Enhanced dual contrast agent,Co-doped NaYF4:Yb,Tm nanorods,for near infrared-to-near infrared upconversion luminescence and magnetic resonance imaging

Dual-modality imaging with magnetic resonance (MR) and upconversion luminescence (UCL) is a promising technique for molecular imaging in biomedical research. Multifunctional lanthanide-based nanoparticles have been widely investigated as agents for contrast enhanced MR and fluorescence imaging. However, the use of rare earth fluoride nanoparticles for dual-modality imaging of T2-weighted MR and UCL is rarely reported. We find that NaYF₄:Yb³⁺,Tm³⁺,Co²⁺ (MUC) nanorods can be applied as a high-performance dual contrast agent for both T2-weighted MR and UCL dual-modality imaging. After modification with 6-O-carboxymethyl chitosan (OCC), MUC nanorods can be endocytosed by cells without showing signs of cytotoxicity. High-quality UCL images of living cells incubated with MUC-OCC nanorods were acquired on a near-infrared (NIR) confocal microscopy under the excitation at 980 nm. Moreover, MUC-OCC nanorods display high transverse (r2) relaxivities in vitro. The application of low-dose MUC-OCC nanorods for NIR-to-NIR UCL and MR dual-modality in vivo imaging was also carried out successfully. In addition, the toxicity of MUC-OCC nanorods was evaluated by MTT assay, serological tests and histological analysis of visceral organs.     

PET/MRI多模态成像预测肿瘤放化疗疗效研究进展

近年来,PET/MRI作为一种新兴的多模态成像技术正逐步应用于临床检查。不同患者或疾病对放化疗的敏感性存在差异,在治疗前及治疗初期快速、准确、无创、有效地预测肿瘤对放化疗的敏感性对制定个体化治疗方案具有重要意义。PET/MRI可同时提供肿瘤的生物学和微环境信息,在预测疗效方面具有巨大的潜力。本文对PET/MRI多模态成像预测肿瘤放化疗疗效的研究进展进行综述。     

Prognostic factor analysis in patients with brain metastases from breast cancer: how can we improve the treatment outcomes?

Purpose  We conducted this study to analyze clinicopathologic features and treatment outcomes for various treatment modalities in breast cancer patients with brain metastases. Patients and methods  Retrospective analysis was performed using medical records of patients who were diagnosed with metastatic brain tumors from breast cancer. The treatment modalities applied included whole-brain radiotherapy (WBRT), surgical resection, stereotactic radiosurgery (SRS) and systemic treatments such as chemotherapy and endocrine therapy. Results  Among 125 female breast cancer patients with brain metastases, 87.2% had Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0–2. The median overall survival (OS) was 6.6 months (95% CI 3.9–9.2). A multivariate analysis using the Cox-regression test identified three risk factors; poor PS (P = 0.023), HER2 positivity (P = 0.013), and no additional systemic treatment (P = 0.006). Those patients who had no risk factors showed outstanding outcome (median OS 49 months). On the contrary, the patients who had all risk factors (poor PS with HER2 positive and did not receive additional systemic chemotherapy) showed dismal prognosis (median OS 2 months). Conclusions  Our new classification according to the suggested risk factors for patients with metastatic brain tumor from breast cancer reflects particular characteristics of each subset of the patients with good prognostic capacity. B.-B. Park and J. E. Uhm contributed equally to the work.     

Combining anatomy and function: the path to true image fusion

Modern imaging technologies visualize different aspects of disease in a non-invasive way. Considerable progress has been made in the fusion of images from different imaging modalities using software approaches. One goal of fusion software is to align anatomical and functional images and allow improved spatial localization of abnormalities. The resulting correlation of the anatomical and functional images may clarify the nature of the abnormality and help diagnose or stage the underlying disease. Whereas successful image fusion software has been developed for the brain, only limited success has been achieved for image alignment in other parts of the body. The development and current status of alternative approaches are presented. Dual-modality imaging is described with devices where two modalities are combined and mounted in a single gantry. The use of existing scanner technology ensures that no compromises are made in the clinical efficacy of either the anatomical or functional imaging modality. A combined positron emission tomography (PET) and computed tomography (CT) scanner has been developed and is undergoing clinical evaluation. Combining PET with MR is technologically more challenging because of the strong magnetic fields restricting the use of certain electronic components. An overview of the current status and future prospects of dual-modality imaging devices is presented.     

基于最大互信息的人脑多模图像快速配准算法

对脑图谱开发过程中来源于不同成像设备的多模图像进行配准。对预处理后的数码图像和MRI图像,首先提取图像的轮廓,采用基于轮廓的力矩主轴法计算初始平移量和旋转量,然后设定初始缩放系数,将此初始配准参数作为改进单纯形法的初始参数,以互信息作为相似性测度迭代搜索,使互信息最大,从而实现最佳配准。结果表明本算法不需要人为预调整待配准图像的分辨率,自动化程度高,配准速度快,精度较高,能够满足脑图谱开发过程中的多模图像配准要求。     

原发性食管小细胞癌临床特点与综合治疗

目的探讨原发性食管小细胞癌的临床病理特征及治疗方法的选择.方法回顾性分析9例原发性食管小细胞癌的临床表现、病理特征、治疗方法及结果.结果TNM分期Ⅱ期3例,Ⅲ期4例,Ⅳ期2例;单纯手术1例,手术 化疗6例,放疗 化疗2例.免疫组化染色NSE阳性9例,Syn、CgA阳性7例,合并糖尿病5例,GLU均阳性.1,2,3年生存率分别为55.6%(5/9),33.3%(3/9)和12.5%(1/8),平均生存期18.1个月.结论原发性食管小细胞癌恶性程度高,TNM分期和治疗方法是影响预后的重要因素,早期发现、综合治疗是延长生存期的关键.     

Validation of fully automatic brain SPET to MR co-registration

Fully automatic co-registration of functional to anatomical brain images using information intrinsic to the scans has been validated in a clinical setting for positron emission tomography (PET), but not for single-photon emission tomography (SPET). In this paper we evaluate technetium-99m hexamethylpropylene amine oxime to magnetic resonance (MR) co-registration for five fully automatic methods. We attached six small fiducial markers, visible in both SPET and MR, to the skin of 13 subjects. No increase in the radius of SPET acquisition was necessary. Distortion of the fiducial marker distribution observed in the SPET and MR studies was characterised by a measure independent of registration and three subjects were excluded on the basis of excessive distortion. The location of each fiducial marker was determined in each modality to sub-pixel precision and the inter-modality distance was averaged over all markers to give a fiducial registration error (FRE). The component of FRE excluding the variability inherent in the validation method was estimated by computing the error transformation between the arrays of MR marker locations and registered SPET marker locations. When applied to the fiducial marker locations this yielded the surface registration error (SRE), and when applied to a representative set of locations within the brain it yielded the intrinsic registration error (IRE). For the best method, mean IRE was 1.2 mm, SRE 1.5 mm and FRE 2.4 mm (with corresponding maxima of 3.3, 4.3 and 5.0 mm). All methods yielded a mean IRE <3 mm. The accuracy of the most accurate fully automatic SPET to MR co-registration was comparable with that published for PET to MR. With high standards of calibration and instrumentation, intra-subject cerebral SPET to MR registration accuracy of <2 mm is attainable. Received 29 May and in revised form 6 October 1999     

手术在小细胞肺癌综合治疗中作用的临床观察

目的 探讨手术治疗在小细胞肺癌以化放疗为主的个体化综合治疗中的年生存率和作用，以及影响患者预后的因素，评价手术治疗的效果。方法 通过回顾性总结分析北京协和医院1995～2004年间部分小细胞肺癌患者临床资料，对比分析手术与非手术联合放化疗对小细胞肺癌患者生存期的影响。结果 接受化放疗及手术组总体中位生存期为（34．0±7．3）个月，1，3年生存率分别为（90．68±4．44）％，（41．82±9．30）％；仅接受化放疗组总体中位生存期为（17．0±2．24）个月，1年生存率为（66．59±9．20）％，3年生存率接近于0。手术组患者术后生活质量较术前有显著提高。结论 对于部分小细胞肺癌患者，包括手术的多学科综合治疗能延长患者的生存期，改善生活质量。对于接受手术和术后放、化疗的患者，术后生物免疫治疗是影响预后的因素之一。     

晚期非小细胞肺癌以手术为主综合治疗的临床观察

背景与目的确诊的非小细胞肺癌(NSCLC)患者中,65%～70%为晚期(Ⅲ、Ⅳ期)。对于这类患者,采用综合治疗有望取得较好的治疗效果。本研究的目的是探讨晚期NSCLC(ⅢB、Ⅳ期)以手术为主综合治疗的疗效。方法总结分析北京协和医院胸外科1995～2003年部分接受以手术为主综合治疗的ⅢB～Ⅳ期NSCLC患者的临床资料,通过评估患者的生存率,评价以手术为主综合治疗的疗效。结果全组51例患者,ⅢB期20例,Ⅳ期31例,总体中位生存期为37.0月±7.6月,术后1年生存率为86.35%±5.21%,3年生存率为52.96%±8.83%。结论以手术为主的综合治疗有望提高可手术晚期NSCLC患者的生存期。