RSNA2015分子影像学

RSNA2015报道的分子影像学研究进展主要包括以下几个方面:①靶向特异性分子探针及复合分子探针的研发和应用:如靶向特异性超顺磁氧化铁纳米探针,放射性核素示踪剂免疫,复合超声微泡对比剂及光学对比剂等,应用于肿瘤血管靶向显像,肿瘤诊断、治疗疗效评估及肿瘤淋巴结转移等.③新型的放射学分子成像方法:如磁性粒子成像,磁共振波谱成像及化学交换饱和转移成像等.③多模态或多参数分子显像:MRI、PET、SPECT、超声及光学分子成像技术中两种或多种技术的结合.④干细胞追踪及显像.     

RSNA2013分子影像学

RSNA2013报道的分子影像学相关研究进展主要包括以下几个方面：①靶向特异性分子探针及复合分子探针的研发及应用：如靶向特异性磁性纳米对比剂、免疫复合超声微泡对比剂及放射荧光杂交示踪剂等,应用于肿瘤血管靶向显像、肿瘤化疗疗效评价、肿瘤淋巴结转移显像等。②多模态分子显像技术的发展：采用MRI、US、SPECT及荧光反射成像（FRI）多模态监测肿瘤抗血管治疗的早期效果。③放射基因图谱的研发及能谱CT分子成像。     

正电子发射体层成像术--分子影像学的新进展

相对于常规B超、CT、MRI等以体内解剖结构显示方法而言，核医学显像，特别是PET技术(正电子发射体层成像术)，使用适当的放射性核素，标记核酸、受体、酶、基因探针等生物分子，直接显示疾病的分子机制，是功能影像学的杰出代表。B超、CT、MRI等传统影像技术，近年来也开始在组织特     

RSNA2012分子影像学进展

RSNA2012报道的分子影像学研究进展主要包括以下几个方面:①靶向特异性分子探针及多功能分子探针的研发:如靶向特异性磁性纳米对比剂、超声微泡对比剂及放射性示踪剂等,应用于肿瘤靶向显像、动脉粥样硬化斑块易损性评价、老年痴呆Aβ斑块显像及感染分期和预后评估等。②多模态分子显像技术的发展:包括MRI、PET、光学成像及超声分子成像。③干细胞示踪及成像。     

乳腺癌放射性核素分子成像研究进展

随着新型特异性显像剂和成像设备的出现,乳腺癌分子成像技术得以快速发展。乳腺癌放射性核素分子成像技术主要包括单光子发射体层成像(SPECT)、正电子发射体层成像(PET)、PET/CT以及正电子发射乳腺成像(PEM)。显像剂包括临床应用最广泛的正电子示踪剂18F-氟代脱氧葡萄糖(18F-FDG)、用于研究肿瘤细胞增殖显像的5-18F-氟尿嘧啶(5-FU)及3-脱氧-3-氟胸腺嘧啶(FLT)、通过肿瘤氨基酸代谢显像的精氨酸-甘氨酸-天冬氨酸(RGD)类,还包括受体类的靶向显像剂如雌激素受体相关的16α-[18F]-17β-雌二醇(FES)、放射性标记的人表皮生长因子受体2(HER2)及表皮生长因子受体(EGFR)等。目前用于乳腺显像的PEM技术对乳腺癌的早期诊断及疗效预测效果显著,就乳腺癌放射性核素分子成像技术的研究进展予以综述。     

PET-CT在乳腺癌诊断中的应用价值

乳腺癌是当今大多数国家妇女最常见的恶性肿瘤.在过去的数十年中,正电子发射体层显像（PET）的应用极大地提高了乳腺肿瘤的临床诊治率.然而由于PET对肿瘤病灶缺乏准确的解剖定位而使18F-氟代脱氧葡萄糖（18F-FDG）PET临床应用的准确性受到限制.PET-CT的完美结合使对肿瘤的解剖定位和诊断的敏感性及特异性得到了明显的提高.本文着重介绍PET-CT在乳腺癌治疗后再分期、疗效观察、术前分期和放疗计划拟定中的应用价值.     

分形分析在放射和核医学灌注成像中的应用:系统回顾

正目的回顾分析近年来对标准的放射和核医学成像技术[CT、MRI、超声、正电子发射体层成像(PET)、单光子发射体层成像(SPECT)]获得的组织灌注影像进行分形分析     

胃CT灌注成像的研究进展

灌注成像（perfusion imaging）是指通过影像学设备直观显示活体组织的灌注过程和作定量或半定量分析的方法,主要包括单光子发射断层成像（SPECT）、正电子发射断层成像（PET）以及CT和MRI灌注成像等.     

如何合理选择和应用医学影像检查技术

近年来,随着影像设备的不断发展,使影像检查技术从单一的X线诊断,发展为包括超声成像,计算机体层成像(CT),磁共振成像(M RI),发射体层成像(ECT),单光子发射体层成像(SPECT),正电子发射体层成像(PET)和数字血管造影术(DSA)等多种成像技术的学科。每种成像技术又有多种检查方法。诚然,各种成像技术都有它的优势和不足,并非一种成像技术可以适用于人体所有器官的疾病诊断,也不是一种成像技术完全能取代另一种成像技术,而是相辅相成,互相补充的。在当今医保制度下,怎样提高医疗费用与诊断效率比,提高医疗服务质量,满足广大病员的需要,…     

表皮生长因子受体-酪氨酸激酶肿瘤分子显像剂的研究进展

目前治疗肿瘤最重要的分子靶向药物是以表皮生长因子受体（EGFR）为靶点的一类化合物,为了更好地实现靶向治疗效果,需要借助分子显像技术实现快速、定量地检测体内EGFR的分布及突变等情况。利用不同核素标记的分子探针实施PET或SPECT显像能够实现快速、无创地对患者进行遴选、疗效评价和监测EGFR靶向治疗,从而提高肿瘤治疗效果。该文介绍了EGFR-酪氨酸激酶小分子显像剂及其最新的研究进展。     

锰中毒的神经影像学研究进展

近二十年来,医学影像学对临床医学的影响非常深刻,在疾病的诊断和治疗中的作用是具革命性的。核磁共振成像(MRI)、正电子发射断层摄影(PET)和单光子发射断层摄影(SPECT)等神经影像学方法在最近十年中已应用于锰中毒和其神经毒理学研究。MRI T1加权图像信号强度增加会反映锰的沉积,功能神经影像学如:PET、SPECT,能早期发现黑质纹状体多巴胺系统的异常,因此MRI、PET、SPECT对于锰中毒的诊断非常重要。     

Diagnostic accuracy of rest/stress ECG-gated Rb-82 myocardial perfusion PET: Comparison with ECG-gated Tc-99m sestamibi SPECT

BACKGROUND: Although single photon emission computed tomography (SPECT) and positron emission tomography (PET) myocardial perfusion imaging (MPI) have evolved considerably over the last decade, there is no recent comparison of diagnostic performance. This study was designed to assess relative image quality, interpretive confidence, and diagnostic accuracy by use of contemporary technology and protocols. METHODS AND RESULTS: By consensus and without clinical information, 4 experienced nuclear cardiologists interpreted 112 SPECT technetium-99m sestamibi and 112 PET rubidium-82 MPI electrocardiography (ECG)-gated rest/pharmacologic stress studies in patient populations matched by gender, body mass index, and presence and extent of coronary disease. The patients were categorized as having a low likelihood for coronary artery disease (27 in each group) or had coronary angiography within 60 days. SPECT scans were acquired on a Cardio-60 system and PET scans on an ECAT ACCEL scanner. Image quality was excellent for 78% and 79% of rest and stress PET scans, respectively, versus 62% and 62% of respective SPECT scans (both p<.05). An equal percent of PET and SPECT gated images were rated excellent in quality. Interpretations were definitely normal or abnormal for 96% of PET scans versus 81% of SPECT scans (p=.001). Diagnostic accuracy was higher for PET for both stenosis severity thresholds of 70% (89% vs 79%, p=.03) and 50% (87% vs 71%, p=.003) and was higher in men and women, in obese and nonobese patients, and for correct identification of multivessel coronary artery disease. CONCLUSION: In a large population of matched pharmacologic stress patients, myocardial perfusion PET was superior to SPECT in image quality, interpretive certainty, and diagnostic accuracy.     

Qualitative [18F]FDG positron emission tomography in primary breast cancer: clinical relevance and practicability

Positron emission tomography (PET) using fluorine-18 2-deoxy-2-fluoro-d-glucose (FDG) is of potential value for the diagnosis of malignant tumours. The aim of this study was to evaluate the use of FDG PET in patients with breast tumours, appraising its applicability in visualising primary carcinomas and regional metastases in a clinical setting. Results of FDG PET were compared with those of mammography, breast ultrasonography and histology in 30 patients with inconclusive breast findings. For PET, transmission and emission images were taken in one or two scan positions, depending on the available time and the clinical status of patients. PET showed focal FDG uptake with high contrast in 21 of 23 primary carcinomas. In one patient, only PET correctly visualized multifocal disease (three foci, Ø 0.4–1 cm). The accuracy of PET in the detection of primary breast cancer was 90%, and in the detection of involved axillary lymph nodes, 94%. All metastases (lymph nodes, lungs, bones, soft tissues) covered by the field of view and demonstrated by other methods (X-ray, computed tomography, magnetic resonance imaging, bone scan) showed FDG uptake. In three patients, only PET initiated further diagnostic procedures. The results indicate that FDG PET can provide a rapid diagnostic study (45–60 min) and allows accurate tumour staging of several organ systems for primary tumour and metastases with a single imaging study in a routine clinical setting.     

Solitary pulmonary nodules and masses: a meta-analysis of the diagnostic utility of alternative imaging tests

The purpose was to assess the clinical utility of diagnostic tests for identifying malignancy within a solitary pulmonary nodule (SPN), and to create a nomogram or "look-up" table using clinical data and non-invasive radiology (positive) test results to estimate post-test probability of malignancy. Studies that examined computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET) and single photon emission computed tomography (SPECT) for the evaluation of SPN. Two reviewers independently abstracted data and assessed study quality. Study-specific and overall positive likelihood ratios (LRs) for each diagnostic test confirming a diagnosis of malignancy and negative LR for each diagnostic test excluding a diagnosis of malignancy within an SPN were calculated. Forty-four of 242 articles were included. Positive LRs for diagnostic tests were: CT 3.91 (95% confidence interval 2.42, 5.40), MRI 4.57 (3.03, 6.1), PET 5.44 (3.56, 7.32) and SPECT 5.16 (4.03, 6.30). Negative LRs were: CT 0.10 (0.03, 0.16), MRI 0.08 (0.03, 0.12), PET 0.06 (0.02, 0.09) and SPECT 0.06 (0.04, 0.08). Differences in performance for all tests were negligible; therefore, the clinician may confidently use any of the four tests presented in further evaluating an SPN. Given the low cost and prevalence of the technology, SPECT appears to be the leading choice for additional testing in SPN evaluation.     

Targeted molecular imaging in oncology

Improvement of scintigraphic tumor imaging is extensively determined by the development of more tumor specific radiopharmaceuticals. Thus, to improve the differential diagnosis, prognosis, planning and monitoring of cancer treatment, several functional pharmaceuticals have been developed. Application of molecular targets for cancer imaging, therapy and prevention using generator-produced isotopes is the major focus of ongoing research projects. Radionuclide imaging modalities (positron emission tomography, PET; single photon emission computed tomography, SPECT) are diagnostic cross-sectional imaging techniques that map the location and concentration of radionuclide-labeled radiotracers. 99mTc- and 68Ga-labeled agents using ethylenedicysteine (EC) as a chelator were synthesized and their potential uses to assess tumor targets were evaluated. 99mTc (t1/2 = 6 hr, 140 keV) is used for SPECT and 68Ga (t1/2 = 68 min, 511 keV) for PET. Molecular targets labeled with Tc-99m and Ga-68 can be utilized for prediction of therapeutic response, monitoring tumor response to treatment and differential diagnosis. Molecular targets for oncological research in (1) cell apoptosis, (2) gene and nucleic acid-based approach, (3) angiogenesis (4) tumor hypoxia, and (5) metabolic imaging are discussed. Numerous imaging ligands in these categories have been developed and evaluated in animals and humans. Molecular targets were imaged and their potential to redirect optimal cancer diagnosis and therapeutics were demonstrated.     

小动物PET及其在生物医学研究中的应用

通过对正电子核素标记的示踪分子参与活体的生理生化过程进行PET,能够从分子水平反映活体的生理生化变化。PET作为目前核医学诊断和研究最先进的分子显像方法,已从临床应用推广到了小动物科学实验。近几年来,随着新的探测技术的不断涌现,专门用于小动物显像的PET扫描仪的各项性能日臻完善,它正逐渐成为现代生物医学研究的一项重要工具。小动物PET将在药物寻找和开发、疾病研究、基因显像等领域发挥重要作用。     

PET/CT在乳腺癌疗效监测中的作用

18F-FDG PET集合了形态学与功能学成像的优势,可通过观察肿瘤细胞内FDG的浓聚程度变化来评价药物治疗的效果,因此在乳腺癌新辅助化疗(NAC)及复发/转移性乳腺癌的综合治疗中颇受关注。本文就18FFDG PET/CT在乳腺癌NAC及复发/转移性乳腺癌治疗中的作用进行总结,同时对近期较受关注的新型显像方式,如雌激素受体显像、细胞乏氧显像、细胞增殖显像、Her-2/neu显像等在乳腺癌中的应用进行归纳及展望。     

乳腺癌放射性核素分子显像研究进展

随着新型特异性显像剂和成像设备的出现,乳腺癌分子成像技术得以快速发展。乳腺癌放射性核素分子成像技术主要包括单光子发射体层成像（ＳＰＥＣＴ）、正电子发射体层成像（ＰＥＴ）、ＰＥＴ／ＣＴ以及正电子发射乳腺成像（ＰＥＭ）。显像剂包括临床应用最广泛的正电子示踪剂１８Ｆ－氟代脱氧葡萄糖 （１８Ｆ－ＦＤＧ ）、用于研究肿瘤细胞增殖显像的５－１８Ｆ－氟尿嘧啶（５－ＦＵ）及３－脱氧－３－氟胸腺嘧啶（ＦＬＴ）、通过肿瘤氨基酸代谢显像的精氨酸－甘氨酸－天冬氨酸（ＲＧＤ）类,还包括受体类的靶向显像剂如雌激素受体相关的１６α－［１８Ｆ］－１７β－雌二醇（ＦＥＳ）、放射性标记的人表皮生长因子受体２（ＨＥＲ２）及表皮生长因子受体（ＥＧＦＲ）等。目前用于乳腺显像的ＰＥＭ技术对乳腺癌的早期诊断及疗效预测效果显著,就乳腺癌放射性核素分子成像技术的研究进展予以综述。     

Multimodality molecular imaging of the lung

The continued progression of chronic lung disease despite current treatment options has led to the increasing evaluation of molecular imaging tools for diagnosis, treatment planning, drug discovery, and therapy monitoring. Concurrently the development of multimodality positron emission tomography (PET) / computed tomography (CT), single-photon emission computed tomography (SPECT)/CT, and magnetic resonance imaging (MRI)/PET scanners has opened the potential for more sophisticated imaging biomarker probes. Here we review the potential uses of multimodality imaging tools, the established uses of molecular imaging in nononcologic lung pathophysiology and drug discovery, and some of the technical challenges in multimodality molecular imaging of the lung.     

Imaging of the dopaminergic neurotransmission system using single-photon emission tomography and positron emission tomography in patients with parkinsonism

Parkinsonism is a feature of a number of neurodegenerative diseases, including Parkinson’s disease, multiple system atrophy and progressive supranuclear palsy. The results of post-mortem studies point to dysfunction of the dopaminergic neurotransmitter system in patients with parkinsonism. Nowadays, by using single-photon emission tomography (SPET) and positron emission tomography (PET) it is possible to visualise both the nigrostriatal dopaminergic neurons and the striatal dopamine D₂ receptors in vivo. Consequently, SPET and PET imaging of elements of the dopaminergic system can play an important role in the diagnosis of several parkinsonian syndromes. This review concentrates on findings of SPET and PET studies of the dopaminergic neurotransmitter system in various parkinsonian syndromes.