2018 Vol. 42, No. 5
Coronary microvascular disease (CMVD) is the clinical syndrome of exertional angina or myocardial ischemia. It is caused by abnormal coronary microvascular structure and/or function that may result from various pathogenic factors. Given the higher incidence of CMVD among patients with coronary heart disease and the poor prognosis of patients with partial CMVD, the early diagnosis, prognostic assessment, and medicaltreatment of CMVDhave critical clinical implications. Quantitative PET/CT analysis can be used toquantify resting and stressed myocardial perfusion values objectively and to obtain coronary flow reserve measurements. Thus, it is an effective approachfor the early diagnosis and prognosis evaluation of CMVD and for guiding therapeutic strategies for this malignancy. In this article, we review the progress in the application of PET/CT blood flow reserve measurement in CMVD.
Among all gynecological malignancies, ovarian cancer has the highest mortality rate. In the diagnosis and staging of ovarian cancer, 18F-FDG PET/CT is superior to conventional imaging. It is used to assess the prognosis of patients with ovarian cancer and the curative effects of ovarian cancer treatments. In addition, it can be used to guide clinical treatment to improve therapeutic effect. 18F-FDG PET/MRI is a multimodal imaging technique that has been recently applied in clinical practice. It exhibits unique advantages in the diagnosis of ovarian cancer given its characteristics of multiple-sequence imaging, high soft-tissue resolution, and low radiation dosage. This review presents an overview of the application of 18F-FDG PET/CT and 18F-FDG PET/MRI in the diagnosis and staging of ovarian cancer.
Multiple myeloma (MM) is a malignant B-cell neoplasm, primarily involving the bone marrow, and some may have extramedullary involvement. Imaging examination is an indispensable tool for comprehensive assessment of MM X-ray and CT have lower lesion detection rate, poor quantitative ability. PET/CT and MRI have great value in the assessment of MM, especially the application of 18F-FDG and other novel molecular probes, whole-body diffusion weighted imaging (DWI), dynamic contrast-enhanced (DCE) MRI and water-fat separation. The author will review the application and progress of PET/CT and MRI in MM.
The complex function of the ankle joint has greatly complicated the examination of its related diseases. The preliminary method for the assessment of foot and ankle diseases involves radiographic assessment, while MRI is used for further diagnosis. Although 99Tcm-MDP bone scintigraphy is sensitive to changes in bone metabolism, it has poor specificity because of its low resolution and inability to provide anatomical structural information. 99Tcm-MDP SPECT/CT combines the sensitivity of 99Tcm-MDP bone scintigraphy with the anatomical structural information provided by CT to show the localization of uptaken MDP and the structural changes associated with foot and ankle diseases. In recent years, SPECT/CT has been gradually used to assist the diagnosis of foot and ankle diseases. In this article, we discuss the clinical application of SPECT/CT tomographic bone scintigraphy in the diagnosis of foot and ankle diseases.
The advantage of noninvasive and whole body imaging makes bone scintigraphy play an important role in the diagnosis of bone diseases, especially in exploring bone metastasis. However, extraosseous uptake on bone scintigraphy has been observed in some instances. Presently, the mechanism of extraosseous uptake is still unclear. Identification of such nonosseous uptake can reduce the blind examinations and improve the diagnostic value of bone scintigraphy. The author reviews the related articles that illustrate the possible causes of extraosseous uptake in the abdominal and pelvic soft tissues to provide essential help for clinical diagnosis.
In the past, clinicians paid little attention to thyroid cancers, particularly papillary thyroid microcarcinoma (PTMC), given their good overall prognoses. Recently, however, international and domestic researchers have given increased attention to PTMC and its diagnosis and treatment because of the increasing incidence of this malignancy. The diagnosis and treatment of PTMC remain controversial at home and abroad given their lack of evidence-based medical evidence. This paper summarizes the controversies surrounding the treatment of PTMC.
Electronic portal imaging devices have become important equipment for radiotherapy quality control and quality assurance. They can be used to verify positioning errors and other quality control indicators. They can also be applied in the daily quality control of the accelerator, dosimetry, and real-time dosimetry to ensure the accuracy of radiotherapy implementation. In this paper, the application of electronic portal imaging devices in radiotherapy is briefly reviewed.
SPECT/CT imaging was conducted on an ectopic kidney in a patient with congenital anal atresia. Most cases of ectopic kidney are found by chance during physical examination given the lack of the specific clinical symptoms of this condition during its early stage. At present, the diagnosis of ectopic kidneys mainly depends on ultrasound and CT. Renal dynamic imaging, however, provides advantages for the evaluation of the individual functions of ectopic kidneys. Gate's method was used to detect the glomerular filtration rate of an ectopic kidney. Literature review was performed to obtain a deep understanding of Gate's method. The following guiding conclusions were drawn:1. The co-occurrence of other organ malformations in newborns with kidney malformations should receive close attention. Early detection and intervention are necessary to manage ectopic kidneys. 2. SPECT/CT enables the advantageous one-stop diagnosis of the morphology and function of ectopic kidneys. 3. Gate's method requires proper correction for the glomerular filtration rate determination of kidneys with special characteristics.
The author reports a case of the hyperfunction of an ectopic parathyroidoma in the anterior superior mediastinum. A 58-year-old woman with pain in the right hip was diagnosed with multiple bone metastases through magnetic resonance imaging (MRI). Computed imaging revealed a soft tissue mass shadow in the anterior superior mediastinum of the patient's tomography (CT) chest. Super-bone imaging through whole-body bone scintigraphy and parathyroid scintigraphy indicated that the mass was an anectopic mediastinum parathyroidoma. Through pathological diagnosis after thoracoscopic surgery, the mass was identified as a parathyroid adenoma with hyperfunction. The ectopic parathyroid adenoma of the anterior superior mediastinum with hyperfunction and accompanied by changes in super-bone imaging is clinically rare. Technetium methylene diphosphonate (99Tcm-MDP) whole-body bone scintigraphy combined with technetium sestamibi (99Tcm-MIBI) parathyroid scintigraphy can provide important information for the diagnosis of suspected ectopic parathyroidoma.
The imaging manifestations of pulmonary lymphoma are various, and it is necessary to make a comprehensive judgment based on the CT features, FDG concentration and other organ invasion conditions. The author selected two pathologically confirmed cases of pulmonary lymphoma, respectively primary pulmonary lymphoma and secondary pulmonary lymphoma, and analyzed their clinical features and 18F-FDG PET/CT imaging findings in detail. It is expected to provide clinical help.