Patients suffering from hepatocellular carcinoma (HCC) with tumor thrombus in the portal vein generally have a poor prognosis. Portal vein tumor thrombus must be distinguished from portal vein blood thrombus, and this...Patients suffering from hepatocellular carcinoma (HCC) with tumor thrombus in the portal vein generally have a poor prognosis. Portal vein tumor thrombus must be distinguished from portal vein blood thrombus, and this identification plays a very important role in management of HCC. Conventional imaging modalities have limitations in discrimination of portal vein tumor thrombus. The application of positron emission tomography (PET) with 18F-fluorodeoxyglucose (18F-FDG) for discrimination between tumor extension and blood thrombus has been reported in few cases of HCC, while portal tumor thrombosis and portal vein clot identified by 18F-FDG PET/CT in HCC patients has not been reported so far. We present two HCC cases, one with portal vein tumor thrombus and one thrombosis who were identified with 18F-FDG PET/CT. This report illustrates the complimentary value of combining the morphological and functional imaging in achieving a correct diagnosis in such clinical situations.展开更多
Intrahepatic cholangiocarcinoma(iCCA)is the second most common type of liver cancer after hepatocellular carcinoma,accounting for 15%of all primary liver neoplasms.In particular,iCCA is the most lethal tumor of these ...Intrahepatic cholangiocarcinoma(iCCA)is the second most common type of liver cancer after hepatocellular carcinoma,accounting for 15%of all primary liver neoplasms.In particular,iCCA is the most lethal tumor of these types,with the greatest increase in incidence in Western countries over the last decade(1,2).Local resection is the only treatment that can achieve cure,but resection rates remain low and survival is still limited to less than 1 year in the presence of locally unresectable or distant metastases(3).Its incidence and mortality have increased in recent years,and the total number of new cases is expected to increase up to 10-fold over the next two to three decades.In recent years,new treatments for iCCA have been developed and overall survival has improved.展开更多
Objective：To clarify the prognostic value of post-treatment 18F-fluorodeoxyglucose （FDG） positron emission tomography （PET）/computed tomography （CT） in patients with advanced head and neck squamous cell carcino...Objective：To clarify the prognostic value of post-treatment 18F-fluorodeoxyglucose （FDG） positron emission tomography （PET）/computed tomography （CT） in patients with advanced head and neck squamous cell carcinoma （HNSCC） after combined intra-arterial chemotherapy and radiotherapy （IACR）.Methods：Thirty-six patients with HNSCC who underwent IACR were recruited.The period from the end of IACR to the last post-treatment 18F-FDG PET/CT examination was 8-12 weeks.Both patient-based and lesion-based analyses were used to evaluate the PET/CT images.For lesion-based analysis,36 regions （12 lesions of recurrences and 24 scars at primary sites） were selected.The Kaplan-Meier method was used to assess the overall survival （OS） stratified by 18F-FDG uptake or visual interpretation results.Results：Twelve patients with recurrence were identified by six months after IACR.The sensitivity and specificity in the patient-based analysis were 67％ （8/12） and 88％ （21/24）,respectively.The mean OS was estimated to be 12.1 months （95％ CI,6.3-18.0 months） for the higher maximum standardized uptake value （SUVmax） group （n=7） and 44.6 months （95％ CI,39.9-49.3 months） for the lower SUVmax group （n=29）.OS in the higher SUVmax group （cut-off point,6.1） or positive visual interpretation group was significantly shorter than that in the lower SUVmax or negative visual interpretation group （P＜0.001 and P＜0.05,respectively）.Conclusions：The SUVmax and visual interpretation of HNSCC on post-IACR 18F-FDG PET/CT can provide prognostic survival estimates.展开更多
Objective The aim of this study was to compare the long-term local control, overall survival, and late toxicities of positron emission tomography/computed tomography （PET/CT）-guided dose escalation radio- therapy ve...Objective The aim of this study was to compare the long-term local control, overall survival, and late toxicities of positron emission tomography/computed tomography （PET/CT）-guided dose escalation radio- therapy versus conventional radiotherapy in the concurrent chemoradiotherapy treatment of locally ad- vanced nasopharyngeal carcinoma （NPC）. Methods Atotal of 48 patients with stage IIl-IVa NPC were recruited and randomly administered PET/CT- guided dose escalation chemoradiotherapy （group A） or conventional chemoradiotherapy （group B）. The dose-escalation radiotherapy was performed using the simultaneous modulated accelerated radiotherapy technique at prescribed doses of 77 gray （Gy） in 32 fractions （f） to the gross target volume （GTV）： planning target volume （PTV） 1 received 64 Gy/32 f, while PTV2 received 54.4 Gy/32 f. Patients in group B received uniform-dose intensity-modulated radiotherapy, PTV1 received 70 Gy/35 f and PTV2 received 58 Gy/29 f. Concurrent chemotherapy consisted of cisplatin [20 mg/m2 intravenous （IV） on days 1-4] and docetaxel （75 mg/m2 IV on days 1 and 8） administered during treatment weeks 1 and 4. All patients received 2-4 cycles of adjuvant chemotherapy of the same dose and drug regimen. Results The use of fluorine-18-fluorodeoxyglucose （18F-FDG） PET/CT significantly reduced the treat- ment volume delineation of the GTV in 83.3% （20/24） of patients. The 5-year local recurrence-free survival rates of the two groups were 100% and 79.2%, respectively （P = 0.019）. The 5-year disease free survival （DFS） rates were 95.8% and 75.0%, respectively （P = 0.018）. The 5-year local progression-free survival and DFS rates were significantly different. The 5-year overall survival （OS） rates were 95.8% and 79.2%, re- spectively. Differences in OS improvement were insignificant （P = 0.079）. Late toxicities were similar in the two groups. The most common late toxicities of the two arms were grade 1-2 skin dystrophy, xerostomia, subcutaneous fibrosis, and hearing loss. There were no cases of grade 4 late toxicity. Conclusion The use of 18F-FDG PET/CT-guided dose escalation radiotherapy is well tolerated and can reduce local recurrence rates for patients with locally advanced NPC compared to conventional chemora- diotherapy.展开更多
This study was to explore the optimal threshold of thyroid-stimulating hormone(TSH)-stimulated serum thyroglobulin(s-Tg) for patients who were to receive18F-fluorodeoxyglucose(18F-FDG) PET/CT scan owing to clinical su...This study was to explore the optimal threshold of thyroid-stimulating hormone(TSH)-stimulated serum thyroglobulin(s-Tg) for patients who were to receive18F-fluorodeoxyglucose(18F-FDG) PET/CT scan owing to clinical suspicion of differentiated thyroid cancer(DTC) recurrence but negative post-therapeutic 131I whole-body scan(131I-WBS). A total of 60 qualified patients underwent PET/CT scanning from October 2010 to July 2014. The receiver operating characteristic(ROC) curve analyses showed that s-Tg levels over 49 μg/L led to the highest diagnostic accuracy of PET/CT to detect recurrence, with a sensitivity of 89.5% and a specificity of 90.9%. Besides, bivariate correlation analysis showed positive correlation between s-Tg levels and the maximum standardized uptake values(SUVmax) of18F-FDG in patients with positive PET/CT scanning, suggesting a significant influence of TSH both on Tg release and uptake of18F-FDG. So, positive PET/CT imaging is expected when patients have negative 131I-WBS but s-Tg levels over 49 μg/L.展开更多
Background: Little is known about the nature of metaistasis to small cervical lymph nodes(SCLNS) in the patients with nasopharyngeal carcinoma(NPC)examined by using 18-fluoro-2-deoxy-glucose(^(18)F-FDG) positron emiss...Background: Little is known about the nature of metaistasis to small cervical lymph nodes(SCLNS) in the patients with nasopharyngeal carcinoma(NPC)examined by using 18-fluoro-2-deoxy-glucose(^(18)F-FDG) positron emission tomography/computed tomography(PET/CT).The present study aimed to evaluate the diagnostic values of PET/CT in identifying metastasis in SCLNs in NPC patients.Methods: Magnetic resonance images(MRI) and PET/CT scans for 470 patients with newly diagnosed, non-distant metastatic NPC were analyzed. Metastatic rates of SCLNs were defined by the positive number of SCLNs on PET/CT scans and total number of SCLNs on MRI scans. Receiver operating characteristic curve was applied to compare PET/CT-determined stage with MRI-determined stage.Results: In total, 2082 SCLNs were identified, with 808(38.8%) ≥ 5 and < 6 mm in diameter(group A), 526(25.3%)≥ 6 and < 7 mm in diameter(group B),374(18.0%)≥ 7 and < 8 mm in diameter(group C), 237(11.4%) ≥8 and<9 mm in diameter(group D),and 137(6.5%) ≥ 9 and <10 mm in diameter(group E).The overall metastatic rates examined by using PET/CT for groups A, B,C,D, and E were 3.5%, 8.0%, 31.3%, 60.0%, and 83.9%, respectively(P< 0.001). In level IV/Vb, the metastatic rate for nodes ≥ 8 mm was 84.6%. PET/CT examination resulted in modification of N category and overall stage for 135(28.7%) and 46(9.8%) patients, respectively. The areas under curve of MRIdetermined and PET/CT-determined overall stage were 0.659 and 0.704 for predicting overall survival, 0.661 and 0.711 for predicting distant metastasis-free survival, and 0.636 and 0.663 for predicting disease-free survival.Conclusions: PET/CT was more effective than MRI in identifying metastatic SCLNs, and the radiologic diagnostic criteria for metastatic lymph nodes in level IV/Vb should be re-defined.展开更多
<strong>Purpose:</strong> This study aimed to evaluate the role of <sup>18</sup>F-FDG PET/CT scans in staging breast carcinoma. <strong>Materials and Methods:</strong> A descriptive...<strong>Purpose:</strong> This study aimed to evaluate the role of <sup>18</sup>F-FDG PET/CT scans in staging breast carcinoma. <strong>Materials and Methods:</strong> A descriptive study on 46 patients who were diagnosed with breast carcinoma in Hanoi Oncology Hospital, Vietnam from June 2019 to June 2021. Those patients underwent <sup>18</sup>F-FDG PET/CT scans for pre-treatment staging. <strong>Results:</strong> There was a positive correlation between the size of primary tumors and their SUV (p < 0.0001, r = 0.759). The mean SUV was reported to be 2.5 for tumors under 2 cm, 5.89 for tumors from 2 - 5 cm, 13.6 for tumors above 5 cm, and 8.23 for skin invasive lesions. In terms of regional lymph node metastasis detection, the sensitivity and specificity of <sup>18</sup>F-FDG PET/CT were 75% and 100%, respectively. The rate of distant metastasis detection was 15.2% (7/46 patients). Metastatic lesions were found in bone, lungs, liver, and lymph nodes. There was a significant difference in SUV among organs (p < 0.001), with the highest SUV found in bone metastasis. The rates of stage I, II, III and IV diagnosed after PET/CT are 8.7%;45.7%;30.4% and 15.2% respectively, compared to 10.9%;54.3%;32.6%;2.2% before taking <sup>18</sup>F-FDG PET/CT. After PET/CT, 17.4% patients (8/46) had their treatment plan changed. <strong>Conclusions: </strong><sup>18</sup>F-FDG PET/CT plays an important role in staging breast carcinoma. Determining accurately the breast carcinoma stage by <sup>18</sup>F-FDG PET/CT could help alter treatment strategy to best suit with patients, and avoid unnecessary surgery.展开更多
Background ^18F-fluorodeoxyglucose （FDG） is the most widely used radiotracer in tumor imaging,but its use for brain gliomas and recurrence is limited by the high ^18F-FDG uptake in normal brain tissue.^11C-methioni...Background ^18F-fluorodeoxyglucose （FDG） is the most widely used radiotracer in tumor imaging,but its use for brain gliomas and recurrence is limited by the high ^18F-FDG uptake in normal brain tissue.^11C-methionine （MET） has low uptake in the normal brain tissue,providing potential advantages over ^18F-FDG.The aim of the study was to investigate the diagnostic value of ^11C-MET compared to ^18F-FDG positron emission tomography and computed tomography （PET/CT） in patients with suspected primary and residual/recurrent gliomas.Methods Eighty paired PET/CT scans using ^11C-MET and 18F-FDG were performed on 44 newly diagnosed patients with suspected gliomas and 36 post-operative patients with suspected residual/recurrent tumors.PET/CT results were evaluated by visual and semiquantitative analysis.The sensitivity,specificity and accuracy for detection of gliomas and residual/recurrent tumors were calculated using visual analysis.Tumor to contralateral normal gray matter （T/G） ratio was calculated for semiquantitative analysis.Results Final pathology of the 44 newly diagnosed patients included 26 gliomas （14 high-grade and 12 low-grade tumors） and 18 non-glioma benign lesions.Residual/recurrent gliomas were verified in 28 patients and excluded in 8/36 post-operative patients by subsequent histopathologic examination and/or clinical follow-up for more than six months.The sensitivity,specificity and accuracy of 11C-MET PET/CT were 88.5%,83.3% and 86.4% for gliomas and 96.4%,87.5% and 94.4% for residual/recurrent gliomas,respectively.The sensitivity,specificity and accuracy of 18F-FDG PET/CT were 50.0%,88.9% and 65.9% for gliomas and 46.4%,100.0% and 58.3% for residual/recurrent gliomas,respectively.11C-MET had a higher sensitivity than 18F-FDG （83.3% vs.33.3%,P=0.031） in low-grade gliomas,but had no significant difference in sensitivity from 18F-FDG for high-grade gliomas （92.9% vs.64.3%,P=0.219）.11C-MET T/G uptake ratios in high-grade gliomas,low-grade gliomas and benign lesions were 1.94±0.53,1.78±0.61 and 1.06±0.34,respectively.18F-FDG T/G uptake ratios in high-grade gliomas,low-grade gliomas and benign lesions were 1.05±0.37,0.66±0.14 and 0.63±0.17,respectively.Conclusions 11C-MET PET/CT is superior to 18F-FDG PET/CT in detecting and delineating gliomas and residual/recurrent tumors,especially low-grade gliomas and residual/recurrent lesions present in gray matter,but its role in non-invasive grading of the tumors is limited.展开更多
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 an...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.展开更多
文摘Patients suffering from hepatocellular carcinoma (HCC) with tumor thrombus in the portal vein generally have a poor prognosis. Portal vein tumor thrombus must be distinguished from portal vein blood thrombus, and this identification plays a very important role in management of HCC. Conventional imaging modalities have limitations in discrimination of portal vein tumor thrombus. The application of positron emission tomography (PET) with 18F-fluorodeoxyglucose (18F-FDG) for discrimination between tumor extension and blood thrombus has been reported in few cases of HCC, while portal tumor thrombosis and portal vein clot identified by 18F-FDG PET/CT in HCC patients has not been reported so far. We present two HCC cases, one with portal vein tumor thrombus and one thrombosis who were identified with 18F-FDG PET/CT. This report illustrates the complimentary value of combining the morphological and functional imaging in achieving a correct diagnosis in such clinical situations.
文摘Intrahepatic cholangiocarcinoma(iCCA)is the second most common type of liver cancer after hepatocellular carcinoma,accounting for 15%of all primary liver neoplasms.In particular,iCCA is the most lethal tumor of these types,with the greatest increase in incidence in Western countries over the last decade(1,2).Local resection is the only treatment that can achieve cure,but resection rates remain low and survival is still limited to less than 1 year in the presence of locally unresectable or distant metastases(3).Its incidence and mortality have increased in recent years,and the total number of new cases is expected to increase up to 10-fold over the next two to three decades.In recent years,new treatments for iCCA have been developed and overall survival has improved.
文摘Objective：To clarify the prognostic value of post-treatment 18F-fluorodeoxyglucose （FDG） positron emission tomography （PET）/computed tomography （CT） in patients with advanced head and neck squamous cell carcinoma （HNSCC） after combined intra-arterial chemotherapy and radiotherapy （IACR）.Methods：Thirty-six patients with HNSCC who underwent IACR were recruited.The period from the end of IACR to the last post-treatment 18F-FDG PET/CT examination was 8-12 weeks.Both patient-based and lesion-based analyses were used to evaluate the PET/CT images.For lesion-based analysis,36 regions （12 lesions of recurrences and 24 scars at primary sites） were selected.The Kaplan-Meier method was used to assess the overall survival （OS） stratified by 18F-FDG uptake or visual interpretation results.Results：Twelve patients with recurrence were identified by six months after IACR.The sensitivity and specificity in the patient-based analysis were 67％ （8/12） and 88％ （21/24）,respectively.The mean OS was estimated to be 12.1 months （95％ CI,6.3-18.0 months） for the higher maximum standardized uptake value （SUVmax） group （n=7） and 44.6 months （95％ CI,39.9-49.3 months） for the lower SUVmax group （n=29）.OS in the higher SUVmax group （cut-off point,6.1） or positive visual interpretation group was significantly shorter than that in the lower SUVmax or negative visual interpretation group （P＜0.001 and P＜0.05,respectively）.Conclusions：The SUVmax and visual interpretation of HNSCC on post-IACR 18F-FDG PET/CT can provide prognostic survival estimates.
基金Supported by grants from the National Natural Science Foundation of China(No.81071831)Jiangsu Provincial Health Bureau issues(No.H201021)+1 种基金Xuzhou City Science and Technology Bureau issues(No.XF10C082)Jiangsu Province Natural Science Foundation of China(No.BK20131131)
文摘Objective The aim of this study was to compare the long-term local control, overall survival, and late toxicities of positron emission tomography/computed tomography （PET/CT）-guided dose escalation radio- therapy versus conventional radiotherapy in the concurrent chemoradiotherapy treatment of locally ad- vanced nasopharyngeal carcinoma （NPC）. Methods Atotal of 48 patients with stage IIl-IVa NPC were recruited and randomly administered PET/CT- guided dose escalation chemoradiotherapy （group A） or conventional chemoradiotherapy （group B）. The dose-escalation radiotherapy was performed using the simultaneous modulated accelerated radiotherapy technique at prescribed doses of 77 gray （Gy） in 32 fractions （f） to the gross target volume （GTV）： planning target volume （PTV） 1 received 64 Gy/32 f, while PTV2 received 54.4 Gy/32 f. Patients in group B received uniform-dose intensity-modulated radiotherapy, PTV1 received 70 Gy/35 f and PTV2 received 58 Gy/29 f. Concurrent chemotherapy consisted of cisplatin [20 mg/m2 intravenous （IV） on days 1-4] and docetaxel （75 mg/m2 IV on days 1 and 8） administered during treatment weeks 1 and 4. All patients received 2-4 cycles of adjuvant chemotherapy of the same dose and drug regimen. Results The use of fluorine-18-fluorodeoxyglucose （18F-FDG） PET/CT significantly reduced the treat- ment volume delineation of the GTV in 83.3% （20/24） of patients. The 5-year local recurrence-free survival rates of the two groups were 100% and 79.2%, respectively （P = 0.019）. The 5-year disease free survival （DFS） rates were 95.8% and 75.0%, respectively （P = 0.018）. The 5-year local progression-free survival and DFS rates were significantly different. The 5-year overall survival （OS） rates were 95.8% and 79.2%, re- spectively. Differences in OS improvement were insignificant （P = 0.079）. Late toxicities were similar in the two groups. The most common late toxicities of the two arms were grade 1-2 skin dystrophy, xerostomia, subcutaneous fibrosis, and hearing loss. There were no cases of grade 4 late toxicity. Conclusion The use of 18F-FDG PET/CT-guided dose escalation radiotherapy is well tolerated and can reduce local recurrence rates for patients with locally advanced NPC compared to conventional chemora- diotherapy.
基金supported by Shanghai Municipal Commission of Health and Family Planning of China(No.20134339)
文摘This study was to explore the optimal threshold of thyroid-stimulating hormone(TSH)-stimulated serum thyroglobulin(s-Tg) for patients who were to receive18F-fluorodeoxyglucose(18F-FDG) PET/CT scan owing to clinical suspicion of differentiated thyroid cancer(DTC) recurrence but negative post-therapeutic 131I whole-body scan(131I-WBS). A total of 60 qualified patients underwent PET/CT scanning from October 2010 to July 2014. The receiver operating characteristic(ROC) curve analyses showed that s-Tg levels over 49 μg/L led to the highest diagnostic accuracy of PET/CT to detect recurrence, with a sensitivity of 89.5% and a specificity of 90.9%. Besides, bivariate correlation analysis showed positive correlation between s-Tg levels and the maximum standardized uptake values(SUVmax) of18F-FDG in patients with positive PET/CT scanning, suggesting a significant influence of TSH both on Tg release and uptake of18F-FDG. So, positive PET/CT imaging is expected when patients have negative 131I-WBS but s-Tg levels over 49 μg/L.
基金supported by grants from the Science and Technology Project of Guangzhou City,China(No.14570006)the Planned Science and Technology Project of Guangdong Province,China(No.2013B020400004)
文摘Background: Little is known about the nature of metaistasis to small cervical lymph nodes(SCLNS) in the patients with nasopharyngeal carcinoma(NPC)examined by using 18-fluoro-2-deoxy-glucose(^(18)F-FDG) positron emission tomography/computed tomography(PET/CT).The present study aimed to evaluate the diagnostic values of PET/CT in identifying metastasis in SCLNs in NPC patients.Methods: Magnetic resonance images(MRI) and PET/CT scans for 470 patients with newly diagnosed, non-distant metastatic NPC were analyzed. Metastatic rates of SCLNs were defined by the positive number of SCLNs on PET/CT scans and total number of SCLNs on MRI scans. Receiver operating characteristic curve was applied to compare PET/CT-determined stage with MRI-determined stage.Results: In total, 2082 SCLNs were identified, with 808(38.8%) ≥ 5 and < 6 mm in diameter(group A), 526(25.3%)≥ 6 and < 7 mm in diameter(group B),374(18.0%)≥ 7 and < 8 mm in diameter(group C), 237(11.4%) ≥8 and<9 mm in diameter(group D),and 137(6.5%) ≥ 9 and <10 mm in diameter(group E).The overall metastatic rates examined by using PET/CT for groups A, B,C,D, and E were 3.5%, 8.0%, 31.3%, 60.0%, and 83.9%, respectively(P< 0.001). In level IV/Vb, the metastatic rate for nodes ≥ 8 mm was 84.6%. PET/CT examination resulted in modification of N category and overall stage for 135(28.7%) and 46(9.8%) patients, respectively. The areas under curve of MRIdetermined and PET/CT-determined overall stage were 0.659 and 0.704 for predicting overall survival, 0.661 and 0.711 for predicting distant metastasis-free survival, and 0.636 and 0.663 for predicting disease-free survival.Conclusions: PET/CT was more effective than MRI in identifying metastatic SCLNs, and the radiologic diagnostic criteria for metastatic lymph nodes in level IV/Vb should be re-defined.
文摘<strong>Purpose:</strong> This study aimed to evaluate the role of <sup>18</sup>F-FDG PET/CT scans in staging breast carcinoma. <strong>Materials and Methods:</strong> A descriptive study on 46 patients who were diagnosed with breast carcinoma in Hanoi Oncology Hospital, Vietnam from June 2019 to June 2021. Those patients underwent <sup>18</sup>F-FDG PET/CT scans for pre-treatment staging. <strong>Results:</strong> There was a positive correlation between the size of primary tumors and their SUV (p < 0.0001, r = 0.759). The mean SUV was reported to be 2.5 for tumors under 2 cm, 5.89 for tumors from 2 - 5 cm, 13.6 for tumors above 5 cm, and 8.23 for skin invasive lesions. In terms of regional lymph node metastasis detection, the sensitivity and specificity of <sup>18</sup>F-FDG PET/CT were 75% and 100%, respectively. The rate of distant metastasis detection was 15.2% (7/46 patients). Metastatic lesions were found in bone, lungs, liver, and lymph nodes. There was a significant difference in SUV among organs (p < 0.001), with the highest SUV found in bone metastasis. The rates of stage I, II, III and IV diagnosed after PET/CT are 8.7%;45.7%;30.4% and 15.2% respectively, compared to 10.9%;54.3%;32.6%;2.2% before taking <sup>18</sup>F-FDG PET/CT. After PET/CT, 17.4% patients (8/46) had their treatment plan changed. <strong>Conclusions: </strong><sup>18</sup>F-FDG PET/CT plays an important role in staging breast carcinoma. Determining accurately the breast carcinoma stage by <sup>18</sup>F-FDG PET/CT could help alter treatment strategy to best suit with patients, and avoid unnecessary surgery.
基金This study was supported by a grant from the National Natural Science Foundation of China （No. 30870731）.
文摘Background ^18F-fluorodeoxyglucose （FDG） is the most widely used radiotracer in tumor imaging,but its use for brain gliomas and recurrence is limited by the high ^18F-FDG uptake in normal brain tissue.^11C-methionine （MET） has low uptake in the normal brain tissue,providing potential advantages over ^18F-FDG.The aim of the study was to investigate the diagnostic value of ^11C-MET compared to ^18F-FDG positron emission tomography and computed tomography （PET/CT） in patients with suspected primary and residual/recurrent gliomas.Methods Eighty paired PET/CT scans using ^11C-MET and 18F-FDG were performed on 44 newly diagnosed patients with suspected gliomas and 36 post-operative patients with suspected residual/recurrent tumors.PET/CT results were evaluated by visual and semiquantitative analysis.The sensitivity,specificity and accuracy for detection of gliomas and residual/recurrent tumors were calculated using visual analysis.Tumor to contralateral normal gray matter （T/G） ratio was calculated for semiquantitative analysis.Results Final pathology of the 44 newly diagnosed patients included 26 gliomas （14 high-grade and 12 low-grade tumors） and 18 non-glioma benign lesions.Residual/recurrent gliomas were verified in 28 patients and excluded in 8/36 post-operative patients by subsequent histopathologic examination and/or clinical follow-up for more than six months.The sensitivity,specificity and accuracy of 11C-MET PET/CT were 88.5%,83.3% and 86.4% for gliomas and 96.4%,87.5% and 94.4% for residual/recurrent gliomas,respectively.The sensitivity,specificity and accuracy of 18F-FDG PET/CT were 50.0%,88.9% and 65.9% for gliomas and 46.4%,100.0% and 58.3% for residual/recurrent gliomas,respectively.11C-MET had a higher sensitivity than 18F-FDG （83.3% vs.33.3%,P=0.031） in low-grade gliomas,but had no significant difference in sensitivity from 18F-FDG for high-grade gliomas （92.9% vs.64.3%,P=0.219）.11C-MET T/G uptake ratios in high-grade gliomas,low-grade gliomas and benign lesions were 1.94±0.53,1.78±0.61 and 1.06±0.34,respectively.18F-FDG T/G uptake ratios in high-grade gliomas,low-grade gliomas and benign lesions were 1.05±0.37,0.66±0.14 and 0.63±0.17,respectively.Conclusions 11C-MET PET/CT is superior to 18F-FDG PET/CT in detecting and delineating gliomas and residual/recurrent tumors,especially low-grade gliomas and residual/recurrent lesions present in gray matter,but its role in non-invasive grading of the tumors is limited.
基金This work was supported by grants from the National Key Laboratory of Infectious Disease Prevention and Control Independent Research Open Project(No.2018SKLID307)Science and Technology Fund Project of Guizhou Health and Health Commission(No.gzwjkj2019-1-065)+1 种基金Science and Technology Plan Project of Guiyang(No.[2017]30-30)the Department of Science and Technology of Guizhou Province(No.[2017]5718).
文摘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.
