Prognostic Value of Interim PET/CT in 227 Patients of DLBCL / 中国实验血液学杂志

OBJECTIVE@#To investigate the prognostic evaluation value of fluorodeoxyglucose (FDG) interim positron emission tomography/computed tomography (PET/CT) for diffuse large B cell lymphoma (DLBCL).@*METHODS@#Two hundred and twenty-seven patients with pathologically diagnosed DLBCL underwent 18F-FDG scans at baseline and before 3 cycles of a rituximab-containing chemotherapy regimen. The Visual Deauville score (DS) and changes in maximum standard uptake values (ΔSUVmax) were calculated for tracer for the predominant lesion of each patient, for prediction of progression-free survival (PFS) and overall survival (OS) using Kaplan-Meier method and COX regression.@*RESULTS@#The median follow-up period was 71 months. Receiver operating characteristic analysis indicated that the best ΔSUV cut-off values for FDG (ΔSUVFDG) was 71%. The sensitivity, specificity and accuracy of DS and ΔSUVmax were 86.9%, 74.3%, 82.8% and 77.8%, 63.5%, 73.1%, respectively in response assessment. Kaplan-Meier analysis showed DS, ΔSUVmax and IPI had significance for prediction of PFS and OS (P = 0.001). The DS 4-5 and IPI 3-5 were independent risk factors of poor prognosis by COX regression analysis.@*CONCLUSION@#Interim PET/CT is important predictor for evaluation therapeutic response and prognosis in DLBCL patients.

Clinical Efficacy and Safety of Different Doses of Dexamethasone Combined with Bortezomib and Thalidomide for Treating Patients with Multiple Myeloma / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To study the clinical efficacy and safety of dexamethasone of different doses combined with bortezomib and thalidomide for treatment of primary multiple myeloma.</p><p><b>METHODS</b>Ninety-six patients with multiple myeloma from January 2013 to January 2014 were randomly divided into group A (high-dose dexamethasone + bortezomib + thalidomide, 32 cases), group B (low-dose dexamethasone + bortezomib + thalidomide, 32 cases) and group C (placebo + bortezomib + thalidomide, 32 cases). The clinical efficacy and safety of patients was compared among 3 groups.</p><p><b>RESULTS</b>The overall remission rate (ORR) in group A and B was significantly higher than that in group C (P<0.05), but the ORR was not significant difference between group A and group B (P>0.05). After treatment, the KPS and RNS score in 3 groups were significantly higher and lower than those before treatment, respectively; the KPS score in group A and B was significantly higher than that in group C (P<0.05), the RNS score in group A and B was significantly lower C (P<0.05). After treatment, the positive expression rates of CD38, CD56 and CD138 as well as small residual lesion (SRL) positive rate in 3 grops were significantly lower than those before treatment, but the positive expression rate of CD19 was significantly higher that before treatment; the positive expression rates of CD38, CD56 and CD138 as well as SRL positive rate in group A and B were significantly lower thant those in group C, while the positive expression rate of CD19 was significantly higher that in group C (P<0.05), but the positive expression rates of CD19, CD38, CD56 and CD138 as well as SRL positive rate were not significantly different between group A and B (P>0.05). The incidence of fatigue, rash, peripheral neuropathy, anlmia, granulocyte deficiance and so on in group B and C was significantly lower than that in group A(P<0.05), but the difference in group B and C was not significant (P>0.05).</p><p><b>CONCLUSION</b>The therapeutic efficacy of different doses of dexamethasone combined with bortezomib and thalidomide for patients with multiple myeloma is similar, can obviously enhance remission rate, prolong the survival time, promote life quality, but the incidence of adverse reactions in low dose dexamethason rigemen is significantly reduced, and the safety is better.</p>

The application of the PET/CT technology in the diagnosis of atypical spinal tuberculosis / 预防医学

Objective To explore the diagnostic value of PET/CT technique in the atypical spinal tuberculosis. Methods A total of 60 patients who had suffered from spinal tuberculosis and spinal metastasis confirmed by surgical interventions from 2010 to 2016 were retrospectively analyzed. 18F-FDG PET/CT examination was made at our department. Image data of X-ray, CT, and PET/CT were compared in the diagnosis accuracy. Results A total of 52 males and 8 females, aged from 38 to 82 years (mean, 50.2 years) were collected. The statistical analysis showed PET/CT technology with sensitivity of 85%, and specificity of 95%, which were significantly higher than those of X-ray and CT (AUC=0.900, P<0.05) . 18F-FDG PET/CT can find more lesions than X-ray and CT, find "cold abscess" and "cold zone" of spinal tuberculosis, that was an exclusive value of PET/CT diagnosis for atypical spinal tuberculosis. Conclusion 18F-FDG PET/CT shows an important clinical diagnostic value for the atypical spinal tuberculosis.

Characteristic findings of malignant melanoma in the sinonasal cavity on magnetic resonance imaging / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Malignant sinonasal melanoma (MSM) is a rare tumor with a perplexing signal intensity due to variable histopathologic components. This study was undertaken to delineate its MR imaging features.</p><p><b>METHODS</b>MR imaging findings of 10 patients (6 women and 4 men, mean age 61.3 years old) with pathologically confirmed MSM were retrospectively reviewed. The location, size, signal intensity, enhancement, and internal imaging characteristics of all tumors were evaluated. Signal intensity and degree of enhancement was graded in comparison with the gray matter and adjacent muscle uptake, respectively.</p><p><b>RESULTS</b>There were 8 tumors that were pathologically confirmed to contain melanin. Compared to gray matter of the brain, 7 of them demonstrated hyperintensity on T1WI and 6 (6/7) showed hypointensity on T2WI. There was multiple linear, dark-signal intensity on T2WI within the mass in 9 of the 10 patients' tumors. Evaluated with gadolinium-enhanced imaging, all 10 patients showed moderate enhancement within the areas that were isointense in the lesion on pregadolinium T1WI. Moreover, some parts which displayed hyperintensity on T1WI within the tumors of 7 patients showed mild enhancement that was similar to muscle on a time-intensity curve (TIC).</p><p><b>CONCLUSIONS</b>MSM shows characteristic MR signal intensity (hyperintensity on T1WI and the linear, low-signal intensity on T2WI), which may provide valuable information for clinical diagnosis. Together with conventional MRI, TIC may be useful for indicating pleomorphic patterns of MSM.</p>