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ABSTRACT: OBJECTIVE: The aim of this study was to evaluate the utility of 3'-deoxy-3'-F-fluorothymidine (F-FLT) PET/computed tomography (CT) imaging in the pretreatment evaluation of metastatic gastric cancer in comparison with F-fluorodeoxyglucose (F-FDG) PET/CT imaging. METHODS: A total of 39 metastatic gastric cancer patients were enrolled in the study. Attenuation-corrected whole-body F-FLT and F-FDG PET/CT (low-dose CT) imaging was performed on two consecutive days before chemotherapy. RESULTS: Accumulation of focal activity was visible in primary tumors on F-FLT PET/CT in 36/39 patients and on F-FDG PET/CT in 37/39 patients, with sensitivities of 92.3 and 94.9%, respectively. Further, three of the 36 FLT-avid primary tumors were almost undetected because they were covered by a high background hepatic uptake. Because of the high physiological uptake of F-FLT in the liver [median maximum standardized uptake value (SUVmax) 5.5, range 4.5-8.3] and the bone marrow (median SUVmax 14.8, range 10.8-22.0), the sensitivity of F-FLT PET/CT versus F-FDG PET/CT for detecting liver metastases and bone metastases was 30.0% (6/20) versus 100% (20/20) and 1/5 (20.0%) versus 5/5 (100%), respectively (P<0.05). Metabolically positive findings of lymph node, peritoneal, and ovarian metastases were similar between the two modalities: 96.8% (30/31) versus 93.5% (29/31), 89.5% (17/19) versus 94.7% (18/19), and 90.9% (10/11) versus 90.9% (10/11) of patients for F-FLT versus F-FDG, respectively (P>0.05). CONCLUSION: F-FLT PET/CT imaging is not recommended for pretreatment assessment of metastatic gastric cancer as it is not competent enough to evaluate liver and bone metastases; moreover, the high background hepatic uptake may cover the gastric primary tumors located adjacent to the liver.
Nuclear Medicine Communications 04/2013; · 1.40 Impact Factor
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ABSTRACT: Although endocrine therapy is an effective method to treat estrogen receptor (ER)-positive breast cancer, approximately 30%-40% of all hormone receptor-positive tumors display de novo resistance. The aim of our current study was to analyze whether F-labeled fluoromisonidazole (1-(2-nitro-1-imidazolyl)-2-hydroxy-3-fluoropropane [F-FMISO]) PET/CT could predict primary resistance to hormonal therapy in ER-positive breast cancer.
Postmenopausal women who had ER-α-positive breast cancer, stages II-IV, and had never received prior endocrine therapy were prospectively enrolled in this study. Patients underwent both F-FDG and F-FMISO PET/CT scans before and after treatment. The hottest F-FDG standardized uptake value (SUV) in the tumor foci, the SUVs at 2 and 4 h, and the TBR2 h and TBR4 h for the target lesions were calculated (TBR2 h = SUV2 h/SUV2 h and TBR4 h = SUV4 h/SUV4 h [TBR is the tumor-to-background ratio]). Clinical outcomes of primary endocrine therapy with letrozole were evaluated according to the criteria of the World Health Organization after at least 3 mo of treatment. Immunohistochemistry for markers of proliferation (Ki67) and hypoxia-induced factor 1α was performed on a subset of tumors that had undergone biopsy or surgery. Pearson and Spearman analysis was used to determine the correlation between the parameters of F-FDG and F-FMISO uptake and clinical or immunohistochemistry outcomes with a 0.01 threshold for statistical significance.
A total of 45 lesions (13 primary, 32 metastatic) from 20 patients met the inclusion criteria in this study. Baseline F-FDG and F-FMISO PET/CT scans were obtained for 33 lesions from 16 patients. The correlation between baseline F-FDG uptake and clinical outcome was weak and did not reach statistical significance (r = 0.37, P = 0.031). However, there was a significantly positive correlation between baseline F-FMISO uptake (SUV2 h, TBR2 h, SUV4 h, and TBR4 h) and clinical outcomes after ≥3 mo of primary endocrine therapy with letrozole (r = 0.77, 0.76, 0.71, and 0.78, respectively; P < 0.0001). The application of a TBR4 h cutoff of ≥1.2 allowed the prediction of 88% of the cases of progressive disease (15/17). Despite poor correlation between F-FMISO uptake and hypoxia-induced factor 1α expression, a marginal positive correlation between TBR4 h and Ki67 expression was measured (r = 0.51, P = 0.011) in a subset of malignant lesions acquired by biopsy or surgery.
F-FMISO PET/CT can be used to predict primary endocrine resistance in ER-positive breast cancer.
Journal of Nuclear Medicine 03/2013; 54(3):333-40. · 6.38 Impact Factor
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ABSTRACT: Lanthanide based upconversion nanophosphors (UCNPs) attracted increasing attention for potential applications in bioimaging, while its in vivo behaviors are not clear until now due to no available quantification imaging tools. Herein, we developed a unique rare-earth cation-exchange-based postlabelling method to introduce (153)Sm into the lattice of UCNPs, providing this (153)Sm-postlabeling UCNP having bifunction of radioactive property and upconversion luminescence under excitation at 980 nm laser. This (153)Sm-postlabelling method shows rapid treatment time of <1 min, high labeling yield of >99%, and without usage of organic solvents. More importantly, this (153)Sm-postlabelling method is also suitable for most of rare earth nanoparticles to track their in vivo behaviors. The dynamic quantification studies of the in vivo fate of the rare-earth nanoparticles were further investigated by radioactive detection method such as single-photon emission computed tomography (SPECT) and gamma counter. The imaging results revealed that UCNPs were mainly captured by the mononuclear phagocyte system (liver and spleen). The amount of nanoparticles in liver arrived at its peak quicker and was about 15 fold of that in spleen. And the nanoparticles will be slowly excreted with the bile. Therefore, the concept of postlabeling (153)Sm onto lanthanide-based UCNPs may serve as a facile strategy of fabricating multifunctional nanoprobes for upconversion luminescence (UCL) and SPECT dual-modality imaging.
Biomaterials 12/2012; · 7.40 Impact Factor
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ABSTRACT: Upconversion luminescence (UCL) properties and radioactivity have been integrated into NaLuF(4):(153)Sm,Yb,Tm nanoparticles by a facile one-step hydrothermal method, making these nanoparticles potential candidates for UCL and single-photon emission computed tomography (SPECT) dual-modal bioimaging in vivo. The introduction of small amount of radioactive (153)Sm(3+) can hardly vary the upconversion luminescence properties of the nanoparticles. The as-designed nanoparticles showed very low cytotoxicity, no obvious tissue damage in 7 days, and excellent in vitro and in vivo performances in dual-modal bioimaging. By means of a combination of UCL and SPECT imaging in vivo, the distribution of the nanoparticles in living animals has been studied, and the results indicated that these particles were mainly accumulated in the liver and spleen. Therefore, the concept of (153)Sm(3+)/Yb(3+)/Tm(3+) co-doped NaLuF(4) nanoparticles for UCL and SPECT dual-modality imaging in vivo of whole-body animals may serve as a platform for next-generation probes for ultra-sensitive molecular imaging from the cellular scale to whole-body evaluation. It also introduces an easy methodology to quantify in vivo biodistribution of nanomaterials which still needs further understanding as a community.
Biomaterials 10/2012; · 7.40 Impact Factor
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ABSTRACT: The long-term retention of nanomaterials in the body is one of the biggest concerns about the safety of these materials for in vivo application. So, it is important to develop some nanomaterials which can be relatively more easily excreted. Rare earth hydroxide, that can be degraded under acidic condition in vivo, is one of the suitable candidates. Herein, Gd(OH)(3) nanorods, which are considered as magnetic resonance imaging (MRI) contrast agents, have been synthesized to evaluate their excretion process and potential toxicity. The long-term in vivo biodistribution of the materials was investigated using single photon emission computed tomography (SPECT) imaging with (153)Sm-doped Gd(OH)(3) nanorods as probes. Biodistribution results showed that the uptake and retention of the Gd(OH)(3) nanorods took place primarily in the liver, spleen and lung. Then, most of the nanorods were excreted from the bodies of mice very rapidly. Body weight data for the mice indicated that, when intravenously injected with 100 mg/kg of the nanorods, the mice survived for 150 days without any apparent adverse effects to their health. In addition, histological, hematological and biochemical analysis indicated that these nanorods have no overt toxicity.
Biomaterials 10/2012; · 7.40 Impact Factor
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ABSTRACT: Objective:To investigate the prevalence and risk of thyroid incidentaloma identified by positron emission tomography/computed tomography (PET/CT).Study Design:Historical cohort study.Setting:Fudan University Shanghai Cancer Center.Methods:A total of 15 948 non-thyroid disease patients who underwent fluorine-18 fluorodeoxyglucose (18F-FDG) PET/CT from November 2006 to September 2010 were included. They were divided into two groups: 12 080 patients for metastatic evaluation and 3868 patients for cancer screening. When thyroid incidentaloma was found, further diagnostic examination was conducted.Main Outcome Measures:Prevalence and risk of thyroid incidentaloma.Results:The prevalence of incidental thyroid 18F-FDG uptake was approximately 2.5% (395 of 15 948). The prevalence of incidentaloma in healthy subjects (118 of 3868; 3.1%) was statistically higher than that in patients with suspected or known cancer (277 of 12 080; 2.3%) (p < .05). Among 395 incidentalomas, 146 patients had further examinations (53 patients with histologic confirmations, 93 patients with clinical monitoring). Finally, 43 lesions were confirmed to be malignancies. Therefore, the cancer risk was 29.5% (43 of 146), and it was higher in cancer screening patients (24 of 59; 40.7%) than in alleged cancer patients (19 of 87; 21.8%) (p < .05). As for FDG uptake pattern, the prevalence of thyroid cancer was 11.6% (5 of 43) and 36.9% (38 of 103) in the group of patients with diffuse and focal uptake, respectively (p < .05). After logistic regression analysis, age, sex, maximal standardized uptake value, and calcification were the potent predictors of differentiation.Conclusion:The presence of focal uptake with high SUVmax and calcification detected on CT images correlates with a high likelihood of thyroid malignancy. When a focal thyroid incidentaloma is detected, further examination should be performed.
Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale 10/2012; 41(5):327-33. · 0.71 Impact Factor
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ABSTRACT: Because of the urinary excretion of fluorine-18 fluorodeoxyglucose ((18)F-FDG), FDG-PET or PET/CT is thought of little value in patients with bladder cancer. The purpose of our study was to investigate the value of (18)F-FDG PET/CT with additional pelvic images in detection of recurrent bladder cancers.
From December 2006 to August 2010, 35 bladder cancer patients (median age 56 years old, ranging from 35 to 96) underwent routine (18)F-FDG PET/CT. To better detect bladder lesions, a new method called as oral hydration-voiding-refilling was introduced, which included that all the patients firstly received oral hydration, then were required to void frequently and finally were demanded to hold back urine when the additional pelvic images were scanned. Lesions were confirmed by either histopathology or clinical follow-up for at least 6 months.
Finally, 12 recurrent cases of 35 patients were confirmed by cystoscope. PET/CT correctly detected 11 of them. Among these 11 true positive patients, 5 patients (45.5 %) were detected only after additional pelvic images. Lichenoid lesions on the bladder wall were missed, which caused 1 false negative result. All three false positive cases were testified to be inflammatory tissues by cystoscope. Therefore, the sensitivity, specificity and accuracy of PET/CT were 91.7 % (11/12), 87.0 % (20/23) and 88.6 % (31/35), respectively.
PET/CT with additional pelvic images can highly detect recurrent lesions in residual bladder tissues. Our method with high accuracy and better endurance could be potentially applied.
Annals of Nuclear Medicine 07/2012; 26(7):571-7. · 1.50 Impact Factor
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ABSTRACT: To investigate the value of whole-body fluorine-18 2-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography for the detection of metastatic bladder cancer.
From December 2006 to August 2010, 60 bladder cancer patients (median age 60.5 years old, range 32-96) underwent whole body positron emission tomography/computed tomography positron emission tomography/computed tomography. The diagnostic accuracy was assessed by performing both organ-based and patient-based analyses. Identified lesions were further studied by biopsy or clinically followed for at least 6 months.
One hundred and thirty-four suspicious lesions were identified. Among them, 4 primary cancers (2 pancreatic cancers, 1 colonic and 1 nasopharyngeal cancer) were incidentally detected, and the patients could be treated on time. For the remaining 130 lesions, positron emission tomography/computed tomography detected 118 true positive lesions (sensitivity = 95.9%). On the patient-based analysis, the overall sensitivity and specificity resulted to be 87.1% and 89.7%, respectively. There was no difference of sensitivity and specificity in patients with or without adjuvant treatment in terms of detection of metastatic sites by positron emission tomography/computed tomography. Compared with conventional imaging modality, positron emission tomography/computed tomography correctly changed the management in 15 patients (25.0%).
Positron emission tomography/computed tomography has excellent sensitivity and specificity in the detection of metastatic bladder cancer and it provides additional diagnostic information compared to standard imaging techniques.
International Journal of Urology 03/2012; 19(7):639-44. · 1.75 Impact Factor
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ABSTRACT: The aim of the present study was to investigate the prognostic significance of FDG uptake measured as maximum standardized uptake value (SUVmax) in primary tumor by positron emission tomography with fluorine-18-fluorodeoxyglucose (FDG-PET/CT) and pretreatment serum squamous cell carcinoma antigen (SCC-ag) in patients with cervical cancer.
82 consecutive patients with biopsy-proven cervical cancer who had PET/CT before any treatment were enrolled in this study. The SUVmax of the primary cervical tumor mass was obtained and compared with pretreatment SCC-ag and pathological prognostic factors after the initial treatment.
There was significant correlation between the SUVmax of the primary tumor and tumor maximum size (p = 0.0024). The serum SCC-ag had a statistically significant association with lymph node metastasis (p = 0.0373), although there was no correlation between the SUVmax of the primary tumor and the serum SCC-ag (r (2) = -0.57). The higher SUVmax of primary tumor (≥11.2) plus pelvic lymph node (PLN) metastasis and higher SUVmax plus higher serum SCC-ag (≥6.4 ng/nl) were two most significant variables that predicted worse prognosis (p = 0.0099 and p = 0.0020, respectively).
Higher pretreatment SUVmax of primary tumor indicated worse prognosis, and the prognosis of patients with higher pretreatment SUVmax plus PLN metastasis was even worse both in patients of squamous cell carcinoma (SCC) and non-SCC of cervix. As for patients with SCC of cervix, higher pretreatment serum SCC-ag not only predicted worse prognosis but also predicted disease recurrence in the posttreatment surveillance.
Journal of Cancer Research and Clinical Oncology 11/2011; 138(2):239-46. · 2.56 Impact Factor
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Yun Sun,
Mengxiao Yu,
Sheng Liang, Yingjian Zhang,
Chenguang Li,
Tiantian Mou,
Wenjiang Yang,
Xianzhong Zhang,
Biao Li,
Chunhui Huang,
Fuyou Li
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ABSTRACT: Rare-earth-based nanoparticles have attracted increasing attention for their unique optical and magnetic properties. However, their application in bioimaging has been limited to photoluminescence bioimaging and magnetic resonance imaging. To facilitate their use in other bioimaging techniques, we developed a simple, rapid, efficient and general synthesis strategy for (18)F-labeled rare-earth nanoparticles through a facile inorganic reaction between rare-earth cations and fluoride ions. The (18)F-labeling process based on rare-earth elements was achieved efficiently in water at room temperature with an (18)F-labeling yield of >90% and completed within 5 min, with only simple purification by aqueous washing and centrifugation, and without the use of organic agents. The effectiveness of (18)F-labeled rare-earth nanoparticles was further evaluated by positron emission tomography (PET) imaging of their in vivo distribution and application in lymph monitoring. In addition, this strategy is proposed for the creation of a dual-model bioimaging technique, combining upconversion luminescence bioimaging and PET imaging.
Biomaterials 04/2011; 32(11):2999-3007. · 7.40 Impact Factor
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Zhongguo fei ai za zhi = Chinese journal of lung cancer 10/2009; 12(10):1123-6.
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ABSTRACT: We report the detailed molecular study of angiogenesis-ralated genes and target therapy of the case of a male 46-year-old patient with extrarenal rhabdoid tumor of pelvic retroperitoneum. The patient was found to have a huge pelvic soft tissue sarcoma and underwent pelvic tumorectomy and appendectomy. The microscopically morphological features and molecular profile by immunohistochemical analysis supported the surgical histological diagnosis of extrarenal rhabdoid tumor. The tumor recurred two weeks after surgery and metastasized to the lung, left abdominal wall and mesenteric lymph nodes. Systemic chemotherapy including ifosfamide, liposomal doxorubicin, Taxol and cisplatin, concurrently with pelvic radiotherapy (58 Gy of total dose). However, the patient did not respond to the combination of chemotherapy and radiotherapy. Immunohistochemical staining and fluorescence in situ hybridization of tumor cells indicated negative expression of human epidermal growth factor receptor-2 (HER-2) and epidermal growth factor receptor (EGFR) and positive expression of vascular endothelial growth factor (VEGF) and vascular endothelial growth factor receptor (VEGFR). So anti-VEGF targeted therapy (Bevacizumab) was administered following the fourth course chemotherapy. However, the condition worsened after the administration of the second cycle of Bevacizumab. Multiple organ failure led to the death of the patient. The patient only survived five months and 20 days after the surgery of the primary tumor.
Cancer biology & therapy 04/2009; 8(5):417-21. · 2.64 Impact Factor
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ABSTRACT: To evaluate the feasibility of lymphoscintigraphy in sentinel lymph node biopsy of breast cancer.
Lymphoscintigraphy was performed after peritumoral or subdermal injection of radioactive colloid. Then, sentinel lymph node (SLN) biopsy guided by gamma detector probe was performed. Factors correlated with identification-detection rate were assessed.
Lymphatic drainage was present in preoperative lymphoscintigraphy in 88(93%) out of 95 patients, with 39 (44.3%) positive for lymphatic drainage other than in the axilla. A total of 91 (95.8%) patients had their SLN identified in the intraoperative procedure. The quality of lymphoscintigraphic image was closely related to SLN identification-detection rate in the intraoperative procedure (P = 0.025).
Sentinel lymph node outside the axilla can be detected by lymphoscintigraphy. The combination of lymphoscintigraphy and gamma detector probe for sentinel lymph node biopsy of breast cancer not only is acceptable but promising.
Zhonghua zhong liu za zhi [Chinese journal of oncology] 12/2002; 24(6):616-8.
