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Objective:To explore the value of 18F-FDG PET/CT in the differential diagnosis of nasopharyngeal carcinoma and nasopharyngeal lymphoma. Methods:A retrospective analysis including 100 patients (77 males, 23 females, age (51.0±12.4) years) with nasopharyngeal carcinoma and 107 patients(61 males, 46 females, age (52.3±18.2) years) with nasopharyngeal lymphoma after 18F-FDG PET/CT at Tianjin Medical University Cancer Institute and Hospital from October 2011 to December 2019 was performed. All patients were confirmed by pathology. Differences of clinical data, PET metabolic parameters and CT morphology between nasopharyngeal carcinoma group and nasopharyngeal lymphoma group were compared (independent-sample t test or Mann-Whitney U test). Multiple regression analysis and ROC curve analysis were used to evaluate the efficacy of the combined features in the differential diagnosis of nasopharyngeal carcinoma and nasopharyngeal lymphoma. Results:As for nasopharyngeal carcinoma group and nasopharyngeal lymphoma group, there were statistically significant differences in SUV max (10.86±3.99 vs 14.81±7.24; t=-4.90, P=0.001), peak of SUV (SUV peak; 7.84±3.13 vs 10.86±5.66; t=-4.79, P=0.001), and total lesion glycolysis (TLG; 39.00(19.98, 62.56) vs 56.75(33.02, 102.06) g; z=-3.24, P=0.001). However, the diagnostic efficiencies were low (AUCs: 0.657, 0.646, 0.636, respectively). Multiple regression model showed that SUV max combined with multiple morphological and clinical features (gender, lesion location, with or without involvement of surrounding structures, cervical lymph node metastasis, parapharyngeal involvement and spleen involvement) could improve the differential diagnosis efficiency significantly (AUC=0.900). Conclusion:18F-FDG PET/CT metabolic parameter SUV max combined with CT morphological and clinical features have high diagnostic efficiency in the differential diagnosis of nasopharyngeal malignant tumors.
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Objective To investigate the application value of conventional ultrasound typing and contrast-enhanced ultrasound (CEUS) in non-mass breast like lesions (NMLs). Methods A total of 50 patients (50 lesions) who were pathologically confirmed to have breast NMLs in Tianjin Fifth Central Hospital. The corresponding relationship between conventional ultrasound typing of NMLs and BI-RADS classification was analyzed, and CEUS was performed on breast NMLs to compare the diagnostic value of combined BI-RADS and CEUS. Results The NMLs conventional ultrasound classified Ⅰa and Ⅱa lesions corresponded to BI-RADS classification 4a; Ⅲ and Ⅳ lesions corresponded to BI-RADS classification 4b; Ⅰb and Ⅱb lesions corresponded to BI-RADS classification 4c. A statistically significant correlation was observed between the expansion of lesion range and the presence of "crab foot sign" in benign and malignant lesions after the enhancement (P < 0.05). Pearson correlation analysis showed that enlarged lesion area, "crab foot sign, " peak intensity, and area under the curve were associated with malignant breast NMLs. The diagnostic value of CEUS combined with BI-RADS was higher than that of conventional ultrasound BI-RADS. Conclusion NMLs conventional ultrasonographic classificationsⅠa andⅡa have the lowest malignant risk, whereas classifications Ⅰb and Ⅱb have the highest value. The expansion of lesion range and the presence of "crab foot sign" after enhancement are helpful for rapid differentiation of benign and malignant NMLs.
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Objective:To explore the predictive values for mutation subtypes of epidermal growth factor receptor (EGFR) in patients with lung adenocarcinoma (LUAD) based on machine learning and 18F-fluorodeoxyglucose (FDG) PET/CT images. Methods:18F-FDG PET/CT images and pathological data of 238 patients with LUAD (126 patients (54 males, 72 females, median age 62 years) with EGFR mutation; 112 patients (68 males, 44 females, median age 61 years) with wild-type EGFR)) were retrospectively collected at Tianjin Medical University Cancer Institute and Hospital between April 2016 and May 2020. Volumes of interest (VOI) of PET and CT images were delineated respectively and three-dimensional-based and two-dimensional-based radiomics features were extracted from VOIs. Three machine learning classifiers of K-nearest neighbor (KNN), support vector machine (SVM) and Adaboost were trained in training set with CT, PET and fusion PET/CT radiomics features respectively. Well trained classifiers were tested in test set. Each predictive model was evaluated by using the receiver operating characteristic (ROC) curve. Results:A total of 126 patients were EGFR mutation including 3 patients with 18 exon mutation, 6 patients with 20 exon mutation, 42 patients with 19 exon mutation, and 75 patients with 21 exon mutation. Finally, patients with 18 exon mutation and 20 exon mutation were removed due to the scale was too small to be trained adequately by machine learning classifiers. Predictive performance of mean PET/CT feature-based model (Adaboost: area under curve (AUC)=0.87, 95% CI: 0.75-0.99) in EGFR mutation subtypes was better than PET feature-based model (Adaboost: AUC=0.64, 95% CI: 0.46-0.83; z=2.04, P<0.05) and CT feature-based model (Adaboost: AUC=0.64, 95% CI: 0.45-0.83; z=2.06, P<0.05). There was no statistical difference between predictive performance of mean PET/CT feature-based model (SVM: AUC=0.76, 95% CI: 0.56-0.96) and PET/CT concatenation feature-based model (SVM: AUC=0.75, 95% CI: 0.59-0.92; z=1.14, P>0.05). Conclusion:Machine learning and 18F-FDG PET/CT radiomics features can provide predictive value for EGFR mutation subtypes in patients with LUAD.
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Objective@#To explore the predictive value of 18F-fluorodeoxyglucose (FDG) PET conventional parameters and radiomics features for human epidermal growth factor receptor 2 (HER2) expression which was uncertain by immunohistochemistry (IHC) detection in invasive breast cancer.@*Methods@#From April 2012 to December 2017, 76 patients (all were females, age: (50.8±10.9) years) with invasive breast cancer and with uncertain HER2 expression by IHC in Tianjin Medical University Cancer Institute and Hospital were enrolled retrospectively. The 18F-FDG PET/CT images before treatment were reviewed and the expression of HER2 were confirmed by fluorescence in situ hybridization (FISH). The tumor lesions were manually outlined, and the radiomics features from PET images were extracted. Wilcoxon test was used to determine whether there was difference in PET conventional metabolic parameters (maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV) and total lesion glycolysis (TLG)) and radiomics features between HER2-negative and HER2-positive groups. The receiver operating characteristic (ROC) curve analysis was used to compare the predictive efficacy of PET radiomics features for HER2 expression.@*Results@#There were 41 HER2-positive patients and 35 HER2-negative patients. No significant differences in PET conventional metabolic parameters between different HER2 expression groups were observed (U values: from -1.598 to 1.551, all P>0.05). A total of 38 PET radiomics features were extracted, and there were significant differences in gray mean, correlation, contrast, inertia, and inverse different moments between 2 groups(U values: from -2.413 to 2.527, all P<0.05). The area under the curve of the above 5 parameters for prediction of HER2 expression were 0.643, 0.638, 0.647, 0.644 and 0.643, respectively, and the contrast was the best parameter.@*Conclusions@#PET radiomics features can effectively identify HER2 expression in patients with invasive breast cancer to some extent, and the contrast may be the best. Conventional metabolic parameters have limited predictive value.
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Objective@#To investigate the value of 18F-fluorodeoxyglucose (FDG) PET/CT in the diagnosis of different pathological types of primary osseous malignant tumors (POMT) in patients over 40 years old.@*Methods@#Fifty-two patients (30 males, 22 females, median age: 60(41-81)years) with POMT who underwent 18F-FDG PET/CT and were pathologically confirmed from January 2013 to May 2018 in Cancer Hospital of Tianjin Medical University were reviewed. The region of interest was drawn and the standardized uptake value (SUV) was automatically measured. The SUV in different pathological types of POMT was compared using one-way analysis of variance or two-sample t test.@*Results@#The 52 POMT included 22 sarcomas, 16 isolated myelomas (IM), and 14 primary bone lymphomas (PBL). The SUV in PBL was significantly higher that than in sarcomas and IM with the maximum SUV (SUVmax) of 21.6±12.4, 13.5±7.7 and 9.0±6.4 respectively(F=7.56, P<0.01), and the mean SUV (SUVmean) of 12.9±7.8, 7.5±4.5, and 5.6±4.4, respectively(F=6.92, P<0.01). In the sarcoma group, the SUV of undifferentiated sarcomas was significantly higher than that of other well-differentiated sarcomas (SUVmax: 21.1±5.4 vs 11.3±6.9, SUVmean: 11.8±3.3 vs 6.3±4.1; t=-2.92, -2.71, both P<0.01). The growth pattern of sarcomas and IM was different on CT images.@*Conclusions@#The FDG uptake of PBL is higher than that of other pathological types. CT features are helpful for the differential diagnosis of POMT in 18F-FDG PET/CT.
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Lung cancer is a malignant tumor with the high morbidity and mortality in the world, and non-small cell lung cancer ( NSCLC) is the most common type. The emergence of epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitor (TKI) in recent years has provided new treatment option for NSCLC patients. The efficacy of EGFR-TKI is closely related to the EGFR mutation status, but the current detection methods for gene mutation have certain limitations. As a non-invasive method, 18F-fluorodeoxyglucose (FDG) PET/CT shows a certain potential in the detection of EGFR gene mutation status. In this paper, the re-cent research and progress of PET/CT in predicting the mutation status of EGFR gene are reviewed.
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Objective To investigate the value of 18 F-fluorodeoxyglucose ( FDG) PET/CT in the diagnosis of different pathological types of primary osseous malignant tumors ( POMT) in patients over 40 years old. Methods Fifty-two patients ( 30 males, 22 females, median age: 60 ( 41-81 ) years ) with POMT who underwent 18 F-FDG PET/CT and were pathologically confirmed from January 2013 to May 2018 in Cancer Hospital of Tianjin Medical University were reviewed. The region of interest was drawn and the standardized uptake value ( SUV) was automatically measured. The SUV in different pathological types of POMT was compared using one-way analysis of variance or two-sample t test. Results The 52 POMT in-cluded 22 sarcomas, 16 isolated myelomas (IM), and 14 primary bone lymphomas (PBL). The SUV in PBL was significantly higher that than in sarcomas and IM with the maximum SUV (SUVmax) of 21.6±12.4, 13.5±7.7 and 9.0±6.4 respectively(F=7.56, P<0.01), and the mean SUV (SUVmean) of 12.9±7.8, 7.5± 4.5, and 5.6±4.4, respectively(F=6.92, P<0.01). In the sarcoma group, the SUV of undifferentiated sar-comas was significantly higher than that of other well-differentiated sarcomas (SUVmax:21.1±5.4 vs 11.3±6.9, SUVmean:11.8±3.3 vs 6.3±4.1;t=-2.92, -2.71, both P<0.01). The growth pattern of sarcomas and IM was different on CT images. Conclusions The FDG uptake of PBL is higher than that of other pathological types. CT features are helpful for the differential diagnosis of POMT in 18 F-FDG PET/CT.
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As an important in vivo noninvasive molecular imaging modality, PET imaging can quantify and visualize the serial trafficking, tumor targeting, cell number maintenance, cell expansion, activation and immunological function of adoptive immune cells in cancer cell therapy. Thereby it may play a significant role in the treatment options and efficacy evaluation for cellular immunotherapy in cancer. This review focuses on PET reporter gene imaging which has been studied intensively and applied widely in the research on imaging monitoring of cellular immunotherapy for cancer, with the purpose to provide innovative clues for the preclinical study and clinical translation research.
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Objective To evaluate the value of 18F-fluorodeoxyglucose (FDG) PET/CT in evaluation of curative effect and progression-free survival (PFS) for lymphoma patients.Methods The data of 85 lymphoma patients were retrospectively analyzed.Before and after 4-8 cycles standardized chemotherapy,the patients were evaluated with 18F-FDG PET/CT.The two-year PFS rate was compared.The value of 18F-FDG PET/CT in evaluation of curative effect and PFS for lymphoma patients received chemoradiotherapy was analyzed.Results The non Hodgkin lymphoma (NHL) was the common type,and the common pathogenic sites were head and neck lymph nodes,mediastinum and retroperitoneum.The majority of patients were accompanied with spleen enlargement and local lesions with high metabolism.The complete remission (CR) rate of Hodgkin lymphoma (HL)patients in PET/CT negative group was significantly higher than that in positive group (86.4％ vs.42.9％,P =0.038).The two-year PFS rates in PET/CT positive group and negative group were 42.9％ and 81.8％,and the difference was statistically significant (x2 =7.70,P =0.006).Thirty-five NHL patients achieved CR,13 achieved partial remission (PR),and 8 achieved stable disease (SD) or disease progression (PD).The two-year PFS rates in the CR group,PR group,SD or PD group were 89.7％,65.3％ and 19.4％ respectively,and the difference was statistically significant (x2 =12.41,P =0.002).PET/CT imaging had a strong PFS predictive effect on T cell lymphoma (TCL) patients (x2 =13.85,P =0.001) and diffuse large B cell lymphoma (DLBCL)patients (x2=13.51,P =0.001),and had no predictive effect on follicular lymphoma (FL) patients (x2 =4.63,P =0.099).Conclusion 18 F-FDG PET/CT can evaluate the curative effect of lymphoma effectively and early predict prognosis,and has great guiding significance in choosing therapeutic schedule.
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Objective To compare the recent adverse reactions caused by 131I-Metuximab (licartin) treatment via two different routes and to assess the safety and advantages of peripheral intravenous bolus of licartin for the treatment of advanced HCC.Methods Clinical data of 54 patients (45 males,9 females,age 33-80 years) with advanced HCC treated with Licartin in Tianjin Medical University Cancer Institute and Hospital from October 2010 to March 2013 were collected and analyzed.The patients were divided into vein group (n=33) with Licartin injected through peripheral vein and artery group (n =21) with Licartin injected through hepatic artery.The results of blood routine examination,liver and kidney function and thyroid function between the two groups (1 week before treatment,4 and 12 weeks after treatment) were compared.The adverse reaction rate (ARR) and adverse reaction progression rate (ARPR) were also compared between the 2 groups.Ten days after Licartin treatment,all patients underwent gamma imaging to access the drug distribution in vivo.x2 test and two-sample t test were used to analyze data.Results There were no significant differences on age,gender and TNM staging between the vein group and the artery group (t =0.721,x2=0.561 and 4.769,all P＞0.05).The vein group showed temporary drug-related leucopenia (x2=7.041,P＜0.05) and increased level of serum total bilirubin (STB;x2 =10.297,P＜0.05) 4 weeks post-treatment.Twelve weeks later,the above parameters returned to baseline.In artery group,no influence on liver and kidney functions was observed,but the numbers of WBC and PLT decreased significantly (x2 =8.949 and 8.778,both P＜0.05) and returned to baseline 12 weeks post-treatment.The ARR in patients who had normal ALT levels before treatment between the two groups was significantly different(3.33％(1/30) vs 5/19,x2=5.718,P＜0.05).No significant difference was observed on ARR in patients with normal level of other parameters,and on ARPR in patients with abnormal preoperative parameters between the two groups (x2 =0.000-2.500,all P＞0.05).The drug's in vivo biodistribution and the thyroid function between the 2 groups showed no significant difference.Conclusion The peripheral intravenous bolus administration of Licartin is safe to treat patients with advanced HCC.
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Objective To explore the value of 18 F-fluorodeoxyglucose (i8 F-FDG) PET/CT examination in the differential diagnosis of the gastric cancer and primary gastric lymphoma (PGL).Methods The clinical data of 80 patients with gastric cancer (60 with non-mucinous adenocarcinoma and 20 with mucinous adenocarcinoma) and 47 patients with PGL [22 with mucosa-associated lymphoid tissue (MALT) and 25 with diffuse large B-cell lymphoma (DLBCL)] who were admitted to the Tianjin Medical University Cancer Institute and Hospital from June 2006 to May 2014 were retrospectively analyzed.Spiral CT scan was first done and then followed by PET.The CT value of the lesions,maximum standardized uptake value (SUVmax) of patients and maximal gastrointestinal wall thickness (THKmax) were analyzed by the ANOVA test.The SUVmax comparison between groups was evaluated with the Student-Newman-Keuls.The lesions type was analyzed by the chi-square test.The THKmax and SUVmax among groups were analyzed by the Pearson correlation analysis.Results 18 F-FDG PET/CT imaging of patients with gastric cancer and PGL showed different types of gastric wall thickening,segmental and limited thickening of gastric wall were the main features of gastric cancer and diffuse and segmental thickening of gastric wall were the main features of PGL.The type Ⅰ,Ⅱ and Ⅲ of lesions were detected in 12,21 and 27 of 60 patients with nonmucinous adenocarcinoma,in 2,7 and 11 of 20 patients with mucinous adenocarcinoma,in 8,8 and 6 of 22 patients with MALT and in 13,7 and 5 of 25 patients with DLBCL respectively.There were significant differences in the 4 pathological types of lesions among all the patients (x2 =14.849,P ＜ 0.05).The lymph nodes beneath the renal hilum and at the retroperitoneum were involved in 16 patients with gastric cancer and in 10 patients with PGL,and 7 patients with gastric cancer and 12 patients with PGL were complicated with splenomegalia,respectively,showing a significant difference in the splenomegalia between patients with PGL and gastric cancer (x2=7.506,P ＜0.05).There was no significant difference in the metastasis of lymph nodes beneath the renal hilum and at the retroperitoneum between patients with PGL and gastric cancer (x2=0.178,P ＞0.05).Among 80 patients with gastric cancer,positive 18F-FDG was detected in 79 patients and negative 18F-FDG in 1 patient with T3 stage of mucinous adenocarcinoma.Among 47 patients with PGL,positive 18 F-FDG was detected in 46 patients and negative 18F-FDG in 1 patient with stage Ⅰ of MALT.The CT value of the lesion,SUVmax and THKmax in patients with non-mucinous adenocarcinoma,mucinous adenocarcinoma,MALT and DLBCL were (40 ± 8)HU,(39±11)HU,(41±11)HU,(38±9)HU and 9.9 ±6.6,5.6±1.9,4.6 ±2.9,18.3±7.6 and (2.1 ± 1.2) cm,(1.9 ± 0.9) cm,(1.3 ± 1.1) cm and (2.6 ± 1.5) cm,respectively,showing significant differences in the SUVmax among all the groups (F =26.920,P ＜ 0.05).In the pairwise comparisons,there were no significant difference between the MALT group and mucinous adenocarcinoma group (P ＞ 0.05),and significant differences among the other groups (P ＜ 0.05).The CT value of the lesions and THKmax among all the patients were compared,with no significant differences (F =0.578,4.510,P ＞ 0.05).There were no significant differences in the SUVmax and THKmax among all the patients (r =0.055,0.346,0.226,0.133,P ＞ 0.05).Conclusions There is an important diagnosis value of PET/CT examination in patients with gastric cancer and PGL.The pathological types of the lesions in patients with gastric cancer and PGL are different.The occurrence of splenomegalia in patients with PGL is easier than that with gastric cancer.SUVmax of patients with DLBCL is higher than those with gastric cancer and MALT.FDG uptake in patients with mucinous adenocarcinoma and MALT are not enough,and these may lead to false negative result of PET/CT examination.
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Objective: To evaluate and compare the safety and efficiency of the combined therapy of 89Sr plus zoledronic acid and those of 89Sr-chloride alone, in patients with painful bone metastases. Methods: A total of 87 patients with osseous metastasis were ran-domly divided into treatment groups of 89Sr-chloride alone (group A, 53 patients) and 89Sr plus zoledronic acid (group B, 34 patients). A total of 17 patients in group B received zoledronic acid 2-14 days after 89Sr therapy, and 13 other patients in the group received 89Sr 4-7 days after zoledronic-acid therapy. Pain response and KPS score were evaluated after the different treatments. Results: No obvious bone marrow suppression and liver damage were found in all cases. All patients who received both 89Sr-chloride and 89Sr plus zoledronic acid showed reduced bone pain and total discomfort, as well as improved KPS score, but the response was more pronounced in group B (P=0.047; P=0.036). No statistical differences in pain score and KPS scores were observed between the groups treated with zoledronic acid first and 89Sr therapy first (P=1.000; P=0.667). Comparison of bone pain relief and changes in the KPS score of different primary tumors after treatment with 89Sr-chloride or 89Sr plus zoledronic acid showed no statistical significance. Conclusion: Compared with 89Sr-chloride, treatment with 89Sr plus zoledronic acid was more effective in patients with painful bone metastases. The safety of these two treatments are similar.
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Objective:To explore the effects of body mass index (BMI) and gender on primary lung cancer 18F-FDG uptake param-eters, standardized uptake value (SUV), and standard uptake value of lean body mass (SUL). Methods:Data of 50 patients with prima-ry lung cancer confirmed by 18F-FDG positron emission tomography (PET)/computed tomography (CT) were retrospectively analyzed. AW4.6 workstation was employed to measure the SUVmean and SUVmax. Meanwhile, PETVCAR (PET Volume Computed Assisted Reading, GE Healthcare) software was used to automatically measure the SULmean, SULmax, and SULpeak. The SUVmean, SUV-max, SULmean, and SULmax of the liver (central region of the right lobe) were also measured automatically by PETVCAR. Afterward, T/N ratios (lesion SUVmax/liver SUVmean, lesion SULmax/liver SULmean, and lesion SULpeak/liver SULmean) of the lung cancer lesions were calculated. Correlations of the 18F-FDG metabolic parameters with BMI and gender of the patients were analyzed. Results:Liver SUVmean and SUVmax demonstrated significant positive correlations with BMI in all the patients (γ=0.38 and 0.36, P0.05). No significant correlation was not-ed between the SUVmean, SUVmax, SULmean, SULmax, and SULpeak of the lung cancer lesions and BMI (P>0.05). The correlation trend is the same as that in different gender groups. Only the SUVmax T/N ratio of the lung cancer lesions showed a significant nega-tive correlation with BMI (γ=?0.29, P0.05). Con-clusion:Patient BMI and gender mainly affect SUV values, particularly SUVmax, by contrast, patient BMI and gender did not signifi-cantly influence SUL and T/N ratio (SUL). Hence, SUL can be more suitable to quantitatively analyze and assess treatment response ob-jectively. This result will be helpful to the clinical application and promotion of PERCIST, which evaluates treatment response mainly by SUL.
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Objective To investigate the inhibitory effects and mechanisms of a nature product derivate oridonin on in?vasion of human lung cancer. Methods Human lung cancer A549 and PC-9 cell lines were treated with oridonin. MTS as?say was used to determine cell proliferation. Transwell assay was used to determine the cell invasion, and adhesion assay to determine the cell adhesion. Flow cytometry was used to determine cell cycle. Western blotting and realtime-PCR were used to detect expression levels of CDK1, mTOR, p53, p21, E-cadherin, CD44,β-catenin, uPA, MMP-2/9, p-AKT and p-Src. The luciferase reporter assay was used to detect the NF-κB promoter activity. Results In vitro proliferation, invasion and adhesion of A549 and PC-9 cells were significantly inhibited by oridonin. The cell cycle was halted by G2/M phase, and ex?pressions of E-cadherin, p53 and p21 were promoted, while expressions of CDK1, mTOR, CD44,β-catenin, uPA, MMP-2/9, p-AKT and p-Src and promoter activity of NF-κB were down-regulated. Conclusion Oridonin is able to inhibit the in vitro invasion of human lung cancer A549 and PC-9 cell lines, which might be correlated with its abilities to regulate the ty?rosine kinase activity.
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Objective To explore the value of urinary N-terminal telopeptide of type Ⅰ collagen (uNTX) combined with bone scintigraphy (BS) for the diagnosis of bone metastases.Methods A total of 227 patients suspected of bone metastases by BS were selected from Jan to May of 2012.UNTX was tested for each subject.The threshold of uNTX was chosen as 65 nmol bone collagen equivalents (BCE)/mmol creatinine (Cr) for the diagnosis of bone metastasis.Patients with uNTX greater than 65 nmol BCE/mmol Cr would be diagnosed as having bone metastasis.Other examinations (CT,MRI,PET/CT or bone biopsy) were also performed to confirm the diagnosis.The uNTX values of benign and malignant bone lesions were compared using two-sample t test.The diagnostic efficacy of uNTX combined with BS was evaluated.A ROC curve was analyzed to evaluate the cut-off value of uNTX for the diagnosis of bone metastasis.Results The mean value of uNTX of all 227 patients was (84.30± 13.29) nmol BCE/mmol Cr,which was significantly higher than the upper limit of normal range (t =21.875,P＜0.01).Using 65 nmol BCE/mmol Cr as the threshold,197 cases were diagnosed as with and 30 without bone metastases,in which 188 and 27 were respectively confirmed by other examinations.The mean uNTX was (88.73 ± 8.37) and (60.76± 9.14) nmol BCE/mmol Cr in patients with and without bone metastases,respectively (t =-18.134,P＜0.01).The sensitivity,specificity,positive predictive value,negative predictive value,accuracy and Youden index of uNTX combined with BS were 98.4％ (188/191),75.0％ (27/36),95.4％ (188/197),90.0％ (27/30),94.7％ (215/227) and 73.4％ respectively.The cut-off value by ROC curve analysis was 78.88 nmol BCE/mmol Cr and the area under the curve was 0.982.Using 78.88 nmol BCE/mmol Cr as threshold,the corresponding sensitivity,specificity,positive predictive value,negative predictive value,accuracy and Youden index were 97.4％(186/191),94.4％(34/36),98.9％(186/188),87.2％(34/39),96.9％(22/227) and 91.8％ respectively.Conclusions Using the cut-off value of 78.88 nmol BCE/mmol Cr,uNTX may have clinical value in helping the differential diagnosis of bone scintigraphy for patients suspected of metastatic bone disease.
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Epidermal growth factor receptor (EGFR) inhibitors are currently widely used for targeted lung cancer therapy. Target-ed therapy evaluation principally relies on genetic testing or rough clinical estimation. PET receptor imaging is highly sensitive and spe-cific. According to domestic and foreign literature, PET imaging using radiolabeled EGFR-targeting agents can be used to predict and monitor therapy response. This paper presents new evaluating methods for targeted lung cancer therapy.
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<p><b>OBJECTIVE</b>To investigate the diagnostic value of (18)F-FDG PET-CT imaging in primary extranodal lymphoma.</p><p><b>METHODS</b>A retrospective analysis of 139 clinically suspected primary extranodal lymphoma patients examined by PET-CT and confirmed by biopsies was performed. Considering the pathological diagnosis as the gold standard, PET-CT imaging of all patients was compared with CT and PET to evaluate the efficacy of 18F-FDG PET-CT in detection of primary extranodal lymphoma. The maximal standardized uptake value (SUVmax) from primary extranodal lymphoma patients was compared, and the data were analyzed by χ² test.</p><p><b>RESULTS</b>Of the total 139 analyzed cases, 128 patients were confirmed to have primary extranodal lymphoma. The sensitivity, specificity and positive rate of PET-CT were 82.8%, 81.8% and 82.7%, respectively, that of CT were 65.6%, 72.7% and 66.2%, and that of PET were 78.9%, 36.4% and 82.0%, respectively. The sensitivity and accuracy of PET-CT were better than that of CT (χ²=9.881, 10.006; P=0.003, 0.002). The specificity of PET-CT were better than that of PET (χ²=4.487, P=0.034). In the gastrointestinal lymphoma, the sensitivity of PET-CT were better than that of CT (χ²=5.110, P=0.024). In the head and neck lymphoma, the sensitivity of PET-CT were better than that of CT (χ²=5.278, P=0.022). In the diffuse large B-cell lymphoma, the sensitivity of PET-CT were better than that of CT (χ²=8.711, P=0.003). The SUV max of mucosa-associated lymphoma was significantly different from that of diffuse large B-cell lymphoma and natural killer/T-cell lymphoma (7.4±4.6 vs 15.8±10.6, P=0.032; 7.4±4.6 vs 13.6±7.1, P=0.046), respectively.</p><p><b>CONCLUSION</b>18F-FDG PET-CT imaging is important in the diagnosis of primary extranodal lymphoma, but the differential diagnosis with other disease is important, and the result should be combined with multiple biopsies.</p>
Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Child , Female , Humans , Male , Middle Aged , Young Adult , Fluorodeoxyglucose F18 , Lymphoma , Diagnosis , Diagnostic Imaging , Positron-Emission Tomography , Prognosis , Retrospective Studies , Sensitivity and Specificity , Tomography, X-Ray ComputedABSTRACT
Malignant pheochromocytomas are rare tumors that arise from chromaffin tissue, and the diagnostic criterion of malig-nancy is based on the development of metastases. In the case a patient suffers the tumor with liver, lung and bone metastases. However, the test results of tumor markers, gastroscopy, chest and abdominal CT, and PET-CT examination are hard to make a definite diagnosis. The patient was finally diagnosed with malignant pheochromocytoma with liver, lung and bone metastases following the needle biopsy of liver and underwent the excision of a right adrenal pheochromocytoma. Therapeutic standard for the malignant pheochromocytomas is not available so far. It is reported that chemotherapeutic CVD regimen (cyclophosphamide, vincristine, and daecarbazine) and suni-tinib may be effectual in the alike cases. The patient received two cycles of CVD and one cycle of sunitinib, nevertheless, slow progres-sion of the disease remained after the treatment. The results of multi-disciplinary treatment have suggested that 131I-MIBG may just be a choice for this patient.
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Objective: Lung metastases are common in patients with differentiated thyroid carcinoma (DTC). Post-therapeutic 131I-whole-body scan (WBS) was conventionally administered after the radioactive iodine treatment (RAI) of DTC lung metastases. This study aimed to investigate the influencing factors of WBS imaging on the RAI of DTC lung metastases. Methods:DTC patients (n=60) with lung metastases treated with 131I were retrospectively included. Before treatment, the thyroid function was assessed. Neck and chest computed tomography (CT) was performed, and WBS was inspected. Patients with lung metastases were classified into negative and positive subgroups according to the imaging of 131I WBS, and the relative influencing factors were analyzed. Results:Univariate analy-sis showed that age and chest CT imaging, which revealed pulmonary fibrosis, calcification, and patchy shadows, were related to WBS imaging. Binary variable logistic regression analysis revealed that pulmonary fibrosis (OR=0.175, P<0.001) and calcification (OR=0.088, P<0.05) went against the development of WBS. Conclusion:WBS imaging on RAI of lung metastases was not obvious in the el-derly. The fibrosis, calcification, and patchy shadows of the lung were not conducive for WBS imaging. The fibrosis and calcification of the lung were the main factors that affect WBS imaging.
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10.3969/j.issn.1000-8179.2013.12.002