Value of dual-time-point (18)F-fluorodeoxyglucose integrated positron emission and computed tomography in differentiation of malignant from benign gastrointestinal diseases / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To explore the value of dual-time-point (18)F-fluorodeoxyglucose integrated positron emission and computed tomography ((18)F-FDG PET-CT) in differentiation of malignant from benign gastrointestinal diseases.</p><p><b>METHODS</b>Sixty five patients with suspected gastrointestinal lesions underwent dual-time-point (18)F-FDG PET-CT imaging. Standardized uptake value (SUV) was calculated for semi-quantitative assessment. The SUV of the two acquisitions were signed SUV(early) and SUV(delayed), respectively. Then the change of SUVmax (ΔSUVmax) was calculated. The ROC curves of the SUV(early), SUV(delayed) and ΔSUV were drawn to find the best cut-off point value for differential diagnosis, and then the sensitivity, specificity, positive predictive value, negative predictive value and accuracy were calculated, respectively.</p><p><b>RESULTS</b>Of the malignant lesions, the SUVmax in delayed imaging were significantly higher than those in early imaging, while there were no significant differences of SUVmax between the two images of the benign lesions. The ΔSUVmax of the malignant lesions were significantly higher than that of the benign ones. Taking the SUVmax higher than 9.2 in early imaging as positive diagnostic criteria, the sensitivity was 72.7%, the specificity was 85.7%, the positive predictive value was 91.4%, the negative predictive value was 60.0%, and the accuracy was 76.9%. Taking the SUVmax higher than 10.9 in delayed imaging as positive diagnostic criteria, the sensitivity was 75.0%, the specificity was 90.5%, the positive predictive value was 94.3%, the negative predictive value was 63.3%, and the accuracy was 80.0%. Taking the ΔSUVmax higher than 5.1% as positive diagnostic criteria, the sensitivity was 95.5%, the specificity was 85.7%, the positive predictive value was 93.3%, the negative predictive value was 90.0%, and the accuracy was 92.3%. The accuracy of dual-time-point (18)F-FDG PET-CT imaging was significantly higher than that of single-time point (18)F-FDG PET-CT imaging.</p><p><b>CONCLUSION</b>Dual-time-point (18)F-FDG PET-CT imaging is a useful method for differentiating malignant from benign gastrointestinal diseases, and it is superior to the single-time point (18)F-FDG PET-CT imaging.</p>

Clinical significance of (18)F-FDG PET/CT evaluation of response to treatment in T-cell lymphoma / 中华血液学杂志

<p><b>OBJECTIVE</b>To investigate the usefulness of (18)F-FDG PET/CT imaging in restaging, evaluating the treatment outcome, monitoring relapse and predicting prognosis of T-cell lymphoma.</p><p><b>METHODS</b>Retrospective analysis of PET/CT image results of thirty-four patients with T-cell lymphoma, and to evaluate its clinical significance in restaging, treatment efficiency, relapse monitor and prognosis prediction.</p><p><b>RESULTS</b>Clinical restaging among the 20 stage I and II patients, 6 were ascended, 9 descended and 5 unchanged. Restaging among the other 14 stage III and IV patients, 3 were ascended, 4 descended and 7 unchanged. There were 12 patients in complete remission (CR), 11 in partial remission (PR), 2 in stable disease (SD) and 9 in progressive disease (PD) among all the 34 patients. There is obvious statistical difference of the standardized uptake value (SUV) between the efficacy group and the inefficacy group after treatment of 6 courses at least in 25 patients among all the 34 patients (P = 0.009). There is obvious statistical difference of the SUV value before and after treatment in 8 patients among all the 34 patients (P = 0.000). There is obvious statistical difference in the survival time between the efficacy group and the inefficacy group after treatment of 6 courses at least in 25 patients among all the 34 patients (P = 0.015).</p><p><b>CONCLUSIONS</b>(18)F-FDG PET/CT imaging plays an very important role in guiding clinical restaging, evaluating the treatment outcome, monitoring relapse and predicting prognosis of T-cell lymphoma. It is helpful to establish personalized treatment planning.</p>

Progress of clinical pathology and application of PET-CT on thyroid carcinoma / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>Identify the significance of variants in papillary thyroid carcinoma (PTC), the role of extracellular matrix (ECM), MMPs, cell adhesion molecular (CAM) and cytokine in lymphatic metastasis in PTC and the value of PET-CT in diagnosis of thyroid carcinoma.</p><p><b>METHODS</b>Five hundred and five cases of PTC which had complete medical records and followed up surveys were selected from the files. Clinical biological characteristic of the histological variants was investigated. Sixty cases of PTC were selected. As the important parts of micro ecosystems, ECM, MMPs, CAMs and cytokine were investigated in use of tissue chip and method of immunohistochemistry. In addition, a group of cases of thyroid carcinoma including PTC was analyzed, follicular thyroid carcinoma and medulla thyroid carcinoma (MTC) and their reports of PET-CT as the initiation.</p><p><b>RESULTS</b>The variants could be divided into three groups in terms of the rate of cervical lymph node metastasis. The high-metastases group included diffuse sclerosing variant, tall cell variant, column cell variant and diffuse follicular variant. The low-metastases group included macrofollicular variant and papillary microcarcinomas. Others are included in the moderate-metastases group. The rate of cervical lymph node metastasis of each group were 83.0% , 55.5% and 34.1% (P < 0. 05), respectively. The 10-year-survival were 75.3% , 95.8% and 100.0% , respectively. The 20-year-survival were 31.2%, 80.3% and 87.5%, respectively. The positive rate of LN, FN, MMP-2, MMP-9, TIMP-2, CD, Integrinbeta-1, ICAM-1, EGFR, TGFR-beta, VEGF-C and E-Cad in metastasis ranged from 51.6% (Integrinbeta-1) to 98.3% (CD), and that in primartumor ranged from 46.7% (FN) to 98.3% (ICAM-1). The expression of E-cad in primartumor was lower than that in normal tissues (P < 0.05). The sensitivity of PET-CT was 100% and the specificity was 85.7%.</p><p><b>CONCLUSIONS</b>The characteristic has significant difference among the variants. Individual treatment should be performed in terms of different variants. Furthermore, some molecules play an important role in the lymph node metastasis of PTC and may be considered as the focus of future study. In addition, compared with CT and Bus, PET-CT is more sensitive and has its unquestionable advantage as a whole body examination, especially for staging and detecting micro metastases, though it requires a high expense.</p>

Study on influence of acupunctural signal on energy metabolism of human brain by positron emission tomography / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To study the biologic process of energy metabolism in brain during acupuncture using positron emission tomography (PET) with 18F-2-desoxyglucose (18FDG) for further elucidation of the relationship between acupunctural signal and nerve system.</p><p><b>METHODS</b>Electroacupuncture (EA) was applied on right lateral of a healthy volunteer and paralytic limbs of 4 patients with cerebral infarction at acupoints L14, LI11, ST36 and SP6 using Hans acupoint-nerve stimulator. PET imaging was conducted on the healthy subject or patients with the same posture before and during EA with GE Advance II PET system.</p><p><b>RESULTS</b>PET showed that in the healthy subject, before EA, the glucose metabolism (GM) in bilateral cerebral cortex, bilateral thalamus, basal nuclei and cerebellum was almost symmetrical, but during EA, the GM in contralateral thalamus, contralateral frontal lobe and parietal lobe (motor and sensory area) increased obviously. While in the patients before EA, the GM in the infarcted area was significantly lower than that in the non-infarcted area, as compared with that observed with CT and MRI, it showed a similar figure but with bigger abnormal area. During EA, GM in the infarcted area increased with apparent reduction of size. Increased GM of focal area, widened cerebral cortex and decreased edematous area were shown in patients with larger infarction area. Quantitative analysis revealed evident change in local/total ratio of glucose and increase of GM change rate.</p><p><b>CONCLUSION</b>(1) EA on limb acupoints of healthy subject could induce obvious increase of regional GM in brain and contralateral thalamus, contralateral frontal lobe and parietal lobe (motor and sensory area). (2) EA on acupoints of paralytic limbs could cause increase of GM in contralateral thalamus, contralateral frontal lobe and parietal lobe. Besides, GM also increased in the area with lowered GM before EA, accompanied with shrinkage or disappearance of lesion. (3) Acupuncture could evoke the function of brain cells and raise the GM in them.</p>