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.     

99mTc-MIBI显像对甲状腺癌及术后随访的临床价值

４６例甲状腺原发肿块（恶性病变１８例,良性病变２８例）及２４例甲状腺癌术后复发或转移患者,应用＾９９ｍＴｃ－ＭＩＢＩ显像。结果１８例甲状腺癌中１４例原发灶有效射性填充。而２８例良性病变中仅９例原发灶有放射性填充。２４例甲状腺癌术后复发或转移患者有１９例呈阳性显示,其阳性率明显高于＾１３１Ｉ显像。＾９９ｍＴｃ－ＭＩＢＩ显像对甲状腺癌尤其是术后复发、转移的早期诊断具有较高的临床价值。     

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 analysis of bone scanning in solitary lesion

A rational analysis procedure for solitary lesions on whole bone scanning was offered.This study was undertaken to analyze retrospectively solitary lesions which obtained final diagnose through the following aspects:(1) diagnosis of bone metastasis,(2) the incidence of bone metastasis in different tumor,(3) the most possible lesion sites indicating bone metastasis,(4) morphological analysis of solitary lesions.The results are:(1) The incidence of solitary lesions in 2465 cases on whole bone scanning is 15.3%.(2) The rate of bone metastasis is 24.8% in 282 patients with primary malignancy.The rate of bone metastasis is 6.3% in 64 patients without primary malignancy,and the total diagnostic rate of bone metastasis is 21.4% in 346 patients.(3) In patients with primary maligancy,the incidence of bone metastasis of solitary lesions is as follows rspectively:bronchi cancer 36.1%(22/61);breast cancer 23.8%(20/84);prostate gland 17.2%(5/29),other urinary system cancer 22.2%(4/18);G.I.system cacer 16.9%(10//59);others 29.0%(9/31).There is no significant difference in different cancer.(4)In patients without primary malignancy,93.7%(60/64)of solitary lesions are benign.(5) From anatomical point of view,we found the diagnostic rate of bone metastasis is as follow:30% in spine;34.2% in pelvis;36.4% in skull;10.8% in other bones,There are significant differences in four groups.It is concluded that:(1)the diagnostic rate of bone metastasis in solitary lesions is 21.4%;(2) The most possible solitary lesions indicating osseous tumor spread are at spine,pelvic and skull.(3) Special attention to “cold”and streak like lesions should be paid.(4) A Clinical analysis procedure for diagnosis of solitary lesions has been summarized out here.     

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.     

~(99)Tc~m-MDP、~(99)Tc~m(V)-DMSA和~(99)Tc4~m-Citrate显像对骨组织良恶性疾病鉴别诊断的对比研究

为评价99Tcm(V)二巯基丁二酸钠(DMSA)显像和99Tcm枸缘酸(Citrate)显像在骨转移癌和骨及骨关节炎症诊断中的意义,对骨转移癌患者和骨及骨关节炎症患者各18例分别进行99Tcm亚甲基二膦酸(MDP)、99Tcm(V)DMSA和99TcmCitrate全身显像,并比较了它们的显像结果。18例经病理学、CT或MRI证实有骨转移癌的患者,99TcmMDP显像共检出64个病灶,99Tcm(V)DMSA显像显示在与99TcmMDP显像相同部位同检出49个病灶,而99TcmCitrate显像仅检出1个病灶。18例经细菌学、CT或MRI证实的骨及骨关节炎症患者,99TcmMDP显像共检出22个病灶,99Tcm(V)DMSA显像显示在与99Tcm MDP显像相同部位同检出17个病灶,99TcmCitrate显像检出16个病灶。本组病例99Tcm(V)DMSA显像诊断骨转移癌的灵敏度为76.56%,特异性为22.73%; 99TcmCitrate显像诊断骨转移癌的灵敏度仅为1.56%,特异性为27.27%。99Tcm(V)DMSA显像诊断骨及骨关节炎症的灵敏度为77.27%,特异性为23.44%;99TcmCitrate显像诊断骨及骨关节炎症的灵敏度为72.73%,特异性为98.44%。以上结果表明,99Tcm(V)DMSA显像在诊断骨转移癌和骨组织炎症时应该慎重,因为它不能区分骨组织的良恶性病变性质,其对骨组织的良恶性病变性质的鉴别诊断应排除外骨组织炎症、骨折等骨组织良性病变的干扰。而99TcmCitrate     

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.     

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 tumors 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.     

乳腺癌筛查中乳腺X射线摄影两种标准体位及乳腺压迫厚度与平均腺体剂量的关系北大核心CSCD

为了使乳腺X射线摄影在乳腺癌筛查中的应用达到最优化,本文回顾性分析了在我院行乳腺X射线摄影和乳腺彩色多普勒超声检查,并取得病理结果的患者共132人、139个病灶,比较乳腺头尾位(craniocaudal view,CC)、内外侧斜位(medial lateral oblique view,MLO)、乳腺压迫厚度、乳腺密度与被检者接受的平均腺体剂量(average glandular dose,AGD)的关系及两种体位上病灶检出情况。结果显示:(1)乳腺压迫厚度及乳腺密度都是AGD的独立影响因素,并呈正相关,且乳腺压迫厚度对AGD的影响比乳腺密度大;(2)曝光参数管电压及管电流随着乳腺压迫厚度的增加有增加趋势,致使AGD增大;(3)同一乳腺CC及MLO的压迫厚度及AGD未发现特定规律,但均数±标准差CC位(2.49±0.84)>MLO位(2.27±0.81),且MLO比CC更易显示病灶。只拍摄乳腺MLO联合乳腺彩色多普勒超声检查具有很大优势,不仅保证了诊断需要,更降低了被检者的AGD值,且被检者乳腺压迫厚度及乳腺密度越大,AGD降低越多。     

含服硝苯吡啶对99mTc-MIBI心肌显像的影响

为观察硝苯吡啶对＾９９ｍＴｃ－ＭＩＢＩ心肌断层显像的影响,把３５例冠心病患者分成硝苯吡啶组和硝酸甘油组,隔日行介入心肌断层显像,静注＾９９ｍＴｃ－ＭＩＢＩ后１ｈ和５ｈ时分别采集图象,分析结果显示硝苯吡啶组虽有４０．０％的心肌节段摄取较用药前改善,但１ｈ显像有３３个节段出现逆向性摄取减少,其中２９个节段５ｈ显像又恢复正常。硝酸甘油组有６９．５％心肌节段较用药前摄取改善,１ｈ显像未见有逆向性摄取减少,     

Parathyroid and bone imaging in primary hyperparathyroidism

Skeletal derangements occur quite often in patient with primary hyperparathyroidism (PHPT). We investigated parathyroid and bone imagings in 59 cases of pathologically proven PHPT. Forty-nine cases were pathologically proven parathyroid adenomas; 8 presented hyperplasia and the other 2 were adenocarcinomas. Parathyroid imaging (early phase imaging, EPI) was conducted at 30 min alter injecting 740-925MBq ^99mTc-MIB1 and 2-3h later (delayed phase imaging, DPI) separately. The following thyroid imagings were performed at the same posture 10 min after intravenous injection of 74～111MBq ^99mTcO4^-. The ^99mTc^- M1B1 subtraction imaging data were obtained by subtracting thyroid imaging from that of DP1. Among 49 cases of proven hyperparathyroid adenoma 45 yielded positive imagings. Eight cases with hyperplasia gave negative results. The results were positive in 2 cases of parathyroid adenocarcinoma. Results of ^99mTc-MDP/bone imaging: 35 cases of hyperparathyroid adenocarcinoma (disease duration 1-6 months) showed normal bone images, while 14 cases showed superscan images, course being 4～12 months. Bone imaging for 2 cases of adenocarcinoma showed multiple, radioactive aggregated loci (brown tumor imaging); course lasting 10～24 months. The results of bone imaging in 8 cases of hyperplasia/hyperparathyroidism were normal. It was concluded that diagnostic accuracy for parathyroid was 79.6% and for parathyroid adenoma was 91.8%, and the technique has no diagnostic value for hyperplasia. The ^99mTc-MDP / bone imaging results for PHPT can be classified into three categories, i.e. normal, superscan and brown tumor. The imaging results correlated well with the different categories and degrees of bone damage, the duration of clinical course and the pathological types. Therefore, it‘s important to use bone imaging data in association with therapy to reflect the stage and progress of PHPT.     

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。     

A comparative study of primary coronary stenting and intravenous thrombolysis for acute myocardial infarction using~(99m) Tc-MIBI SPECT imaging

1 INTRODUCTIONRe-perfusion therapy is one of the important progresses of acute myocardial infarction (AMI) therapy. It is established that early intravenous thrombolysis is effective and convenient for patency-related artery (IRA)[']. But obvious limitation existsfor thrombolysis application such as low IRA patency rate, recuxrent ischeAnc events,high re-infarction rate, hemorrhage complication and so many contraindications. Recentyearst primary coronary steming has been developed as …     

~(99m)Tc-甲氧基异丁基异腈测定槲皮素磷酸酯钾对小鼠心肌营养性血流的影响

采用~(99m)Tc-甲氧基异丁基异腈(MIBI)示踪剂测定槲皮素磷酸酯钾(PQP)对小鼠心肌营养性血流的影响。实验表明ip PQP 200mg/kg可使小鼠每克心肌~(99m)Tc-MIBI的摄取能力与对照组相比增加55.36％,这一结果表明PQP有增加心肌营养性血流的作用,同时也表明可以用~(99m)Tc-MIBI替代~(36)Rb测定心肌营养性血流。     

核素关节显像在类风湿关节炎病人中的应用

报道２０例次活动期类风湿关节炎病人的＾９９ｍＴｃ－人免疫球蛋白（ＨＩＧ）关节显像结果,其中１６例与＾９９ｍＴｃ－ＭＤＰ显像进行了对照。结果表明,所有病人＾９９ｍＴｃ－ＨＩＧ显像均为异常,表现为关节周围软组织即关节囊的放射性增高。它与临床的符合率明显高于＾９９ｍＴｃ－ＭＤＰ显像;每个病人临床总分与其显像总分之间呈显著性相关（Ｐ＜０．０１,ｒ＝０．９３）;临床累及且显像阳性的关节,其摄取放射性的多少与     

89SrCl2加99Tc-MDP(云克)联合治疗转移性骨癌骨痛的疗效分析

采用89SrCl2 加99Tc-MDP(云克) 联合治疗与89SrCl2单项治疗方法,分别对106例骨转移癌患者进行治疗.结果表明,2种方法疗效均较好,但两者相比,联合治疗法治疗骨转移癌导致的骨痛总有效率达88.2%,明显高于89SrCl2单项治疗组(65.4%),两组相比P<0.05.原发灶中以乳癌疗效最佳,总有效率达100%,按组织学类型分析,其疗效依序为浸润性癌>腺癌>鳞癌.因此,联合治疗应以乳癌(尤其是乳腺浸润性癌)转移性骨癌导致的骨痛为首选病例.联合治疗产生的毒副作用并不多于89SrCl2单项治疗;对生存质量及体力状况的改善,联合治疗组亦明显高于89SrCl2单项治疗组.     

精细乳房模型及其在乳腺X射线摄影剂量评估中的应用

乳腺是对辐射致癌最敏感的组织之一,而辐射致癌风险与受照剂量密切相关。为更准确地评估电离辐射所致乳腺受照剂量,本文建立了一个具有皮肤、皮下脂肪、乳房后侧脂肪、悬吊韧带、纤维腺体区脂肪、输乳管、小叶、输乳窦和乳头等精细结构的乳房数学模型,并将其体素化为体素模型。考虑到在乳腺X射线摄影中的应用,对乳房体素模型进行头尾位（CC位）压迫,建立压迫乳房模型,并与中国成年女性参考人体素体模（CRAF）相拼接。采用Geant4对乳腺X射线摄影进行蒙特卡罗模拟,计算了一系列平均腺体剂量转换因子。根据计算结果,采用精细乳房模型计算的平均腺体剂量转换因子低于我国现行国家标准的取值,但与美国放射学会（ACR）标准的取值差别不大。     

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     

99mTc标记新型硼酸结构快速心肌灌注显像药物的制备及初步显像评价

^99mTc-TEBO为临床批准的快速心肌灌注显像药物,该药物初始摄取高,但心肌滞留不稳定,为此,本研究通过优化其硼酸结构,分别制备标记物^99mTc-2SP、^99mTc-4LPA及^99mTc-2MDM,制备时间均为30 min,均为无色澄明液体,放化纯度均>95%,分别在健康小型猪体内进行SPECT动态显像,并与99mTc TEBO进行对比。结果表明：^99mTc-TEBO注射后0~5 min,左室心肌快速摄取,但随后心肌放射性迅速洗脱,在10 min时心肌约洗脱至峰值的75%,与心血池放射性浓度比值为1.63。^99mTc-2SP引入2-甲磺酰基吡啶-5-硼酸基后心肌初始摄取高,心肌滞留时间明显延长,心肌洗脱较缓慢,左室心肌均清晰显影,在第10 min时心肌摄取仍可保持峰值的95%,与心血池放射性浓度比值为3.75,明显高于^99mTc-TEBO。而另外两种显像剂^99mTc-4LPA和^99mTc-2MDM在注射后15 min内显像不理想。因此,^99mTc-2SP是有潜力的心肌灌注显像药物。     

~(18)F-FDG PET/CT in diagnosis of skeletal metastases

This work is to evaluate correlated lesions in PET and CT images of patients suffering skeletal metastases so as to improve efficacy of ~(18)F-FDG PET/CT in diagnosing bone metastases. PET and CT images of 25 patients with malignant tumor suspected bone metastases were reviewed independently by three experts. A region of interest was placed over each lesion, and the standardized uptake value (SUV) was calculated at the maximal single pixel value.The t and χ~2 tests were used for statistical analysis. Of the 203 lesions detected on the PET and CT images, 189 were malignant and 14 were benign lesions. PET alone identified 159 malignant lesions and 6 benign lesions, CT alone identified 152 malignant lesions and 11 benign lesions. For PET, the diagnostic sensitivity, specificity and accuracy were 84.1%, 71.4% and 83.3%, respectively, while 80.4%, 71.4% and 83.3% for CT. No significant difference was found between PET and CT in detecting bone metastases (χ~2=0.89, 0.19, 0.59,P>0.05). Statistical difference of positive ratio of PET was found between osteoblastic and osteolytic or mixed lesions (χ~2=47.33, 7.93, both P<0.05).Of the 122 positive lesions on both CT and PET scan, the mean SUV was 5.76±3.41, 8.52±5.37 and 7.78±4.96 in osteoblastic lesions, osteolytic lesions and mixed lesions, respectively. Significant difference was found between osteoblast lesions and osteolytic lesions (t=2.28, P<0.05). PET images alone may leave out half of osteoblastic letions,but combined analysis of PET and CT images gives better diagnosis.