淀粉样蛋白显像剂~(11)C-PIB的自动化制备优化及临床初步应用

采用国产自动化碘代甲烷仪,通过氢化锂铝/四氢呋喃(LAH/THF)还原法制得的~(11)C-碘代甲烷(~(11)CH3I),在线转换成活性更高的~(11)C-三氟磺酸甲酯(~(11)CH3OTf),通入锥形反应瓶内,和1.0mg PIB前体6-OH-BTA-0丁酮溶液在盐冰浴条件下反应,利用改进的HPLC方法纯化产品,并对最终产品进行质量控制。用昆明小鼠进行急性毒性试验,并行4例临床AD患者及1例正常人PET/CT显像。结果表明,改进后的自动化制备工艺,最终得到可供注射的~(11)C-PIB 10%乙醇溶液,改进后使用前体原料更少,产率稳定。改进后的~(11)C-PIB制备路线稳定可靠,初步临床研究表明,制备的~(11)C-PIB显像剂可以用于阿尔茨海默病诊断。     

18F-FDG PET/CT显像对结直肠癌术后复发及转移的诊断价值

探讨18F-脱氧葡萄糖(18F-FDG)PET/CT显像对结直肠癌术后复发和转移的诊断价值.对63例结直肠癌术后患者进行全身18F-FDG PET/CT显像检查.根据手术或活组织病理学检查、多种影像学检查及6个月以上的临床随访结果.63例患者中,有45例最终诊断为肿瘤复发或转移.以患者计算,18F-FDG PET/CT显像诊断的灵敏度为95.6%,特异性为83.3%,准确性为92.1%.以病灶计算,18F-FDG PET/CT显像诊断的灵敏度为96.9%,特异性为66.7%,准确性为95.7%.18F-FDG PET比同机CT平扫对病灶检出率高(x2=6.449,P=0.011).依据18F-FDG PET/CT显像结果,13例(20.6%)患者改变了临床再分期,其中12例提高了临床再分期、1例降低了临床再分期.18F-FDG PET/CT显像对结直肠癌术后复发和转移的诊断具有重要临床价值.     

牛奶造影剂充盈法在~(18)F-FDG PET/CT诊断胃癌中的增益价值

探讨牛奶造影剂充盈后延迟显像在18F-FDG PET/CT诊断胃癌中的增益价值。临床疑诊胃癌或须除外胃癌患者81例,在行18F-FDG PET/CT常规全身显像后,口服纯牛奶和复方泛影葡胺混合液500-600 m L充盈胃腔,10-20 min后进行胃局部延迟显像。肉眼分析比较胃腔充盈前后的图像差别,以手术和胃镜活检病理以及临床随访为确诊依据,评估牛奶造影剂充盈胃腔方法在PET/CT诊断胃癌中的增益价值。81例患者中,经病理确诊为胃癌者51例,良性病变30例。牛奶造影剂充盈胃腔后PET诊断胃癌的灵敏度从常规显像的60.7%提高至82.3%(?2=5.829,P=0.016),特异性从46.7%提高至76.6%(?2=5.711,P=0.017)。综合分析PET和CT所见,CT弥补了6例(6/9)18F-FDG摄取不高的胃癌病灶的检出。常规显像和牛奶造影剂充盈胃腔后延迟显像PET/CT诊断胃癌的灵敏度分别88.2%、94.1%,特异性分别为83.3%、90.0%,二者的诊断效能无显著性差异(?2=0.487,P=0.484和?2=0.144,P=0.704)。牛奶造影剂充盈后延迟显像胃癌病灶及其侵犯范围的显示程度较空腹状态时更清楚(t=6.866,P=0.000),在45.0%(23/51)弥漫型胃癌或18F-FDG摄取较低患者中提示CT的影像改变更有助于准确地显示和判断肿瘤的侵犯范围。18F-FDG PET/CT对原发性胃癌具有较高的诊断价值,采用牛奶造影剂胃充盈法尽管未能显著提高其诊断效能,却能更清晰地显示胃癌病灶及其侵犯范围。     

单次化疗后肿瘤内~(99)Tc~m-Annexin Ⅴ的分布与bcl-2、bax蛋白表达的相关性研究

采用99Tcm-rh-Annexin Ⅴ作为核素凋亡显像示踪剂,观察小鼠单次化疗后肿瘤内bcl-2与bax蛋白的表达。结果显示,单次化疗后化疗组肿瘤组织的放射性摄取百分数(%/g)、阳性细胞数及bax蛋白表达均明显多于对照组(P<0.01);bcl-2蛋白表达两组间差异无显著性(P=0.220);化疗组bcl-2/bax明显高于对照组(P<0.01)。相关性研究表明,对照组与化疗组肿瘤组织的放射性摄取百分数与TUNEL阳性细胞数均呈明显正相关(r=0.801,r=0.769)。对照组肿瘤组织内bax蛋白表达与放射性摄取及TUNEL阳性细胞数均呈明显正相关(r=0.849、0.652),bcl-2/bax比值与放射性摄取百分数及TUNEL阳性细胞数均呈明显负相关(r=-0.820、-0.694)。以上结果提示,肿瘤组织内99Tcm-rh-Annexin Ⅴ的分布可以反映化疗后早期肿瘤组织细胞凋亡的状况以及凋亡调控蛋白bax表达水平的变化。     

分化型甲状腺癌的18FDG PET显像及血清TSH水平的影响

甲状腺乳头状癌和滤泡状癌术后病人共32例进行了18FDG PET显像.为评价血清促甲状腺激素(TSH)水平对18FDGPET显像的影响,根据患者血清TSH浓度,将患者分为TSH水平抑制组(TSH≤0.3μIU/mL)和TSH水平非抑制组(TSH＞0.3μIU/mL)2组,并进行阳性检出率和转移病灶的18FDG摄取程度比较.32例18FDG PET受检者中,17例临床确诊为转移性甲状腺癌患者有14例阳性(82.4%),其中TSH水平抑制组6例(33.3%),TSH水平非抑制组8例(57.1%),两组间无明显的显著性差异(x2=1.814,P=0.178).TSH水平抑制组中有3例患者,临床确诊为复发,但18FDG PET显像未能显示病灶.18FDG PET显像的14例阳性患者共有24个甲状腺癌转移灶,分别位于甲状腺床、颈部、骨骼和肺部.转移灶的18FDG摄取程度,TSH水平非抑制组的转移灶明显高于抑制组(P＜0.05).本研究表明,分化型甲状腺癌进行18FDG PET显像时,高TSH血清水平有可能有利于发现甲状腺癌转移灶.     

~(18)F-FDG和~(18)F-NaF示踪剂在大鼠经脉的microPET显像

探讨利用微型正电子发射断层显像(micro positron emission tomography system,microPET)显示示踪剂在足三里穴位注射后沿经脉走行的循经迁移线。分别将0.03~0.1mL 200~300uCi的~(18)F-氟化钠和~(18)F-FDG注入大鼠足三里穴位,分别进行microPET图像和CT图像采集,将microPET图像和CT图像融合并重建融合后的三维图像。结果表明:~(18)F-FDG与~(18)F氟化钠均能显示循经迁移线,但~(18)F-氟化钠的骨骼摄取明显,~(18)F-FDG优于~(18)F-氟化钠在经脉中的显像,表明~(18)F-FDG更适合用于经脉显像。     

Calculations of Neutron Elastic and Inelastic Scattering from Light Nuclei

1.Optical model analysisWe choose the optical model potential of the Woods-Saxon formV(r)=-Uf(r,r_1,α_1) i4Wα_2d/(dr)f(r,r_2,α_2) U_s(/(h/mc))~21/r d/(dr)-f(r,r_3,α_3)·Lf(r,r_j,α_i)=[1 exp((r-r_jA~(1/3))/α_i)]~(-1) (j=1,2,3)where U,W,and U_s are the depth parameters of the real potential,the imaginarypotential,and spin-orbit term respectively,and r_j are the radius parameters,and α_j are the surface-diffuseness parameters.     

11C-MET和18F-FDG PET/CT对胶质瘤诊断的价值比较

对26例胶质瘤和18例颅内良性病变患者行18F-FDG和11C-MET PET/CT颅脑显像,定性和半定量分析两种显像图像.结果显示:11C-MET和18SF-FDG PET/CT对胶质瘤诊断的准确率分别为88.6%和65.9%.半定量分析,26例胶质瘤11C-MET摄取值比值TINGmax显著高于18F-FDG的TI...     

单次化疗后肿瘤内99Tcm-Annexin Ⅴ的分布与bcl-2、bax

目的 评价应用99Tcm-rh-AnnexinⅤ显像检测单次化疗后肿瘤细胞凋亡的可行性，并探讨其在肿瘤组织内的分布与凋亡调控蛋白bcl-2、bax表达的相关性。方法 采用直接标记法标记rh-AnnexinⅤ作为核素凋亡显像示踪剂。将小鼠肝癌细胞（Hca-F25）接种于小鼠右腋下部位；随机分为A（n=9，对照组）、B（n=10，化疗组）两组，8d后肿瘤生长至直径约1cm时，B组一次性接受环磷酰胺（cyclophosphamide）腹腔内注射，剂量为150mg/kg；20h后两组同时由鼠尾静脉注入99Tcm-rh-AnnexinⅤ；4h后行SPECT显像并处死、取材，应用井型闪烁探测器检测荷瘤小鼠肿瘤组织内示踪剂分布，以%ID/g（每克组织百分注射剂量率）表示。采用TUNEL法检测肿瘤细胞凋亡；采用采用免疫组化SP法检测标本中bcl-2、bax蛋白表达。结果 单次化疗后B组肿瘤组织的%ID/g、TUNEL检测阳性细胞数及bax蛋白表达均明显多于A组（P<0.01）；bcl-2蛋白表达A、B两组间差异无显著性（P＝0.220）；A组bcl-2/bax明显高于B组（P<0.01）。相关性研究表明，在A、B组中肿瘤组织的%ID/g与TUNEL阳性细胞数均呈明显正相关（r=0.801，r=0.769），而bcl-2蛋白表达与bax蛋白表达间无明确相关性；A组肿瘤组织内bcl-2、bax蛋白表达与肿瘤组织的%ID/g及TUNEL阳性细胞数均无明确相关性；B组肿瘤组织内，bcl-2蛋白表达与%ID/g及TUNEL阳性细胞数均无明确相关性，bax蛋白表达与%ID/g及TUNEL阳性细胞数均呈明显正相关（r＝0.849、0.652），而bcl-2／bax比值与%ID/g及TUNEL阳性细胞数均呈明显负相关（r＝－0.820、－0.694）。结论 肿瘤组织内99Tcm-rh-AnnexinⅤ的分布可以反映化疗后早期肿瘤组织细胞凋亡的状况以及凋亡调控蛋白bax表达水平的变化。     

HL-1M托卡马克等离子体H_α观测

等离子体参数的提高及约束改善是受控核聚变主要的研究课题之一。对于工作气体为氢和氘的等离子体,对H_α/Dα辐射的观测十分重要。氢原子由一个原子核和一个电子组成,在可见光范围,巴尔末线系H_α656.28nm辐射是最强的线,激发能E=12.09eV,跃迁2p·~2po～3d·~2D,一个光子能量hv=3.03×10~(-19)W。电离能E_∞=13.6eV。HL-1等离子体参数为R=102cm,α=17～26cm,电子温度T_e=0.3～1.5keV,     

AD显像剂11C-PIB合成效率的影响因素

¹¹C-PIB是诊断阿尔茨海默病（AD）的特征靶Aβ斑块的正电子放射性药物,本工作系统研究了以¹¹CH₃-Triflate为甲基化试剂合成¹¹C-PIB合成的影响因素。在国产碳多功能合成仪上, 研究前体量、溶剂、反应温度及体系的pH等对¹¹C-PIB效率的影响,并对合成条件进行优化。结果显示：前体量、溶剂、反应温度及体系的pH均明显影响合成效率。优化后的合成条件为：丙酮为溶剂,前体浓度为5 g/L,反应温度为常温,pH为中性。在此条件下,¹¹C-PIB的合成效率为65.2%±4.7%(n=8,校正效率),产品的放化纯度大于99%,比活度为70.6 GBq/g（18.0 TBq/mmoL）。从¹¹CO₂到¹¹C-PIB的合成时间为30 min, 单次合成的产量为3.7 GBq。以上结果表明,通过优化合成条件,可以稳定、高质量地合成¹¹C-PIB,以满足临床需要。     

Clinical value of 18F-FDG PET/CT in evaluation of hepatic vein, inferior vena cava and right atrium tumor thrombi in ]~epatocellular carcinoma： Initial results

In this paper,eleven consecutive hepatocellular carcinoma(HCC) patients with an embolus in the hepatic vein(HV),inferior vena cava(IVC)and right atrium(RA) were studied with 18F-FDG PET/CT and contrast enhanced CT.When correlated with final diagnosis,18F-FDG PET/CT and contrast enhanced CT was positive in 11 patients(100%),7 patients(63.6%),respectively.The accuracy of PET/CT and contrast-enhanced CT were 100%,63.6%.Three cases with secondary blood thrombi in the distant IVC,which were confirmed by PET/CT,cannot be identified by contrast enhanced CT.The average survival was 3 months(range,1-12mo).The 12 months survival rate was 9.1%.Our results suggest that highly metabolic tumor thrombus in the HV,IVC and RA may be depicted on 18F-FDG PET/CT in HCC patients.It may discriminate between malignant and secondary benign blood thrombi.     

18F-FDG PET/CT对恶性胸膜间皮瘤诊断及预后评估的价值

回顾性分析了本院2006年10月—2010年3月间19例临床怀疑胸膜间皮瘤患者的¹⁸F-FDG PET/CT图像,探讨¹⁸F-FDG PET/CT对恶性胸膜间皮瘤诊断及预后评估的价值。通过¹⁸F-FDG PET/CT显像获得最大标准摄取值（SUVmax）、摄取类型、临床分期、病理类型及血清中癌胚抗原（CEA）水平,对恶性胸膜间皮瘤进行准确诊断、术前分期及预后评估。所有患者扫描后分别经外科手术、穿刺活检、胸腔镜、胸水细胞学检查或纵隔镜等检查,以病理结果为金标准。结果显示,19例中17例经病理证实为恶性胸膜间皮瘤(PET/CT确诊16例,漏诊1例),2例良性病变（PET/CT确诊1例,误诊1例）。¹⁸F-FDG PET/CT显像判断胸膜间皮瘤的符合率为89%（17/19）,敏感度为94%（16/17）,假阴性率为6%（1/17）,特意度为50%（1/2）。恶性胸膜间皮瘤SUVmax（11.88±5.39）与良性组SUVmax（4.10±0.85）相比,其差异具有统计学意义（P=0.005 8,P＜0.01)。恶性胸膜间皮瘤病理包括上皮型、肉瘤型、混合型及非典型4种,在各不同病理类型间,非上皮型SUVmax（15.88±3.94）较上皮型（7.40±2.82）高,其差异具有统计学意义（t=4.56,P＜0.01)。在不同临床分期中,Ⅳ级SUVmax（19.83±3.57）较Ⅱ、Ⅲ分级患者放射性摄取明显增高,其差异具有统计学意义（F=7.69,P<0.01)。胸膜间皮瘤¹⁸F-FDG PET/CT显像中,病灶摄取类型可分为结节形、线形、环形及混合形4种,其中环形放射性摄取（SUVmax=16.63±4.51）与其他三种摄取类型（SUVmax=10.61±4.85）相比,其差异具有统计学意义(t=3.64,P＜0.01)。以血清中癌胚抗原（CEA）≥5 μg/L为标准,患者SUVmax(14.19±5.15)明显高于CEA＜5 μg/L组SUVmax(8.60±4.04),其差异具有统计学意义( t=2.39,P＜0.05)。以上结果提示,¹⁸F-FDG PET/CT对于恶性胸膜间皮瘤的诊断的敏感度较高;不同组织病理学类型中,上皮型预后好于其他类型;随着临床分期的进展,SUVmax递增,提示与肿瘤恶性程度加剧相关。不同类型¹⁸F-FDG PET/CT显像中,环形摄取类型常提示肿瘤恶性程度较高。血清中CEA升高,也提示肿瘤恶性程度增加,预后不良。综上所述,¹⁸F-FDG PET/CT显像在临床分期、疗效评价、监测复发及预后评估等方面将发挥重要作用。     

Comparison of diagnostic accuracy between ^18F-FDG PET and PET/CT for pulmonary neoplasm

Aimed at comparing diagnostic accuracy of 18F-FDG PET with PET/CT for pulmonary neoplasm,a study based on multi-center clinical trial of the diagnoses,in randomized and semi-blind ways,was executed from January 2006 to June 2007.It included 55 patients,i.e.16 with histopathologically proved lung tumors,16 with tuberculosis and 23 with benign lesions (inflammation,pseudotumor,granuloma,fibrosis and others).The histopathologic and clinic results were served as reference standard.Statistical significances in pulmonary nodule diagnosis between 18F-FDG PET and PET/CT were determined with 95% confidence interval obtained by ROC analysis.The 18F-FDG PET detected lung neoplasm with a sensitivity of 87.5% (14/16),a specificity of 59.0% (23/39),an accuracy of 67.3% (37/55) and a positive-likelihood ratio of 2.13.The 18F-FDG PET/CT detected lung neoplasm with a sensitivity of 93.8% (15/16),a specificity of 61.5% (24/39),an accuracy of 70.9% (39/55) and a positive-likelihood ratio of 2.43.The area under curves (AUC) of 18F-FDG PET and PET/CT were 0.803±0.068 and 0.799±0.063,respectively.It can be concluded that the diagnostic accuracy for malignant pulmonary nodules between 18F-FDG PET and PET/CT was not statistically different.     

单管法~(11)C-CH_3I的合成条件优化及胆碱生产与临床应用

通过对合成11C-CH3I所用试剂的用量、反应的载气流量、压力和反应温度、蒸发时间等条件进行优化,进而用柱色层法合成了11C-胆碱。在反应条件为:Li Al H4和57%HI的用量分别为0.3 mL和0.5 mL,反应的最佳载气流量和压力分别为27 mL/min、0.28 kPa,反应温度为180℃,蒸发时间为12 min下,11C-CH3I的校正后标记产率为62.2%±3.4%,放化纯度95%。临床脑胶质瘤和前列腺瘤疑似患者各1例在18F-FDG显像24 h后分别接受11C-胆碱检查,并与18F-FDG显像结果对照。显像结果表明,18F-FDG检查示低代谢区11C-胆碱均呈高代谢,联合用药可以更准确地区分病变的性质。     

18F-FDG PET/CT for malignant small intestinal neoplasms

In this paper, 18F-FDG PET/CT data of 19 malignant SINs (small intestinal neoplasms) were consecutively reviewed. Nnine patients accepted PET/CT scan for preoperative diagnosis and staging, while ten patients presented follow-up after treatment and restaging. The results were correlated with abdomen enhanced CT and surgical pathological findings. Abdominal pain and weight loss were the most common findings. About 16% SINs located in the duodenum, 52% in the jejunum and 32% in the ileum. Lymphoma was the most frequent neoplasms. PET/CT revealed residual or recurrent malignant SINs in 5 patients who had negative or non-definite findings by abdomen CT and demonstrated extra-abdomen metastasis in 3 patients. Clinical decisions of treatment were changed for 6 patients after PET/CT examinations. The 18F-FDG PET/CT were better than CT in accuracy, negative predictive value and positive predictive value (89.5% vs 68.4%, 100% vs 66.7%, and 81.8% vs 69.2%, respectively). Whole body 18F-FDG PET/CT may be an effective molecular imaging method for staging and restaging of malignant SINs.     

18F-FDG PET/CT显像在食管癌分期中的应用

对30例食管癌初诊患者于手术或放化疗前一周内进行18F-FDG PET/CT检查,将15例手术治疗患者的130枚区域淋巴结的PET/CT结果与病理学检查相比较.所有患者的远处转移灶及15例非手术治疗患者的区域淋巴结转移根据活组织病理学检查、多种影像学检查临床随访而定,随访时间均大于6个月.结果显示:30例食管癌患者,原发病灶18F-FDG PET/CT均为高代谢病灶(100%),病灶界限显示清晰.以患者为单位计算,30例食管癌患者,20例(66.7%)证实有区域淋巴结转移,18F-FDG PET/CT真阳性18例,假阳性2例,假阴性2例,诊断的灵敏度、特异性和准确性分别为90.0%、80.0%、86.7%.以淋巴结为单位计算,在15例手术治疗患者的共130枚淋巴结中,病理学检查证实为淋巴结转移33枚(25.4%),PET/CT真阳性23枚.18F-FDG PET/CT对区域淋巴结转移诊断的灵敏度、特异性及准确性分别为69.7%、97.9%、90.8%.检出远处转移4例(13.3%),分布于肝脏、肺及骨骼.30例PET/CT显像后,16例提高了临床分期;1例降低了临床分期;13例与18F-FDG PET/CT显像前的临床分期一致.     

~(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.     

结直肠癌~(18)F-FDG PET/CT分期与手术病理关联分析

探讨了18F-FsDG PET/CT对结直肠癌术前TNM分期的价值.41例结直肠癌患者均于手术治疗前两个星期内进行PET/CT检查,将PET/CT结果与手术病理学检查结果对结直肠癌原发灶的诊断对比分析,发现18F-FDG PET灵敏度为97.6%,PET/CT为100%.18F-FDG PET/CT对结直肠癌术前T分期、术前N分期、远处转移及TNM分期的准确性分别为85.4%、85.4%、97.6%和75.6%,均与手术病理学检查结果一致(0.574,0.670,0.918,0.664,均P<0.001).得出结论:直肠癌18F-FDG PET/CT检查结果与手术病理学检查结果有较好的一致性,可用于结直肠癌的术前临床分期.     

18F-FDG PET/CT早期监测小剂量顺铂在体化疗敏感性的实验研究

42只双侧前胸壁荷瘤的VX2兔模型(共计84个肿瘤)随机分为治疗组(n=32)和对照组(n=10).治疗组静脉给予4mg/kg顺铂前(Pre-therapy)和给药后95-100min(Day 0)、Day 1、Day7、Day 14行PET/CT显像;对照组不给化疗药物,其余与实验组相同.取葡萄糖摄取最大值(SUVmax)进行分析,CT测量肿瘤大小.按肿瘤体积分组,Day 7时治疗组肿瘤体积增长>1倍则为不敏感,反之为敏感.结果显示:(1)Day 0敏感组SUVmax减低率为(-48.96±12.27)%,而不敏感组和对照组为(21.26±18.26)%和(7.16±13.47)%,三组SUVmax变化有显著差异(P<0.05).(2)Pre-therapy、Day 0、Day 1、Day 14两组肿瘤体积无显著性差异(P>0.05),但Day 7敏感组肿瘤体积小于不敏感组及对照组,差异有显著性(P<0.05).(3)Day 7、Day 14敏感组肿瘤坏死率大于不敏感组及对照组,差异有显著性(P<0.05).(4)HE染色观察不同时间点切除的肿瘤标本发现:Day 7、Day 14时敏感组肿瘤细胞数少而炎性和坏死细胞数增加.表明根据化疗药物给予后FDG减低程度,18F-FDG PET/CT能在体、早期、灵敏检出肿瘤对化疗药物的敏感性.