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Amino acid tracer O-(2-[ 18F]fluoroethyl)- L-tyrosine ( 18F-FET) PET plays a pivotal role in the clinical management of gliomas. In this article, the application of 18F-FET PET in tumor diagnosis and differentiation with other diseases, treatment guidance, treatment response assessment and prognosis prediction of gliomas are reviewed.
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O6-methylguanine-DNA methyltransferase (MGMT) promoter methylation is an important molecular biomarker which plays a key role in tumor development and determine the molecular subtypes and prognosis of gliomas. Radiomics and imaging examinations like MR and PET can obtain information of morphology, function, metabolism and molecular alterations of gliomas, which may help comprehensively and non-invasively predict MGMT promoter methylation status in gliomas. The relationships between imaging features and MGMT promoter methylation status of gliomas were reviewed in this article.
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Objective: To observe the value of MR in prediction of glioma isocitrate dehydrogenase (IDH) 1 mutation status. Methods: Nineteen-two patients with glioma were divided into IDH mutation positive group and negative group, and their imaging characteristics were retrospectively reviewed, including lesions' site, signal intensity, boundary, growth pattern, degree of enhancement and surrounding edema. Then two-class Logistic model was established. Results: There were significant differences between different grades and location of gliomas between the two groups (both P<0.05). There were no significant differences in tumor signal intensity, boundary and growth pattern (P=0.269, 0.606, 0.139). There were statistically significant difference in degree of enhancement and surrounding edema (all P<0.01). Logistic regression analysis showed that the signal uniformity (X1), boundary (X2) and degree of enhancement (X3) of gliomas were statistically significant (P=0.004, 0.037, 0.001), and the regression equation was: logit (P)=2.668+1.415X1-2.097X2-3.229X3 (χ2=41.583, P<0.001), the sensitivity of the model was 70.70%, and the specificity was 80.40%. Conclusion: MRI can be used to non-invasively predict IDH1 mutation status of gliomas before surgical operation.
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Objective To investigate the value of intravoxel incoherent motion DWI (IVIM-DWI) in differential diagnosis of high-grade gliomas and brain metastases.Methods Conventional MRI,contrast-enhanced MRI and IVIM-DWI were performed before surgery or chemoradiotherapy in 24 patients with high-grade gliomas and 28 patients with brain metastases.The diffusion constant (D),pseudodiffusion coefficient of perfusion (D*) and the perfusion fraction (f) in the parenchyma and peritumoral edema region within 1 cm and the normal centrum semiovale in the opposite side were measured,then the relative values of all parameters in each region (rD*,rD,rf) were calculated.Independent sample t test was used to analyze the parameters.ROC curve analysis of the parameters statistically different between high grade gliomas and brain metastases were performed,and the diagnostic efficacies were evaluated.Results The D* and rD* values of tumor parenchyma and in peritumoral edema within 1 cm of high-grade gliomas were higher than those of brain metastases (all P＜0.05).The f and rf values of tumor parenchyma and in peritumoral edema within 1 cm of highgrade gliomas were lower than those of brain metastases (all P＜0.01).The AUC of D* value in peritumoral edema within 1 cm was the highest,but there was no statistically different between any two AUC except the rD* value of peritumoral edema within 1 cm (P =0.033).Conclusion IVIM-DWI can distinguish the differences of diffusion and perfusion information in parenchyma and edema area between high-grade gliomas and brain metastases,therefore providing the basis for differential diagnosis of them.
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The progressive encephalopathy with edema,hypsarrhythmia,and optic atrophy (PEHO) syndrome is a unique pediatric neurodevelopmental disorder,characterized by a combination of severe mental retardation,early onset epileptic seizures,pedal edema,optic/cerebellar atrophy,and early death.The affected individuals have neither optic atrophy nor the typical neuroradiological findings has been described as PEHO-like syndrome.At present,there are few reports about PEHO syndrome in China.In this study,we summarizes the incidence,etiology,clinical manifestations,and related genes of PEHO syndrome,and aims to provide assistance for future clinical work.
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Objective To evaluate the value of localization diagnosis of 1H-magnetic resonance spectroscopy (MRS) in the patients with structural MRI-negative temporal lobe epilepsy (TLE) based on the results of localization diagnosis of electroencephalogram (EEG) in patients with TLE without lesion.Methods Thirty-three patients with MRI-negative TLE and 33 age-and sex-matched healthy control subjects underwent MRS and took the side localized by scalp/video EEG as standard,to evaluate the value of N-acetyl-L-aspartic acid (NAA)/creatine (Cr),NAA/(Cr + choline (Cho)) in the localization diagnosis of TLE.Results There was no significant difference in NAA/Cr,Cho/Cr and NAA/(Cr + Cho) in bilateral hippocampi of 33 healthy controls,and the mean values of them in bilateral hippocampi were regarded as normal values.The NAA/Cr and NAA/(Cr + Cho) ratios were significantly decreased in both sides of the hippocampi ipsilateral and contralateral to the seizure side.Taking NAA/Cr and NAA/(Cr +Cho) as an index to localize respectively and comparing with the localization diagnosis of EEG,spectral anomalies were found in 28 cases and 29 cases respectively,and the abnormal rate reached 85％ and 88％.The localization diagnosis of 17 and 18 cases was consistent with the EEG,the rate being 52％ and 55％ respectively,but 12％ (4/33) and 18％ (6/33) were opposite.There were 36％ (12/33) and 27％ (9/33) cases who could not be localized.The localization diagnosis results by NAA/Cr and NAA/(Cr +Cho) were not significantly different.Conclusions The existence of mirror-image foci may be the main reason of the failure of localization diagnosis.1H-MRS has higher value for localization of TLE foci,and combining 1H-MRS with other techniques can further improve the accuracy and reliability of localizing the epileptic foci in patients with TLE.Compared with EEG in the diagnosis of TLE,there are no significant differences in the localization diagnosis of TLE by NAA/Cr and NAA/(Cr + Cho),which can all be the standard indices of localization diagnosis.
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Objective To evaluate the manifestations and diagnostic value of CT enterography (CTE) in primary intestinal T-cell lymphoma (PITCL).Methods Eighteen patients with PITCL confirmed by pathology were reviewed retrospec tively.The characteristics of lesion site,amount of foci,pattern and degree of contrast enhancement,lymphadenopathy,involvement of other organs and complications were recorded.Results In all of the 18 patients with PITCL,multiple lesions were seen in 13 cases (13/18,72.22％),and solitary involvement was seen in 5 cases (5/18,27.78％).Twelve ca ses were located at jejunum/ileum,3 of them were also involved in the colon.Five cases were located only in the colon,and 1 in the duodenum.Six cases were complicated with intestinal perforation.The patients were categorized into 6 types according to the CT manifestation:infiltration type (n=7),diffuse jejunum mucosa ileum metaplasia type (n =3),luminal aneurismal dilatation type (n =3),polypoid mass type (n =2),mesentery type (n=1),mixed type (n =2).Conclusion CTE can clearly display the imaging of PITCL and it has high value for the diagnosis of PITCL.
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To increase the dissolution rate and extent of valsartan, valsartan nanosuspensions have been prepared. Controlled precipitation assisted with sonication is utilized to prepare valsartan nanosuspensions, the concentration of the drug, stabilizer and costablizer had a great effect on the stability of the preparation according to the pre-experiment. So the method of central composite design-response surface is used to optimize the prescription based on the above three factors and the particle size as the response value. The software Origin 8.0 is used to draw the view of the three-dimensional effects and 2D contour map, to get the optimal prescription area. Valsartan nanosuspensions were prepared. The mean diameter and zeta potential are about 216.6 nm and -57.7 mV, respectively. Compared with the microsuspensions and commercial preparation, the dissolution of valsartan nanosuspensions was faster and the bioavailability can be enhanced to some extent.