Double-balloon enteroscopy (DBE) and video capsule endoscopy are useful for the diagnosis of lymphoma in the small intestine. However, DBE cannot be safely performed in cases with passage disturbance due to wall thick...Double-balloon enteroscopy (DBE) and video capsule endoscopy are useful for the diagnosis of lymphoma in the small intestine. However, DBE cannot be safely performed in cases with passage disturbance due to wall thickening and stenosis. Additionally, video capsule endoscopy cannot be performed in such cases because of the risk of retention. Here, we report 4 cases of primary follicular lymphoma of the gastrointestinal tract that could be detected using 18F-fluoro-deoxyglucose positron emission tomography combined with computed tomography (PET-CT). The endoscopic findings of these 4 cases included lesions with wall thickening, which comprised macroscopically clusters of nodules, dense clusters of whitish granules or small nodules, fold thickening and ulcers with irregular margins that occupied the whole lumen with edematous mucosa. All patients fulfilled the World Health Organization grade 1 criteria. 18 F-fluorodeoxyglucose PET-CT can help predict the risks that may result from certain endoscopic examinations, such as DBE and video capsule endoscopy.展开更多
The differential diagnosis of solitary pulmonary nodules （SPNs） remains a challenge. It is acknowledged that combining positron-emission tomography （PET） and computed tomography （CT） offers the most reliable non...The differential diagnosis of solitary pulmonary nodules （SPNs） remains a challenge. It is acknowledged that combining positron-emission tomography （PET） and computed tomography （CT） offers the most reliable noninvasive method for the diagnosis of SPNs. Since Townsend et al1 developed integrated PET/CT in 1999, this technique has increasingly been introduced into clinical practice. To date, nuclear medicine physicians have usually undertaken PET/CT diagnosis, but the question is surfacing as how to make full use of the information of CT image to improve the accuracy of SPN diagnosis. To answer this question, we performed a retrospective study on 60 patients with SPNs.展开更多
Objective To observe the efficacy of deep learning(DL)model based on PET/CT and its combination with Cox proportional hazard model for predicting progressive disease(PD)of lung invasive adenocarcinoma within 5 years a...Objective To observe the efficacy of deep learning(DL)model based on PET/CT and its combination with Cox proportional hazard model for predicting progressive disease(PD)of lung invasive adenocarcinoma within 5 years after surgery.Methods The clinical,PET/CT and 5-year follow-up data of 250 patients with lung invasive adenocarcinoma were retrospectively analyzed.According to PD or not,the patients were divided into the PD group(n=71)and non-PD group(n=179).The basic data and PET/CT findings were compared between groups,among which the quantitative variables being significant different between groups were transformed to categorical variables using receiver operating characteristic(ROC)curve and corresponding cut-off value.Multivariant Cox proportional hazard model was used to select independent predicting factors of PD of lung invasive adenocarcinoma within 5 years after surgery.The patients were divided into training,validation and test sets at the ratio of 6∶2∶2,and PET/CT data in training set and validation set were used to train model and tuning parameters to build the PET/CT DL model,and the combination model was built in serial connection of DL model and the predictive factors.In test set,the efficacy of each model for predicting PD of lung invasive adenocarcinoma within 5 years after surgery was assessed and compared using the area under the curve(AUC).Results Patients'gender and smoking status,as well as the long diameter,SUV max and SUV mean of lesions measured on PET images,the long diameter,short diameter and type of lesions showed on CT were statistically different between groups(all P<0.05).Smoking(HR=1.787[1.053,3.031],P=0.031)and lesion SUV max>4.15(HR=5.249[1.062,25.945],P=0.042)were both predictors of PD of lung invasive adenocarcinoma within 5 years after surgery.In test set,the AUC of PET/CT DL model for predicting PD was 0.847,of the combination model was 0.890,of the latter was higher than of the former(P=0.036).Conclusion DL model based on PET/CT had high efficacy for predicting PD of lung invasive adenocarcinoma within 5 years after surgery.Combining with Cox proportional hazard model could further improve its predicting efficacy.展开更多
Pancreatic cancer(PC)remains one of the deadliest cancers worldwide,and has a poor,five-year survival rate of 5%.Although complete surgical resection is the only curative therapy for pancreatic cancer,less than20%of n...Pancreatic cancer(PC)remains one of the deadliest cancers worldwide,and has a poor,five-year survival rate of 5%.Although complete surgical resection is the only curative therapy for pancreatic cancer,less than20%of newly-diagnosed patients undergo surgical resection with a curative intent.Due to the lack of early symptoms and the tendency of pancreatic adenocarcinoma to invade adjacent structures or to metastasize at an early stage,many patients with pancreatic cancer already have advanced disease at the time of their diagnosis and,therefore,there is a high mortality rate.To improve the patient survival rate,early detection of PC is critical.The diagnosis of PC relies on computed tomography(CT)and/or magnetic resonance imaging(MRI)with magnetic resonance cholangiopancreatography(MRCP),or biopsy or fine-needle aspiration using endoscopic ultrasound(EUS).Although multi-detector row computed tomography currently has a major role in the evaluation of PC,MRI with MRCP facilitates better detection of tumors at an early stage by allowing a comprehensive analysis of the morphological changes of the pancreas parenchyma and pancreatic duct.The diagnosis could be improved using positron emission tomography techniques in special conditions in which CT and EUS are not completely diagnostic.It is essential for clinicians to understand the advantages and disadvantages of the various pancreatic imaging modalities in order to be able to make optimal treatment and management decisions.Our study investigates the current role and innovative techniques of pancreatic imaging focused on the detection of pancreatic cancer.展开更多
Objective： To investigate the validity of CT perfusion in assessing angiogenic activity of lung cancer. Methods： Fifty-six patients with lung cancer scheduled for elective surgical resection received 16-slice helica...Objective： To investigate the validity of CT perfusion in assessing angiogenic activity of lung cancer. Methods： Fifty-six patients with lung cancer scheduled for elective surgical resection received 16-slice helical CT perfusion imaging. Time-density curve （TDC）, blood flow （BF）, blood volume （BV）, mean transmit time （MTT） and permeability surface area product （PS） were calculated. 18F-deoxyglucose-positron emission tomography （FGD-PET） was carried out in 14 out of the 56 patients to calculate standardized uptake values （SUVs）. Tumor microvessel density （MVD） was examined using CD34 immunohistochemical staining of the resected tumor tissue. Pearson’s correlation analysis was used to evaluate potential correlation between CT perfusion parameters and MVD or SUV. Results： Average time to peak height （TPH） of the TDCs （including two types of TDC） was 24.38±5.69 seconds. Average BF, BV, MTT and PS were 93.42±53.45 ml/100g/min,93.42±53.45 ml/100g,6.83±4.51 s and 31.92±18.73 ml/100g/min, respectively. Average MVD was 62.04±29.06/HPF. The mean SUV was 6.33±3.26. BF was positively correlated with MVD （r=0.620,P0.01） and SUV （r=0.891, P0.01）. PS was also positively correlated with SUV （r=0.720, P0.05）. A positive correlation was also observed between tumor MVD and SUV （r=0.915, P0.01）. Conclusions： CT perfusion imaging is a reliable tool to evaluate the tumor neovascularity of lung cancer.展开更多
Glioma,the most common primary intracranial tumor,has high morbidity and mortality.The detection of circulating tumor cells(CTCs)is an important part of the liquid biopsy of gliomas.CTCs,carrying the genetic and biolo...Glioma,the most common primary intracranial tumor,has high morbidity and mortality.The detection of circulating tumor cells(CTCs)is an important part of the liquid biopsy of gliomas.CTCs,carrying the genetic and biological information of tumor tissue,provide a new perspective and dimension for the study of tumor metastasis,progression,chemotherapy sensitivity and drug resistance.Cerebrospinal fluid(CSF)circulates through the ventricle and spinal cord cistern,which can better maintain the original information of tumor cells compared with the complicated environments of tissues and plasma.Study on the dynamic changes of CTCs in the CSF of the central nervous system(CNS)is relatively rare.However,the analysis of CTCs in CSF can be used to guide the treatment of gliomas and reveal the patho-physiological and genetic mechanisms of tumor cell metastasis to the CSF.This paper reviews the progress in the research on CTC detection in gliomas.展开更多
Background With the significant improvement in the survival of patients with nasopharyngeal carcinoma （NPC） undergoing radiotherapy and the growing availability of the sophisticated imaging modalities, the number of...Background With the significant improvement in the survival of patients with nasopharyngeal carcinoma （NPC） undergoing radiotherapy and the growing availability of the sophisticated imaging modalities, the number of radiation encephalopathy （RE） cases relating to NPC radiotherapy is increasing. In this study, we investigated the metabolic and density changes of the compromised brain tissues during delayed RE using a positron-emission tomography-computed tomography （PET/CT） to provide clinical evidences for the diagnosis of delayed RE following radiotherapy for NPC. Methods The PET/CT manifestations and the clinical data of 53 pathologically confirmed NPC patients with delayed RE following radical radiotherapy and 15 healthy volunteers were investigated. The standardized uptake values （SUV） of the bilateral temporal lobes, the occipital lobe and the brain stem were measured respectively; and then the metabolic reduction rate of 88 temporal lobes and 13 brain stems were calculated for a statistical comparison between the two groups. Results The earliest case of delayed RE in the investigated patients occurred 1.5 years after radiotherapy. Delayed RE frequently involved the inferior temporal lobe. For patients with delayed RE confirmed by clinical symptoms and imaging findings, PET maintained a 100% coincidence rate with CT; however, in the 25 temporal lobes of the 35 delayed RE patients, PET revealed obvious hypometabolic changes whereas CT displayed normal density. The incidence of brain stem metabolic reductions was 24.5% （13/53） in the investigated patients, including 4 patients with hypometabolic changes shown by PET and negative finding shown by CT. The incidence of granuloma adjacent to the hypometabolic region in the temporal lobe was 12.5% （11/88）. Conclusion Delayed RE patients exhibit significant hypometabolic changes in the inferior temporal lobe, captured by PET much earlier than by CT. PET/CT offers a valuable means for the diagnosis of delayed RE in subacute stages and granuloma formation.展开更多
Radionuclide imaging is now the premier imaging method in clinical practice for its high sensitivity and tomographic capability.Current clinically available radio imaging methods mostly use positron-emission tomograph...Radionuclide imaging is now the premier imaging method in clinical practice for its high sensitivity and tomographic capability.Current clinically available radio imaging methods mostly use positron-emission tomography(PET)and single-photon emission computed tomography(SPECT)to detect anatomic abnormalities that conventional imaging techniques typically have challenges for visualizing.Contrast agents are indispensable for radionuclide imaging,and the radionuclide is always attached to a suitable vector that achieves targeted delivery.Nowadays,peptides have attracted increasing interest in targeting vectors of contrast agents,mainly due to their high specificity for target receptors at nanomolar concentrations and low toxicity.Radiolabeled peptide probes as kinds of PET/SPECT tracers had become essential tools for clinical radionuclide diagnosis.This review mainly summarizes radiolabeled peptide probes for bioimaging,including fundamental concepts of radiolabeled peptide probe design,some typical peptide analogs radiocontrast agents for PET,SPECT,and the combination imaging.展开更多
Fluorodeoxyglucose positron emission tomography/conlputed tomography （FDG PET/CT） is widely applied in non-small cell lung cancer （NSCLC）. The standardized uptake value （SUV）, a semi-quantitative index, plays an...Fluorodeoxyglucose positron emission tomography/conlputed tomography （FDG PET/CT） is widely applied in non-small cell lung cancer （NSCLC）. The standardized uptake value （SUV）, a semi-quantitative index, plays an essential role in NSCLC tbr diagnosis, staging, and efficacy evaklation. It has been px3posed that the SUV of tumors may correlate with the presence or absence of chemotherapy resistance-associated biomarkers based on studies that have displayed a close correlation between SUV and the expression levels of excision repair cross-complementary Group 1 （ERCC 1 ）1~1 and Tp53-induced glycolysis and apoptosis regulator.121 FDG avidity of NSCLC and ERCC 1 and ribonucleotide reductase subunit M 1 （RRM 1 ） levels have not been as extensively investigated. Based on these findings, we looked tbr correlations among metabolic parameters （SUVm,,. metabolic tumor volume [MTV], and total lesion glycolysis [TLG]） and ERCC1 and RRM1 expression in patients with NSCLC, to investigate whether FDG uptake reflects the presence or absence ofchemoresistance proteins （ERCC1 and RRM 1 ） within tumor cells.展开更多
文摘Double-balloon enteroscopy (DBE) and video capsule endoscopy are useful for the diagnosis of lymphoma in the small intestine. However, DBE cannot be safely performed in cases with passage disturbance due to wall thickening and stenosis. Additionally, video capsule endoscopy cannot be performed in such cases because of the risk of retention. Here, we report 4 cases of primary follicular lymphoma of the gastrointestinal tract that could be detected using 18F-fluoro-deoxyglucose positron emission tomography combined with computed tomography (PET-CT). The endoscopic findings of these 4 cases included lesions with wall thickening, which comprised macroscopically clusters of nodules, dense clusters of whitish granules or small nodules, fold thickening and ulcers with irregular margins that occupied the whole lumen with edematous mucosa. All patients fulfilled the World Health Organization grade 1 criteria. 18 F-fluorodeoxyglucose PET-CT can help predict the risks that may result from certain endoscopic examinations, such as DBE and video capsule endoscopy.
文摘The differential diagnosis of solitary pulmonary nodules （SPNs） remains a challenge. It is acknowledged that combining positron-emission tomography （PET） and computed tomography （CT） offers the most reliable noninvasive method for the diagnosis of SPNs. Since Townsend et al1 developed integrated PET/CT in 1999, this technique has increasingly been introduced into clinical practice. To date, nuclear medicine physicians have usually undertaken PET/CT diagnosis, but the question is surfacing as how to make full use of the information of CT image to improve the accuracy of SPN diagnosis. To answer this question, we performed a retrospective study on 60 patients with SPNs.
文摘Objective To observe the efficacy of deep learning(DL)model based on PET/CT and its combination with Cox proportional hazard model for predicting progressive disease(PD)of lung invasive adenocarcinoma within 5 years after surgery.Methods The clinical,PET/CT and 5-year follow-up data of 250 patients with lung invasive adenocarcinoma were retrospectively analyzed.According to PD or not,the patients were divided into the PD group(n=71)and non-PD group(n=179).The basic data and PET/CT findings were compared between groups,among which the quantitative variables being significant different between groups were transformed to categorical variables using receiver operating characteristic(ROC)curve and corresponding cut-off value.Multivariant Cox proportional hazard model was used to select independent predicting factors of PD of lung invasive adenocarcinoma within 5 years after surgery.The patients were divided into training,validation and test sets at the ratio of 6∶2∶2,and PET/CT data in training set and validation set were used to train model and tuning parameters to build the PET/CT DL model,and the combination model was built in serial connection of DL model and the predictive factors.In test set,the efficacy of each model for predicting PD of lung invasive adenocarcinoma within 5 years after surgery was assessed and compared using the area under the curve(AUC).Results Patients'gender and smoking status,as well as the long diameter,SUV max and SUV mean of lesions measured on PET images,the long diameter,short diameter and type of lesions showed on CT were statistically different between groups(all P<0.05).Smoking(HR=1.787[1.053,3.031],P=0.031)and lesion SUV max>4.15(HR=5.249[1.062,25.945],P=0.042)were both predictors of PD of lung invasive adenocarcinoma within 5 years after surgery.In test set,the AUC of PET/CT DL model for predicting PD was 0.847,of the combination model was 0.890,of the latter was higher than of the former(P=0.036).Conclusion DL model based on PET/CT had high efficacy for predicting PD of lung invasive adenocarcinoma within 5 years after surgery.Combining with Cox proportional hazard model could further improve its predicting efficacy.
文摘Pancreatic cancer(PC)remains one of the deadliest cancers worldwide,and has a poor,five-year survival rate of 5%.Although complete surgical resection is the only curative therapy for pancreatic cancer,less than20%of newly-diagnosed patients undergo surgical resection with a curative intent.Due to the lack of early symptoms and the tendency of pancreatic adenocarcinoma to invade adjacent structures or to metastasize at an early stage,many patients with pancreatic cancer already have advanced disease at the time of their diagnosis and,therefore,there is a high mortality rate.To improve the patient survival rate,early detection of PC is critical.The diagnosis of PC relies on computed tomography(CT)and/or magnetic resonance imaging(MRI)with magnetic resonance cholangiopancreatography(MRCP),or biopsy or fine-needle aspiration using endoscopic ultrasound(EUS).Although multi-detector row computed tomography currently has a major role in the evaluation of PC,MRI with MRCP facilitates better detection of tumors at an early stage by allowing a comprehensive analysis of the morphological changes of the pancreas parenchyma and pancreatic duct.The diagnosis could be improved using positron emission tomography techniques in special conditions in which CT and EUS are not completely diagnostic.It is essential for clinicians to understand the advantages and disadvantages of the various pancreatic imaging modalities in order to be able to make optimal treatment and management decisions.Our study investigates the current role and innovative techniques of pancreatic imaging focused on the detection of pancreatic cancer.
基金supported by grants from The National Key Technology R&D Program of China(No. 2009BAI86B00)Research in the Special Needs of Critical Care Technology and Equipment(No. 2009BAI86B05)PLA General Hospital Nursery Fund (No. 09KMM38)
文摘Objective： To investigate the validity of CT perfusion in assessing angiogenic activity of lung cancer. Methods： Fifty-six patients with lung cancer scheduled for elective surgical resection received 16-slice helical CT perfusion imaging. Time-density curve （TDC）, blood flow （BF）, blood volume （BV）, mean transmit time （MTT） and permeability surface area product （PS） were calculated. 18F-deoxyglucose-positron emission tomography （FGD-PET） was carried out in 14 out of the 56 patients to calculate standardized uptake values （SUVs）. Tumor microvessel density （MVD） was examined using CD34 immunohistochemical staining of the resected tumor tissue. Pearson’s correlation analysis was used to evaluate potential correlation between CT perfusion parameters and MVD or SUV. Results： Average time to peak height （TPH） of the TDCs （including two types of TDC） was 24.38±5.69 seconds. Average BF, BV, MTT and PS were 93.42±53.45 ml/100g/min,93.42±53.45 ml/100g,6.83±4.51 s and 31.92±18.73 ml/100g/min, respectively. Average MVD was 62.04±29.06/HPF. The mean SUV was 6.33±3.26. BF was positively correlated with MVD （r=0.620,P0.01） and SUV （r=0.891, P0.01）. PS was also positively correlated with SUV （r=0.720, P0.05）. A positive correlation was also observed between tumor MVD and SUV （r=0.915, P0.01）. Conclusions： CT perfusion imaging is a reliable tool to evaluate the tumor neovascularity of lung cancer.
文摘Glioma,the most common primary intracranial tumor,has high morbidity and mortality.The detection of circulating tumor cells(CTCs)is an important part of the liquid biopsy of gliomas.CTCs,carrying the genetic and biological information of tumor tissue,provide a new perspective and dimension for the study of tumor metastasis,progression,chemotherapy sensitivity and drug resistance.Cerebrospinal fluid(CSF)circulates through the ventricle and spinal cord cistern,which can better maintain the original information of tumor cells compared with the complicated environments of tissues and plasma.Study on the dynamic changes of CTCs in the CSF of the central nervous system(CNS)is relatively rare.However,the analysis of CTCs in CSF can be used to guide the treatment of gliomas and reveal the patho-physiological and genetic mechanisms of tumor cell metastasis to the CSF.This paper reviews the progress in the research on CTC detection in gliomas.
基金This study was supported by grants from the National Natural Science Foundation of China(No.30500136)the Natural Science Foundation of Guangdong Province(No.06021352)
文摘Background With the significant improvement in the survival of patients with nasopharyngeal carcinoma （NPC） undergoing radiotherapy and the growing availability of the sophisticated imaging modalities, the number of radiation encephalopathy （RE） cases relating to NPC radiotherapy is increasing. In this study, we investigated the metabolic and density changes of the compromised brain tissues during delayed RE using a positron-emission tomography-computed tomography （PET/CT） to provide clinical evidences for the diagnosis of delayed RE following radiotherapy for NPC. Methods The PET/CT manifestations and the clinical data of 53 pathologically confirmed NPC patients with delayed RE following radical radiotherapy and 15 healthy volunteers were investigated. The standardized uptake values （SUV） of the bilateral temporal lobes, the occipital lobe and the brain stem were measured respectively; and then the metabolic reduction rate of 88 temporal lobes and 13 brain stems were calculated for a statistical comparison between the two groups. Results The earliest case of delayed RE in the investigated patients occurred 1.5 years after radiotherapy. Delayed RE frequently involved the inferior temporal lobe. For patients with delayed RE confirmed by clinical symptoms and imaging findings, PET maintained a 100% coincidence rate with CT; however, in the 25 temporal lobes of the 35 delayed RE patients, PET revealed obvious hypometabolic changes whereas CT displayed normal density. The incidence of brain stem metabolic reductions was 24.5% （13/53） in the investigated patients, including 4 patients with hypometabolic changes shown by PET and negative finding shown by CT. The incidence of granuloma adjacent to the hypometabolic region in the temporal lobe was 12.5% （11/88）. Conclusion Delayed RE patients exhibit significant hypometabolic changes in the inferior temporal lobe, captured by PET much earlier than by CT. PET/CT offers a valuable means for the diagnosis of delayed RE in subacute stages and granuloma formation.
基金supported by the National Key R&D Program of China(No.2018YFE0205400)。
文摘Radionuclide imaging is now the premier imaging method in clinical practice for its high sensitivity and tomographic capability.Current clinically available radio imaging methods mostly use positron-emission tomography(PET)and single-photon emission computed tomography(SPECT)to detect anatomic abnormalities that conventional imaging techniques typically have challenges for visualizing.Contrast agents are indispensable for radionuclide imaging,and the radionuclide is always attached to a suitable vector that achieves targeted delivery.Nowadays,peptides have attracted increasing interest in targeting vectors of contrast agents,mainly due to their high specificity for target receptors at nanomolar concentrations and low toxicity.Radiolabeled peptide probes as kinds of PET/SPECT tracers had become essential tools for clinical radionuclide diagnosis.This review mainly summarizes radiolabeled peptide probes for bioimaging,including fundamental concepts of radiolabeled peptide probe design,some typical peptide analogs radiocontrast agents for PET,SPECT,and the combination imaging.
文摘Fluorodeoxyglucose positron emission tomography/conlputed tomography （FDG PET/CT） is widely applied in non-small cell lung cancer （NSCLC）. The standardized uptake value （SUV）, a semi-quantitative index, plays an essential role in NSCLC tbr diagnosis, staging, and efficacy evaklation. It has been px3posed that the SUV of tumors may correlate with the presence or absence of chemotherapy resistance-associated biomarkers based on studies that have displayed a close correlation between SUV and the expression levels of excision repair cross-complementary Group 1 （ERCC 1 ）1~1 and Tp53-induced glycolysis and apoptosis regulator.121 FDG avidity of NSCLC and ERCC 1 and ribonucleotide reductase subunit M 1 （RRM 1 ） levels have not been as extensively investigated. Based on these findings, we looked tbr correlations among metabolic parameters （SUVm,,. metabolic tumor volume [MTV], and total lesion glycolysis [TLG]） and ERCC1 and RRM1 expression in patients with NSCLC, to investigate whether FDG uptake reflects the presence or absence ofchemoresistance proteins （ERCC1 and RRM 1 ） within tumor cells.
