Dual combination therapy targeting DR5 and EMMPRIN in pancreatic adenocarcinoma

The goal of the study was to assess the efficacy of combined extracellular matrix metalloprotease inducer (EMMPRIN)- and death receptor 5 (DR5)-targeted therapy for pancreatic adenocarcinoma in orthotopic mouse models with multimodal imaging. Cytotoxicity of anti-EMMPRIN antibody and anti-DR5 antibody (TRA-8) in MIA PaCa-2 and PANC-1 cell lines was measured by ATPlite assay in vitro. The distributions of Cy5.5-labeled TRA-8 and Cy3-labeled anti-EMMPRIN antibody in the 2 cell lines were analyzed by fluorescence imaging in vitro. Groups 1 to 12 of severe combined immunodeficient mice bearing orthotopic MIA PaCa-2 (groups 1-8) or PANC-1 (groups 9-12) tumors were used for in vivo studies. Dynamic contrast-enhanced-MRI was applied in group 1 (untreated) or group 2 (anti-EMMPRIN antibody). The tumor uptake of Tc-99m-labeled TRA-8 was measured in group 3 (untreated) and group 4 (anti-EMMPRIN antibody). Positron emission tomography/computed tomography imaging with (18)F-FDG was applied in groups 5 to 12. Groups 5 to 8 (or groups 9 to 12) were untreated or treated with anti-EMMPRIN antibody, TRA-8, and combination, respectively. TRA-8 showed high killing efficacy for both MIA PaCa-2 and PANC-1 cells in vitro, but additional anti-EMMPRIN treatment did not improve the cytotoxicity. Cy5.5-TRA-8 formed cellular caps in both the cell lines, whereas the maximum signal intensity was correlated with TRA-8 cytotoxicity. Anti-EMMPRIN therapy significantly enhanced the tumor delivery of the MR contrast agent, but not Tc-99m-TRA-8. Tumor growth was significantly suppressed by the combination therapy, and the additive effect of the combination was shown in both MIA PaCa-2 and PANC-1 tumor models.     

Tc-99m Radiolabeled Peptide p5 + 14 is an Effective Probe for SPECT Imaging of Systemic Amyloidosis

Purpose

Systemic peripheral amyloidosis is a rare disease in which misfolded proteins deposit in various organs. We have previously developed I-124 labeled peptide p5?+?14 as a tracer for positron emission tomography imaging of amyloid in patients. In this report, we now document the labeling efficiency, bioactivity, and stability of Tc-99m labeled p5?+?14 for single-photon emission computed tomography (SPECT) imaging of amyloidosis, validated in a mouse model of systemic amyloidosis.

Procedures

Radiochemical yield, purity, and biological activity of [^99mTc]p5?+?14 were documented by instant thin-layer chromatography (ITLC), SDS-PAGE and a quantitative amyloid fibril pulldown assay. The efficacy and stability were documented in serum amyloid protein A (AA) amyloid-bearing or wild-type (WT) control mice imaged with SPECT/X-ray computed tomography (CT) at two time points. The uptake and retention of [^99mTc]p5?+?14 in hepatosplenic amyloid was evaluated using region of interest (ROI) and tissue counting measurements.

Results

Tc-99m p5?+?14 was produced with a radiochemical yield of 75 % with greater than 90 % purity and biological activity comparable to that of radioiodinated peptide. AA amyloid was visualized by SPECT/CT imaging with specific uptake seen in amyloid-laden organs at levels ～5 folds higher than in healthy mice. ROI analyses of decay-corrected SPECT/CT images showed <20 % loss of radiolabel from the 1 to 4 h imaging time points. Biodistribution data confirmed the specificity of the probe accumulation by amyloid-laden organs as compared to non-diseased tissues.

Conclusion

[^99mTc]p5?+?14 is a specific and stable radiotracer for systemic amyloid in mice and may provide a convenient and inexpensive alternative to imaging of peripheral amyloidosis in patients.

     

Role of nuclear medicine in the evaluation of the solitary pulmonary nodule

Tomographic imaging with either F-18 fluoro deoxyglucose (FDG) (a nonmetabolizable glucose analog that reflects tumor increased glucose metabolism) or technetium Tc-99m Depreotide (a synthetic peptide that binds with high affinity to cell surface receptors with increased expression on certain tumor cells) provides improved sensitivity and specificity in the differential diagnosis of solitary pulmonary nodules (SPN) compared with noninvasive and some invasive procedures. F-18 FDG requires instrumentation capable of coincident imaging whereas Tc-99m Depreotide can be imaged on standard gamma cameras equipped to perform single photon emission computed tomography (SPECT) imaging. Either technique performs better than CT alone, and both are cost effective on the basis of reducing unnecessary biopsies and thoracotomies in patients with negative studies indicating that the SPN is nonmalignant.     

SPECT Imaging with <Superscript>99m</Superscript>Tc-Labeled EGFR-Specific Nanobody for <Emphasis Type="Italic">In Vivo</Emphasis> Monitoring of EGFR Expression

Purpose

Overexpression of the epidermal growth factor receptor (EGFR) occurs with high incidence in various carcinomas. The oncogenic expression of the receptor has been exploited for immunoglobulin-based diagnostics and therapeutics. We describe the use of a llama single-domain antibody fragment, termed Nanobody®, for the in vivo radioimmunodetection of EGFR overexpressing tumors using single photon emission computed tomography (SPECT) in mice.

Methods

Fluorescence-activated cell sorting (FACS) analysis was performed to evaluate the specificity and selectivity of 8B6 Nanobody to bind EGFR on EGFR overexpressing cells. The Nanobody was then labeled with ^99mTc via its C-terminal histidine tail. Uptake in normal organs and tissues was assessed by ex vivo analysis. In vivo tumor targeting of ^99mTc-8B6 Nanobody was evaluated via pinhole SPECT in mice bearing xenografts of tumor cells with either high (A431) or moderate (DU145) overexpression of EGFR.

Results

FACS analysis indicated that the 8B6 Nanobody only recognizes cells overexpressing EGFR. In vivo blood clearance of ^99mTc-8B6 Nanobody is relatively fast (half-life, 1.5 h) and mainly via the kidneys. At 3 h postinjection, total kidney accumulation is high (46.6?±?0.9%IA) compared to total liver uptake (18.9?±?0.6%IA). Pinhole SPECT imaging of mice bearing A431 xenografts showed higher average tumor uptake (5.2?±?0.5%IA/cm³) of ^99mTc-8B6 Nanobody compared to DU145 xenografts (1.8?±?0.3%IA/cm³, p?

Conclusion

The EGFR-binding Nanobody investigated in this study shows high specificity and selectivity towards EGFR overexpressing cells. Pinhole SPECT analysis with ^99mTc-8B6 Nanobody enabled in vivo discrimination between tumors with high and moderate EGFR overexpression. The favorable biodistribution further corroborates the suitability of Nanobodies for in vivo tumor imaging.

     

Analysis of liver single photon emission computed tomography in a case of fulminant hepatic failure

Fulminant hepatic failure is associated with a high mortality rate. Thus, accurate assessment of hepatic functional reserve and hepatic regeneration is important. We describe a 67-year-old woman who survived subacute hepatic failure. We had an opportunity to monitor the clinical course of the patient using single photon emission computed tomography (SPECT) with 99mTc-galactosyl-human serum albumin (99mTc-GSA) and frequent hematological examinations. On admission, prothrombin time was remarkably prolonged (23.1% of control). The liver uptake of 99mTc-GSA was also considerably low. She responded well to treatment. Four weeks after admission, SPECT analysis showed a dramatic increase in liver uptake of 99mTc-GSA, suggesting promotion of hepatic regeneration. Moreover, functional liver volume calculated from the SPECT data showed a marked increase at 4 weeks after admission, whereas CT scan showed no change at that point. This indicated that SPECT with 99mTc-GSA reflected functional hepatocytes more accurately than liver volume determined by CT scan, which cannot exclude nonfunctional hepatocytes. The patient's condition improved in parallel with the improvements in the indices measured by SPECT and hematological examinations. SPECT analysis is practically useful for the prompt assessment of improvement in patients with fulminant hepatic failure.     

99Tcm—MIBI显像预测小细胞肺癌化疗疗效的临床研究

目的探讨99Tcm-MIBI显像预测小细胞肺癌化疗疗效的价值。方法53例小细胞肺癌患者根据胸部CT结果分为化疗有效组（完全缓解＋部分缓解）39例和无效组（病情稳定＋疾病进展）14例,于化疗前行99Tcm-MIBI肺显像,静脉注射99Tcm-MIBI740MBq后10—30min及2—3h分别行早期及延迟显像,分别获得早期相肿瘤与正常肺组织摄取比值（ER）和延迟相肿瘤／正常肺摄取比值（DR）,计算滞留指数（RI）。采用t检验及秩和检验分析化疗有效组与化疗无效组ER、DR和RI之间的差别。结果99Tcm-MIBI显像结果中,化疗有效组的ER、DR分别为2．33±0．21、2．44±0．19,均显著高于化疗无效组的2．02±0．31、1．86±0．30,差异有统计学意义（t=-3．401、-6．724,P均〈0．05）。化疗有效组的RI中位值为5．31％,高于化疗无效组的-9．26％,差异有统计学意义（Z=-3．612,P〈0．05）。结论99Tcm-MIBI显像在预测小细胞肺癌化疗疗效方面具有重要的临床价值。     

I-124-PET/US Fusion Imaging in Comparison to Conventional Diagnostics and Tc-99m Pertechnetate SPECT/US Fusion Imaging for the Function Assessment of Thyroid Nodules

The purpose of this study is to investigate I-124 positron emission tomography (PET)/ultrasound (US) fusion imaging for function assessment of thyroid nodules. In 70 patients, 201 lesions were examined with conventional diagnostics (CD) (thyroid US, laboratory findings and Tc-99m pertechnetate scintigraphy), Tc-99m pertechnetate single photon emission computed tomography (SPECT) and I-124 PET/computed tomography (CT). Subsequently, US fusion imaging (SPECT/US and PET/US) was performed by three experienced investigators. Patients referred for thyroid diagnostics in a clinical routine setting were included in this study if CD produced equivocal results. PET/US was superior to CD and SPECT/US in 96% and 86%, respectively, and ambiguous findings in CD were clarified by PET/US in 96% of the 70 patients. Regarding nodule-based function assessment, 10% (66%), 39% (14%) and 71% (4%) of the 201 lesions were rated with absolute certainty (equivocal or uncertain) using CD, SPECT/US and PET/US, respectively (p < 0.001). PET/US has the potential to improve the function assessment of thyroid nodules in comparison to CD.     

SPECT/螺旋CT融合显像鉴别诊断颅骨良恶性病变的临床价值

目的：探讨SPECT/螺旋CT融合显像鉴别诊断颅骨良恶性病变的临床价值。方法：对19例恶性肿瘤患者全身骨扫描（WBS）显示颅骨放射性浓聚的21个病灶行SPECT/CT融合显像,由两名有经验的核医学科医生独立阅片。患者同期接受MRI和/或CT检查,各检查时间间隔不超过两周,并对所有病例进行随访,平均随访约9个月,随访结果主要根据随后的影像学检查（MRI、CT或随后的骨扫描）及临床信息。结果：根据同期影像及随访检查共10个病灶诊断为恶性病变,11个病灶诊断为良性病变。SPECT/CT融合显像检出全部10个恶性病灶及8个良性病变,诊断符合率为85.71%。1个病灶在SPECT/CT融合显像中诊断为恶性,而同期MRI及随访检查显示良性病变。另有两个病灶在SPECT/CT中难以确定其性质,同期影像及随访检查亦显示为良性。SPECT/CT融合显像在肯定性诊断为良、恶性病灶中诊断颅骨恶性病变的敏感性、特异性、阳性预测值、阴性预测值分别为100.00%、88.89%、90.91%、100.00%。结论：SPECT/螺旋CT融合显像对鉴别诊断颅骨良恶性病变有较高的敏感性和特异性。     

~(99)Tc~m-MIBI显像预测小细胞肺癌化疗疗效的临床研究

目的 探讨~(99)Tc~m-MIBI显像预测小细胞肺癌化疗疗效的价值.方法 53例小细胞肺癌患者根据胸部CT结果分为化疗有效组(完全缓解+部分缓解)39例和无效组(病情稳定+疾病进展)14例,于化疗前行~(99)Tc~mMIBI肺显像,静脉注射~(99)Tc~m-MIBI 740 MBq后10～30 min及2～3 h分别行早期及延迟显像,分别获得早期相肿瘤与正常肺组织摄取比值(ER)和延迟相肿瘤/正常肺摄取比值(DR),计算滞留指数(RI).采用t检验及秩和检验分析化疗有效组与化疗无效组ER、DR和RI之间的差别.结果 ~(99)Tc~m-MIBI显像结果中,化疗有效组的ER、DR分别为2.33±0.21、2.44±0.19,均显著高于化疗无效组的2.02±0.31、1.86±0.30,差异有统计学意义(t=-3.401、-6.724,P均<0.05).化疗有效组的RI中位值为5.31%,高于化疗无效组的-9.26%,差异有统计学意义(Z=-3.612,P<0.05).结论 ~(99)Tc~m-MIBI显像在预测小细胞肺癌化疗疗效方面具有重要的临床价值.     

Left ventricular cavity-to-myocardium count ratio in exercise and resting technetium-99m-tetrofosmin SPECT: correlation with left ventricular function

The aim of this study was to assess the value of the cavity-to-myocardium count ratio (C/M ratio) calculated in exercise and resting technetium-99m (Tc-99m) tetrofosmin single photon emission computed tomography (SPECT) images to identify patients with depressed exercise and resting left ventricular ejection fraction (LVEF). We studied 60 patients with recent coronary artery diseases (CAD) undergoing first-pass ventriculography to calculate LVEF and myocardial perfusion SPECT imaging to calculate left ventricular C/M ratios. The group A of 30 CAD patients with higher LVEF (40%) had significant higher C/M ratios than the group B of 30 CAD patients with abnormal LVEF (<40%) during exercise and rest. However, C/M ratios between exercise and rest did not differ significantly in the both groups A and B. There is significant correlation between exercise/rest LVEF and exercise/rest C/M ratios. Tc-99m tetrofosmin C/M ratios calculated SPECT perfusion images are useful parameters in identifying patients with depressed LVEF in CAD patients.     

Myocardial flow reserve derived by dynamic perfusion single-photon emission computed tomography reflects the severity of coronary atherosclerosis

A novel single-photon emission computed tomography (SPECT) camera was developed to evaluate dynamic myocardial perfusion flow. However, it is unclear whether myocardial flow reserve (MFR) derived by dynamic perfusion SPECT using the novel SPECT camera (D-SPECT) reflects the severity of coronary atherosclerosis. In the present study, we therefore examined the relationship between MFR using D-SPECT and severity of coronary lesions. The study population comprised 40 patients who underwent both a myocardial dynamic perfusion SPECT study and invasive coronary angiography. The severity of coronary atherosclerosis was evaluated using the Gensini score. All patients underwent a rest/stress SPECT imaging protocol using Tc-99m-sestamibi, and dynamic acquisition was performed. Stress and rest flow was evaluated, and the global and regional MFR was calculated. Global MFR showed a significant negative correlation with Gensini score (r?=???0.345, p?=?0.037). Multiple linear regression analysis showed that only global MFR was independently related to Gensini score (p?=?0.018). Regional MFR was significantly lower in regions with ?90% ≤ stenotic lesions compared with regions with <?90% stenotic lesions (p?=?0.009). Global MFR derived by dynamic perfusion SPECT using D-SPECT reflects the severity of coronary atherosclerosis. Further, regional MFR is modulated by severe coronary artery stenotic lesions.     

18F-前列腺特异性膜抗原-1007 PET/CT显像、11C-胆碱PET/CT显像及单光子发射计算机断层成像术骨显像对前列腺癌骨转移的诊断价值比较

目的探讨¹⁸F-前列腺特异性膜抗原(PSMA)-1007标记的正电子发射体层显像融合计算机体层显像技术(PET/CT)显像、11C-胆碱(11C-CHO)PET/CT显像及单光子发射计算机断层成像术(SPECT)骨显像在前列腺癌骨转移诊断上的差异。方法回顾性分析2018年9月至2020年7月北部战区总医院核医学科收治的43例男性前列腺癌患者的临床资料,年龄(77.47±11.87)岁,年龄范围为55~89岁。所有患者行¹⁸F-PSMA-1007 PET/CT显像、11C-CHO PET/CT显像及SPECT骨显像检查。分别统计¹⁸F-PSMA-1007 PET/CT显像、11C-CHO PET/CT及SPECT骨显像诊断骨转移的阳性例数和阴性例数,计算三种方法各自的灵敏度、特异度、准确性、阳性预测值、阴性预测值,绘制受试者工作特征(ROC)曲线,计算并比较各自曲线下面积(AUC),评价三种检查方法对前列腺癌骨转移的诊断效能。结果 43例前列腺癌患者中,27例患者出现骨转移。¹⁸F-PSMA-1007 PET/CT显像示26例患者发生骨转移,漏诊1例;11C-CHO PET/CT显像示24例患者发生骨转移,误诊1例,漏诊4例;SPECT骨显像示23例患者发生骨转移,误诊3例,漏诊7例,三者诊断前列腺癌骨转移的灵敏度、特异度、准确性分别为96.3%(26/27)、100%(16/16)、97.7%(42/43);85.2%(23/27)、93.8%(15/16)、88.4%(38/43);74.1%(20/27)、81.3%(13/16)、76.7%(33/43)。¹⁸F-PSMA-1007 PET/CT显像、11C-CHO PET/CT和SPECT骨显像ROC曲线的AUC和95%CI分别为0.981(0.885~1.000)、0.913(0.763~0.967)、0.777(0.624~0.889)。三种检查的AUC曲线下面积进行两两比较,差异均有统计学意义(P<0.05)。采用Wilcoxon秩和检验对27例患者三种方法检出的骨转移灶的数量进行两两比较发现,¹⁸F-PSMA-1007 PET/CT显像与SPECT骨显像比较,差异有统计学意义(Z=-2.484,P=0.013),¹⁸F-PSMA-1007 PET/CT显像与11C-CHO PET/CT显像比较,差异无统计学意义(Z=-0.160,P=0.873);11C-CHO PET/CT显像与SPECT骨显像比较,差异有统计学意义(Z=-2.085,P=0.037)。结论 PET/CT显像较SPECT骨显像能发现更多的骨转移灶。¹⁸F-PSMA-1007 PET/CT显像对前列腺癌骨转移诊断的灵敏度、特异度及准确性高于其他两种检查方式。在低前列腺特异性抗原(PSA)的情况下,能够精确地对前列腺癌骨转移做出诊断。     

99mTc-3PRGD2 SPECT/CT显像联合增强CT评估肺部肿瘤淋巴结转移的诊断价值:基于41例患者的前瞻性临床试验

  目的  探讨99mTc-3PRGD2 SPECT/CT显像结合增强CT评估胸部肿块淋巴结转移的诊断价值。  方法  前瞻性招募41位患有可疑肺部病变的受试者,分别行99mTc-3PRGD2 SPECT/CT显像和增强CT影像学检查,并行肿瘤切除及淋巴结清扫术,记录上述各项检查对肺部肿瘤淋巴结转移检出情况,以患者手术病理检查或随访情况作为确诊依据。病理结果为“金标准”,分析99mTc-3PRGD2显像、肺部增强CT及二者联合判断肺部恶性肿瘤淋巴结是否转移的诊断能力,分析其敏感度、特异性、准确度、阳性预测值及阴性预测值。  结果  99mTc-3PRGD2显像、增强CT及二者联合诊断肺部肿瘤淋巴结转移的敏感度、特异性、准确度、阳性预测值、阴性预测值分别为54.6%（6/11）、68.4%（13/19）、63.3%（19/30）、50.0%（6/12）、72.2%（13/18）,72.3%（8/11）、47.4%（9/19）、56.7%（17/30）、44.4%（8/18）、75.0%（9/12）和81.8%（9/11）、89.5%（17/19）、86.7%（26/30）、81.8%（9/11）、89.5%（17/19）。99mTc-3PRGD2显像的诊断能力相对增强CT的特异性高,敏感度低。两种方法联合诊断胸部的恶性肿瘤淋巴结转移的诊断效能预测指标均高于单独应用增强CT（χ2=6.914,P=0.009）和99mTc-3PRGD2显像（χ2=7.751,P=0.005）。Kappa检验显示99mTc-3PRGD2 SPECT/CT显像、增强CT和二者联合诊断与病理结果的一致性分别为0.225、0.177、0.713（P>0.05）,差异无统计学意义。  结论  胸部增强CT联合99mTc-3PRGD2 SPECT/CT显像对于诊断肺部肿瘤淋巴结的转移有很高的准确性,有助于患者的手术决策。      

单光子发射型计算机体层摄影脑血流灌注显像评估缺氧缺血性脑病新生儿局部脑血流量的分布

背景新生儿缺氧缺血性脑病是较常见的新生儿疾病,可引起脑瘫、智力低下和惊厥.目前,该病常用的检查方法有CT扫描、MRI成像及单光子发射型计算机体层摄影等方法.目的探讨新生儿缺氧缺血性脑病单光子发射型计算机体层摄影显像的特征,并与CT扫描、MRI成像进行比较,为新生儿缺氧缺血性脑病患儿的功能监测和早期干预提供理论基础.设计以缺氧缺血性脑病患儿为研究对象,正常新生儿为对照组的观察对比研究.单位一所大学医院的核医学科.对象选择1998-09/2000-10在济宁医学院附属医院儿科住院的新生儿30例作为观察组,男23例,女7例;并随机选择同期10例正常新生儿为对照组,男7例,女3例.方法对两组对象进行单光子发射型计算机体层摄影脑血流灌注显像,并与其CT、MRI结果进行对比.主要观察指标①缺氧缺血性脑病患儿和新生儿单光子发射型计算机体层摄影脑血流显像特征比较;②单光子发射型计算机体层摄影脑血流灌注显像与CT和MRI检查的对比.结果22例同时做单光子发射型计算机体层摄影、CT和MRI的患儿中,轻度组7例,单光子发射型计算机体层摄影、CT和MRI阳性数分别为7,3和5例;中度组10例中,3种方法的阳性数分别为10,8和9例;重度组5例,3种方法均为阳性;单光子发射型计算机体层摄影、CT和MRI总的阳性检出率分别为100%,72.73%和86.36%.轻度组单光子发射型计算机体层摄影显像与MRI灵敏度无明显差异,与CT比较差异有显著性(x2=3.95,P＜0.05);中、重度组3种方法差异无显著性意义(x2=0.83,P＞0.05).结论单光子发射型计算机体层摄影脑血流灌注显像是新生儿缺氧缺血性脑病较灵敏的监测方法,可以为其预后评估和早期干预提供影像学参考依据.     

Multimodal <Emphasis Type="Italic">In Vivo</Emphasis> Imaging of Tumorigenesis and Response to Chemotherapy in a Transgenic Mouse Model of Mammary Cancer

Purpose

Transgenic mice expressing the polyoma middle T oncoprotein (PyMT) in the mammary epithelium were explored by multimodal imaging to monitor longitudinally spontaneous tumor growth and response to chemotherapy.

Procedures

Positron emission tomography (PET) with 2-deoxy-2-[¹⁸F]fluoro-d-glucose ([¹⁸F]FDG) and 3'-deoxy-3'-[¹⁸F]fluorothymidine ([¹⁸F]FLT), single photon emission tomography (SPECT) with [^99mTc]TcO₄ ([^99mTc]TEC), X-ray computed tomography, and fluorescent confocal endomicroscopy (FCE) images were acquired during tumor progression in female PyMT mice. Imaging with [¹⁸F]FDG and [^99mTc]TEC was also performed in untreated, doxorubicin-treated, and docetaxel-treated PyMT mice. Total tumor volumes were quantified. Tumors were collected and macroscopic and histological examinations were performed.

Results

All PyMT mice developed multifocal tumors of the mammary epithelium that became palpable at 8 weeks of age (W8). Computed tomography (CT) detected tumors at W14, while a clear tumoral uptake of [^99mTc]TEC and [¹⁸F]FDG was present as early as W6 and W8, respectively. No contrast between mammary tumors and surrounding tissue was observed at any stage with [¹⁸F]FLT. FCE detected an angiogenic switch at W10. Lung metastases were not clearly evidenced by imaging. Doxorubicin and docetaxel treatments delayed tumor growth, as shown by [¹⁸F]FDG and [^99mTc]TEC, but tumor growth resumed upon treatment discontinuation. Tumor growth fitted an exponential model with time constant rates of 0.315, 0.145, and 0.212 week^?1 in untreated, doxorubicin, and docetaxel groups, respectively.

Conclusions

Molecular imaging of mammary tumors in PyMT is precocious, precise, and predictive. [¹⁸F]FDG-PET and [^99mTc]TEC SPECT monitor tumor response to chemotherapy.

     

99Tcm-MIBI SPECT/CT显像结合T/NT半定量分析对原发甲状旁腺腺瘤术前定位的价值

  目的  99Tcm-MIBI SPECT/CT显像结合T/NT半定量分析对原发甲状旁腺腺瘤术前定位的价值。  方法  回顾性分析我院术后诊断为原发甲状旁腺腺瘤81例患者的99Tcm--MIBI SPECT/CT显像及临床资料,结合T/NT半定量分析,探讨不同部位腺瘤的检出率。  结果  99Tcm-MIBI SPECT/CT断层显像、平面显像对腺瘤检出率分别为95.7%（67/70）、90%（63/70）;99Tcm-MIBI SPECT/ CT断层和平面显像腺瘤检出率差异无统计学意义（ χ2=1.723,P=0.189）。根据腺瘤的位置将腺瘤分为上侧和下侧。99Tcm-MIBI SPECT/CT断层显像、平面显像对上侧腺瘤检出率分别为92.8%（13/14）、85.7%（12/14）,对下侧腺瘤检出率分别为100%（53/ 53）、100%（53/53）。99Tcm-MIBI SPECT/CT断层显像上下侧腺瘤检出率差异无统计学意义（ χ2=3.84,P=0.20）,99Tcm-MIBI SPECT/CT平面显像下侧腺瘤检出率高于上侧（ χ2=7.80,P=0.04）。下侧腺瘤体积大于上侧（Z=-3.19,P=0.001）,腺瘤体积和早期相T/NT比值及血清甲状旁腺激素具有弱相关性（r=0.475、0.329,P < 0.05）。  结论  通过对原发甲状旁腺瘤患者行术前99Tcm-MIBI SPECT/CT显像,并结合T/NT半定量分析,提高了不同部位腺瘤定位的准确度,能够为手术提供有价值的参考。      

Utility of 99mTc-PEG4-E[PEG4-c(RGDfK)]2 in Posttherapy Surveillance of Patients with Reelevated Carcinoembryonic Antigen Levels

ObjectivesTo evaluate the efficacy of ^99mTc-PEG₄-E[PEG₄-c (RGDfK)]₂ (^99mTc-3PRGD2) single photon emission computed tomography (SPECT) in monitoring the recurrence of malignancies.Materials and Methods^99mTc-3PRGD2 SPECT was performed on 28 patients (10 females and 18 males; median age 49.2 years) suspected of recurrent malignancies due to an asymptomatically reelevated carcinoembryonic antigen level. The SPECT was performed 0.5 h after an intravenous injection of 11.1 MBq/kg (0.3 mCi/kg) of ^99mTc-3PRGD2. The SPECT and concurrent contrast-enhanced computed tomography (ceCT) findings were analyzed with reference to the histopathological findings and/or clinical follow-up data.ResultsRecurrences were identified in 20 out of the 28 patients (prevalence 71.4s%) with altogether 26 lesions. Fifteen lesions were confirmed by histopathological findings, and the other 11 lesions were confirmed by serial radiological or clinical follow-up. Of the 20 patients with recurrent malignancies, 12 (60s%) were correctly identified by ^99mTc-3PRGD2 SPECT. In the patient-based analysis, the sensitivity and specificity of ^99mTc-3PRGD2 SPECT were 60 and 100s%, respectively, and the positive and negative predictive values were 100 and 50s%, respectively. In the lesion-based evaluation, the sensitivity and specificity were 62 and 100s%, respectively. The sensitivity and specificity of the ceCT in the patient-based evaluation were 60 and 75s%, respectively, and the positive and negative predictive values were 86 and 40s%, respectively. In the lesion-based evaluation, the sensitivity and specificity of the ceCT were 70 and 84s%, respectively.Conclusions^99mTc-3PRGD2, as a new SPECT tracer targeting the integrin α_vβ₃ receptor, was more useful in distinguishing recurrences as compared to ceCT.Key Words: ^99mTc-PEG₄-E[PEG₄-c(RGDfK)]₂, Integrin α_vβ₃, Carcinoembryonic antigen, Recurrence, Single photon emission computed tomography     

Detection of colorectal tumors with water enema-multidetector row computed tomography

Purpose

To retrospectively determine the diagnostic capabilities of water enema-multidetector row computed tomography (WE-MDCT) in the detection of colorectal tumors.

Materials and methods

One hundred and one patients (55 male, 46 female) who had WE-MDCT and videocolonoscopy because of suspected colorectal tumors were included. Results of complete videocolonoscopy, surgery, and histopathologic analysis were used as standard of reference. Sensitivity, specificity, and accuracy, and positive and negative predictive values of WE-MDCT for the diagnosis of colorectal tumors were estimated with 95% confidence intervals (CIs).

Results

Ninety-two colorectal tumors (64 malignant, 28 benign) were confirmed in 71 patients (prevalence, 71/101; 70%). Overall sensitivity for colorectal tumor detection was 87% (80/92; 95%CI: 78%?C93%) on a per lesion basis. For malignant and benign tumor detection, sensitivity was 100% (64/64; 95%CI: 94%?C100%) and 57% (16/28; 95%CI: 37%?C76%), respectively. For colorectal tumors ??10?mm, sensitivity was 99% (76/77; 95%CI: 93%?C100%). Seventy-nine of the 83 colorectal tumors ??6?mm were detected, yielding a sensitivity of 95% (79/83; 95%CI: 88%?C99%) for this specific size category. On a per patient basis, WE-MDCT had a sensitivity of 100% (71/71; 95%CI: 94%?C100%), a specificity of 100% (30/30; 95%CI: 88%?C100%), an accuracy of 100% (101/101; 95%CI: 96%?C100%), a positive predictive value of 100% (71/71; 95%CI: 94%?C100%), and a negative predictive value of 100% (30/30; 95%CI: 86%?C100%) for the diagnosis of colorectal tumor.

Conclusion

Our results suggest that WE-MDCT is a promising imaging technique for the detection of malignant colorectal tumors. However, our results should be validated by larger and prospective studies.     

Predicting Early Chemotherapy Response with Technetium-99m Methoxyisobutylisonitrile SPECT/CT in Advanced Non-Small Cell Lung Cancer

Purpose  

The purpose of this study is to examine the prognostic value of prechemotherapy technetium-99m methoxyisobutylisonitrile (^99mTc-MIBI) uptake with single photon emission computed tomography/computed tomography (SPECT/CT) in relation to tumor size change measured by CT.