Current state of prostate-specific membrane antigen PET/CT imaging-targeted biopsy techniques for detection of clinically significant prostate cancer.

Clinically significant prostate cancer (csPCa) is the focus of clinical diagnosis and treatment of prostate cancer (PCa). The current standard for diagnosing csPCa in men at risk relies on a transrectal (and in some instances transperineal) ultrasound-guided biopsy (TRUS-GB) that is blind to the location of cancer, leading to false-negative csPCa diagnoses. Over the past decade, PSMA PET/CT imaging-targeted prostate biopsy (PSMA PET/CT-TB), which obtains tissue samples from a defined suspicious area, has emerged as a promising solution for improving csPCa detection. Its feasibility and higher csPCa diagnostic value have been reported by a few case reports and studies. The current manuscript will review this latest targeted prostate puncture technology, summarize the existing applications of PSMA PET/CT-TB, including technical considerations, and discuss the advantages and challenges of each technique.

Comparative research on 99mTc-Rituximab and 99mTc-sulfur colloid in sentinel lymph node imaging of breast cancer.

BACKGROUND: 99mTc-Rituximab is a new specific radiopharmaceutical that binds to the CD20 receptor which is highly expressed on the surface of B cells. We conducted a study in which 99mTc-Rituximab was compared with filtered 99mTc-sulfur colloid (fTcSC) for sentinel lymph node (SLN) detection in patients with breast cancer. METHOD: The study is divided into three parts. 1. Initially, 25 patients were selected for an internal controlled trial to received both 99mTc-Rituximab and fTcSC, the interval time is separated by ≥2 days. 2. Then, 91 patients were selected for a randomized controlled trial (41 and 50 patients in the 99mTc-Rituximab and fTcSC groups, respectively). All patients were administered either agent at the 6- and 12-o' clock positions by subareolar injection technique. SLN mapping was then performed 2 h after injection. 3. Serial dynamic images were further acquired for 2 h in 31 patients (22 and 9 patients from 99mTc-Rituximab and fTcSC cohorts, respectively). RESULTS: The identification rate of lymphoscintigraphy and SLNB in all and axilla regions for 99mTc-Rituximab and 99mTc-SC were 98.5% vs 98.7, 100% vs 98.4%, respectively. The mean number of SLNs identified by 99mTc-Rituximab and fTcSC was respectively 2.72 and 3.28, with a significant difference of P = 0.013 (paired sample t-test). The difference exists in the internal mammary and clavicular area, not in the axillary. The mean number of axillary sentinel lymph node biopsy (SLNB) for 99mTc-Rituximab and fTcSC was 2.95 vs 3.14, respectively, and no significant difference existed. 99mTc-Rituximab also exhibited a significantly faster injection site clearance rate when compared with fTcSC (0.193 ± 0.057 h- 1 vs 0.021 ± 0.007 h- 1, respectively). CONCLUSION: No significant difference was observed in identification rate and number of axillary SLN imaging and SLNB, between the two tracers. Compared to fTcSC, 99mTc-Rituximab based imaging demonstrated a fewer number of secondary lymph nodes and had faster injection site clearance rate. TRIAL REGISTRATION: www.chictr.org.cn, ChiCTR1900024990 (retrospectively registered August 6, 2019).

[Change of Bt protein in soil after growing Bt corns and returning corn straws to soil and its effects on soil nutrients].

The spatiotemporal dynamics of Bt protein in soil and the change of soil nutrients in rhizosphere soil, root surface soil and soils at 0-20, 20-40 and 40-60 cm were measured in greenhouse experiments. Two Bt corns, 5422Bt1 and 5422CBCL, and their near isogenic non-Bt variety 5422 were grown for 90 days and the crop residues were retained to soil. Results showed that 1.59 and 2.78 ng x g(-1) Bt protein were detected in the rhizosphere soil with Bt corns 5422Bt1 and 5422CBCL immediately after harvest. However, there were only trace amounts of Bt protein (< 0.5 ng x g(-1)) were detected in root surface soil after 90 days and in bulk soil in the two Bt corn treatments after 30, 60 and 90 days. When corn residues returned to soil, Bt protein declined rapidly within 3 days and only trace amounts of Bt protein were measured after 7 days. There were no sig- nificant differences in organic matter, available nutrient (alkaline hydrolytic N, available P, available K) or total nutrient (total N, total P, total K) in root surface soils and soils at 0-20 cm, 20-40 cm and 40-60 cm among the Bt and non-Bt corns after 90 days. Sixty days after returning crop residues of 5422Btl to soil, the contents of organic matter and total N increased and the content of available K reduced significantly in the 0-20 cm soil depth. There were no significant differences in any other parameter at the 0-20 cm depth, neither for any parameter in the 20-40 cm and 40-60 cm soil depths compared to those in the non-Bt corn 5422 treatment. There were no significant differences in soil nutrient contents in Bt corn 5422CBCL treatment compared to those in non-Bt corn 5422 treatment except that available phosphorus content was reduced in root surface soils, and total P content increased at the 0-20 cm soil depth after 90 days. When crop residues of Bt corn 5422 CBCL were returned to soil, only available P content in the 0-20 cm soil layer was evidently higher compared to the soil receiving crop residues of non-Bt corn 5422. Results suggested that Bt protein released from root and crop residues of Bt corns would not accumulate in soil, and growing Bt corns and returning crop residues to soil would have no significant effect on soil nutrients in general.

[Significance of sentinel lymph node detection for cN0 laryngeal carcinoma].

OBJECTIVE: The purpose of this study was to investigate the clinical value of radiolabeled tracer method, methylene blue method and combination of these two methods in detection of sentinel lymph node (SLN), and to evaluate the accuracy of SLN in predicting the cervical lymph nodes status in laryngeal carcinoma patients with clinically negative neck lymph nodes (cN0 ). METHODS: Forty-one patients with cN0 laryngeal neoplasms underwent SLN detection using both of radiolabeled tracer and methylene blue. SLN imaging was performed with laryngoscope-guided injection of radioactive isotope 99Tc(m)-sulfur colloid (SC) into the laryngeal carcinoma before surgery, then all these patients underwent intraoperative lymphatic mapping with a handheld gamma-detecting probe. After mapping of SLN, methylene blue was subsequently injected at the same spots around the tumor in order to identify SLN during surgery. The results of SLN detection by isotope tracer, dye and combination of both methods were compared. RESULTS: The SLN detection rates by radiolabeled tracer, methylene blue and combined method were 87.8%, 70.7% and 92.7%, respectively (P < 0.01). The number of detected SLN was significantly different between radiolabeled tracer method and combined method (P < 0.05), and also between blue dye method and combined method (P < 0.01). However, no statistically significant difference was found between methylene blue method and radiolabeled tracer method (P > 0.05). Nine patients were found to have lymph node metastasis by final pathological examination. The sensitivity, accuracy and negative predictive values of SLN detection by the combined method using radiolabeled tracer and methylene blue were 88.9%, 97.4% and 96.7%, respectively. CONCLUSION: The combined method using radiolabeled tracer and methylene blue can improve the accuracy of sentinel lymph node detection. Furthermore, sentinel lymph node detection can accurately predict the cervical lymph node status in cN0 laryngeal carcinoma.

Experimental study of [99mTc(PNP5) (DBODC)]+ as a new myocardial perfusion imaging agent.

OBJECTIVES: This study was aimed to compare the properties of [(99m)Tc(PNP5)(DBODC)]+ with (99m)Tc-MIBI in normal swine and in canine models of myocardial ischemia. METHODS: Seven anesthetized swine were injected intravenously with [(99m)Tc(PNP5)(DBODC)]+. Serial planar images were acquired meanwhile. Twelve adult dogs were studied. A critical stenosis of left anterior descending artery was produced. [(99m)Tc(PNP5)(DBODC)]+ or (99m)Tc-MIBI (randomly) was injected intravenously at the end of 3 min of adenosine infusion. The occluder was released after adenosine infusion. Myocardial SPECT imaging was obtained at 30, 60, 90 and 180 min, respectively, after tracer injection. Rest myocardial SPECT imaging was acquired on the next day. RESULTS: Blood disappearance of [(99m)Tc(PNP5)(DBODC)]+ was biexponential with an initial half-time of 2.97 +/- 0.48 min and a late half-time of 52.49 +/- 19.49 min. Myocardial [(99m)Tc(PNP5)(DBODC)]+ uptake was similar to (99m)Tc-MIBI. Heart-to-liver ratio of [(99m)Tc(PNP5)(DBODC)]+ was significantly higher than that of (99m)Tc-MIBI (0.99 +/- 0.03 vs. 0.46 +/- 0.10, p < 0.05) 30 min after injection. In canine models of myocardial ischemia, image quality of [(99m)Tc(PNP5)(DBODC)]+ was better than (99m)Tc-MIBI. Segments with perfusion defects by [(99m)Tc(PNP5)(DBODC)]+ was 3.60 +/- 1.52 and 4.25 +/- 0.96 by (99m)Tc-MIBI (p = n.s.). CONCLUSIONS: [(99m)Tc(PNP5)(DBODC)]+ seems to be a promising new myocardial perfusion imaging agent.

[Stress myocardial perfusion single photon emission computed tomography imaging in the detection of coronary artery disease in woman].

OBJECTIVE: To assess the diagnostic efficacy of stress myocardial perfusion imaging (MPI) in female coronary artery disease (CAD) patients. METHODS: Two hundred and fifty-nine consecutive female patients, aged 60 +/- 8, underwent stress myocardial perfusion single photon emission computed tomography (SPECT) imaging and coronary angiography with an interval of < 60 days. Among them, 227 patients underwent exercise MPI, injected intravenously with (99m)Tc-methoxyisobutyl isonitrile (MIBI) 740 - 925 MBq when the exercise end point was reached, and 32 patients underwent pharmacologic stress MPI, injected intravenously with persantine or adenosine and then (99m)Tc-MIBI. RESULTS: Among the 227 patients undergoing exercise MPI 79 had significant coronary artery stenosis with the overall sensitivity and specificity for detecting coronary artery disease of 63% and 97% respectively. According to the exercise heart rate, the 227 patients were divided into two groups: group 1 (n = 137) the patients of which achieved adequate exercise end points, and group 2 (n = 90) the patients of which only reached submaximal exercise. The sensitivity of exercise MPI for detecting CAD was 86% in the group 1 and 38% in the group 2. Among the 32 patients who underwent pharmacologic stress MPI 13 had significant CAD with the sensitivity and specificity of 85% and 84% respectively. CONCLUSION: Stress MPI is an efficient protocol for the detection of CAD in women, and pharmacologic stress MPI is more suitable for the women with decreased exercise capacity and advanced age.

[Diagnostic value of 99mTc-N-NOET myocardial perfusion imaging during exercise for coronary artery disease].

OBJECTIVE: To assess the value of (99m)Tc-N-NOET ((99m)Tc-N-ethoxy-N-ethyl dithiocarbamato-nitrito) myocardial perfusion SPECT for the diagnosis of coronary artery disease. METHODS: A total of 42 patients [mean age (54 +/- 9) years, 35 men] with suspected chest pain were included in this study. 740 MBq of (99m)Tc-N-NOET was injected intravenously during bicycle exercise when the heart rate attained reached more than 85% of the expected maximum, or in cases of angina pectoris, severe arrhythmias and ischemic ST segment changes. (99m)Tc-N-NOET 740 MBq, SPECT myocardial imaging acquisitions were obtained at 15 minutes and 2 hours after (99m)Tc-N-NOET injection. Coronary angiography was performed in all patients. RESULTS: Coronary artery stenosis was detected in 26 patients and normal coronary angiography was shown in 16 patients. (99m)Tc-N-NOET myocardial perfusion imaging was abnormal in twenty-one patients out of the 26 patients with significant coronary artery stenosis (sensitivity, 81%); 14 out of 16 patients with normal angiography had a normal myocardial perfusion imaging (specificity, 88%). The positive predictive value, negative predictive value and predictive accuracy of (99m)Tc-N-NOET myocardial perfusion imaging for detection of CAD was 91%, 74% and 83%, respectively. The sensitivity of the imaging for detecting single vessel, double vessels and triple vessels disease were 60% (6/10), 86% (6/7) and 100% (9/9), respectively. There was mild (99m)Tc-N-NOET lung uptake in patients with coronary artery stenosis 15 minutes post (99m)Tc-N-NOET injection. CONCLUSION: SPECT myocardial perfusion imaging with (99m)Tc-N-NOET supplied an important diagnostic tool for detecting coronary artery disease. Lung uptake with stress (99m)Tc-N-NOET might be related to coronary artery disease.

[Myocardial perfusion imaging with [(99m)Tc (N) (PNP5) (DBODC)](+) in canine model of acute myocardial ischemia].

OBJECTIVE: (99m)Tc-[bis (dimethoxypropylphosphinoethyl)-ethoxyethylamine (PNP5)]-[bis (N-ethoxyethyl)-dithiocarbamate (DBODC)] nitride ([(99m)Tc (N) (PNP5) (DBODC)](+)) is a new myocardial perfusion tracer with high heart uptake and rapid liver clearance. The objectives of this study were to compare the myocardial imaging of [(99m)Tc (N) (PNP5) (DBODC)](+) with (99m)Tc-MIBI in a canine model of acute myocardial ischemia. METHODS: The left anterior descending artery (LAD) was occluded in 12 adult beagle dogs, adenosine was then infused intravenously at a rate of 0.14 mg.kg(-1).min(-1) for 6 min. At the end of 3 min of adenosine infusion, 185 MBq of [(99m)Tc (N) (PNP5) (DBODC)](+) or (99m)Tc-MIBI was injected intravenously. The occluder was released after 6 min adenosine infusion. Serial myocardial SPECT imaging acquisitions were obtained at 0.5, 1, 1.5 and 2 h after tracer injection, respectively. Rest myocardial SPECT imaging was acquired in the next day. RESULTS: Similar as (99m)Tc-MIBI, [(99m)Tc (N) (PNP5) (DBODC)](+) exhibited high heart uptake, minimal lung uptake and minimal redistribution. No significant myocardial washout was observed with both tracers over a period of 2 hours. [(99m)Tc (N) (PNP5) (DBODC)](+) clearance from the liver was more rapid than that with (99m)Tc-MIBI (heart-liver radio at 60 min, 1.36 +/- 0.43 vs. 0.58 +/- 0.21, P = 0.005). [(99m)Tc (N) (PNP5) (DBODC)](+) the ability to detect myocardial ischemia was also comparable between the two tracers ([(99m)Tc (N) (PNP5) (DBODC)](+) detected 3.60 +/- 1.52 defect segments, (99m)Tc-MIBI detected 4.25 +/- 0.96 defect segments, P = 0.48). The image quality of [(99m)Tc (N) (PNP5) (DBODC)](+) was better than (99m)Tc-MIBI. CONCLUSION: [(99m)Tc (N) (PNP5) (DBODC)](+) is comparable to (99m)Tc-MIBI on detecting myocardial ischemia in this model and liver clearance is more rapid and the image quality is better than (99m)Tc-MIBI.