Hematological malignancies are suitable diseases for radioimmunotherapy because of their high sensitivity to radiation and well-defined immunophenotypes. Beta emitters like 131I and 90Y have achieved some outcomes in radioimmunotherapy of hematological malignancies. Compared with beta particles, alpha particles have higher linear energy transfer, greater relative biological effects and shorter range, which give alpha particles the ability to kill tumor cells more effectively with less damage to normal tissue. This review summarizes the current studies of targeted alpha-particle therapy in hematological malignancies.

Differentiated thyroid cancer(DTC) has become the most common head and neck tumor, and most DTC patients have a good prognosis after treatment. However, patients with metastasis and loss of differentiation have a poor prognosis and lack of effective diagnosis and treatment. Radiopharmaceuticals targeting prostate specific membrane antigen (PSMA) have been used in imaging and treatment of patients with prostate cancer, but the research on DTC is still at the exploratory stage. In this paper, the application status and prospect of targeted PSMA imaging and treatment of DTC were reviewed, and the future perspectives were also presented.

Strontium-89 chloride (hereinafter referred to as " 89Sr") is a radiopharmaceutical for the treatment of bone metastases, especially systemic multiple bone metastases, but its clinical application is limited due to the adverse effect of myelosuppression. In addition to the radiobiological effects of 89Sr itself, bone tumor burden during 89Sr treatment, radiotherapy, chemotherapy and anti-androgen therapy before 89Sr treatment are all important factors leading to myelosuppression. The authors review the related factors of myelosuppression induced by 89Sr treatment of bone metastases.

Bone is one of the most common sites of distant metastasis of malignant tumors,whose is second only to those of lung metastasis and liver metastasis.Malignant tumors with high incidence of bone metastasis include prostate cancer,breast cancer,and lung cancer,and nearly 70％ of patients with advanced breast or prostate cancers have bone metastasis.Bone metastasis often causes pain,fracture,and hypercalcemia,which can seriously affect the quality of life.No standard treatment exists for tumor bone metastasis,and combining multiple therapies is often necessary.Bisphosphonates and radionuclides are extensively used individually to treat multiple bone metastases,but the concurrent use of both drugs is rarely researched.In this paper,recent studies on the concurrent use of radionuclides and bisphosphonates were reviewed.

Objective To estimate clinical value of 18F-FDG PET/CT imaging combined with serum tumor markers(CEA,NSE,CFRA21-1)in the diagnosis of single lung nodules.Methods 91 cases of patients with single lung nodules confirmed by pathologic results received 18F-FDG PET/CT imaging.At the same time, 4mL of venous blood was collected and the serum was stored in the freezer.The serum levels of tumor markers CEA,NSE,CFRA21-1 were then measured by radioimmunoassay method.Results The sensitivity of the 18F-FDG PET/CT examination was 84.8%(56/66)for the detection of malignant tumor of lung single nodules,and the accuracy of the diagnosis of pulmonary single nodules was 86.8%(79/91);The sensitivity of the 18F-FDG PET/CT imaging combined with blood tumor markers(CEA +NSE +CFRA21-1)was 93.9%(62/66)for the detection of pulmonary single nodular malignancy,and the accuracy of the diagnosis of pulmonary single nodules was 95.6%(87/91).Compared with 18F-FDG PET/CT,the sensitivity and accuracy of combination method were significantly different(P<0.05).Conclusion The 18F-FDG PET/CT imaging combined with blood tumor markers(CEA +NSE +CFRA21-1)can improve the sensitivity and accuracy of PET/CT imaging in the diagnosis of pulmonary single nodules,with high clinical values.

目的:探讨食管癌18F-FDG PET/CT显像最大标准摄取值(maximum standardized uptake value,SUVmax)的临床意义.方法:回顾性分析60例食管癌患者PET/CT显像数据,研究食管癌原发病灶SUVmax与病灶大小(横径和长度)的相关性、不同长度原发病灶之间SUVmax的差异及原发病灶SUVmax与淋巴结转移和远处转移的相关性.结果:60例患者食管鳞癌病灶SUVmax与病灶的横径、长度相关性差异有统计学意义(r=0.495,P=0.000;r=0.420,P=0.001).不同长度病灶间SUVmax比较,<3.0 cm与3.0～5.0 cm病灶之间差异有统计学意义(t=-2.860,P=0.007),<3.0 cm与>5.0 cm病灶之间差异有统计学意义(t=-3.036,P=0.005),但3.0～5.0 cm与>5.0 cm病灶之间差异无统计学意义(t=-1.164,P=0.251).SUVmax与淋巴结转移和远处转移无相关性(F=1.256,P=0.293).结论:食管癌SUVmax对评价肿瘤原发病灶的大小具有重要价值,但SUVmax无法预测是否有淋巴结转移和远处转移.

目的:在对膀胱癌进行诊断时选用18F-FDG PETCT显像诊断,对其价值进行研究.方法:本研究纳入的对象为2015年1月—2017年1月我院收治的患有膀胱癌的40例患者,针对其进行病理学检查,再分别对其展开增强CT和18F-FDG PETCT显像诊断,增强CT诊断为A组,18F-FDG PETCT显像诊断为B组,对比两组诊断结果和肿瘤淋巴转移情况.结果:B组的诊断正确率及肿瘤淋巴转移准确率均高于A组,P<0.05具有统计学意义.结论:增强C T及18F-FDG PETCT显像诊断在膀胱癌患者的诊断中均具有良好的效果,但18F-FDG PETCT显像诊断对于肿瘤病灶转移情况的诊断价值更高.

1 患者资料 患者男性, 48岁,两年前面部出现皮疹伴瘙痒,无发热,于当地皮肤科多次治疗后均未见明显好转.2016年3月因意外摔伤导致面部皮损、红肿,遂于南京皮肤研究所诊治,诊断为银屑病,予软膏外敷治疗后仍未见好转.该患者在治疗前签署了知情同意书,并且该研究获得了江苏省苏北人民医院伦理委员会的批准.2016年11月于本院皮肤科就诊,取皮肤活检,组织病理学结果表现为真皮全层及皮下脂肪内结节性或弥漫性中等及较大多形性淋巴样细胞浸润;结合苏木精-伊红染色法形态及免疫组化结果,首先考虑T细胞淋巴瘤,部分有亲毛囊现象,部分区域伴反应性B细胞增生.该患者后经复旦大学附属肿瘤医院确诊为(面部皮损,活检)外周T细胞淋巴瘤-非特指型(peripheral T-cell lymphomas-unspecified, PTCL-U)(图1).EB病毒编码的小RNA原位杂交检测结果为阴性,提示无人类疱疹病毒4型感染.随后进行PET/CT检查.采用GE Discovery VCT型PET/CT仪,其中CT为64排螺旋CT,显像剂为 18F-FDG (上海原子科兴药业有限公司),放化纯度>95%.

1 患者资料 患者女性,33岁,既往体健,半月前无明显诱因出现左大腿隐痛,后疼痛放射至左膝.左大腿活动自如,无明显压痛,局部皮温正常,无色素沉着,无静脉怒张,局部皮肤无破溃.左足背动脉可触及,腹股沟及锁骨上未触及明显的淋巴结肿大.肝肾功能、凝血、感染性标记物及肿瘤标记物等均未见异常.

1 临床资料 患者,女,30岁,甲状腺乳头状腺癌术后10月余,停服甲状腺素片(优甲乐)4周,收住院,拟行Na131I内照射治疗.常规行Na131I治疗前准备,进行甲状腺99mTcO4-静态显像(Figure 1),可见左侧甲状腺有手术残留,双侧胸部有3处异常放射性浓聚灶,考虑软组织摄取,性质待定.由于患者有颈部淋巴结转移,根据2015年版中国《甲状腺癌诊治指南》给予患者空腹口服Na131I 150mci,服Na131I后5d出院前常规行Na131I全身显像(Figure 2),可见甲状腺99mTcO4-静态显像上胸部3处异常放射性浓聚灶在Na131I全身显像上仍有异常放射性浓聚,融合图像(Figure 3)进一步证实为甲状腺癌双侧气管旁淋巴结转移灶.此外,在Na131I全身显像上还可见双肺多发转移灶.

[目的]探讨18F-FDG PET/CT显像在血清肿瘤标志物CA199水平升高诊断中的应用价值.[方法]15例血CA199水平升高者行18F-FDG PET/CT显像,并对结果进行分析.[结果]15例血CA199升高者18F-FDG PET/CT显像发现恶性病变仅1例,余皆为良性病变,14例良性病变包括胆结石3例、胆囊炎2例、慢性胰腺炎1例、肝硬化2例、卵巢畸胎瘤2例和糖尿病4例.18F-FDG PET/CT显像对恶性肿瘤的检出率为6.7％.[结论]当患者血CA199水平升高时,应行常规影像学检查和血糖检测,排除良性病变,必要时行18F-FDG PET/CT显像.

患者 男,76岁.腹痛6月,反复呃逆、食欲缺乏一月,体重下降20斤,无腹泻,巩膜及皮肤黏膜无黄染,无咳嗽气喘.胃镜检查:胃底体嵴部溃疡样改变,浅表性胃炎;病理示(胃底体嵴)轻度慢性浅表性胃炎.全腹部CT平扫:肝囊肿、前列腺钙化.血常规未见异常.肿瘤标志物CA125: 51.31U/ml,CA199:7.10 U/ml,余未见异常.头颅MRI平扫:双侧额顶叶白质区多发缺血灶及陈旧性腔隙性梗死灶.18F-FDG PET/CT检查:胰体尾部增粗伴FDG代谢异常增高,延迟显像标准摄取值(standardized uptake value,SUV)最大值升高,腹主动脉周围多发淋巴结FDG代谢异常增高,盆腹腔多发肠管表面腹膜FDG代谢异常增高灶,延迟显像SUV最大值升高,考虑为胰腺癌及其多发转移(图1、2、3).双侧肺门淋巴结对称性FDG代谢轻度增高,考虑为炎性.诊断胰腺癌后,病人化疗1个疗程,因病人身体衰弱,无法继续化疗,4月后死亡.

BACKGROUND:Recent studies have shown the LyP-1 peptide can home to either tumor lymphatics or the tumor cells and be internalized by targeted cells. This study aimed to investigate the possibility of using Na(131)I labeled LyP-1 peptide as an imaging agent or a therapeutic radiopharmaceutical in breast carcinoma and its metastasis.METHODS:The 10-mer cyclic peptide contained the LyP-1 sequence (YCGNKRTRGC) was synthesized by the solid phase method. Disulfide bonds between the cysteines maintain the cyclic structure. The LyP-1 peptide was labeled with Na(131)I using the chloramine-T method. The [(131)I] LyP-1 peptide and a [(131)I] control peptide were injected via tail vein into nude mice bearing MDA-MB-435 tumor xenografts. Biodistribution and imaging results in vivo were obtained.RESULTS:The labeling efficiencies of LyP-1 peptide reached 80% ± 5% (n = 5). The radiochemical purity was about 96%. The radiochemical purity of the labeled compound remains 92% at 24 hours in human serum at 37°C. In the biodistribution studies, the [(131)I] LyP-1 peptide accumulated in the tumor to a higher level than in other organs. The [(131)I] LyP-1 peptide can successfully image the tumor in nude mice bearing MDA-MB-435 tumor xenografts.CONCLUSIONS:The LyP-1 peptide could be effectively labeled with Na(131)I and the labeled compound is stable in human serum at 37°C for 24 hours. The high specificity of [(131)I] LyP-1 peptide suggests it may be a promising new radiotracer for identifying tumors.

Objective: To compare the18F-FDG cell binding in the drug-resistan breast cancer cell Bcap37/MDR1 and breast cancer cell Bcap37,to lay the foundation for a further study of the inhibitory effect of chemotherapy in breast cancer cell Bcap37/MDR1 and breast cancer cell Bcap37.Methods: Several different binding conditions were tested.① The cell number was 1.25×105~1×107/bottle.②The reaction time was 20~120 min.③The radioactivity of18F-FDG was 1.85~29.6 KBq.④The glucose concentration was 0~5.5 mmol/L.The count of CPM(B) in cells and CPM(F) in supernatant were measured by the γ equipment.The binding efficiency of Bcap37 and Bcap37/MDR1 cell with18F-FDG were calculated and compared.Result: When other conditions were invariable,and separately changed cell number,the reaction time and the18F-FDG radioactivity,the binding efficiency of Bcap37 was higher than the Bcap37/MDR1.The difference was significant(P<0.05).The difference of binding efficiency between Bcap37 and Bcap37/MDR1 cell at the 0 and 1.39 mmol/L groups was significant(P< 0.05);The difference of binding efficiency between Bcap37 and Bcap37/MDR1 cell at 2.78 mmol/L and 5.5 mmol/L groups was not statistically significant(P>0.05).Conclusions: The18F-FDG cell binding of breast cancer Bcap37/MDR1 was lower than the Bcap37.It showed that the proliferation and metabolism of drug resistance of tumor cells were lower than the parental tumor cells.

目的探讨周围型肺癌18F-FDG PET/CT显像特点及其最大标准摄取值（SUVmax）与肺癌的病理类型及病灶大小的相关性。方法回顾性分析50例经病理证实的周围型肺癌的18F-FDG PET/CT及螺旋CT资料,分析肺癌病理类型、病灶大小与SUVmax的相关性。结果以SUVmax≥2.5作为判断恶性的标准,本组18 F-FDG PET/CT阳性率为92.00%（46/50）。鳞癌的SUVmax明显高于腺癌（P〈0.05）;病灶大小与SUVmax呈正相关（r=0.674,P〈0.001）。结论 18F-FDG PET/CT显像对诊断周围型肺癌有很高价值,结合螺旋CT形态学特点,能初步判断肺癌的病理类型。

Objective To observe the imaging characteristics of peripheral lung cancer on 18 F-FDG PET/CT,as well as the correlation between the maximal standardized uptake value(SUV max) and the pathological types and size of the lesions.Methods Data of 18 F-FDG PET/CT and MSCT for 50patients with peripheral lung cancer confirmed by pathology were analyzed retrospectively.The correlation between SUV max of lesions and the pathological types and size were analyzed.Results Taking SUVmax=2.5as the cutoff for malignant or benign lesions,the positive rate was 92.00%(46/50).SUV max of squamous cell carcinoma was higher than that of adenocarcinoma(P0.05).There was positive correlation between the size and SUV max of the lesions(r=0.674,P0.001).Conclusion Combined with morphological characteristics of MSCT,18 F-FDG PET/CT has high value in diagnosing peripheral lung caner,as well as in preliminary judgment of their pathological types.

本文对40例肝硬化合并自发性细菌性腹膜炎（sponta-neous bacteria peritonitis,SBP）患者的血清降钙素原（PCT）、透明质酸（HA）、Ⅳ型胶原（CⅣ）、层粘蛋白（LN）进行联检,并同时与36例肝硬化不伴SBP患者进行观察比较,现将结果报道如下。1对象和方法

[Purpose] To assess the clinical application of 18 F-FDG PET/CT imaging in the diagnosis for gastric cancer.[Methods] Forty-nine gastric cancer patients proven by gastroscopy and histopathological examination received 18 F-FDG PET/CT imaging.The 18 F-FDG PET/CT diagnostic results were compared with pathology,other imaging findings and clinical follow up.[Results] 18 F-FDG PET/CT was positive in 44 cases with positive rate 89.8%(44/49).18 F-FDG PET/CT scan for lymphatic metastasis resulted in a sensitivity of 82.1%(32/39).18 F-FDG PET/CT scan for distance metastasis resulted in a sensitivity of 91.6%(11/12).[Conclusion] 18 F-FDG PET/CT imaging is sensitive for finding primary lesion,lymphatic metastasis and distance metastasis with a higher diagnostic value for gastric cancer.