2021 Vol. 45, No. 5
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2021, 45(5): 271-275.
doi: 10.3760/cma.j.cn121381-202105007-00050
Abstract:
On April 13, 2021, Japan decided to discharge nuclear waste water from the Fukushima Daiichi nuclear power plant into the sea. This news has aroused the close attention of people all over the world. The discharge of nuclear waste water into the sea will have a serious impact on the marine environment and the public. This paper reviews the types, contents, detection methods, and possible hazard of the radionuclides in the nuclear waste water from Fukushima Daiichi nuclear power plant in Japan, and puts forward some constructive suggestions for this incident.
On April 13, 2021, Japan decided to discharge nuclear waste water from the Fukushima Daiichi nuclear power plant into the sea. This news has aroused the close attention of people all over the world. The discharge of nuclear waste water into the sea will have a serious impact on the marine environment and the public. This paper reviews the types, contents, detection methods, and possible hazard of the radionuclides in the nuclear waste water from Fukushima Daiichi nuclear power plant in Japan, and puts forward some constructive suggestions for this incident.
2021, 45(5): 276-283.
doi: 10.3760/cma.j.cn121381-202003044-00044
Abstract:
Objective To evaluate the diagnostic value of 99Tcm-methylene disphosphonate (MDP) SPECT/CT fusion imaging in pelvic metastases in tumor patients. Methods The clinical data of 148 patients diagnosed with malignant tumor and suspected bone metastasis were retrospectively analyzed in Sichuan Cancer Hospital from August 2018 to December 2018. The patients, composed of 77 males and 71 females aged 29–86 (48.8±14.5) years, were divided into primary pelvic tumor group (63 cases) and non-primary pelvic tumor group (85 cases). All the patients underwent SPECT/CT fusion imaging of the abnormal concentration of the pelvis after first SPECT whole-body plane bone imaging. After 6 months to 1 year of follow-up with histomathological examination and imaging examination(SPECT, CT, SPECT/CT, and MRI), the coincidence rates, accuracy, and positive predictive values of SPECT whole-body plane bone imaging and SPECT/CT fusion imaging in the diagnosis of bone metastasis were compared. Qualitative data were compared by Pearson χ2 test. One-way analysis of variance was used in comparing the positive predictive values of multiple imaging tests. Results A total of 309 lesions with increased metabolism were detected through SPECT whole-body plane bone imaging, of which 239 were consistent with the follow-up results. The diagnostic coincidence rate was 77.3% (239/309), the accuracy rate of bone metastasis was 92.9% (208/224), and the accuracy rate of benign lesions was 77.3% (34/44). A total of 367 lesions with increased metabolism were detected by SPECT/CT fusion imaging, of which 349 were consistent with the results obtained through follow-up. The diagnostic coincidence rate was 95.1% (349/367), the accuracy rate of bone metastasis was 98.4% (299/304), and the accuracy rate of benign lesions was 87.7% (50/57). Statistically significant differences in diagnostic coincidence rate, diagnostic accuracy of bone metastasis, and diagnostic accuracy of benign lesions were found (χ2=0.595, 28.795, 4.546, all P<0.01). The number of lesions detected by SPECT/CT fusion imaging in the pelvic lesions was higher than that detected through SPECT whole-body plane bone imaging, and the number of lesions detected in the primary pelvic tumor group was higher than that in the non-primary pelvic tumor group, and the difference was statistically significant (χ2=17.385, P=0.036). The positive predictive value of SPECT/CT was the highest (84%, 52/62), followed by those of SPECT (79%, 48/61), MRI (76%, 47/62), and CT (65%, 39/60), and the differences were statistically significant (F=5.492, P=0.003). Conclusion Compared with SPECT plane bone imaging, 99Tcm-MDP SPECT/CT can improve the accuracy of differential diagnosis of pelvic metastases in tumor patients, and the application of 99Tcm-MDP SPECT/CT fusion examination can improve the detection rate of bone metastases in primary pelvic tumors.
2021, 45(5): 284-290.
doi: 10.3760/cma.j.cn121381-202005024-00057
Abstract:
Objective To investigate changes in resting glucose metabolism in the brain of patients with anemia of different degrees. Methods The brain 18F-fluorodeoxyglucose (FDG) PET/CT imaging data of 51 patients who were clinically diagnosed with anemia in People's Hospital of Zhengzhou University from December 2016 to April 2019 were retrospectively analyzed. The study population included 16 males and 35 females aged 21−60 (41.13±9.78) years. According to the diagnostic criteria of anemia in WHO and relevant literature, the patients were divided into 3 groups: mild anemia (90 g/L–lower limits of normal), moderate anemia (60–90 g/L) and severe anemia (30−60 g/L). A total of 56 healthy physical examiners were recruited as controls; this group included 29 males and 27 females aged 19–58 (41.96±9.27) years. Statistical Parametric Mapping 8 software was used to process and analyze the PET images of anemia group and healthy controls. The brain PET images of all anemia groups and the control group were tested by voxel-to-voxel two-sample t-test to obtain difference distribution maps of brain PET metabolism between each group. XjView software was used to conduct stereotaxic and quantitative analyses of voxel values in brain regions reflecting statistical differences. The t values of all abnormal regions were obtained. Results Compared with those in the control group, hypometabolic brain areas in patients with anemia were mainly distributed in the bilateral superior, middle, and inferior frontal gyri; the right inferior temporal gyri; and the right inferior parietal lobule gyri, the total voxel value was 3705 (t=5.01–5.85, all P<0.05). Hypermetabolic areas were not observed in anemia patients. Compared with that in the mild group, hypometabolism in the moderate group was observed in the bilateral inferior frontal, right middle frontal, right inferior temporal gyri, and the right inferior parietal lobule gyri, the total voxel value was 832 (t=5.22–5.86, all P<0.05). Hypometabolism in the severe group was observed in the bilateral superior frontal, bilateral middle-inferior frontal, right inferior temporal, and right inferior parietal lobule gyri, the total voxel value was 1834 (t=5.42–6.05, all P<0.05). Compared with that in the moderate group, hypometabolism in the severe group was noted in the left superior frontal, left middle-inferior frontal, and right middle frontal gyri, right inferior temporal lobe, and right inferior parietal lobule gyri, the total voxel value was 1598 (t=5.72–6.48, all P<0.05). Conclusions Patients with anemia showed relative reductions in regional cerebral resting glucose metabolism. The cerebral regions demonstrating reduced metabolism were mainly related to emotion cognition. As anemia progressed, areas reflecting a decrease in cerebral metabolism increased.
2021, 45(5): 291-299.
doi: 10.3760/cma.j.cn121381-202004036-00058
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Objective To investigate the effects of isocorydine (ICD) on the proliferation and radiosensitivity of cervical cancer SiHa cells and determine the underlying mechanism. Methods Different concentrations (25, 50, 100, and 200 μmol/L) of ICD were used to treat cervical cancer SiHa cells (ICD treatment group). Normal cultured SiHa cells without ICD treatment were set as the normal control (NC) group. The 3-(4,5-dimethylthiazole-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay was used to detect cell proliferation. Cell clone formation experiment was conducted to determine the radiation sensitization effect of ICD on cells. Western blot analysis was employed to detect phosphorylated histone H2AX (γ-H2AX), phosphorylated phosphatidylinositol 3-kinase (p-PI3K), and phosphorylated protein kinase B (p-Akt) expression. Real-time quantitative PCR (qRT-PCR) was used to detect the expression of microRNA-129-5p (miR-129-5p). SiHa cells were transfected with miR-NC and miR-129-5p, and the roles of transfection of miR-129-5p on cell proliferation, radiosensitivity, cyclinD1, and γ-H2AX protein expression were observed. Anti-miR-NC and anti-miR-129-5p were transfected into SiHa cells, which were then treated with ICD to evaluate the effects on ICD-induced cell proliferation, radiosensitivity, and PI3K/Akt signaling pathway. Data between two groups were compared by independent sample t test. Results The MTT assay showed that the 25, 50, 100, and 200 μmol/L ICD treatment groups exhibited significant increase in the proliferation inhibition rate ((10.26±1.03)%, (22.16±2.21)%, (44.09±4.41)%, (70.88±7.09)%) of SiHa cells compared with the NC group ((0.05±0.01)%), and the differences were statistically significant (t=29.736−30.013, all P<0.05). The cell clone formation, Western blot, and qRT-PCR analyses showed that the 100 μmol/L ICD treatment group had increased radiosensitivity to different doses of X-rays (t=19.135−44.478, all P<0.05), increased γ-H2AX protein expression (t=15.041, P<0.05) and miR-129-5p expression (t=19.682, P<0.05), and decreased expression of p-PI3K and p-Akt protein compared with the NC group (t=14.897, 15.429; both P<0.05). Transfected (highly expressed) miR-129-5p considerably increased the proliferation inhibition rate ((75.06±7.51)% vs. (1.04±0.10)%; t=29.566, P<0.05), radiosensitivity to different doses of X-rays (t=13.239−37.015, all P<0.05), and γ-H2AX protein expression (t=17.076, P<0.05) of SiHa cells and evidently decreased the expression of the cyclinD1 protein (t=17.393, P<0.05) compared with transfected miR-NC. The transfection of anti-miR-129-5p (low expression of miR-129-5p) reversed the inhibitory effect of ICD on SiHa cell proliferation and PI3K/Akt signaling pathway and reversed its ability to enhance cell radiosensitivity compared with the transfection of anti-miR-NC, and the differences were statistically significant (t=13.370−28.252, all P<0.05). Conclusion ICD inhibits the proliferation of cervical cancer SiHa cells and enhances radiosensitivity by up-regulating the expression of miR-129-5p and the PI3K/Akt signaling pathway.
2021, 45(5): 300-306.
doi: 10.3760/cma.j.cn121381-202104003-00062
Abstract:
Objective To understand the current status of radiation hygiene management in non-medical institutions in Tianjin to provide scientific basis for strengthening health management in the radiological department. Methods A cross-sectional questionnaire survey was conducted from August to October 2020 according to the Notice of Municipal Health Commission on the implementation plan of the Tianjin occupation disease prevention and control project in 2020, to evaluate 35 non-medical institutions in Tianjin according to the industry category of monitoring objects, the basic situation of radiation source, occupation health management, personal protective equipment, and auxiliary protective devices. Data were entered by double input method and analyzed. Results The survey covered 11 industries including computers, telecommunications, and other electronic equipment manufacturing; port handling and storage; metal products; and petroleum and natural gas extraction. The survey includes 91 class Ⅱ and 84 class Ⅲ radiation devices; 53 class Ⅱ, 7 class Ⅲ, 88 class Ⅳ, and 253 class Ⅴ radiation sources; 4 unsealed radioactive material class B workplace; and 2 unsealed radioactive material class C workplace. A total of 921 radiation workers in the 35 radiological non-medical institutions underwent occupation health examination, and the annual effective dose of radiation workers was lower than 20 mSv. The 35 institutions were equipped with 274 personal protective equipment, 194 personal dose alarming devices, and 135 radiation dosimeter. Twenty-nine non-medical institutions (82.9%, 29/35) carried out occupation health assessment and self-inspection, and 34 non-medical institutions (97.1%, 34/35) completed the radiation protection test. The rate of institutions that qualified in the radiation protection test and the declaration of occupational hazard items were both 85.7% (30/35). Conclusions The 35 non-medical institutions could take radiation hygiene protection management seriously. This study provides a scientific basis for the supervision and law enforcement of related policies. Nevertheless, strengthening the implementation of personal protective equipment and radiation dosimetry, as well as occupation disease risk monitoring and evaluation, is necessary.
2021, 45(5): 307-312.
doi: 10.3760/cma.j.cn121381-202102029-00046
Abstract:
Fibroblast activation protein (FAP), as one of the molecular markers of cancer-associated fibroblasts (CAFs), is highly specifically expressed in activated CAFs. FAP can be used as a theranostic target for malignant tumors since it can promote tumor invasion, metastasis and immune escape. Gallium-68-labeled FAP inhibitor (68Ga-FAPI) is a small molecular probe synthesized based on FAP, which can be visualized in vivo by PET/CT imaging. At present, 68Ga-FAPI PET/CT has been successfully used in the diagnosis and staging of glioma, esophageal cancer, hepatocellular carcinoma, pancreatic ductal adenocarcinoma and other malignant tumors. This paper reviews the clinical application of 68Ga-FAPI PET/CT in malignant tumors.
Fibroblast activation protein (FAP), as one of the molecular markers of cancer-associated fibroblasts (CAFs), is highly specifically expressed in activated CAFs. FAP can be used as a theranostic target for malignant tumors since it can promote tumor invasion, metastasis and immune escape. Gallium-68-labeled FAP inhibitor (68Ga-FAPI) is a small molecular probe synthesized based on FAP, which can be visualized in vivo by PET/CT imaging. At present, 68Ga-FAPI PET/CT has been successfully used in the diagnosis and staging of glioma, esophageal cancer, hepatocellular carcinoma, pancreatic ductal adenocarcinoma and other malignant tumors. This paper reviews the clinical application of 68Ga-FAPI PET/CT in malignant tumors.
2021, 45(5): 313-318.
doi: 10.3760/cma.j.cn121381-202004037-00033
Abstract:
Primary breast lymphoma (PBL) is a rare malignant extranodal tumor originating in the mammary gland. The clinical manifestations of PBL are often lack of specificity, and the course of the disease progresses rapidly. Early diagnosis is beneficial to improve the prognosis of patients. As an increasingly mature molecular imaging technology, 18F-fluorodeoxyglucose (FDG) PET combined with CT or MRI has high diagnostic sensitivity and accuracy for PBL, and has important value in cancer staging and efficacy evaluation. This paper reviews the application progress of 18F-FDG PET in the diagnosis and treatment of PBL.
Primary breast lymphoma (PBL) is a rare malignant extranodal tumor originating in the mammary gland. The clinical manifestations of PBL are often lack of specificity, and the course of the disease progresses rapidly. Early diagnosis is beneficial to improve the prognosis of patients. As an increasingly mature molecular imaging technology, 18F-fluorodeoxyglucose (FDG) PET combined with CT or MRI has high diagnostic sensitivity and accuracy for PBL, and has important value in cancer staging and efficacy evaluation. This paper reviews the application progress of 18F-FDG PET in the diagnosis and treatment of PBL.
2021, 45(5): 319-324.
doi: 10.3760/cma.j.cn121381-202008035-00053
Abstract:
Hepatocellular carcinoma (HCC) is one of the leading causes of cancer mortality worldwide. Various imaging modalities provide important information about HCC for its clinical management. With the continuous progress of PET/CT research in oncology, it has played crucial roles in detecting, distinguishing, accurately staging, and evaluating local, residual and recurrent HCC. Dual tracer technology has become an important technology to assist HCC diagnosis, and the advent of new radiotracers has improved the ability to detect lesions. This paper reviews the current status of PET/CT for HCC.
Hepatocellular carcinoma (HCC) is one of the leading causes of cancer mortality worldwide. Various imaging modalities provide important information about HCC for its clinical management. With the continuous progress of PET/CT research in oncology, it has played crucial roles in detecting, distinguishing, accurately staging, and evaluating local, residual and recurrent HCC. Dual tracer technology has become an important technology to assist HCC diagnosis, and the advent of new radiotracers has improved the ability to detect lesions. This paper reviews the current status of PET/CT for HCC.
2021, 45(5): 325-331.
doi: 10.3760/cma.j.cn121381-202005009-00034
Abstract:
Over the recent years, the detection rate of thyroid cancer gradually increases due to the application of high resolution ultrasound and fine-needle aspiration cytology. Although most of the patients with differentiated thyroid cancer (DTC) have sound prognosis, some patients easily develop cervical lymph node metastasis or distant metastasis to lung, bone and brain. In worse cases, dedifferentiation of lesions will occur, leading to poor prognosis. At present, many studies at home and abroad have shown that gene mutation plays an important role in DTC occurring and developing process, as well as in its prognosis. Inhibitors of relevant genes are regarded as a new hope to patients with dedifferentiation of focus, and they are of great significance to the guidance of clinician’s decision. The mechanism and clinical significance of common gene mutations in DTC are reviewed in this paper.
Over the recent years, the detection rate of thyroid cancer gradually increases due to the application of high resolution ultrasound and fine-needle aspiration cytology. Although most of the patients with differentiated thyroid cancer (DTC) have sound prognosis, some patients easily develop cervical lymph node metastasis or distant metastasis to lung, bone and brain. In worse cases, dedifferentiation of lesions will occur, leading to poor prognosis. At present, many studies at home and abroad have shown that gene mutation plays an important role in DTC occurring and developing process, as well as in its prognosis. Inhibitors of relevant genes are regarded as a new hope to patients with dedifferentiation of focus, and they are of great significance to the guidance of clinician’s decision. The mechanism and clinical significance of common gene mutations in DTC are reviewed in this paper.
2021, 45(5): 332-337.
doi: 10.3760/cma.j.cn121381-202005005-00041
Abstract:
131I therapy is a routine adjuvant therapy for patients with differentiated thyroid carcinoma (DTC) after operation, which can effectively reduce the recurrence rate of the disease, prolong the survival period of patients, and play a positive role in the prognosis. However, when 131I treats the primary lesion, it will also cause damage to local tissues of the human body (such as the salivary gland) and affect the life quality of patients. At present, salivary gland injury in DTC patients after 131I therapy has caused widespread clinical concern. This review focuses on the evaluation and prevention of salivary gland injury.
131I therapy is a routine adjuvant therapy for patients with differentiated thyroid carcinoma (DTC) after operation, which can effectively reduce the recurrence rate of the disease, prolong the survival period of patients, and play a positive role in the prognosis. However, when 131I treats the primary lesion, it will also cause damage to local tissues of the human body (such as the salivary gland) and affect the life quality of patients. At present, salivary gland injury in DTC patients after 131I therapy has caused widespread clinical concern. This review focuses on the evaluation and prevention of salivary gland injury.
2021, 45(5): 338-341.
doi: 10.3760/cma.j.cn121381-202006034-00059
Abstract:
The authors reported a case of giant multilocular prostatic cystadenoma (PC) with 18F-fluorodeoxyglucose (FDG) PET/CT imaging, and the imaging characteristics and differential diagnosis of the disease were analyzed. 18F-FDG PET/CT can not only locate the lesion and determine the relationship between it and the surrounding tissues, but also identify benign and malignant according to the degree of radioactive uptake of the tumor, thus providing sufficient evidence for clinical diagnosis. Since PC is rare in clinical practice, and there is no report on the application of 18F-FDG PET/CT for diagnosis, the author analyzed the 18F-FDG PET/CT imaging characteristics of this case, aiming to improve the understanding of the disease and avoid misdiagnosis.
The authors reported a case of giant multilocular prostatic cystadenoma (PC) with 18F-fluorodeoxyglucose (FDG) PET/CT imaging, and the imaging characteristics and differential diagnosis of the disease were analyzed. 18F-FDG PET/CT can not only locate the lesion and determine the relationship between it and the surrounding tissues, but also identify benign and malignant according to the degree of radioactive uptake of the tumor, thus providing sufficient evidence for clinical diagnosis. Since PC is rare in clinical practice, and there is no report on the application of 18F-FDG PET/CT for diagnosis, the author analyzed the 18F-FDG PET/CT imaging characteristics of this case, aiming to improve the understanding of the disease and avoid misdiagnosis.
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