宫颈癌三维放射治疗的新进展

基于CT、MRI、PET图像的三维后装治疗计划系统的应用,提高了剂量计算的精确度和准确度.宫颈癌放疗时剂量优化、屏蔽、多通道施源器及调强放疗技术的应用,有效地降低了正常组织的受照剂量.腔内后装放疗时,微型热释光片体内剂量测量是预测直肠并发症的有效指针,施源器的固定对确保剂量的准确性具重要意义.基于CT、MRI和光束扫描的凝胶三维剂量仪是目前三维剂量核实的主要手段,PET影像在宫颈癌的腔内后装治疗和体外调强放疗中的作用日益突出.     

Global cerebral blood flow during infusion of adenosine in humans: assessment by magnetic resonance imaging and positron emission tomography

Adenosine, an endogenous vasodilator, induces a cerebral vasodilation at hypotensive infusion rates in anaesthetized humans. At lower doses (< 100 μg kg^?1 min^?1), adenosine has shown to have an analgesic effect. This study was undertaken to investigate whether a low dose, causing tolerable symptoms of peripheral vasodilation affects the global cerebral blood flow (CBF). In nine healthy volunteers CBF measurements were made using axial magnetic resonance (MR) phase images of the internal carotid and vertebral arteries at the level of C2–3. Quantitative assessment of CBF was also obtained with positron emission tomography (PET) technique, using intravenous bolus []> ¹⁵O]butanol as tracer in four of the subject at another occasion. During normoventilation (5.4 ± 0.2 kPa, mean ± s.e.m.), the cerebral blood flow measured by magnetic resonance imaging technique, as the sum of the flows in both carotid and vertebral arteries, was 863 ± 66 mL min^?1, equivalent to about 64 ± 5 mL 100 g^?1 min^?1. The cerebral blood flow measured by positron emmission tomography technique, was 59 ± 4 mL 100 g^?1 min^?1. All subjects had a normal CO₂ reactivity. When adenosine was infused (84 ± 7 μg kg^?1 min^?1) the cerebral blood flow, measured by magnetic resonance imaging was 60 ± 5 mL 100 g^?1 min^?1. The end tidal CO₂ level was slightly lower (0.2 ± 0.1 kPa) during adenosine infusion than during normoventilation. In the subgroup there was no difference in cerebral blood flow as measured by magnetic resonance imaging or positron emission tomography. In conclusion, adenosine infusion at tolerable doses in healthy volunteers does not affect global cerebral blood flow in unanaesthetized humans.     

Functional clusters in the human parietal cortex as revealed by an observer-independent meta-analysis of functional activation studies

The human parietal cortex is a highly differentiated structure consisting of cytoarchitectonically defined subareas that are specifically connected with other cortical and subcortical areas. Based on evidence from neurophysiological studies in subhuman primates these subareas are supposed to be functionally highly specialized. Here, we reviewed 51 different neuroimaging studies on healthy subjects with activation of the parietal lobe in statistical parametric maps. Running a cluster analysis on the stereotactic coordinates of the centers of gravity of the activation areas and plotting them into Talairach space showed a high consistency of the mean activation foci for similar paradigms across different laboratories and functional imaging modalities. Our meta-analysis exposed seven distinct pairs of quite symmetrically distributed subareas of the parietal cortex of each hemisphere as well as three unpaired regions that are critically involved in the generation of limb and eye movements in egocentric and allocentric coordinates, but also in attention, memory and cognitive problem solving. These data highlights the modular organization of the human parietal lobe. By its locally interspersed distributed circuits it orchestrates specialized cognitive subfunctions interfacing perception and action. Our meta-analysis provides a new framework for understanding information processing in the human parietal cortex.     

Procaine-lnduced increases in limbic rCBF correlate positively with increases in occipital and temporal EEG fast activity

Summary Previous independent EEG and PET studies suggest that administration of intravenous procaine hydrochloride selectively activates limbic brain structures. To further elucidate procaine's effects and explore the relationship between quantitative EEG (qEEG) and regional cerebral blood flow (rCBF), we simultaneously recorded qEEG and sampled rCBF using O-15 water PET in 20 healthy volunteers during single-blind injections of saline (baseline condition) followed by intravenous procaine (1.84 mg/kg). After thorough screening of EEG records, a subgroup of 7 subjects with EEG data relatively free of both muscle and movement artifacts was selected for analysis. Quantitative spectral EEG data from right occipital and temporal leads were then correlated with each subject's PET rCBF values on a pixel by pixel basis, both at baseline and after procaine. The most striking finding was that the increases in occipital and temporal omega activity from baseline to procaine positively correlated with rCBF increases in the amygdala and its efferents (p<.05), in a pattern very similar to the rCBF increases seen after procaine administration. This suggests that omega activity may reflect activation of deeper brain limbic structures. Also, the convergence of EEG and PET data further supports procaine's selective limbic activation.     

采用MRF二次混合多阶先验的PET图像的贝叶斯重建

在正电子发射成像（肿）中，很多方法被用来抑制重建图像中的噪声效果，其中。在所有方法中，贝叶斯重建或者最大化后验估计的方法被证明具有在重建图像质量方面相对于其他方法的优越性。基于贝叶斯重建，本研究提出了一种应用于贝叶斯重建中新的综合了二次一阶先验和二次二阶先验的马尔可夫随机场混合多阶先验。基于不同阶数的二次平滑先验的自身的不同性质，该新先验的设计的目的是实现自适应的发挥这些算子的作用。该混合先验能够保持其先验能量函数凸性，从而保证整体目标贝叶斯后验能量函数的凹性。模拟实验和实验结果的比较证明了对于PET重建，该先验在抑制背景噪声和保持边缘方面均具有很好的表现。     

A Case of Adenomyoepithelioma of the Breast Showing Strong Uptake of 18F‐Fluorodeoxyglucose on a Positron Emission Tomography

An adenomyoepithelioma of the breast is a rare tumor characterized by biphasic proliferation of both epithelial and myoepithelial cells. This tumor is generally considered as a benign neoplasm, and there are few reports describing the imaging features of this tumor through ¹⁸F‐fluorodeoxyglucose positron emission tomography (FDG‐PET). Here, we report a case of an adenomyoepithelioma that showed strong uptake of FDG on PET similar to that observed with a malignant tumor. A 73‐year‐old woman presented to our hospital with a 3.5‐cm, mobile, and elastic hard tumor in the upper area of the left breast. Although the findings of mammography, ultrasonography, and contrast‐enhanced magnetic resonance imaging suggested that the tumor was malignant, it was diagnosed as an adenomyoepithelioma by core needle biopsy. An invasive ductal carcinoma, 0.5‐cm in size, was detected in the medial upper area of the ipsilateral breast during an examination. Although FDG‐PET demonstrated no lymph node or distant metastases from the invasive ductal carcinoma, strong uptake of FDG was detected in the adenomyoepithelioma. Breast conserving surgery and sentinel lymph node biopsy for the invasive ductal carcinoma together with resection of the adenomyoepithelioma was performed. A diagnosis of adenomyoepithelioma was confirmed through histologic examination of the resected specimen. This case indicates that some adenomyoepitheliomas may show a strong uptake of FDG on PET, which resembles a malignant tumor.