Direct comparison of choline PET/CT and MRI in the diagnosis of lymph node metastases in patients with prostate cancer.

BACKGROUND: Lymph node detection in prostate cancer is challenging and critical to determine treatment policy. Choline PET/CT (positron emission tomography/computed tomography) and magnetic resonance imaging (MRI) have been used for the evaluation of lymph node metastasis in patients with prostate cancer for the past decade. However, only limited patients underwent direct comparison studies. PURPOSE: To evaluate the diagnostic performance of choline PET/CT compared with MRI imaging for detecting lymph node metastases in prostate cancer patients. MATERIAL AND METHODS: Relevant English-language articles published before February 2018 were searched in PubMed database, Embase database, and Cochrane Library databases search using the keywords: (Prostate Neoplasm OR Prostate Cancer OR prostate carcinoma) and (Lymph Node) and (PET/CT OR positron emission tomography/computed tomography) and (choline or 2-hydroxy-N,N,N-trimethylethanaminium) and (magnetic resonance imaging OR MRI). Articles were included that directly compare the diagnostic performance and clinical utility of choline PET/CT and MRI for detecting lymph node metastases in prostate cancer patients. Study quality was assessed with QUADAS criteria. Analyses were performed on a per patient and a per node basis. The pooled sensitivity, specificity, diagnostic odds ratio (DOR), positive likelihood ratio (LR+), and negative likelihood ratio (LR-) were calculated using Meta-Disc 1.4 software. Summary receiver-operating characteristic (SROC) curves constructed. RESULTS: A total of 362 patients from 8 studies involving fulfilled the inclusion criteria. On patient-based analysis, the pooled sensitivity, specificity, and DOR with a 95% confidence interval (CI) for choline PET/CT imaging were 0.59 (95%CI, 0.50-0.67), 0.92 (95%CI, 0.87-0.96), 17.37 (95%CI, 4.42-68.33), and for MRI imaging, they were 0.52 (95%CI, 0.44-0.61), 0.87 (95%CI, 0.81-0.92), 6.05 (95%CI, 3.09-11.85), respectively. On node-based, the corresponding values for choline PET/CT imaging were 0.51 (95%CI, 0.46-0.57), 0.99 (95%CI, 0.98-0.99), 65.55 (95%CI, 23.55-182.45), and for MRI imaging, they were 0.39 (95%CI, 0.34-0.44), 0.97 (95%CI, 0.96-0.97), 15.86 (95%CI, 8.96-28.05), respectively. CONCLUSION: Choline PET/CT performed better than MRI imaging in evaluating the lymph nodes metastasis of prostate cancer patients and had the potential to be broadly applied in clinical practice.

Evaluation of Visceral Adipose Tissue Oxygenation by Blood Oxygen Level-Dependent MRI in Zucker Diabetic Fatty Rats.

OBJECTIVE: This study aimed to investigate the feasibility of blood oxygen level-dependent magnetic resonance imaging (BOLD-MRI) to evaluate visceral adipose tissue (VAT) oxygenation in Zucker diabetic fatty (ZDF) rats and its associations with systemic metaflammation. METHODS: Five-week-old ZDF rats and Zucker lean (ZL) rats were fed a high-fat diet (HFD) for 18 weeks. A baseline BOLD-MRI scan of perirenal adipose tissue was performed after 8 weeks of HFD feeding, and then the rats were randomized to receive pioglitazone or a vehicle for the following 10 weeks. At sacrifice, BOLD-MRI scan, Hypoxyprobe-1 injection, and circulating T helper 17 (Th17), regulatory T (Treg) cells, and monocyte subtype flow cytometry analysis were performed. RESULTS: HFD feeding led to a significant increase in VAT BOLD-MRI R2* signals (20.14 ± 0.23 per second vs. 21.53 ± 0.20 per second; P = 0.012), an indicator for decreased oxygenation. R2* signal was significantly correlated with VAT pimonidazole adduct-positive area, insulin resistance, Th17 and Treg cells, CD43 + and CD43+ + monocyte subtypes, and VAT macrophage infiltration. Pioglitazone treatment improved the insulin resistance and was associated with a delayed progression of VAT oxygenation. CONCLUSIONS: This work demonstrated the feasibility of BOLD-MRI for detecting the VAT oxygenation status in ZDF rats, and the BOLD-MRI signals were associated with insulin resistance and systemic metaflammation in ZDF rats during the development of obesity.

[Manifestations of PET/CT Imaging in Primary Central Nervous System Lymphoma].

OBJECTIVE: To investigate the PET/CT features of primary central nervous system lymphoma(PCNSL). METHODS: A retrospective analysis of PET/CT imaging manifestations and clinical data was performed in 4 PCNSL cases which were confirmed by surgery or stereotactic pathologic biopsy. RESULTS: The pathologic biopsy in 4 patients all showed diffuse large B cell lymphoma with a total of 8 lesions. All cases were performed with 18F-FDG PET/CT imaging except 1 patient simultaneously with 18F-FLT PET/CT imaging in the brain. Single lesion was found in 2 cases which both were located in the left frontal lobe. Multiple lesions were found in 2 cases, out of them 1 case located in the corpus callosum and the right lateral ventricle Angle, and the other 1 located in dual lateral ventricle and pineal region. In 18F-FDG PET/CT image, 4 patients were characterized by high metabolism, even higher than the surrounding brain tissue. The patient which underwent 18F-FLT PET/CT imaging was also presented with high metabolism and had better Target and non-target ratio(T/N). 3 cases with surrounded by edema and 2 cases with area of cystic necrosis. CONCLUSION: PCNSL are characterized by high metabolism in 18F-FDG PET/CT images and can better contrast with the surrounding normal brain. Combined use of other tracer such as 18F-FLT can improve the diagnostic value of PET/CT in PCNSL.

Inflammatory monocyte/macrophage modulation by liposome-entrapped spironolactone ameliorates acute lung injury in mice.

AIM: To examine the therapeutic/preventive potential of liposome-encapsulated spironolactone (SP; Lipo-SP) for acute lung injury (ALI) and fibrosis. MATERIALS & METHODS: Lipo-SP was prepared by the film-ultrasonic method, and physicochemical and pharmacokinetic characterized for oral administration (10 and 20 mg/kg for SP-loaded liposome; 20 mg/kg for free SP) in a mouse model bleomycin-induced ALI. RESULTS: Lipo-SP enhanced bioavailability of SP with significant amelioration in lung pathology. Mechanistically, SP-mediated mineralocorticoid receptor antagonism contributes to inflammatory monocyte/macrophage modulation via an inhibitory effect on Ly6C(hi) monocytosis-directed M2 polarization of alveolar macrophages. Moreover, Lipo-SP at lower dose (10 mg/kg) exhibited more improvement in body weight gain. CONCLUSION: Our data highlight Lipo-SP as a promising approach with therapeutic/preventive potential for ALI and fibrosis.

Polysplenia Syndrome With Splenic and Skeletal Muscle Metastases From Thyroid Carcinoma Evaluated by FDG PET/CT: Case Report and Literature Review: A Care-Compliant Article.

Polysplenia syndrome (PSS) is a rare congenital abnormality. Metastases to spleen and skeletal muscle from differentiated thyroid cancer (DTC) are also extremely rare. Our case report aims to present an interesting case of PSS associated with splenic metastasis (SM) and skeletal muscle metastasis (SMM) from advanced papillary thyroid carcinoma which was evaluated on fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT). An 84-year-old Chinese man was admitted with the history of multiple enlarged masses in bilateral neck, right axillary, and inguinal areas for >2 months. The results of ultrasonography examination were highly suggestive of malignancy. The histological results of the following biopsy were consistent with papillary thyroid carcinoma with involvement of multiple regional lymph nodes. He was referred for an FDG PET/CT imaging to evaluate the situation. FDG PET/CT showed that an intense FDG-avid thyroid mass with widespread regional lymph node involvement and distant metastases in the body. Unexpected sites of metastases were detected in the spleens and skeletal muscles. Most interestingly, FDG PET/CT imaging also described the typical imaging findings of PSS including the 2 right-sided spleens, azygos and hemiazygos continuation of inferior vena cava (IVC), right-sided stomach, middle line liver, a short pancreas, preduodenal portal vein (PPV), and malrotation of gut. Whole body FDG PET/CT imaging can accurately evaluate the situation of DTC by detecting regional lymph node involvement, common and rare sites of distant metastases which are closely related to staging, management, and prognosis of this disease. Whole-body FDG PET/CT is also valuable in demonstrating the typical imaging features of PSS.

TrkC expression predicts favorable clinical outcome in invasive ductal carcinoma of breast independent of NT-3 expression.

BACKGROUND: TrkC, a member of neurotrophin receptor family, functions not only as an oncogene, but also act as a tumor suppressor via a manner of dependence receptor in human malignant tumors. Little is known on the action of TrkC for the clinical prognosis and the progression of breast cancer according to the availability of its ligand NT-3. We sought to investigate the prognostic relevance of NT-3-TrkC axis in breast cancer and estimate its role during the process of breast cancer progression. METHODS: 236 cases of invasive ductal carcinoma (IDC), 60 pure ductal carcinoma in situ (DCIS) and 30 normal breast tissue (NBT) between 2004 and 2005 were included in the study. Spearman's rank correlation test was used to analyze the association of NT-3-TrkC expression and breast cancer progression. The Kaplan-Meier method and Cox proportional hazards model were performed to identify the relevant prognostic factors. RESULTS: 50.4% IDC tumors displayed absent or low TrkC expression, while 49.6% was high TrkC expression. TrkC expression was negatively associated with lymph node metastasis (P = 0.029) and tumor proliferation (P = 0.015). Patients with lower TrkC expressing tumors had a higher risk of recurrence (odds ratio, 0.401; 95% confidence interval, 0.207-0.778; P = 0.007). The layered analysis indicated that patients with high TrkC expression tumors had a favor disease-free survival whether NT-3 and TrkC were co-expressed or solitarily expressed in the tumor (P = 0.000). NT-3 was demonstrated to be not a predictor of IDC patients' prognosis. But NT-3 expression was inversely correlated with the progression of breast cancer (r = -0.341, P = 0.000), since more IDC tumors showed high NT-3 expression than DCIS tumors (51.7% vs. 25.9%), while no NBT showed high NT-3 expression, as well. CONCLUSION: The study indicates TrkC expression reduces tumor relapse independent of NT-3 availability in the IDC. Elevated NT-3 expression contributes to the progression of breast cancer.

[Clinical application of T2*GRE multiple echo sequence on articular cartilage disease in the knee].

OBJECTIVE: To evaluate the correlation between T2* relaxation time and the pathological changes in the knee joint of patients with osteoarthritis (OA) and analyze the changes of T2* relaxation time in early cartilage injury. METHODS: Sixty-two patients with OA in different phases underwent magnetic resonance imaging (MRI) of the knee and the articular cartilage T2* relaxation time was recorded, with 20 young healthy volunteers as the control group. RESULTS: Patients with mild OA showed significantly different T2* relaxation time for most of the articular cartilage from that of the healthy volunteers (P<0.05), but no such difference was found between serious OA group and the healthy volunteers. The change of T2* relaxation time of the cartilage was also associated with age, weight and body height, and the potential effects of other factors could not be excluded. CONCLUSION: The articular cartilage shows no obvious morphological changes in early OA of the knee, a stage characterized mostly by alterations of the tissue structure and compositions. Cartilage pathologies can be the most obvious on the weight-bearing surface of the medial condyle of the femur or in the patella. T2* relaxation time measurement can be helpful in the detection of early cartilage pathologies.

[Magnetic resonance imaging and radiography for diagnosis of lower limb osteosarcoma: a comparative study].

OBJECTIVE: To investigate the diagnostic value of magnetic resonance imaging (MRI) for lower limb osteosarcoma by comparing the findings between X-ray and MRI. METHODS: Fifteen surgically or pathologically confirmed patients with lower limb osteosarcoma (11 males and 4 females) underwent both plain and enhanced MRI (with CT scanning in 4 cases) in addition to radiography, and the findings were compared. RESULTS: The diagnostic accuracy of both MRI and X-ray film was 100%. Compared with X-ray, MRI was capable of clear display of the lesion extent, perpendicular periosteal reaction, the two layers of Codman's triangle and the skip lesions. CONCLUSION: Plain X-ray film provides a convenient and practical diagnostic modality for lower limb osteosarcoma, but MRI has better performance in clearer display of the tumor range and identification of early-stage lesions.

[Diagnosis of lesions in the major abdominal blood vessels by three-dimensional dynamic contrast-enhanced magnetic resonance angiography].

OBJECTIVE: To elucidate the working principles of three-dimensional dynamic contrast-enhanced magnetic resonance angiography(3D DCE-MRA)and assess its value in the diagnosis of lesions in the major abdominal blood vessels. METHODS: The imaging data of 3D DCE-MRA and conventional MR examination in 32 cases of suspected major abdominal blood vessel diseases were obtained and analyzed retrospectively. RESULTS: The peak flow of contrast agents through the abdominal aorta at the level of renal artery occurred 17 to 23 s after the injections. Normal presentation was found in 3 cases, with clear images of the abdominal aorta and its branches. Abdominal aortic aneurysm was identified in 7 cases, where the involved segment of the aorta was irregularly broadened and the actual lumen of the abdominal aorta was displayed. Aortic dissection was found in 18 cases, and the intima, the double-lumen, and the position where the abdominal aortic branches originated could be seen with 12 entry sites and 16 re-entry sites. Atherosclerosis was found in 3 cases, with tortuous abdominal aorta whose lumen was morphologically irregular. One case was found with thrombosis in the left iliac vein which was not visualized. CONCLUSIONS: 3D DCE-MRA is a non-invasive alternative for conventional angiography and has significant importance in the diagnosis of lesions in major abdominal blood vessels.