Diagnostic value of combined CT lymphangiography and 99Tcm-DX lymphoscintigraphy in primary chylopericardium.

OBJECTIVE: To investigate the diagnostic value of combined 99Tcm-DX lymphoscintigraphy and CT lymphangiography (CTL) in primary chylopericardium. METHODS: Fifty-five patients diagnosed with primary chylopericardium clinically were retrospectively analyzed. 99Tcm-DX lymphoscintigraphy and CTL were performed in all patients. Primary chylopericardium was classified into three types, according to the 99Tcm-DX lymphoscintigraphy results. The evaluation indexes of CTL include: (1) abnormal contrast distribution in the neck, (2) abnormal contrast distribution in the chest, (3) dilated thoracic duct was defined as when the widest diameter of thoracic duct was > 3 mm, (4) abnormal contrast distribution in abdominal. CTL characteristics were analyzed between different groups, and P < 0.05 was considered a statistically significant difference. RESULTS: Primary chylopericardium showed 12 patients with type I, 14 patients with type II, and 22 patients with type III. The incidence of abnormal contrast distribution in the posterior mediastinum was greater in type I than type III (P = 0.003). The incidence of abnormal contrast distribution in the pericardial and aortopulmonary windows, type I was greater than type III (P = 0.008). And the incidence of abnormal distribution of contrast agent in the bilateral cervical or subclavian region was greater in type II than type III (P = 0.002). CONCLUSION: The combined application of the 99Tcm-DX lymphoscintigraphy and CTL is of great value for the localized and qualitative diagnosis of primary chylopericardium and explore the pathogenesis of lesions.

A case report of pyogenic sacroiliitis in a 9-month-old child.

A very rare condition, pyogenic sacroiliitis is responsible for 1-2% of all osteoarticular infections in children. Diagnosis is often delayed in the pediatric population due to non-specific signs and symptoms during presentation, difficulty in assessing the joint, more common differential diagnosis and low yield diagnostic findings in conventional radiography. A delayed diagnosis of this condition can lead to permanent joint damage. A 9-month-old presented to the emergency department with a history of fever, being unsettled and clingy along with refusal to weight bear over the past few days. On initial assessment, she was found to be tachycardic and afebrile with abnormal posture of her left leg held in external rotation at the hip joint. On examination, she refused to weight bear, presented with alternating tenderness of her left and right hip joints and spinal tenderness at the L5 position. Investigations done showed slightly raised inflammatory counts, normal hip and pelvic radiographs, normal hip ultrasound and blood culture growing staphylococcus aureus and Magnetic Resonance Imaging spine showing right sacroiliitis leading the diagnosis of pyogenic sacroiliitis. This case report highlights the importance of examination of the back and the importance of avoiding fixation error by history. Although rare, clinicians should consider the diagnosis of sacroiliitis in children who present with fever, being unsettled with decreased and painful movements around the pelvic region.

Is it sufficient to evaluate metastatic bone involvement in breast cancer using SPECT/CT? A new approach of SPECT/CT-guided targeted bone marrow biopsy.

OBJECTIVE: To investigate the feasibility, safety, and clinical application value of single photon emission computed tomography/computed tomography (SPECT/CT)-guided bone marrow biopsy (BMB) in breast cancer (BC) patients with suspected bone metastases (BM) and compare its diagnostic performance for detection of BM with SPECT/CT. METHODS: The records of breast cancer patients referred for bone scintigraphy (BS), SPECT/CT and SPECT/CT-guided BMB from January of 2018 to June of 2021 in our hospital were retrospectively reviewed. 49 Patients were consecutively included in this study, all 49 specimens were analyzed by pathological and immunohistochemical studies.The biopsy success rate, total examination time, biopsy operation time, complications, CT radiation dose, and pathological and immunohistochemical results were recorded. The diagnostic performance based on SPECT/CT and SPECT/CT-guided BMB were compared with pathological, immunohistochemical examinations and the results of subsequent follow-up. RESULTS: Bone samples of the sites with high uptake were obtained in all 49 patients under BMB. No severe postoperative complications occurred. Among all 49 cases, 34 specimens were positive for metastatic breast cancer (69%, 34/49), and positive for benign tissue in 15 cases (31%, 15/49). 1 case of 15 cases was subsequently diagnosed as metastatic breast cancer according to the follow-up result. SPECT/CT-guided BMB demonstrated significantly higher negative predictive value (NPV) when compared to SPECT/CT (p = 0.021 < 0.05). Patients with differential expression of ER, PR, and HER-2 between primary lesions and metastatic lesions accounted for 12, 17, and 5 cases, respectively, and the changing rates were 35.2% (12/34), 50% (17/34), and 14.7% (5/34), respectively. Molecular subtype changes occurred in 7 patients, accounting for 47% (16/34) of metastatic patients. CONCLUSION: It is insufficient to evaluate BM in BC patients using SPECT/CT imaging. SPECT/CT-guided BMB provided significantly higher sensitivity and NPV than SPECT/CT for detection of BM in BC patients. Our research redefines a new approach which can confirm diagnosis and potential molecular subtype changes for suspected bone metastatic lesions in BC patients, which can offer important opportunities for precision treatment and improved quality of life of BC patients with BM.

[Comparative study ofmethylene blue tracer and double tracer containing nuclide in sentinel lymph node biopsy of breast cancer].

Objective: To compare the application effect of blue dye single tracer and blue dye combined with nuclide double tracer in sentinel lymph node biopsy (SLNB) of breast cancer surgery. Methods: A total of 92 breast cancer patients in Shandong Cancer Hospital and Institute from November 2017 to October 2019 underwent methyleneblue dye combined with (99)Tc(m) sulfur colloid nuclide double tracer in SLNB, while other 92 cases in Jining First People Hospital underwent blue dye single tracer. The number of SLN detection, detection rate, accuracy rate, sensitivity, and false negative rate of the two groups were compared. The impacts of age, menstruation, tumor location, tumor size, clinical stage, pathological type, and estrogen receptor (ER), progesterone receptor (PR), human epidermal receptor 2 (HER-2), molecular typing, dynamic enhanced magnetic resonance imaging (DCE-MRI)on the detection rate of SLN were analyzed. Results: The number of detection, detection rate, accuracy, sensitivity, and false negative rate of the blue dye single tracer group were 3.20±1.10, 90.22%, 93.48%, 95.24% and 4.76%, respectively; the double tracer group were 3.37±1.02, 92.39%, 95.65%, 95.65% and 4.35%, respectively, without significant difference (all P>0.05). In different age, menstrual condition, tumor location, clinical stage, pathological type, ER, PR, HER-2 expression and molecular typing, the detection rate of single tracer group and double tracer group had no significant difference (all P>0.05). However, in the tumor size of 2-5 cm and without DCE-MRI examination, the detection rate of single tracer group was significantly lower than that of double tracer group. Conclusion: The effect of blue dye single tracer in detecting SLN of breast cancer is equivalent to that of double tracer method, which is worthy of promotion and application in primary hospitals.

Evaluations for Determination of Optimum Shields in Nuclear Medicine.

BACKGROUND: 131I source is widely used in the treatment of hyperthyroidism and thyroid cancers. 131I emits both beta and gamma-rays. Radiation protection is considered for gamma rays emitted by 131I. It seems no special shield against 131I source to be designed. OBJECTIVE: This research aims to evaluate determination of optimum shields in nuclear medicine against 99Tcm and 131I sources by dosimetric method. Additionally, Monte Carlo simulation was used to find the optimum thickness of lead for protection against 131I source. MATERIAL AND METHODS: This is an experimental research in the field of radiation protection. A calibrated model of GraetzX5C Plus dosimeter was used to measure exposure rates passing through the shields. The efficiency of the shields was evaluated against 99Tcm and 131I. Furthermore, Monte Carlo simulation was used to find the optimum thickness of lead for protection against 131I source. RESULTS: The findings of the dosimetric method show that the minimum and maximum efficiencies obtained by the lead apron with lead equivalent thickness of 0.25 mm and the syringe holder shields with thickness of 0.5 mm lead were 50.86% and 99.50%, respectively. The results of the simulations show that the minimum and maximum efficiencies obtained by lead thicknesses of 1 mm and 43 mm were 19.36% and 99.79%, respectively. CONCLUSION: The optimum shields against 99Tcm are the syringe holder shield, the tungsten syringe shield, and the lead partition, respectively. Furthermore, based on simulations, the thicknesses of 11-28 mm of lead with efficiencies between 90.6% to 99% are suggested as the optimum thicknesses to protect against 131I source.

Radiation level in the surroundings of patients undergoing 99Tcm-MDP SPECT bone imaging and influence factors / 中华放射医学与防护杂志

Objective To study the radiation level in the surrounding of patients undergoing 99Tcm-MDP SPECT bone imaging and associated influencing factors and provide experimental data for the radiation safety of personnel around the patients.Methods A total of 367 patients undergoing whole-body bone imaging in Cancer Hospital,Chinese Academy of Medical Sciences were investigated to measure the ambient dose equivalent rate around the patients at different time and different distances from the patients,analyze the variations of ambient dose equivalent rate with time and distances,estimate the dose level at different distances around the patients,and evaluate the radiation dose to personnel around the patients.Results The ambient dose equivalent rate around the patient decreased exponentially with time;the effective half-life of 99Tcm in patients' body increased with time.The ambient dose equivalent rate varied by power function with increasing distance within 4 meters from the patient with the mean power value of -1.45.The radiation levels were 238.3 μSv at 0.5 m,99.7 μSv at 1 m,and 61.8 μSv at 1.5 m from the patient undergoing 99Tcm injection to its vanishing in patients' body.At different time points,the radiation doses at 0.5 m off the patient for 10 min were:9.9,3.0,1.9 μSv at 0,3 and 6 h,respectively.Conclusions The ambient dose equivalent rate around the patients undergoing 99Tcm-MDP SPECT bone imaging decrease rapidly with increasing time and distance.The patients can cause a certain degree of exposures to the surrounding personnel,but the exposure level is far lower than the relevant national standards.It is suggested that the patients should not receive other types of diagnosis and treatments spending lot of time and in close contact with medical staff while bone imaging being conducted on the same day.

Comparison of real-time ultrasound and radionuclide imaging for Meckel's diverticulum in children / 中国医学影像技术

Objective: To explore the value of real-time ultrasound and 99Tcm-pertechnetate scintigraphy for diagnosis of Meckel's diverticulum (MD) in children. Methods: Totally 156 children with clinically diagnosed MD or complications and then treated with surgical operations were enrolled. Real-time ultrasound examination and 99Tcm-pertechnetate scintigraphy were performed before operation. Taking surgical pathological results as gold standards, the diagnostic efficacies of these two methods were compared. Results: MD was diagnosed in 105 children after operation. The sensitivity, specificity and accuracy of ultrasound for MD was 87.62% (92/105), 88.24% (45/51) and 87.82% (137/156), while of 99Tcm-pertechnetate scintigraphy was 71.43% (75/105), 72.55% (37/51) and 71.79% (112/156), respectively. The sensitivity, specificity and accuracy of ultrasound were all higher than those of 99Tcm-pertechnetate scintigraphy in diagnosis of MD. Conclusion: Real-time ultrasound can effectively diagnose MD and complications, which can be used as the preferred auxiliary diagnostic method for clinic.

An Investigation to Determine an Optimum Protective Garment Material in Nuclear Medicine.

AIM: The aim of this study is to find an optimum material to protect garment for protection against 99Tcm radionuclide. MATERIALS AND METHODS: Monte Carlo simulation code was applied to investigate radiation attenuation of 13 shielding materials including: Ba, gray Sn, white Sn, Sb, Bi, Bi2O3, BaSO4, Sn/W, Sb/W, Pb and W with thicknesses of 0.5 and 1 mm to determine an optimum protective garment material in nuclear medicine against 99Tcm. Furthermore, the dose enhancement on the staff body was investigated for shielding materials such as tungsten and lead. RESULTS: The findings of the simulations show that the maximum and minimum attenuation obtained with thicknesses of 1 mm W and 1 mm BaSO4 were 96.46% and 14.2%, respectively. The results also demonstrate that tungsten does not cause any dose enhancement on staff body but this is not true for lead. Tungsten provides the highest radiation attenuation without dose enhancement on the body of staff. CONCLUSION: Among materials evaluated, tungsten is the optimum material and it can be applied for the design of protective garment for nuclear medicine staff against 99Tcm.

Preoperative diagnosis and surgical strategies of primary hyperparathyroidism / 中华内分泌外科杂志

Objective To investigate the preoperative localizaion diagnosis and surgical strategies of primary hyperparathyroidism (pHPT).Methods The clinical data of pHPT patients who underwent initial parathyroid surgery at the Peking Union Medical College Hospital from Jan.2009 to Apr.2017 were retrospectively analyzed to explore preoperative localization and surgical options.Results There were a total of 902 surgical cases included in the study with 674 women and 228 men.All had preoperative parathyroid ultrasonography (US) (sensitivity 97.18％,positive predictive value (PPV) 98.40％) and 99Tcm-sestamibi (MIBI) scan (sensitivity 94.24％,PPV 98.00％).The combination of US and MIBI scan had a sensitivity of 92.39％ and PPV of 97.37％.MIBI scan showed negative results in 51 cases.We found that male patients with cystic lesions were more likely related to negative MIBI scan (P＜0.05).Among 89 patients with negative MIBI and/or US,39 received neck CT,17 received positron emission tomography (PET)/CT,and 9 received ultrasound-guided biopsy for further localization.800 patients (88.69％) underwent minimally invasive parathyroid surgery (MIP) with anesthesia of cervical plexus block.656 patients (72.72％) had normal parathyroid hormone (PTH) level on the first post-operative day,140 patients (15.52％) had postoperative hypocalcaemia and 234 patients (25.94％) presented hypocalcaemic symptoms within 3 days after operation,which could be relieved by intravenous calcium or continuous medicine taken by mouth.During the follow-up of the 800 MIP patients,4 had recurrence and one patient was not cured.Conclusions Parathyroid US and MIBI scan are of good value in localizaion diagnosis.Neck CT or PET/CT should be used as supplementary approaches in patients with negative US and/or MIBI scan.MIP with anesthesia of cervical plexus block is simple and feasiable for pHPT cases with accurate localization.

Diagnostic efficacy of 99Tcm-sestamibi SPECT/CT for parathyroid lesions in patients with secondary hyperparathyroidism caused by chronic kidney disease / 中国医学影像技术

Objective To investigate the efficacy of SPECT/CT in detecting parathyroid lesions in chronic kidney disease (CKD) with secondary hyperparathyroidism (sHPT) patients.Methods Within 2 weeks before parathyroidectomy (PTX),52 patients of CKD with sHPT underwent 99Tcm-sestamibi (99Tcm-MIBI) dual-phase planar and delayed SPECT/CT scintigraphy.Taking surgical pathology as the golden standards,the sensitivity,specificity and accuracy of dual-phase planar,SPECT,CT and SPECT/CT were calculated and compared.Results Totally 172 lesions were detected in surgical operation,including 13 parathyroidomas (PM),26 adenomatoid hyperplasias (AH) and 133 diffuse parathyroid hyperplasias (PH).The sensitivity of 99Tcm-MIBI dual-phase planar,SPECT,CT and SPECT/CT was 55.81％ (96/172),70.35％ (121/172),79.65％ (137/172) and 81.40％ (140/172),respectively,while the specificity was 92.05％(81/88),90.91％ (80/88),76.14％ (67/88),93.18％ (82/88),the accuracy was 68.08％ (177/260),77.31％ (201/260),78.46％ (204/260) and 85.38％ (222/260),respectively.The sensitivity of SPECT/CT was superior to that of SPECT (x9 =17.053,P＜0.001) and 99Tcm-MIBI dual-phase planar (x2 =44.000,P＜0.001).SPECT/CT was superior to CT (x2 =10.316,P =0.001) for specificity,and superior to CT (x2 =13.136,P＜0.001),SPECT (x2 =14.815,P＜0.001) or 99Tcm-MIBI dual-phase planar (x2=39.706,P＜0.001) for accuracy.Conclusion SPECT/CT fusion imaging is better in localization of parathyroid lesions of CKD with sHPT patients than 99Tcm-MIBI dual-phase planar,SPECT or CT imaging alone.

Value of 99Tcm-MDP SPECT/CT in clinical decision-making for nasopharyngeal carcinoma and a comparison of the values of different imaging techniques for diagnosing skull-base bone invasion / 中华肿瘤杂志

Objective@#To analyze the clinical value of SPECT/CT in diagnosis of skull base bone invasion and clinical decision-making for nasopharyngeal carcinoma (NPC), and to compare their diagnostic value with SPECT/CT, CT, MRI, and MRI combined with SPECT (MRI-SPECT) for skull base bone invasion.@*Methods@#Before treatment, among 348 newly diagnosed NPC patients, CT scan was performed in 186 patients (group A) and the remaining 162 patients received MRI scan (group B). Clinical doctors then made clinical management decisions according to the CT or MRI results. After that, all patients underwent 99Tcm-MDP SPECT/CT examination for nasopharyngeal local tomography, and the results were provided to the clinical doctors to make clinical management decisions again. The changes between the two clinical management decisions were scored according to diagnosis, range of lesion, staging, treatment regimens, and auxiliary examination. The diagnostic value of CT scan, MRI scan, SPECT/CT and MRI-SPECT for skull base bone invasion was then evaluated and compared.@*Results@#In terms of changes in scores of clinical management decisions, the score of group A was 1.387 and group B was 0.951, showing a significant difference between the two groups by Wilcoxon test (Z=6.570, P<0.001). By χ2 test, there were correlations between CT and SPECT/CT (χ2 =98.495, P<0.001), and between MRI and SPECT/CT (χ2 =32.662, P<0.001). The consistency of CT and SPECT/CT (Kappa=0.713) was greater than MRI and SPECT (Kappa=0.449). The sensitivity of CT, MRI, SPECT/CT and MRI-SPECT was 67.1%, 84.5%, 90.8% and 100%, the specificity was 73.3%, 92.3%, 85.6% and 84.6%, and the area under the ROC curve was 0.702, 0.884, 0.882 and 0.923, respectively.@*Conclusions@#SPECT/CT has important impact on clinical management decision for NPC. In the judgement of skull base invasion, the diagnostic value of SPECT/CT is significantly higher than CT and approximately equal to MRI. SPECT/CT should be one of the routine examination methods of nasopharyngeal carcinoma. In addition, in view of its greater diagnostic value, MRI combined with SPECT should be the focus of future imaging studies.

Application of 99TCm tracer technique in rabbit cerebral thromboembolic stroke / 药物评价研究

Objective To study the application of 99Tcm in rabbit cerebral thromboembolic stroke and thrombolysis effect of recombinant tissue plasminogen activator (rt-PA).Methods The 0.5 mL radioactive pertechnetate sodium (specification:5 mCi/2mL and radiation intensity 92.5 MBq/mL) was combined with 30 μL stannous chloride (5 mg/mL),and the 20 μL mixture was joined to whole blood,red blood cells,and plasma for labelling.Then 50 μL CaCl2 (0.5 mol/L) and bovine thrombin (50 IU/mL) were doped in mixture,and rapidly sucked into a polyethylene plastic pipe (PE80).Thrombus was formed for 2 h at 37 ℃ and cut into small pieces of 10 mm.Autologous blood clots combined with 99Tcm from external carotid artery were injected to internal carotid artery of rabbit,the radioactivity (counts per minute,CPM) was measured by gamma counting instrument,and the improvement of rt-PA 4.5 mg/kg (clinical equivalent dose) on this model was observed.Results After thromboembolism,CPM increased approximately by (5.1 ± 1.3) times,which suggested that the model was reliable.The rt-PA 4.5 mg/kg had significant progressive thrombolysis effect.Conclusion 99Tcm tracer technology could be applied to rabbit cerebral stroke model,which is stable and reliable

The analysis of localization and diagnosing of radionuclide myocardial perfusion imaging for stable angina pectoris / 中国医学装备

Objective: To analyze the application value of radionuclide myocardial perfusion imaging in the localization and diagnosis for stable angina pectoris in clinical practice. Methods: A total of 70 patients who had been diagnosed with stable angina pectoris (SAP) were enrolled, and all patients underwent ATP-loaded ATP-99Tcm-MIBI (99Tcm-MIBI) myocardial perfusion imaging (MPI) and coronary angiography (CAG) were used to compare the accuracy of MPI imaging in localization and diagnosis for SAP. Results:In the 70 cases of patients with two methods of examination: ①In MPI diagnosis, positive patients were 50 cases, and the positive predictive value of SAP, sensitivity, negative predictive value and specificity were, respectively, 92.0%, 90.2%, 75.0% and 78.9%. There were 45 patients were consistently diagnosed as SAP by the two methods and the total compliance rate was 90.0%. ②in 70 patients, 51 cases were diagnosed as SAP by CAG examination, the positive rate was 72.9%; ③in 50 MPI positive patients, 46 patients were consistent with the results of CAG diagnosis, and the positive rate was 92.0%. The difference between the two methods was statistically significant (x2= 5.72, P<0.05). Conclusion: 99Tcm-MIBI myocardial perfusion imaging can be used as a gatekeeper in patients with stable angina pectoris, and has high application value in the location and diagnosis for stable angina pectoris. The diagnosis and treatment links of stable angina pectoris can save costs and provide a reliable evidencet for clinical practice.

Research of radiation dose rate around patients underwent renal dynamic imaging of SPECT with 99Tcm-DTPA / 中国医学装备

Objective:To study the radiation dose rate around patients underwent renal dynamic imaging of SPECT with 99Tcm-DTPA, so as to provide the basis for ensuring the radiation safety of the surrounding environment and the general public.Methods: 109 patients who underwent renal dynamic imaging were enrolled in this study, and the radiation dose rates of different time and different distance after 99Tcm-DTPA was injected patients were measured. And then, the changes of dose rate following time and distance were analyzed. Results: At the 0.5h, 1h, 2h, 3h, 6h, and 7h after radiopharmaceuticals were injected patients underwent renal dynamic imaging, the radiation dose rates were 0.76-8.86 μSv/h, 0.68-7.27 μSv/h, 0.57-4.52 μSv/h, 0.56-3.90 μSv/h, 0.23-2.07 μSv/h and 0.21-1.05 μSv/h, respectively, between 0.5 m and 4 m away from patients. At 24h after radiopharmaceuticals were injected, all of radiation dose rates at different distances around patients were same with background values.Conclusion: The radiation dose rates around patients underwent renal dynamic imaging will rapidly decrease with the increasing of time and distance. At 24h after radiopharmaceuticals were injected, all of radiation dose rates at different distances away from patients were same with background values.

99Tcm-MIBI Gated Myocardial Perfusion Imaging in Evaluating Coronary Microangiopathy in Patients with Diabetic Mellitus / 中国医学影像学杂志

Purpose To evaluate the clinical guiding value of 99Tcm-methoxyisobutylisonitrile gated myocardial perfusion imaging (99Tcm-MIBI G-MPI) in diagnosing the coronary microangiopathy in patients with diabetic mellitus.Materials and Methods Sixty patients with clinical confirmed coronary microvascular angina were selected and assigned into two groups,with 26 patients (with diabetes mellitus) in group A and 34 patients in group B (without diabetes mellitus).The region,extent and range of coronary microangiopathy was detected by 99Tcm-MIBI G-MPI,and the difference of myocardial ischemia between the two groups was statistically analyzed.Results The ratio of abnormal myocardial perfusion in group A was significantly higher than that in group B (96.15％ vs.73.53％,x2=5.43,P＜0.05);the total number of abnormal coronary branches in group A was significantly larger than that in group B (82.67％ vs.62.67％,P＜0.05);the total number abnormal perfusion segments in group A was significantly larger than that in group B (P＜0.05),and the abnormal perfusion segments number of anterior wall,septum,apical region and inferior wall in group A was significantly larger than that ingroup B (P＜0.05);the rate of abnormal perfusion at single coronary supplying region in group A was significantly lower than that in group B (P＜0.05).Conclusion 99Tcm-MIBI G-MPI is of great clinical significance for diagnosing coronary microangiopathy and evaluating myocardial ischemia in patients with diabetes mellitus.

The diagnostic value of 99TcM-2-(2-methyl-5-nitro-1H-imidazol-1-yl) ethyl dihydrogen phosphate hypoxia imaging and its evaluation performance for radiotherapy efficacy in non-small-cell lung cancer.

BACKGROUND AND AIM: This study was designated to assess the diagnostic value of 99TcM-2-(2-methyl-5-nitro-1H-imidazol-1-yl) ethyl dihydrogen phosphate (99TcM-MNLS) hypoxia imaging and its evaluation performance for radiotherapy efficacy in patients with non-small-cell lung cancer (NSCLC). PATIENTS AND METHODS: A total of 61 patients with NSCLC were selected for this study. All patients were injected with 99TcM-MNLS within 1 week prior to radiotherapy and they were injected with 99TcM-MNLS again 3 months after radiotherapy. Qualitative analysis along with semiquantitative analysis results were obtained from hypoxia imaging. Meanwhile, the effect of radiotherapy on patients with NSCLC was evaluated based on the solid tumor curative effect evaluation standard. Finally, SPSS 19.0 statistical software was implemented for statistical analysis. RESULTS: There was no significant difference in age or sex between the NSCLC patient group and benign patient group (P>0.05). 99TcM-MNLS was selectively concentrated in tumor tissues with a clear imaging in 24 hours. Results from both qualitative analysis and semiquantitative analysis indicated that the sensitivity and specificity of 99TcM-MNLS hypoxia imaging in diagnosing NSCLC were 93.8% and 84.6% and 72.9% and 100%, respectively. Moreover, the receiver operating characteristic curve provided evidence that 99TcM-MNLS hypoxia imaging was a powerful diagnostic tool in distinguishing malignant lung cancer from benign lesions. As suggested by 24-hour imaging, the tumor-to-normal ratio of patients in the 99TcM-MNLS high-intake group and low-intake group had a decline of 24.7% and 14.4% after radiotherapy, respectively. The decline in the tumor-to-normal ratio between the two dosage groups was significantly different (P<0.05). CONCLUSION: 99TcM-MNLS hypoxia imaging had reliable values in both diagnosing NSCLC and evaluating therapeutic effects of radiotherapy on patients with NSCLC.

A preliminary study on the bone-targeting potential of a new type of bisphosphonate in rabbits / 中国药学杂志

OBJECTIVE: To study the bone-targeting potential and dynamic changing process in vivo of a new type of anti-osteoporosis bisphosphonate drug under research (SC). METHODS: The distribution in rabbits and bone-targeting of SC was observed by isotope tracer technique. 99Tcm-SC was injected into the rabbits, then the SPECT images were collected and analyzed in 12 h. RESULTS: The labeling rate of 99Tcm-SC could be maintained above 90% within 12 h, which proved the good stability of 99Tcm-SC in vitro. The rabbit bone imaging showed that the targeting of SC to bone was equivalent to MDP, a bone imaging agent. CONCLUSION: This study provides valuable data for the non-clinical and clinical studies of SC. SC has a good potential for being developed into a new generation of anti-osteoporosis drug.

Different diagnostic efficacy of solitary pulmonary nodules in 99 Tcm-MIBI SPECT/CT varient background selected / 西安交通大学学报(医学版)

Objective To assess the diagnostic accuracy of solitary pulmonary nodules while selecting different backgrounds in 99 Tcm‐MIBI SPECT/CT examination .Methods Totally 38 suspected solitary pulmonary nodules (SPN) were analyzed retrospectively .The lesions were divided into malignant group and benign group according to the pathological findings . We selected two different backgrounds , contralateral lung field ( DL ) and the contralateral soft tissue (NST) .The maximum counts and the mean counts of lesion to non‐lesion ratio (L/N) were calculated to evaluate diagnostic efficacy using ROC curve . The relationship between lesion size , pathological grading and L/N ratio was analyzed by Spearman correlation analysis . Results With DL and NST as the backgrounds ,the maximum counts and the mean counts of L/N between benign and malignant groups both differed significantly (all P0 .05) .The size and pathological grading of SPN did not affect 99 Tcm‐MIBI accumulation in the SPN (all P>0 .05) .Conclusion DL and NST both can be used as the background in diagnosis of pulmonary nodules on 99 Tcm‐MIBI SPECT/CT examination .The mean counts of the contralateral tissue used as the background can provide a stable result and a high diagnostic accuracy to assess the SPN .

Value of 99Tcm-MIBI tomography and registration with integrated CT in preoperative localization and diagnosis of secondary hyperparathyroidism / 中华内分泌外科杂志

Objective To evaluate the value of technetium-99m methoxy isobutyl isonitrile (99Tcm-MIBI)tomography and integrated CT in preoperative localization diagnosis of secondary hyperparathyroidism (SHPT).Methods 28 patients with SHPT were selected.15 minutes and 90 minutes (delayed images)after intravenous administration of 99Tcm-MIBI 370 MBq,static anterior planar images of the neck and chest were obtained.99Tcm-MIBI tomography and integrated CT scan were acquired after the delayed imaging.The imaging findings were compared to the pathological results.Results The detection rate of SHPT lesions by 99Tcm-MIBI dua-phase imaging and 99Tcm-MIBI tomography and registration with integrated CT scan was 53.3％ and 70.7％ respectively.The difference had statistical significance(X2 =5.903,P＜0.05).The fusion imaging with integrated CT can provide detailed anatomy data and more information for surgical doctors.Conclusion 99Tcm-MIBI tomography and registration with integrated CT scan can improve the detection rate of SHPT compared with 99Tcm-MIBI dua-phase imaging,provide more detailed anatomy data,and has high clinical value in preoperative localization and diagnosis of SHPT.

Clinical analysis of primary hyperparathyroidism: 35 cases / 中华内分泌外科杂志

Objective To summarize the clinical characters,diagnosis and surgical treatment of primary hyperparathyoidism (PHPT).Methods The diagnosis,treatment and efficacy of 35 cases of PHPT were retrospectively reviewed.Results PHPT presented a variety of clinical manifestations,and occoured to different age groups without significant gender differences.All the 35 cases had elevated blood calcium and PTH.All patients underwent preoperative ultrasonography and 99Tcm-MIB imaging,and the positive rates were 68.6％ and 97.1％ respectively.34 patients received surgical treatment,among whom 30 cases had parathyroid adenoma,1 case had parathyroid hyperplasia and 3 cases had parathyroid carcinoma.Through operation,31 cases were cured,2 cases improved,and 1 case of parathyroid carcinoma suffered from lung metastasls.Conclusions PHPT can be diagnosed according to co-elevated serum calcium and PTH.Ultrasonography combined with 99Tcm-MIB imaging should be recommend for preoperative localization.The main cause of PHPT is solitary parathyroid adenoma.PTPT can be cured by surgery.Minimally invasive parathyroidectomy with accurate location is an efficient surgical strategy,and the prognosis is favorable.