简介：Objective:Prostatecancers(PCa)inAsianindividualsaremolecularlydistinctfromthosefoundintheirCaucasiancounterparts.ThereisnoriskstratificationtoolforAsianmenwithrapidbiochemicalrecurrence(BCR)followingradicalprostatectomy(RadP).Thisstudyaimstoassessthedetectionrateof^68Ga-prostate-specificmembraneantigen-positronemissiontomography/computedtomography(PSMA-PET/CT)fordiagnosisofclinicalrecurrenceandasatreatmentdecisionmakingtoolinAsianpatientswithBCRpost-RadP.Methods:^68GaPSMA-PETandCTbodywith/withoutbonescan[conventionalworkup(CWU)]wereperformedin55AsianpatientswithBCRwithin36monthspost-RadP.Twoblindedreviewersassessedtheimages.Detectionratesof^68GaPSMAPET/CTwereevaluated,andimpactonmanagementwasreviewedbycomparisonwithCWU.Results:MediantimetoBCRpost-RadPwas8.1months.Detectionratefor^68GaPSMA-PET/CTwas80%(44/55).Apositivescanwassignificantlyassociatedwithincreasingprostate-specificantigen(PSA)level[oddsratio(OR)=1.13(95%CI1.05–1.30),P=0.017],butnotwithhigherGleasongradeorshorterPSAdoublingtime.ComparedtoCWU,68GaPSMA-PET/CTdetectedanadditional106lesionsin33/44patientswithapositivescan,resultinginachangeinmanagementin25/44(56.8%)patients:10tohormonaltherapy(HT)andwholepelvisradiotherapy(RT)inadditiontobedRT,and15topalliativeHTalone.Conclusions:Inthepresentreport,wedemonstratedthediagnosticandtreatmentdecisionutilityof^68GaPSMA-PET/CTinAsianmenwithrapidBCR.DetectionofsmallvolumenodalandsystemicrecurrencesatlowPSAlevels(<1.0ng/mL)highlightstheroleofthetoolinassigningpatientstotreatmentintensificationwithHT-RTorpalliativeHTinpolymetastaticdisease.

简介：目的评价3D打印共面穿刺模板（3D-PCPT）辅助CT引导经皮穿刺活检术在肺原发小微结节诊断中的应用价值。方法对43例肺原发微小结节患者行经皮肺穿刺活检及诊断,评价3D-PCPT辅助CT引导下肺穿刺活检的穿刺成功率、恶性肿瘤诊断率及并发症发生率,并对与上述指标可能有关的因素进行相关性分析。结果43例患者均顺利完成穿刺操作。穿刺病灶直径为0.45~2.00cm,中位直径为1.50cm。35例患者采用1~2根定位针,8例患者未应用定位针;36例患者进行了1~2次活检,7例患者因取材不满意进行了3~4次活检。病理学诊断有1例患者无阳性结果,穿刺成功率为97.7%（42/43）,恶性肿瘤诊断率为69.8%。并发症：针道出血发生率为62.8%（27/43）,气胸发生率为30.2%（13/43）,1例（2.3%）患者需胸腔闭式引流,2例（4.7%）患者出现术后咯血,所有并发症经对症处理后均康复。病灶直径与1次活检成功率、恶性肿瘤诊断率、针道出血发生率相关（P﹤0.05）,病灶越小,1次活检成功率及恶性肿瘤诊断率越低,针道出血发生率越高。定位针与1次活检成功率相关,应用定位针者的1次活检成功率明显高于未应用定位针者（P=0.006）。结论3D-PCPT辅助CT引导技术具有良好的临床应用可行性,有助于使穿刺技术流程标准化,值得进一步推广,有较好的临床应用前景。

简介：目的：探寻未手术及放疗的肺癌行根治性或预防性放疗锁骨上淋巴结靶区勾画的范围。方法：将锁骨上区域按主要解剖转移途径分区,回顾性分析肺癌在锁骨上淋巴结的转移分布特点,进一步精确肺癌在锁骨上淋巴结靶区勾画范围。结果：锁骨上淋巴结转移的肺癌病例中有双侧锁骨上淋巴结的占31%;锁骨上淋巴结转移在Ⅰ区出现的占22%,多数与其他区（如Ⅱ区及Ⅳ区）同时出现;锁骨上Ⅱ区淋巴结转移占绝大部分,为99%,与他区一同出现或单独出现。锁骨上Ⅲ区出现淋巴结转移的约3.9%,且全部合并有Ⅱ区淋巴结转移,多伴有大的肿瘤负荷,纵隔及锁骨上广泛的淋巴结转移。Ⅳ区出现淋巴结转移的占16%,均合并有Ⅰ区或Ⅱ区淋巴结转移。结论：Ⅰ区及Ⅱ区是肺癌锁骨上淋巴结转移的主要集中区,临床上考虑进行锁骨上预防性照射时建议包括Ⅰ、Ⅱ区;当Ⅱ区存在淋巴结转移时,结合患者耐受性,考虑Ⅳ区照射。

简介：

简介：肺癌患者治疗前的预后评估对制定合理的治疗方案至关重要。^18F-FDGPET／CT作为分子影像检查手段，能有效地反映患者的肿瘤代谢负荷，其中全身肿瘤代谢体积（whole-bodymetabolictumorvolume，MTVwb）及全身病灶总糖酵解值（whole-bodytotallesionglycolysis，TLGwb）作为全身肿瘤代谢负荷参数，在评价预后方面有很好的应用前景。

简介：目的评价双时相显像在胰腺良恶性鉴别诊断中的应用价值。方法对24例胰腺癌患者和10例胰腺良性病变患者进行^18F-FDGPET双时相显像（早注射FDG后50-60min行早期显像,注射后120-150min行延迟显像）,测定两次显像病灶的标准摄取值（standarduptakevalue,SUV）,并计算SUV变化率（ΔSUV）。结果胰腺癌组SUV早期显像=4.63±2.09,SUV延迟显像=5.86±2.74,ΔSUV=（24.76±15.58）%,差异有显著性（t=7.94,P〈0.01）。而胰腺良性病变SUV早期显像=2.48±0.95,SUV延迟显像=2.81±1.18,ΔSUV=（12.66±20.97）%,差异有显著性（t=2.67,P〈0.05）,且胰腺癌组SUV延迟显像明显高于良性病变组（t=2.25,P〈0.05）。结论胰腺恶性病变SUV延迟显像升高的幅度高于良性病变,但黏液腺癌SUV延迟显像升高的幅度低于良性病变,总体而言,双时相显像方法简便,在临床上具有一定的实用价值。

简介：目的：探讨乏脂肪型肾错构瘤患者的CT灌注参数与肾功能生化检测指标的相关性。方法：选择在本院诊治的乏脂肪型肾错构瘤患者34例作为观察组,同期选择在我院进行体检的健康人34例作为对照组,两组都进行肾功能相关生化检测指标（BUN、Scr、TG、TC、HDL-C、LDL-C）的检测与CT灌注参数（BV、BF、PS、MTT）检测,同时进行相关性分析。结果：观察组的血清BUN、Scr、TG、TC和HDL-C值明显高于对照组,而LDL-C值明显低于对照组,对比差异都有统计学意义（P〈0.05）。观察组肾皮质的BV、BF、PS值明显低于对照组,而MTT值明显高于对照组,对比差异都有统计学意义（P〈0.05）。乏脂肪型肾错构瘤发生的主要危险因素包括BV、PS、BUN与TC等（P〈0.05）;Pearson相关系数分析显示乏脂肪型肾错构瘤患者的BV、BF、PS与BUN、TC存在明显的负相关性（P〈0.05）,而MTT与BUN、TC存在明显的正相关性（P〈0.05）。结论：乏脂肪型肾错构瘤患者存在明显的肾功能与血脂等生化指标异常,同时CT灌注参数也处于异常情况,可参与到乏脂肪型肾错构瘤的形成,存在一定的相关性,在临床上有很好的应用价值。

简介：Objective:Toclarifytheprognosticvalueofpost-treatment18F-fluorodeoxyglucose(FDG)positronemissiontomography(PET)/computedtomography(CT)inpatientswithadvancedheadandnecksquamouscellcarcinoma(HNSCC)aftercombinedintra-arterialchemotherapyandradiotherapy(IACR).Methods:Thirty-sixpatientswithHNSCCwhounderwentIACRwererecruited.TheperiodfromtheendofIACRtothelastpost-treatment18F-FDGPET/CTexaminationwas8-12weeks.Bothpatient-basedandlesion-basedanalyseswereusedtoevaluatethePET/CTimages.Forlesion-basedanalysis,36regions(12lesionsofrecurrencesand24scarsatprimarysites)wereselected.TheKaplan-Meiermethodwasusedtoassesstheoverallsurvival(OS)stratifiedby18F-FDGuptakeorvisualinterpretationresults.Results:TwelvepatientswithrecurrencewereidentifiedbysixmonthsafterIACR.Thesensitivityandspecificityinthepatient-basedanalysiswere67%(8/12)and88%(21/24),respectively.ThemeanOSwasestimatedtobe12.1months(95%CI,6.3-18.0months)forthehighermaximumstandardizeduptakevalue(SUVmax)group(n=7)and44.6months(95%CI,39.9-49.3months)forthelowerSUVmaxgroup(n=29).OSinthehigherSUVmaxgroup(cut-offpoint,6.1)orpositivevisualinterpretationgroupwassignificantlyshorterthanthatinthelowerSUVmaxornegativevisualinterpretationgroup(P<0.001andP<0.05,respectively).Conclusions:TheSUVmaxandvisualinterpretationofHNSCConpost-IACR18F-FDGPET/CTcanprovideprognosticsurvivalestimates.

简介：Aseventyeightyearsoldmalepatientunderwentawholebody18F-FDGPET/CTimagingtodiagnosethelesionwhichwasshowedintherightlungbyachestXraytestandCTscanbefore.Besidestheintense18F-FDGuptakeofthelesionintherightlung,alesionintheleftparotidglandalsoshowedintense18F-FDGuptake.Toevaluatethepathologyofthelesionintheleftparotidgland,aparotidglandscintigraphyimagingwithTc-99mpertechnetatewasdoneandrevealedaWarthin'stumor.Laterafineneedleaspiration(FNA)confirmedthatitwasaWarthin'stumor.

简介：Objective:Weinvestigatedthecorrelationbetweenthenumberofcirculatingtumorcells(CTCs)andwholebodymetabolictumorvolume(WBMTV)measuredby18F-fluorodeoxyglucose(FDG)positronemissiontomography/computedtomography(PET/CT).TheaimwastoevaluatethevalueoftheincorporationofCTCnumberandWBMTVintheprognosticpredictionofstageIIIsmall-celllungcancer(SCLC).Methods:Onehundredandtwenty-ninepatientswereenrolledinthisstudy.Allpatientsweretreatedwithfourcyclesofaplatinum-basedregimenandconcurrentchestirradiation,followedbyprophylacticcranialirradiation.BloodsamplesforCTCanalysiswereobtainedfrom112patientsbeforetheinitiationofchemotherapy(asabaseline),aftercycle1andaftercycle4.CTCsweremeasuredusingtheCELLSEARCH?system.ThepatientsunderwentpretreatmentFDGPET/CTWBMTV,whichincludedallmalignantlesions.TheSpearmanranktestwasusedtodeterminethecorrelationamongCTCcounts,WBMTVanddiseasestage.Overallsurvival(OS)andprogression-freesurvival(PFS)curveswereproducedusingtheKaplan-Meiermethod,andsurvivaldifferencesbetweengroupswereassessedbythelog-ranktest.Results:ThenumberofCTCsatbaselinedidnotcorrelatewithWBMTVbeforetheinitiationoftherapy(P=0.241).ThenumberofCTCsatbaselineandtheWBMTVbeforetheinitiationoftherapywereindependentrelevantfactorsforPFSandOS.Thesubgroupanalysis(GroupA:CTCcount>19.5andaWBMTV>266.5cm^3;GroupB:CTCcount>19.5andaWBMTV≤266.5cm^3;GroupC:CTCcount≤19.5andaWBMTV>266.5cm^3;GroupD:CTCcount≤19.5andaWBMTV≤266.5cm^3)showedthatthedifferenceswerestatisticallysignificantinthemedianPFS(GroupAvs.D,P<0.001;GroupBvs.D,P=0.018;GroupCvs.D,P=0.029)andinthemedianOS(GroupAvs.D,P<0.001;GroupBvs.D,P=0.012).Conclusions:CTCnumberandWBMTVarerelatedtoprogressionanddeathinpatientswithSCLC.TheincorporationofCTCnumberandWBMTVscanscanprovideadetailedprognosticpredictionforSCLC.