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Objective:To compare the diagnostic values of different diagnostic criteria of prostate specific membrane antigen (PSMA) PET/CT for primary prostate cancer (PCa).Methods:From May 2019 to May 2021, 2-(3-(1-carboxy-5-((6- 18F-fluoro-pyridine-3-carbonyl)-amino)-pentyl)-ureido)-pentanedioic acid ( 18F-DCFPyL) PET/CT images of 78 patients (age: (68.5±1.4) years) with clinically suspected PCa in Shanxi Bethune Hospital were retrospectively collected and blind diagnosed by the three criteria of SUV max, PSMA reporting and data system (PSMA-RADS) score and molecular imaging PSMA (miPSMA) score. The diagnostic efficacy for PCa, the correlation between the diagnostic results and disease risk, and the consistency of the diagnostic results of the three criteria were compared. Delong test, Spearman rank correlation analysis, and intra-class correlation coefficient (ICC) were used to analyze data. Results:The sensitivities of SUV max, PSMA-RADS score and miPSMA score for PCa were all 93.75%(60/64) and the specificities were 12/14, 10/14 and 12/14 respectively; AUCs of the three criteria were 0.951, 0.862 and 0.951, with no significant difference between SUV max and miPSMA score ( z=0.00, P=1.000), while there were significant differences between PSMA-RADS score and SUV max or miPSMA score ( z values: 2.71, 2.93, P values: 0.007, 0.030). There were positive correlations between the diagnostic results of the three criteria and the disease risk (International Society of Urological Pathology (ISUP) grading: rs values: 0.66, 0.62, 0.63, all P<0.001; D′Amico grouping: rs values: 0.67, 0.64, 0.67, all P<0.001). The diagnostic results of the three criteria were highly consistent (ICC=0.941, 95% CI: 0.903-0.967). Conclusion:The SUV max and miPSMA score have higher diagnostic efficiency and correlation of disease risk, which are more suitable for clinical application.
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Objective To compare the clinical features of papillary thyroid microcarcinoma (PTMC) and non-microcarcinoma papillary thyroid carcinoma (PTC). Methods Clinical data of 522 patients (156 males, 366 females, age:16-77 years) with PTC treated with 131 I from January 2014 to September 2018 were analyzed retrospectively. Patients were divided into PTMC group (46 males, 139 females, age:(38.5± 6. 5) years;tumor diameter≤1.0 cm) and non-microcarcinoma PTC group (110 males, 227 females, age:(40.5±4.5) years; tumor diameter>1.0 cm). General information and TNM status of patients were com-pared. The t' test andχ2 test were used to analyze the data. Results Patients was relatively young in PTMC group ( t'=2.20, P<0.05) , but no difference was observed in gender between 2 groups (χ2=3.45, P>0. 05;mostly females) . The incidence of extraglandular invasion in PTMC group was significantly lower than that in PTC group (33.51％(62/185) vs 56.08％(189/337);χ2=24.37, P<0.01), mainly in peripheral muscle/fibrous adipose tissue (χ2=11.01, P<0.01) and tracheal infiltration (χ2=5.35, P<0.05). Nodular goiter and Hashimoto's thyroiditis were commonly shown in both groups, and the tumor distribution was bilobar and/or multi-foci. The rate of regional lymph node metastasis was higher in non-microcarcinoma PTC group (88.43％ (298/337) vs 82.16％ (152/185);χ2=3.94, P<0.05), and central lymph node metastasis oc-curred more in PTMC group (χ2=5.75, P<0.05). Besides, non-microcarcinoma PTC group was likely to involve more lymph node areas (χ2=5.69, P<0.05) and distant metastasis (9.50％ (32/337) vs 2.16％(4/185);χ2=10.00, P<0.01). There were no differences of extraglandular infiltration, tumor distribution or lymph node metastasis between moderate-and high-risk PTMC and non-microcarcinoma PTC groups (χ2 values:0.01-3.33, all P>0.05) . Conclusions Clinical characteristics of PTC can be influenced by tumor diameter. The features of primary tumor and lymph node metastasis between patients with moderate- and high-risk PTMC and non-microcarcinoma PTC patients are similar, which suggests that 131 I therapy is neces-sary to patients with moderate-and high-risk PTMC.
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Objective To compare the diagnostic value of ventilation/perfusion ( V/Q) combined with pulmonary perfusion single photon emission computed tomography combined with CT ( SPECT/CT) fu-sion tomography imaging and computed tomographic pulmonary angiography ( CTPA) in evaluation of pulmo-nary embolism. Methods We retrospectively analyzed 60 patients with clinically suspected pulmonary em-bolism diagnosed in Shanxi Dayi Hospital from May 2015 to May 2017. All patients underwent pulmonary V/Q imaging and lung perfusion SPECT/CT fusion tomography, and CTPA inspections were completed with-in 3 days. The final clinical diagnosis and follow-up confirmed the presence or absence of pulmonary embol-ism. The diagnostic efficacy of two imaging methods for pulmonary embolism were calculated and compared. Results Of the 60 cases of patients, 33 cases were diagnosed with pulmonary embolism; the sensitivity, specificity, and accuracy of V/Q combined with pulmonary perfusion SPECT/CT fusion tomography were 96. 97％ (32/33), 92. 59％ (25/27) and 95％ (57/60), respectively; the sensitivity, specificity, and accuracy of CTPA were 81. 82％ (27/33), 92. 59％ (25/27) and 86. 67％ (52/60), respectively; both have no diagnostic uncertainty, there was no significant difference in the qualitative diagnosis of pulmonary embolism between the two examination methods ( P >0. 05 ) . V/Q combined with pulmonary perfusion SPECT/CT fusion tomography found 253 lung segment and 50 unmatched sub-pulmonary segments, including 15 V/Q mismatch lung segment and 5 sub-segment caused by lung lesions which were confirmed by lung perfusion SPECT/CT fusion image ( 5 interlobular or pleural effusion, 4 local emphysema and pulmonary bulla, 3 interlobular hypertrophy, 8 pulmonary parenchymal inflammation); CTPA found 3 sub-segmental pulmonary filling defects, 6 cases of false-negative cases were multiple sub-pulmonary segment pulmonary embolism. Conclusions V/Q combined with pulmonary perfusion SPECT/CT fusion tomography is similar to CTPA in diagnosing pulmonary embolism, and both of them have better diagnostic efficacy; the former has advantages in the diagnosis of sub-pulmonary segment pulmonary embolism, and can exclude false-posi-tive diagnoses due to other lung lesions and provide additional diagnostic information for lung disease.
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Objective To analyze and discuss the clinical value of single photon emission computed tomography(SPECT)/CT fusion imaging in differentiating benign and malignant spinal lesions.Methods From January 2017 to January 2018,70 cases with benign and malignant spinal lesions in Shanxida Hospital were studied.SPECT/CT fusion imaging and SPECT examination were used to compare the diagnosis results between the two groups.Results After SPECT diagnosis,a total of 98 bone metastatic lesions were detected,including 10 false positive lesions,60 benign lesions and 28 false negative lesions.After SPECT/CT fusion imaging,there were 100 lesions,including 4 false positive lesions,59 benign lesions and 37 false negative lesions.In this study,a total of 145 lesions were found in 70 patients with benign and malignant spinal lesions,including 95 benign lesions and 50 malignant lesions.The specificity,sensitivity and accuracy of SPECT/CT fusion imaging [95.79％ (91/95),92.00％ (46/50),93.79％ (136/145)] were higher than those of the control group [82.11％ (78/95),64.00％ (32/50),and 82.76％ (120/145)],the differences were statistically significant (x2 =9.048,11.422,9.578,all P ＜0.05).Conclusion In the diagnosis of benign and malignant spinal diseases,SPECT/CT fusion imaging can accurately distinguish benign and malignant lesions,and clearly reflect the development of the disease,which lay a solid foundation for good treatment in the future.
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Objective@#To compare the clinical features of papillary thyroid microcarcinoma (PTMC) and non-microcarcinoma papillary thyroid carcinoma (PTC).@*Methods@#Clinical data of 522 patients (156 males, 366 females, age: 16-77 years) with PTC treated with 131I from January 2014 to September 2018 were analyzed retrospectively. Patients were divided into PTMC group (46 males, 139 females, age: (38.5±6.5) years; tumor diameter≤1.0 cm) and non-microcarcinoma PTC group (110 males, 227 females, age: (40.5±4.5) years; tumor diameter>1.0 cm). General information and TNM status of patients were compared. The t′ test and χ2 test were used to analyze the data.@*Results@#Patients was relatively young in PTMC group (t′=2.20, P<0.05), but no difference was observed in gender between 2 groups (χ2=3.45, P>0.05; mostly females). The incidence of extraglandular invasion in PTMC group was significantly lower than that in PTC group (33.51%(62/185) vs 56.08%(189/337); χ2=24.37, P<0.01), mainly in peripheral muscle/fibrous adipose tissue (χ2=11.01, P<0.01) and tracheal infiltration (χ2=5.35, P<0.05). Nodular goiter and Hashimoto′s thyroiditis were commonly shown in both groups, and the tumor distribution was bilobar and/or multi-foci. The rate of regional lymph node metastasis was higher in non-microcarcinoma PTC group (88.43% (298/337) vs 82.16% (152/185); χ2=3.94, P<0.05), and central lymph node metastasis occurred more in PTMC group (χ2=5.75, P<0.05). Besides, non-microcarcinoma PTC group was likely to involve more lymph node areas (χ2=5.69, P<0.05) and distant metastasis (9.50% (32/337) vs 2.16% (4/185); χ2=10.00, P<0.01). There were no differences of extraglandular infiltration, tumor distribution or lymph node metastasis between moderate- and high-risk PTMC and non-microcarcinoma PTC groups (χ2 values: 0.01-3.33, all P>0.05).@*Conclusions@#Clinical characteristics of PTC can be influenced by tumor diameter. The features of primary tumor and lymph node metastasis between patients with moderate- and high-risk PTMC and non-microcarcinoma PTC patients are similar, which suggests that 131I therapy is necessary to patients with moderate- and high-risk PTMC.
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Objective@#To analyze and discuss the clinical value of single photon emission computed tomography(SPECT)/CT fusion imaging in differentiating benign and malignant spinal lesions.@*Methods@#From January 2017 to January 2018, 70 cases with benign and malignant spinal lesions in Shanxida Hospital were studied.SPECT/CT fusion imaging and SPECT examination were used to compare the diagnosis results between the two groups.@*Results@#After SPECT diagnosis, a total of 98 bone metastatic lesions were detected, including 10 false positive lesions, 60 benign lesions and 28 false negative lesions.After SPECT/CT fusion imaging, there were 100 lesions, including 4 false positive lesions, 59 benign lesions and 37 false negative lesions.In this study, a total of 145 lesions were found in 70 patients with benign and malignant spinal lesions, including 95 benign lesions and 50 malignant lesions.The specificity, sensitivity and accuracy of SPECT/CT fusion imaging [95.79%(91/95), 92.00%(46/50), 93.79%(136/145)] were higher than those of the control group [82.11%(78/95), 64.00%(32/50), and 82.76%(120/145)], the differences were statistically significant(χ2=9.048, 11.422, 9.578, all P<0.05).@*Conclusion@#In the diagnosis of benign and malignant spinal diseases, SPECT/CT fusion imaging can accurately distinguish benign and malignant lesions, and clearly reflect the development of the disease, which lay a solid foundation for good treatment in the future.
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Objective To explore the correlation between the change of CT value of osteolytic bone metastasis after the treatment of zoledronic acid and bone metabolism before treatment in breast cancer patients.Methods Twenty breast cancer patients with osteolytic bone metastases were diagnosed by 99m Tc-MDP bone scintigraphy and 99m Tc-MDP SPECT/CT ( contain 16-slice spiral CT) for the first time entered this study.After treatment of zoledronic acid for 3-12 months with the same method, 99m Tc-MDP bone scintigraphy and 99mTc-MDP SPECT/CT were peformed in the 20 breast cancer patients again with the same CT scan parameters(voltages:120kV, tube currents:80mA, pitches:3.75mm).With using regions of interesting (ROI)technique, the T/NT value of osteolytic bone metastases in the first 99m Tc-MDP bone scintigraphy were measured.The CT value of same ROI before and after zoledronic acid therapy were measured (CT1 and CT2), and the change of CT value (△CT,△CT=CT2-CT1) were calculated.The correlation between them were analyzed. SPSS 16.0 was applied for variance and linear correlation analyses.Results (1)A total of 30 lesions of osteolytic bone metastases were detected in the 20 breast cancer patients by the first 99m Tc-MDP bone scintigraphy and 99m Tc-MDP SPECT/CT.The CT value before therapy was significantly higher than that after therapy(425 ±152HU vs 120 ±73HU, t=9.95, P<0.01).(2)The change of CT value after therapy was positively correlated with and the T/NT value of osteolytic bone metastasis(r=0.907, P<0.01).(3)The change of CT value of positive lesions after therapy was significantly higher than that of negative lesions by 99mTc-MDP bone scan(W=15,P=0.001). Conclusion 99m Tc-MDP bone scintigraphy provides an effective method to predict the efficacy of zoledronic acid for breast cancer pa-tients with osteolytic bone metastases.The breast cancer patients with high bone metabolism should be recommended zoledronic acid thera-py, conversely should not be recommended.