A prognostication system based on clinical parameters and [18F]-FDG PET/CT in patients with newly diagnosed multiple myeloma.

PURPOSE: This study aimed to assess prognosis of patients with newly diagnosed multiple myeloma (NDMM) by combining [18F]-FDG positron emission tomography (PET)/CT parameters and clinical indices. METHODS: Clinical data and PET/CT parameters of 133 NDMM patients were retrospectively analyzed for associations between clinical indices and PET/CT parameters. Independent predictors of progression-free survival (PFS) and overall survival (OS) were determined. A new prognostic prediction system (NPPS) was constructed based on our findings. Prediction effectiveness was compared among the NPPS, International Staging System (ISS), Revised ISS (R-ISS), and R2-ISS. RESULTS: Prevalence of elevated ß2-microglobulin, serum creatinine (sCr), serum calcium (sCa), and C-reactive protein concentrations was higher in patients with higher SUVmax (≥ 5.3). Prevalence of elevated sCa, sCr, and extramedullary disease (EMD) was higher in patients with a higher number of focal lesions (≥ 10). SUVmax, serum free-light chain (sFLC) ratio, and EMD were independent predictors of PFS and OS. The NPPS used SUVmax, sFLC ratio, and EMD could effectively predict OS and was more effective at prognostication than the ISS, R-ISS, and R2-ISS. CONCLUSIONS: [18F]-FDG PET/CT parameters play a significant role in predicting prognosis in NDMM patients. The NPPS based on SUVmax, sFLC ratio, and EMD outperformed the ISS, R-ISS, and R2-ISS in prognostication.

[Surveillance and risk assessment system of schistosomiasis in Jiangsu Province. II. Surveillance pattern and effect of Oncomelania hupensis snail status in Dongtai City, Jiangsu Province].

OBJECTIVE: To explore the method of Oncomelania hupensis snail surveillance in transmission-interrupted regions of schistosomiasis, so as to provide a new pattern for the surveillance of snail status in the transmission-interrupted areas. METHODS: In Dongtai County, north of Jiangsu Province where the transmission of schistosomiasis was interrupted, the surveillance of snail status was performed by means of the village-level general survey, village-level sampling survey, snail survey in key settings of township and county, and snail reporting by residents. In addition, quality-control snail sites were set up for quality control. The effectiveness and cost of the four methods of snail surveillance was compared. RESULTS: A total of 163 079 settings and 22 785.62 hm2 were surveyed in Dongtai County from 2008 to 2013, and 89 residual snail breeding sites were found, with a snail area of 1.48 hm2. The patterns of village-level general survey, village-level sampling survey, and snail survey in key settings of township and county were employed for investigation of 94 550, 45 033 and 23 496 settings, consisting of 57.98%, 27.61% and 14.41% of total settings, and 2, 0 and 6 settings were found with snails, with 0.021/thousand, 0, and 0.255/thousand detection rates of settings with snail breading sites, respectively. The pattern of snail survey in key settings of township and county was more effective than that of village-level survey to detect-snail breeding sites (χ2 = 19.158, P = 0). The recovery rate of quality-control snail breeding sites was 52.56%, 38.27% and 73.62% for the three patterns of snail survey, respectively, and the pattern of snail survey in key settings of township and county showed a higher quality for snail survey than that of village-level survey (χ2 = 111.597 and 85.991, both P = 0). During the period from 2008 to 2013, 289 person-times reported 279 suspected snail habitats and 1 501 living snails, and no Oncomelania snails were found. During the 6-year period, there were 1617.5, 964.7 and 527.7 thousand RMB invested for village-level general survey, village-level sampling survey, and snail survey in key settings of township and county, and the cost of snail survey per hm2 was 129.88, 133.6 and 162.57 RMB/hm2, respectively. The cost of village-level general survey and snail survey in key settings of township and county to detect a snail-breeding site was 808 800 and 88 000 RMB, respectively (t = 12.850, P = 0.000), and the cost of snail survey in key settings of township and county was 10.88% of that of village-level general survey. CONCLUSION: The snail survey in key settings of township and county is a highly effective and high-quality method for snail surveillance, which miay serve as a prior way for the surveillance of snail status in the transmission-interrupted areas of schistosomiasis.

Prognostic predictive value of total lesion glycolysis from 18F-FDG PET/CT in post-surgical patients with epithelial ovarian cancer.

PURPOSE: The aim of this study was to determine an optimal threshold method for the segmentation of malignant lesions from (18)F-FDG PET/CT images and to evaluate the prognostic value of the total lesion glycolysis in post-surgical patients with epithelial ovarian cancer. METHODS: We retrospectively reviewed 47 patients with pathologically proven epithelial ovarian cancer who underwent (18)F-FDG PET/CT imaging after surgery. The follow-up time was 26.6 ± 19.8 months (ranged from 4 to 89 months). For each patient, every lesion was segmented by 2 thresholds with 3D-area growing algorithm, standard uptake value (SUV) 2.5, and background method. The detection rates were compared. The optimal threshold method was then used to calculate whole-body metabolic tumor volume (WBMTV) and whole-body total lesion glycolysis (WBTLG). The prognostic significance of SUV(max), WBMTV, WBTLG, and other pathological variables for overall survival were assessed by Cox proportional hazards regression analysis and Kaplan-Meier survival analysis. RESULTS: A total of 142 metastatic lesions of 47 patients were confirmed by long-term clinical follow-up or pathological findings. The detection rates of the threshold SUV 2.5 and background methods were 37.32% (53/142) and 96.48% (137/142), respectively, which showed significant difference between the 2 methods (P < 0.005). In multivariate analysis, WBTLG, obtained from the background method, was an independent predictive factor associated with the prognosis (HR 1.043, 95% CI 1.01-1.078, P = 0.011), and none of the other factors had statistical association. Survival analysis also showed that the survival time was clearly shortened with WBTLG increasing (P < 0.001). CONCLUSIONS: In this group of post-surgery patients with epithelial ovarian cancer, the background method could segment much more malignant lesions than SUV = 2.5 method, and WBTLG, obtained from this method, could be used as an independent prognostic factor.

[Surveillance after schistosomiasis transmission interrupted in sandy areas].

The surveillance after schistosomiasis transmission interrupted in sandy areas showed that the schistosomiasis endemic did not occur locally, but the factors of transmission still existed. Therefore, we should continue to enhance the management of mobile population and snail control, and explore appropriate measures for schistosomiasis monitoring.

Improved myocardial perfusion and cardiac function by controlled-release basic fibroblast growth factor using fibrin glue in a canine infarct model.

OBJECTIVE: Angiogenic therapy is emerging as a potential strategy for the treatment of ischemic heart disease but is limited by a relatively short half-life of growth factors. Fibrin glue (FG) provides a reservoir for controlled-release of growth factors. The aim of this study was to evaluate the effects of basic fibroblast growth factor (bFGF) incorporating FG on angiogenesis and cardiac performance in a canine infarct model. METHODS: Acute myocardial infarction was induced by ligation of the left anterior descending coronary artery (LAD). Group I (n=6) underwent ligation of LAD alone. In Group II, transmural channels were created in the infarct area (n=6). In Group III, non-transmural channels were created to locate FG cylinders containing bFGF (n=6). Eight weeks after operation, myocardial perfusion was assessed by single photon emission computed tomography, cardiac function by echocardiography, and vascular development by immunohistochemical staining. RESULTS: Total vascular density and the number of large vessels (internal diameter ≥50 µm) were dramatically higher in Group III than in Groups I and II at eight weeks. Only the controlled-release group exhibited an improvement in regional myocardial perfusion associated with lower defect score. Animals in Group III presented improved cardiac regional systolic and diastolic functions as well as global systolic function in comparison with the other two groups. CONCLUSIONS: Enhanced and sustained angiogenic response can be achieved by controlled-release bFGF incorporating FG within transmyocardial laser channels, thus enabling improvement in myocardial perfusion and cardiac function.

Isolation and molecular characterization of Vibrio parahaemolyticus from fresh, low-temperature preserved, dried, and salted seafood products in two coastal areas of eastern China.

A total of 1293 seafood samples from fishing farm, retail markets, restaurants and cooking rooms of hotels in Jiangsu province and Shanghai city of China were collected and analyzed for the prevalence of Vibrio parahaemolyticus during July to October in 2007. Two hundred and fifty one isolates of V. parahaemolyticus were identified, of which 8 isolates were positive for tdh and 2 were positive for trh gene. Three tdh positive isolates were identified from low-temperature preserved seafood samples and 5 isolates from fresh seafood samples, of these tdh positive isolates, 3 were positive in ORF8-PCR test. The genetic diversity among V. parahaemolyticus isolates was assessed using random amplified polymorphic DNA (RAPD)-PCR and the results showed that there were 33 different genetic patterns that were clustered into nine groups (groups A to I) at 82% similarity level. About 31.9% of the isolates belong to type III9d that were widely distributed in fresh, iced, frozen, dried and salted seafood samples. Seven tdh positive isolates belonged to group A and one belonged to group C, 2 trh positive isolates were type I10d belonging to group F, which was identical to that of reference strains isolated from patients. This study demonstrated genetic variability within V. parahaemolyticus isolates from seafood in Chinese markets and confirmed the presence of toxigenic V. parahaemolyticus not only in fresh but also in iced and frozen seafood products indicating that low-temperature preserved seafood might be also a vehicle for transmitting pathogenic V. parahaemolyticus.

[Feasibility of apoptosis-imaging agent 99mTc-HYNIC-annexin V in early assessment of chemotherapeutic effect on tumor models].

OBJECTIVE: To evaluate if 99mTc-HYNIC-annexin V may be used to detect the early chemotherapeutic effect and to determine the best timing for detecting apoptosis in vivo. METHODS: Annexin V was labeled with 99mTc using HYNIC as a bifunctional agent. Normal Kunming mice received inoculation of Ehrlich ascites cells into the right upper limb. After the tumor reached 1 cm in diameter, the mice were randomly divided into saline treatment group as control and cyclophosphamide (150 mg/kg injected intraperitoneally) treatment group. 99mTc-HYNIC-annexin V was injected intravenously at 1 h and 24 h after treatment. Region of interest technique (ROI) from the SPECT images taken at different time was used to get the ratio of tumor/limb in each group. TUNEL staining was used to detect apoptotic cells and the rates of positive stained cells were calculated. RESULTS: After treatment with saline, only little amount of the radiolabeled tracer could be seen in the tumor and showed weak image of the tumor. But after 24 h of treatment with cyclophosphamide, clear image on the tumor could be seen. 24 h after the treatment of cyclophosphamide, the ratio of tumor/limb was (6.27 +/- 0.24) which was much higher than that at 24 h after treatment with saline (2.36 +/- 0.18) and that at 1 h after cyclophosphamide treatment (4.00 +/- 0.38). At 24 h after cyclophosphamide treatment, TUNEL staining showed a significantly higher rate of apoptotic cells in the mice. CONCLUSION: 99mTc-HYNIC-annexin V can be used as an apoptosis-imaging agent to detect and evaluate the early curative effect after chemotherapy. The effective detection of apoptotic response in tumor with 99mTc-HYNIC-annexin V requires a 24 h interval after chemotherapy. SPECT images can be obtained at 60 min after injection of the imaging agent. It suggests that 99mTc-HYNIC-annexin V may become a promising agent for apoptosis-imaging in clinical application.

Study of 99mTc-annexin V uptake in apoptotic cell models of Parkinson's disease.

OBJECTIVE: To investigate the feasibility of radiolabelled annexin V imaging for early diagnosis of Parkinson's disease. METHODS: 99mTc-HYNIC-annexin V was prepared and its binding to apoptotic cell models of Parkinson's disease was studied in vitro. Cellular models of Parkinson's disease were produced by administering different concentrations of 1-methyl-4-phenylpyridinium to PC12 and SH-SY5Y cell lines. Cell apoptosis rates were analysed by flow cytometry. Annexin V was labelled with 99mTc by hydrazinonicotinamide (HYNIC). Cell binding studies were carried out using cellular models of Parkinson's disease. Cell uptake studies were also performed after different levels of MPP treatment, and the correlation between the degree of apoptosis and Tc-HYNIC-annexin V uptake was analysed. RESULTS: The specific activity of 99mTc-HYNIC-annexin V was 3.7-74 x 10 Bq.mg protein. In-vitro binding of 99mTc-HYNIC-annexin V to model cells was specific, saturable and time dependent. Scatchard analysis gave a Kd of 7.16+/-1.78 nmol.l, Bmax values of 179+/-33 fmol per 10(6) cells (PC12) and 220+/-26 fmol per 10(6) cells (SHSY5Y). MPP at different concentrations can induce cell apoptosis in a dose-dependent manner; cellular uptake of 99mTc-HYNIC-annexin V as indicated by membrane-bound radiolabelled annexin V activity was linearly correlated with total fluorescence, as observed by FITC-annexin V flow cytometry (PC12: r=0.924; SH-SY5Y: r=0.937, P<0.01). CONCLUSIONS: 99mTc-HYNIC-annexin V retains its receptor-binding activity and has a high affinity to cellular models of Parkinson's disease. The uptake of radioactivity correlated well with cell apoptosis rates; thus, 99mTc-annexin V is a potential imaging agent with which to detect early neuron damage in Parkinson's disease.

[Clinical value of radionuclide imaging in differentiate the origin of cervical mass].

OBJECTIVE: To study the clinical value of thyroid imaging in differentiate the origin cervical mass. METHOD: Sixty-nine patients with cervical mass were subjected to 99mTc-pertechnetate imaging. 99Tc-MIBI hot spot imaging and perfusion imaging were performed in some of patients with cold or cool nodules. The findings of thyroid imaging were compared with follow up and histopathologic results. RESULT: Thirty-three of 69 patients were found with thyroid nodules, 36 patients mass were outside thyroid. Twelve of 33 thyroid nodules were found to be subacute thyroiditis. Two cases regarded as thyroglossal duct cyst were found to be ectopic thyroid glands. Twenty-seven of 36 masses out side thyroid were thyroglossal duct cysts. CONCLUSION: 99m Tc-pertechnetate imaging, 99mTc-MIBI hot spot imaging and perfusion imaging are useful to differentiate the origin of cervical mass, and differentiate ectopic thyroid from thyroglossal duct cyst.

Technetium-99m labeled antisense oligonucleotide-noninvasive tumor imaging in mice

The 15-mer oligonucleotide sequence was synthesized, aminolinked (sense and antisense phosphodiester) and conjugated with S-Acetyl-NHS-MAG3 by a N-hydroxy-succinimide derivative. The purified MAG3-DNA was radiolabeled with 99mTc by transchelation from sodium tartrate and free 99mTc was separated by gel filtration. The radiolabeled antisense and sense probes were injected intravenously in mammary tumor-bearing KM mice(1×106 cells,6 days post inoculation).Biodistribution was studied and the mice were imaged.Essentially complete conjugation was achieved by reverse-phase Sep-Pak C18 chromatography analysis.The MAG3-DNA was labeled with 99mTc at room temperature and neutral pH, with a mean labeling efficiency of 80.11 percent (s.d=2.96 percent , N=4). After labeling, the stability of the DNA in saline or serum was retained as determined by reverse-phase Sep-Pak C18 chromatography analysis, except a shift at 30 min in serum incubation which might suggest a short time serum protein binding. The labeled antisense DNA still remained the ability to hybridize with its complementary DNA. The pharmacodynamics of 99mTc labeled c-myc probes (antisense and sense) in mammary tumor-bearing KM mice did not change with the time postinjection. The highest accumulation of label was in the liver first, with the kidney and small bowel next. The injected activity localized in the lesion as early as 30min and reached a saturation value at 4hr. The accumulation of radioactivity in the tumor was lower at all time points in animals receiving the blocking oligonucleotides or sense probes. All images obtained with 99mTc-MAG3-c-myc antisense probes showed specific accumulation of radioactivity at the site of tumor. Radiolabel rapidly accumulates at the site of tumor and remains associated with the site even though circulation levels of radioactivity have greatly diminished. The tumor was readily evident since 45min and reached the highest tumor-to-muscle ratio at 4hr. The quite encouraging result was obtained at 20hr to 22hr when the background activity was diminished sufficiently. Positive imaging was not obtained in case of control group (in which non-conjugated, non-labeled antisense oligonucleotides were administered 2hr before the radiolabeled antisense probes were injected) and of sense group. Conclusion The 99mTc labeled antisense probe may provide a sensible and specific tool for noninvasive imaging of c-myc oncogene mRNA for a variety of malignant tumors at an earlier stage