2022 Vol. 46, No. 12
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2022, 46(12): 713-717.
doi: 10.3760/cma.j.cn121381-202202007-00245
Abstract:
Objective To estimate the effective dose of 68Ga-Octreotide PET/CT imaging patients to the surrounding population. Methods Twenty patients (15 males and 5 females, aged 30–68 (49.0±12.2) years) who received 68Ga-Octreotide PET/CT imaging at Peking University Cancer Hospital from October 2021 to December 2021 were randomly selected. After intravenous injection of 68Ga-Octreotide, the air absorbed dose rate at 1 m away from the patient was measured by radiation monitoring dosimeter 0 h later, at 0.3 m away from the patient 1.0 h later, and at 0.3, 0.5, 1.0, and 1.5 m away from the patient 1.5 h later. Based on the patterns of human social activity proposed by the National Commission for Radiological Protection and Measurement No.155 report, integral method was used to estimate the effective dose of 8Ga-Octreotide PET/CT imaging patients to the surrounding population. Results Immediately after the injection of 68Ga-Octreotide, the air absorbed dose rate at 1.0 m away from the patient was 12.97–33.67 (20.24±6.57) μSv/h. At 1.0 h later, the air absorbed dose rate at 0.3 m away from the patient was 32.73–57.69(48.98±6.20) μSv/h. At 1.5 h later, the air absorbed dose rates at 0.3, 0.5, 1.0, and 1.5 m away from the patient were 24.04–42.39 (35.98±4.56), 11.83–28.83 (20.70±4.55), 5.17–13.42 (8.07±2.61), and 1.51–7.01 (3.75±1.72) μSv/h, respectively. The estimated effective doses were as follows: 8.22–21.33 (12.83±4.15) μSv to a family member exposed to the patients at the daytime; 38.92–68.62 (58.25±7.38) μSv to a family member who shared a bed at night with the patients; 8.37–21.73 (13.06±4.23) μSv to a colleague; and 32.97–58.15 (49.36±6.26) μSv to an adjacent passenger. The radiation doses per 68Ga-Octreotide PET/CT imaging patients was estimated to be 2.66–4.69 (3.98±0.50) μSv to the operator and 9.70–25.17(15.13±4.90) μSv to the attending nurses. Conclusion The effective dose of 68Ga Octreotide PET/CT imaging patients to the surrounding population is far lower than the effective dose limit specified in the national standard.
2022, 46(12): 718-723.
doi: 10.3760/cma.j.cn121381-202112001-00249
Abstract:
Objective To evaluate the diagnostic efficacy of the radiological features of pancreatic CT imaging in patients with functional abdominal pain (FAP), recurrent acute pancreatitis (RAP), and chronic pancreatitis (CP). Methods Retrospective analysis was performed on the CT image data of 168 patients who received abdominal enhanced CT examination in Beijing Tiantan Hospital, Capital Medical University from December 2017 to December 2020. According to the criteria for admission and emission, 48 patients were selected for the study, including 23 males and 25 females, aged 39 to 84 (47.8±10.2) years, and 16 cases of FAP (FAP group), 18 cases of RAP (RAP group), and 14 cases of CP (CP group). The pancreas outline was obtained by drawing the region of interest on the CT image. Sixty-two radiologic features were extracted from each region of interest, which were divided into five categories, namely, the first-order statistics, the gray-level co-occurrence matrix (GLCM), the gray-level run-length matrix, the neighbouring gray tone difference matrix (NGTDM), and the morphological features, and compared among the three groups. According to the groups, three IsoSVM machine learning models were established, trained, and tested on the missing cross validation samples. The Wilcoxon rank sum test was used to compare the radiation characteristics of the patients with RAP, FAP, and CP. The predictive performance of individual radiological characteristics was evaluated using the receiver operator characteristic curve and the area under the curve (AUC). Results In the univariate analysis, a significant difference was found between the patient groups in nine radiation group characteristics (eight GLCM characteristics and one NGTDM characteristic) (Z=3.45–29.76, all P<0.05). Compared RAP patients with FAP and CP patients, the AUC ranges were 0.76–0.93 and 0.73–0.91. The overall prediction accuracy of the IsoSVM machine learning model was 82.1%. The sensitivity and specificity of the FAP group were 78.7% and 100%, respectively, and the AUC was 0.90. The sensitivity and specificity of the RAP group were 95.2% and 77.8%, respectively, and the AUC was 0.87, while those of the CP group were 70.9%, 94.8%, and 0.89, respectively. Conclusion Some of the radiographic features of CT imaging have a good evaluation efficiency in the diagnosis of pancreatitis and can distinguish between patients with FAP, RAP, and CP.
2022, 46(12): 724-729.
doi: 10.3760/cma.j.cn121381-202111003-00241
Abstract:
Objective To evaluate the effectiveness of manual identification and localization methods of gold fiducial marker (GFM) in prostate cancer radiotherapy based on MRI. Methods Sixteen patients with prostate cancer who were treated in Tangshan People's Hospital from June 2019 to June 2021 were included in this prospective study. The age of patients was (58.5±4.1) years. All the patients received radiotherapy localization CT scan after the implantation of three GFMs. Single-sequence (SS) and combined sequence (CS) method were used for MRI scanning for all the patients. All GFMs on the images obtained by the two sequencing methods were manually identified and located by five radiologists. The average coordinates of a single GFM center (CsGFM) and three GFM space centroids (CmGFM) were calculated. The consistency of the two sequencing methods was evaluated using Bland-Altman method. Sequencing accuracy was determined by comparison with CT localization and calculation of the imter-marker distance (IMD) of GFM. The difference between groups was analyzed by paired sample t test. Results The positive rate of GFM identification by SS method was 79.17% (38/48), and that of CS method was 93.75% (45/48). (1) In SS method, the range of 95% limit of agrecment (LoA) between the GFM central coordinate calculated by each radiologist and the mean value of CsGFM coordinates in left-right, superior-inferior, and anterior-posterior directions were −1.46–0.97, −1.06–1.73, and −1.96–1.12 mm, respectively; in CS method, the values were −0.79–1.09, 0.10–1.47, and −0.87–1.40 mm, respectively. In SS method, the 95%LoA of the three GFM space centroid coordinates calculated by each radiologist and the mean value of CmGFM coordinates in left-right, superior-inferior, and anterior-posterior directions were −1.38–0.94, −1.60–1.07, and −1.07–1.75 mm, respectively; in CS method, the values were −0.57–0.76, −0.71–0.98, and −1.16–0.76 mm, respectively. (2) For accuracy, compared with CT localization, the IMD in SS method was (0.59±0.39) mm, which was significantly higher than that in CS method (0.32±0.17) mm. The difference was statistically significant (t=−1.89, P=0.027). Conclusion The effectiveness of two manual identification and localization methods of GFM based on MRI can meet the clinical requirement. The positive rate, localization consistency and accuracy of CS method are superior to those of SS method.
2022, 46(12): 730-734.
doi: 10.3760/cma.j.cn121381-202204021-00247
Abstract:
Left ventricular assist device (LVAD) implantation is an important and effective method for the treatment of patients with end-stage heart failure. Infection is the most common complication. Delayed diagnosis or inadequate evaluation will lead to reduced survival and other serious consequences. In recent years, 18F-fluorodeoxyglucose(FDG) PET/CT plays an unique and important clinical effect in the diagnosis, location, classification, degree evaluation, treatment guidance and prognosis prediction of infection after LVAD implantation. The paper reviews the progress of clinical application of 18F-FDG PET/CT in infection after LVAD implantation.
Left ventricular assist device (LVAD) implantation is an important and effective method for the treatment of patients with end-stage heart failure. Infection is the most common complication. Delayed diagnosis or inadequate evaluation will lead to reduced survival and other serious consequences. In recent years, 18F-fluorodeoxyglucose(FDG) PET/CT plays an unique and important clinical effect in the diagnosis, location, classification, degree evaluation, treatment guidance and prognosis prediction of infection after LVAD implantation. The paper reviews the progress of clinical application of 18F-FDG PET/CT in infection after LVAD implantation.
2022, 46(12): 735-741.
doi: 10.3760/cma.j.cn121381-202203029-00251
Abstract:
Fibroblast activation protein (FAP) is overexpressed in cancer-associated fibroblasts in 90% of epithelial tumors, but hardly expressed in normal tissues. Therefore, FAP is an important target for tumor diagnosis and treatment. A series of imaging agents targeting FAP have shown favorable imaging results in preclinical studies with specific high uptake and non-targeted low uptake. Compared with fluorodeoxyglucose imaging, FAP imaging showed higher uptake value and sensitivity in most malignancies. Since then, a large number of clinical studies have been gradually carried out. Some progress has been made in the study of various malignant tumors with imaging agents targeting FAP, and some studies have confirmed that FAP is effective in some non-tumor diseases (such as myocardial infarction, immunoglobulin G4, Tuberculosis, etc.) are also highly expressed. So imaging agents targeting FAP can also be used for the diagnosis of non-neoplastic diseases. This article reviews the research progress of novel molecular probes for PET targeting FAP and their clinical translation.
Fibroblast activation protein (FAP) is overexpressed in cancer-associated fibroblasts in 90% of epithelial tumors, but hardly expressed in normal tissues. Therefore, FAP is an important target for tumor diagnosis and treatment. A series of imaging agents targeting FAP have shown favorable imaging results in preclinical studies with specific high uptake and non-targeted low uptake. Compared with fluorodeoxyglucose imaging, FAP imaging showed higher uptake value and sensitivity in most malignancies. Since then, a large number of clinical studies have been gradually carried out. Some progress has been made in the study of various malignant tumors with imaging agents targeting FAP, and some studies have confirmed that FAP is effective in some non-tumor diseases (such as myocardial infarction, immunoglobulin G4, Tuberculosis, etc.) are also highly expressed. So imaging agents targeting FAP can also be used for the diagnosis of non-neoplastic diseases. This article reviews the research progress of novel molecular probes for PET targeting FAP and their clinical translation.
2022, 46(12): 742-748.
doi: 10.3760/cma.j.cn121381-202204032-00246
Abstract:
Neuroinflammation is a common pathological manifestation of many central nervous system diseases, and microglia are the first to respond to damage to the central nervous system. The relative molecular mass of 18 000 translocator protein (TSPO) is highly expressed in microglia at the onset of neuroinflammation, a property that makes it suitable for assessing the activation of microglia proliferation in the brain. Since the development of radioligands targeting TSPO, more than 60 radioligands targeting TSPO have been developed for the study of neuroinflammatory diseases in order to gain a better understanding of their pathological processes. The author reviews the use of targeted TSPO positron tracers for neuroinflammatory imaging.
Neuroinflammation is a common pathological manifestation of many central nervous system diseases, and microglia are the first to respond to damage to the central nervous system. The relative molecular mass of 18 000 translocator protein (TSPO) is highly expressed in microglia at the onset of neuroinflammation, a property that makes it suitable for assessing the activation of microglia proliferation in the brain. Since the development of radioligands targeting TSPO, more than 60 radioligands targeting TSPO have been developed for the study of neuroinflammatory diseases in order to gain a better understanding of their pathological processes. The author reviews the use of targeted TSPO positron tracers for neuroinflammatory imaging.
2022, 46(12): 749-754.
doi: 10.3760/cma.j.cn121381-202202014-00242
Abstract:
As one of the main treatments of differentiated thyroid cancer (DTC), thyroid-stimulating hormone (TSH) suppression therapy reduces the risk of recurrence and metastasis of DTC. It also accelerates bone turnover, leads to decreased bone density and deterioration of bone microstructure, increases the risk of osteoporosis and fragility fractures, thus affecting the survival rate and quality of life of DTC patients. This article reviews the recent research progress of osteoporosis caused by TSH suppression therapy in DTC patients to provide a reference for the development of individualized treatment strategies for DTC patients.
As one of the main treatments of differentiated thyroid cancer (DTC), thyroid-stimulating hormone (TSH) suppression therapy reduces the risk of recurrence and metastasis of DTC. It also accelerates bone turnover, leads to decreased bone density and deterioration of bone microstructure, increases the risk of osteoporosis and fragility fractures, thus affecting the survival rate and quality of life of DTC patients. This article reviews the recent research progress of osteoporosis caused by TSH suppression therapy in DTC patients to provide a reference for the development of individualized treatment strategies for DTC patients.
2022, 46(12): 755-759.
doi: 10.3760/cma.j.cn121381-202204006-00248
Abstract:
Hypothyroidism is often combined with dyslipidemia such as elevated serum cholesterol and triglyceride levels, which is one of the major risk factors for atherosclerotic cardiovascular disease, and seriously affects patients' quality of life and survival. This paper reviews the recent research progress on the regulation of thyroid hormone on lipid metabolism, the effect of hypothyroidism and subclinical hypothyroidism on lipids, and the treatment of hypothyroidism combined with dyslipidemia, in order to provide reference for the prevention and treatment of hypothyroidism combined with dyslipidemia.
Hypothyroidism is often combined with dyslipidemia such as elevated serum cholesterol and triglyceride levels, which is one of the major risk factors for atherosclerotic cardiovascular disease, and seriously affects patients' quality of life and survival. This paper reviews the recent research progress on the regulation of thyroid hormone on lipid metabolism, the effect of hypothyroidism and subclinical hypothyroidism on lipids, and the treatment of hypothyroidism combined with dyslipidemia, in order to provide reference for the prevention and treatment of hypothyroidism combined with dyslipidemia.
2022, 46(12): 760-764.
doi: 10.3760/cma.j.cn121381-202203024-00243
Abstract:
In recent years, the morbidity of thyroid cancer is increasing, and the metastasis of thyroid cancer is also growing, so the early diagnosis and treatment of thyroid cancer and distant metastasis are important methods to reduce mortality. Artificial intelligence(AI), as an emerging science and technology, is developing rapidly. The combination of AI and the medical field can provide an auxiliary role for the early diagnosis of thyroid cancer. This review focuses on the progress of AI based on deep learning for ultrasound images, fine needle puncture cytology, histopathology and lymphatic metastasis in the diagnosis of thyroid cancer. Furthermore, we provide guidance for the future application of AI in relation to thyroid cancer.
In recent years, the morbidity of thyroid cancer is increasing, and the metastasis of thyroid cancer is also growing, so the early diagnosis and treatment of thyroid cancer and distant metastasis are important methods to reduce mortality. Artificial intelligence(AI), as an emerging science and technology, is developing rapidly. The combination of AI and the medical field can provide an auxiliary role for the early diagnosis of thyroid cancer. This review focuses on the progress of AI based on deep learning for ultrasound images, fine needle puncture cytology, histopathology and lymphatic metastasis in the diagnosis of thyroid cancer. Furthermore, we provide guidance for the future application of AI in relation to thyroid cancer.
2022, 46(12): 765-772.
doi: 10.3760/cma.j.cn121381-202204004-00250
Abstract:
The Hippo signaling pathway is an evolutionarily conserved signaling pathway centered on the kinase cascade reaction that plays a key role in regulating organ size, tissue homeostasis, tissue regeneration, wound healing and tumorigenesis in mammals. The Hippo signaling pathway is stimulated by changes in cell density, external mechanical stress and/or other intrinsic and extrinsic signals that cause the core complex controlling the transcriptional co-activator Yes-associated protein (YAP) and transcriptional co-activator with PDZ binding motif protein to translocate into the nucleus, thereby regulating various biological effects. In addition, YAP, as a major effector molecule of Hippo signaling pathway, is aberrantly expressed in many tumors and is closely related to tumorigenesis and development, including tumor cell proliferation and apoptosis, tumor metastasis and drug resistance, etc. The effect of Hippo signaling pathway on tumor cell radiation effect is mainly reflected in the effect of YAP on tumor cell radiosensitivity and radiation resistance. The author reviews the molecular types regulating Hippo signaling pathway, the regulatory role of Hippo signaling pathuay on tumor and its effect on radiation effect, aiming to provide new ideas for tumor therapy and the development of radiosensitizing agents.
The Hippo signaling pathway is an evolutionarily conserved signaling pathway centered on the kinase cascade reaction that plays a key role in regulating organ size, tissue homeostasis, tissue regeneration, wound healing and tumorigenesis in mammals. The Hippo signaling pathway is stimulated by changes in cell density, external mechanical stress and/or other intrinsic and extrinsic signals that cause the core complex controlling the transcriptional co-activator Yes-associated protein (YAP) and transcriptional co-activator with PDZ binding motif protein to translocate into the nucleus, thereby regulating various biological effects. In addition, YAP, as a major effector molecule of Hippo signaling pathway, is aberrantly expressed in many tumors and is closely related to tumorigenesis and development, including tumor cell proliferation and apoptosis, tumor metastasis and drug resistance, etc. The effect of Hippo signaling pathway on tumor cell radiation effect is mainly reflected in the effect of YAP on tumor cell radiosensitivity and radiation resistance. The author reviews the molecular types regulating Hippo signaling pathway, the regulatory role of Hippo signaling pathuay on tumor and its effect on radiation effect, aiming to provide new ideas for tumor therapy and the development of radiosensitizing agents.
2022, 46(12): 773-776.
doi: 10.3760/cma.j.cn121381-202205010-00244
Abstract:
This article reports the whole-body 18F-fluorodeoxyglucose (FDG) PET/CT imaging of a patient who suffering primary adrenal lymphoma (PAL) complicated with hepatocellular carcinoma. PAL is relatively rare in clinical practice, and it is easy to be misdiagnosed as metastasis when patients have other malignant tumors.This article mainly analyzes the imaging characteristics of whole body 18F-FDG PET/CT in PAL complicated with hepatocellular carcinoma, in order to provide more reference for its diagnosis.
This article reports the whole-body 18F-fluorodeoxyglucose (FDG) PET/CT imaging of a patient who suffering primary adrenal lymphoma (PAL) complicated with hepatocellular carcinoma. PAL is relatively rare in clinical practice, and it is easy to be misdiagnosed as metastasis when patients have other malignant tumors.This article mainly analyzes the imaging characteristics of whole body 18F-FDG PET/CT in PAL complicated with hepatocellular carcinoma, in order to provide more reference for its diagnosis.
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