2018 Vol. 42, No. 5

Clinical Investigations
Evaluation of the image quality of integrated imaging in coronary combined with carotid and cerebrovascular computed tomography angiography
Shurong Liu, Guoqiang Chen, Liang Zheng, Yuzhen Zhang, Ruijuan Han, Ruiping Zhao, Qi Yang, Kuncheng Li, Kai Sun, Bin Lyu
2018, 42(5): 389-396. doi: 10.3760/cma.j.issn.1673-4114.2018.05.001
Objective To evaluate the image quality, radiation dose and key technologies of integrated imaging in coronary combined with carotid and cerebrovascular computed tomography angiography (CTA), which hopes to offer a non-invasive imaging method for cardiovascular and cerebrovascular diseases evaluation.Methods A total of 493 symptomatic patients referred for simultaneous coronary, carotid, and cerebrovascular CTA were prospectively included. The subjects were divided into two groups according to CT model. Group A (300 cases), on which 3rd generation dual-source CT was performed, was further divided into groups A1 (n=69, HR ≤ 65 bpm) and A2 (n=231, HR>65 bpm), while group B (113 cases), on which 2nd generation dual-source CT was performed, was further divided into groups B1 (n=92, HR ≤ 65 bpm) and B2 (n=101, HR>65 bpm).Objective and subjective image quality and radiation dose were nalyzed, factors influencing image quality were determined, and the key technologies of the method were described. The measurement data were tested by independent sample t test, the frequency parameter composition ratio in the patient's clinical data was tested by chi-square χ2 test, and Cohen Kappa analysis was used to evaluate the consistency of the image quality score.Results (1) No statistically significant difference between groups A and B was found in terms of age (t=0.58, P=0.847), gender (χ2=1.45, P=0.228), and body mass index (t=1.20, P=0.277). (2)Objective evaluation of image quality:Common carotid artery, internal carotid artery, middle cerebral artery, and vertebral artery CT values and noise in group A were significantly lower than those in group B (t=1.98-4.49, all P < 0.05), although no statistically significant difference between groups was found in terms of aortic root CT values (t=0.68, P=0.495) and noise score (t=0.31, P=0.755). (3) The consistency of the image quality assessment was good (Kappa value=0.912). ① Subjective evaluation of image quality:The average coronary CTA image quality score of group A was better than that of group B (t=0.018, P=0.001), and the rate of non-diagnostic coronary grade 4 vessels based on number of patients in group A was lower than that in group B (χ2=6.63, P=0.014). ② Carotid-cerebrovascular CTA score of group A was better than group B (t=0.013, P=0.004), and carotid-cerebrovascular grade 4 vessels were less likely to be diagnosed in group A than in group B (χ2=4.38, P=0.036). ③ The effective radiation dose of group A was significantly lower than that of group B[(1.48±0.33) mSv vs. (2.14±0.52) mSv; t=14.79, P=0.001].Conclusions Integrated imaging by coronary and cerebrovascular CTA is a non-invasive imaging method which adopted different heart rates were captured by different scan time windows can providing high image quality with significant reduction of radiation for evaluation of coronary and cerebrovascular disease.
Comparison of toxicities and treatment outcome of weekly and triweekly cisplatin concurrent with intensity-modulated radiotherapy for locally advanced nasopharyngeal carcinoma
Mingwei Yang, Xiaoshen Wang, Fan Wang, Lin Yang, Fan Zhang, Hao Wang, Yin Lyu, Qibin Wu, Zhuting Tong
2018, 42(5): 397-402. doi: 10.3760/cma.j.issn.1673-4114.2018.05.002
Objective To evaluate the rates of hematologic and mucosal toxicities and treatment outcome of a weekly cisplatin (QW) and triweekly cisplatin (Q3W) regimens concurrent with intensity-modulated radiotherapy (IMRT) for local regionally advanced nasopharyngeal carcinoma (NPC).MethodsA total of 148 patients with biopsy-proven NPC staged at Ⅲ to IVB were retrospectively enrolled from October 2009 to December 2013 in this study. Among all patients, 75 and 73 received QW and Q3W cisplatin chemotherapy regimens concurrent with IMRT, respectively. All patients received neoadjuvant chemotherapy. The χ2-test was used to compare clinical characteristics of the patients and hematologic and mucosal toxicities. Tumor response and survival rates were estimated through the Kaplan-Meier method with log-rank test.Results The mean total cycles of the cisplatin regimen was 3.64 in the QW group with 15 patients (20%) reaching five cycles and 1.86 in the Q3W group with 86% reaching two cycles. Grades 1, 2 leucopenia were 31% vs. 51% and 35% vs. 19%, respectively, in the QW and Q3W groups. The two groups showed significant differences in Grades 1 and 2 leucopenia (χ2=6.150, 4.500, both P < 0.05) but not for other hematological toxicities and mucositis (χ2=0.137, P=0.934). The complete remission rates at 6 months after radiotherapy for the QW and QW3 groups were 98.7% and 98.6%, respectively. The 5-year estimated overall survival, disease-free survival, local recurrence-free survival, regional recurrence-free survival, and distant metastasis-free survival rates of the QW and Q3W groups were 77.84% vs. 79.97% (χ2=3.78, P=0.059), 67.96% vs. 69.10% (χ2=1.25, P=0.27), 88.76% vs. 86.96% (χ2=0.43, P=0.56), 91.49% vs. 90.84% (χ2=0.18, P=0.67), and 77.86% vs. 78.90% (χ2=0.31, P=0.56), respectively, and were not significantly different between the two groups.ConclusionsHematological toxicities associated with the QW3 regimen concurrent with IMRT for locally advanced NPC were milder than those associated with the QW weekly regimen. Mucositis and treatment outcome did not significantly differ between the two groups. Patients showed better compliance with the Q3W regimen than with the QW regimen.
Prognostic value of 18F-FLT PET/CT imaging in patients with recurrent gliomas
Daojia Liu, Junxin Wu, Mingdeng Tang, Duanyu Lin, Jieping Zhang, Shengxu Li, Zhihua Cai, Qinghu Lyu
2018, 42(5): 403-408. doi: 10.3760/cma.j.issn.1673-4114.2018.05.003
Objectives To evaluate the prognostic value of proliferation volume (PV) measured by pretreating patients with recurrent gliomas with 18F-fluorothymidine (FLT) PET/CT imaging.MethodsThe clinical data of 20 patients that underwent 18F-FDG PET/CT and 18F-FLT PET/CT examinations from January 2012 to January 2016 showed that recurrent gliomas were retrospectively analyzed. We measured the ratio of the maximum standard uptake value of the tumor to the mean standard uptake value of the normal brain tissue (T/NFLT), PV, and maximum diameter via 18F-FLT PET/CT imaging, T/NFDG was measured by 18F-FDG PET/CT imaging. The follow-up time lasted until December 2016.ResultThe median survival time of 20 patients with recurrent gliomas was 7 months. The optimal PV, T/NFLT, diameter, T/NFDG, and age cut-off values were 12.565 cm3, 7.752, 2.800 cm, 1.192, and 52 years, with the area under the curve values of 0.958, 0.865, 0.745, 0.646, and 0.667, respectively. Kaplan-Meier single factor analysis revealed that the survival times significantly differed among patients with different PV (< 12.565 cm3 vs. ≥ 12.565 cm3), T/NFLT (< 7.752 vs. >7.752), maximum diameter (< 2.800 cm vs. >2.800 cm), and T/NFDG values (< 1.192 vs. >1.192), as well as different pathologies of the first operation (WHO Ⅱ vs. WHO Ⅲ and Ⅲ) (χ2=12.587, 12.219, 4.285, 5.955, 6.787; all P < 0.05). Cox single-factor analyses indicated that PV, T/NFLT, T/NFDG, and pathology were the risk factors of survival, with the hazard ratios of 0.113 (95% CI:0.024-0.530), 0.105 (95% CI:0.021-0.513), 0.314 (95% CI:0.109-0.903), and 0.262 (95% CI:0.082-0.838), respectively. Cox multifactor analyses indicated that PV was an independent predictor of survival risk.Conclusion PV is an important factor in the prognosis prediction of patients with recurrent gliomas via 18F-FLT PET/CT imaging.
Effects of the different PET image reconstruction methods on distribution of dopamine transporter in healthy human brain
Yuhua Zhu, Jiaying Lu, Huiwei Zhang, Jingjie Ge, Ping Wu, Weiqi Bao, Zizhao Ju, Jian Wang, Yihui Guan, Chuantao Zuo
2018, 42(5): 409-413. doi: 10.3760/cma.j.issn.1673-4114.2018.05.004
Objective To study the effect of the reconstruction method on the semi-quantitative distribution of dopamine transporter (DAT) in the brain, 2β-carbomethoxy-3β- (4-fluorophe-nyl)- (N-11C-methyl)tropane (11C-CFT) PET images of healthy subjects were reconstructed by different PET reconstruction methods.Methods From March 2014 to June 2015, the 11C-CFT PET images of 41 healthy subjects were reconstructed by filtering back projection (FBP) method and ordered subsets expectation maximization (OSEM) iterative method. The brain regions of interest (ROI), namely, caudate nucleus, anterior putamen, and posterior shell nucleus, were automatically sketched with the parietal and occipital cortex lacking of DAT distribution as reference regions. The semi-quantitative value of DAT distribution was calculated using the following formula:radioactivity count of ROI/radioactivity count of parietal and occipital cortex-1. Paired t-test was used to compare the semi-quantitative values of DAT distribution. Correlation analysis was performed using the Pearson correlation analysis.ResultsThe values of DAT distribution based on OSEM were as follows:caudate nucleus (1.77-2.15), anterior putamen (2.17-2.39), and posterior putamen (1.71-2.06). The values of DAT distribution based on FBP were as follows:caudate nucleus (1.68-2.10), anterior putamen (2.07-2.37), and posterior putamen (1.62-1.96). In the bilateral caudate nucleus and anterior and posterior putamen, the 11C-CFT of DAT distribution by OSEM was significantly higher than that by FBP (t=9.658-15.859, all P=0.000). The Pearson correlation analysis showed that the semi-quantitative values of DAT distribution by FBP and OSEM were positively correlated with each other in the bilateral caudate nucleus and anterior and posterior putamen (R2=0.907-0.951, all P=0.000). The DAT distribution by OSEM and FBP decreased with aging in the caudate nucleus and anterior and posterior putamen.Conclusions A significant difference was found in the semi-quantitative value of the DAT distribution in the brain of healthy subjects by different PET reconstruction methods. Therefore, a consistent PET image reconstruction method should be used in a multicenter or longitudinal study.
Basic Science Investigations
Biological evaluation of PET/CT imaging agent 18F-fluoropropionic acid in hepatocellular carcinoma
Jing Zhao, Zhanwen Zhang, Hui Ma, Dahong Nie, Ningyi Jiang, Sheng Liu, Ganghua Tang
2018, 42(5): 414-419. doi: 10.3760/cma.j.issn.1673-4114.2018.05.005
Objective To evaluate the potential of 18F-fluoropropionic acid (18F-FPA) as a PET/CT tracer in the imaging of hepatocellular carcinoma (HCC) and to identify the mechanism underlying 18F-FPA uptake.Methods (1) 18F-FPA was synthesized from the precursor methyl-2-bromopropionate. (2) 18F-FPA uptake by SK-Hep 1 HCC cells was quantified in vitro at different time points. To further investigate the mechanism underlying 18F-FPA uptake, the inhibitory effects of the fatty acid synthase inhibitor Orilistat and the acetyl-CoA carboxylase inhibitor 5-tetradecyloxy-2-furoic acid on 18F-FPA uptake were observed. (3) Micro-PET/CT imaging results for 18F-FPA and 18F-FDG for mouse models of human hepatocellular carcinoma SK-Hep 1 were obtained and compared. Mthe radioactivity uptake ratios of 18F-FDA and 18F-FDG were compared and analyzed with t test.Results(1) 18F-FPA was synthesized with a yield of 45±2% through a simple process. (2) 18F-FPA uptake ratio by SK-Hep 1 cells gradually increased from (1.3±0.4)% after 5 min to (4.6 ±0.2)% after 120 min. In the cell uptake inhibition experiments, 18F-FPA uptake by SK-Hep 1 cells gradually decreased as inhibitor concentration increased. Under Orilistat and TOFA concentrations of 400 μmol, 18F-FPA uptake by SK-Hep 1 cells decreased by (40.3±4.0)% and (26.0±6.0)%, respectively. (3) 18F-FPA showed rapid and accurate tumor localization in mouse models of human hepatocellular carcinoma SK-Hep 1 with a tumor/liver ratio of 1.63±0.26. When used in 18F-FDG PET/CT imaging, the tumor/liver ratio of 18F-FPA reached 1.09±0.21. The imaging results provided by 18F-FPA were superior to those provided by 18F-FDG (t=4.055, P=0.047).Conclusion 18F-FPA can be used as an alternative radiotracer in the detection of hepatocellular carcinoma, its uptake is related to fatty acid synthesis.
Protective effect of gonadotropin releasing hormone antagonist on ovarian function injury induced by pelvic radiotherapy
Yan Tan, Chuntang Sun, Gaoshu Yan, Zixuan Fan, Peng Diao, Qian Peng, Xingbo Luo, Weidong Wang
2018, 42(5): 420-424, 435. doi: 10.3760/cma.j.issn.1673-4114.2018.05.006
Objectives To investigate the protective effect and mechanism of a gonadotropin-releasing hormone antagonist (GnRH-ant) against an ovarian function injury induced by pelvic radiotherapy in a rat model.Method 1. Ten female Wistar rats were randomly assigned to gonadotropin-releasing hormone agonist (GnRH-a) and GnRH-ant groups using the random number table method. The rats were subcutaneously injected with goserelin (0.25 mg once) or cetrorelix (5 μg/day for 10 days). Changes in luteinizing hormone (LH) and estradiol (E2) in each group were dynamically observed. 2. Forty female Wistar rats were randomly divided into four groups (control, GnRH-ant, R, and GnRH-ant+R) and then given corresponding treatments. Ovarian wet weight, levels of serum LH, E2, and AMH, and the number of follicles at every stage were compared between groups through analysis of variance and independent sample t-test.Results1. In the GnRH-a group, LH and E2 levels increased initially and then gradually decreased, reaching a low value in approximately 10 d. In the GnRH-ant group, LH and E2 levels decreased rapidly, reaching the minimum value in 4 d without flare-up effect. 2. After pelvic radiotherapy, the ovarian wet weight in the GnRH-ant+R group was significantly higher[(58.3±9.1) mg vs. (37.8±7.1) mg, t=5.61, P=0.000] than that in group R. In the GnRH-ant+R group, the levels of E2[(57.49±13.45) pg/mL vs. (16.64±6.54) pg/mL, t=8.64, P=0.000] and AMH[(5.47±1.32) mIU/mL vs. (2.23±0.72) mIU/mL, t=6.81, P=0.000] were significantly higher than those in group R. The FSH level in GnRH-ant+R group was significantly lower[(27.74±7.75) mIU/mL vs. (8.35±1.43) mIU/mL, t=7.75, P=0.000] than that in group R. The number of primordial and primary follicles in group GnRH-ant+R was significantly higher (46.2±12.3 vs. 27.6±5.1, t=4.42, P=0.000) than that in group R.Conclusions GnRH-ant can rapidly induce ovarian inhibition without flare-up effect. Subcutaneous injection of GnRH-ant before pelvic radiotherapy can inhibit the ovary and stop the follicles in the primary and primordial follicle stages, thus reducing the damage induced by radiotherapy.
Preparation and characteristic analysis of 99Tcm-MIBI liposomes
Hui Li, Junjie Sun, Weipeng Li, Gang Zi, Chao Yuan
2018, 42(5): 425-429. doi: 10.3760/cma.j.issn.1673-4114.2018.05.007
Objective To study the preparation and analyze the characteristics of 99Tcm-methoxy isobutyl isonitrile (MIBI) liposomes.Methods 99Tcm-MIBI liposomes were prepared through the ethanol injection-ultrasonication method. Liposome size and encapsulation efficiency were determined, and ultrasonication duration and soybean lecithin-to-cholesterol mass ratio were optimized to observe their effects on the stability of 99Tcm-MIBI liposomes.Results When the mass concentration of 99Tcm-MIBI was 0.01 mg/mL, the average particle size was (171.4±25.2) nm, and the average encapsulation efficiency was (8.5±1.3)%. The optimal preparation conditions consisted of the mass ratio of soy lecithin to cholesterol of 4:1, the 99Tcm-MIBI mass concentration of 0.01 mg/mL, and ultrasonication duration of 5 min. Electron micrograph images revealed that after the first day, particles reduced in size and appeared regular and uniform in shape. The particles appeared completely spherical or elliptical. Particle sizes and shapes negligibly changed after 30 d.Conclusion 99Tcm-MIBI liposomes with small particle size, high encapsulation efficiency, and stable entrapment efficiency can be obtained through the ethanol-ultrasonication technique.
In vitro CT imaging of gold nanorods as novel CT contrast agents
Wei Yin, Ri Liu, Minjie Wang, Jing Gong
2018, 42(5): 430-435. doi: 10.3760/cma.j.issn.1673-4114.2018.05.008
Objective To investigate the in vitro CT imaging parameters of gold nanorods as novel CT contrast agents.Methods Gold nanorods were prepared with a gold seed and a growth solution. PEG-modified gold nanorods and non-ionic iodine contrast agent were configured into eight concentrations (0, 0.1, 0.2, 0.4, 0.6, 0.8, 1.0, 2.0 mg/mL). The different concentrations of the gold nanorod solutions in air and water bath were subjected to in vitro CT scanning imaging at different tube voltages (80-140 kV) and milliamp seconds (50-400 mAs). The development effect was observed, and the CT value was measured.Results (1) At different concentrations of the gold nanorod solutions, the CT value scanned in water is the closest to the true value, whereas the CT value in air is low. (2) The lower the tube voltage is, the higher the CT value of the gold nanorod solution is. At a solution concentration of 2.0 mg/mL, the difference in the signal-to-noise ratio at different tube voltages is evident. (3) The image quality is positively correlated with mAs, but the image quality is not significantly changed at ≥ 300 mAs. (3) At 80 kV and 300 mAs, the CT values of the gold nanorods and the iodine contrast agent increase as the concentration increases and show a highly positive correlation (r=0.990, 0.994, both P < 0.05). The difference in CT values between the two agents increases, and the contrast of the gold nanorods is higher than that of the iodine contrast agents.Conclusion Gold nanorods exhibit superior imaging characteristics to those of existing CT contrast agents. When gold nanorods are scanned with iCT at 80 kV and 300 mAs and under water bath conditions, an excellent image quality can be achieved.
Review Articles
Progress in the measurement of coronary reverse flow in coronary microvascular diseaseswith PET/CT
Kun Peng, Jianming Li
2018, 42(5): 436-440, 446. doi: 10.3760/cma.j.issn.1673-4114.2018.05.009
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.
Advances in clinical application of 18F-FDG PET/CT and 18F-FDG PET/MRI in ovarian cancer
Wei Zhang, Lijuan Yu
2018, 42(5): 441-446. doi: 10.3760/cma.j.issn.1673-4114.2018.05.010
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.
The application and progress of PET/CT and MRI in multiple myeloma
Jianpu Chen, Chongjiao Li, Bing Wen, Yong He
2018, 42(5): 447-452. doi: 10.3760/cma.j.issn.1673-4114.2018.05.011
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.
Application of SPECT/CT in diagnosis and treatment of foot and ankle diseases
Xiaoyue Chen, Xinyun Zhang, Zhongming Shi, Quanyong Luo
2018, 42(5): 453-457. doi: 10.3760/cma.j.issn.1673-4114.2018.05.012
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.
Analysis of abdominal and pelvic extraosseous uptake of 99Tcm-methylene diphosphonate on bone scintigraphy
Ruiguo Zhang, Qiang Jia, Jian Tan
2018, 42(5): 458-462. doi: 10.3760/cma.j.issn.1673-4114.2018.05.013
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.
Progress in the treatment of papillary thyroid microcarcinoma
jie Deng, dong Duan
2018, 42(5): 463-467. doi: 10.3760/cma.j.issn.1673-4114.2018.05.014
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.
Advances in the application of electronic portal imaging device in radiotherapy
Kexin Li, Yongjian Ju
2018, 42(5): 468-471. doi: 10.3760/cma.j.issn.1673-4114.2018.05.015
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.
Case Reports
Ectopic kidney SPECT/CT imaging in a patient with congenital anal atresia
Weiguang Chao, Jing Zhang, Keyi Lu
2018, 42(5): 472-474. doi: 10.3760/cma.j.issn.1673-4114.2018.05.016
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.
Hyperfunction of an ectopic parathyroid adenoma in the anterior superior mediastinum: a case report of whole-body bone scintigraphy
Xulong Zhao, Zaiying Long, Liming Yu, Yanxia Zhao
2018, 42(5): 475-477. doi: 10.3760/cma.j.issn.1673-4114.2018.05.017
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.
Difficult and Complicated Cases Analysis
Differential diagnosis and analysis of pulmonary lymphoma using 18F-FDG PET/CT
Libo Zhang, Wenchao Ma, Hui Huang, Peihe Chen, Yufan Zhang, Wengui Xu
2018, 42(5): 478-481. doi: 10.3760/cma.j.issn.1673-4114.2018.05.018
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.