Preoperative detecting metastases of cervical cancer in pelvic and para-aortic lymph nodes：comparison of integrated ~（18）F-FDG PET/CT with or without contrast enhancement

Purpose: Compared the performance of contrast-enhanced PET/CT and non-enhanced PET/CT for preoperatively detecting pelvic and para-aortic lymph node metastases in patients with cervical cancer. Methods: This prospective study included 72 patients with clinically M0 cervical cancer. They underwent surgery within two weeks of PET/CT imaging. Imaging consisted of a whole-body PET/CT protocol without intravenous contrast, followed by abdominal and pelvic PET/CT protocol including contrast-enhanced CT. We compared the diagnostic efficiency between the methods on per-patient and per-lesion basis. Results: Patient-based analysis showed that the sensitivity, specificity, and accuracy of contrast-enhanced PET/CT were 63.6% (14/22), 94.0% (47/50), and 84.7%(61/72), respectively, whereas those of non-enhanced PET/CT were 54.5% (12/22), 88.0% (44/50), and 77.8% (56/72), respectively, and those of enhanced CT alone were 36.4% (8/22), 80.0% (40/50), and 66.7% (48/72), respectively. Lesion-based analysis showed that the sensitivity, specificity, and accuracy of contrast-enhanced PET/CT were 77.7% (87/112), 98.7%(938/950), and 96.5% (1025/1062), respectively, whereas those of non-enhanced PET/CT were 69.6% (78/112), 97.5% (926/950), and 94.5% (1004/1062), respectively, and those of enhanced CT were 54.4% (61/112), 96.1% (913/950), and 91.7% (974/1062), respectively. Contrast-enhanced PET/CT had the best sensitivity, specificity and accuracy. Although patient-based analysis showed no significant difference between contrast-enhanced PET/CT and non-enhanced PET/CT (p =0.540, 0.295 and 0.286), the specificity and accuracy of these two methods were significantly different on lesion-based analysis (p =0.043 and 0.027).     

Mammography and 99mTc-MIBI scintimammography in breast cancer diagnosis

The aim of this work has been to evaluate whether a diagnostic protocol based on the joint use of mammography and ^99mTc-MIBI scintimammography can help to distinguish the lesions and to reduce the number of biopsies required in patients with suspected breast cancer,A total of 58 women were evaluated by palpation ,mammography,scintimammography,Twenty-four patints were scintimammographed with ^99mTc-MIBI at 10 min after injection.Thirty-four patients were taken doublepase scintimammography with ^99mTc-MIBI 10min and 60-90 min fater injection. Based on mammography,the supicion degrees of malignancy were rated,and 30 results of malignancy were confirmed by histopatology,Based on mammography,18 lesion were considered to be most probably benign (of which 3 were histopathologically breast cancer),19 as indeterminate(of which 9 were histopatologically breast cancer),and 21 as malignant (of which 18 were histopathologically breast cancer),The results of early and delayed phases ^99mTc-MIBI scintimammography were the same.The sensitivity,specificity and accuracy of scintimammography were 74.29%,86.96% and 79.31%,respectively,Scintimammography gave 16 correct diagnosis in 19 mammogram indeterminate (84.2%) and demonstrated 5 out of 8 cases axillary lymph nodes metastasis (72.5%),These studies show that ^99mTc-MIBI scintimammography used as a complementary testing technique to mammography is useful in the examination of patients with suspected breast cancer,The adoption of a joint mammography-scintimammography diagnostic protocol could considerably reduce the number of biopsies performed in patients with lesion of indeterminate mammographic suspicion of malignancy.     

Joint imaging of 99mTcO4- and 99mTc-MIBI for thyroid carcinoma recurrence and cervical metastases

In this paper, the joint imaging of 99mTcO4- and 99mTc-methoxy isobutyl isonitrile was compared with neck Color Doppler Ultrasonography (CDU) to identify its value in thyroid carcinoma, postoperative recurrence or cervical metastases. Thyroid carcinoma patients (150 operated and 21 re-operated with suspected postoperative recurrence or cervical metastases) were retrospectively analyzed. Taking the pathological result as the gold standard, the thyroid foci (437 cases), the thyroid foci of ≥1-cm diameter (215 cases) and the suspected postoperative recurrence or cervical metastases (87 cases) were compared by diagnostic results of the joint imaging and the neck CDU. The sensitivity, specificity and accuracy of the joint imaging were 64.18%, 80.00% and 67.82%, and 44.78%, 40.00% and 43.68%, respectively, for the cases with suspected postoperative recurrence or cervical metastases. For thyroid carcinoma of ≥1-cm diameter, the sensitivity of the joint imaging was 97.75%, and the neck CDU was 89.89%, but both specificity and accuracy was similar for thyroid carcinoma independence on their diameter. For thyroid carcinoma, the sensitivity of the joint imaging was 81.99%, and the neck CDU was 89.10%. The results show that the joint imaging is sensitive for large diameter thyroid carcinoma.     

^99mTc-3P4 -RGD2 radiotracers for SPECT/CT of esophageal tumor

In recent years,several RGD（Arg-Gly-Asp）-based radiotracers have already been successfully tested in human for the visualization of integrin αvβ3,demonstrating its feasibility in tumor diagnosis.In this paper,we evaluated the 99mTc-3P4-RGD2 single photon emission computed tomography/computerized tomography（SPECT/CT）in patients suffering from space occupying disease of esophagus.40 patients（34 males and 6 female;mean age： 58.3 years） with a suspected space occupying lesion of esophagus were included,thus finally obtaining their definite pathologic diagnosis（malignant,n=32;benign,n=8）.All patients underwent endoscopic,barium esophagography and SPECT/CT imaging preoperatively.The chest SPECT was performed at 4 h after administration of99mTc-3P4-RGD2 with a dose of 939±118 MBq.The diagnosis precision,sensitivity and specificity among these methods were compared.The relationship between radioactive uptake and clinical pathological stage of esophageal carcinoma was discussed by calculating the tumor to normal esophagus（T/N）.Meanwhile,the integrin αvβ3 expression was assessed immunohistochemically in postoperative esophageal tissues.31 patients were diagnosed as esophageal carcinoma;and 1,leiomyosarcoma;and 6.leimyoma;and 2,esophageal tuberculosis.The accuracy,sensitivity and specificity of barium esophagography,endoscopic and SPECT/CT imaging are 92.5/93.8/87.5%,97.5/96.9/100%,and 90/90.6/87.5%,respectively.Abnormal accumulation of radiotracer in 29 malignant lesions is observed.The SPECT/CT imaging displayed the region of radioactive uptake and lesions matched extremely with the T/N ratio from 1.31 to 2.79（mean 2.04）.A case with pulmonary metastases and a case with mediastinal lymph node metastases were found which were missed by barium esophagography and endoscopic.The99mTc-3P4-RGD2 uptake of the esophageal carcinoma masses had no relevance to the tumor pathologic classification（P〉0.05）.There was a significant positive correlation between T/N ratio and positive cell percentage of integrin αvβ3（r=0.976）,demonstrating the certain clinical potential in the diagnosis of esophageal carcinoma.     

Complement of 99mTc-octreotide scintimammography to mammography in evaluating breast cancers

In this paper,the 99mTc-octreotide scintimammography as a useful complementary technique of mammography was evaluated in diagnosing breast cancers.The 45 breast lesions were consecutively detected by mammography,and 99mTc-octreotide scintimammography,and both combination technique on the basis of self-examination,physical examination.Clinical diagnosis was confirmed by histopathologic analysis.Radioactivity uptake ratios for tumor vs normal breast tissues (T/NT) were calculated using regions of interest.In the breast cancer groups and the benign lesion groups,the average uptake ratios of the 99mTc-octreotide were 1.63±0.19 and 1.09±0.13,respectively,and t was 9.638 (P0.001).Based on sensitivity,specificity,accuracy,positive predicting value,and negative predicting value,99mTc-octreotide scintimammography was 87%,79%,84%,90%,and 73%,the mammography was 65%,64%,64%,80%,and 45%,and both combination was 95%,100%,97%,100% and 92%,respectively.This showed that the 99mTc-octreotide scintimammography was more useful than mammography in the evaluating suspected breast cancers,and the combination technique can accurately discriminate lesions.     

Evaluation of some ratio effects in ^99mTc－MIBI imaging of breast tumors

The effectiveness of using some ratios in 99mTc-MIBI imaging fbr the diagnosis of breast tumors was evaluated. After 100 patients with the breast tumor underwent 99mTc-MIBI imaging, the ratios of tunor to contralateral uptake (T/N). tumor to heart uptake (T/H), and tumor to sternum uptake (T/S) were obtained and then analysed about their reproducibility and values in differentiating benign breast lesion the from malignant tumor. To detect breast cancers, the sensitivity, specificit y and accuracy of T/N were 92%, 90% and 91%, respectively. However, those of T/S were 70% (p ＜0.01), 74% (p ＜0.05), 72% (p ＜0.01), and those of T/H were 74%(p ＜0.05). 76% (p ＞0.05). 75% (p ＜0.01). The average coefticients of variation(CV) of T/N, T/S and T/H were 9.439±9.712. 4.856+4.420 (p ＞0.05), and 3.736±3.489 (p ＜0.05). It was found that T/N had the best sensitivity, specificity and accuracy todetect the breast cancer, but its reproducibility is poor. On the other hand, T/H has better reproducibility.     

Clinical significance of combined determination of serum PG I ,PGⅡ and GAS for diagnosis of gastric cancer

To evaluate the clinical value of combined determination of serum PG I, PG Ⅱ and GAS for early diagnosis of gastric cancer, the serum levels of PG I, PG Ⅱ and GAS in 190 healthy controls and 129 patients with gastric disorders were measured by RIA. The 129 patients include 68 cases of gastric cancer. The results showed that the serum levels of PG I and PG I/PG Ⅱ ratio in gastric cancer patients were obviously lower than those in healthy controls, while comparing with controls, the serum GAS levels were significantly higher. The diagnostic accuracy of the determinations for gastric cancer was evaluated by receiver operating characteristic （ROC） curve analysis. The area under the curve （AUC） levels of serum PG I, PG I/PG Ⅱ ratio and GAS were 0.833, 0.842 and 0.851, respectively. As serum PG I or PG I/PG II ratio or GAS were combined, the sensitivity and specificity of determination for gastric cancer diagnosis were 94.2% and 73.4%, respectively. All these results indicated that the combined determination of serum PG I, PG Ⅱ and GAS levels may be used as a tool for primary screening of gastric cancer.     

An analytical simulation technique for cone-beam CT and pinhole SPECT

This study was aimed at developing an efficient simulation technique with an ordinary PC.The work involved derivation of mathematical operators,analytic phantom generations,and effective analytical projectors developing for cone-beam CT and pinhole SPECT imaging.The computer simulations based on the analytical projectors were developed by ray-tracing method for cone-beam CT and voxel-driven method for pinhole SPECT of degrading blurring.The 3D Shepp-Logan,Jaszczak and Defrise phantoms were used for simulation evaluations and image reconstructions.The reconstructed phantom images were of good accuracy with the phantoms.The results showed that the analytical simulation technique is an efficient tool for studying cone-beam CT and pinhole SPECT imaging.     

Comparable investigation in dopamine transporters with ^99mTc-TRODAT-1 and ^131I-FP-CIT SPECT in Parkinson＇s disease patients

Dopamine transporter （DAT） mediates the regulation of dopaminergic function. Two agents of TRODAT-1 and FP-CIT were observed in evaluating DAT change of Parkinson＇s disease （PD）. The relationship between them was also evaluated. The results suggested that ^99mTc-TRODAT-1 SPECT and ^131I-FP-CIT SPECT may serve as sensitive and objective in vivo markers to reflect the severity of PD. The ^99mTc-TRODAT-1 image is more accurate and clearer compared with ^131I-FP-CIT.     

Improving the detecting efficiency of suspected gastrointestinal tumors with dual-time-point ~(18)F-FDG PET/CT

We conducted a retrospective analysis of 221 subjects with 256 suspected gastrointestinal lesions from2007 to 2015 to explore the detecting efficiency of dualtime-point fluorine-18 fludeoxyglucose(~(18)F-FDG) positron emission tomography/computed tomography(PET/CT)and pathology examination. The abdominal delayed PET/CT was performed within 45 min of the conventional scan.The change in maximum standardized uptake value(ASUV_(max)) and morphological features of the suspected lesions between the conventional and dual-time-point PET/CT were compared. The sensitivity, specificity, positive predictive value, and negative predictive value(NPV) of conventional PET/CT were 81.6%(84/103), 56.2%(86/153), 55.6%(84/151), and 81.9%(86/105), respectively.Those of dual-time-point PET/CT were 94.1%(97/103),78.4%(120/153), 74.6%(97/130), and 95.2%(120/126),respectively. There was a significant difference between the conventional and dual-time-point PET/CT(P 0.005).The SUV_(early) and the %△SUV_(max) could not present more information in differential diagnoses, but the rate of tumors with increased SUVdelay accounted for 79.6%(82/103) and more than that of nonneoplastic lesions(15.5%, 29/187)(x~2= 115.5, P 0.01). Therefore, the dual-time-point~(18)F-FDG PET/CT had a higher sensitivity and NPV than the conventional PET/CT to detect gastrointestinal tumors.The constant morphology and increased SUV_(delay) help to detect the tumors and adding delayed imaging on the locality will be an effective method when we accidentally find a suspected gastrointestinal tumor on the conventional PET/CT images.     

Evaluation of suspected local recurrence in lung cancer and head & neck cancer: A comparison between 99mTc-HL91 SPECT and CT for biopsy proven lesions

CT has rather low accuracy for the follow-up of rumors after therapy. This study was to determine whether the diagnostic accuracy can be improved with 99mTc-HL91 SPECT in comparison with parallel results of CT imaging. Thirty patients of lung cancer or head & neck cancer, suspected of recurrences on clinical symptoms and CT during clinical follow-up after therapy, underwent 99mTc-HL91 SPECT. The radioactivity ratios of tumor to normal tissues (T/NT) were calculated using the region of interest technique. Results of 99mTc-HL91 SPECT were verified by histopathology. The 99mTc-HL91 average uptake ratios of T/NT in the group of recurrent lesions and non-recurrent lesions were 1.58±0.16 and 1.18±0.14, respectively. A significant difference was found between T/NT data of the two phases (t=4.87, P<0.001). The 99mTc-HL91 SPECT shows sensitivity of 72.73%, specificity of 89.47% and accuracy of 83.83% for differentiating recurrent lesion, while the CT shows sensitivity of 63.63%, specificity of 84.21% and accuracy of 76.67%. A combination of 99mTc-HL91 SPECT and CT for 21 patients with lung cancers or head & neck cancers with congruent results shows sensitivity of 100%, specificity of 94.12% and accuracy of 95.23%. It is concluded that 99mTc-HL91 SPECT may play a role in differentiating recurrent lesions in patients with lung cancer and head & neck cancer. Furthermore, the combination of CT and 99mTc-HL91 SPECT is a more effective method for diagnosing recurrence of lung cancer and head & neck cancer.     

99mTc-tetrofosmin SPECT显像在肺癌和纵膈淋巴结转移的临床研究

对32例手术病理证实的肺癌和肺结核病人(其中鳞状上皮癌16例,腺癌8例,小细胞肺癌4例,肺转移癌2例,肺结核2例),进行     

99mTc-tetrofosmin SPECT显像在肺癌和纵膈淋巴结转移的临床研究

对３２例手术病理证实的肺癌和肺结核病人（其中鳞状上皮癌１６例,腺癌８例,小细胞肺癌４例,肺转移癌２例,肺结核２例）,进行＾９９ｍＴｃ－ＴＦ ＳＰＥＣＴ显像和ＣＴ检查,将结果直接与手术结果对比,来评价肺和纵膈淋巴结病变。结果在肺癌原发灶,＾９９ｍＴｃ－ＴＦ ＳＰＥＣＴ显像具有较高的灵敏度（９３％,２８／３０）,但２例肺结核病灶也显示＾９９ｍＴｃ－ＴＦ的摄取增高。有５例手术证实伴有肿瘤中心坏死的肺癌病     

99Tcm-抗纤维蛋白单克隆抗体对兔动静脉血栓的放免显像

The anti-fibrin McAb SZ-63 is labeled by using the method of 2-iminothiolane modification and ⁹⁹Tc^m-glucoheptonate(GH) transchelation. The experimental femoral arterial and venous thrombi are prepared in rabbits, then ⁹⁹Tc^m-SZ-63 is injected into ear-edge vein and imaged by SPECT. ⁹⁹Tc^m-labeled murine IgG is used as a negative control. The old arterial and venous thrombi in rabbits are clearly imaged 2 to 4 h after injection of ⁹⁹Tc^m-SZ-63. McAb SZ-63 would be a potential agent for diagnosis and therapy of thrombotic disease.     

符合线路SPECT-18FDG显像诊断肺癌的研究

用双探头ＥＣＴ进行＾１８ＦＤＧ符合线路显像,探讨对肺癌的诊断价值。３９例未确诊的肺部病变患者,禁食４ｈ静脉注入３７－１１１ＭＢｑ＾１８ＦＤＧ。静休１－２ｈ在胸部行断层显像,用叠代法重建。检测病灶区与对侧对照区核素的浓聚比值,超过１．３为显像阳性。根据显像结果与肺癌诊断的灵敏度为９３％（２５／２７）,特异性８３％（１０／１２）,符合率９０％（３５／３９）,本显像技术对肺癌诊断有较好的应用价值。     

18F-FDG符合线路成像在肿瘤及其转移灶探测中的临床应用

为评价^18氟-脱氧葡萄糖(^18F-FDG)符合线路成像在诊断肿瘤性质或肿瘤转移的临床应用价值，对87例临床怀疑为恶性肿瘤或肿瘤转移复发的患者，空腹肘静脉注射^18F-FDG259—298MBq后40-60min，采用GEHAWKEYE符合线路单光子发射型计算机断层(SPECT)进行卧位显像；经迭代法处理和重建，获得经X线衰减校正后的横断面、冠状面和矢状面三维断层图像；以目测双盲阅片进行诊断分析，并与手术病理或CT／MRI以及临床随访作出的最后诊断进行了对比。结果显示：87例患者中显像阳性61例，其中假阳性5例，真阳性56例；阴性26例，其中假阴性2例，真阴性24例。87例患者中共检出病灶136个，其中淋巴结和远处转移灶41个。符合线路成像对肿瘤或其转移灶诊断的灵敏度为96．6％(56／58)，特异性为82．8％(24／29)，阳性预测值91．8％(56／61)，阴性预测值92．3％(24／26)，诊断准确率92．0％(80／87)。表明 ^18F-FDG符合线路成像对于肿瘤的诊断具有较高的灵敏度和特异性；在肿瘤定性、肿瘤复发和转移灶的寻找方面有着独特的优势，是临床肿瘤诊断研究的有效手段。     

Electron impact ionisation of encapsulated Tc@C60 and Tc@C70

The present study shows simultaneous surface ionisation and electron impact ionisation during the formation and investigation of endohedral fullerenes ^99mTc@C₆₀ and ^99mTc@C₇₀. The endohedral fullerenes were generated using a mass spectrometer with a triple rhenium filament as an ion source. The ionisation energies (IE) determined were: 8.52 ± 0.25 eV for ^99mTc@C₆₀ and 9.57 ± 0.25 eV for ^99mTc@ C₇₀.     

99Tcm-3PRGD2 SPECT显像用于胰腺癌荷瘤裸鼠动物实验及临床转化研究

本工作探讨了新型示踪剂⁹⁹Tc^m-HYNIC-3PEG₄-E［c(RGDfK)］₂（⁹⁹Tc^m-3PRGD₂）用于胰腺癌的诊断价值及临床转化可行性。用免疫组化实验测定PANC-1胰腺癌细胞以及肿瘤组织中的整合素α_vβ₃的表达。将PANC-1胰腺癌细胞种植于BALB/c裸鼠肩部,建立合格的动物模型。以联肼尼克酰胺(HYNIC)作为双功能连接剂,采用无亚锡一步法制备⁹⁹Tc^m-3PRGD₂。在0.5~6.0 h,每隔0.5 h行一次荷瘤鼠⁹⁹Tc^m-3PRGD₂全身平面显像,观察全身分布情况,于肿瘤及健侧勾画感兴趣区（ROI, region of interest）,计算肿瘤与本底(T/NT)的比值。对6例胰腺肿瘤患者行99Tcm-3PRGD₂单光子发射的计算机断层显像（SPECT）,评估对胰腺癌的检出率。结果表明：PANC-1胰腺癌细胞以及肿瘤组织中高表达整合素α_vβ₃。⁹⁹Tc^m-3PRGD2标记率大于99%。荷瘤鼠显像显示肿瘤对示踪剂摄取好,0.5 h时即可见肿瘤显影,1.5 h时T/NT达最大值,6.0 h时肿瘤仍可清晰显示。⁹⁹Tc^m-3PRGD₂ SPECT显像可检出6例患者的胰腺肿瘤原发灶和肝转移灶,检出率为100%。⁹⁹Tc^m-3PRGD₂是一种安全有效的示踪剂,特异性结合整合素α_vβ₃,⁹⁹Tc^m-3PRGD₂ SPECT对胰腺癌的临床诊断具有潜在的应用前景。