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Objective:The relationship between the effect of early metabolism in 18F-FDG PET/CT and conventional CT based on the RE-CIST standard to evaluate the best objective response after chemotherapy in patients with non-small cell lung cancer (NSCLC). Meth-ods:We studied 40 patients with unresectable locally advanced or advanced NSCLC that were confirmed pathologically. The patients were 35 years old to 78 years old and included 31 males and 9 females. Three patients have unresectable stageⅢA, 8 patients have stageⅢB, 29 patients have stageⅣ, 12 patients have squamous cell carcinoma, and 28 patients have adenocarcinoma. The PET/CT for the effect of chemotherapy was evaluated in NSCLC according to the SUV standard (SUVmax reduction>30%of primary lung can-cer after one cycle of chemotherapy), and the CT for the effect of chemotherapy was evaluated on the basis of NSCLC according to the RECIST standard. The objectives of the study are as follows:compare the differences and consistency between 18F-FDG PET/CT metabol-ic response after the first cycle of chemotherapy and the RECIST best objective response after the first or second cycle of chemothera-py with the paired chi-square test and kappa test;calculate the 18F-FDG PET/CT to predict the best objective response of two cycles of chemotherapy according to RECIST on the basis of NSCLC in terms of sensitivity, specificity, accuracy, positive predictive value, and neg-ative predictive value;compare the differences in SUVmax reduction between the metabolic remission group and metabolic no relief group with the two-sample t-test. All statistical methods were 0.05 for the inspection level, and P<0.05 was considered statistically sig-nificant difference (SPSS19.0). Results:Differences were found between the first cycle of chemotherapy for the RECIST best objective response and 18F-FDG PET/CT metabolic response (χ2=5.063, P=0.021), and the results had bad consistency (Kappa=0.240, P=0.085). No differences were observed between the second cycle of chemotherapy for the RECIST best objective response and 18F-FDG PET/CT metabolic response (χ2=2.083, P=0.146);the results had good consistency (Kappa=0.413, P=0.006). The sensitivity, specificity, accura-cy, positive predictive value, and negative predictive value were 82%, 61%, 70%, 61%, and 82%, respectively. The differences in SUV-max reduction between the metabolic remission group and metabolic no relief group with the two-sample t-test were statistically sig-nificant (P<0.001). Conclusion: 18F-FDG PET/CT may predict the best objective response to chemotherapy for NSCLC patients. Com-pared with conventional CT, 18F-FDG PET/CT can be an early and accurate way to evaluate the chemotherapy effect in NSCLC.
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Purpose To investigate the CT gemstone spectral imaging features of gastric stromal tumors (GST), so as to discuss the value of CT gemstone spectral imaging in the diagnosis and differential diagnosis of GST. Materials and Methods Thirty patients with GST proved pathologically were scanned by gemstone spectral imaging. Their GSI scanning image data and the related clinical data were retrospectively analyzed, and the quantitative analysis based on iodine content of the lesions in both arterial phase and portal phase was carried out. Results The GSI findings showed that the lesions were intra-luminal, extra-luminal or both intra-and extra-luminal soft tissue mass, the sizes were various, and they protruded either toward the inner side of stomach or the opposite or both. Among them, the diameter of 4 tumors in the low risk group ranged from 1 to 5 cm; in the intermediate risk group, 3 tumors had diameters from 1 to 5 cm, and 3 others were from 6 to 19 cm; in high-risk group, 18 tumors' diameter were between 6 to 9 cm, 2 were between 1 to 5 cm, and the rest 1 had multiple lesions in various sizes. Fifteen tumors occurred in gastric body, 10 occurred in gastric antrum, 4 were at the bottom of the stomach, and 1 had multifocal growth. Sixteen patients had internal and external growth of lesions, among whom 14 patients were at high risk; 10 patients' lesions were outside the cavity, including 6 patients at high risk and 1 patient at low risk; and 4 patients had lesions inside the cavity, including 3 patients at low risk. At the arterial phase the foci mildly strengthened, and they strengthened increasingly at the portal phase. The material value based water and iodine figure showed that material value based iodine of the lesions at both arterial phase and portal phase was higher than that in the normal gastric wall tissue, and the material value based iodine of the lesions at portal phase was higher than that at arterial phase (F=378.6 and 296.6, P<0.05). At arterial phase, the iodine content of the lesions in the mucosa was slightly higher than that in the submucosa and muscular layer (t= - 2.245, P<0.05). Conclusion CT gemstone spectral imaging can accurately show the external forms and internal changes of GST lesions and iodine content measurement can provide quantitative diagnostic information, therefore they can provide more effective information for clinical diagnosis.
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Objective To analyze the CT and MRI performances of chromophobe cell renal carcinoma,to improve the understanding of the disease.Methods The CT and MRI performances of 16 patients with chromophobe cell renal carcinoma confirmed by post-operation pathology were analyzed retrospectively.Results Among 13 cases examined by CT,8 cases had homogeneous lesion including the homogeneous lesions density of 5 cases higher than that of normal renal parenchyma,and the other 5 cases had inhomogeneous density.After enhanced scan,the uneven essence ingredients were markedly enhanced in homogeneous density and inhomogeneous density cases,and the enhancement degree in arterial phase was lower than that of the renal cortex and higher than that of the renal medulla.Among 8 cases checked by MRI,2 cases had signal homogeneity with long T1 weighted imaging and long T2 weighted imaging signal,of which 5 cases appeared high signal in T1 weighted imaging flat lesions.The enhancement mode were similar with CT.In 5 patients examined by CT and MRI at the same time,their density,signal and the pattern strengthening were similar.Conclusions Chromophobe cell renal carcinoma is a rare malignant renal cell carcinoma,and CT and MRI can reflect the composition and hemodynamic changes.When homogeneity and high density or T1WI appeared high signal,disease was large and necrosis was less,and strengthening belt was appeared in lesions,it is value on diagnosis of chromophobe cell renal carcinoma.
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Objective To explore the value of gemstone spectral imaging (GSI) with single source dual-energy CT in characterizing the benign and malignant solitary pulmonary nodules (SPN).Methods Totally 32 patients with SPN underwent phaseⅢ enhanced CT scan using single source dual-energy CT by GSI mode.Three types of images were reconstructed for analysis:the water concentration (WC),iodine concentration (IC) and normalized iodine concentration (NIC).Results The IC of lung squamous cell carcinoma lung adenocarcinoma,hamartoma,sclerosing hemangioma,inflammatory pseudotumor were (11.66± 2.72) μg/ml,(12.36±2.97) μg/ml,(10.20±3.11) μg/ml,(16.58±3.58) μg/ml,(21.67±3.76) μg/ml,the IC of lung adenocarcinoma and lung squamous cell carcinoma had no difference (P ＞ 0.05),there were significant differences in the value of iodine material between other nodules (all P ＜ 0.05).The WC of lung adenocarcinoma,lung squamous cell carcinoma,hamartoma,sclerosing hemangioma,inflammatory pseudotumor were (1 021.31±13.83) μg/ml,(1 027.98±12.53) μg/ml,(1 003.42±13.67) μg/ml,(1 029.61±12.06) μg/ml,(1 051.61±13.81) μg/ml,there was no significant difference in the value of water material between nodules (all P ＞ 0.05).Conclusion The spectral CT imaging may be helpful for characterizing the pathological type of SPN.
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Objective To analysis the spiral CT scan diagnosis value of lymph node metastasis in thoracic esophageal carcinoma and investigate the rules of lymph node metastasis distributions.Methods 117 patients with surgically and pathologically proved esophageal carcinoma underwent CT scans of the chest before the surgical operation to identify the presence of lymph node metastasis and evaluate the diagnosis value of spiral CT in lymph node metastasis.CT imaging which was detected by CT and histopathological analysis performed with attention to the distribution characteristics.Results In 117 cases of esophageal patients,the diagnosis of sensitivity,specific and accuracy degree on lymph node metastasis were 86.0 ％,80.6 ％,84.6 ％.The most lymph node metastasis in the upper thoracic esophagus is the mediastinum group[8/14(57.1％)]and the trachea group[4/14(28.6 ％)].the middle is on the trachea surrounding group[21/41(51.2 ％)],the main pulmonary artery window group[17/41(41.5 ％)]and subcarinal group[15/41(36.6 ％)].the lower thoracic esophagus is around the side of preventriculus[7/19(36.8 ％)]and the left gastric artery[5/19(26.3 ％)]respectively.Conclusion Spiral CT imaging can accurately evaluate the lymph node metastasis of esophageal and distribution characteristics.