Pancreatic neuroendocrine tumor detected by technetium-99m methoxy-2-isobutylisonitrile single photon emission computed tomography/computed tomography:A case report

BACKGROUND Pancreatic neuroendocrine tumors(NETs)account for about 1%–2%of pancreatic tumors and about 8%of all NETs.Computed tomography(CT),magnetic resonance imaging,and endoscopic ultrasound are common imaging modalities for the diagnosis of pancreatic NETs.Furthermore,somatostatin receptor imaging is of great value for diagnosing pancreatic NETs.Herein,we report the efficacy of technetium-99m methoxy-2-isobutylisonitrile(99mTc-MIBI)single photon emission CT(SPECT)/CT for detecting pancreatic NETs.CASE SUMMARY A 57-year-old woman presented to our hospital with a 1-d history of persistent upper abdominal distending pain.The distending pain in the upper abdomen was aggravated after eating,with nausea and retching.Routine blood test results showed a high neutrophil percentage,low leukomonocyte and monocyte percentages,and low leukomonocyte and eosinophil counts.Amylase,liver and kidney function,and tumor markers alpha-fetoprotein,carcinoembryonic antigen,and cancer antigen(CA)125,CA72-4,CA19-9,and CA153 were normal.Abdominal CT showed a mass,with multiple calcifications between the pancreas and the spleen.The boundary between the mass and the pancreas and spleen was poorly defined.Contrast-enhanced CT revealed that the upper abdominal mass was unevenly and gradually enhanced.99mTc-MIBI SPECT/CT revealed that a focal radioactive concentration,with mild radioactive concentration extending into the upper abdominal mass,was present at the pancreatic body and tail.The 99mTc-MIBI SPECT/CT manifestations were consistent with the final pathological diagnosis of pancreatic NET.CONCLUSION 99mTc-MIBI SPECT/CT appears to be a valuable tool for detecting pancreatic NETs.

Same day yttrium-90 radioembolization with single photon emission computed tomography/computed tomography: An opportunity to improve care during the COVID-19 pandemic and beyond

BACKGROUND The coronavirus disease 2019(COVID-19)pandemic has made it more challenging for patients to undergo yttrium-90(Y-90)radioembolization(RE).Same day Y-90 RE provides an opportunity to minimize logistical challenges and infection risk associated with COVID-19,thus improving patient access.AIM To describe the use of same day Y-90 RE with routine single photon emission computed tomography/computed tomography(SPECT/CT)in order to optimize therapy.METHODS All patients were selected for Y-90 RE through a multidisciplinary tumor board,and were screened and tested for COVID-19 infection per institutional protocol.A same day procedure was developed,consisting of angiography,imaging,and Y-90 resin particle delivery.Routine SPECT/CT after technetium-99m macroaggregated albumin(Tc-99m MAA)administration was performed for assessment of arterial supply,personalized dosimetry,and extrahepatic activity.Post-treatment Y-90 bremsstrahlung SPECT/CT was performed for confirmation of particle delivery,by utilization of energy windowing to limit signal from previously administered Tc-99m MAA particles.RESULTS A total of 14 patients underwent same day Y-90 RE between March and June 2020.Mean lung shunt fraction was 6.13%(range 3.5%-13.1%).Y-90 RE was performed for a single lesion in 7 patients,while the remaining 7 patients had treatment of multifocal lesions.The largest lesion measured 8.3 cm.All patients tolerated the procedure well and were discharged the same day.CONCLUSION Same day Y-90 RE with resin-based microspheres is feasible,and provides an opportunity to mitigate infection risk and logistical challenges associated with the COVID-19 pandemic and beyond.We recommend consideration of SPECT/CT,especially among patients with complex malignancies,for the potential to improve outcomes and eligibility of patients to undergo same day Y-90 RE.

Deep brain stimulation of the subthalamic nucleus treats Parkinson's disease through enhancing metabolic activity of the corpus striatum Verification by single photon emission computed tomography and positron emission tomography

BACKGROUND:Subthalamic nucleus deep brain stimulation (STN DBS) for Parkinson's disease (PD) has achieved good effects,but to date the mechanism of STN DBS remains poorly understood. STN DBS may increase dopamine levels or metabolic activity of the corpus striatum. OBJECTIVE:To validate the effects of STN DBS on dopamine metabolism and glucose metabolism in the corpus striatum of hemiparkinsonian monkeys using single photon emission computed tomography (SPECT) and position emission tomography (PET). DESIGN,TIME AND SETTING:A controlled animal study was performed at the Neurosurgery Laboratory,Changhai Hospital of the Second Military Medical University of Chinese PLA between January 2004 and December 2007. METHODS:Hemiparkinsonism was induced in adult Rhesus Macaque monkeys,which exhibit similar characteristics of PD in humans,through unilateral internal carotid artery infusion of 1-methy-4-phenyl-1,2,3,6-tetrahydropyrindine. Following model establishment,stimulation electrodes were implanted in the right STN,and chronic high-frequency stimulation (60 μs pulse width,130 Hz frequency,and 1.5-2.0 V pressure) was performed. MAIN OUTCOME MEASURES:The changes in dopamine transporter (DAT),D2 receptor (D2R),and glucose metabolism in the corpus striatum following STN DBS were observed using SPECT and PET. RESULTS:SPECT examination showed that DAT specific binding in the right corpus striatum was increased at 3 months after DBS compared with prior to stimulation,and D2R specific binding in the right corpus striatum gradually decreased near levels on the left (non-electrode-implanted) side within 3 months after DBS. PET examination showed that the glucose metabolism in the right corpus striatum was markedly increased at 3 months after effective DBS. Hemiparkinsonism monkeys showed improved left limb rigidity,increased activities,and stable gait under chronic high-frequency stimulation. CONCLUSION:STN DBS increased striatal DAT,decreased D2R,and enhanced glucose metabolism,suggesting that chronic,high-frequency STN stimulation enhanced the metabolic activity of the corpus striatum,a mechanism for improving the PD symptoms of hemiparkinsonian monkeys.

Positron emission computed tomography/single photon emission computed tomography in Parkinson disease

Parkinson disease(PD)is the second-most common neurodegenerative disorder.Its main pathological mechanism is the selective degeneration and deletion of dopaminergic neurons in the dense part of the substantia nigra and the damage of dopaminergic neurons caused by the abnormal deposition of a Lewy body,leading to a decreased dopamine level.Positron emission computed tomography(PET)/single photon emission computed tomography(SPECT)is a molecular imaging technology that can directly or indirectly reflect changes in molecular levels by using a specific tracer.With the research and development on the tracers of related enzymes for labeling dopamine transporter and dopamine receptor and for being involved in dopamine formation,this imaging technology has been applied to all aspects of PD research.It not only contributes to clinical work but also provides an important theoretical basis for exploring the pathological mechanism of PD at a molecular level.Therefore,this review discusses the application value of PET/SPECT in PD in terms of early diagnosis,disease severity evaluation,clinical manifestations,differential diagnosis,and pathological mechanism.

Correlations of single photon emission computed tomography joints scan and bone metabolic markers in active rheumatoid arthritis

Objective To explore the correlation between quantitative value of joint bone scan by single photon emission computed tomography(SPECT)and serum bone metabolic markers in patients with active rheumatoid arthritis(RA).Methods Clinical data of 60 newly diagnosed RA patients were retrospectively collected in Department

Rheumatoid arthritis: Nuclear medicine state-of-the-art imaging

Rheumatoid arthritis(RA)is an autoimmune disease,which is associated with systemic and chronic inflammation of the joints,resulting in synovitis and pannus formation.For several decades,the assessment of RA has been limited to conventional radiography,assisting in the diagnosis and monitoring of disease.Nevertheless,conventional radiography has poor sensitivity in the detection of the inflammatory process that happens in the initial stages of RA.In the past years,new drugs that significantly decrease the progression of RA have allowed a more efficient treatment.Nuclear Medicine provides functional assessment of physiological processes and therefore has significant potential for timely diagnosis and adequate follow-up of RA.Several single photon emission computed tomography(SPECT)and positron emission tomography(PET)radiopharmaceuti-cals have been developed and applied in this field.The use of hybrid imaging,which permits computed tomography(CT)and nuclear medicine data to be acquired and fused,has increased even more the diagnostic accuracy of Nuclear Medicine by providing anatomical localization in SPECT/CT and PET/CT studies.More recently,fusion of PET with magnetic resonance imaging(PET/MRI)was introduced in some centers and demonstrated great potential.In this article,we will review studies that have been published using Nuclear Medicine for RA and examine key topics in the area.

Effects of intravascular laser phototherapy on delayed neurological sequelae after carbon monoxide intoxication as evaluated by brain perfusion imaging:A case report and review of the literature

BACKGROUND Delayed neurological sequelae(DNS)caused by carbon monoxide(CO)intoxication poses considerable treatment challenges for clinical practitioners.In this report,we used nuclear medicine imaging and the Mini-Mental State Examination(MMSE)to evaluate the effectiveness of intravascular laser irradiation of blood(ILIB)therapy for the management of DNS.CASE SUMMARY A 51-year-old woman presented to our medical center experiencing progressive bradykinesia,rigidity of limbs,gait disturbance,and cognitive impairment.Based on her neurological deficits,laboratory tests and imaging findings,the patient was diagnosed with delayed neurological sequelae of CO intoxication.She received intensive rehabilitation and ILIB therapy during 30 sessions over 2 mo after diagnosis.Brain single-photon emission computed tomography was performed both prior to and after ILIB therapy.The original hypoperfusion area in bilateral striata,bilateral frontal lobe,right parietal lobe,and bilateral cerebellum showed considerable improvement after completion of therapy.The patient’s MMSE score also increased markedly from 6/30 to 25/30.Symptoms of DNS became barely detectable,and the woman was able to carry out her daily living activities independently.CONCLUSION ILIB therapy could facilitate recovery from delayed neurological sequelae in patients with CO intoxication,as demonstrated by improved cerebral blood flow and functional outcomes in our patient.

The combined therapeutic effects of ^(131)iodinelabeled multifunctional copper sulfide-loaded microspheres in treating breast cancer

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.

Differentiation of radiation necrosis from glioblastoma recurrence after radiotherapy

The standard treatment of glioblastoma,the most common type of primary-brain-tumor,involves radiotherapy with concomitant temozolomide chemotherapy.A patient with glioblastoma,post radiotherapy developed magnatic resonance imaging(MRI)changes consistent with either radiation-induced tumor necrosis or tumor recurrence.Perfusion MRI was suggestive of radiation necrosis,but magnetic resonance spectroscopy and 99mTc-Tetrofosmin single photon emission computed tomography was indicative of tumor recurrence.Positron emission tomography scan was not available.Tumor recurrence was documented by biopsy.Several advanced imaging methods are available to differentiate tumor recurrence from radiation necrosis in glioblastoma patients.However,in inconclusive cases,brain biopsy should be performed for definite diagnosis.

Progress in the application of molecular imaging inpsychiatric disorders

Psychiatric disorders have always attracted a lot of attention from researchers due to the difficulties in their diagnoses and treatments.Molecular imaging,as an emerging technology,has played an important role in the researchers of various diseases.In recent years,molecular imaging techniques including magnetic resonance spectroscopy,nuclear medicine imaging,and fluorescence imaging have been widely used in the study of psychiatric disorders.This review will briefly summarize the progression of molecular imaging in psychiatric disorders.