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Differentiation of brain and pulmonary masses with 18F-FDG PET/CT: comparison of two cases 18F-FDG PET/CT对脑、肺肿物的鉴别:两例比较
Pub Date : 2020-04-25 DOI: 10.3760/CMA.J.CN321828-20200313-00101
Hongping Shi, Yaping Luo
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引用次数: 0
131I treatment of hyperthyroidism with hepatolenticular degeneration: a case report 甲状腺机能亢进伴肝豆状核变性1例
Pub Date : 2020-04-25 DOI: 10.3760/CMA.J.CN321828-20190725-00143
Hongming Zheng
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引用次数: 0
Value of visual analysis and SUVR during 18F-AV45 PET/CT imaging in the diagnosis of mild cognitive impairment and Alzheimer′s disease 18F-AV45 PET/CT影像视觉分析和SUVR在轻度认知障碍和阿尔茨海默病诊断中的价值
Pub Date : 2020-04-25 DOI: 10.3760/CMA.J.CN321828-20200225-00067
Chenpeng Zhang, Cheng Wang, Mei Xin, Qian Xia, L. Wan, Junwei Qiu, Qun Xu, Ling Yue, S. Xiao, Jianju Liu
Objective To evaluate the value of visual analysis and standardized uptake value ratio (SUVR) during 18F-florbetapir (AV45) PET/CT brain imaging in diagnosis of β-amyloid (Aβ) deposition in patients with mild cognitive impairment (MCI) and Alzheimer′s disease (AD), and to explore the clinical ancillary value of the two indexes. Methods From December 2018 to July 2019, a total of 47 subjects, including 5 (3 males, 2 females, age (58±13) years) normal controls (NC), 8 (2 males, 6 females, age (66±10) years) patients with AD and 34 (16 males, 18 females, age (70±7) years) patients with MCI were enrolled. All subjects underwent 18F-AV45 PET/CT scan. All images were evaluated by visual analysis and SUVR were calculated. The diagnostic efficiencies of visual analysis and SUVR were compared by McNemar test and Kappa test. One-way analysis of variance and Welch test were used to compare data differences. The best threshold value of SUVR was obtained by receiver operating characteristic (ROC) curve analysis. Results The positive rate of Aβ deposition for all subjects was 46.81%(22/47) by SUVR analysis, and 38.30%(18/47) by visual analysis. There was no significant difference between the two methods (χ2=33.15, P>0.05), and the consistency was good (Kappa=0.83). Considering the clinical diagnosis as the"gold standard", the Aβ deposition obtained by visual analysis and SUVR analysis can effectively distinguish AD from NC, and the sensitivities were 7/8 vs 8/8, respectively, both specificities were 5/5(χ2=9.48, P>0.05), with good consistency (Kappa=0.84). SUVR quantitative analysis could distinguish AD from NC, AD from MCI (F values: 3.99-8.79, all P 0.05). ROC curve analysis showed that the best threshold value of precuneus′ SUVR was 1.08 for the differential diagnosis of AD and NC; for the differential diagnosis of AD and MCI, the best threshold value of lateral temporal′s SUVR was 1.06. Conclusion Visual analysis was consistent with SUVR′s qualitative determination during 18F-AV45 PET/CT imaging for brain Aβ deposition, while SUVR quantitative analysis could assist in the differential diagnosis of AD and NC, AD and MCI. Key words: Alzheimer Disease; Cognition disorders; Amyloidogenic proteins; Positron-emission tomography; Tomography, X-ray computed
目的评价18F-florbetapir (AV45) PET/CT脑成像中视觉分析和标准化摄取值比(SUVR)对轻度认知障碍(MCI)和阿尔茨海默病(AD)患者β-淀粉样蛋白(Aβ)沉积的诊断价值,并探讨这两项指标的临床辅助价值。方法2018年12月至2019年7月共纳入47例受试者,其中正常对照(NC) 5例(3男2女,年龄(58±13)岁;AD患者8例(2男6女,年龄(66±10)岁;MCI患者34例(16男18女,年龄(70±7)岁。所有受试者均行18F-AV45 PET/CT扫描。通过视觉分析对所有图像进行评价,并计算SUVR。采用McNemar检验和Kappa检验比较视觉分析和SUVR的诊断效率。采用单因素方差分析和Welch检验比较数据差异。通过受试者工作特征(ROC)曲线分析获得SUVR的最佳阈值。结果所有受试者血清Aβ沉积阳性率分别为46.81%(22/47)和38.30%(18/47)。两种方法的结果差异无统计学意义(χ2=33.15, P < 0.05),一致性较好(Kappa=0.83)。以临床诊断为“金标准”,视觉分析和SUVR分析获得的Aβ沉积可有效区分AD和NC,敏感性分别为7/8和8/8,特异性均为5/5(χ2=9.48, P>0.05),一致性较好(Kappa=0.84)。SUVR定量分析可区分AD与NC、AD与MCI (F值:3.99 ~ 8.79,P均为0.05)。ROC曲线分析显示,楔前叶SUVR鉴别AD与NC的最佳阈值为1.08;对于AD和MCI的鉴别诊断,颞外侧SUVR的最佳阈值为1.06。结论在18F-AV45 PET/CT成像中,视觉分析与SUVR对脑Aβ沉积的定性判断一致,而SUVR定量分析有助于AD与NC、AD与MCI的鉴别诊断。关键词:阿尔茨海默病;认知障碍;Amyloidogenic蛋白质;正电子发射断层扫描;x线计算机断层扫描
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引用次数: 0
Study of statistical parametric mapping aided semi-quantitative analysis of 11C-PIB PET imaging acquired by hybrid PET/MR and its clinical application PET/MR混合成像11C-PIB PET影像的统计参数映射辅助半定量分析及其临床应用研究
Pub Date : 2020-04-25 DOI: 10.3760/CMA.J.CN321828-20200211-00040
Xun Sun, W. Ruan, Xiaojuan Huang, Fang Liu, Xuehan Hu, Yongkang Gai, Qingyao Liu, X. Lan
Objective To explore the feasibility of statistical parametric mapping (SPM) aided semi-quantitative analysis in 11C-Pittsburgh compound B (PIB) β-amyloid (Aβ) PET imaging acquired by hybrid PET/MR, and evaluate its possibility in assisting the diagnosis or differential diagnosis for cognitive impairment. Methods From January 2018 to September 2019, 13 Alzheimer′s disease (AD) patients (4 males, 9 females; age (59.2±5.8) years) and 10 vascular cognitive disorders (VCD) patients (9 males, 1 female; age (59.5±11.5) years) who underwent 11C-PIB PET/MR in PET center of Union Hospital, Tongji Medical College, Huazhong University of Science and Technology were retrospectively analyzed. The standardized uptake value ratio (SUVR) of eight key brain regions (cerebral white matter, striatum, thalamus, posterior cingulate gyrus, frontal cortex, posterior parietal cortex, lateral temporal cortex and occipital cortex) to cerebellum cortex were obtained by manual delineation and SPM-aided semi-automatic segmentation with the help of synchronous three-dimensional T1 weighted imaging (3D T1WI). Pearson correlation analysis was carried out on the SUVR obtained by the two methods. Independent-sample t test and paired t test were used to analyze the data. Results There was no significant difference between AD group and VCD group in age and Mini-Mental State Examination (MMSE) score (19.7±4.7 vs 21.7±3.8; t values: 0.095 and 1.098, both P>0.05). Except thalamus(r=0.179, P=0.413), there were good correlations between SUVR obtained by segmentation and delineation in the other 7 key regions (r values: 0.678-0.893, all P<0.05). The SUVR of 8 key regions obtained by the two methods in AD group was significantly higher than that in VCD group (1.519-2.055 vs 1.105-1.618; t values: 2.799-11.582, all P<0.01). The SUVR of striatum (1.942±0.205), posterior cingulate gyrus (1.915±0.249), frontal lobe (1.983±0.264), parietal lobe (2.008±0.296) and temporal cortex (1.931±0.254) in AD group was significantly higher than that of cerebral white matter (1.746±0.192; t values: 3.793-6.992, all P<0.01). But in VCD group, there was no region with the SUVR higher than that of cerebral white matter. Conclusions Hybrid PET/MR can acquire the PET and MRI images synchronously, which can realize the accurate brain segmentation and obtain the semi-quantitative data of key brain regions aided by SPM. The method can analyze the characteristics and differences of amyloid imaging in AD and VCD, which is expected to provide an accurate imaging analysis method for the diagnosis and differential diagnosis of cognitive disorders. Key words: Alzheimer disease; Cognition disorders; Amyloid; Positron-emission tomography; Magnetic resonance imaging
目的探讨统计参数定位(SPM)辅助半定量分析PET/MR混合成像11C-Pittsburgh compound B (PIB) β-amyloid (Aβ) PET图像的可行性,并评价其辅助诊断或鉴别诊断认知功能障碍的可能性。方法2018年1月~ 2019年9月对13例阿尔茨海默病(AD)患者(男4例,女9例;年龄(59.2±5.8)岁),血管性认知障碍(VCD)患者10例(男9例,女1例;回顾性分析华中科技大学同济医学院协和医院PET中心11C-PIB PET/MR患者的年龄(59.5±11.5)岁。在同步三维T1加权成像(3D T1WI)的帮助下,通过人工圈定和spm辅助半自动分割,获得脑白质、纹状体、丘脑、扣带回后区、额叶皮层、后顶叶皮层、外侧颞叶皮层和枕叶皮层8个关键脑区与小脑皮层的标准化摄取值比(SUVR)。对两种方法得到的SUVR进行Pearson相关分析。采用独立样本t检验和配对t检验对数据进行分析。结果AD组与VCD组在年龄、MMSE评分(19.7±4.7 vs 21.7±3.8)上无显著差异;t值分别为0.095和1.098,P值均为0.05)。除丘脑(r=0.179, P=0.413)外,其他7个关键区域的分割所得SUVR与圈定结果均有较好的相关性(r值为0.678 ~ 0.893,均P<0.05)。两种方法获得的8个关键区域的SUVR, AD组显著高于VCD组(1.519-2.055 vs 1.105-1.618;t值:2.799 ~ 11.582,P均<0.01)。AD组纹状体(1.942±0.205)、扣带回后回(1.915±0.249)、额叶(1.983±0.264)、顶叶(2.008±0.296)、颞叶(1.931±0.254)的SUVR显著高于脑白质(1.746±0.192);t值:3.793 ~ 6.992,P均<0.01)。而在VCD组,没有任何区域的SUVR高于脑白质。结论PET/MR混合成像可同步获取PET和MRI图像,可在SPM辅助下实现准确的脑区分割,获得脑关键区域的半定量数据。该方法可分析AD与VCD的淀粉样蛋白影像学特征及差异,有望为认知障碍的诊断和鉴别诊断提供准确的影像学分析方法。关键词:阿尔茨海默病;认知障碍;淀粉样蛋白;正电子发射断层扫描;磁共振成像
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引用次数: 0
Mid-long-term prognostic value of preoperative 18F-FDG PET/CT imaging on patients with resectable non-small cell lung cancer 术前18F-FDG PET/CT显像对可切除非小细胞肺癌癌症患者的中期预后价值
Pub Date : 2020-04-25 DOI: 10.3760/CMA.J.CN321828-20190801-00156
Xuetao Chen, Yuyi Zhang, Z. Yao, S. Luo, Congxia Chen, Xu Li
Objective To investigate the role of preoperative 18F-fluorodeoxyglucose (FDG) PET/CT imaging in mid-long-term prognosis of patients with resectable non-small cell lung cancer (NSCLC). Methods Seventy resectable NSCLC patients (35 males, 35 females, median age 64 years) in Beijing Hospital between April 2010 and August 2016 were enrolled into this retrospectively study. All patients underwent 18F-FDG PET/CT imaging followed by pulmonary resection with mediastinal or hilar lymph nodes dissection within 1 month. The findings of PET/CT imaging including characteristics of primary lesions and mediastinal or hilar lymph nodes (size and maximum standardized uptake value (SUVmax) of primary lesion, SUVmax and distribution of high metabolic lymph nodes (HML)) were analyzed, and patients were followed up. Survival outcome indicators were defined as overall survival (OS) and progression-free survival (PFS). Survival analysis was conducted by Kaplan-Meier method, log-rank method and Cox proportional hazard models to assess the predictive factors. Results Patients were followed up for 0.9-8.2 years. Among 70 patients, 31.4% (22/70) had disease progression and 24.3% (17/70) died. As for OS, there were significantly differences between patients with SUVmax of primary lesion≥10 and 3 cm and ≤3 cm (4.8 vs 7.4 years), with unilateral mediastinal or hilar HML and bilateral sides or without HML (4.4 vs 7.4 years), with SUVmax of mediastinal or hilar lymph nodes ≥5.0 and <5.0 (3.8 vs 7.3 years) (χ2 values: 10.135-15.238, all P<0.01), as well as PFS (3.9 vs 6.7, 3.8 vs 6.6, 3.8 vs 6.4, 3.3 vs 6.3 years; χ2 values: 8.410-14.600, all P<0.01). Cox multivariate analysis demonstrated that the size and SUVmax of primary lesion were independent predictive factors of OS and PFS (all P<0.01). Moreover, the distribution of mediastinal or hilar HML had marginal significance in predicting OS (P=0.051). Conclusions Size and SUVmax of primary lesion in preoperative 18F-FDG PET/CT imaging are predictive factors for the survival of postoperative NSCLC. The distribution of the mediastinal or hilar HML may have significance for the survival prediction of postoperative NSCLC. Key words: Carcinoma, non-small-cell lung; Positron-emission tomography; Tomography, X-ray computed; Deoxyglucose; Prognosis
目的探讨术前18f -氟脱氧葡萄糖(FDG) PET/CT成像对可切除非小细胞肺癌(NSCLC)患者中长期预后的影响。方法对2010年4月至2016年8月北京医院收治的70例可切除的非小细胞肺癌患者(男35例,女35例,中位年龄64岁)进行回顾性研究。所有患者均在1个月内行18F-FDG PET/CT显像,并行肺切除术合并纵隔或肺门淋巴结清扫。分析PET/CT影像学表现,包括原发病灶及纵隔或肺门淋巴结特征(原发病灶大小及最大标准化摄取值(SUVmax)、SUVmax及高代谢淋巴结分布(HML)),并对患者进行随访。生存结局指标定义为总生存期(OS)和无进展生存期(PFS)。生存率分析采用Kaplan-Meier法、log-rank法和Cox比例风险模型评估预测因素。结果随访时间为0.9 ~ 8.2年。70例患者中,31.4%(22/70)出现疾病进展,24.3%(17/70)死亡。在OS方面,原发病变SUVmax≥10、3cm和≤3cm的患者(4.8 vs 7.4年)、单侧纵隔或肺门HML、双侧或无HML的患者(4.4 vs 7.4年)、纵隔或肺门淋巴结SUVmax≥5.0和<5.0 (3.8 vs 7.3年)的患者(χ2值:10.13.5 ~ 15.238,均P<0.01)以及PFS (3.9 vs 6.7、3.8 vs 6.6、3.8 vs 6.4、3.3 vs 6.3年;χ2值:8.410 ~ 14.600,P均<0.01)。Cox多因素分析显示,原发病变大小和SUVmax是OS和PFS的独立预测因素(均P<0.01)。此外,纵隔或肺门HML分布对预测OS有边际意义(P=0.051)。结论术前18F-FDG PET/CT原发病灶大小和SUVmax是影响术后NSCLC生存的预测因素。纵隔或肺门HML的分布可能对术后NSCLC的生存预测有重要意义。关键词:肺癌,非小细胞肺;正电子发射断层扫描;断层扫描,x射线计算机;脱氧葡萄糖;预后
{"title":"Mid-long-term prognostic value of preoperative 18F-FDG PET/CT imaging on patients with resectable non-small cell lung cancer","authors":"Xuetao Chen, Yuyi Zhang, Z. Yao, S. Luo, Congxia Chen, Xu Li","doi":"10.3760/CMA.J.CN321828-20190801-00156","DOIUrl":"https://doi.org/10.3760/CMA.J.CN321828-20190801-00156","url":null,"abstract":"Objective \u0000To investigate the role of preoperative 18F-fluorodeoxyglucose (FDG) PET/CT imaging in mid-long-term prognosis of patients with resectable non-small cell lung cancer (NSCLC). \u0000 \u0000 \u0000Methods \u0000Seventy resectable NSCLC patients (35 males, 35 females, median age 64 years) in Beijing Hospital between April 2010 and August 2016 were enrolled into this retrospectively study. All patients underwent 18F-FDG PET/CT imaging followed by pulmonary resection with mediastinal or hilar lymph nodes dissection within 1 month. The findings of PET/CT imaging including characteristics of primary lesions and mediastinal or hilar lymph nodes (size and maximum standardized uptake value (SUVmax) of primary lesion, SUVmax and distribution of high metabolic lymph nodes (HML)) were analyzed, and patients were followed up. Survival outcome indicators were defined as overall survival (OS) and progression-free survival (PFS). Survival analysis was conducted by Kaplan-Meier method, log-rank method and Cox proportional hazard models to assess the predictive factors. \u0000 \u0000 \u0000Results \u0000Patients were followed up for 0.9-8.2 years. Among 70 patients, 31.4% (22/70) had disease progression and 24.3% (17/70) died. As for OS, there were significantly differences between patients with SUVmax of primary lesion≥10 and 3 cm and ≤3 cm (4.8 vs 7.4 years), with unilateral mediastinal or hilar HML and bilateral sides or without HML (4.4 vs 7.4 years), with SUVmax of mediastinal or hilar lymph nodes ≥5.0 and <5.0 (3.8 vs 7.3 years) (χ2 values: 10.135-15.238, all P<0.01), as well as PFS (3.9 vs 6.7, 3.8 vs 6.6, 3.8 vs 6.4, 3.3 vs 6.3 years; χ2 values: 8.410-14.600, all P<0.01). Cox multivariate analysis demonstrated that the size and SUVmax of primary lesion were independent predictive factors of OS and PFS (all P<0.01). Moreover, the distribution of mediastinal or hilar HML had marginal significance in predicting OS (P=0.051). \u0000 \u0000 \u0000Conclusions \u0000Size and SUVmax of primary lesion in preoperative 18F-FDG PET/CT imaging are predictive factors for the survival of postoperative NSCLC. The distribution of the mediastinal or hilar HML may have significance for the survival prediction of postoperative NSCLC. \u0000 \u0000 \u0000Key words: \u0000Carcinoma, non-small-cell lung; Positron-emission tomography; Tomography, X-ray computed; Deoxyglucose; Prognosis","PeriodicalId":10099,"journal":{"name":"Chinese Journal of Nuclear Medicine and Molecular Imaging","volume":"40 1","pages":"219-223"},"PeriodicalIF":0.0,"publicationDate":"2020-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46820034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Application of PSMA ligands PET imaging in the diagnosis and treatment of non-prostate tumors PSMA配体PET显像在非前列腺肿瘤诊断和治疗中的应用
Pub Date : 2020-04-25 DOI: 10.3760/CMA.J.CN321828-20190722-00137
Guanyun Wang, Peng Yu, Jing Ning, Baixuan Xu
Prostate specific membrane antigen (PSMA) is a hot topic in molecular imaging research of prostate cancer. However, non-prostate related PSMA can also be expressed in physiological tissues and different benign and malignant diseases, especially in tumor-associated endovascular endothelial cells. Related clinical studies have demonstrated the staging potential of PSMA ligands PET imaging in non-prostate tumors. This article summarizes the application of PSMA ligands PET imaging in the diagnosis and treatment of non-prostate tumors. Key words: Prostate-specific membrane antigen; Positron-emission tomography; Trends
前列腺特异性膜抗原(PSMA)是癌症分子影像学研究的热点。然而,非前列腺相关的PSMA也可以在生理组织和不同的良性和恶性疾病中表达,尤其是在肿瘤相关的血管内内皮细胞中。相关临床研究已经证明PSMA配体PET成像在非前列腺肿瘤中的分期潜力。本文综述了PSMA配体PET显像在非前列腺肿瘤诊断和治疗中的应用。关键词:前列腺特异性膜抗原;正电子发射断层扫描;趋势
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引用次数: 0
Effects of different reconstruction algorithms on SUV of pulmonary nodules in 18F-FDG PET/CT 不同重建算法对18F-FDG PET/CT肺结节SUV的影响
Pub Date : 2020-04-25 DOI: 10.3760/CMA.J.CN321828-20191122-00266
Bin Zhao, Binwei Guo, Bin Huang, M. Liang, ZhiXing Qin, X. Hao, Sijin Li, Zhifang Wu
Objective To compare four reconstruction algorithms of 18F-fluorodeoxyglucose (FDG) PET/CT on standardized uptake value (SUV) of pulmonary nodules. Methods A total of 46 patients (27 males, 19 females; median age: 66 (range: 44-82) years) with solid pulmonary nodules from February 2018 to July 2019 in the First Hospital of Shanxi Medical University who performed 18F-FDG PET/CT imaging were enrolled. All PET/CT images were retrospectively reconstructed by using four algorithms reconstructions including ordered subset expectation maximization (OSEM), OSEM+ time of flight (TOF), OSEM+ TOF+ point spread function (PSF) and block sequential regularized expectation maximization (BSREM) (G1-G4). Nodule and background parameters were analyzed semi-quantitatively and visually. The maximum of SUV(SUVmax), mean of SUV(SUVmean) and peak of SUV (SUVpeak) were collected by the region of interest (ROI). Nodules were divided into small nodule group (diameter ≤10 mm) and large nodule group (10 mm < diameter ≤30 mm). Kruskal-Wallis rank sum test and Bonferroni method were performed to compare the differences of SUVs between G1-G4, and Spearman correlation analysis was used to analyze the correlation between the change rate of SUV (%ΔSUV) and the diameter of nodules. The receiver operating characteristic (ROC) curve analysis was used to analyze the diagnostic efficacy of SUV for the differential diagnosis of pulmonary nodules and to get the optimal threshold. Results There were 114 pulmonary nodules (large nodules, n=55; small nodules, n=59). In visual analysis, the visual detection rates of small nodules in G4 were 55.93%(33/59), 44.07%(26/59), 20.34%(12/59) higher than those in G1-G3. Of 114 pulmonary nodules in 46 patients, there were differences in SUVmax and SUVmean between G1-G4 (median SUVmax : 2.65-5.29, median SUVmean: 2.05-2.99; H values: 20.628 and 17.749, respectively, both P 0.05). The optimal threshold values of SUVmax in G1-G4 were 4.335, 5.185, 5.410, 5.745 and the area of under curves (AUCs) were 0.747, 0.699, 0.756, 0.778 respectively. The AUC of SUVmean and SUVpeak also showed a similar trend. Conclusion Among the four reconstruction algorithms, BRERM can not only enhance the image quality, but also significantly improve the SUVmax and SUVmean of lung nodules diameter below 10 mm, and thus its diagnostic threshold of SUV should be appropriately increased. Key words: Lung neoplasms; Positron-emission tomography; Tomography, X-ray computed; Image processing, computer-assisted; Deoxyglucose
目的比较4种18f -氟脱氧葡萄糖(FDG) PET/CT对肺结节标准化摄取值(SUV)的重建算法。方法共46例患者,其中男27例,女19例;纳入2018年2月至2019年7月在山西医科大学第一医院行18F-FDG PET/CT成像的实性肺结节患者,中位年龄:66岁(范围:44-82岁)。采用有序子集期望最大化(OSEM)、OSEM+飞行时间(TOF)、OSEM+ TOF+点扩散函数(PSF)和块顺序正则化期望最大化(BSREM) (G1-G4) 4种算法对所有PET/CT图像进行回顾性重构。对结节和背景参数进行半定量和可视化分析。通过感兴趣区域(ROI)收集SUV的最大值(SUVmax)、平均值(SUVmean)和峰值(SUVpeak)。将结节分为小结节组(直径≤10 mm)和大结节组(直径≤10 mm)。采用Kruskal-Wallis秩和检验和Bonferroni法比较G1-G4间SUV的差异,采用Spearman相关分析分析SUV变化率(%ΔSUV)与结节直径的相关性。采用受试者工作特征(ROC)曲线分析SUV对肺结节鉴别诊断的诊断效果,得出最佳阈值。结果114例肺结节(大结节55例;小结节,n=59)。视觉分析中,G4小结节的视觉检出率分别比G1-G3高55.93%(33/59)、44.07%(26/59)、20.34%(12/59)。46例肺结节114例,G1-G4间SUVmax和SUVmean有差异(中位SUVmax: 2.65-5.29,中位SUVmean: 2.05-2.99;H值分别为20.628和17.749,P均为0.05)。g1 ~ g4的SUVmax最优阈值分别为4.335、5.185、5.410、5.745,下曲线面积(aus)分别为0.747、0.699、0.756、0.778。SUVmean和SUVpeak的AUC也呈现出类似的趋势。结论在四种重建算法中,BRERM不仅能增强图像质量,而且能显著提高直径小于10 mm肺结节的SUVmax和SUVmean,应适当提高其对SUV的诊断阈值。关键词:肺肿瘤;正电子发射断层扫描;断层扫描,x射线计算机;图像处理,计算机辅助;脱氧葡萄糖
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引用次数: 0
Development of 177Lu-EB-RGD molecular probe and its imaging and therapy in the patient-derived xenografts of non-small cell lung cancer 177Lu-EB-RGD分子探针的研制及其在非小细胞肺癌患者源性异种移植中的显像和治疗
Pub Date : 2020-04-25 DOI: 10.3760/CMA.J.CN321828-20190626-00118
Kaili Fu, Liang Zhao, Zhide Guo, Xuejun Wen, Lanlin Yao, Xianzhong Zhang, Xiaoyuan Chen, Q. Lin, Hua Wu, Haojun Chen
Objective To develop a novel αvβ3-targeted theranostic agent 177Lu-Evans blue (EB)-Arg-Gly-Asp (RGD) and evaluate its value for SPECT imaging and targeted radionuclide therapy in the non-small cell lung cancer (NSCLC)-patient-derived xenografts (PDX). Methods The αvβ3-targeted molecule RGD was conjugated with the albumin binding moiety EB to obtain EB-RGD, and EB-RGD was further conjugated with the chelator 1, 4, 7, 10-tetraazacyclododecane-1, 4, 7, 10-tetraacetic acid (DOTA) for 177Lu radiolabeling. NSCLC-PDX mice models (n=68) were established. 177Lu-EB-RGD SPECT imaging, biodistribution study were performed in 28 PDX mice models after being injected with 177Lu-EB-RGD or 177Lu-RGD. Targeted radionuclide therapy were subsequently performed in NSCLC-PDX mice models, saline group (group A), 18.5 MBq 177Lu-RGD group (group B), 18.5 MBq 177Lu-EB-RGD group (group C), 29.6 MBq 177Lu-EB-RGD group (group D), n=10 in each group; tumor volumes of PDX mice models in each group were observed within 50 d. Differences between 2 groups were compared using independent-sample t test. Results 177Lu-EB-RGD was radiolabeled at a specific activity of (55±14) GBq/μmol, with a radiochemical yield of more than 95% and a radiochemical purity of more than 95%. Regarding the SPECT imaging, tumors in NSCLC-PDX mice were clearly observed from 4 to 96 h post-injection and the tumor to muscle ratio (T/M) reached 7.34±0.67, 14.63±3.82, 15.69±3.58 and 15.99±5.42 at 4, 24, 72, 96 h post-injection, respectively. Biodistribution study further confirmed the findings from SPECT imaging, and the tumor uptake of 177Lu-EB-RGD were markedly increased compared to 177Lu-RGD 4 h post-injection ((10.15±1.17) vs (3.30±1.47) percent injection dose per gram (%ID/g); t=18.60, P<0.05). Regarding targeted radiotherapy, the tumor volumes were quickly increased within 50 d after treatment in group A and B, while the tumor volumes were decreased in group C and D, until the tumors in group C and D disappeared at the 28th day after initial treatment with no sign of recurrence during the observation period. Conclusions 177Lu-EB-RGD can target αvβ3-positive NSCLC-PDX with intense tumor to background ratio and strong tumor inhibition efficacy. The preclinical data suggests that 177Lu-EB-RGD may be an effective new treatment option for advanced NSCLC patients with resistance or ineffective results for targeted therapy. Key words: Carcinoma, non-small-cell lung; Xenograft model antitumor assays; Evans blue; Arginine-glycine-aspartic acid; Lutetium; Mice, nude
目的研制新型αvβ3靶向治疗药物177Lu-Evans blue (EB)- arg - gy - asp (RGD),并评价其在非小细胞肺癌(NSCLC)患者源性异种移植物(PDX) SPECT显像和靶向放射性核素治疗中的应用价值。方法将αvβ3靶向分子RGD与白蛋白结合片段EB偶联得到EB-RGD,再将EB-RGD与螯合物1,4,7,10 -四氮杂环十二烷- 1,4,7,10 -四乙酸(DOTA)偶联,进行177Lu放射性标记。建立NSCLC-PDX小鼠模型(n=68)。分别注射177Lu-EB-RGD和177Lu-RGD后,对28只PDX小鼠模型进行SPECT显像和生物分布研究。随后对NSCLC-PDX小鼠模型、生理盐水组(A组)、18.5 MBq 177Lu-RGD组(B组)、18.5 MBq 177Lu-EB-RGD组(C组)、29.6 MBq 177Lu-EB-RGD组(D组)进行靶向放射性核素治疗,每组n=10;观察各组PDX小鼠模型50 d内肿瘤体积变化,采用独立样本t检验比较两组间差异。结果177Lu-EB-RGD的放射标记比活性为(55±14)GBq/μmol,放射化学产率大于95%,放射化学纯度大于95%。SPECT显像显示,注射后4 ~ 96 h NSCLC-PDX小鼠肿瘤清晰可见,注射后4、24、72、96 h肿瘤与肌的比值(T/M)分别为7.34±0.67、14.63±3.82、15.69±3.58、15.99±5.42。生物分布研究进一步证实了SPECT成像结果,注射后4 h, 177Lu-EB-RGD的肿瘤摄取比177Lu-RGD明显增加((10.15±1.17)vs(3.30±1.47)%注射剂量/克(%ID/g);t = 18.60, P < 0.05)。在靶向放疗方面,A组和B组在治疗后50 d内肿瘤体积迅速增大,C组和d组肿瘤体积逐渐减小,直到C组和d组在初始治疗后第28天肿瘤消失,观察期内无复发迹象。结论177Lu-EB-RGD可靶向αvβ3阳性NSCLC-PDX,瘤本比高,抑瘤效果强。临床前数据提示,对于耐药或靶向治疗无效的晚期NSCLC患者,177Lu-EB-RGD可能是一种有效的新治疗选择。关键词:肺癌,非小细胞肺;异种移植瘤模型抗肿瘤测定;伊文思蓝;Arginine-glycine-aspartic酸;镏;老鼠,裸体
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引用次数: 0
Application of 18F-AV45 PET imaging in subtle cognitive decline and mild cognitive impairment patients 18F-AV45 PET显像在轻度认知减退及轻度认知障碍患者中的应用
Pub Date : 2020-04-25 DOI: 10.3760/CMA.J.CN321828-20190812-00166
Shuhua Ren, Qi Huang, Jin-Qing Hu, Donglang Jiang, Jianfei Xiao, Q. Guo, F. Xie, Fengchun Hua, Y. Guan
Objective To investigate the correlations between cerebral β-amyloid (Aβ) deposition assessed by 18F-florbetapir (AV45) PET imaging and clinical cognitive symptoms in patients with subtle cognitive decline (SCD) and mild cognitive impairment (MCI). Methods Data of twenty-four patients (11 males, 13 females, age: (63.2±7.6) years) diagnosed as SCD (n=15) or MCI (n=9) from December 2018 to March 2019 in Shanghai Jiao Tong University Affiliated Sixth People′s Hospital were collected prospectively. All patients underwent 18F-AV45 PET imaging, brain MRI T1 scan and Mini-Mental State Examination (MMSE) within two weeks. 18F-AV45 PET images were analyzed visually (positive, mild positive, negative). After being pretreated according to the MRI, 18F-AV45 PET images were analyzed semi-quantitatively by calculating the standardized uptake value ratio (SUVR) of Aβ deposition in 8 regions of interest (ROIs; frontal lobe, lateral parietal lobe, lateral temporal lobe, medial temporal lobe, occipital lobe, basal ganglia, posterior cingulate and precuneus), with cerebellar gray matter as the reference. Partial correlation coefficients between regional SUVRs and MMSE score were calculated. Results 18F-AV45 PET imaging showed that 16 patients with positive results and 8 patients with mild positive results. MMSE score of 24 patients was 28.2±2.0, and the SUVR was 0.93-1.87. Correlation analysis revealed that Aβ deposition in frontal cortex (r=-0.432), posterior cingulate lobe (r=-0.434) and precuneus (r=-0.418) was negatively correlated with MMSE score (all P 0.05). Conclusion 18F-AV45 PET imaging can noninvasively detect brain Aβ deposition in patients, and can effectively reflect the clinical cognitive status of patients with SCD and MCI to a certain extent. Key words: Cognition disorders; Amyloid; Positron-emission tomography
目的探讨18F-氟倍他吡(AV45)PET显像评估的轻度认知功能减退(SCD)和轻度认知功能障碍(MCI)患者大脑β-淀粉样蛋白(Aβ)沉积与临床认知症状的相关性。方法前瞻性收集2018年12月至2019年3月在上海交通大学附属第六人民医院诊断为SCD(n=15)或MCI(n=9)的24例患者(男11例,女13例,年龄:(63.2±7.6)岁)的数据。所有患者在两周内接受了18F-AV45 PET成像、脑MRI T1扫描和简易精神状态检查(MMSE)。视觉分析18F-AV45 PET图像(阳性、轻度阳性、阴性)。根据MRI预处理后,通过计算8个感兴趣区域(ROI;额叶、顶叶、颞叶外侧、颞叶内侧、枕叶、基底神经节、后扣带和楔前叶)Aβ沉积的标准化摄取值比(SUVR),对18F-AV45 PET图像进行半定量分析,以小脑灰质为参考。计算区域SUVR与MMSE评分之间的偏相关系数。结果18F-AV45 PET显像显示16例阳性,8例轻度阳性。24例患者MMSE评分为28.2±2.0,SUVR为0.93-1.87。相关分析显示,Aβ在额叶皮层(r=-0.432)、扣带回后叶(r=-0.434)和楔前叶(r=0.418)的沉积与MMSE评分呈负相关(均P<0.05),能够在一定程度上有效反映SCD和MCI患者的临床认知状况。关键词:认知障碍;淀粉样蛋白;正电子发射断层扫描
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引用次数: 0
PET imaging of Alzheimer′s disease related abnormal protein deposition 阿尔茨海默病相关异常蛋白质沉积的PET成像
Pub Date : 2020-04-25 DOI: 10.3760/CMA.J.CN321828-20200304-00085
C. Zuo, Huiwei Zhang, Y. Guan
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引用次数: 0
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中华核医学与分子影像杂志
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