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Objective:To explore the uptake characteristics and temporal changes of 68Ga-fibroblast activation protein inhibitors (FAPIs) and 18F-FDG in the anastomotic site of reconstructed digestive tracts after radical surgery for gastrointestinal adenocarcinoma. Methods:A cohort of 43 patients (28 males, 15 females; age range 28-79 years) who underwent radical surgery for gastrointestinal adenocarcinoma and underwent 18F-FDG PET/CT follow-up between November 2020 and June 2022 in the First Affiliated Hospital of the Air Force Medical University was prospectively included. One week after the 18F-FDG PET/CT examination, 68Ga-FAPI-04 PET/CT imaging was performed. ROIs were drawn on the PET images at the highest uptake level of anastomotic sites of reconstructed digestive tract and abdominal wall incisions, and SUV max and target-to-background ratio (TBR) were determined. χ2 test, one-way analysis of variance, Kruskal-Wallis rank sum test (Bonferroni correction) and Wilcoxon signed-rank test were supplied. Results:There were 86 surgical wounds (13 gastric-intestinal anastomotic sites, 14 esophagus-intestinal anastomotic sites, 16 intestinal-intestinal anastomotic sites, and 43 abdominal wall incisions) included. In 68Ga-FAPI-04 PET imaging, SUV max of gastric-intestinal anastomotic sites was higher than that of abdominal wall incisions, with a statistically significant difference (adjusted P=0.014). The TBR did not show statistically significant differences among different types of surgical wounds ( H=3.88, P=0.275). In 18F-FDG PET imaging, SUV max of gastric-intestinal, esophagus-intestinal, and intestinal-intestinal anastomotic sites were all higher than that of abdominal wall incisions, with statistically significant differences (adjusted all P<0.001). There were no statistically significant differences in TBR among different types of surgical wounds ( H=3.02, P=0.388). In 68Ga-FAPI-04 PET imaging, the TBR of all types of anastomotic sites exhibited a decreasing trend with increasing postoperative time. Except for intestinal-intestinal anastomotic sites, the differences in TBR between < 0.5-year and ≥ 1.5-year groups were statistically significant for other types of surgical wounds (adjusted P<0.05). In 18F-FDG PET imaging, the TBR of abdominal wall incisions showed a decreasing trend with increasing postoperative time. However, the TBR of other types of surgical wounds did not show a decreasing trend, and the differences in TBR among different time groups were not statistically significant ( H values: 0.53-2.75, P values: 0.252-0.768). In comparing the two PET imaging agents, for all surgical wounds within the <0.5-year and 0.5-1.5-year groups, the 68Ga-FAPI-04 TBR was consistently higher than the 18F-FDG TBR ( z values: -3.17 and -2.55, P values: 0.002 and 0.011). However, in the ≥1.5-year group, the TBR values tended to be consistent, and the differences were not statistically significant ( z=-0.70, P=0.485). Conclusions:The 18F-FDG uptake in the anastomotic sites of reconstructed digestive tracts reaches a low level under half a year after surgery and does not significantly change over time, while the 68Ga-FAPIs uptake remains relatively high within the first 1.5 years after surgery but decreases over time. These patterns suggest that clinical attention should be paid to the differential diagnosis of anastomotic inflammation or fibrosis, which resulting in agent uptake and local tumor recurrence.
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OBJECTIVE To discuss the factors affecting the blood concentration of high-dose methotrexate （HD-MTX） and the occurrence of adverse drug reactions （ADR） when treating lymphoma with HD-MTX. METHODS From July 2020 to November 2021， the information of HD-MTX patients who had been monitored for HD-MTX blood drug concentration in the First Affiliated Hospital of Guangdong Pharmaceutical University was collected by retrospective analysis， such as medical record number， age， sex， height， body mass， chemotherapy plan， dosage； test indexes such as alanine transaminase， aspartate transaminase， total bilirubin， creatinine clearance （CrCl）， albumin （ALB） and other indexes were also collected before and after administration. The blood concentrations （c6 h， c24 h， c48 h） of HD-MTX were recorded， drug information of proton pump inhibitors （PPIs） was extracted and used， and ADR occurring within 48 h after administration were all evaluated. Single factor analysis， multiple linear regression and χ2 test were used to analyze the influential factors. RESULTS A total of 133 patients were included in this paper. The results of the single factor analysis of HD-MTX blood drug concentration showed that age， CrCl had an effect on c 6 h （P＜0.05）； age， CrCl and ALB had an effect on c24 h （P＜0.05）； age， body mass index （BMI）， CrCl， combined use of PPIs and ALB had an effect on c48 h （P＜0.05）. The results of multiple linear regression analysis showed that age and CrCl had no effect on c 6 h （P＞0.05）， age was the main influential factor of c 24 h （P＜0.05）， and CrCl and combined use of PPIs were the main influential factors of c48 h （P＜0.05）； the coefficient of variance expansion was between 1 and 3.5， indicating that the analysis results were acceptable. The overall incidence of adverse reactions was 51.13%， of which the blood and lymphatic system reactions were the most common. The results of the influential factors of ADR showed that age， BMI， liver function and CrCl had effect on the incidence of ADR （P＜0.05）. CONCLUSIONS During the process of HD-MTX in the treatment of lymphoma， the patient’s age， CrCl and combined use of PPIs should be considered， and the patient’s blood concentration should be monitored； at the same time， the age of patients， BMI， liver function and CrCl have an impact on the incidence of ADR.
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Objective:To exploring the uptake of fibroblast activation protein (FAP) inhibitor (FAPI) in pancreatic cancer through 68Ga-FAPI-04 PET/CT imaging, and provide a basis for the FAP-targeted imaging of pancreatic cancer. Methods:Pancreatic cancer-patient-derived tumor xenograft (PDX) mouse models ( n=8) were developed, then 68Ga-FAPI-04 and 18F-FDG microPET/CT imaging were performed (4 in each group). The differences of percentage activity of injection dose per gram of tissue (%ID/g) of 68Ga-FAPI-04 and 18F-FDG were analyzed by independent-sample t test. 68Ga-FAPI-04 and 18F-FDG PET/CT imaging were performed in 5 patients (4 males, 1 female, age: 46-74 (63.0±11.9) years) with pancreatic cancer, and the maximum standardized uptake value (SUV max) of 68Ga-FAPI-04 and 18F-FDG in primary pancreatic cancer and the SUV max ratio of liver metastases to liver tissue were compared by paired t test. Results:MicroPET/CT imaging showed that 68Ga-FAPI-04 was obviously uptaken at all time points in the tumor of PDX mice. The uptake of 68Ga-FAPI-04 in PDX mice 60 min after injection was significantly higher than that of 18F-FDG ((6.58±0.44) and (4.29±0.13) %ID/g; t=4.152, P=0.008 9). PET/CT showed that the SUV max of 68Ga-FAPI-04 in pancreatic cancer was significantly higher than that of 18F-FDG (16.82±3.08 and 5.14±2.20; t=6.893, P=0.000 1) and the SUV max ratio of liver metastases to liver tissue of 68Ga-FAPI-04 was also significantly higher than that of 18F-FDG (4.57±1.47 and 1.30±0.16; t=3.803, P=0.019 1). Conclusion:68Ga-FAPI-04 can be highly uptaken in pancreatic cancer, suggesting that FAP can be a potential target for PET/CT imaging of pancreatic cancer.
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Cardiac neural crest cells(CNCCs) are a special subgroup of neural crest cells that originate from the dorsal side of the ectodermal neural tube. During embryonic development, they are a pluripotent stem cell group that can migrate to the periphery and differentiate into many types of cells. They are essential for proper development of heart and outflow tract(OFT). Hypoplastic aortic arch(HAA) is a type of congenital heart malformation caused by abnormal development of the ventricular outflow tract in the embryonic period, and often combined with other cardiac malformations. It is a common and poor prognosis after birth in complex congenital heart disease, which seriously endangers children's health. There is a significant correlation between abnormal development of CNCCs and HAA. Although the influencing factors are still unclear, related experiments have screened out relevant genetic and environmental factors. Discussing the mechanism of its involvement in the development of cardiac outflow tract is helpful to understand the pathogenesis of HAA and promote the progress of treatment methods. This article reviews the genetic and environmental factors affecting the development of CNCCs and their correlation with HAA.
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Objective To observe the application value of PET glucose metabolic imaging and MR structural imaging in diagnosis of Alzheimer disease (AD) and mild cognitive impairment (MCI).Methods Totally 18 patients with AD (AD group),6 patients with MCI (MCI group) and 10 healthy volunteers (HC group) were enrolled.There were 11 cases of moderate or severe AD and 7 cases of mild AD in AD group.PET and structural MR imaging of the brain were performed.The radioactivity distribution in the brain and the hippocampal atrophy were observed through visually evaluation and quantitative analysis.Results The glucose metabolism reduced in certain regions of the brain in all AD patients (18/18,100％).Among them,11 patients with moderate or severe AD accompanied hippocampal atrophy,while 3 of 7 patients with mild AD showed hippocampal atrophy.No hippocampal atrophy was found in 5 patients with MCI (5/6,83.33 ％),but 2 of them showed decreased radioactivity in the brain.The symmetric mild diminution of radioactivity distribution without hippocampal atrophy was found in all subjects in HC group (10/10,100％).Two cases in HC group showed mild encephalanalosis.Conclusion Both of PET glucose metabolic imaging and MR structural imaging can be used to diagnose AD or MCI with different focus.Combination of these two techniques is helpful to improving diagnostic accuracy.