Interpretation of presynaptic dopaminergic PET imaging results / 中华核医学与分子影像杂志

Presynaptic dopaminergic PET imaging is a useful method for the diagnosis of parkinsonism. Based on the expert consensus on operation and clinical application of dopamine transporter brain PET imaging technology published in 2020, this paper further recommends the relevant elements of result interpretation of presynaptic dopaminergic PET imaging.

Application and progress of radiomics in tumor PET imaging / 中华核医学与分子影像杂志

Radiomics can quantitatively analyze and process large amounts of image features from medical image data to quantify tumor heterogeneity and non-invasively evaluate tumor biological behavior. Radiomics in nuclear medicine, especially in PET is developing rapidly. This article reviews the application of radiomics in the tumor identification and prognosis evaluation, and discusses the challenges and prospects for radiomics, in order to raise the awareness of radiomics in PET.

Application of 18F-FDG PET/CT metabolic parameters in the prediction of perineural invasion in non-metastatic rectal cancer / 中华核医学与分子影像杂志

Objective:To investigate the value of 18F-FDG PET/CT metabolic parameters in predicting perineural invasion (PNI) in patients with non-metastatic rectal cancer. Methods:From August 2012 to April 2020, 81 patients (51 males, 30 females, median age: 63 years) who received PET/CT examination and pathologically confirmed as rectal cancer in the Affiliated Hospital of Qingdao University were retrospectively analyzed. The 18F-FDG PET/CT metabolic parameters including SUV max, metabolic tumor volume (MTV) and total lesion glycolysis (TLG), and clinicopathological factors including gender, age, carcinoembryonic antigen (CEA), carbohydrate antigen (CA)19-9, maximum tumor diameter, degree of differentiation, T stage, lymph node metastasis, and TNM stage were recorded. Mann-Whitney U test and χ2 test were used to compare the differences of each parameter between PNI positive group and PNI negative group. Multivariate logistic regression was used to analyze the independent predictor of positive PNI. ROC curve was used to analyze its predictive efficacy. Results:Of 81 patients, 32(39.51%) were PNI positive and 49(60.49%) were PNI negative. There were significant differences of T stage ( χ2=10.73, P=0.010), lymph node metastasis ( χ2=6.21, P=0.013), TNM stage ( χ2=7.61, P=0.022), MTV (14.6(10.4, 24.7)and 9.0(5.4, 14.5) cm 3; U=-3.48, P=0.001) and TLG (108.588(72.749, 182.707) and 65.365(35.593, 117.682) g; U=-2.79, P=0.005) between PNI positive group and PNI negative group. Multivariate logistic regression analysis showed that MTV was the independent predictor of positive PNI in non-metastatic rectal cancer patients (odds ratio ( OR)=1.130, 95% CI: 1.025-1.245, P=0.014). The optimal threshold of MTV was 9.53 cm 3 and AUC was 0.73 with the sensitivity of 81.82%(27/33) and the specificity of 59.18%(29/49). Conclusion:18F-FDG PET/CT metabolic parameter MTV can predict PNI in non-metastatic rectal cancer with high sensitivity.

Prediction model for probability of malignancy in solitary pulmonary nodules on 18F-FDG PET/CT of smokers with pulmonary fibrosis / 中华核医学与分子影像杂志

Objective:To establish and validate a malignant risk prediction model of solitary pulmonary nodules (SPNs) with pulmonary fibrosis in long-term smokers based on 18F-flurodeoxyglucose (FDG) PET/CT. Methods:PET/CT images of 222 SPNs combined with pulmonary fibrosis which were shown in integrated CT scan in 169 patients (all males; age 68(63, 75) years) were analyzed retrospectively. All patients were examined in PET/CT Center of the Affiliated Hospital of Qingdao University from January 2011 to December 2019 and all had definite smoking history. The benign and malignant nodules were judged according to the pathological diagnosis or follow-up imaging data of lung lesions (follow-up≥2 years). The clinical characteristics (age, smoking index), morphological characteristics (longest diameter of lesion, density, location, distribution, relative position of fibrosis, spiculation, lobulation, calcification, vacuole, vascular convergence, pleural indentation, emphysema and severity of bilateral pulmonary fibrosis) and metabolic characteristics (maximum standardized uptake value (SUV max)) of the benign and malignant lesions were analyzed by χ2 test and Mann-Whitney U test. Then multivariate logistic regression analysis was applied to select independent risk factors of malignant nodules, and a risk prediction model was established and verified by the area under the receiver operating characteristic (ROC) curve and k-fold cross validation ( k=10) respectively. Results:Among 169 patients, 222 SPNs were detected (157 malignant nodules, 65 benign nodules). Univariate analysis showed that smoking index, speculation, lobulation, vascular convergence sign, calcification, emphysema, nodule size, relative position of nodule and fibrosis, SUV max and severity of bilateral pulmonary fibrosis were significantly different between the benign and malignant nodules ( z values: 2.514-9.858, χ2 values: 4.353-18.442, all P<0.05). Result of multivariate logistic regression analysis showed that calcification, vascular convergence and SUV max were the independent risk factors of malignant nodules combined with pulmonary fibrosis (odds ratio ( OR): 0.048-2.534, all P<0.05). The risk prediction model was as follow: P=1/(1+ e - x), x=-1.839-3.033×calcification+ 0.930×vascular convergence+ 0.754×SUV max(with calcification/vascular convergence=1, without calcification/vascular convergence=0). The area under ROC curve was 0.932(95% CI: 0.895-0.969), and the sensitivity and specificity of the model were 87.9% and 86.2%, respectively. Results of k-fold cross validation showed that the prediction accuracy of 10 test sets was 0.847±0.075, and was 0.862±0.010 in training sets. Conclusions:Calcification, vascular convergence and SUV max are independent risk factors of malignant SPNs combined with pulmonary fibrosis in long-term asymptomatic smokers. The model based on the above variables presents high diagnostic efficiency in diagnosing malignant SPNs.

Bone pain, thyroid nodule and lymphadenectasis: a report of one case with literature review / 中华风湿病学杂志

Objective:By analyzing the clinical and pathologic manifestations of systemic mastocytosis (SM) to improve the recognition of the disease.Methods:Clinical manifestations, diagnosis and treatment of a middle-aged male patient with SM was reported with multidisciplinary discussions.Results:A middle-aged man with bone pain, thyroid nodules and lymphadenectasis came to our clinic. Thyroid cancer with lymph node and bone metastasis was suspected by imaging examination. The pathological results showed cell proliferation with transparent cytoplasm and irregular nuclear in the trabecular bone. Toluidine blue staining showed the proliferated cells were mast cells(+). Immunohistochemistry showed proliferating mast cells stained with CD117 and CD2. SM with extensive bone marrow involvement was diagnosed and treated with thalidomide and calcitriol.Conclusion:Knowing the characteristics of SM is helpful for accurate diagnosis and treatment.

Application of Metabolic Parameters Measured by ¹⁸F-FDG PET/CT in the Evaluation of the Prognosis of Non-small Cell Lung Cancer / 中国肺癌杂志

Tumor-node-metastasis (TNM) staging system is the most important basis for making therapeutic decisions and predicting prognosis of lung cancer patients. The metabolic parameters including standardized uptake value (SUV), metabolic tumor volume (MTV) and total lesion glycolysis (TLG) measured by ¹⁸F-fluorodeoxyglucose-positron emission tomography (¹⁸F-FDG PET/CT) associate with tumor aggressiveness and can provide additional prognostic information. A new staging methodology combines the conventional cTNM with the metabolic tumor burden quantified from the PET images is a better predictor of overall survival with superior stratifying power may help oncologists to make better treatment plans. ¹⁸F-FDG PET/CT image texture analysis, as an emerging research tool, is used to quantify the spatial heterogeneity of radioactive uptake in tumors, thereby to explore the biological characteristics of the tumor. This article reviews developments in evaluating the ¹⁸F-FDG PET/CT metabolic parameters and its role as a prognostic factor for non-small cell lung cancer.
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A model of malignant risk prediction for solitary pulmonary nodules on 18F-FDG PET/CT: building and estimating / 中华核医学与分子影像杂志

Objective To develop a model of malignant risk prediction of solitary pulmonary nodules(SPN) with the metabolic characteristics of the lesion.Methods A total of 362 patients (291 malignant cases and 71 benign cases;194 males,168 females;median age:61 years) who underwent PET/CT imaging from January 2013 to July 2017 were analyzed.The diagnosis of malignant SPN was based on pathological results,and that of benign SPN was based on pathological or follow-up results.Differences of clinical/imaging characteristics in patients with benign and those with malignant SPN were analyzed.Risk factors were screened by multivariate non-conditional logistic regression analysis.The self-verification of the model was done by the receiver operating characteristic (ROC) curve analysis,out-of-group verification was performed by k-fold cross-validation.Results There were statistically significant differences in age,maximum standardized uptake value (SUVmax),size,lobulation,spiculation,pleural traction,vessel connection,calcification,vacuole,and emphysema between patients with benign and malignant nodules (all P＜0.05).The risk factors for malignant nodules included age,SUVmax,size,lobulation,calcification and vacuole.The odds ratio (OR) values (95％ CI) were 1.040(1.007-1.075),1.612(1.287-2.017),1.149(1.074-1.230),4.650(2.138-10.115),0.216(0.085-0.548),and 3.043(1.302-7.111),respectively.The logistic regression model was as follows:P=1/(1+e-x),x=-5.583+0.039×age+0.477×SUVmaxx+0.139×size+1.537×lobulation-1.532×calcification+ 1.1 13×vacuole.The estimated area under the curve (AUC) for the model was 0.915(95％ CI:0.883-0.947),sensitivity was 89.7％,specificity was 78.9％.K-fold cross-validation showed that the training accuracy was 0.899±0.011,the predictive accuracy was 0.873±0.053.Conclusions The risk factors for malignant nodules included age,SUVmax,size,lobulation,calcification and vacuole.After verification,the model has a satisfactory accuracy.It may help clinics make accurate decisions.

Clinical value of Fluorine-18-fluorodeoxyglucose PET-CT examination in intrahepatic cholangiocarcinoma staging / 中华消化外科杂志

Objective To evaluate the clinical value of Fluorine-18-fluorodeoxyglucose (18F-FDG) positron-emission temography-computed tomography (PET-CT) examination in intrahepatic cholangiocarcinoma (ICC) staging.Methods The retrospective cross-sectional study was conducted.The clinicopathological data of 190 patients with ICC who were admitted to the Eastern Hepatobiliary Surgery Hospital Affiliated to Naval Military Medical University from September 2013 to June 2016 were collected.There were 107 males and 83 females,aged from 37 to 79 years,with an average age of 57 years.There were 90 cases without distant metastasis undergoing surgery treatment and 100 with distant metastasis undergoing non-surgical treatment.Patients underwent preoperative CT,magnetic resonance imaging (MRI),and PET-CT examination,and then received surgery or non-surgery according to preference of patients and their family members.Observation indicators:(1) imaging features on preoperative CT,MRI,PET-CT examination;(2) treatment;(3) evaluation of tumor diameter,multiple tumors,macrovascular invasion,and bile duct invasion by three examinations in ICC staging of patients undergoing operation;(4) evaluation of regional lymph node metastasis by three tests in ICC staging of patients undergoing operation;(5) evaluation of distant metastasis in ICC staging by three tests.Measurement data with normal distribution were represented as Mean±SD,and comparison between groups was analyzed by single factor ANOVA and paired comparison was analyzed by SNK method.Measurement data with skewed distribution were described as M (range).Count data were described as absolute number or percentage,and comparison between groups was analyzed using the chi square test.Results (1) Imaging features on preoperative CT,MRI,PET-CT examination:all the 190 patients received routine upper abdominal CT,MRI,and systemic PET-CT examination before treatment.CT imaging of ICC showed inhomogeneous low density on plain scan,peripheral enhancement in arterial phase,persistent enhancement of tumor margin in portal phase,and sometimes mild to moderate centripetal enhancement.MRI imaging showed heterogeneous low signal on T1-weighted imaging,uneven high,and slightly high signal on T2-weighted imaging.Reinforcement on MRI is the same as CT.Transverse images,fusion transverse images and maximum intensity projection images of PET-CT imaging showed abnormal high FDG uptake around the tumor.(2) Treatment:81 out of the 90 ICC patients with surgery treatment underwent hepatectomy and lymphadenectomy,and 9 underwent only tumor tissue biopsy and lymph node biopsy due to intraoperative finding of abdominal metastasis.Of the 100 non-operated patients,30 received systemic chemotherapy,23 received local radiotherapy,and 47 gave up treatment.(3) Evaluation of tumor diameter,multiple tumors,macrovascular invasion,and bile duct invasion by three examinations in ICC staging of patients undergoing operation:the tumor diameters of ICC on CT,MRI and PET-CT were (6.8±2.8)cm,(6.9±2.9)cm,(7.2±2.8)cm,respectively.There was no significant difference among the three methods (F=0.085,P＞0.05).CT,MRI,PET-CT had similar accuracy of 80.0％ (72/90),78.9％ (71/90),72.2％ (65/90) on diagnosing multiple tumors,87.8％(79/90),92.2％ (83/90),94.4％ (85/90) for macrovascular invasion,and 93.3％ (84/90),95.6％ (86/90),96.7％ (87/90) for vascular and bile duct invasion,respectively,there was no significant difference in the above indicators between the three groups (x2 =1.801,2.662,1.131,P＞0.05).(4) Evaluation of regional lymph node metastasis by three examinations in ICC staging of patients undergoing operation:the accuracy of CT,MRI and PET-CT examination for lymph node metastasis was 62.2％ (56/90),68.9％(62/90),86.7％ (78/90) and sensitivity was 40.0％ (16/40),47.5％ (19/40),80.0％ (32/40),respectively,showing significant differences between the three groups (x2 =14.446,14.666,P＜0.05),showing a significant difference between CT and PET-CT examination (x2=14.134,13.333,P＜0.05),showing a significant difference between MRI and PET-CT examination (x2=8.229,9.141,P＜0.05).The sensitivity of CT,MRI and PET-CT examination for lymph node metastasis was 80.0％ (40/50),86.0％ (43/50),92.0％ (46/50),showing no significant difference between the three groups (x2=2.990,P＞0.05).(5) Evaluation of distant metastasis in ICC staging by three tests:there were 27,34 and 100 cases with distant metastasis evaluated by CT,MRI and PET-CT examination,including 40 with supraclavicular lymph node metastasis,32 with bone metastasis,30 with mediastinal lymph node metastasis,20 with hilar lymph node metastasis,17 with pulmonary metastasis;77 patients had more than 2 sites of metastasis.The accuracy of CT,MRI and PET-CT examination for distal metastasis in 190 ICC patients was 61.58％ (117/190),65.26％ (124/190),98.42％ (187/190),respectively,with a significant difference between the three groups (x2=83.639,P＜0.05),with a significant difference between CT and PET-CT examination (x2=80.592,P＜0.05),between MRI and PET-CT examination (x2=70.284,P＜ 0.05).Conclusion PET-CT examination makes up for the deficiency of CT and MRI in judging regional lymph node metastasis and distant metastasis,and contributes to the clinical staging of ICC.

Correlation of Glut-1, Glut-3 and HK-H expression with 18F-FDG uptake in non-small cell lung cancer and pulmonary inflammatory lesions / 中华核医学与分子影像杂志

Objective To analyze the expression of glucose transport protein (Glut)-l,Glut-3 and hexokinase (HK)-Ⅱ in non-small-cell lung cancer (NSCLC) lesions and pulmonary inflammatory lesions and discuss the correlation of them with 18F-fluorodeoxyglucose (FDG) uptake.Methods Twenty-four patients with NSCLC and 22 patients with pulmonary inflammatory lesions (25 males,21 females;age range:37-81 years) who underwent PET/CT from November 2012 to May 2016 were retrospectively analyzed.All patients had surgery and were confirmed by pathology.The expression of Glut-1,Glut-3 and HK-Ⅱ in the lesions was detected by immunohistochemistry.Immunohistochemical staining scores and maximum standardized uptake value (SUVmax) were calculated.One-way analysis of variance,the least significant difference t test,two-sample t test and Spearman correlation analysis were used.Results The SUVmax of NSCLC lesions was 8.71 ± 7.62,higher than that of pulmonary inflammatory lesions (3.29 ± 2.16;t =3.220,P＜ 0.05).Immunohistochemical staining scores of Glut-1,Glut-3 and HK-Ⅱ were 3.75±0.99,4.04±1.00 and 4.00±0.78 for NSCLC lesions respectively,and were all higher than those of pulmonary inflammatory lesions (2.32±0.65,2.89±0.83,2.41±0.50;t values:5.340,5.160,8.130,all P＜0.01).The expression of Glut-1 and HK-Ⅱ was positively correlated with SUVmax in NSCLC lesions (rs values:0.414,0.457,both P＜0.05).The expression of Glut-1,Glut-3 and HK-Ⅱ was not correlated with SUVmax(rs values:0.392,0.070,-0.066,all P＞0.05),but the expression of Glut-3 was higher than that of Glut-1 and HK-Ⅱ (F=4.123,t values:0.970,0.150,all P＜0.05) in pulmonary inflammatory lesions.Conclusions The expression of Glut-1,Glut-3 and HK-Ⅱ is higher in NSCLC lesions than that in pulmonary inflammatory lesions.Glut-1 and HK-Ⅱ are the important factors for 18F-FDG uptake in NSCLC.Glut-3 may play an important role in 18F-FDG uptake in pulmonary inflammatory lesions.

Imaging characteristics of lung adenocarcinomas appearing as pure ground-glass nodules on 18F-fluorodeoxyglucose PET-CT / 中华放射学杂志

Objective To compare the 18F-FDG PET metabolic characteristics and VHRCT morphological characteristics between invasive and non-invasive adenocarcinoma presenting as pure ground-glass nodules(pGGN).Methods Fifty-one patients with pGGN from October 2010 to June 2016 were retrospectively enrolled in this study.There were totally 52 lesions with sizes of no more than 30 mm and were grouped depending on pathological and follow-up diagnosis (31 lesions in the invasive adenocarcinoma group and 21 lesions in the non-invasive group).Clinical and imaging features were analyzed including age,gender,lesion location,size,density,SUVmax T/N,spiculation,lobulation,pleural indentation,vascular connection signs,vacuole sign and the air bronchogram.T test or x2-test was used in the comparison of different manifestations between the two groups.Logistic regression analysis on clinical parameters was applied.The ROC curve was used to find the cutoff of T/N.Results In the invasive adenocarcinoma group,T/N,SUV density and size were 1.97±0.71,1.16±0.54,-(431±104)HU,(18.48±5.65)mm,respectively.In the non-invasive group,T/N,SUVmax density,size were 1.20±0.28,0.64±0.20,-(533± 109)HU,(12.05±5.04)mm,respectively.The differences of T/N,SUVmax density and size had statistical significance between the two groups (t=-5.40,-4.87,-3.39,-4.21,P＜0.05).Lobulation and vascular connection signs in the invasive adenocarcinoma group were found in 21 and 13 cases respectively,while in the non-invasive group,they were present in 2 and 1 case,respectively,which showed significant differences between the two groups(x2=17.85,7.01,P＜0.05).T/N,lobulation,and vascular connection signs were the independent factors for the differentiation of benign and malignant lesions.The ORs were 52.547,8.375,72.206,respectively.When T/N=l.62,the area under the ROC curve was 0.885.The sensitivity,specificity and accuracy were 77.42％,90.48％,82.69％,respectively.Conclusions Pulmonary pGGNwith T/N no less than 1.62,lobulation and vascular connection sign indicates an invasive adenocarcinoma.

Analysis on illuminated dose level of operators' eyes in imaging quality control test of positron emission tomography / 中华放射医学与防护杂志

Objective To investigate the eye lens dose to the operators who tended to test the quality control of positron emission tomography (PET).Methods Before encapsulation and in preparation of point source,line source 1 and line source 2,the two operators were worn with lens thermoluminescence dosimeter each at the left of the left eye,the front of the left eye,between the right eye and the left eye,the left of the right eye,and the front of the right eye.Measurement and analysis were made of the radiation doses to eye lens received by the operators in order to calculate their maximum annual doses.Results The maximum lens dose was 2 439.80 μSv for the test of 5 PETs.There appears to be the same trend in the eye lens doses for the first and second operators.(x2 =15.629-16.155,P ＜ 0.05).The first operator have received higher eye lens dose higher than the second(Z =2.611,P ＜ 0.05).Conclusions The dose to the eye lens for a single PET test is relatively low.

Estimation of patient radiation dose and risk from whole body 18F-FDG PET/CT examination / 中华核医学与分子影像杂志

Patients are exposed to both the internal radiation from radiopharmaceutical and the external radiation from the X-rays during PET/CT examination. Estimating patients′ radiation dose from whole body PET/CT examination could eliminate their apprehension and give clinical physicians guidance about whether the patients need to perform PET/CT examination. The calculation methods, influencing factors, cancer risk of PET/CT imaging and how to reduce the radiation dose are reviewed in this paper.

Current status and perspectives of chimeric antigen receptor modified T cells for cancer treatment

Chimeric antigen receptor (CAR) is a recombinant immunoreceptor combining an antibody-derived targeting fragment with signaling domains capable of activating cells, which endows T cells with the ability to recognize tumor-associated surface antigens independent of the expression of major histocompatibility complex (MHC) molecules. Recent early-phase clinical trials of CAR-modified T (CAR-T) cells for relapsed or refractory B cell malignancies have demonstrated promising results (that is, anti-CD19 CAR-T in B cell acute lymphoblastic leukemia (B-ALL)). Given this success, broadening the clinical experience of CAR-T cell therapy beyond hematological malignancies has been actively investigated. Here we discuss the basic design of CAR and review the clinical results from the studies of CAR-T cells in B cell leukemia and lymphoma, and several solid tumors. We additionally discuss the major challenges in the further development and strategies for increasing anti-tumor activity and safety, as well as for successful commercial translation.

The application value of MSCT in diagnosis of acute appendicitis / 实用放射学杂志

Objective To discuss the application value of MSCT in the diagnosis of acute appendicitis.Methods 30 patients with appendicitis were enrolled as a research group,meanwhile 30 healthy adults without any diseases were as a control group.Some MSCT findings were observed or measured including diameter and position of appendix,fluid and gas density in appendix cavity, periappendicural fat density and peritoneal thickening,ascites and so on.Results The outside diameter of acute appendicitis appen-dix was (9.78±2.33)mm on average,whereas the diameter of normal adults appendix was (5.05±0.53)mm,exhibiting a signifi-cant difference (t=24.85,P <0.01).Rough periappendicural fat with increased density in 25 patients (83.33%)with the CT value of about -40 to 20 HU,exudation and peritoneal thickening around the appendix in 13 (43.33%),thickening and edematous appen-dix walls in 29 (96.67%),fecal stone in the appendix cavity with high density in 9(30.00%),the appendicitis in combination with intestinal obstruction in 1 (3.33%),and the appendicitis with peritoneal thickening in 80.00% and with peritoneal effusion in 23.33%were found in the study.Conclusion Full abdominal MSCT can help to the diagnosis of acute appendicitis,and some MSCT findings can be useful for the diagnosis including the appendix diameter≥6 mm,appendix cavity effusion,lumen stone,peripheral increased adipose density and peritoneal effusion.

The application of 18F-FDG PET/CT in thyroid tumor / 中华核医学与分子影像杂志

The clinical application of 18F-FDG PET/CT in thyroid tumor is primarily for restaging of patients with DTC but having a negative 131i whole-body scan in the presence of elevated serum Tg and TgAb levels.In parallel with the accumulation of clinical experience and increasing clinical utilization of 18F-FDG PET/CT,the application of 18F-FDG PET/CT in thyroid tumors is also broadened.This review aims at updating the application of 18F-FDG PET/CT in different types of thyroid tumors.

Characteristics of lymph nodes on 18F-FDG PET/CT imaging in patients with non-Hodgkin's lymphoma and widespread lymph node metastases carcinoma / 中华核医学与分子影像杂志

Objective To compare the characteristics of lymph nodes on 18F-FDG imaging in patients with NHL and widespread lymph node metastases carcinoma (WLNMC) for helping the differential diagnosis.Methods A total of 40 NHL patients(22 males,18 females,average age 51 years) and 42 WLNMC patients (19 males,23 females,average age 61 years) confirmed by histopathology from November 2010 to May 2015 were included in this retrospective study.The regions and the metabolism features of the lesions on PET/CT images were observed and recorded with routine visual method.Two-sample t test and x2 test were used for statistical analysis.Results Lymph nodes of NHL were kidney-shaped (47.2％,142/301),which was significantly different from that of WLNMC with circular form (47.6％,140/294;x2 =36.261,P＜0.05).Lymph nodes of NHL mostly showed homogeneous density with no necrosis (51.8％,156/301);however,that of WLNMC showed uneven density (20.4％,60/294) or with necrosis (32.3％,95/294;x2 =26.266,P＜0.05).Both of the two kinds of lymph nodes showed the characteristic of fusion (30.6％ (92/301) vs 36.1％ (106/294);x2 =2.019,P＞0.05).The ratios of lymph nodes with clear boundary in NHL and WLNMC were significantly different:28.2％(85/301) vs 19.4％(57/294);x2 =6.413,P＜0.05.Lymph nodes with symmetric distribution were more in NHL patients (52.5％,158/301)than that in WLNMC patients (42.2％,124/294;X2=6.347,P＜0.05).Sizes of lymph nodes in NHL patients and WLNMC patients were not significantly different:(2.08±0.65) cm vs (1.97±0.81) cm;t=0.316,P＞0.05.SUVmax of lymph nodes in NHL patients (9.02±3.97) was much higher than that in WLNMC patients (6.92± 1.34;t=0.370,P＜0.05).Conclusions Some characteristics of lymph nodes on 18F-FDG PET/CT imaging,such as the distribution,morphology,density and glucose metabolism features,are different in patients with NHL and WLNMC.Those differences may be helpful for the differential diagnosis.

Differential diagnosis of rat C6 glioma and inflammation with 18F-FDG, 11C-MET and 11C-CHO PET/CT imaging and their correlations with HIF-1α and VEGF / 中华核医学与分子影像杂志

Objective To compare 18F-FDG、11C-MET and 11C-CHO PET/CT in rat C6 glioma and inflammation models and observe their correlations with HIF-1α and VEGF expressions.Methods Thirtytwo male Wistar rats were included to bear both C6 glioma and turpentine oil-induced acute inflammation (AI).18F-FDG,11C-MET and 11C-CHO PET/CT were performed on rats.The SUVmax ratios of tumor-tomuscle (T/M),AI-to-muscle (AI/M) and tumor selectivity index (SI) were calculated.One-way analysis of variance and two-sample t test were used for statistical analyses.HIF-1α and VEGF expression was detected by immunohistochemical staining.Spearman correlation analysis was performed to evaluate the relationship between T/M ratios and the expressions of HIF-1α or VEGF.Results T/M ratios of 18F-FDG,11 C-MET and 11C-CHO in C6 glioma were 6.89±2.53,2.75±0.87,2.73±1.01,and the AI/M were 4.77±2.21,1.75±0.66,2.23±0.90 respectively.The 18F-FDG and 11C-MET uptake between C6 glioma and AI were significantly different(tFDG =2.133,tMET =3.267,both P＜0.05).The SIMET was significantly higher than SIFDG(t =2.600,P＜0.05).The 11C-CHO uptake between tumor and inflammation showed no significant difference(t=1.537,P＞0.05).T/M ratios of 18F-FDG and 11C-MET were positively related to HIF-1α and VEGF expressions(rs =0.725,0.637,0.621,0.764,all P＜0.05).The T/M ratio of 11C-CHO related only to VEGF (rs =0.682,P＜0.05).Conclusions 18F-FDG and 11 C-MET PET/CT may differentiate C6 glioma from AI,and 11 C-MET PET/CT seems more tumor-selective.11C-CHO PET is less valuable for the differential diagnosis.The 18F-FDG and 11 C-MET uptake of C6 glioma may be related to tumor hypoxia.All the three tracers could reflect tumor angiogenesis,but with different sensitiveness.

Detection and Significance of Anti-β2 Glycoprotein 1 Antibodies in Female Infertility and Threatened Abortion / 现代检验医学杂志

Objective To analysis the correlation of the anti-β2 glycoprotein 1 antibodies in female infertility and threatened a-bortion.Methods Selected 547 patients with female infertility,229 patietns with threatened abortion,229 patietns with ir-regular menses and 31 normal female between August 2013 to January 2014.All the anti-β2 glycoprotein 1 antibodies (Ig-G/Ig-M)were detected by ELISA.Detected the anti-β2 glycoprotein 1 antibodies (Ig-G/Ig-M)of 114 patients who treated with aspirin and prednisone combined with gamma globulin.Results The positive rate of anti-β2GP1 antibodies (Ig-G/Ig-M)of female infertility,threatened abortion,irregular menses and normal female were 0.36%,0.43%,1.6%,0% and 20.29%, 19.21%,8.3% and 3.2%,respectively.The positive rate of aβ2GP1-IgM of female infertility,threatened abortion,irregular menses were higher than normal female.The anti-β2GP1-IgM of the treated female infertility were 47.14± 34.85 RU/ml and 31.14±27.64 RU/ml,respectively.The anti-β2GP1-IgM of the treated threatened abortion were 37.75±31.20 RU/ml and 24.34±24.48 RU/ml,respectively.The levels of anti-β2GP1-IgM of the treated patietns were significantly lower than before.Conclusion There was a close relationship between anti-β2GP1-IgM antibodies and female infertility and threatened abortion,anti-β2GP1-IgM antibodies maybe one of the immune factors for female infertility and threatened abortion.

Retrograde caudate lobectomy combined with right hemi-hepatectomy / 中华消化外科杂志

Retrograde caudate lobectomy is a proper technique to resect the tumor in caudate lobe when the tumor is too big or closely adherent to the inferior vena cava.A male patient aged 44 years was admitted to the Eastern Hepatobiliary Surgery Hospital in November 2007.The ligaments around the liver were firstly dissected to mobilize the whole liver,and the right hepatic pedicle was dissected and ligated,then the liver was splited anteriorly along the Cantlie's line.The tumor was opposed in the sight and then it was dissected from the liver parenchyma.The short hepatic veins were ligated and the tumor was detached from the inferior vena cava.The inflow blood was occluded for 19 minutes,and the total blood loss was 4500 ml.The technique of retrograde caudate lobectomy can improve the success rate and safety of caudate lobectomy when the tumor in the caudate lobe is too large or adherent to the inferior vena cava.

Total caudate lobectomy via anterior hepatic transection / 中华消化外科杂志

Total caudate lobectomy via anterior hepatic transection is still a new technique to resect the tumor in the caudate lobe,which is mastered only by few surgeons.The procedure was successfully performed on a 21-year old patient with focal nodular hyperplasia in caudate lobe.The right and left lobes were first mobilized,then the short hepatic veins were dissected to detach the caudate lobe from the retrohepatic vena cava.Then the liver was split anteriorly and the partial middle lobe was resected.With this process,the tumor was in the sight and we dissected it from the liver parenchyma.The inflow blood was occluded 3 times with a period of 29,27 and 27 minutes,respectively,with an interval of 5 minutes.The total blood loss during operation was 1000 ml.The patient recovered quickly without any complications.The technique for caudate lobectomy via anterior hepatic transection can improve the success rate and safety of caudate lobectomy and deserve clinical consideration.