Uterine cervical cancer still remains an important socioeconomic issue because it largely affects women of reproductive age.Prognosis is highly depended on extent of the disease at diagnosis and,therefore,accurate sta...Uterine cervical cancer still remains an important socioeconomic issue because it largely affects women of reproductive age.Prognosis is highly depended on extent of the disease at diagnosis and,therefore,accurate staging is crucial for optimal management.Cervical cancer is clinically staged,according to International Federation of Gynecology and Obstetrics guidelines,but,currently,there is increased use of cross sectional imaging modalities [computed tomography(CT),magnetic resonance imaging(MRI),positron emission tomography-CT(PET-CT)] for the study of important prognostic factors like tumor size,parametrial invasion,endocervical extension,pelvic side wall or adjacent/distal organs involvement and lymph node status.Imaging indications also include cervical cancer follow-up,evaluation of tumor response to treatment and selection of suitable candidates for less radical surgeries like radical trachelectomy for fertility preservation.The preferred imaging method for local cervical cancer evaluation is MRI;CT is equally effective for evaluation of extrauterine spread of the disease.PETCT shows high diagnostic performance for the detection of tumor relapse and metastatic lymph nodes.The aim of this review is to familiarize radiologists with the MRI appearance of cervical carcinoma and to discuss the indications of cross sectional imaging during the course of the disease in patients with cervical carcinoma.展开更多
Medical imaging is of crucial importance for diagnosis and initial staging as well as for differentiation of multiple myeloma(MM)from other monoclonal plasma cell diseases.Conventional radiography represents the refer...Medical imaging is of crucial importance for diagnosis and initial staging as well as for differentiation of multiple myeloma(MM)from other monoclonal plasma cell diseases.Conventional radiography represents the reference standard for diagnosis of MM due to its wide availability and low costs despite its known limitations such as low sensitivity,limited specificity and its inability to detect extraosseous lesions.Besides conventional radiography,newer cross-sectional imaging modalities such as whole-body low-dose computed tomography(CT),whole-body magnetic resonance imaging(MRI)and18F-fluorodeoxyglucose(FDG)positron emission tomography(PET)/CT are available for the diagnosis of osseous and extraosseous manifestations of MM.Whole-body low-dose CT is used increasingly,replacing conventional radiography at selected centers,due to its higher sensitivity for the detection of osseous lesions and its ability to diagnose extraosseous lesions.The highest sensitivity for both detection of bone marrow disease and extraosseous lesions can be achieved with whole-body MRI and18F-FDG PET/CT.According to current evidence,MRI is the most sensitive method for initial staging while18F-FDG PET/CT allows monitoring of treatment of MM.There is an evolving role for assessment of treatment response using newer MR imagingtechniques.Future studies are needed to further define the exact role of the different imaging modalities for individual risk stratification and therapy monitoring.展开更多
Gastric cancer is the second leading cause of cancer mortality worldwide. The diagnosis of gastric cancer has been significantly improved with the broad availability of gastrointestinal endoscopy. Effective technologi...Gastric cancer is the second leading cause of cancer mortality worldwide. The diagnosis of gastric cancer has been significantly improved with the broad availability of gastrointestinal endoscopy. Effective technologies for accurate staging and quantitative evaluation are still in demand to merit reasonable treatment and better prognosis for the patients presented with advanced disease. Preoperative staging using conventional imaging tools, such as computed tomography (CT) and endoscopic ultrasonography, is inadequate. Positron emission tomography (PET), using <sup>18</sup>F-fluorodeoxyglucose (FDG) as a tracer and integrating CT for anatomic localization, holds a promise to detect unsuspected metastasis and has been extensively used in a variety of malignancies. However, the value of FDG PET/CT in diagnosis and evaluation of gastric cancer is still controversial. This article reviews the current literature in diagnosis, staging, response evaluation, and relapse monitoring of gastric cancer, and discusses the current understanding, improvement, and future prospects in this area.展开更多
Objective：To test whether Shenfu Injection（参附注射液,SFI）might attenuate the impact of cerebral energy dysfunction after resuscitation in a pig model of cardiac arrest（CA）.Methods：Thirty-four Wuzhishan miniatur...Objective：To test whether Shenfu Injection（参附注射液,SFI）might attenuate the impact of cerebral energy dysfunction after resuscitation in a pig model of cardiac arrest（CA）.Methods：Thirty-four Wuzhishan miniature inbred pigs were randomly divided into three groups：the SFI group（n=12）,the saline group（SA group,n=12）,and the sham-operated group（sham group,n=10）.Following successful return of spontaneous circulation（ROSC）from 8-min untreated ventricular fibrillation,animals received a continuous infusion of either SFI（0.2 mL/min）or saline for 6 h.Cerebral performance category score was evaluated at 24and 48 h after ROSC,followed by positron emission tomography and computed tomography scans of cerebral glucose uptake.Surviving pigs were euthanized 48 h after ROSC,and the brains were removed for detecting mitochondrial function.Results：Compared with the SA group,SFI treatment produced a better neurologic outcome48 h after ROSC（P〈0.05）.However,there was no significant difference of survival rate between the SA and SFI groups（83.3%vs.81.8%,P〉0.05）.After ROSC,the SA group showed a decrease in the maximum standardized uptake value of different regions in the brain tissue,where SFI treatment can ameliorate these decreases（P〈0.01or P〈0.05）.Improved mitochondrial respiratory properties and higher mitochondrial membrane potential were also found following SFI treatment compared with the SA group at 48 h after ROSC（P〈0.05 or P〈0.01）.Conclusion：SFI treatment after resuscitation has significant neuroprotective effects against disruption of cerebral energy metabolism from CA by improving glucose uptake and by normalizing mitochondrial function.展开更多
Pancreatic cancer is one of the most common gastrointestinal tumors, with its incidence staying at a high level in both the United States and China. However, the overall 5-year survival rate of pancreatic cancer is st...Pancreatic cancer is one of the most common gastrointestinal tumors, with its incidence staying at a high level in both the United States and China. However, the overall 5-year survival rate of pancreatic cancer is still extremely low. Surgery remains the only potential chance for long-term survival. Early diagnosis and precise staging are crucial to make proper clinical decision for surgery candidates. Despite advances in diagnostictechnology such as computed tomography(CT)and endoscopic ultrasound,diagnosis,staging and monitoring of the metabolic response remain a challenge for this devastating disease.Positron emission tomography/CT(PET/CT),a relatively novel modality,combines metabolic detection with anatomic information.It has been widely used in oncology and achieves good results in breast cancer,lung cancer and lymphoma.Its utilization in pancreatic cancer has also been widely accepted.However,the value of PET/CT in pancreatic disease is still controversial.Will PET/CT change the treatment strategy for potential surgery candidates?What kind of patients benefits most from this exam?In this review,we focus on the utility of PET/CT in diagnosis,staging,and assessment of resectability of pancreatic cancer.In addition,its ability to monitor metabolic response and recurrence after treatment will be emphasis of discussion.We hope to provide answers to the questions above,which clinicians care most about.展开更多
AIM: To evaluate the capacity of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) for detecting multiple primary cancer of upper gastrointestinal (UGI) tract. METHODS: Fifteen p...AIM: To evaluate the capacity of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) for detecting multiple primary cancer of upper gastrointestinal (UGI) tract. METHODS: Fifteen patients (12 without cancer histories and 3 with histories of upper GI tract cancer) were investigated due to the suspicion of primary cancer of UGI tract on X-ray barium meal and CT scan. Subsequent whole body 18F-FDG PET/CT scan was carried out for initial staging or restaging. All the patients were fi nally confi rmed by endoscopic biopsy or surgery. The detection rate of multiple primary malignant cancers was calculated based on 18F-FDG PET/CT and endoscopic examinations.RESULTS: 18F-FDG PET/CT scan was positive in 32 suspicious lesions, 30/32 were true positive primary lesions, and 2/32 were false positive. In 15 suspicious lesions with negative 18F-FDG PET/CT scan, 12/15 were true negative and 3/15 were false negative. Among the 15 patients, 12 patients had 29 primary synchronous tumors confirmed by pathology, including 8 cases of esophageal cancers accompanied with gastric cancer and 4 of hypopharynx cancers with esophageal cancer. The other 3 patients had 4 new primary metachronous tumors, which were multiple primary esophageal cancers. PET/CT imaging detected local lymph node metastases in 11 patients. Both local lymph node metastases and distant metastases were detected in 4 patients. On a per-primary lesion basis, the sensitivity, specificity, accuracy, negative predictive value and positive predictive value of 18F-FDG PET/CT for detecting multiple primary cancer of UGI tract were 90.9%, 85.7%, 89.4%, 80% and 93.7%, respectively. CONCLUSION: The whole body 18F-FDG PET/CT may play an important role in evaluating the multiple primary malignant tumors of UGI tract cancer.展开更多
The main therapeutic options for colorectal cancer are surgical resection and adjuvant chemotherapy in non-metastatic disease.However,the evaluation of the overall adjuvant chemotherapy benefit in patients with a high...The main therapeutic options for colorectal cancer are surgical resection and adjuvant chemotherapy in non-metastatic disease.However,the evaluation of the overall adjuvant chemotherapy benefit in patients with a high risk of recurrence is challenging.Radiological images can represent a source of data that can be analyzed by using automated computer-based techniques,working on numerical information coded within Digital Imaging and Communications in Medicine files:This image numerical analysis has been named“radiomics”.Radiomics allows the extraction of quantitative features from radiological images,mainly invisible to the naked eye,that can be further analyzed by artificial intelligence algorithms.Radiomics is expanding in oncology to either understand tumor biology or for the development of imaging biomarkers for diagnosis,staging,and prognosis,prediction of treatment response and diseases monitoring and surveillance.Several efforts have been made to develop radiomics signatures for colorectal cancer patient using computed tomography(CT)images with different aims:The preoperative prediction of lymph node metastasis,detecting BRAF and RAS gene mutations.Moreover,the use of delta-radiomics allows the analysis of variations of the radiomics parameters extracted from CT scans performed at different timepoints.Most published studies concerning radiomics and magnetic resonance imaging(MRI)mainly focused on the response of advanced tumors that under-went neoadjuvant therapy.Nodes status is the main determinant of adjuvant chemotherapy.Therefore,several radiomics model based on MRI,especially on T2-weighted images and ADC maps,for the preoperative prediction of nodes metastasis in rectal cancer has been developed.Current studies mostly focused on the applications of radiomics in positron emission tomogra-phy/CT for the prediction of survival after curative surgical resection and assessment of response following neoadjuvant chemoradiotherapy.Since colorectal liver metastases develop in about 25%of patients with color展开更多
Objective： To prospectively compare the discriminative capacity of dynamic contrast enhanced-magnetic resonance imaging（DCE-MRI） with that of^18F-fluorodeoxyglucose（^18F-FDG） positron emission tomography/computed...Objective： To prospectively compare the discriminative capacity of dynamic contrast enhanced-magnetic resonance imaging（DCE-MRI） with that of^18F-fluorodeoxyglucose（^18F-FDG） positron emission tomography/computed tomography（PET/CT） in the differentiation of malignant and benign solitary pulmonary nodules（SPNs）.Methods： Forty-nine patients with SPNs were included in this prospective study. Thirty-two of the patients had malignant SPNs, while the other 17 had benign SPNs. All these patients underwent DCE-MRI and ^18F-FDG PET/CT examinations. The quantitative MRI pharmacokinetic parameters, including the trans-endothelial transfer constant（K^trans）, redistribution rate constant（Kep）, and fractional volume（Ve）, were calculated using the Extended-Tofts Linear two-compartment model. The ^18F-FDG PET/CT parameter, maximum standardized uptake value（SUV（max））, was also measured. Spearman＇s correlations were calculated between the MRI pharmacokinetic parameters and the SUV（max） of each SPN. These parameters were statistically compared between the malignant and benign nodules. Receiver operating characteristic（ROC） analyses were used to compare the diagnostic capability between the DCE-MRI and ^18F-FDG PET/CT indexes.Results： Positive correlations were found between K^trans and SUV（max）, and between K（ep） and SUV（max）（P〈0.05）.There were significant differences between the malignant and benign nodules in terms of the K^trans, K（ep） and SUV（max） values（P〈0.05）. The areas under the ROC curve（AUC） of K^trans） K（ep） and SUV（max） between the malignant and benign nodules were 0.909, 0.838 and 0.759, respectively. The sensitivity and specificity in differentiating malignant from benign SPNs were 90.6% and 82.4% for K^trans; 87.5% and 76.5% for K（ep）; and 75.0% and 70.6%for SUV（max）, respectively. The sensitivity and specificity of K^trans and K（ep） were higher than those of SUV（max）, but there was no significant differe展开更多
Over recent years,[18F]-fluorodeoxyglucose positron emission tomography acquired together with low dose computed tomography(FDG-PET/CT)has proven its role as a staging modality in patients with non-small cell lung can...Over recent years,[18F]-fluorodeoxyglucose positron emission tomography acquired together with low dose computed tomography(FDG-PET/CT)has proven its role as a staging modality in patients with non-small cell lung cancer(NSCLC).The purpose of this review was to present the evidence to use FDG-PET/CT for response evaluation in patients with NSCLC,treated with epidermal growth factor receptor(EGFR)-tyrosine kinase inhibitors(TKI).All published articles from 1November 2003 to 1 November 2013 reporting on 18FFDG-PET response evaluation during EGFR-TKI treatment in patients with NSCLC were collected.In total 7studies,including data of 210 patients were eligible for analyses.Our report shows that FDG-PET/CT responseduring EGFR-TKI therapy has potential in targeted treatment for NSCLC.FDG-PET/CT response is associated with clinical and radiologic response and with survival.Furthermore FDG-PET/CT response monitoring can be performed as early as 1-2 wk after initiation of EGFR-TKI treatment.Patients with substantial decrease of metabolic activity during EGFR-TKI treatment will probably benefit from continued treatment.If metabolic response does not occur within the first weeks of EGFR-TKI treatment,patients may be spared(further)unnecessary toxicity of ineffective treatment.Refining FDG-PET response criteria may help the clinician to decide on continuation or discontinuation of targeted treatment.展开更多
Psoas muscle metastasis, though rare, is the commonest site of skeletal muscle involvement in cervical carcinoma. The appropriate clinical management of this condition, particularly of the pain related to malignant ps...Psoas muscle metastasis, though rare, is the commonest site of skeletal muscle involvement in cervical carcinoma. The appropriate clinical management of this condition, particularly of the pain related to malignant psoas syndrome, is still evolving and the diagnostic features on conventional morphological imaging modalities are often non specific, with the differential diagnosis lying between sarcoma, hematoma, and abscess. In this report, a comparison of various morphofunctional imaging modalities was made. Fluorodeoxyglucosepositron emission tomography(FDG-PET)/computed tomography(CT) was the first to suspect disease involvement of the psoas muscle, demonstrating intense FDG uptake(compared with the contralateral muscle), while ultrasound showed heterogeneous echotexture, and magnetic resonance imaging(MRI) showed subtle altered signal intensity in the right psoas muscle. Both anatomical imaging modalities and non contrast CT of the PET-CT examination demonstrated a bulky psoas muscle, without any focal abnormality. On diffusionweighted imaging of MRI(DWI-MRI), restricted diffusion of the involved muscle was an important observation. The psoas muscle metastatic involvement was proven histopathologically. Thus, enhanced glucose metabolism and restricted diffusion in the newer noninvasive molecular imaging modalities(e.g., PET/CT and DWI-MRI) could serve as valuable adjunctive parameters in diagnosing this entity in the absence of a focal abnormality in the anatomical modalities. In the treatment response monitoring scenario, FDG-PET/CT demonstrated near complete resolution following administration of 3 cycles of systemic chemotherapy and local external radiotherapy.展开更多
Background： Cerebral glucose metabolism changes are always observed in patients suffering from malignant tumors. This preliminary study aimed to investigate the brain glucose metabolism changes in patients with lung ...Background： Cerebral glucose metabolism changes are always observed in patients suffering from malignant tumors. This preliminary study aimed to investigate the brain glucose metabolism changes in patients with lung cancer of different histological types. Methods： One hundred and twenty patients with primary untreated lung cancer, who visited People＇s Hospital of Zhengzhou University from February 2012 to July 2013, were divided into three groups based on histological types confirmed by biopsy or surgical pathology, which included adenocarcinoma （52 cases）, squamous cell carcinoma （43 cases）, and small-cell carcinoma （25 cases）. The whole body ^18F-fiuorodeoxyglucose （^18F-FDG） positron emission tomography （PET）/computed tomography （CT） of these cases was retrospectively studied. The brain PET data of three groups were analyzed individually using statistical parametric maps （SPM） software, with 50 age-matched and gender-matched healthy controls for comparison. Results： The brain resting glucose metabolism in all three lung cancer groups showed regional cerebral metabolic reduction. The hypo-metabolic cerebral regions were mainly distributed at the left superior and middle frontal, bilateral superior and middle temporal and inferior and middle temporal gyrus. Besides, the hypo-metabolic regions were also found in the right inferior parietal lobule and hippocampus in the small-cell carcinoma group. The area of the total hypo-metabolic cerebral regions in the small-cell carcinoma group （total voxel value 3255） was larger than those in the adenocarcinoma group （total voxel value 1217） and squamous cell carcinoma group （total voxel value 1292）. Conclusions： The brain resting glucose metabolism in patients with lung cancer shows regional cerebral metabolic reduction and the brain hypo-metabolic changes are related to the histological types of lung cancer.展开更多
Imaging study plays a crucial role in the diagnosis of prostate cancer. As early screening and management of prostate cancer has evolved over the past decade, research is now focusing on how to detect clinically signi...Imaging study plays a crucial role in the diagnosis of prostate cancer. As early screening and management of prostate cancer has evolved over the past decade, research is now focusing on how to detect clinically significant prostate cancer and avoid overdiagnosis accurately. This article provides an overview of recent advances in imaging in prostate cancer diagnosis, including new ultrasound imaging techniques, positron emission computed tomography, multiparametric magnetic resonance imaging, and emerging areas such as imaging histology, by systematically reviewing and summarizing the existing literature.展开更多
AIM: To review the benefits of single photon emission computed tomography(SPECT)/computed tomography(CT) hybrid imaging for diagnosis of various endocrine disorders.METHODS: We performed MEDLINE and Pub Med searches u...AIM: To review the benefits of single photon emission computed tomography(SPECT)/computed tomography(CT) hybrid imaging for diagnosis of various endocrine disorders.METHODS: We performed MEDLINE and Pub Med searches using the terms: "SPECT/CT"; "functional anatomic mapping"; "transmission emission tomography"; "parathyroid adenoma"; "thyroid cancer"; "neuroendocrine tumor"; "adrenal"; "pheochromocytoma"; "paraganglioma"; in order to identify relevant articles published in English during the years 2003 to 2015. Reference lists from the articles were reviewed to identify additional pertinent articles. Retrieved manuscripts(case reports, reviews, meta-analyses and abstracts) concerning the application of SPECT/CT to endocrine imaging were analyzed to provide a descriptive synthesis of the utility of this technology.RESULTS: The emergence of hybrid SPECT/CT camera technology now allows simultaneous acquisition of combined multi-modality imaging, with seamless fusion of three-dimensional volume datasets. The usefulness of combining functional information to depict the biodistribution of radiotracers that map cellular processes of the endocrine system and tumors of endocrine origin, with anatomy derived from CT, has improved the diagnostic capability of scintigraphy for a range of disorders of endocrine gland function. The literature describes benefits of SPECT/CT for ^(99m)Tc-sestamibi parathyroid scintigraphy and ^(99m)Tc-pertechnetate thyroid scintigraphy, ^(123)I- or ^(131)I-radioiodine for staging of differentiated thyroid carcinoma, ^(111)In- and ^(99m)Tclabeled somatostatin receptor analogues for detection of neuroendocrine tumors, ^(131)I-norcholesterol(NP-59) scans for assessment of adrenal cortical hyperfunction, and ^(123)I- or ^(131)I-metaiodobenzylguanidine imaging for evaluation of pheochromocytoma and paraganglioma.CONCLUSION: SPECT/CT exploits the synergism between the functional information from radiopharmaceutical imaging and anatomy from CT, translating to improved diagnostic accuracy and meaningful 展开更多
BACKGROUND Giant cell tumor of bone is a locally aggressive and rarely metastasizing tumor,and also a potential malignant tumor that may develop into a primary malignant giant cell tumor.AIM To evaluate the role of mu...BACKGROUND Giant cell tumor of bone is a locally aggressive and rarely metastasizing tumor,and also a potential malignant tumor that may develop into a primary malignant giant cell tumor.AIM To evaluate the role of multimodal imaging in the diagnosis of giant cell tumors of bone.METHODS The data of 32 patients with giant cell tumor of bone confirmed by core-needle biopsy or surgical pathology at our hospital between March 2018 and March 2023 were retrospectively selected.All the patients with giant cell tumors of the bone were examined by X-ray,computed tomography(CT)and magnetic resonance imaging(MRI),and 7 of them were examined by positron emission tomography(PET)-CT.RESULTS X-ray imaging can provide overall information on giant cell tumor lesions.CT and MRI can reveal the characteristics of the internal structure of the tumor as well as the adjacent relationships of the tumor,and these methods have unique advantages for diagnosing tumors and determining the scope of surgery.PET-CT can detect small lesions and is highly valuable for identifying benign and malignant tumors to aid in the early diagnosis of metastasis.CONCLUSION Multimodal imaging plays an important role in the diagnosis of giant cell tumor of bone and can provide a reference for the treatment of giant cell tumors.展开更多
Primary small cell carcinoma（SCC） is a group of aggressive neoplasms that mainly arise from the lung and digestive tract. Endometrial small cell carcinoma（ESCC） is extremely rare. To our knowledge, less than 90 ca...Primary small cell carcinoma（SCC） is a group of aggressive neoplasms that mainly arise from the lung and digestive tract. Endometrial small cell carcinoma（ESCC） is extremely rare. To our knowledge, less than 90 cases have been reported, and most of these reports were dedicated to describing the clinicopathologic or immunochemical features of ESCC. Herein, we present a new case of ESCC involving a 51-year-old woman and mainly focus on the magnetic resonance imaging（MRI） and positron emission tomography/computed tomography（PET/CT） findings. MRI showed that the uterus was significantly enlarged（11.6 cm × 11.1 cm × 14.4 cm）, and a giant irregular mass（7.5 cm × 8.4 cm × 8.5 cm） was observed in the uterine cavity. The lesion demonstrated an extremely low apparent diffusion coefficient（ADC） value [（0.553±0.088）×10^–3 mm^2/s] and a high FDG uptake value（22.7）. Multiple metastatic lymph nodes（LNs） were identified at different positions, with diameters ranging from 0.3 to 2.8 cm and a maximum standardized uptake value（SUV max） ranging from 6.9 to 19.3.展开更多
BACKGROUND Routinely, after receiving prostate specific antigen (PSA) testing and digital rectum examination, patients with suspected prostate cancer are required to undergo prostate biopsy. However, the ability of ul...BACKGROUND Routinely, after receiving prostate specific antigen (PSA) testing and digital rectum examination, patients with suspected prostate cancer are required to undergo prostate biopsy. However, the ability of ultrasound-guided prostate biopsy to detect prostate cancer is limited. Nowadays, a variety of diagnostic methods and more sensitive diagnostic methods, such as multi-parameter prostate magnetic resonance imaging (mpMRI) and prostate-specific membrane antigen positron emission tomography/computed tomography (PSMA PET/CT) can be applied clinically. Furthermore, laparoscopic/robot-assisted prostatectomy is also a safe and effective procedure for the treatment of benign prostatic hyperplasia. So maybe it is time to reconsider the necessary to perform prostate biopsy before radical prostatectomy. AIM To explore the feasibility of radical prostatectomy without prostate biopsy in the era of new imaging technology and minimally invasive techniques. METHODS From June 2014 to November 2018, 11 cases of laparoscopic radical prostatectomy without prostate biopsy were performed at the three tertiary medical centers involved in this study. All patients received prostate magnetic resonance imaging and prostate cancer was suspected, including six patients with positive 68Ga- PSMA PET/CT results. Laparoscopic radical prostatectomy and pelvic lymph node dissection were performed for all patients. RESULTS All surgeries were accomplished successfully. The mean age was 69 ± 7.7 year, the mean body mass index was 24.7 ± 1.6 kg/m2, the range of serum PSA was 4.3 to >1000 ng/mL, and the mean prostate volume was 40.9 ± 18.3 mL. The mean operative time was 96 ± 23.3 min, the mean estimated blood loss was 90 ± 90.9 mL, and the median duration of catheter placement was 14 d. The final pathology confirmed that all specimens were prostate cancer except one case of benign prostatic hyperplasia. No major complications occurred in 90 d postoperatively. CONCLUSION The current practice of mandating a prostatic biopsy before prosta展开更多
BACKGROUND Bone is one of the common sites of metastasis from prostate carcinoma.Bone scintigraphy(BS)is one of the most sensitive imaging modalities currently used for bone metastatic work-up.Skeletal metastasis in p...BACKGROUND Bone is one of the common sites of metastasis from prostate carcinoma.Bone scintigraphy(BS)is one of the most sensitive imaging modalities currently used for bone metastatic work-up.Skeletal metastasis in prostate carcinoma commonly involves pelvic bones but rarely involves extrapelvic-extraspinal sites.AIM To retrospectively analyze the BS data to determine the pattern of skeletal metastases in the prostate carcinoma.METHODS This retrospective observational study involves patients with biopsy-proven prostate carcinoma referred for BS for staging assessment.Patients with abnormal BS were evaluated for the pattern of skeletal involvement and data were pre-sented in descriptive format in the form of percentages.RESULTS A total of 150 patients with biopsy-proven prostate cancer who were referred for staging were included in the study.Thirteen of 150 patients(8.67%)had no abnormal uptake on planar images,ruling out metastatic disease.Twenty-four patients(16%)had heterogeneous uptake in the spine with distribution charac-teristic of degenerative disease and no scan pattern of metastatic disease.Thirty patients(20%)had multifocal uptake involving both pelvic and extra pelvic bones on planar images typical for skeletal metastasis and were considered metastatic.Eighty-three out of 150 patients(55.3%)had increased tracer uptake,which was indeterminate,thus,single photon emission computed tomography-computed tomography(SPECT-CT)was acquired,which showed 51 with metastatic disease,31 benign lesions,and one indeterminate finding.Seven of 150 patients had exclusive pelvic bone uptake,which was found to be metastatic in 4/7 patients in SPECT-CT.Fifty six out of 150 patients showed exclusive extrapelvic tracer uptake,of which only 3 had vertebral metastatic disease.None of the patients with increased uptake exclusively in the extrapelvic-extraspinal location was metastatic.CONCLUSION The incidence of exclusive extrapelvic skeletal metastatic disease in prostate carcinoma is 2%(excluding one patient with indeterminate展开更多
Compared to conventional cancer treatment, combination therapy based on well-designed nanoscale platforms may offer an opportunity to eliminate tumors and reduce recurrence and metastasis.In this study, we prepared mu...Compared to conventional cancer treatment, combination therapy based on well-designed nanoscale platforms may offer an opportunity to eliminate tumors and reduce recurrence and metastasis.In this study, we prepared multifunctional microspheres loading ^(131)I-labeled hollow copper sulfide nanoparticles and paclitaxel( ^(131)I-HCu SNPs-MS-PTX) for imaging and therapeutics of W256/B breast tumors in rats.18 F-fluordeoxyglucose(18 F-FDG) positron emission tomography/computed tomography(PET/CT) imaging detected that the expansion of the tumor volume was delayed(Po0.05) following intra-tumoral(i.t.) injection with ^(131)I-HCu SNPs-MS-PTX plus near-infrared(NIR) irradiation. The immunohistochemical analysis further confirmed the anti-tumor effect. The single photon emission computed tomography(SPECT)/photoacoustic imaging mediated by ^(131)I-HCu SNPs-MS-PTX demonstrated that microspheres were mainly distributed in the tumors with a relatively low distribution in other organs. Our results revealed that ^(131)I-HCu SNPs-MS-PTX offered combined photothermal, chemo-and radio-therapies, eliminating tumors at a relatively low dose, as well as allowing SPECT/CT and photoacoustic imaging monitoring of distribution of the injected agents non-invasively. The copper sulfide-loaded microspheres, ^(131)I-HCu SNPs-MS-PTX, can serve as a versatile theranostic agent in an orthotopic breast cancer model.展开更多
In the new era of functional magnetic resonance imaging(MRI), the utility of chest MRI is increasing exponentially due to several advances, including absence of ionizing radiation, excellent tissue contrast and high c...In the new era of functional magnetic resonance imaging(MRI), the utility of chest MRI is increasing exponentially due to several advances, including absence of ionizing radiation, excellent tissue contrast and high capability for lesion characterization and treatment monitoring. The application of several of these diagnostic weapons in a multiparametric fashion enables to better characterize thymic epithelial tumors and other mediastinal tumoral lesions, accurate assessment of the invasion of adjacent structures and detection of pathologic lymph nodes and metastasis. Also, "do not touch lesions" could be identified with the associated impact in the management of those patients. One of the hotspots of the multiparametric chest MR is its ability to detect with acuity early response to treatment in patients with mediastinal malignant neoplasms. This has been related with higher rates of overall survival and progression free survival.Therefore, in this review we will analyze the current functional imaging techniques available(18 F-Fluorodeoxiglucose positron emission tomography/computed tomography, diffusion-weighted imaging, dynamic contrast-enhanced MRI, diffusion tensor imaging and MR spectroscopy) for the evaluation of mediastinal lesions, with a focus in their correct acquisition and post-processing. Also, to review the clinical applications of these techniques in the diagnostic approach of benign and malignant conditions of the mediastinum.展开更多
AIM: To assess whole-body fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in the management of small bowel obstructions (SBOs) secondary to gastric cancer and its role in treatment s...AIM: To assess whole-body fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in the management of small bowel obstructions (SBOs) secondary to gastric cancer and its role in treatment strategies. METHODS: The medical records of all of the patients who were admitted for an intestinal obstruction after curative resection for gastric cancer were retrospectively reviewed. PET/CT was performed before a clinical treatment strategy was established for each patient. The patients were divided into 2 groups: patients with no evidence of a tumor recurrence and patients with evidence of a tumor recurrence. Tumor recurrences included a local recurrence, peritoneal carcinomatosis or distant metastases. The primary endpoint was the 1-year survival rate, and other variables included patient demographics, the length of hospital stay, complications, and mortality. RESULTS: The median time between a diagnosis of gastric cancer and the detection of a SBO was 1.4 years. Overall, 31 of 65 patients (47.7%) had evidence of a tumor recurrence on the PET/CT scan, which was the only factor that was associated with poor survival. Open and close surgery was the main type of surgical procedure reported for the patients with tumor recurrences. R0 resections were performed in 2 patients, including 1 who underwent combined adjacent organ resection. In the group with no evidence of a tumor recurrence on PET/CT, bowel resections were performed in 7 patients, adhesiolysis was performed in 7 patients, and a bypass was performed in 1 patient. The 1-year survival curves according to PET/CT evidence of a tumor recurrence vs no PET/CT evidence of a tumor recurrence were significantly different, and the 1-year survival rates were 8.8% vs 93.5%, respectively. There were no significant differences (P = 0.71) in the 1-year survival rates based on surgical vs nonsurgical management (0% with nonoperative treatment vs 20% after exploratory laparotomy). CONCLUSION: 18 F-FDG PET/CT can be used to identify the causes of bowel obstr展开更多
文摘Uterine cervical cancer still remains an important socioeconomic issue because it largely affects women of reproductive age.Prognosis is highly depended on extent of the disease at diagnosis and,therefore,accurate staging is crucial for optimal management.Cervical cancer is clinically staged,according to International Federation of Gynecology and Obstetrics guidelines,but,currently,there is increased use of cross sectional imaging modalities [computed tomography(CT),magnetic resonance imaging(MRI),positron emission tomography-CT(PET-CT)] for the study of important prognostic factors like tumor size,parametrial invasion,endocervical extension,pelvic side wall or adjacent/distal organs involvement and lymph node status.Imaging indications also include cervical cancer follow-up,evaluation of tumor response to treatment and selection of suitable candidates for less radical surgeries like radical trachelectomy for fertility preservation.The preferred imaging method for local cervical cancer evaluation is MRI;CT is equally effective for evaluation of extrauterine spread of the disease.PETCT shows high diagnostic performance for the detection of tumor relapse and metastatic lymph nodes.The aim of this review is to familiarize radiologists with the MRI appearance of cervical carcinoma and to discuss the indications of cross sectional imaging during the course of the disease in patients with cervical carcinoma.
文摘Medical imaging is of crucial importance for diagnosis and initial staging as well as for differentiation of multiple myeloma(MM)from other monoclonal plasma cell diseases.Conventional radiography represents the reference standard for diagnosis of MM due to its wide availability and low costs despite its known limitations such as low sensitivity,limited specificity and its inability to detect extraosseous lesions.Besides conventional radiography,newer cross-sectional imaging modalities such as whole-body low-dose computed tomography(CT),whole-body magnetic resonance imaging(MRI)and18F-fluorodeoxyglucose(FDG)positron emission tomography(PET)/CT are available for the diagnosis of osseous and extraosseous manifestations of MM.Whole-body low-dose CT is used increasingly,replacing conventional radiography at selected centers,due to its higher sensitivity for the detection of osseous lesions and its ability to diagnose extraosseous lesions.The highest sensitivity for both detection of bone marrow disease and extraosseous lesions can be achieved with whole-body MRI and18F-FDG PET/CT.According to current evidence,MRI is the most sensitive method for initial staging while18F-FDG PET/CT allows monitoring of treatment of MM.There is an evolving role for assessment of treatment response using newer MR imagingtechniques.Future studies are needed to further define the exact role of the different imaging modalities for individual risk stratification and therapy monitoring.
文摘Gastric cancer is the second leading cause of cancer mortality worldwide. The diagnosis of gastric cancer has been significantly improved with the broad availability of gastrointestinal endoscopy. Effective technologies for accurate staging and quantitative evaluation are still in demand to merit reasonable treatment and better prognosis for the patients presented with advanced disease. Preoperative staging using conventional imaging tools, such as computed tomography (CT) and endoscopic ultrasonography, is inadequate. Positron emission tomography (PET), using <sup>18</sup>F-fluorodeoxyglucose (FDG) as a tracer and integrating CT for anatomic localization, holds a promise to detect unsuspected metastasis and has been extensively used in a variety of malignancies. However, the value of FDG PET/CT in diagnosis and evaluation of gastric cancer is still controversial. This article reviews the current literature in diagnosis, staging, response evaluation, and relapse monitoring of gastric cancer, and discusses the current understanding, improvement, and future prospects in this area.
基金Supported by the Beijing Natural Science Foundation(No.7132092)Beijing Scientific Research Project for Outstanding Doctoral Thesis Guidance Teacher(No.20121002501)
文摘Objective：To test whether Shenfu Injection（参附注射液,SFI）might attenuate the impact of cerebral energy dysfunction after resuscitation in a pig model of cardiac arrest（CA）.Methods：Thirty-four Wuzhishan miniature inbred pigs were randomly divided into three groups：the SFI group（n=12）,the saline group（SA group,n=12）,and the sham-operated group（sham group,n=10）.Following successful return of spontaneous circulation（ROSC）from 8-min untreated ventricular fibrillation,animals received a continuous infusion of either SFI（0.2 mL/min）or saline for 6 h.Cerebral performance category score was evaluated at 24and 48 h after ROSC,followed by positron emission tomography and computed tomography scans of cerebral glucose uptake.Surviving pigs were euthanized 48 h after ROSC,and the brains were removed for detecting mitochondrial function.Results：Compared with the SA group,SFI treatment produced a better neurologic outcome48 h after ROSC（P〈0.05）.However,there was no significant difference of survival rate between the SA and SFI groups（83.3%vs.81.8%,P〉0.05）.After ROSC,the SA group showed a decrease in the maximum standardized uptake value of different regions in the brain tissue,where SFI treatment can ameliorate these decreases（P〈0.01or P〈0.05）.Improved mitochondrial respiratory properties and higher mitochondrial membrane potential were also found following SFI treatment compared with the SA group at 48 h after ROSC（P〈0.05 or P〈0.01）.Conclusion：SFI treatment after resuscitation has significant neuroprotective effects against disruption of cerebral energy metabolism from CA by improving glucose uptake and by normalizing mitochondrial function.
基金Supported by The New Outstanding Youth Program of Shang-hai Municipal Health Bureau,No.XYQ2013090the Shanghai Young Physician Training Program,the Zhuo-Xue Project of Fudan University+2 种基金the Scientific Research Project supported by Huashan Hospital,Fudan University,No.2013QD21the Nation-al Natural Science Foundation of China,No.81071884Research Fund for the Doctoral Program of Higher Education of China, No. 20110071110065
文摘Pancreatic cancer is one of the most common gastrointestinal tumors, with its incidence staying at a high level in both the United States and China. However, the overall 5-year survival rate of pancreatic cancer is still extremely low. Surgery remains the only potential chance for long-term survival. Early diagnosis and precise staging are crucial to make proper clinical decision for surgery candidates. Despite advances in diagnostictechnology such as computed tomography(CT)and endoscopic ultrasound,diagnosis,staging and monitoring of the metabolic response remain a challenge for this devastating disease.Positron emission tomography/CT(PET/CT),a relatively novel modality,combines metabolic detection with anatomic information.It has been widely used in oncology and achieves good results in breast cancer,lung cancer and lymphoma.Its utilization in pancreatic cancer has also been widely accepted.However,the value of PET/CT in pancreatic disease is still controversial.Will PET/CT change the treatment strategy for potential surgery candidates?What kind of patients benefits most from this exam?In this review,we focus on the utility of PET/CT in diagnosis,staging,and assessment of resectability of pancreatic cancer.In addition,its ability to monitor metabolic response and recurrence after treatment will be emphasis of discussion.We hope to provide answers to the questions above,which clinicians care most about.
基金Supported by The Fund from the Bureau of Public Health of Xiamen City for creative research by young scientists,No.WQK0704the fund from the Health Department of Fujian Province for young scholars,No.2008-1-49
文摘AIM: To evaluate the capacity of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) for detecting multiple primary cancer of upper gastrointestinal (UGI) tract. METHODS: Fifteen patients (12 without cancer histories and 3 with histories of upper GI tract cancer) were investigated due to the suspicion of primary cancer of UGI tract on X-ray barium meal and CT scan. Subsequent whole body 18F-FDG PET/CT scan was carried out for initial staging or restaging. All the patients were fi nally confi rmed by endoscopic biopsy or surgery. The detection rate of multiple primary malignant cancers was calculated based on 18F-FDG PET/CT and endoscopic examinations.RESULTS: 18F-FDG PET/CT scan was positive in 32 suspicious lesions, 30/32 were true positive primary lesions, and 2/32 were false positive. In 15 suspicious lesions with negative 18F-FDG PET/CT scan, 12/15 were true negative and 3/15 were false negative. Among the 15 patients, 12 patients had 29 primary synchronous tumors confirmed by pathology, including 8 cases of esophageal cancers accompanied with gastric cancer and 4 of hypopharynx cancers with esophageal cancer. The other 3 patients had 4 new primary metachronous tumors, which were multiple primary esophageal cancers. PET/CT imaging detected local lymph node metastases in 11 patients. Both local lymph node metastases and distant metastases were detected in 4 patients. On a per-primary lesion basis, the sensitivity, specificity, accuracy, negative predictive value and positive predictive value of 18F-FDG PET/CT for detecting multiple primary cancer of UGI tract were 90.9%, 85.7%, 89.4%, 80% and 93.7%, respectively. CONCLUSION: The whole body 18F-FDG PET/CT may play an important role in evaluating the multiple primary malignant tumors of UGI tract cancer.
文摘The main therapeutic options for colorectal cancer are surgical resection and adjuvant chemotherapy in non-metastatic disease.However,the evaluation of the overall adjuvant chemotherapy benefit in patients with a high risk of recurrence is challenging.Radiological images can represent a source of data that can be analyzed by using automated computer-based techniques,working on numerical information coded within Digital Imaging and Communications in Medicine files:This image numerical analysis has been named“radiomics”.Radiomics allows the extraction of quantitative features from radiological images,mainly invisible to the naked eye,that can be further analyzed by artificial intelligence algorithms.Radiomics is expanding in oncology to either understand tumor biology or for the development of imaging biomarkers for diagnosis,staging,and prognosis,prediction of treatment response and diseases monitoring and surveillance.Several efforts have been made to develop radiomics signatures for colorectal cancer patient using computed tomography(CT)images with different aims:The preoperative prediction of lymph node metastasis,detecting BRAF and RAS gene mutations.Moreover,the use of delta-radiomics allows the analysis of variations of the radiomics parameters extracted from CT scans performed at different timepoints.Most published studies concerning radiomics and magnetic resonance imaging(MRI)mainly focused on the response of advanced tumors that under-went neoadjuvant therapy.Nodes status is the main determinant of adjuvant chemotherapy.Therefore,several radiomics model based on MRI,especially on T2-weighted images and ADC maps,for the preoperative prediction of nodes metastasis in rectal cancer has been developed.Current studies mostly focused on the applications of radiomics in positron emission tomogra-phy/CT for the prediction of survival after curative surgical resection and assessment of response following neoadjuvant chemoradiotherapy.Since colorectal liver metastases develop in about 25%of patients with color
基金supported by the Jiangsu Province Natural Science Foundation (No. BK20161291)the Nantong Science Foundation of China (No. MS2201507)the Nantong Municipal Commission of Health and Family Planning Young Fund (No. WQ2014047)
文摘Objective： To prospectively compare the discriminative capacity of dynamic contrast enhanced-magnetic resonance imaging（DCE-MRI） with that of^18F-fluorodeoxyglucose（^18F-FDG） positron emission tomography/computed tomography（PET/CT） in the differentiation of malignant and benign solitary pulmonary nodules（SPNs）.Methods： Forty-nine patients with SPNs were included in this prospective study. Thirty-two of the patients had malignant SPNs, while the other 17 had benign SPNs. All these patients underwent DCE-MRI and ^18F-FDG PET/CT examinations. The quantitative MRI pharmacokinetic parameters, including the trans-endothelial transfer constant（K^trans）, redistribution rate constant（Kep）, and fractional volume（Ve）, were calculated using the Extended-Tofts Linear two-compartment model. The ^18F-FDG PET/CT parameter, maximum standardized uptake value（SUV（max））, was also measured. Spearman＇s correlations were calculated between the MRI pharmacokinetic parameters and the SUV（max） of each SPN. These parameters were statistically compared between the malignant and benign nodules. Receiver operating characteristic（ROC） analyses were used to compare the diagnostic capability between the DCE-MRI and ^18F-FDG PET/CT indexes.Results： Positive correlations were found between K^trans and SUV（max）, and between K（ep） and SUV（max）（P〈0.05）.There were significant differences between the malignant and benign nodules in terms of the K^trans, K（ep） and SUV（max） values（P〈0.05）. The areas under the ROC curve（AUC） of K^trans） K（ep） and SUV（max） between the malignant and benign nodules were 0.909, 0.838 and 0.759, respectively. The sensitivity and specificity in differentiating malignant from benign SPNs were 90.6% and 82.4% for K^trans; 87.5% and 76.5% for K（ep）; and 75.0% and 70.6%for SUV（max）, respectively. The sensitivity and specificity of K^trans and K（ep） were higher than those of SUV（max）, but there was no significant differe
文摘Over recent years,[18F]-fluorodeoxyglucose positron emission tomography acquired together with low dose computed tomography(FDG-PET/CT)has proven its role as a staging modality in patients with non-small cell lung cancer(NSCLC).The purpose of this review was to present the evidence to use FDG-PET/CT for response evaluation in patients with NSCLC,treated with epidermal growth factor receptor(EGFR)-tyrosine kinase inhibitors(TKI).All published articles from 1November 2003 to 1 November 2013 reporting on 18FFDG-PET response evaluation during EGFR-TKI treatment in patients with NSCLC were collected.In total 7studies,including data of 210 patients were eligible for analyses.Our report shows that FDG-PET/CT responseduring EGFR-TKI therapy has potential in targeted treatment for NSCLC.FDG-PET/CT response is associated with clinical and radiologic response and with survival.Furthermore FDG-PET/CT response monitoring can be performed as early as 1-2 wk after initiation of EGFR-TKI treatment.Patients with substantial decrease of metabolic activity during EGFR-TKI treatment will probably benefit from continued treatment.If metabolic response does not occur within the first weeks of EGFR-TKI treatment,patients may be spared(further)unnecessary toxicity of ineffective treatment.Refining FDG-PET response criteria may help the clinician to decide on continuation or discontinuation of targeted treatment.
文摘Psoas muscle metastasis, though rare, is the commonest site of skeletal muscle involvement in cervical carcinoma. The appropriate clinical management of this condition, particularly of the pain related to malignant psoas syndrome, is still evolving and the diagnostic features on conventional morphological imaging modalities are often non specific, with the differential diagnosis lying between sarcoma, hematoma, and abscess. In this report, a comparison of various morphofunctional imaging modalities was made. Fluorodeoxyglucosepositron emission tomography(FDG-PET)/computed tomography(CT) was the first to suspect disease involvement of the psoas muscle, demonstrating intense FDG uptake(compared with the contralateral muscle), while ultrasound showed heterogeneous echotexture, and magnetic resonance imaging(MRI) showed subtle altered signal intensity in the right psoas muscle. Both anatomical imaging modalities and non contrast CT of the PET-CT examination demonstrated a bulky psoas muscle, without any focal abnormality. On diffusionweighted imaging of MRI(DWI-MRI), restricted diffusion of the involved muscle was an important observation. The psoas muscle metastatic involvement was proven histopathologically. Thus, enhanced glucose metabolism and restricted diffusion in the newer noninvasive molecular imaging modalities(e.g., PET/CT and DWI-MRI) could serve as valuable adjunctive parameters in diagnosing this entity in the absence of a focal abnormality in the anatomical modalities. In the treatment response monitoring scenario, FDG-PET/CT demonstrated near complete resolution following administration of 3 cycles of systemic chemotherapy and local external radiotherapy.
文摘Background： Cerebral glucose metabolism changes are always observed in patients suffering from malignant tumors. This preliminary study aimed to investigate the brain glucose metabolism changes in patients with lung cancer of different histological types. Methods： One hundred and twenty patients with primary untreated lung cancer, who visited People＇s Hospital of Zhengzhou University from February 2012 to July 2013, were divided into three groups based on histological types confirmed by biopsy or surgical pathology, which included adenocarcinoma （52 cases）, squamous cell carcinoma （43 cases）, and small-cell carcinoma （25 cases）. The whole body ^18F-fiuorodeoxyglucose （^18F-FDG） positron emission tomography （PET）/computed tomography （CT） of these cases was retrospectively studied. The brain PET data of three groups were analyzed individually using statistical parametric maps （SPM） software, with 50 age-matched and gender-matched healthy controls for comparison. Results： The brain resting glucose metabolism in all three lung cancer groups showed regional cerebral metabolic reduction. The hypo-metabolic cerebral regions were mainly distributed at the left superior and middle frontal, bilateral superior and middle temporal and inferior and middle temporal gyrus. Besides, the hypo-metabolic regions were also found in the right inferior parietal lobule and hippocampus in the small-cell carcinoma group. The area of the total hypo-metabolic cerebral regions in the small-cell carcinoma group （total voxel value 3255） was larger than those in the adenocarcinoma group （total voxel value 1217） and squamous cell carcinoma group （total voxel value 1292）. Conclusions： The brain resting glucose metabolism in patients with lung cancer shows regional cerebral metabolic reduction and the brain hypo-metabolic changes are related to the histological types of lung cancer.
文摘Imaging study plays a crucial role in the diagnosis of prostate cancer. As early screening and management of prostate cancer has evolved over the past decade, research is now focusing on how to detect clinically significant prostate cancer and avoid overdiagnosis accurately. This article provides an overview of recent advances in imaging in prostate cancer diagnosis, including new ultrasound imaging techniques, positron emission computed tomography, multiparametric magnetic resonance imaging, and emerging areas such as imaging histology, by systematically reviewing and summarizing the existing literature.
文摘AIM: To review the benefits of single photon emission computed tomography(SPECT)/computed tomography(CT) hybrid imaging for diagnosis of various endocrine disorders.METHODS: We performed MEDLINE and Pub Med searches using the terms: "SPECT/CT"; "functional anatomic mapping"; "transmission emission tomography"; "parathyroid adenoma"; "thyroid cancer"; "neuroendocrine tumor"; "adrenal"; "pheochromocytoma"; "paraganglioma"; in order to identify relevant articles published in English during the years 2003 to 2015. Reference lists from the articles were reviewed to identify additional pertinent articles. Retrieved manuscripts(case reports, reviews, meta-analyses and abstracts) concerning the application of SPECT/CT to endocrine imaging were analyzed to provide a descriptive synthesis of the utility of this technology.RESULTS: The emergence of hybrid SPECT/CT camera technology now allows simultaneous acquisition of combined multi-modality imaging, with seamless fusion of three-dimensional volume datasets. The usefulness of combining functional information to depict the biodistribution of radiotracers that map cellular processes of the endocrine system and tumors of endocrine origin, with anatomy derived from CT, has improved the diagnostic capability of scintigraphy for a range of disorders of endocrine gland function. The literature describes benefits of SPECT/CT for ^(99m)Tc-sestamibi parathyroid scintigraphy and ^(99m)Tc-pertechnetate thyroid scintigraphy, ^(123)I- or ^(131)I-radioiodine for staging of differentiated thyroid carcinoma, ^(111)In- and ^(99m)Tclabeled somatostatin receptor analogues for detection of neuroendocrine tumors, ^(131)I-norcholesterol(NP-59) scans for assessment of adrenal cortical hyperfunction, and ^(123)I- or ^(131)I-metaiodobenzylguanidine imaging for evaluation of pheochromocytoma and paraganglioma.CONCLUSION: SPECT/CT exploits the synergism between the functional information from radiopharmaceutical imaging and anatomy from CT, translating to improved diagnostic accuracy and meaningful
基金Supported by the Technology Innovation Leading Program of Shaanxi,No.2023KXJ-095the Shaanxi Provincial People's Hospital Science and Technology Talent Support Program for Elite Talents,No.2021JY-38 and No.2021JY-50the Shaanxi Provincial People's Hospital Science and Technology Development Incubation Foundation,No.2023YJY-39.
文摘BACKGROUND Giant cell tumor of bone is a locally aggressive and rarely metastasizing tumor,and also a potential malignant tumor that may develop into a primary malignant giant cell tumor.AIM To evaluate the role of multimodal imaging in the diagnosis of giant cell tumors of bone.METHODS The data of 32 patients with giant cell tumor of bone confirmed by core-needle biopsy or surgical pathology at our hospital between March 2018 and March 2023 were retrospectively selected.All the patients with giant cell tumors of the bone were examined by X-ray,computed tomography(CT)and magnetic resonance imaging(MRI),and 7 of them were examined by positron emission tomography(PET)-CT.RESULTS X-ray imaging can provide overall information on giant cell tumor lesions.CT and MRI can reveal the characteristics of the internal structure of the tumor as well as the adjacent relationships of the tumor,and these methods have unique advantages for diagnosing tumors and determining the scope of surgery.PET-CT can detect small lesions and is highly valuable for identifying benign and malignant tumors to aid in the early diagnosis of metastasis.CONCLUSION Multimodal imaging plays an important role in the diagnosis of giant cell tumor of bone and can provide a reference for the treatment of giant cell tumors.
文摘Primary small cell carcinoma（SCC） is a group of aggressive neoplasms that mainly arise from the lung and digestive tract. Endometrial small cell carcinoma（ESCC） is extremely rare. To our knowledge, less than 90 cases have been reported, and most of these reports were dedicated to describing the clinicopathologic or immunochemical features of ESCC. Herein, we present a new case of ESCC involving a 51-year-old woman and mainly focus on the magnetic resonance imaging（MRI） and positron emission tomography/computed tomography（PET/CT） findings. MRI showed that the uterus was significantly enlarged（11.6 cm × 11.1 cm × 14.4 cm）, and a giant irregular mass（7.5 cm × 8.4 cm × 8.5 cm） was observed in the uterine cavity. The lesion demonstrated an extremely low apparent diffusion coefficient（ADC） value [（0.553±0.088）×10^–3 mm^2/s] and a high FDG uptake value（22.7）. Multiple metastatic lymph nodes（LNs） were identified at different positions, with diameters ranging from 0.3 to 2.8 cm and a maximum standardized uptake value（SUV max） ranging from 6.9 to 19.3.
文摘BACKGROUND Routinely, after receiving prostate specific antigen (PSA) testing and digital rectum examination, patients with suspected prostate cancer are required to undergo prostate biopsy. However, the ability of ultrasound-guided prostate biopsy to detect prostate cancer is limited. Nowadays, a variety of diagnostic methods and more sensitive diagnostic methods, such as multi-parameter prostate magnetic resonance imaging (mpMRI) and prostate-specific membrane antigen positron emission tomography/computed tomography (PSMA PET/CT) can be applied clinically. Furthermore, laparoscopic/robot-assisted prostatectomy is also a safe and effective procedure for the treatment of benign prostatic hyperplasia. So maybe it is time to reconsider the necessary to perform prostate biopsy before radical prostatectomy. AIM To explore the feasibility of radical prostatectomy without prostate biopsy in the era of new imaging technology and minimally invasive techniques. METHODS From June 2014 to November 2018, 11 cases of laparoscopic radical prostatectomy without prostate biopsy were performed at the three tertiary medical centers involved in this study. All patients received prostate magnetic resonance imaging and prostate cancer was suspected, including six patients with positive 68Ga- PSMA PET/CT results. Laparoscopic radical prostatectomy and pelvic lymph node dissection were performed for all patients. RESULTS All surgeries were accomplished successfully. The mean age was 69 ± 7.7 year, the mean body mass index was 24.7 ± 1.6 kg/m2, the range of serum PSA was 4.3 to >1000 ng/mL, and the mean prostate volume was 40.9 ± 18.3 mL. The mean operative time was 96 ± 23.3 min, the mean estimated blood loss was 90 ± 90.9 mL, and the median duration of catheter placement was 14 d. The final pathology confirmed that all specimens were prostate cancer except one case of benign prostatic hyperplasia. No major complications occurred in 90 d postoperatively. CONCLUSION The current practice of mandating a prostatic biopsy before prosta
文摘BACKGROUND Bone is one of the common sites of metastasis from prostate carcinoma.Bone scintigraphy(BS)is one of the most sensitive imaging modalities currently used for bone metastatic work-up.Skeletal metastasis in prostate carcinoma commonly involves pelvic bones but rarely involves extrapelvic-extraspinal sites.AIM To retrospectively analyze the BS data to determine the pattern of skeletal metastases in the prostate carcinoma.METHODS This retrospective observational study involves patients with biopsy-proven prostate carcinoma referred for BS for staging assessment.Patients with abnormal BS were evaluated for the pattern of skeletal involvement and data were pre-sented in descriptive format in the form of percentages.RESULTS A total of 150 patients with biopsy-proven prostate cancer who were referred for staging were included in the study.Thirteen of 150 patients(8.67%)had no abnormal uptake on planar images,ruling out metastatic disease.Twenty-four patients(16%)had heterogeneous uptake in the spine with distribution charac-teristic of degenerative disease and no scan pattern of metastatic disease.Thirty patients(20%)had multifocal uptake involving both pelvic and extra pelvic bones on planar images typical for skeletal metastasis and were considered metastatic.Eighty-three out of 150 patients(55.3%)had increased tracer uptake,which was indeterminate,thus,single photon emission computed tomography-computed tomography(SPECT-CT)was acquired,which showed 51 with metastatic disease,31 benign lesions,and one indeterminate finding.Seven of 150 patients had exclusive pelvic bone uptake,which was found to be metastatic in 4/7 patients in SPECT-CT.Fifty six out of 150 patients showed exclusive extrapelvic tracer uptake,of which only 3 had vertebral metastatic disease.None of the patients with increased uptake exclusively in the extrapelvic-extraspinal location was metastatic.CONCLUSION The incidence of exclusive extrapelvic skeletal metastatic disease in prostate carcinoma is 2%(excluding one patient with indeterminate
基金partially supported by National Natural Science Foundation of China (Nos. 81771861, 81471708, 81673018, 81530053, 81471685)the award of the "National Youth Thousand Talents Plan" of China, the Program for Professor of Special Appointment (Eastern Scholar) at Shanghai Institutions of Higher Learning (No. 2012-05)+2 种基金Shanghai Municipal Education Commission-Gaofeng Clinical Medicine Grant Support (No. 20172010)2018 Shanghai Scientific and Technological Innovation Program(No. 18410711200)the Ph.D. Innovation Fund of Shanghai Jiao Tong University, School of Medicine (BXJ201821)
文摘Compared to conventional cancer treatment, combination therapy based on well-designed nanoscale platforms may offer an opportunity to eliminate tumors and reduce recurrence and metastasis.In this study, we prepared multifunctional microspheres loading ^(131)I-labeled hollow copper sulfide nanoparticles and paclitaxel( ^(131)I-HCu SNPs-MS-PTX) for imaging and therapeutics of W256/B breast tumors in rats.18 F-fluordeoxyglucose(18 F-FDG) positron emission tomography/computed tomography(PET/CT) imaging detected that the expansion of the tumor volume was delayed(Po0.05) following intra-tumoral(i.t.) injection with ^(131)I-HCu SNPs-MS-PTX plus near-infrared(NIR) irradiation. The immunohistochemical analysis further confirmed the anti-tumor effect. The single photon emission computed tomography(SPECT)/photoacoustic imaging mediated by ^(131)I-HCu SNPs-MS-PTX demonstrated that microspheres were mainly distributed in the tumors with a relatively low distribution in other organs. Our results revealed that ^(131)I-HCu SNPs-MS-PTX offered combined photothermal, chemo-and radio-therapies, eliminating tumors at a relatively low dose, as well as allowing SPECT/CT and photoacoustic imaging monitoring of distribution of the injected agents non-invasively. The copper sulfide-loaded microspheres, ^(131)I-HCu SNPs-MS-PTX, can serve as a versatile theranostic agent in an orthotopic breast cancer model.
文摘In the new era of functional magnetic resonance imaging(MRI), the utility of chest MRI is increasing exponentially due to several advances, including absence of ionizing radiation, excellent tissue contrast and high capability for lesion characterization and treatment monitoring. The application of several of these diagnostic weapons in a multiparametric fashion enables to better characterize thymic epithelial tumors and other mediastinal tumoral lesions, accurate assessment of the invasion of adjacent structures and detection of pathologic lymph nodes and metastasis. Also, "do not touch lesions" could be identified with the associated impact in the management of those patients. One of the hotspots of the multiparametric chest MR is its ability to detect with acuity early response to treatment in patients with mediastinal malignant neoplasms. This has been related with higher rates of overall survival and progression free survival.Therefore, in this review we will analyze the current functional imaging techniques available(18 F-Fluorodeoxiglucose positron emission tomography/computed tomography, diffusion-weighted imaging, dynamic contrast-enhanced MRI, diffusion tensor imaging and MR spectroscopy) for the evaluation of mediastinal lesions, with a focus in their correct acquisition and post-processing. Also, to review the clinical applications of these techniques in the diagnostic approach of benign and malignant conditions of the mediastinum.
文摘AIM: To assess whole-body fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in the management of small bowel obstructions (SBOs) secondary to gastric cancer and its role in treatment strategies. METHODS: The medical records of all of the patients who were admitted for an intestinal obstruction after curative resection for gastric cancer were retrospectively reviewed. PET/CT was performed before a clinical treatment strategy was established for each patient. The patients were divided into 2 groups: patients with no evidence of a tumor recurrence and patients with evidence of a tumor recurrence. Tumor recurrences included a local recurrence, peritoneal carcinomatosis or distant metastases. The primary endpoint was the 1-year survival rate, and other variables included patient demographics, the length of hospital stay, complications, and mortality. RESULTS: The median time between a diagnosis of gastric cancer and the detection of a SBO was 1.4 years. Overall, 31 of 65 patients (47.7%) had evidence of a tumor recurrence on the PET/CT scan, which was the only factor that was associated with poor survival. Open and close surgery was the main type of surgical procedure reported for the patients with tumor recurrences. R0 resections were performed in 2 patients, including 1 who underwent combined adjacent organ resection. In the group with no evidence of a tumor recurrence on PET/CT, bowel resections were performed in 7 patients, adhesiolysis was performed in 7 patients, and a bypass was performed in 1 patient. The 1-year survival curves according to PET/CT evidence of a tumor recurrence vs no PET/CT evidence of a tumor recurrence were significantly different, and the 1-year survival rates were 8.8% vs 93.5%, respectively. There were no significant differences (P = 0.71) in the 1-year survival rates based on surgical vs nonsurgical management (0% with nonoperative treatment vs 20% after exploratory laparotomy). CONCLUSION: 18 F-FDG PET/CT can be used to identify the causes of bowel obstr
