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Objective:To evaluate the additional value of chest thin layer CT over 99Tc m-hydrazinonicotinyl-(polyethylene glycol) 4-E[(polyethylene glycol) 4-c(RGDfK)] 2(HYNIC-PEG 4-E[PEG 4-c(RGDfK)] 2; 3PRGD 2) SPECT/CT in detecting isolated pulmonary space. Methods:This was a prospective study conducted in General Hospital of Ningxia Medical University. There were 87 patients with solitary pulmonary space occupying between July 2015 and December 2016, and 74 of those patients (49 males, 25 females, age range: 37-80 (58.4±9.6) years) who had pathological results were enrolled. 99Tc m-3PRGD 2 SPECT/CT imaging was performed routinely, and then the chest thin layer CT images were acquired. The maximum radioactive counts ratio of tumor to non-tumor (T/N)≥1.5 was the standard for positive planer 99Tc m-3PRGD 2 imaging, and that ≥2.0 was the standard for positive SPECT/CT imaging. According to the pathological results as gold standard, the diagnostic efficiencies of 99Tc m-3PRGD 2 planer and SPECT/CT imaging, chest thin layer CT and chest thin layer CT+ 99Tc m-3PRGD 2 SPECT/CT imaging for malignant pulmonary lesions were calculated. Kappa test was used to compare the consistency of the imaging methods and pathological results. Results:The post-surgery histopathology confirmed that 51 patients were with malignancy and 23 had benign lesions. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of 99Tc m-3PRGD 2 planer imaging, SPECT/CT imaging and chest thin layer CT in the diagnosis of malignant pulmonary lesions were 47.1%(24/51), 65.2%(15/23), 52.7%(39/74), 75.0%(24/32), 35.7%(15/42); 86.3%(44/51), 47.8%(11/23), 74.3%(55/74), 78.6%(44/56), 11/18 and 84.3%(43/51), 52.2%(12/23), 74.3%(55/74), 79.6%(43/54), 12/20, respectively. Those of the chest thin layer CT+ SPECT/CT were 98.0%(50/51), 73.9%(17/23), 90.5%(67/74), 89.3%(50/56) and 17/18 respectively. The Kappa values between the imaging methods ( 99Tc m-3PRGD 2 planer imaging, SPECT/CT imaging, chest thin layer CT and the chest thin layer CT+ SPECT/CT) and pathological examination were 0.100, 0.250, 0.354 and 0.765 (all P<0.001). Conclusion:Chest thin layer CT has an incremental value over 99Tc m-3PRGD 2 SPECT/CT imaging in the differential diagnosis of benign and malignant pulmonary lesions.
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Objective To analyze the image characteristics of whole-body bone planar scan and SPECT/CT imaging in patients with polyostotic bone fibrous dysplasia ( PFD) . Methods Twenty-three pa-tients with PFD (12 males, 11 females, age: 10-77(31.4±3.4) years) between June 2007 and March 2017 were enrolled. Twenty-one patients were confirmed pathologically and 2 was diagnosed by follow-up re-sults. The images of 99Tcm-methylene diphosphonate (MDP) whole-body bone scan and SPECT/CT imaging were retrospectively analyzed. Results Bone involvement in the extremities was the most common and lesions in the lower and right limbs were more than those in the upper and left limbs. Lesions were frequently unilat-erally on whole-body bone planar images in 18 of the other 23 patients ( 78. 3％) . Among them, 15/16 with limb lesions showed no bone deformation in limbs, while the enlargement and deformity were more common in the skull, ribs and pelvis. Vertebral involvement was found in 7 of 23 patients (30.4％), and the hand and foot bone involvement was found in 6 of 23 patients (26.1％). Most lesions (96.9％, 248/256) presented high or mod-erate abnormal uptake, which distributed in a stripe shape in the extremities, ribs and skull. On SPECT/CT ima-ges, the ground glass, vegetable sponge and mixed lesions showed higher uptake compared with the cystic le-sions. Conclusions The PFD has certain characteristics on whole-body bone scan. SPECT/CT imaging can reflect pathological, blood flow and metabolic changes of PFD.
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Purpose To compare the diagnostic efficacy of 99Tcm-MIBI SPECT/CT tomography and SPECT imaging in evaluating neoadjuvant chemotherapy (NAC) in breast cancer,and to explore the clinical gain value of SPECT/CT tomography.Materials and Methods Forty-seven patients with biopsy pathologically confirmed breast cancer in General Hospital of Ningxia Medical University from 2010 to 2015 were retrospectively analyzed.99Tcm-MIBI SPECT/CT test was performed before NAC and 4-6 courses after.The patients were assigned into effective group and ineffective group based on the pathological response after NAC,the MIBI intake rate of tumors in the two groups was compared,and the efficiency of SPECT,CT and SPECT/CT in evaluating NAC were respectively calculated and compared.Results According to the postoperative pathological response,47 patients were divided into effective group (n=30) and ineffective group (n=17).In early phase,the T/N value of effective group and ineffective group was 1.46±0.58 and 1.10+0.48,respectively,with a statistically significant difference (t=2.185,P＜0.05).There was no significant difference between SPECT,CT and SPECT/CT in evaluating NAC efficacy and pathological response (P＞0.05).The sensitivity,specificity and accuracy of these three methods in evaluating NAC efficacy were respectively:80.0％,52.9％ and 70.2％ (SPECT);86.7％,70.6％ and 80.9％ (CT);92.3％,88.2％ and 89.4％ (SPECT/CT).There was a statistically significant difference between the specificity and accuracy of SPECT/CT tomography and SPECT imaging in evaluating NAC efficacy (x2=5.10 and 8.16,P＜0.05).Conclusion The intake rate of tumors can predict the sensitivity of NAC.The diagnostic efficacy of 99Tcm-MIBl SPECT/CT tomography is more effective than that of SPECT imaging in evaluating the efficacy of NAC in breast cancer.
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Objective To explore the imaging characteristics and diagnostic value of 18 F-FDG PET/CT in patients with hepatic epithelioid hemangioendothelioma ( HEH) . Methods From January 2014 to December 2015, 5 HEH patients (2 males, 3 females; average age (49.2±13.7) years) confirmed by pathology and underwent 18 F-FDG PET/CT imaging were enrolled in this retrospective study. The character-istics of PET/CT images were analyzed. Two-sample t test and Pearson linear correlation analysis were used for data analysis. Results A total of 26 lesions were detected in 4 patients with multiple lesions, of which 88.5%( 23/26) distributed at the liver edge, and 42. 3%( 11/26) had hepatic capsule retraction sign. SUVmax of the 26 lesions was 5.1±2.6 and it was not correlated with tumor size (r=0.054, P>0.05). Lesion FDG uptake in patients with distant metastases was higher than that in patients without distant metastases (6.08±1.80 vs 3.84±1.14;t=4.15, P<0.05). Two patients underwent the delayed imaging, and FDG up-take in 11/14 lesions was higher compared with that of early imaging, and 3/14 lesions were newly detected by the delayed imaging. One patient had diffuse low-density lesions with diameters between 6.1 and 35.5 mm and SUVmax between 2.6 and 8.1. Conclusion Liver lesions of HEH patients show some features on 18F-FDG PET/CT images which can find distant metastases, and the delayed imaging can improve the detection rate of lesions.
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Objective To summarize the SPECT/CT manifestation of spondylitis caused by Brucells infection and to evaluate the diagnostic value.Methods From June 2012 to October 2015,a total of 28 patients (14 males,14 females,average age 46.4 years) with Brucellosis spondylitis confirmed by laboratory test and pathology were included.The images of whole-body bone scan and SPECT/CT fusion imaging were retrospectively analyzed.According to the pathological and serologic test results,the diagnostic efficacy of imaging was calculated.x2 test was used.Results Most of the Brucellosis spondylitis happened in the lumbar(76.7％,43/56),and the most common locations were L3,L4,L5 (72.1％,31/43).Two or more involved consecutive vertebra were found in 71.4％ (20/28) of the patients.Moderate radioactive distribution was showed in 89.2％ (50/56) of lesions,high radioactive distribution was showed in 5.4％ (3/56) of lesions,and mild radioactive distribution was showed in the rest 3 lesions.Thirty-three lesions(58.9％,33/56) had diffuse increased radioactivity uptake in the affected vertebra,and 32.1％(18/56) showed diffuse increased radioactivity at the superior and inferior margin of the vertebra;only 8.9％ (5/56) of lesions were on one side of the vertebral bodies.The SPECT/CT results were as follows:(1) Bone destruction was showed in 80.4％ (45/56) of lesions,and the edge of the lesion was clear.(2) For 66.7％ (30/45) of lesions,bone hyperplasia was seen along with bone destruction and moderate radioactivity concentration on the edge of destruction area.(3) The damage of the intervertebral disc was mild,and the vertebral abscess was relatively rare (5.4％,3/56).The diagnostic accuracy of SPECT/CT was statistically higher than that of whole-body bone scan:67.8％(38/56) vs 96.2％(54/56);x2=13.1,P＜0.05.Conclusion SPECT/CT imaging has a higher diagnostic efficiency than whole-body bone scan in Brucellosis spondylitis.
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Objective To explore the diagnostic value of whole?body bone scan combined with SPECT/CT imaging for osteofibrous dysplasia( OFD) . Methods A total of 30 patients ( 14 males, 16 fe?males, age range 10-48 ( average age 29.2) years) with OFD confirmed by pathology from June 2007 to De?cember 2014 were included. The images of whole?body bone scan and SPECT/CT imaging were retrospec?tively analyzed. Results Nineteen patients (63.3%, 19/30) showed monostotic OFD, which mainly in?volved extremities (n=18), especially the femur. Eleven patients(36.7%, 11/30) showed polyostotic OFD, which frequently be seen unilaterally (n=7). Highly or obviously abnormal uptakes of radiotracer were shown in most lesions (95.3%, 81/85) on whole?body bone planar images, the ribs and extremities showed abnormal uptake along the backbone orientation, while the cranium, pelvis and spine showed irregu?lar bulky uptake of radioactivity. On SPECT/CT images, the lesions of high or obvious abnormal uptake of radiotracer mainly showed cystic expansion growth, ground glass, vegetable sponge and mixed appearance;and the higher the radioactive aggregation degree was, the more the morphological changes were. The density and morphological changes on CT were not obvious for lesions with moderately and mildly abnormal uptake of radiotracer. Conclusion The whole?body bone scan combined with SPECT/CT imaging is an effective diag?nostic method for OFD.