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Objective:To explore the diagnostic value of 68Ga-prostate specific membrane antigen (PSMA)-11 PET/MR multiparameter multimodal functional imaging in the diagnosis of naive prostate cancer (PCa), and to analyze its efficacy in the early stages of PCa. Methods:From July to September 2019, 45 suspected or pathologically confirmed PCa patients (average age: 69 years) who met the inclusion criteria were collected to perform 68Ga-PSMA-11 PET/MR examination in Nanjing First Hospital. After the scanning was completed, the method of region of interest (ROI) was used to semi-quantitatively calculate the tumor radioactive uptake in the fusion image, including the maximum standardized uptake value (SUV max), tumor metabolic volume (MTV) and mean standardized uptake value (SUV mean), and PSMA expression load was calculated(SUV mean×MTV). Apparent diffusion coefficient (ADC) values of ROI were measured in ADC images ( b=1 500 s/mm 2). The efficacy of 68Ga-PSMA-11 PET/MR in the preoperative diagnosis of PCa and the effect on clinical staging were evaluated with the pathological results. The correlation between prostate specific antigen (PSA) and radiation uptake in PCa tissues, PSMA expression load and ADC values was analyzed by Pearson correlation. Independent-sample t test was used to analyze the data. Results:Pathologically, 38 of the 45 patients were with PCa and 7 patients had benign prostatic hypertrophy (BPH), and metastasis occurred in 12 of the 38 PCa patients. 68Ga-PSMA-11 PET/MR detected 39 cases of PCa with one of which was false-positive. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 68Ga-PSMA-11 PET/MR were 100%(38/38), 6/7, 97.4%(38/39), 6/6 and 97.8%(44/45), respectively. The tumor tissues of PCa often showed focal radioactive uptake, and the T 2 weighted imaging (WI) showed focal low signal and limited dispersion. BPH showed slightly uneven uptake, and T 2WI and diffusion weighted imaging (DWI) showed uneven diffuse signals. SUV max of PCa was significantly higher than that of BPH (24.66±19.21 vs 4.97±2.13; t=5.208, P<0.001). ADC values of PCa were significantly lower than that of BPH ((0.91±0.37)×10 -3vs (1.08±0.24)×10 -3 mm/s 2; t=2.816, P<0.05). SUV max and the expression loads of PSMA in PCa were positively correlated with PSA ( r values: 0.42 and 0.71, both P<0.05). ADC values of tumor tissues in PCa were negatively correlated with PSA ( r=-0.37, P=0.013). Conclusion:68Ga-PSMA-11 PET/MR has great merits in the early diagnosis and staging of PCa.
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Objective@#To synthesis 177Lu-prostate specific membrane antigen (PSMA)-I&T with automated module, evaluate the biodistribution and pharmacokinetics in mice and study the targeting property in human prostate cancer cell line LNCaP Clone FGC.@*Methods@#The iQS-TS automated module was applied in labeling 177Lu-PSMA-I&T. Radiochemical purity and stability were determined with high performance liquid chromatography (HPLC). The biodistribution was observed in normal ICR mice and U-SPECT/CT imaging was performed in LNCaP Clone FGC tumor-bearing mice. Independent-sample t test was used to analyze the data.@*Results@#177Lu-PSMA-I&T was stable in vitro and in vivo, with the radiolabeled yield of (91.5±4.9)% and radiochemical purity >99%. The half maximal inhibitory concentration (IC50) of 177Lu-PSMA-I&T binding to LNCaP Clone FGC cells was (26.74±3.53) nmol/L. The uptake of 177Lu-PSMA-I&T by LNCaP Clone FGC cells increased with time and significantly decreased after the inhibitor addition (t values: 4.301-27.483, all P<0.05). 177Lu-PSMA-I&T was cleared from blood rapidly and predominantly excreted by kidneys. Significant radioactive uptake was observed in tumors with a long retention time.@*Conclusion@#177Lu-PSMA-I&T can be produced in a convenient and efficient procedure using iQS-TS automated module, with good biological properties and excellent affinity and targeting property towards prostate cancer cells, which making it a potential radiopharmaceutical for prostate cancer therapy.
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Objective To investigate the safety and efficacy of 177Lu-prostate specific membrane antigen (PSMA)-617 in the treatment of metastatic castration-resistant prostate cancer (mCRPC).Methods From August 2017 to September 2018,11 patients(average age 70.6 years) with mCRPC who underwent 177Lu-PSMA-617 therapy in Nanjing First Hospital were studied.All patients underwent 68Ga-PSMA-11 PET/CT before therapy to assess the tumor radioactive uptake.Blood routine examination and renal function test results were documented before and after therapy to assess the safety.The efficacy was reflected by the changes of prostate specific antigen (PSA) levels and maximum standardized uptake value (SUVmax) on 68Ga-PSMA-11 PET/CT imaging.Paired t test and Wilcoxon's sign rank test were used to analyze the data.Results No acute side effects were observed after therapy of 177Lu-PSMA-617.There were no statistically significant differences after therapy in WBC counts,RBC counts,and PLT,as well as Hb levels (t values:-0.28-1.11,all P＞ 0.05).No kidney toxicity was found.The PSA level after 177Lu-PSMA-617 therapy was significantly lower than that before therapy (80.70 (14.29,1 538.00) μg/L vs 604.60 (88.41,3 980.00) μg/L;u =59,P =0.023).Of the 11 patients,only 2 had elevated PSA levels and disease progression,while the other 9 patients had varying decreases,of which 2/11 decreased by ＞30％ and 7/11 decreased by ＞50％.After therapy,SUVmax of metastatic lesions and metastatic lymph nodes were decreased in 9 and 2 patients respectively.Conclusions 177Lu-PSMA-617 has a good therapeutic value for mCRPC.It is safe and has no obvious side effects.
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Objective To investigate the clinical value of 18F-FDG PET/CT in diagnosing G3 NEN and compare it with 68Ga-DOTA-NOC PET/CT.Methods Twenty-three patients (12 males,11 females;average age (63± 12) years) diagnosed of NEN between January 2006 and November 2016 were retrospectively recruited in this study:11 patients with gastroenteropancreatic NEN (GEP-NEN),10 with G3 NEN in lungs,1 with malignant pheochromocytoma and 1 with G3 NEN of unknown primary site.All patients underwent 18F-FDG PET/CT for staging and evaluation of biological behavior,and 9 of them also underwent 68Ga-DOTA-NOC PET/CT within 1 week.Image interpretation was analyzed by visual and semi-quantitative analysis,and SUVmax was calculated.Results All 23 cases showed positive results on 18F-FDG PET/CT (100％,23/23),with primary tumor SUVmax 10.56±3.94.Compared with 18F-FDG PET/CT,the positive detection rate of 68Ga-DOTA-NOC PET/CT was lower (6/9 vs 9/9),with primary tumor SUVmax 14.24± 10.00.There were 22 patients with distant metastasis.The most frequent metastatic sites associated with G3 NEN in lungs were lymph nodes and bones,while those with GEP-NEN were lymph nodes and the liver.In one patient with non-functional NEN,some metastatic lesions showed negative results on 18F-FDG PET/CT but positive results on 68 Ga-DOTA-NOC PET/CT.Conclusions 18 F-FDG PET/CT has higher diagnostic ability for G3 NEN and may serve as a useful tool for evaluating biological behavior of G3 NEN.68Ga-DOTA-NOC PET/CT is valuable as a complementary diagnostic tool in a small proportion of high differentiated G3 NEN.
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OBJECTIVE To explore the value of spiral CT in detecting narrow level of obstructive sleep apnea hypopnea syndrome(OSAHS) through investigating measured parameters of upper airway. METHODS The upper airway levels from the roof of nasopharynx to the inferior border of cricoid cartilage were scanned with spiral CT in 127 OSAHS patients and 52 controls.The coronal and sagittal diameter and the cross sectional areas of palate,uvula,tongue, epiglottis level were measured using image handling workstation.The measured values of each level were divided by the measured values of the cricoid cartilage level,and get relative values.The relative values of the OSAHS patients and controls were compared. RESULTS The relative values of posterior soft palate and uvula region,lingual region and epiglottis regions were statistically different.The difference also existed between genders.The relative values of 46 controls and 17 OSAHS patients were in the normal range. Among 127 OSAHS,the relative values of 110 cases with OSAHS(86.6%) were below the normal range in every region,while in control group,the relative values were found below the normal range in only 6 persons (11.2%).CONCLUSION The relative values of each regions is useful to judge the narrow level of upper airway in OSAHS patients.
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The purpose of quality control is to form a standard,scientific,and unified control system for PET-CT.The improvement of regulations is the base.The training of technicians is the key.The establishment of radiological protection rules is the assurance.So it is an important link to improve the quality control of PET-CT for better sensitivity and accuracy of PET-CT.
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Objective To further control the indications and to improve the effect of intra-esophageal metallic stents.Methods 83 metallic stents were be planted into esophageal through endoscopy and under X-ray TV guiding using two kinds of stent meterials in 72 cases with benign or maligant stenosis(esophageal,cardiac orifice).Results The operation of planting stents was successful in all patients and the effect of treatment of esophageal stenosis with stents covered by dacron kint membrane was best.The clinical symptoms and food intaking ablities of all patients were improved.Conclusion Home-made nitinol stents can be plant in treatment of malighent esophageal stenosis.It should be first choice for the patients without indications of surgery or after operation.