2018 Vol. 42, No. 6

Clinical Investigations
The characteristics of 18F-FDG PET/CT in pulmonary cryptococcosis
Jin Zhou, Donglang Jiang, Fang Xie, Liping Zhu, Yihui Guan, Fengchun Hua
2018, 42(6): 481-485. doi: 10.3760/cma.j.issn.1673-4114.2018.06.001
ObjectiveTo investigate the 18F-FDG PET/CT imaging characteristics and PET metabolic characteristics of pulmonary cryptococcosis (PC).MethodsA retrospective study was performed in 22 patients with PC (16 male and 6 female; 34-81 years old), confirmed through etiology or pathological examination from March 2011 to October 2015. To analyze the clinical data, CT patterns (single nodule, multiple nodules, pneumonia type, and mixed type), CT signs (vessel convergence sign, spiculation sign, halo sign, air bronchogram, and lobulation), and FDG metabolic patterns(hypermetabolism and hypometabolism) of PC were analyzed.ResultsPC was characterized by single nodule(9/22), multiple nodules(7/22), pneumonia type (1/22), and mixed type (5/22) for the 22 patients with PC. Most of the nodules were found in the inferior lobe of the lung. There were 15 cases(15/22, 68.18%) involving one or both inferior lobe of the lungs, of which 9 cases(9/22, 40.91%) involving the right inferior lobe, 2 cases(2/22, 9.09%) involving the left inferior lobe. Vessel convergence sign(12/21) was the most common sign, followed by spiculation(10/21), halo sign(8/22), air-bronchogram sign(6/21), and lobulation(4/21) with nodules on CT scan. The maximum standardized uptake value of PC was from 1.00 to 12.67 on 18F-FDG PET/CT scan, and hypermetabolism type (20/22) was the predominant pattern. Six patients with single nodule were misdiagnosed as malignant tumors.ConclusionsMost cases of PC were characterized with single and multiple nodules. A relative high rate of misdiagnosis was obtained using 18F-FDG PET/CT scan with varied standardized uptake value. Diagnosis of single nodule with high FDG metabolism in lung cancer should differentiate from PC.
18F-FDG PET/CT manifestations of pulmonary large cell neuroendocrine carcinoma
Wei Liu, Tiannyu Li, Lei Fan, Chongyang Ding
2018, 42(6): 486-490. doi: 10.3760/cma.j.issn.1673-4114.2018.06.002
ObjectiveTo investigate the 18F-FDG PET/CT manifestations of pulmonary large cell neuroendocrine carcinoma(LCNEC).MethodsThe 18F-FDG PET/CT manifestations of 37 lung LCNEC patients confirmed by pathology from October 2009 to May 2017 were analyzed. These manifestations include lesion location, shape characteristics, lymph node metastasis, lesion metabolism, and predictive value of primary tumor maximum standardized uptake value(SUVmax) for lymph node metastasis. Pearson's correlation was used to analyze the relation between primary tumor SUVmax and maximum tumor diameter.ResultsAll 37 patients with lung LCNEC were with single lung node, including 28 patients located peripherally(28/37, 75.7%) and 9 patients located centrally(9/37, 24.3%). Lobulation of tumors was found in 30 cases(30/37, 81.1%), and spiculation was observed in 10 cases(10/37, 27.0%). The tumors were smooth and well defined in 29 cases(29/37, 78.4%), whereas pleural indentation, necrosis, cavity, calcification, and air bronchograms were found in 9, 2, 1, 1, and 1 cases, respectively. The metabolism of 18F-FDG in 37 lesions was higher than that in the liver. The SUVmax was 11.7±5.2(3.3-25.3), and the maximum tumor diameter(3.2±1.5) cm. These two parameters showed a positive correlation(r=0.569, P=0.000). Mediastinal and/or hilar lymphadenectasis was observed in 15 cases. Distant metastasis was observed in 8 cases, including bone metastasis in 4 cases, adrenal gland metastasis in 1 cases, liver and bone metastasis in 2 cases, and adrenal gland and bone metastasis in 1 case. Primary tumor SUVmax had a predictive value for lymph node metastasis. When the cut-off value was 11.9, the Youden index was 0.573, and the diagnostic efficiency was the highest with 80% sensitivity and 77.3% specificity.ConclusionsThe 18F-FDG PET/CT manifestations of most pulmonary large cell neuroendocrine carcinoma are characterized by round soft tissue nodules or masses with clear margins, rare air bronchograms, and high 18F-FDG uptake. Primary tumor SUVmax is an important semi-quantitative indicator for predicting lymph mode metastasis.
Analysis of factors affecting the residual radioactive activity of injection of 18F-FDG
Nan Lin, Li Zhang, Guansheng Tong, Jiong Cai
2018, 42(6): 491-494. doi: 10.3760/cma.j.issn.1673-4114.2018.06.003
ObjectiveThe factors influencing residual radioactivity in 18F-FDG injection were analyzed to guide the packing of radiopharmaceuticals.MethodsA total of 100 patients subjected to 18F-FDG PET/CT in Beijing Shijitan Hospital from October 2017 to December 2017 were analyzed. Patients were divided into different groups based on the volume and radioactivity of the radiopharmaceuticals they received. The residual radioactivity of the syringe tube, syringe needle, three-way valve, scalp needle, and background was then measured separately using a radioactivity meter. The curve of the total residual radioactivity as a function of 18F-FDG concentration was then fitted. SPSS 17.0 statistical software was used to test the normality of the data distribution, and results were analyzed by Spearman correlation.ResultsThe residual radioactivity values of the syringe needle tube, syringe needle, three-way valve, and scalp intravenous needle were 1.59(0.93), 3.35(3.43), and 1.70(0.92) MBq, respectively. The total residual radioactivity was 7.09(4.31 MBq) and significantly related to the concentration of 18F-FDG applied(r=0.594, P < 0.01). According to the fitting curve obtained, the appropriate radioactivity concentration of 18F-FDG is less than 600 MBq/mL.ConclusionsIn clinical work, appropriate dilution of the 18F-FDG injection volume and decreasing the radioactivity of pharmaceuticals can effectively reduce the total residual radioactivity of the procedure. Medical institutions should measure the appropriate dilution concentration of radioactive drugs according to the specifications of the syringes to increase the precision of injection and reduce the irradiation dose of the staff.
Changes of bone mass in patients with Graves' hyperthyroidism before and after 131I therapy based on CT spectral imaging
Renfei Wang, Xiaoli Tian, Jian Tan, Guizhi Zhang, Ruiguo Zhang, Yajing He
2018, 42(6): 495-499, 506. doi: 10.3760/cma.j.issn.1673-4114.2018.06.004
ObjectiveTo investigate the value of CT spectral imaging to evaluate bone mass in patients with Graves' hyperthyroidism, and the changes of bone mass before and after 131I therapy.MethodsSixty-eight patients(13 males, 55 females; age 40.6±10.7yr) with Graves' hyperthyroidism who received 131I therapy from June to October 2015 were involved in our study. The bone mineral density(BMD) of lumbar was obtained by dual energy X-ray absorptiometry(DXA), and the calcium-water concentration of L3 was measured by CT spectral imaging before 131I therapy. Pearson correlation analysis and linear regression were performed to explore the relationship between them. All clinical data were collected to assess the efficacy of 131I therapy after 6 months. CT spectral imaging was repeated, in order to compare the changes of bone mass using comparative t-test.ResultsOf these patients with Graves' hyperthyroidism, 30.9% (21/68) patients with osteopenia and 10.3%(7/68) patients with osteoporosis were diagnosed according to the results of BMD by DXA. The calcium (water) densities of L3 were (64.33±14.65), (48.29±4.45) and (41.65±1.21) g/cm3 in patients with normal bone mass, bone loss and osteoporosis, respectively. The differences between the three groups were statistically significant (χ2=35.811, P < 0.001). The bone mineral density of L3 were (1.252±0.305), (1.103±0.254) and (0.539±0.066) g/cm3 in patients with normal bone mass, bone loss and osteoporosis, respectively. The differences between the three groups were statistically significant (F=12.968, P < 0.001). The calcium-water concentrations of L3 (g/cm3) were highly correlated with BMD values (g/cm2) of lumbar determined by DXA(r=0.794, hypothesis testing standard α=0.01, t=10.605, P < 0.001). Equation of linear regression:the calcium-water concentration of L3=24.485+34.529 BMD value of lumbar. Furthermore, after 131I therapy, the calcium-water concentrations of L3 increased(t=7.86, P < 0.001) in the cured group of patients. But there weren't significant difference in the uncured group of patients(t=2.29, P=0.062).ConclusionsCT spectral imaging can be used to evaluate bone mass in patients with Graves' hyperthyroidism. Bone mass can be improved with remission of hyperthyroidism after 131I therapy.
Study of image quality and diagnostic accuracy of low-dose coronary angiography using third-generation dual-source CT with free breathing and heart rate
Jiahuan Xu, Wenwen Zhang, Yuhang Lyu, Qingyu Ji, Guoqiang Chen, Ruijuan Han, Yuhang Su, Kai Sun
2018, 42(6): 500-506. doi: 10.3760/cma.j.issn.1673-4114.2018.06.005
ObjectiveTo prospectively investigate the diagnostic accuracy, image quality, and radiation doses of electrocardiogram (ECG)-triggered high-pitch acquisition (turbo flash) coronary computed tomography(CT) angiography(CCTA) using third-generation dual-source CT compared with coronary angiography(CAG) for the diagnosis of significant coronary stenoses.MethodsProspectively collected 1003 patients who received the third-generation dual-source CCTA examination from April 2016 to April 2017. Among them, 70 patients underwent coronary angiography(CAG) 30 days after CCTA examination to score the image quality of each segment of coronary artery and calculate the effective radiation dose. The sensitivity, specificity, positive predictive value and negative predictive value of CCTA for coronary artery lesions were calculated using CAG results as the gold standard. The consistency of CCTA and CAG in grading coronary artery stenosis was evaluated by Kappa value and U test.Results(1) Image quality:no non-diagnostic image quality was observed in the right coronary artery nor left anterior descending artery. The rate of coronary segments with non-diagnostic image quality reached 0.04% in the left circumflex artery. (2) Diagnostic accuracy:the sensitivity, specificity, and positive and negative predictive values totaled 97.0%(289/298), 98.3%(706/718), 96.0%(289/301), 98.7%(706/715) for segment assessment and 97.5%(159/163), 85.1% (40/47), 95.8%(159/166), 90.9%(40/44) for vessel assessment, and all the values are 100% for patients assessment. CCTA was highly consistent with the site of coronary artery stenosis shown by CAG(U=2.4, P < 0.05). ⑶ Radiation doses:the effective radiation dose was(1.17±0.29) mSv on average.ConclusionsCCTA using the prospectively ECG-triggered high-pitch mode (turbo flash) of the third-generation dual-source CT system is associated with high diagnostic accuracy for the assessment of coronary artery stenoses at low doses.
Quantitative analysis value of uric acid deposition in patients with hyperuricemia by Gemstone spectal CT
Junjie Bin, Mei Wu, Zhongqi Wang, Huiling Chen, Guan Li
2018, 42(6): 507-512. doi: 10.3760/cma.j.issn.1673-4114.2018.06.006
ObjectiveTo evaluate the quantitative analysis value of gemstone spectral CT for diagnosing urate deposition in the first metatarsophalangeal joint and periarticular soft tissue of patients with hyperuricemia.MethodsThis work involved 84 patients with hyperuricemia who underwent foot gemstone spectral CT from October 2016 to June 2017. The patients were divided into three groups:36 patients (group A) with normal imaging, 23 patients(group B) with bone destruction, and 25 patients(group C) with bone destruction and uric acid crystallization. The basal concentrations of uric acid(calcium) in the first metatarsophalangeal joint cortical bone, cancellous bone and periarticular soft tissue were measured using gemstone spectral CT scanning. The age, serum uric acid value, and basal concentration of uric acid(calcium) were compared by univariate ANOVA among the three groups. In intra-group comparison, LSD method was used for the data with equal variance, and Tamhane's T2 test was used for the data with unequal variance.Correlation of serum uric acid value with the uric acid(calcium) level of the first metatarsophalangeal joint cortical bone, cancellous bone, and periarticular soft tissue in all hyperuricemia patients was analyzed by linear regression.ResultsSignificant differences in age, serum uric acid value, and uric acid (calcium) concentration were found for periarticular soft tissues of the first metatarsophalangeal joints(P < 0.05). No differences were observed between the uric acid(calcium) concentration in the first metatarsophalangeal joint cortical bone and cancellous bone. The following values were obtained for age:group A(39.1±11.1) years old, group B (48.5±13.9) years old, and group C (43.2±12.5) years old (LSD, P=0.019); for serum uric acid value:group A(489.5±90.6) μmol/L, group B(494.7±77.2) μmol/L, and group C(581.3±69.2) μmol/L(LSD, P < 0.001); for the uric acid (calcium) concentration in the periarticular soft tissues of the first metatarsophalangeal joints:group A (1169.58±7.88) mg/cm3, group B (1193.13±16.35) mg/cm3, and group C (1308.20±85.89) mg/cm3(χ2=61.698, P < 0.001); for the uric acid(calcium) concentration in the first metatarsophalangeal joints:group A (1324.8±31.4) mg/cm3, group B (1335.6±37.3) mg/cm3, and group C (1320.4±43.5) (LSD, P=0.346); for the uric acid(calcium) concentration in the cancellous bone of the first metatarsophalangeal joints:group A (1134.3±13.3) mg/cm3, group B (1145.8±23.3) mg/cm3, and group C (1145.8±30.9) mg/cm3 (χ2=3.464, P=0.177). The serum uric acid value was linearly positively correlated with the uric acid(calcium) concentration in periarticular soft tissues of the first metatarsophalangeal joints, but not with the uric acid(calcium) concentration in cortical bone and cancellous bone of the first metatarsophalangeal joints.ConclusionGemstone spectral CT can measure quantitatively the internal and external base material concentrations of joints and define the crystallization of uric acid salt, which can provide a basis for clinical judgment.
The study for biological effect dose of spinal cord in thoracic tumors with the model of conformal and intensity modulated technique and conventional fractionation
Weidong Liu, Jianping Liu, Meng Guo, Haifang Yang, Bin Jiang, Chunyu Xu
2018, 42(6): 518-523. doi: 10.3760/cma.j.issn.1673-4114.2018.06.008
ObjectiveTo investigate the necessity and feasibility of evaluation for spinal cord biological effect dose (BED) in clinical radiotherapy on thoracic tumors in the model of conformal or intensity modulated technique and conventional fractionation.MethodsFrom 16 May 2016 to 31 December 2016, 30 patients accepting thoracic radiotherapy were selected in the Radio-chemotherapy department of Tangshan City People's Hospital. Radiotherapy plans of these patients were evaluated by the evaluation module of the RTIS treatment plan system, and then the physical dose(PhD) and BED were compared, respectively. After that, the PhD and BED of the spinal cord in different dose curves for 2.0 Gy irradiation 1 and 30 times were calculated by the linear quadratic equation(L-Q model). T test was used for all comparison between groups in statistics.ResultsThe BED curve of the spinal cord was on the left of the PhD curve, and the BED curve of planning target volume(PTV) was on the right of the PhD curve. In the radiotherapy plans of the 30 patients, for the spinal cord, the minimum maximum, average doses of PhD and BED were (80.41±274.75), (3398.00±1200.95), (1265.79±762.49) cGy and (74.71±249.34), (3118.93±1181.96), (1181.44±742.18) cGy, separately, the differences of them were significantly(t=0.826, 6.143, 5.234, all P < 0.05). However, for the PTV of target the minimum, maximum, average doses of PhD and BED were (3615.51±1566.10), (5505.26±1731.64), (4984.33±1615.59) cGy and (3500.97±1576.92), (5672.93±1791.98), (5047.63±1646.57) cGy, all of them were no significances in statistics (t=6.953, -2.164, -1.193, all P>0.05). With the decline of the dose curve, the PhD and BED were reducing, and the BED were lower than the PhD in the curve for corresponding dose.ConclusionsIn the radiotherapy of thoracic tumors, considering potential enhancement of local target control and better spinal cord protection, it is necessary to evaluate the BED of the spinal cord.
Comparison of digital subtraction computed tomography angiography and color doppler ultrasound on the detection rate of carotid atherosclerosis plaques and the evaluation of plaque properties and stenosis degree
Jinglai Sun, Chengxiang Wei, Wenhuai Han, Jie Xu, Fenglan Chen
2018, 42(6): 513-517. doi: 10.3760/cma.j.issn.1673-4114.2018.06.007
ObjectiveTo compare the value of digital subtraction computed tomography angiography (DSCTA) and color doppler ultrasound (CDUS) in the detection of carotid atherosclerotic plaques, plaque properties, and degree of stenosis.MethodsA total of 90 patients suspicted with carotid artery stenosis were diagnosed in the department from January 2015 to October 2017 and examined with DSCTA and CDUS. The detection rates and plaques of carotid atherosclerotic plaques diagnosed by the two methods were observed. The nature and degree of carotid artery stenosis were compared.ResultsDSCTA examination of bilateral neck of the 90 patients revealed 52 carotid artery stenosis, 3 of which were bilateral stenosis. A total of 29 cases were diagnosed with mild stenosis, 9 cases with moderate stenosis, 12 cases with severe stenosis, and 2 cases with complete occlusion. A total of 175 plaques, including 133 calcified plaques, 30 mixed plaques, and 12 plaques, were detected. In the 90 necks of both necks, CDUS findings revealed 54 carotid stenosis, of which 3 were bilateral stenosis. Mild stenosis occurred in 26 cases, moderate stenosis in 10 cases, severe stenosis in 16 cases, and complete occlusion in 2 cases. A total of 218 plaques were detected, and they included 138 calcified plaques, 39 mixed plaques, and 41 plaques. No significant difference was observed between DSCTA and CDUS in terms of diagnosis of carotid stenosis (χ2=0.75, P=0.861). For most of the visible plaques and lipid plaques, the detection rate of < 5 mm small plaques(60) was significantly higher than that of DSCTA(25) (χ2=10.035, P=0.002).ConclusionsThe two diagnostic methods feature high diagnostic capability for carotid stenosis and desirable clinical application value. CDUS was superior to DSCTA in detecting carotid atherosderotic plaque < 5 mm in diameter.
Basic Science Investigation
Automated synthesis and biodistribution study of cardiac fatty acid metabolism imaging agent 18F-FTHA
Yulin He, Xiaojun Zhang, Jianbo Li, Guojian Zhang, Jinming Zhang, Xuemei Wang
2018, 42(6): 524-529. doi: 10.3760/cma.j.issn.1673-4114.2018.06.009
ObjectiveTo achieve the fully automated synthesis of myocardial fatty acid metabolism imaging agent 14(R, S)-[18F]fluoro-6-thia-heptadecanoic acid (18F-FTHA), its biological distribution characteristics in normal Kunming mice were evaluated.MethodsAn automated synthesis module benzyl-14-tosyloxy-6-thia-heptadecanoate was used as precursor. The synthesis process was completed in four steps:nucleophilic substitution, alkaline hydrolysis, semi-preparative high-performance liquid chromatography, and solid-phase extraction. The physical(traits, activity, specific activity, half-life, and radionuclide purity), chemical (chemical purity, radiochemical purity, and room temperature stability), and biological properties (toxicity, sterility, and bacterial endotoxin) of the compound were identified. Twenty Kunming mice were randomly divided into four groups, with five mice in each group. The imaging agent 18F-FTHA 7.4 MBq(volume < 0.2 mL) was injected through the tail vein. A group of mice was sacrificed at 15, 30, 60, and 90 min after injection, and the blood and main organs, such as heart, liver, spleen, lung, kidney, muscle, and bone, were obtained and weighed. The radioactivity count was measured by a gamma counter. The radioactive uptake(%ID/g) was calculated.ResultsThe total synthesis time was about 50 min. The synthetic yield was(10.0±1.7)%. The 18F-FTHA is an injection containing 10% ethanol. The compound is a sterile, endotoxin-free, colorless clear solution. Its pH value is 6-7, specific activity is 65 GBq/mmol, radioactive nuclear purity is ≥ 99%, and radiochemical purity is > 98%, which remained at > 95% after 6 h at room temperature. Biodistribution experiments in normal Kunming mice showed that 18F-FTHA rapidly cleared in the blood, and a high myocardial uptake and low non-target organ uptake were observed. At 60 min after injection, the radioactivity uptake of myocardium, lungs, and liver reached(19.04±4.87)%ID/g, (3.05±0.52)%ID/g and(5.99±2.96)%ID/g, respectively. The heart-to-lung and heart-to-liver uptake ratios totaled 6/1 and 3/1, respectively. The liver uptake at 15 and 30 min was slightly higher than the myocardial uptake.ConclusionsThe synthesis of 18F-FTHA, which features high radiochemical purity and good stability, has been automatically completed. Physical, chemical, and biological property identification results confirmed that the compound is safe and reliable. The biological distribution experiments on mice confirmed that myocardial uptake was higher than that of non-target organs. Thus, 18F-FTHA is suitable for experimental research.
Review Articles
Current status of diagnosis and treatment in differentiated thyroid carcinoma under the guidance of new standards
Ziyan Wang, Chengtao Feng, Gaohong Zhu
2018, 42(6): 530-534. doi: 10.3760/cma.j.issn.1673-4114.2018.06.010
Differentiated thyroid carcinoma(DTC), which can be divided into papillary thyroid carcinoma and follicular thyroid carcinoma, is the most common malignant tumor of the endocrine system. Ultrasound of DTC features important clinical value. The treatment of DTC includes surgery, thyroid stimulating hormone-suppression, and 131I radiotherapy in vivo. DTC presents the highest incidence of thyroid cancer, and the value has increased annually in recent years. At the same time, new research have constantly put forward new viewpoints in diagnosis and treatment of DTC. The diagnosis and treatment of differentiated thyroid carcinoma were investigated and reviewed in this article.
Value of 18F-FDG PET/CT for diagnosing and treating childhood and adolescent lymphoma
Yeye Zhou, Shengming Deng, Bin Zhang, Yiwei Wu
2018, 42(6): 535-540. doi: 10.3760/cma.j.issn.1673-4114.2018.06.011
Childhood and adolescent lymphomas account for 10%-15% of all pediatric cancers. Most cases of pediatric lymphoma involve highly aggressive tumors and extranodal sites. As such, accurate staging and early assessment of therapeutic response are of great value for lymphoma in children and adolescents. Conventional imaging modalities (e.g., ultrasound, CT, MRI, and 67Ga) present some limitations in their diagnosis and treatment. 18F-FDG PET/CT is a new imaging technique that combines the functional data of PET with the morphological information of CT. This article reviews the current role of 18F-FDG PET/CT in the staging, efficacy evaluation, and follow-up of childhood and adolescent lymphoma and finds that 18F-FDG PET/CT is more sensitive than other imaging techniques in monitoring lymph nodes and the spleen. By imaging more lesions, the accuracy of 18F-FDG PET/CT for staging is better than that achieved by traditional imaging methods. At the same time, because of its metabolic changes earlier than the anatomical changes, assessing treatment efficacy promptly and accurately, as well as determining the nature of residual lesions, may be possible. Because of its lower recurrence rate, the trade-offs between monitoring recurrence and radiation exposure during the follow-up period must be weighed.
Progress in research on the use of 18F-FDG PET/CT in the staging, recurrence detection, and prognosis evaluation of patients with gastric carcinoma
Xin Xu, Shengming Deng, Jihui Li, Wei Zhang
2018, 42(6): 541-546. doi: 10.3760/cma.j.issn.1673-4114.2018.06.012
Gastric cancer is the most common malignancy of the digestive tract worldwide.18F-FDG PET/CT is a novel imaging technique that combines the functional data of PET with the morphological information of CT. It is widely used in the diagnosis and staging of patients with gastric cancer. It is also used to evaluate the recurrence rates, chemotherapy response, and prognosis of patients with gastric cancer. To understand new trends in the clinical application of 18F-FDG PET/CT in gastric cancer, this article provides a review of the value of 18F-FDG PET/CT in the staging and evaluation of the recurrence and prognosis of gastric cancer.
Glycometabolism mechanism in hepatocellular carcinoma and its application in PET
Peihe Chen, Wengui Xu, Xiaofeng Li, Hui Huang
2018, 42(6): 547-552. doi: 10.3760/cma.j.issn.1673-4114.2018.06.013
Hepatocellular carcinoma (HCC) is one of the most lethal tumors and has high malignancy and low survival. Generally, the glucose metabolism in malignant tumors is significantly different from normal tissues, which show high uptake. However, it varies greatly in HCC. Low glucose metabolism is often observed in well- and moderately differentiated HCC. Furthermore, glycolysis has been widely confirmed to be a nonspecific biological phenomenon in malignant tumors, including HCC, by positron emission tomography (PET) combined with computed tomography using 18-fluorine-fluorodeoxyglucose (a glucose analogue). However, to determine the value of PET and develop new effective drugs and molecular probes, we need to comprehensively understand how hepatocellular cancer cells use glucose to supply energy. In this article, we reviewed and summarized the glycometabolism characteristics of HCC and their application in PET.
Applications and advances of PET imaging in Alzheimer's disease
Min Fan, Weiwei Deng, Yahua Zhu, Chunyin Zhang
2018, 42(6): 553-558. doi: 10.3760/cma.j.issn.1673-4114.2018.06.014
Alzheimer's disease (AD) is the main type of senile dementia and accounts for about 60% to 80% of dementia cases. With the prolongation of the average life expectancy of our country's population and the increase of the elderly population, the continuous increase of the incidence rate of AD brings a huge economic burden to the society and the family, which has attracted the attention of scholars at home and abroad. PET is an advanced clinical imaging examination technique that can provide a higher sensitivity and accuracy for the diagnosis of AD. In this paper, the application progress of PET imaging in Alzheimer's disease was reviewed.
Research progress of radionuclide imaging probes in apoptosis
Kaixiu Zhang, Xuemei Wang, Jianmin Zhao
2018, 42(6): 559-564, 576. doi: 10.3760/cma.j.issn.1673-4114.2018.06.015
At present, there are many methods for detecting apoptosis in vitro, but these methods just are traumatic in material extraction and tissue biopsy by sacrificing of animals in vitro, which limits their clinical application and transformation. In vivo detection methods have become the focus of current research because of non-invasive and real-time monitoring of apoptosis in vivo. Radionuclide apoptotic cell imaging technology among has good research prospects in non-invasive, early stage, dynamic, sensitive, quantitative, and detection intravital. It is the most widely studied and mature technology for detecting apoptosis intravital. Radionuclide apoptosis imaging has been widely used in the detection of apoptosis in cardiovascular diseases, central nervous system diseases, organ transplant rejection, and the evaluation of efficacy and prognosis of malignant tumor after radiotherapy and chemotherapy. This article reviews the progress of radionuclide imaging probes in apoptosis.
Case Reports
Misdiagnosis of endometrial tuberculosis by 18F-FDG PET/CT imaging: a case report
Zilong Zhao, Yanfeng Gao, Juan Wu, Jianying Pan, Zemin Wang, Maorong Zhou
2018, 42(6): 565-568. doi: 10.3760/cma.j.issn.1673-4114.2018.06.016
The author reported a patient who was hospitalized because of headache, tinnitus, and weakness in both lower limbs. This article analyzes the characteristics of the patient from clinical symptoms, related laboratory tests, and ultrasound, MRI, PET/CT. At the same time, this paper also reviews the common imaging diagnostic methods for endometrial tuberculosis through literature. The purpose of this paper is to suggest that nuclear medicine physicians can not easily diagnose malignant lesions even if they have similar indirect signs of malignant lesions, and avoid preconceived thinking, thus reducing the rate of misdiagnosis.
99Tcm-MIBI SPECT/CT imaging on angiolipoma of the mediastinum: a case report
Yanjun Zhao, Yao Hu, Ping Tang, Jianming Ni
2018, 42(6): 569-571. doi: 10.3760/cma.j.issn.1673-4114.2018.06.017
The author reported one case of mediastinal angiolipoma of 99Tcm-MIBI SPECT/CT imaging, The characteristics of the disease were introduced according to clinical symptoms, CT, 99Tcm-MIBI SPECT/CT tumor positive imaging and pathological diagnosis, meanwhile, the understanding of mediastinal angiolipoma was deepened by reviewing the literature. The result of imaging findings of 99Tcm-MIBI SPECT/CT showed no significant ingestion. Conclusion suggests that preoperative multiple imaging examinations are helpful to observe the growth pattern and internal components of mediastinal angiolipoma and is helpful for diagnosis and differential diagnosis.
Difficult and Complicated Cases Analysis
Differential diagnosis and analysis of 2 cases of bone neoplasms by 18F-FDG PET/CT
Wei Jiang, Qiang Fu, Guotao Yin, Xiaozhou Yu, Xiang Zhu, Wengui Xu
2018, 42(6): 572-576. doi: 10.3760/cma.j.issn.1673-4114.2018.06.018
Many kinds of primary malignant bone tumors exist. In view of the complexity and diversity of imaging manifestations of different diseases, two kinds of diseases that are relatively common and usually misdiagnosed were selected:osteosarcoma and Ewing sarcoma. The diagnostic characteristics from the clinical features and 18F-FDG PET/CT imaging features were analyzed, which may provide guidance in clinical practice.