (t=−8.767, −4.106, −7.259, all P<0.01). Twelve months after treatment, the effective rate of GD1 group was 63% (63/100), whereas that of GD2 group was 78% (78/100). The difference between the two groups was statistically significant (χ2=5.409, P=0.020). Conclusion Vitamin D deficiency may be involved in GD development. Vitamin D supplementation may improve the efficacy of 131I in GD treatment.
2020, 44(8): 499-506.
doi: 10.3760/cma.j.cn121381-201904004-00061
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Objective To investigate the alteration of baseline brain activity levels in first-episode depressive disorder patients by the amplitude of low frequency fluctuation (ALFF) and fractional amplitude of low frequency fluctuation (fALFF) based on the resting state functional magnetic resonance imaging (rs-fMRI). The correlations between the scores of HAMD-17 and the abnormal brain regions of ALFF and fALFF were analyzed. Methods Seventeen first-episode depressive patients (depression group: 5 males and 12 females, aged 19−54 years old) and 17 normal volunteers (control group: 8 males and 9 females, aged 20−58 years old) awere enrolled. Demographic data and HAMD-17 scores of the two groups were collected and analyzed by retrospective analysis, and rs-fMRI scanning was performed on the two groups. Based on the MATLAB R2017a platform, ALFF and fALFF methods were used to analyze the resting state scanning data. The ALFF and fALFF values of the two groups were compared by using DPABI v4.3 statistical software. The brain regions with statistically significant differences between the two groups were extracted by REST1.8 software. SPSS19.0 was used to analyze the demographic data. Two independent samples t-test was used for continuous variables with normal distributions. Pearson correlation analysis was performed between these brain regions and HAMD-17 scores. Results Compared with the control group, the depressive disorder patients of depression group had decreased ALFF in the right anterior cingulate (0.51±0.11 vs. 0.76±0.12) and right anterior cingulate and paracingulate gyrus (0.56±0.08 vs. 0.77±0.16), the difference was statistically significant (t=−7.08, −4.56, both P<0.05). Compared with the control group, the disorder patients of depressive group showed decreased fALFF in the right anterior cingulate (0.96±0.06 vs. 1.04±0.05), and increased fALFF in left lingual gyrus (1.11±0.09 vs. 0.99±0.08), the difference was statistically significant (t=−5.64, 4.61, both P<0.05). A negative correlation among ALFF values was found in the right anterior cingulate cortex and HAMD-17 score in first-episode depression patients (r=−0.640, P=0.006), whereas no correlation was found among ALFF values in the right anterior cingulate cortex, fALFF in the right anterior cingulate and left lingual gyrus, and HAMD-17 scores. Conclusions The values of ALFF and fALFF in the right anterior cingulate gyrus and left lingual gyrus may change in first-episode depression patients under resting state. The spontaneous abnormal brain nerve activity in these brain regions may be related to HAMD-17 scores.
2020, 44(8): 507-514.
doi: 10.3760/cma.j.cn121381-201905004-00056
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Alzheimer disease (AD) is a neurodegenerative disease with insidious onset. The pathological features of AD are senile plaques formed by the deposition of amyloid-β protein and neurofibrillary tangles formed by abnormal aggregation of Tau protein. Through the use of PET molecular probes specifically targeting Tau protein, noninvasive and accurate detection of AD can be completed, which provides an effective method for early diagnosis, disease progression monitoring, pathogenesis and cognitive function evaluation of AD. Represented by 18F-AV1451, this review summarizes the clinical research progress of Tau protein PET imaging in AD.
Alzheimer disease (AD) is a neurodegenerative disease with insidious onset. The pathological features of AD are senile plaques formed by the deposition of amyloid-β protein and neurofibrillary tangles formed by abnormal aggregation of Tau protein. Through the use of PET molecular probes specifically targeting Tau protein, noninvasive and accurate detection of AD can be completed, which provides an effective method for early diagnosis, disease progression monitoring, pathogenesis and cognitive function evaluation of AD. Represented by 18F-AV1451, this review summarizes the clinical research progress of Tau protein PET imaging in AD.
2020, 44(8): 515-521.
doi: 10.3760/cma.j.cn121381-201906035-00066
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Non-small cell lung cancer (NSCLC) is a malignant tumor with high morbidity and mortality. Considering the number of in-depth studies on its pathogenesis, the number of lung cancer driver genes that have been discovered is increasing. Molecular targeted therapy for driver genes has also made significant progress. Therefore, clarifying the mutation status of the driver gene in clinical treatment decisions is particularly important. 18F-fluorodeoxyglucose(FDG) PET/CT plays an important role in the early diagnosis, staging, efficacy evaluation, and prognosis evaluation of NSCLC. 18F-FDG PET/CT is valuable in predicting the mutation status of driver genes in NSCLC. This review focuses on the correlation between 18F-FDG PET/CT related metabolic parameters and the mutation status of epidermal growth factor receptor, anaplastic lymphoma kinase, kirsten rate sarcoma viral oncogene homolog, and other driver genes in NSCLC.
Non-small cell lung cancer (NSCLC) is a malignant tumor with high morbidity and mortality. Considering the number of in-depth studies on its pathogenesis, the number of lung cancer driver genes that have been discovered is increasing. Molecular targeted therapy for driver genes has also made significant progress. Therefore, clarifying the mutation status of the driver gene in clinical treatment decisions is particularly important. 18F-fluorodeoxyglucose(FDG) PET/CT plays an important role in the early diagnosis, staging, efficacy evaluation, and prognosis evaluation of NSCLC. 18F-FDG PET/CT is valuable in predicting the mutation status of driver genes in NSCLC. This review focuses on the correlation between 18F-FDG PET/CT related metabolic parameters and the mutation status of epidermal growth factor receptor, anaplastic lymphoma kinase, kirsten rate sarcoma viral oncogene homolog, and other driver genes in NSCLC.
2020, 44(8): 522-527.
doi: 10.3760/cma.j.cn121381-201904004-00060
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Medullary thyroid carcinoma (MTC) is a type of neuroendocrine tumor that originates from calcitonin-producing parafollicular C cells of the thyroid. It is a moderate malignant thyroid carcinoma with a high recurrence rate and an early metastasis rate. The common diagnostic methods include detection of calcitonin, and tumor markers (such as carcinoembryonic antigen), ultrasound, fine needle aspiration cytology(FNAC), which have low specificity. And FNAC has high technical requirements. Radical surgery is currently the first choice of treatment of MTC. However, invasive and metastatic lesions are difficult to completely remove. Procalcitonin and novel molecular targeting probes provide new ideas for the early diagnosis and effective treatment of MTC. This review comprehensively discussed the recent advances in the diagnosis and treatment of this disease.
Medullary thyroid carcinoma (MTC) is a type of neuroendocrine tumor that originates from calcitonin-producing parafollicular C cells of the thyroid. It is a moderate malignant thyroid carcinoma with a high recurrence rate and an early metastasis rate. The common diagnostic methods include detection of calcitonin, and tumor markers (such as carcinoembryonic antigen), ultrasound, fine needle aspiration cytology(FNAC), which have low specificity. And FNAC has high technical requirements. Radical surgery is currently the first choice of treatment of MTC. However, invasive and metastatic lesions are difficult to completely remove. Procalcitonin and novel molecular targeting probes provide new ideas for the early diagnosis and effective treatment of MTC. This review comprehensively discussed the recent advances in the diagnosis and treatment of this disease.
2020, 44(8): 528-533.
doi: 10.3760/cma.j.cn121381-201903030-00046
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Axial spondyloarthritis is a common disease that threatens human health and quality of life. In the past, the treatment of axial spondyloarthritis was delayed due to the difficulty of early diagnosis, resulting in irreversible damage to the spine and joints. However, with the development and application of MRI and its new technologies in recent years, especially relaxation time map imaging, not only can early spondyloarthritis be accurately detected but its quantitative analysis can also be achieved. This article introduces the value of relaxation time map imaging in the diagnosis of early spondyloarthritis.
Axial spondyloarthritis is a common disease that threatens human health and quality of life. In the past, the treatment of axial spondyloarthritis was delayed due to the difficulty of early diagnosis, resulting in irreversible damage to the spine and joints. However, with the development and application of MRI and its new technologies in recent years, especially relaxation time map imaging, not only can early spondyloarthritis be accurately detected but its quantitative analysis can also be achieved. This article introduces the value of relaxation time map imaging in the diagnosis of early spondyloarthritis.
2020, 44(8): 534-540.
doi: 10.3760/cma.j.cn121381-201904013-00050
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The severe health risks of radiation workers occupationally exposed to low-dose ionizing radiation cannot be ignored. According to domestic and foreign investigations and studies on the health effects caused by low-dose ionizing radiation, this review discusses the main types and mechanisms of the health effects currently being studied in the field of radiobiology, and provides a reference for occupational safety protection and health surveillance of radiation workers.
The severe health risks of radiation workers occupationally exposed to low-dose ionizing radiation cannot be ignored. According to domestic and foreign investigations and studies on the health effects caused by low-dose ionizing radiation, this review discusses the main types and mechanisms of the health effects currently being studied in the field of radiobiology, and provides a reference for occupational safety protection and health surveillance of radiation workers.
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