Direct technetium-99m labeling of anti-hepatoma monoclonal antibody fragment:a radioimmunoconjugate for hepatocellular carcinoma imaging

AIM To directly radiolabel an anti-hepatomamAb fragment HAb18 F（ab’）2 with 99mTc bystannous-reduced method,and assess thestability,biodistribution and radioimmun-oimaging（RⅡ）.METHODS Immunoreactive fraction wasdetermined according to Lindmo’s method.Ellman’s reagent was used to determine thenumber of thiols in the reduced F（ab’）2.Labelingefficiency and homogeneity were measured bypaper chromatography,sodium dodecylsulphatepolyacrylamide gel electrophoresis（SDS-PAGE）and autoradiography.Challenge assay involvedthe incubation of aliquots of labeled antibody inethylenediaminetetraacetate（ EDTA ）and L-cysteine（L-cys）solutions with different molarratio at 37℃ for 1h,respectively.Investigationsin vivo utilized nude mice bearing humanhepatocellular carcinoma（HHCC）xenograftswith gamma camera imaging and tissuebiodistribution studies at regular intervals.RESULTS The labeling procedure was finishedwithin 1.5 h compared with the'pretinning'method which would take at least 21h.In vitrostudies demonstrated that the radiolabeled mAbfragment was homogeneous and retained itsimmunoreactivity.Challenge studies indicatedthat 99mTc-labeled HAb18 F（ab’）2 in EDTA is morestable than in L-cys.Imaging and biodistribution showed a significant tumor uptake at 24 h post-injection of 99mTc-labeled HAb18 F（ab’）2.Theblood,kidney,liver and tumor uptakes at 24hwere 0.56±0.09,56.45±11.36,1.43±0.27 and6.57±3.01（%ID/g）,respectively.CONCLUSION 99mTc-HAb18 F（ab’）2 conjugateprepared by this direct method appears to be aneffective way to detect hepatoma in nude micemodel.

Effect of Technetium-99 Conjugated with Methylene Diphosphonate on IgM-RF,IgG-RF and IgA-RF

To explore the effect of technetium-99 conjugated with methylene diphosphonate ( 99 Tc-MDP) on IgM-RF, IgG-RF and IgA-RF (RFs), 47 cases were selected for study, including 33 patients with rheumatoid arthritis (RA) and 15 patients with joint pain/arthritis. After 99 Tc-MDP for drips model being given to the patients by intravenous drip 0.2 g daily for 5 days, the injection A and B models of 99 Tc-MDP were used to the patients by intravenous injection one set daily for 10 days, that was one course of treatment. The next course started after 10 days. Each case used it from 2 to 4 courses of treatment. The RFs in serum were determined by the method of enzyme-linked immunoabsorption assay (ELISA) before and after 2 and 4 courses of treatment. In the patients with RA, the concentrations of IgM-RF were 296.2±108.4 IU/ml, 189.5±92.3 IU/ml and 107.8±72.5 IU/ml; the concentrations of IgG-RF were 325.6±126.2 IU/ml, 209.7±98.2 IU/ml and 160.2±80.8 IU/ml; the concentrations of IgA-RF were 330.4±136.3 IU/ml, 210.7±89.2 IU/ml and 148.8±72.2 IU/ml before and after 2 and 4 courses of treatment, respectively. The concentrations of the above RFs were significantly lower after 2 and 4 courses than those before treatment ( P <0.05 and P <0.01). There was no significant difference in RFs concentrations in the patients with joint pain/arthritis before and after use of 99 Tc-MDP. In the patients with positive RFs before treatment, the RFs concentrations were decreased significantly after 2 and 4 courses of treatment ( P <0.05 and P <0.01). There was no obvious change of RFs concentrations in the patients with negative RFs after treatment of 99 Tc-MDP. It was concluded that 99 Tc-MDP could obviously reduce the abnormally high concentrations of RFs, but not influence the normal RFs, which indicated that 99 Tc-MDP has an important effect on controlling the activities of RA.

Technetium-99m-labeled macroaggregated albumin lung perfusion scan for diagnosis of hepatopulmonary syndrome: A prospective study comparing brain uptake and whole-body uptake

BACKGROUND Hepatopulmonary syndrome (HPS) is an arterial oxygenation defect induced by intrapulmonary vascular dilatation (IPVD) in the setting of liver disease and/or portal hypertension.This syndrome occurs most often in cirrhotic patients(4%-32%) and has been shown to be detrimental to functional status,quality of life,and survival.The diagnosis of HPS in the setting of liver disease and/or portal hypertension requires the demonstration of IPVD (i.e.,diffuse or localized abnormally dilated pulmonary capillaries and pulmonary and pleural arteriovenous communications) and arterial oxygenation defects,preferably by contrast-enhanced echocardiography and measurement of the alveolar-arterial oxygen gradient,respectively.AIM To compare brain and whole-body uptake of technetium for diagnosing HPS.METHODS Sixty-nine patients with chronic liver disease and/or portal hypertension were prospectively included.Brain uptake and whole-body uptake were calculated using the geometric mean of technetium counts in the brain and lungs and in the entire body and lungs,respectively.RESULTS Thirty-two (46%) patients had IPVD as detected by contrast-enhancedechocardiography.The demographics and clinical characteristics of the patients with and without IPVD were not significantly different with the exception of the creatinine level (0.71±0.18 mg/dL vs 0.83±0.23 mg/dL;P=0.041),alveolararterial oxygen gradient (23.2±13.3 mmHg vs 16.4±14.1 mmHg;P=0.043),and arterial partial pressure of oxygen (81.0±12.1 mmHg vs 90.1±12.8 mmHg;P=0.004).Whole-body uptake was significantly higher in patients with IPVD than in patients without IPVD (48.0%±6.1%vs 40.1%±8.1%;P=0.001).The area under the curve of whole-body uptake for detecting IPVD was significantly higher than that of brain uptake (0.75 vs 0.54;P=0.025).The optimal cut-off values of brain uptake and whole-body uptake for detecting IPVD were 5.7%and 42.5%,respectively,based on Youden’s index.The sensitivity,specificity,and accuracy of brain uptake> 5.7%and whole-body uptake> 42.5%for detecting IPVD were23%,89%,and 59%and 100%,52%,and 74%,respectively.CONCLUSION Whole-body uptake is superior to brain uptake for diagnosing HPS.

Leukocyte-technetium-99m uptake in Crohn's disease:Does it show subclinical disease?

AIM:To evaluate inflammatory activity in patients with Crohn's disease (CD) using technetium-99m-hexamethylpropyleneamine oxime (99mTc-HMPAO) granulocyte scintigraphy.METHODS: Twenty patients (7 male and 13 female) with CD and five healthy volunteers were selected for 99mTc-HMPAO granulocyte scintigraphy. The Crohn's Disease Activity Index (CDAI), blood tests and C-reactive protein (CRP) of each patient were performed 7 d before the scintigraphic images. The leukocytes were labeled according to the International Society of Radiolabeled Blood Elements (ISORBE) consensus protocol and the scintigraphic images, including single photon emission computed tomography, were obtained 30 min and 2 h after injection of the radiolabeled leukocytes.RESULTS:The labeling yield of the leukocytes with the lipophilic complex 99mTc-HMPAO was 55.0%±10%. Six of the 20 patients (30%) presented congruent results for the three parameters investigated (CDAI, Scintigraphic Index and CRP). On the other hand, 14 patients (70%) did not show congruent results. There was no significant correlation between the indices analyzed according to the Spearman test (P>0.05,n=20).CONCLUSION: The results suggest that 99mTc-HMPAO-labeled leukocyte scintigraphy could be important for determining inflammatory activity in CD even in the absence of clinical symptoms.

Technetium-99m-labeled annexin V imaging for detecting prosthetic joint infection in a rabbit model

Accurate and timely diagnosis of prosthetic joint infection is essential to initiate early treatment and achieve a favorable outcome. In this study, we used a rabbit model to assess the feasibility of technetium-99m-labeled annexin V for detecting prosthetic joint infection. Right knee arthroplasty was performed on 24 New Zealand rabbits. After surgery, methicillin-susceptible Staphylococcus aureus was intra-articularly injected to create a model of prosthetic joint infection （the infected group, n = 12）. Rabbits in the control group were injected with sterile saline （n= 12）. Seven and 21 days after surgery, technetium-99m-labeled annexin V imaging was per- formed in 6 rabbits of each group. Images were acquired 1 and 4 hours after injection of technetium-99m- labeled annexin V （150 MBq）. The operated-to-normal-knee activity ratios were calculated for quantitative ana- lysis. Seven days after surgery, increased technetium-99m-labeled annexin V uptake was observed in all cases. However, at 21 days a notable decrease was found in the control group, but not in the infected group. The operated-to-normal-knee activity ratios of the infected group were 1.84 ±0.29 in the early phase and 2.19 ±0.34 in the delay phase, both of which were significantly higher than those of the control group （P=0.03 and P=0.02）. The receiver operator characteristic curve analysis showed that the operated-to-normal-knee activity ratios of the delay phase at 21 days was the best indicator, with an accuracy of 80%. In conclusion, technetium- 99m-labeled annexin V imaging could effectively distinguish an infected prosthetic joint from an uninfected prosthetic joint in a rabbit model.

First-principles calculations of lattice stability of technetium and rhenium

Lattice constants, total energies and densities of state of technetium(Tc) and rhenium(Re) with different crystalline structures were calculated with the GGA+PBE function, ultra-soft pseudo-potential and plane wave method in first-principles. The results were compared with those of projector augmented wave(PAW) method in first-principles and experimental data. The lattice stability results prove that HCP phase is the most stable phase, which agrees well with those of PAW method in first-principles and CALPHAD method. Further analyses of densities of state also give the same result of lattice stability for HCP-, FCC-, BCC-Tc and Re. Analyses of atomic populations show that the lattice stability of technetium and rhenium is probably related to the electrons in p and d state.

Quantitative Analysis of the Tomographic Technetium－99m MIBI （^（99m）Tc－MIBI） Myocardial Bullseye Display： Application to Diag

In this study, the 99mTc-MIBI myocardial bullseye display of 31 healthy persons and 34 patients with myocardial ischemia and 17 patients with myocardial infarction were analyzed quantitatively, and compared with the results of myocardial tomography analysis and qualitative bullseye analysis. The sensitivities of the three methods were 88.2%, 91.2 % and 94.1 % respectively (P>0.05),and the specificities were 93. 5%, 83, 9% and 83. 9% respectively (P<0.05).On the other hand, the quantitative analysis obviously outperformed the other two methods in the detection of ischemic segments of myocardium near infarction zone (P<0. 01). The quantitative analysis of 99mTc-MIBI myocardial bullseye (quantitative bullseye) was an objective, specific and sensitive method for diagnosis of coronary artery disease.

2-41 Gas-phase Chemistry of Technetium Carbonyl Complexes

Gas-phase chemical behaviors of short-lived technetium carbonyls were studied by using low temperature isothermalchromatograph (IC) coupled with a 252Cf spontaneous fission (SF) source. Fission products recoiled from the252Cf SF source were thermalized in a CO contained mixed gas, and then technetium carbonyls were formed inreactions of CO gas and various technetium isotopes. A gas-jet system was employed to transport the volatilecarbonyls from a recoil chamber to the IC. Short IC columns made of Fluorinated Ethylene Propylene (FEP) Teflonand quartz were used to obtain the chemical information of technetium carbonyls. The results of 104Tc -106Tc car-bonyls were found to be strongly influenced by theirprecursors, showing the chemical behaviors of 104Mo-106Mo carbonyls, respectively. However, 107Tc and108Tc could represent the chemical information of elementtechnetium, due to their high independent yieldsand very short half-lives of their precursors 107Mo and108Mo.

Removal of Technetium (⁹⁹Tc) from Aqueous Waste by Manganese Oxide Nanoparticles Loaded into Activated Carbon

Technetium-99 is a radioactive isotope with a half-life of 2.13 × 105 year. 99Tc is a significant contaminant of concern to the world. For this reason, a detailed understanding of technetium chemistry is essential for the protecting the public and the environment especially after increasing the various applications and uses of isotopes in the medical practices. Therefore, treatment of waste increases prior to the safe discharge to the environment or the storage. The sorption of technetium in the form of pertechnetate on a nano manganese oxide loaded into activated carbon has been investigated. Nano manganese oxide (NMO) was synthesized from manganese chloride and potassium permanganate by co-precipitation and forming a new composite by loading a nanoparticle into a modified activated carbon by different ratios. Modifications of activated carbons using different concentrations of HNO3 (4 M, 6 M and 8 M) are used in prepared composites. Fourier transform infrared spectroscopy (FT-IR), X-Ray Diffraction (XRD) and Scanning Electron Microscope (SEM) were used to characterize the prepared composites. The adsorption of anions from low level radioactive aqueous waste was examined using batch technique. Different parameters affecting on the adsorption process were studied for the removal of . The results revealed that NMO/AC (4 M, 6 M and 8 M) has a high adsorption efficiency (93.57%, 90.3% and 90.3%) respectively compared to NMO and AC which have a lower adsorption efficiency (41% and 38.9%) respectively. Moreover, the adsorption isotherm belonged to Freundlich model, the adsorption data followed pseudo-second order model and the thermodynamic study indicated that the adsorption of on Nano-composites was an exothermic and spontaneous process.

Anti-sense oligonucleotide labeled with technetium-99m using hydrazinonictinamide derivative and N-hydroxysuccinimidyl S-acetylmercaptoacetyltriglycline: A comparison of radiochemical behaviors and biological properties

AIM:To explore and compare the radiochemical behavior and biological property of anti-sense oligonuc-leotide (ASON) labeled with technetium-99m using N-hydroxysuccinimidyl S-acetylmercaptoacetyltriglycl ine (NHS-MAG3) and hydrazinonictinamide derivative (HYNIC). METHODS:After HYNIC and NHS-MAG3 were synthesized, ASON was labeled with technetium-99m using HYNIC and NHS-MAG3 as a bifunctional chelator. The in vivo and in vitro stability, binding rates of labeled compounds to serum albumen, biodistribution of 99mTc-MAG3-ASON and 99mTc-HYNIC-ASON in BALB/C mouse and its HT29 tumor cellular uptake were compared. RESULTS:The labeling efficiency and stability of 99mTc-MAG3-ASON were significantly higher than those of 99mTc-HYNIC-ASON (P = 0.02, and P = 0.03, respectively). 99mTc-MAG3-ASON had a significantly lower rate of binding to serum albumen than 99mTc-HYNIC-ASON (P < 0.05). In contrast to 99mTc-HYNIC-ASON, the biodistribution of 99mTc-MAG3-ASON was significantly lower in blood, heart, liver and stomach (P < 0.05), slightly lower in intestines and spleen (P > 0.05) and significantly higher in lung and kidney (P < 0.05). The HT29 tumor cellular uptake rate of 99mTc-MAG3-ASON was significantly higher than that of 99mTc-HYNIC-ASON (P < 0.05). CONCLUSION:99mTc-MAG3-ASON shows superior radiochemical behaviors and biological properties than 99mTc-HYNIC-ASON. 99mTc-MAG3-ASON is a potential radiopharmaceutical agent for in vivo application.

Guava extract (Psidium guajava) alters the labelling of blood constituents with technetium-99m

Psidium guajava (guava) leaf is a phytotherapic used in folk medicine to treat gastrointestinal and respiratory dis-turbances and is used as anti-inflammatory medicine. In nuclear medicine, blood constituents (BC) are labelled with techne-tium-99m (99mTc) and used to image procedures. However, data have demonstrated that synthetic or natural drugs could modify the labelling of BC with 99mTc. The aim of this work was to evaluate the effects of aqueous extract of guava leaves on the labelling of BC with 99mTc. Blood samples of Wistar rats were incubated with different concentrations of guava extract and labelled with 99mTc after the percentage of incorporated radioactivity (%ATI) in BC was determined. The results suggest that aqueous guava extract could present antioxidant action and/or alters the membrane structures involved in ion transport into cells, thus decreasing the radiolabelling of BC with 99mTc. The data showed significant (P<0.05) alteration of ATI in BC from blood incubated with guava extract.

锝[^(99)Tc]亚甲基二膦酸盐注射液联合甲氨蝶呤及硫酸羟氯喹治疗对类风湿性关节炎患者红细胞沉降率及类风湿因子的影响

目的:探究锝[^(99)Tc]亚甲基二膦酸盐注射液联合甲氨蝶呤及硫酸羟氯喹治疗对类风湿性关节炎(RA)患者红细胞沉降率(ESR)及类风湿因子(RF)的影响。方法:选取2021年4月—2022年5月抚州市立医院收治的RA患者66例,选用随机数字表法分为两组,各33例。对照组接受甲氨蝶呤及硫酸羟氯喹治疗,观察组接受锝[^(99)Tc]亚甲基二膦酸盐注射液联合甲氨蝶呤及硫酸羟氯喹治疗,两组均持续治疗3个月。对比两组临床疗效、炎症因子水平、ESR及RF、类风湿关节炎活动度(DAS28)评分、症状改善情况、视觉模拟评分法(VAS)评分、不良反应。结果:观察组临床总有效率为96.97%(32/33),高于对照组的75.76%(25/33),差异有统计学意义(P<0.05);治疗后,观察组白介素-6(IL-6)(3.52±0.47)pg/mL,肿瘤坏死因子-α(TNF-α)(3.91±1.02)pg/mL,C蛋白反应(CRP)(12.33±5.15)mg/L,RF(31.62±15.16)IU/mL,ESR(25.89±10.69)mm/h,均低于对照组的(8.03±1.02)pg/mL、(7.94±2.54)pg/mL、(16.38±6.41)mg/L、(42.98±16.87)IU/mL、(35.92±11.84)mm/h,关节肿胀数目(2.01±0.45)个,关节压痛数目(4.15±1.31)个,均少于对照组的(4.05±1.56)、(6.14±2.02)个,僵硬时间(25.56±9.13)min,短于对照组的(32.85±11.85)min,双手平均握力(12.03±2.91)kPa,高于对照组的(9.51±1.05)kPa,DAS28评分(2.02±0.74)分,VAS评分(2.12±0.29)分,均低于对照组的(4.38±1.29)、(4.15±0.57)分,差异均有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:锝[^(99)Tc]亚甲基二膦酸盐注射液联合甲氨蝶呤及硫酸羟氯喹在RA患者中应用效果较佳,能够减轻炎症反应,改善临床症状及关节活动度,减轻疼痛,且未增加不良反应。

An aqueous extract of Liu Wei Di Huang Wan alters the labeling of blood constituents with Technetium-99m

The Liu Wei Di Huang Wan is a formula of a traditional Chinese medicine that is used to treat asthma patients and has been shown to have several important properties,such as antioxidant and free radical scavenging activities.The influence of an extract of Liu Wei Di Huang Wan on the labeling of blood constituents with technetium-99m was investigated.Anticoagulated blood(Wistar rats) was incubated with the extract,stannous chloride and technetium-99m,as sodium pertechnetate.Samples were centrifuged and aliquots of plasma and blood cells were separated and precipitated with trichloroacetic acid,to obtain soluble and insoluble fractions of the blood constituents.The percentage of radioactivity(%ATI) in all the fractions was determined.The analysis of the results shows that the extract at the highest concentration used(70 mg/mL) decreased significantly(P<0.05) the %ATI(from 96.48 ± 1.19 to 54.46 ± 7.38) on blood cells compartment,(from 81.11 ± 4.15 to 61.33 ± 4.74) on insoluble fractions of blood cells and(from 65.91 ± 2.44 to 13.15 ± 3.62) on insoluble fractions of plasma.In conclusion,the results suggest that the substances present on this extract can alter this labeling process,probably due to(i) redox properties(antioxidant and chelator activities) and/or(ii) specific actions in the binding sites where the 99mTc would be bound on the blood constituents.As a consequence,precaution is suggested on the interpretation of the nuclear medicine results from performed with blood constituents labeled with 99m Tc in patients that have undertaken LWDHW,although the current findings were obtained in experimental animal models.

锝[^(99)Tc]亚甲基二膦酸盐注射液对类风湿性关节炎的治疗作用及对心理弹性、生活质量的影响

目的探讨锝[^(99)Tc]亚甲基二膦酸盐注射液对类风湿性关节炎的治疗作用及对心理弹性、生活质量的影响。方法选取2021年1-12月黑龙江中医药大学附属第一医院类风湿性关节炎患者100例为研究对象,按照随机数表法分为对照组和观察组,各50例。对照组采用传统治疗方案(甲氨蝶呤片+来氟米特),观察组在对照组基础上加用锝[^(99)Tc]亚甲基二膦酸盐注射液进行治疗。统计分析两组临床治疗效果、心理弹性、生活质量。结果用药后,观察组压痛关节计数、肿胀关节计数、疼痛评分、患者对疾病总体状况的自我评分、第三方医生对患者目前疾病总体状况的评分、类风湿因子、血沉、C反应蛋白水平均低于对照组,差异有统计学意义(P<0.05);用药后,观察组乐观性、力量性、韧性评分均高于对照组,差异有统计学意义(P<0.05)。观察组生活质量评分为(91.45±5.52)分,高于对照组,差异有统计学意义(t=12.143,P<0.05)。结论锝[^(99)Tc]亚甲基二膦酸盐注射液对类风湿性关节炎的治疗作用显著,能够改善患者的心理弹性、生活质量。

模拟高放废物地质处置条件下锝在去离子水体系中的胶体行为

^(99)Tc是高放废物地质处置中重点关注的关键核素,深地质处置条件下其在地下水中的胶体行为对其迁移行为可能存在较大影响,亟需系统开展研究。本文在模拟高放废物地质处置的低氧和低浓(氧气含量小于5 ppm、^(99)Tc初始浓度10^(-9)~10^(-5) mol/L)条件下,首先探讨了用膜过滤法研究锝胶体行为的可行性,发现pH值和离子强度等对^(99)Tc的液闪测定无明显影响,且过滤器对Tc(Ⅳ)和Tc(Ⅶ)均无显著吸附行为,基于此初步建立了锝胶体行为研究的膜过滤实验方法,并采用该方法研究了去离子水体系中锝的胶体行为。结果表明:Tc(Ⅶ)不易发生水解反应,在低氧条件下无明显胶体行为,并能长期稳定地存在于体系中,可能具有较强的迁移能力;Tc(Ⅳ)易水解而聚集为胶体,在较宽pH值范围内(pH=4~11)以真胶体形式在398 d实验周期内较长期地稳定存在于体系中,其浓度高于以离子形态存在的Tc(Ⅳ)的数倍甚至1个数量级,所形成的胶体可能会提高地质处置条件下Tc(Ⅳ)的迁移能力,但体系离子强度升高会使Tc(Ⅳ)胶体易凝聚为大颗粒物质甚至沉淀,导致锝以真胶体形态存在和迁移的可能性降低,因此高放废物处置中,锝胶体行为对其迁移行为的影响应予以足够重视和研究。

^(99m)Tc标记的前列腺特异性膜抗原抑制剂HYNIC-P137的制备与临床转化

为开发低膀胱滞留的前列腺癌SPECT显像剂,在68 Ga-P137结构的基础上制备了^(99m)Tc-P137,对其进行临床前评估和初步的临床转化研究。通过固相合成方法制备标记前体HYNIC-P137,用EDDA作为共配体对前体进行^(99m)Tc标记,并对产物^(99m)Tc-P137进行质控。考察^(99m)Tc-P137的脂水分配系数和体外稳定性,考察其在PSMA阳性细胞和阴性细胞上的摄取和抑制。进行正常昆明小鼠的生物分布和荷瘤鼠的SPECT/CT显像,最后进行临床转化研究。结果表明,前体HYNIC-P137的固相合成方便易得,标记产物^(99m)Tc-P137的放化纯度接近100%,体外稳定性好,亲水性较强。正常昆明小鼠生物分布显示,该探针血液清除较快,主要通过肾脏代谢。荷瘤鼠的小动物SPECT/CT显示,^(99m)Tc-P137主要在PSMA阳性肿瘤和肾脏区域浓集,且均可被明显抑制,显示出高度的体内特异性。临床转化显示,^(99m)Tc-P137在膀胱蓄积较低,肝内放射性较高,对前列腺癌原位灶和淋巴结转移均具有良好的检出性能。研究表明,^(99m)Tc-P137有望成为高亲和性、低膀胱滞留的新型三七素类SPECT前列腺癌显像探针。

^(99)Tc^(m)-3PRGD_(2)SPECT/CT评估非小细胞肺癌淋巴结转移

目的观察^(99)Tc^(m)-3PRGD_(2)SPECT/CT评估非小细胞肺癌(NSCLC)淋巴结转移的价值。方法回顾性分析25例NSCLC患者^(99)Tc^(m)-3PRGD_(2)SPECT/CT资料;以术后病理结果为金标准,观察SPECT/CT定性(目视观察)及半定量分析[计算病灶/本底放射性计数比值(T/B)]评估NSCLC淋巴结转移的效能。结果肺内NSCLC病灶均呈明显^(99)Tc^(m)-3PRGD_(2)摄取阳性,其摄取程度差异无统计学意义(Z=-1.19,P=0.234);伴与不伴淋巴结转移肺内原发灶之间T/B差异具有统计学意义(Z=-2.52,P=0.012);以9.23为阈值,根据肺内原发灶T/B评估NSCLC淋巴结转移的AUC为0.79。共40个淋巴结区域存在转移,其中27个区域呈^(99)Tc^(m)-3PRGD_(2)明显阳性摄取、13个区域呈轻度摄取或无摄取;131个区域为良性淋巴结,包括15个区域呈阳性摄取、116个区域呈阴性摄取。转移性与良性淋巴结之间,摄取^(99)Tc^(m)-3PRGD_(2)程度差异具有统计学意义(Z=-7.19,P<0.001);T/B差异亦有统计学意义(Z=-7.82,P<0.001)。淋巴结定性分析及半定量分析评估NSCLC淋巴结转移的曲线下面积(AUC)分别为0.78及0.91,差异具有统计学意义(Z=4.19,P<0.001)。结论^(99)Tc^(m)-3PRGD_(2)SPECT/CT有助于评估NSCLC淋巴结转移。

肺灌注显像显示1例男童棕色脂肪摄取^(99)Tc^(m)-MAA

患儿男,10岁,口唇、颜面部及四肢青紫7年余,活动后加重,伴耐力下降;1周前外院超声心动图提示卵圆孔未闭;否认家族遗传病史。查体:全身皮肤青紫,以颜面、口唇及肢端为著。实验室检查未见明显异常。于约18℃检查室内行^(99)Tc^(m)-聚合白蛋白(macroaggregated albumin,MAA)肺灌注显像,双肺灌注未见明显异常,颅脑、甲状腺、唾液腺、肾脏、脾脏、胰腺、部分肠道、部分四肢骨及双侧锁骨上区显影(图1A);断层扫描见双侧锁骨上区棕色脂肪组织(brown adipose tissue,BAT)显影(图1B);诊断:心脏右向左分流(right-to-left shunt,RLS)畸形、BAT摄取^(99)Tc^(m)-MAA。

自拟补肾强骨汤治疗老年肝肾不足型风湿性关节炎合并骨质疏松患者的效果及对骨代谢、关节功能和炎症因子水平的影响

目的探究自拟补肾强骨汤治疗老年肝肾不足型风湿性关节炎(RA)合并骨质疏松(OP)患者的效果及对骨代谢、关节功能和炎症因子水平的影响。方法选取2021年1月至2022年12月上饶市人民医院收治的60例老年RA合并OP患者作为研究对象,按照随机数字表法分为试验组(n=30)和对照组(n=30)。对照组给予碳酸钙D3片+骨化三醇软胶囊联合锝[99Tc]亚甲基二膦酸盐注射液治疗,试验组在对照组的基础上配合使用自拟补肾强骨汤。比较两组患者的临床疗效,治疗前后的骨密度、骨代谢指标、关节功能及炎症因子水平变化,记录治疗期间不良反应的发生情况。结果试验组患者的治疗有效率为93.33%,高于对照组的73.33%,差异有统计学意义(P<0.05);试验组患者治疗后的L2~L4椎体骨密度(BMD)、骨钙素(BGP)高于对照组,骨碱性磷酸酶(BALP)水平、关节功能指数(DAS28)低于对照组,差异有统计学意义(P<0.05);试验组患者治疗后的白细胞介素-6(IL-6)、C反应蛋白(CRP)及红细胞沉降率(ESR)低于对照组,差异有统计学意义(P<0.05);两组患者的不良反应发生率比较,差异无统计学意义(P>0.05)。结论自拟补肾强骨汤治疗老年肝肾不足型RA合并OP患者的疗效确切,可有效提高骨密度水平,改善骨代谢,恢复关节功能,降低炎症因子水平,且不良反应少。

全身骨显像加做局部平面显像对恶性肿瘤的临床诊断价值

目的探讨局部平面显像对于全身骨显像的补充诊断价值,以期提高临床的重视及全身骨显像的检查质量。方法选取2020年11月至2021年6月在西安交通大学第一附属医院核医学科行全身骨显像的恶性肿瘤患者681例,对于可疑病灶或定位不清等加做局部平面显像。结果681例恶性肿瘤患者的全身骨显像图像共定位病灶例数485例(71.2%),其中定位准确272例(56.1%),定位错误213例(43.9%);患者加做局部骨显像后,定位病灶例数340例(49.9%),其中定位准确313例(92.1%),定位错误例27(7.9%)。全身骨显像加做局部显像的定位准确率92.1%,明显高于单纯全身骨显像的定位准确率56.1%(272/485)。结论全身骨显像加做局部骨显像能提高病灶定位的准确率,对临床诊断一定的价值。