2022 Vol. 46, No. 3
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2022, 46(3): 1-4.
Abstract:
2022, 46(3): 131-138.
doi: 10.3760/cma.j.cn121381-202103019-00149
Abstract:
Objective To evaluate the diagnostic value of 18F-fluorodeoxyglucose (FDG) PET/CT imaging in patients with secondary renal lymphoma (SRL) and its differential analysis with renal immune disease (RID). Methods The 18F-FDG PET/CT images and clinical characteristics of 12 patients with SRL confirmed by histopathological examination or clinical comprehensive diagnosis in Tianjin First Central Hospital from December 2017 to December 2020 were analyzed retrospectively. The patients in the SRL group comprised 7 males and 5 females, aged 50±15 years. At the same time, 10 patients with positive 18F-FDG PET/CT imaging and final diagnosis of RID were selected, including 2 cases of IgG4-related kidney disease and 8 cases of antineutrophil cytoplasmic antibody-associated vasculitis. These 5 males and 5 females, aged 60±10 years, comprised the RID group. Ten healthy subjects with normal kidneys by 18F-FDG PET/CT imaging were selected as the healthy control group (5 males and 5 females, aged 55±10 years). The 18F-FDG PET/CT features of renal and extrarenal invasion were observed and recorded. The maximal standardized uptake value (SUVmax) of renal lesion or renal cortex, the ratio of SUVmax in renal lesion or renal cortex to mean standardized uptake value (SUVmean) of liver, and SUVmax of extrarenal invasions were measured and calculated. One-way ANOVA was used to compare SUVmax and ratio of standardized uptake value (SUVratio) among the three groups, and independent sample t test was used to compare SUVmax of extrarenal 18F-FDG uptake in the SRL group and RID group. Results The 12 patients with SRL exhibited multifocal masses (n=6) and diffuse nephromegaly (n=6) in bilater kidneys with abnormally increased 18F-FDG uptake. In 10 patients with RID, the 18F-FDG PET/CT imaging of the affected kidneys showed bilateral diffuse nephromegaly with increased 18F-FDG uptake of renal parenchyma, which was similar to diffuse nephromegaly in SRL. However, in terms of extrarenal involvement, the patients in the RID group had common sites of involvement, and the patients in the SRL group were mostly associated with the involvement of different tissues and organs of the whole body, with irregular distribution. Statistical analysis showed that SUVmax and SUVratio of renal lesions in the SRL group were significantly higher than those in the RID group (21.88±12.04 vs. 9.09±3.51 and 11.38±6.52 vs. 3.67±1.12, respectively), and SUVmax and SUVratio of renal lesions in the two groups were significantly higher than those in the healthy control group (SUVmax=3.23±0.39, SUVratio=1.47±0.25; F=17.189, 18.361; both P<0.001). 18F-FDG SUVmax of extrarenal lesions in the SRL group was significantly higher than that in the RID group (27.67±15.09 vs. 7.55±3.70, t=−3.889, P=0.001). Conclusion 18F-FDG PET/CT has a good clinical value in the diagnosis of SRL and the evaluation of systemic involvement, and it is helpful in distinguishing SRL from RID.
2022, 46(3): 139-145.
doi: 10.3760/cma.j.cn121381-202102020-00158
Abstract:
Objective To compare the application value of 18F-fluorodeoxyglucose (FDG) PET/MRI and MRI in the preoperative T and N staging of patients with esophageal cancer. Methods The clinical and imaging data of 30 patients who underwent radical resection for esophageal cancer in the Second Affiliated Hospital of the Air Force Military Medical University from January 2018 to December 2019 were retrospectively analyzed. The sample included 25 males and 5 females, aged 42–77(62.9±8.0) years old. All patients underwent 18F-FDG PET/MRI examination within 2 weeks before operation, and the postoperative histopathological examination results were used as the “gold standard” for staging. The Kappa test was employed to evaluate the consistency of 18F-FDGPET/MRI and MRI in the preoperative T and N staging of patients with esophageal cancer and in postoperative histopathological staging. The staging accuracy was compared using the χ2 test, and the values of the maximum standardized uptake (SUVmax), mean standardized uptake (SUVmean), apparent diffusion coefficient minimum vaalue (ADCmin), and apparent diffusion coefficient mean value (ADCmean) of metastatic lymph nodes and benign lymph nodes were compared using independent sample t test. Results 18F-FDG PET/MRI and MRI showed strong consistency in the preoperative T staging and postoperative histopathological staging of patients with esophageal cancer (Kappa value=0.757, 0.698; both P<0.001). The accuracy rates of 18F-FDG PET/MRI and MRI in the diagnosis of preoperative T staging in patients with esophageal cancer were 83.3% (25/30) and 80.0% (24/30) respectively, with no significant difference (χ2=0.110, P>0.05). The diagnostic accuracy of 18F-FDG PET/MRI for preoperative N staging in patients with esophageal cancer was higher than that of MRI (76.7% (23/30) vs. 66.7% (20/30)), and the difference was statistically significant (χ2=11.273, P<0.01). The SUVmax and SUVmean values of the metastatic lymph nodes were higher than those of the benign lymph nodes (5.77±2.66 vs. 2.79±1.29 and 3.16±1.28 vs. 1.78±1.01, respectively), and the difference was statistically significant (t=6.39, 5.96; both P<0.001). Furthermore, the ADCmin of metastatic lymph nodes was lower than that of benign lymph nodes (1.02±0.33 vs. 1.20±0.24), and the difference was statistically significant (t=−3.81, P<0.001). In comparison, there was no statistical significance in the comparison of ADCmean (t=−1.52, P>0.05). Conclusions The value of 18F-FDG PET/MRI in the preoperative T staging of patients with esophageal cancer is comparable to that of MRI, while its diagnostic performance for preoperative N staging of patients with esophageal cancer is better than MRI. Thus, it can be considered the preferred non-invasive preoperative staging method for patients with esophageal cancer.
2022, 46(3): 146-151.
doi: 10.3760/cma.j.cn121381-202111006-00160
Abstract:
Objective To investigated the dose of eye lens of some interventional-radiology workers in three hospitals in Chongqing, as well as to analyze the related factors and to put forward the countermeasures to reduce the equivalent dose. Methods A total of 99 interventional radiology workers (92 males and 7 females; aged 20–40(30.0±6.2) years) from three hospitals (two general hospitals and one cancer hospital) in Chongqing were included. They were monitored by thermoluminescence dosimetry for one month, and the annual equivalent dose of eye lens was estimated according to the number of surgeries. Wilcoxon rank sum test was used to compare the difference in lens equivalent dose between the left and right eyes of interventional radiology workers. Multiple linear regression was used to analyze the factors influencing lens equivalent dose in the left and right eyes of interventional-radiology workers. Kruskal-Wallis H test was used to analyze the difference in the overall distribution of lens equivalent dose of the left or right eyes of interventional-radiology workers in three hospitals with different operation types. Bonferroni method was used to compare the lens equivalent dose of left or right eyes with different operation types. Results For the 99 interventional radiologists in the three hospitals, the median estimated annual equivalent dose was 5.38(2.46, 13.10) mSv for the left eyes and 3.54(1.55, 8.48) mSv for the right eyes. The estimated annual equivalent dose of the lens in the left and right eyes of two radiation workers were 42.72 mSv and 48.00 mSv respectively, which were close to the International Commission on Radiological Protection's single annual dose limit of 50 mSv. They did not exceed the annual equivalent dose limit of 150 mSv for eye lens in China. A significant difference existed in the equivalent dose of lens in the left and right eyes of interventional-radiology workers in three hospitals (Z=−5.599, P<0.001). Among the influencing factors, gender, smoking habit, operation exposure time, and instrument output dose had no significant effect on the equivalent dose of left and right eyes ( Conclusions The estimated annual equivalent dose of some interventional-radiology workers in three hospitals in Chongqing did not exceed the existing national standard. Attention should be paid to the shift arrangement, protective measures, and health monitoring of medical workers in lower extremity venography operation.
2022, 46(3): 152-156.
doi: 10.3760/cma.j.cn121381-202107020-00161
Abstract:
Compared with men, women have different anatomical and physiological basis of coronary artery and neurohormone levels, resulting in more often from non-obstructive coronary microvascular dysfunction. Absolute quantitative myocardial perfusion imaging (MPI) is a noninvasive functional examination, which increases diagnosis performance, treatment evaluation, and prognostic evaluation of coronary artery disease (CAD). The change of heart rate and blood pressure in stress test, as the alternative indicator of autonomic nerve function, has a role in predicting blood perfusion parameters and adverse cardiovascular events. This review summarizes the gain value of stress MPI heart rate and blood pressure change on CAD diagnosis and risk assessment, so as to provide a basis for promoting the clinical application of stress MPI and formulating a diagnosis and treatment plan aimed to improving female autonomic nerve function.
Compared with men, women have different anatomical and physiological basis of coronary artery and neurohormone levels, resulting in more often from non-obstructive coronary microvascular dysfunction. Absolute quantitative myocardial perfusion imaging (MPI) is a noninvasive functional examination, which increases diagnosis performance, treatment evaluation, and prognostic evaluation of coronary artery disease (CAD). The change of heart rate and blood pressure in stress test, as the alternative indicator of autonomic nerve function, has a role in predicting blood perfusion parameters and adverse cardiovascular events. This review summarizes the gain value of stress MPI heart rate and blood pressure change on CAD diagnosis and risk assessment, so as to provide a basis for promoting the clinical application of stress MPI and formulating a diagnosis and treatment plan aimed to improving female autonomic nerve function.
2022, 46(3): 157-161.
doi: 10.3760/cma.j.cn121381-202012034-00156
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With the wide application of PET in clinic, 18F-AlF-labeled peptide biomolecular probes are increasing in the spotlight. The procedure of 18F-AlF labeling of biomolecule conjugates is simple, valid and has tremendous potential. 18F-AlF-biomolecule conjugates PET imaging has high sensitivity and spatial resolution, with ideal quantification properties to trace biological targets of various tumors, so as to provide important information for accurate diagnosis and treatment of tumors. Part of them are in clinical research stage and show a broad scope in future clinical application. In this paper, the authors review the current process of 18F-AlF-labeled peptide molecular probes for PET tumor imaging.
With the wide application of PET in clinic, 18F-AlF-labeled peptide biomolecular probes are increasing in the spotlight. The procedure of 18F-AlF labeling of biomolecule conjugates is simple, valid and has tremendous potential. 18F-AlF-biomolecule conjugates PET imaging has high sensitivity and spatial resolution, with ideal quantification properties to trace biological targets of various tumors, so as to provide important information for accurate diagnosis and treatment of tumors. Part of them are in clinical research stage and show a broad scope in future clinical application. In this paper, the authors review the current process of 18F-AlF-labeled peptide molecular probes for PET tumor imaging.
2022, 46(3): 162-167.
doi: 10.3760/cma.j.cn121381-202108020-00153
Abstract:
Endometriosis is a common gynecological disease with a high incidence in women of childbearing age and has a wide range of sites in the body. Conventional imaging examinations and laparoscopy cannot effectively detect systemic, small and insidious endometriosis lesions. Radionuclide labeled choline analogs, estrogen analogs and somatostatin analogs have the potential to detect endometriosis lesions, and can provide functional and metabolic information of endometriosis lesions, which have special value for the diagnosis of endometriosis. In this paper, the diagnostic methods of endometriosis are reviewed, and the research progress of molecular imaging diagnosis of endometriosis is disscussed.
Endometriosis is a common gynecological disease with a high incidence in women of childbearing age and has a wide range of sites in the body. Conventional imaging examinations and laparoscopy cannot effectively detect systemic, small and insidious endometriosis lesions. Radionuclide labeled choline analogs, estrogen analogs and somatostatin analogs have the potential to detect endometriosis lesions, and can provide functional and metabolic information of endometriosis lesions, which have special value for the diagnosis of endometriosis. In this paper, the diagnostic methods of endometriosis are reviewed, and the research progress of molecular imaging diagnosis of endometriosis is disscussed.
2022, 46(3): 168-173.
doi: 10.3760/cma.j.cn121381-202109016-00150
Abstract:
Multiple myeloma (MM) is a proliferous plasma cell malignancy. Abnormal proliferation of clonal plasma cells could not only involve skeletal system but also invade extramedullary and cause tissues or organs damage. 18F-fluorodeoxyglucose (FDG) PET/CT has become one of the most primary imaging methods for condition evaluation of MM by monitoring systemic glucose metabolism. The authors review the clinical application of 18F-FDG PET/CT in the diagnosis, staging, efficacy evaluation and prognosis prediction of MM, analyze its limitations, also introduce and prospect the application of new molecular probes in MM, in order to improve the clinicians' understanding of the clinical value of PET/CT in the diagnosis and treatment of MM, and further play the essential role of PET/CT in the clinical decision-making of MM.
Multiple myeloma (MM) is a proliferous plasma cell malignancy. Abnormal proliferation of clonal plasma cells could not only involve skeletal system but also invade extramedullary and cause tissues or organs damage. 18F-fluorodeoxyglucose (FDG) PET/CT has become one of the most primary imaging methods for condition evaluation of MM by monitoring systemic glucose metabolism. The authors review the clinical application of 18F-FDG PET/CT in the diagnosis, staging, efficacy evaluation and prognosis prediction of MM, analyze its limitations, also introduce and prospect the application of new molecular probes in MM, in order to improve the clinicians' understanding of the clinical value of PET/CT in the diagnosis and treatment of MM, and further play the essential role of PET/CT in the clinical decision-making of MM.
2022, 46(3): 174-179.
doi: 10.3760/cma.j.cn121381-202007026-00159
Abstract:
Diabetes mellitus is a chronic and metabolic disease affecting more than 400 million people in the world. The pathogenesis of type 1 and type 2 diabetes mellitus is associated with the decrease or functional impairment of pancreatic β cells. With long-term hyperglycemia, diabetic patients will develop cardiovascular disease, neuropathy, diabetic foot and other complications. This paper reviews the application research progress of different types of PET and SPECT molecular imaging in the function monitoring of pancreatic β cells, and early diagnosis of diabetic complications such as coronary artery disease, cardiomyopathy, autonomic neuropathy, brain abnormalities and diabetic foot in diabetic patients.
Diabetes mellitus is a chronic and metabolic disease affecting more than 400 million people in the world. The pathogenesis of type 1 and type 2 diabetes mellitus is associated with the decrease or functional impairment of pancreatic β cells. With long-term hyperglycemia, diabetic patients will develop cardiovascular disease, neuropathy, diabetic foot and other complications. This paper reviews the application research progress of different types of PET and SPECT molecular imaging in the function monitoring of pancreatic β cells, and early diagnosis of diabetic complications such as coronary artery disease, cardiomyopathy, autonomic neuropathy, brain abnormalities and diabetic foot in diabetic patients.
2022, 46(3): 180-184.
doi: 10.3760/cma.j.cn121381-202102006-00148
Abstract:
The incidence rate of prostate cancer (PCa) ranks first among all male tumors, and PCa is prone to bone metastasis, which is characterized by pain, decreased quality of life, fractures, bone functional decline, impairment of hematopoiesis, and reduced survival rate. Bone scan index (BSI) is a method to quantitatively measure the severity of bone diseases. It can not only quantitatively evaluate the degree of bone tumor involvement in PCa patients, but also incorporate fully quantitative assessments of disease burden in associating bone scintigraphy post-treatment changes with clinical examination outcome, to assess progression or remisson of disease. In this paper, BSI, the development of automated BSI and its research in PCa are reviewed to provide reference for clinical practice.
The incidence rate of prostate cancer (PCa) ranks first among all male tumors, and PCa is prone to bone metastasis, which is characterized by pain, decreased quality of life, fractures, bone functional decline, impairment of hematopoiesis, and reduced survival rate. Bone scan index (BSI) is a method to quantitatively measure the severity of bone diseases. It can not only quantitatively evaluate the degree of bone tumor involvement in PCa patients, but also incorporate fully quantitative assessments of disease burden in associating bone scintigraphy post-treatment changes with clinical examination outcome, to assess progression or remisson of disease. In this paper, BSI, the development of automated BSI and its research in PCa are reviewed to provide reference for clinical practice.
2022, 46(3): 185-192.
doi: 10.3760/cma.j.cn121381-202102016-00162
Abstract:
Radiotherapy has become one of the main approaches in cancer treatment. However, tumor have radioresistance and normal tissues have radiation tolerant doses, both seriously affect the effect of cancer radiotherapy. It is of importance to develop radiation sensitizers to improve the radiosensitivity of tumor cells. Nuclear receptors are a kind of transcription factor superfamily, which are abundantly expressed in cells and participates in various pathophysiological processes. Recent studies have suggested that nuclear receptors and their related ligands may play important roles in tumor radioresistanace, which provide novel targets for radiosensitization. In this review, the research progress of nuclear receptors and related ligands in tumor radiosensitization is discussed.
Radiotherapy has become one of the main approaches in cancer treatment. However, tumor have radioresistance and normal tissues have radiation tolerant doses, both seriously affect the effect of cancer radiotherapy. It is of importance to develop radiation sensitizers to improve the radiosensitivity of tumor cells. Nuclear receptors are a kind of transcription factor superfamily, which are abundantly expressed in cells and participates in various pathophysiological processes. Recent studies have suggested that nuclear receptors and their related ligands may play important roles in tumor radioresistanace, which provide novel targets for radiosensitization. In this review, the research progress of nuclear receptors and related ligands in tumor radiosensitization is discussed.
2022, 46(3): 193-196.
doi: 10.3760/cma.j.cn121381-202012043-00143
Abstract:
The authors report a case of hepatic paragonimiasis with 18F-fluorodeoxyglucose PET/CT imaging, which is rare in clinic and easily misdiagnosed as hepatocellular carcinoma, cholangiocarcinoma or liver abscess. After entering the human body, paragonimiasis can lead to multi-system and multi-organ lesions. PET/CT as a systemic examination can find more organs involved, so as to make a more accurate diagnosis of liver paragonimiasis, strengthen understanding and reduce misdiagnosis.
The authors report a case of hepatic paragonimiasis with 18F-fluorodeoxyglucose PET/CT imaging, which is rare in clinic and easily misdiagnosed as hepatocellular carcinoma, cholangiocarcinoma or liver abscess. After entering the human body, paragonimiasis can lead to multi-system and multi-organ lesions. PET/CT as a systemic examination can find more organs involved, so as to make a more accurate diagnosis of liver paragonimiasis, strengthen understanding and reduce misdiagnosis.
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