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Objective@#To analyze the predictive value of serum carcinoembryonic antigen(CEA) level combined with primary PET/CT metabolic parameters, metabolic tumor volume(MTV) and total glycolysis(TLG) in liver metastasis of colorectal cancer.@*Methods@#The clinical data of 86 patients with colorectal cancer who underwent PET/CT examination in the People's Hospital of Zhejiang Province from January 2013 to December 2017 were retrospectively analyzed.Univariate and multivariate logistic regression was used to analyze the relationship between clinicopathological parameters, MTV, TLG and liver metastasis.@*Results@#Of the 86 patients, there were 17 cases(19.77%) of liver metastases.Univariate analysis showed that there were significant differences in T stage(χ2=8.83), tumor location(χ2=5.43) and serum CEA content(t=11.65) between the liver metastasis group and the non-liver metastasis group(all P<0.05). The levels of TLG[(101.94±20.14)g] and MTV[(14.09±3.25)cm3] in the liver metastasis group were significantly lower than those in the non-liver metastasis group[(135.95±22.63)g, (25.09±4.33)cm3](t=5.66, 9.80, all P<0.01). Multivariate logistic regression analysis showed that T stage(OR=3.56, 95%CI: 1.06-12.00), tumor location(OR=1.38, 95% CI: 1.05-1.81), TLG(OR=1.68, 95% CI: 1.11-2.54), MTV(OR=3.86, 95% CI: 1.63-9.14) and serum CEA(OR=2.95, 95% CI: 1.60-5.41) were the influencing factors of liver metastases in patients with colorectal cancer(all P<0.05).@*Conclusion@#T stage, tumor location, primary PET/CT metabolic parameters(TLG, MTV) and serum CEA levels are the influencing factors of liver metastasis in patients with colorectal cancer, suggesting that the detection of serum CEA level combined with primary PET/CT metabolic parameters has certain predictive value for liver metastasis of colorectal cancer.
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Objective To analyze the predictive value of serum carcinoembryonic antigen ( CEA) level combined with primary PET/CT metabolic parameters,metabolic tumor volume( MTV) and total glycolysis( TLG) in liver metastasis of colorectal cancer.Methods The clinical data of 86 patients with colorectal cancer who underwent PET/CT examination in the People＇s Hospital of Zhejiang Province from January 2013 to December 2017 were retrospectively analyzed.Univariate and multivariate logistic regression was used to analyze the relationship between clinicopathological parameters,MTV, TLG and liver metastasis. Results Of the 86 patients, there were 17 cases (19.77%) of liver metastases.Univariate analysis showed that there were significant differences in T stage( χ2 =8.83),tumor location(χ2 =5.43) and serum CEA content(t=11.65) between the liver metastasis group and the non-liver metastasis group(all P＜0.05).The levels of TLG[(101.94 ±20.14)g] and MTV[(14.09 ±3.25)cm3] in the liver metastasis group were significantly lower than those in the non-liver metastasis group[(135.95 ± 22.63) g, (25.09 ± 4.33)cm3] ( t=5.66,9.80,all P＜0.01).Multivariate logistic regression analysis showed that T stage ( OR=3.56,95%CI:1.06-12.00),tumor location(OR=1.38,95% CI:1.05-1.81),TLG(OR=1.68,95% CI: 1.11-2.54),MTV(OR=3.86,95% CI:1.63-9.14) and serum CEA( OR=2.95,95% CI:1.60-5.41) were the influencing factors of liver metastases in patients with colorectal cancer( all P＜0.05).Conclusion T stage, tumor location,primary PET/CT metabolic parameters(TLG,MTV) and serum CEA levels are the influencing factors of liver metastasis in patients with colorectal cancer,suggesting that the detection of serum CEA level combined with primary PET/CT metabolic parameters has certain predictive value for liver metastasis of colorectal cancer.
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Objective To explore the diagnostic value of PET/CT technique in the atypical spinal tuberculosis. Methods A total of 60 patients who had suffered from spinal tuberculosis and spinal metastasis confirmed by surgical interventions from 2010 to 2016 were retrospectively analyzed. 18F-FDG PET/CT examination was made at our department. Image data of X-ray, CT, and PET/CT were compared in the diagnosis accuracy. Results A total of 52 males and 8 females, aged from 38 to 82 years (mean, 50.2 years) were collected. The statistical analysis showed PET/CT technology with sensitivity of 85%, and specificity of 95%, which were significantly higher than those of X-ray and CT (AUC=0.900, P<0.05) . 18F-FDG PET/CT can find more lesions than X-ray and CT, find "cold abscess" and "cold zone" of spinal tuberculosis, that was an exclusive value of PET/CT diagnosis for atypical spinal tuberculosis. Conclusion 18F-FDG PET/CT shows an important clinical diagnostic value for the atypical spinal tuberculosis.
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Objective To study the tolerance to 188Re-1-hydroxy-1 ,1-ethylidene disodium phosphonate(HEDP) in patients with bone pain caused by osseous metastases. Methods Thirty-one patients(10with prostate cancer, 9 with breast cancer, 3 with lung cancer, 5 with liver cancer, 2 with rectal cancer, 1with esophageal cancer and 1 with renal cancer) received a single injection dose of 188Re-HEDP. The patients were divided into four groups according to the injection dose: 20 MBq/kg (6 patients), 30 MBq/kg(6 patients), 40 MBq/kg (9 patients), and 50 MBq/kg (10 patients). Haematological toxicity (WHO grading) of grade Ⅲ- Ⅳ was considered unacceptable. Vital signs and adverse effects after injection were recorded for 8 weeks. Blood counts were measured weekly during a period of 8 weeks. Biochemical parameters and electrocardiogram were assayed at week 4 and 8. Statistical analysis was performed for per-protocol (pp) population (t-test). Results Twenty-seven patients belonged to PP population with 5 in the group of 20 MBq/kg, 5 in the group of 30 MBq/kg, 8 in the group of 40 MBq/kg and 9 in the group of 50 MBq/kg.No obvious adverse effects and no significant change of vital signs, electrocardiogram, liver and renal function were found after injection. Alkaline phosphatase was slightly higher than baseline at week 4 and 8 after therapy, but the difference was not statistically significant. In the 20 MBq/kg group, reversible grade Ⅰ leucopenia was noted in 1 patient. In the 30 MBq/kg group, 2 patients showed reversible grade Ⅰ leucopenia including 1 alone with reversible grade Ⅲ thrombopenia. In the 40 MBq/kg group, reversible grade Ⅰ leucopenia and thrombopenia was observed in 1 patient and reversible grade Ⅱ leucopenia and thrombopenia in another patient. In the .50 MBq/kg group, 3 patients showed reversible grade Ⅱ leucopenia. The lowest level of thrombopenia was at week 4(143.5 × 109/L), leucopenia at week 6 (5.4 × 109/L) and anaemia at week 8(t = 3.1325, 3.3156, 3.4917, all P ＜ 0. 05 compared with baseline). At week 8, the mean level of platelet and leucocyte recovered to baseline. "Bounce pain" was found in 2 of 27 patients (7.41%).Conclusions The dose of 20 MBq/kg, 30 MBq/kg, 40 MBq/kg or 50 MBq/kg of 188Re-HEDP do not cause significant side effects on cancer patients with bone metastases, though there is a tendency that the haematological toxicity may increase as the dose of 188Re-HEDP increases.
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Objective To investigate the biodistribution,excretion and other pharmacokinetics,of 188Re-1-hydroxy-1,1-ethylidene disodium phosphonate (HEDP) in cancer patients with osseous metastases who were suffering form bone pain. Methods A single dose (20,30,40,and 50 MBq/kg,10 patients in every group) of 188Re-HEDP was administered as a bolus injection,meanwhile dynamic images on patient's chest were collected for 30 min. Anterior and posterior whole-body images were obtained at 1,2,4,5,12,24,36,48,60 and 72 h after injection of 188Re-HEDP. By region of interest (ROI) technology,the curve of time-background corrected counts of left cardiac ventricle could be generated,and the background-corrected counts of various organs and total whole body could be calculated as a geometric mean using the anterior and posterior scans,and transformed to the percentage injected dose ( % ID). Urine was collected after injection of 188Re-HEDP. Counts of urine were measured by γ counter. Analysis of variance and t-test were used. Results Linear relationship of metabolism of 188Re-HEDP was observed in the doses from 20 to 50 MBq/kg,with correlation coefficient r2 = 0. 9376. A two-compartment model was the best fit for metabolism of 188Re-HEDP with the parameters median area under curve (AUC) 3.32 × 105,3.97 × 105,7.83 × 105,8.58 ×105,respectively; median α 0.06,0.05,0.04,0.06 respectively; median β 1.16 ×10-3,1.16 × 10-3,1.03 × 10-3,1.15 × 10 -3 respectively; median A 3591.21,4858.23,5642. 48,4167.05 respectively; median B 293.97,352.95,614.41,1063.82 respectively; median T1/2(α) 12.51,12.83,15.41,12.02 min respectively; median T1/2(β) 595.47,596.50,673.09,600.93 min respectively in the doses of 20,30,40and 50 MBq/kg. 188Re-HEDP was taken up mainly by bone up to 40% ID at 4 h. Urine profile showed that 66.79 % ID was eliminated within 24 h,being its 74% collected along the first 5 h after-administration.Conclusions In the doses of 20,30,40 and 50 MBq/kg,metabolism of 188Re-HEDP presented linear model. Pharmacokinetics of 188 Re-HEDP followed a two-compartment model administrated by blood vessel.Following injection,188 Re-HEDP was taken up mainly by bone and excreted by uropoietic system.