PET-CT在结直肠癌肝转移诊治中的应用进展

用葡萄糖类似物18F-FDG作为显像剂的PET-CT是一种无创性显像方法,它在肿瘤尤其是转移性结直肠癌的诊断、分期、再分期、疗效监测和随访中有非常重要的作用.PET-CT融合显像将功能显像和解剖显像结合在一起,提高了全身肿瘤显像的敏感性和特异性,明显优于单独PET或CT.目前,PET-CT在结直肠癌肝转移中的应用主要是检测和甄别肝脏转移性病灶、制定治疗方案和进行疗效评价.     

肿瘤短链脂肪酸代谢PET显像剂研究进展

18F-FDG PET显像在临床上发挥着越来越重要的作用，但其在某些肿瘤的应用中存在一定的弊端，易产生假阳性和假阴性。脂肪酸代谢PET显像在脂类代谢显像中占有非常重要的地位，在一定程度上可弥补糖代谢的不足，能提高对肿瘤诊断的灵敏度和准确率。笔者就目前应用于临床前和临床研究中的肿瘤短链脂肪酸代谢PET显像剂进行综述。     

18F-FDG和18F-FLT PET-CT在肿瘤非手术治疗早期疗效评价中的应用

早期监测肿瘤在不同治疗方法中的疗效已成为临床上亟待解决的问题.PET可从分子水平上观察细胞生物学行为,尤其是对肿瘤的早期诊断、分期及疗效评价具有较高的特异度.18F-FDG为葡萄糖类代谢显像剂,作为目前应用最为广泛的显像剂,因其本身固有的一些特点表现为对肿瘤的非特异性显像.3'-脱氧-3'-18F-氟胸腺嘧啶(18F-FLT)为核苷酸类代谢显像剂,在细胞增殖显像方面的应用较为广泛.两者在肿瘤监测、分期及疗效评价方面各具特点.该文就PET-CT在肿瘤疗效评价中的应用进行综述,同时探讨两者在监测非手术治疗疗效时何者更具有优势.     

11C-蛋氨酸PET/CT显像在脑胶质瘤中的应用价值

胶质瘤是最常见的颅内原发肿瘤,其病死率及致残率均较高.常规影像学方法在脑胶质瘤的术前分级、预后判断、复发与坏死的鉴别等方面存在一定不足.PET是反映肿瘤生物学特性的一种理想的非侵入性的功能显像方法,而PET/CT则实现了功能代谢图像与解剖形态图像的同机融合,为胶质瘤的诊断提供了功能代谢信息,弥补了常规影像的不足.目前已有多种分子影像途径及示踪剂用于脑胶质瘤的定位诊断及疗效监测.其中,11C-蛋氨酸(MET)PET/CT在脑胶质瘤的诊断、分级、预后评估、浸润范围的勾画、活检计划及放疗计划的制定、放疗后坏死病灶组织和肿瘤复发的鉴别诊断等方面起到重要作用.笔者就近年来11C-MET PET/CT显像在脑胶质瘤中的应用进展做一综述.     

PET及PET-CT在监测肿瘤治疗效果中的价值

18F-氟代脱氧葡萄糖(18F-FDG)PET和PET-CT既能准确鉴别肿瘤残留与纤维化,又能通过定量评价治疗前后18F-FDG摄取的变化来早期预测疗效和评价预后,指导临床及时调整治疗方案,因此越来越多地被用于监测肿瘤放化疗疗效。目前已建立了一些应用PET和PET-CT监测肿瘤疗效的具体方法,研究结果显示,PET及PET-CT在监测肿瘤疗效方面存在明显的优势,但也存在问题。     

PET/MRI融合显像在脑胶质瘤诊断和治疗中的研究进展

脑胶质瘤发病率较高,是颅内最常见的原发肿瘤。MRI技术在脑胶质瘤分级、手术定位和术后放疗靶区勾画中有着重要的作用。但是,越来越多的研究发现,MRI在肿瘤显像方面仍存在局限性,如准确确定肿瘤边界。PET利用组织代谢原理进行功能显像,有利于发现增殖活跃的肿瘤组织。PET与MRI图像的融合,实现了解剖与功能共同显像,为提高脑胶质瘤诊断的准确性提供了一条新途径。     

^18F—FDG PET—CT在头颈部肿瘤放射治疗中的应用

正电子发射型计算机断层显像（PET）是一种功能性影像技术,目前已广泛应用于恶性肿瘤的诊断中。PET—CT实现了PET和CT的两种技术的优势互补,使其在头颈部肿瘤放疔中的临床应用已受到越来越多的关注,但对临床的指导意义目前仍存在争议。本文分析了PET—CT在头颈部肿瘤放疗中的应用,包括肿瘤分期,预测放射治疗敏感性及预后,制定放疗计划,评估疗效并监测肿瘤复发等。     

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.     

恶性淋巴瘤的多模态显像研究进展

医学影像学技术在肿瘤的临床分期、再分期、疗效评价甚至预后判断中发挥着重要作用,多模态影像技术（如PET/CT和PET/MR）近年来发展的非常迅速。18F-FDG PET/CT已广泛用于亲和18F-FDG的恶性淋巴瘤的初始分期以及疗效评估,治疗期间使用18F-FDG PET/CT评估治疗反应的价值尚不确定,初步的研究认为PET/MR应用于淋巴瘤的分期是可行的。笔者就多模态显像PET/CT、PET/MR在淋巴瘤中的研究现状及进展进行综述。     

胃癌PET/CT分子影像探针的研究进展

胃癌是最常见的消化系统恶性肿瘤之一, 预后较差, 准确地诊断及分期对胃癌临床治疗决策的制定具有重要意义。放射性核素显像如PET/CT或PET/MR可以在分子或细胞水平对肿瘤进行显像, 在胃癌的诊断、分期、再分期和疗效评估方面提供重要的信息。由于传统的正电子核素示踪剂18F-FDG在胃癌的应用中存在一些局限性, 多种新型分子探针逐渐被开发并应用于胃癌诊断中。笔者就PET/CT分子影像探针在胃癌诊断中的临床应用现状和研究进展进行综述。     

Knee injury and Osteoarthritis Outcome Score (KOOS) - validation of a Swedish version

The Knee injury and Osteoarthritis Outcome Score (KOOS) is a self-administered instrument measuring outcome after knee injury at impairment, disability, and handicap level in five subscales. Reliability, validity, and responsiveness of a Swedish version was assessed in 142 patients who underwent arthroscopy because of injury to the menisci, anterior cruciate ligament, or cartilage of the knee. The clinimetric properties were found to be good and comparable to the American version of the KOOS. Comparison to the Short Form-36 and the Lysholm knee scoring scale revealed expected correlations and construct validity. Item by item, symptoms and functional limitations were compared between diagnostic groups. High responsiveness was found three months after arthroscopic partial meniscectomy for all subscales but Activities of Daily Living.     

Endovascular management of carotid-cavernous fistulas

Objective To investigate endovascular treatment of traumatic direct carotid-cavernous fistulas （CCF） and their complications such as pseudoaneurysms. Methods： Over a five-year period, 22 patients with traumatic direct CCFs were treated endovascularly in our institution. Thirteen patients were treated once with the result of CCF occluded, 8 twice and 1 three times. Treatment modalities included balloon occlusion of the CCF, sacrifice of the ipsilateral internal carotid artery with detachable balloon, coll embolization of the cavernous sinus and secondary pseudoaneurysms, and covered-stem management of the pseudoaneurysms. Results All the direct CCFs were successfully managed endovascularly. Four patients developed a pseudoaneurysm after the occlusion of the CCF with an incidence of pseudoaneurysm formation of 18.2% （4/22）. A total number of 8 patients experienced permanent occlusion of the ICA with a rate of ICA occlusion reaching 36.4% （8/22）. Followed up through telephone consultation from 6 months to 5 years, all did well with no recurrence of CCF symptoms and signs. Conclusion Traumatic direct CCFs can be successfully managed with endovascular means. The pseudoaneurysms secondary to the occlusion of the CCFs can be occluded with stent-assisted coiling and implantation of covered stents.     

The acutely limping child

Acute limping may be the result of multiple pathologies in children. The differential diagnosis varies based on the age of the child. Irrespective of age, the initial imaging work-up includes AP and frog leg radiographs of the pelvis and ultrasound; MRI may sometimes be helpful. In children less than 3 years, infections and trauma are most frequent. MRI is the imaging modality of choice when osteomyelitis is clinically suspected. Between the ages of 3 and 10 years, transient synovitis of the hip and Legg-Calvé-Perthes disease are main considerations but infection, inflammation and focal bony lesions are also considered. In children over 10 years, slipped capital femoral epiphysis also is considered.     

Do Balance Board Training Programs Reduce the Risk of Ankle Sprains in Athletes?

Introduction Ankle sprains are the most common musculo-skeletal injury that occurs in athletes,particularly in sports that require jumping and landing on one foot such as soccer,and basketball(1-4).These injuries often result in significant time loss from participation,long-term disability,and have a major impact on health care costs and resources(5-8).     

High Intensity Interval Training:New Insights

KEY POINTS ·High-intensity interval training(HIT)is characterized by repeated sessions of relatively brief，intermittent exercise.often performed with an“a11 out”effort or at an intensity close to that which elicits peak oxygen uptake(i.e.，≥90%of VO2 peak).     

Developmental validation of the PowerPlex(®) ESI 16 and PowerPlex(®) ESI 17 Systems: STR multiplexes for the new European standard

In response to the ENFSI and EDNAP groups’ call for new STR multiplexes for Europe, Promega^® developed a suite of four new DNA profiling kits. This paper describes the developmental validation study performed on the PowerPlex^® ESI 16 (European Standard Investigator 16) and the PowerPlex^® ESI 17 Systems. The PowerPlex^® ESI 16 System combines the 11 loci compatible with the UK National DNA Database^®, contained within the AmpFlSTR^® SGM Plus^® PCR Amplification Kit, with five additional loci: D2S441, D10S1248, D22S1045, D1S1656 and D12S391. The multiplex was designed to reduce the amplicon size of the loci found in the AmpFlSTR^® SGM Plus^® kit. This design facilitates increased robustness and amplification success for the loci used in the national DNA databases created in many countries, when analyzing degraded DNA samples. The PowerPlex^® ESI 17 System amplifies the same loci as the PowerPlex^® ESI 16 System, but with the addition of a primer pair for the SE33 locus. Tests were designed to address the developmental validation guidelines issued by the Scientific Working Group on DNA Analysis Methods (SWGDAM), and those of the DNA Advisory Board (DAB). Samples processed include DNA mixtures, PCR reactions spiked with inhibitors, a sensitivity series, and 306 United Kingdom donor samples to determine concordance with data generated with the AmpFlSTR^® SGM Plus^® kit. Allele frequencies from 242 white Caucasian samples collected in the United Kingdom are also presented. The PowerPlex^® ESI 16 and ESI 17 Systems are robust and sensitive tools, suitable for the analysis of forensic DNA samples. Full profiles were routinely observed with 62.5 pg of a fully heterozygous single source DNA template. This high level of sensitivity was found to impact on mixture analyses, where 54–86% of unique minor contributor alleles were routinely observed in a 1:19 mixture ratio. Improved sensitivity combined with the robustness afforded by smaller amplicons has substantially improved the quantity of data obtained from degraded samples, and the improved chemistry confers exceptional tolerance to high levels of laboratory prepared inhibitors.