Background Blood-based biomarkers have emerged as promising tools for detecting Alzheimer’s disease (AD) pathology, but validation of automated plasma assays in Chinese clinical populations remains limited. This study evaluated the diagnostic performance of a fully automated chemiluminescent plasma biomarker assay for detecting amyloid-β (Aβ) pathology in a Chinese memory clinic cohort under different pre-analytical conditions. Methods We enrolled 409 cognitively impaired participants from a single-center memory clinic, using amyloid-β positron emission tomography (Aβ-PET) as the reference standard. Plasma samples were analyzed under two pre-analytical conditions: frozen batch-processed samples from a historical cohort (n = 198) and freshly collected samples analyzed in real time in a prospective cohort (n = 211). Additionally, 95 participants underwent tau-PET imaging. Six plasma biomarkers were quantified using the Vazyme® AD Assay. Results Across cohorts, p-tau217, p-tau217/Aβ42 ratio, and NfL/p-tau217 ratio consistently achieved excellent diagnostic performance (AUCs 0.92–0.95), followed by p-tau181 (AUCs 0.86–0.90). GFAP (AUCs 0.82–0.83) and the Aβ42/40 ratio (AUCs 0.76–0.81) showed moderate discriminative performance. Plasma p-tau217 alone achieved diagnostic accuracy comparable to composite biomarker models. A dual cut-point strategy reduced the indeterminate zone to <30%, with positive predictive values of 0.97–0.99 and negative predictive values of 0.86–0.87. Plasma p-tau217 was also significantly associated with tau-PET burden in both meta-temporal and neocortical regions (P < 0.001). Conclusion This automated chemiluminescent plasma biomarker assay demonstrated high diagnostic accuracy for detecting Aβ pathology in a Chinese memory clinic cohort under different pre-analytical conditions. The findings support its potential utility as a practical blood-based biomarker approach in specialized clinical settings, while further multicenter studies are needed to confirm its generalizability across broader populations and healthcare environments.

Background The development of a unified and efficient protocol for the automated synthesis of PET imaging agents is crucial for enhancing operational efficiency and safety. This study aimed to streamline the sequential production process of 18F-fluorodeoxyglucose ([18F]FDG) and [68Ga]Ga-DOTA-TATE with only single cassette and reagents loading using the AllinOne 36-valve synthesis module, with the goal of improving hot cell utilization and minimizing radiation exposure for operators. The protocol was designed to allow for sequential synthesis without the need for repeated hot cell access or waiting for radiation levels to decrease, thereby reducing the time and resources required for PET imaging agent production. Results Our study demonstrated the stability and reliability of the newly designed synthesis protocol. The activity yields for two batches of [18F]FDG were 73 ± 6.2 % and 64 ± 4.7 % (n = 3), respectively, all with synthesis times about 23 min, and with a radiochemical purity consistently over 96 %. For [68Ga]Ga-DOTA-TATE, the yield was 71 ± 5.8 % with synthesis times about 18 min (n = 3), with a purity exceeding 97 %. The synthesized products met all quality control criteria, including appearance, pH value, radioactivity concentration, sterility, endotoxin levels, and solvent residue. Conclusion The single-cassette protocol significantly improved efficiency and reduced radiation exposure. High yields and purities confirm its clinical feasibility, ensuring PET imaging agent availability. This scalable solution enhances patient care by simplifying the production process and meeting the demands of various patients for different PET imaging agents within a single day, demonstrating its potential in clinical settings.

BACKGROUND:This study was designed to investigate the relationship of irisin with the severity of Parkinson's disease (PD) and dopamine (DOPA) uptake in patients with PD and to understand the role of irisin in PD.METHODS:The plasma levels of irisin and α-syn were measured by enzyme-linked immunosorbent assay (ELISA). Motor and nonmotor symptoms were assessed with the relevant scales. DOPA uptake was measured with DOPA positron emission tomography (PET)/magnetic resonance imaging (MRI).RESULTS:The plasma levels of α-syn and irisin in patients with PD gradually increased and decreased, respectively, with the progression of the disease. There was a negative correlation between plasma α-syn and irisin levels in patients with PD. The level of irisin in plasma was negatively correlated with Unified Parkinson's Disease Rating Scale (UPDRS)-III scores and positively correlated with Montreal Cognitive Assessment (MoCA) scores. The striatal/occipital lobe uptake ratios (SORs) of the ipsilateral and contralateral caudate nucleus and anterior and posterior putamen in the high-irisin group were significantly higher than those in the low-irisin group, and irisin levels in the caudate nucleus and anterior and posterior putamen contralateral to the affected limb were lower than those on the ipsilateral side. The level of irisin was positively correlated with the SORs of the ipsilateral and contralateral caudate nucleus and putamen in PD patients.CONCLUSIONS:Irisin plays a neuroprotective role by decreasing the level of α-syn. Irisin is negatively correlated with the severity of motor symptoms and cognitive impairment. More importantly, irisin can improve DOPA uptake in the striatum of patients with PD, especially on the side contralateral to the affected limb.

Objective:To investigate the value of 18F-FDG positron emission tomography/computed tomography (PET/CT) two time point imaging for the identification of the potential epileptogenic zone (EZ) in temporal lobe epilepsy (TLE).Methods:Fifty-two patients with TLE were prospectively enrolled in the 18F-FDG PET/CT two time point imaging study. The early imaging was obtained approximately 40 min (43.44 ± 18.04 min) after 18F-FDG injection, and the delayed imaging was obtained about 2 to 3 h (160.46 ± 28.70 min) after the injection. Visual and semi-quantitative analysis of 18F-FDG uptake were performed at the two time points in EZ and contralateral symmetrical region. The mean standardized uptake value (SUVmean) of EZ and contralateral symmetrical region was calculated to determine the asymmetry index (AI) of the early and delayed images, as well as in the MRI positive and negative patient groups.Results:Semi-quantitative analysis demonstrated that AI of the early and delayed 18F-FDG PET/CT images was 13.47 ± 6.10 and 16.43 ± 6.66, respectively. The ΔAI was 2.95 ± 3.05 in 52 TLE patients between the two time points. The AI of the EZ was significantly elevated in delayed images compared to the early images (p < 0.001). The AI of delayed imaging was also significantly elevated compared to the early imaging in both MRI positive (ΔAI = 2.81 ± 2.54, p < 0.001) and MRI negative (ΔAI = 3.21 ± 3.91, p < 0.003) groups, and more pronounced in MRI negative group. Visual analysis also showed that the delayed imaging appeared to be superior to the early imaging for identification of potential EZ.Conclusion:Delayed 18F-FDG PET imaging provided significantly better than the early imaging in the identification of potential EZ, which can be valuable during epilepsy pre-surgical evaluation in patients with TLE.

目的:探讨难治性癫痫患儿性别、年龄、大脑皮层代谢改变对丘脑代谢的影响,了解难治性癫痫患儿丘脑代谢异常发生机制.方法:回顾性分析2015年3月—2021年6月于河南大学人民医院就诊的197例难治性癫痫患儿发作间期18F一氟代脱氧葡萄糖(18F-FDG)正电子发射断层显像(Positron emission tomography/Computed tomography,PET/CT)的脑代谢资料,选取139例单侧大脑皮质代谢异常患儿为本试验对象.根据丘脑代谢有无异常分为异常组(n=21)与无异常组(n=118),采用统计学方法分析两组间的年龄构成及性别比例有无差异;根据大脑皮质代谢异常累及脑叶数目分为简单组(累及1个脑叶)与复杂组(累及≥2个脑叶),分析两组间丘脑代谢异常发生率有无差异.结果:单侧大脑皮质代谢异常的139例(简单组74例,复杂组65例)患者中发生丘脑代谢异常者21例(简单组7例,复杂组14例),丘脑代谢异常均发生在单侧且位于病变大脑皮质同侧.统计学分析显示,丘脑异常组与无异常组间的年龄构成及性别比例的差异均不存在统计学意义(P>0.05).简单组与复杂组间的丘脑代谢异常发生率存在显著差异(P<0.05).结论:难治性癫痫患儿可发生与皮质代谢改变一致的同侧丘脑代谢改变,丘脑代谢异常发生率与大脑皮质异常累及范围有关,与年龄、性别无关,多脑叶受累时的丘脑异常发生率高于单脑叶受累.

Objective:To reveal the specific region location of brain function injury after sleep deprivation by exploring cerebral glucose metabolism and blood perfusion changes and the correlation between them in healthy volunteers of sleep deprivation.Methods:From January 2019 to December 2019, a total of 17 healthy volunteers (8 males, 9 females; age (22.5±1.7) years) from People′s Hospital of Zhengzhou University were enrolled prospectively. All patients accepted MRI three-dimensional (3D) arterial spin labeling (ASL) and 18F-FDG PET/CT scanning at 2 h after normal sleep and after sleep deprivation of 24 h. Statistical parametric mapping (SPM) software was used for image processing, and brain metabolism and perfusion differences activation graphs before and after sleep deprivation were obtained respectively. Then the common activated brain regions were obtained as ROI. The cerebral blood flow (CBF) and the SUV ratio (SUVR; the cerebellum was the reference area) were calculated. Pearson correlation analysis and paired t test were used for data analysis. Results:The cerebral metabolism and perfusion of the subjects after sleep deprivation were reduced, and the abnormal brain areas were similar. Brain areas with reduced metabolism were more than those with reduced perfusion. The brain areas with reduced metabolism and perfusion after sleep deprivation were commonly in the frontal lobe, temporal lobe, parietal lobe, etc. The CBF and SUVR value of left dorsolateral frontal gyrus after sleep deprivation were correlated ( r=0.58, P=0.014). The mean CBF value ((46.32±7.39) ml·100 g -1·min -1) and SUVR value (1.46±0.04) of whole brain after sleep deprivation were lower than those before sleep deprivation ((54.91±6.51) ml·100 g -1·min -1, 1.53±0.06; t values: -2.67, -3.72, P values: 0.012, 0.001). Conclusions:The specific region′s location of brain function injury after sleep deprivation is preliminarily revealed. 18F-FDG PET/CT was more sensitive than 3D-ASL for brain function research of sleep deprivation and left dorsolateral frontal gyrus may be a key responsible functional region in subjects of sleep deprivation.

目的:分析布鲁菌病患者 18F-氟代脱氧葡萄糖正电子发射计算机断层成像( 18F-fluorodeoxyglucose positron emission tomography-computed tomography， 18F-FDG PET-CT)检查的表现特点及其应用价值。 方法:纳入2012年12月至2022年5月河南省人民医院和河南省胸科医院确诊的15例布鲁菌病患者。回顾性分析患者的临床资料，并观察全身各组织器官 18F-FDG PET-CT表现，测量各特定部位病变区的病灶大小、形态、密度及氟代脱氧葡萄糖(fluorodeoxyglucose，FDG)的最大标准摄取值，将最大标准摄取值≥肝脏FDG摄取值视为阳性摄取。 结果:15例布鲁菌病患者的年龄范围为28~64岁，7例有牛羊接触史或食用过牛羊肉，3例有疫区生活史，既往均无肝炎、肝硬化及肝脏肿瘤等病史。临床呈急性或亚急性起病，主要表现为发热、多汗、无力，5例有腰痛，2例有咳嗽、胸闷，病程为15 d至2个月。所有患者 18F-FDG PET-CT检查均发现全身多脏器受累改变，11例患者的躯干骨髓腔和6例患者的脾脏呈轻度弥漫性阳性摄取，5例患者的胸部或腰椎、8例的肝脏、3例的肺部、3例的前列腺、1例的附睾、1例的脾脏、2例的脊髓、8例的多发淋巴结、1例的腰大肌、1例的股骨头韧带分别可见局灶性FDG摄取值增高。 结论:18F-FDG PET-CT检查可见布鲁菌病患者全身骨关节及软组织脏器感染播散状态，尤其对检出脊柱外脏器组织病变具有优势。

Abstract Collecting duct carcinoma is a rare and highly aggressive renal tumor with a poor prognosis. The presence of metastasis is common at collecting duct carcinoma diagnosis, but widespread metastases involving multiple soft tissues are extremely unusual. Here, we describe a 65-year-old man presenting with fever and lower leg pain as the first and main manifestations. After receiving anti-infective therapy for over 6 weeks without improvement, 18F-FDG PET/CT revealed a primary renal carcinoma with widespread metastases. A biopsy from the tubercle of fascicular spinal muscle indicated a diagnosis of collecting duct carcinoma.

目的 前瞻性分析大脑静息葡萄糖代谢改变在初诊肺癌患者情绪障碍发病中的临床意义.方法 实验组来自临床拟诊肺癌并拟行全身(脑+躯干)18F-氟脱氧葡萄糖(18F-FDG)正电子发射断层显像/计算机体层摄影(PET/CT)检查的患者,对照组来自健康体格检查者.所有被试者在18F-FDG PET/CT检查前接受哈密尔顿抑郁量表(HAMD)及焦虑量表(MAS)评定,对比分析大脑静息葡萄糖代谢改变、情绪障碍评分以及两者之间的相关性.结果 最终纳入155例肺癌患者(实验组)及152例健康体检者(对照组),实验组HAMD评分及MAS评分均高于对照组(t=1.020.P=0.04;t=0.09,P=0.03);实验组脑PET显像存在以双侧额、颞叶为主的多个脑区葡萄糖代谢减低,且受累脑区平均标准化摄取值(SUV)在双侧额叶及左侧颞叶分别与HAMD评分呈负相关(r=-0.68、-0.60、-0.55),在左侧额叶及左侧颞叶分别与MAS评分呈负相关(r=-0.59、-0.58).结论 大脑静息葡萄糖代谢改变与情绪障碍在肺癌患者中具有显著相关性,且以额叶为著.脑葡萄糖代谢改变可能是肺癌患者情绪障碍发病的神经病理基础,有望作为神经生物学标记用于临床评估.

Objective:To investigate changes in resting glucose metabolism in the brain of patients with anemia of different degrees.Methods:The brain 18F-fluorodeoxyglucose (FDG) PET/CT imaging data of 51 patients who were clinically diagnosed with anemia in People's Hospital of Zhengzhou University from December 2016 to April 2019 were retrospectively analyzed. The study population included 16 males and 35 females aged 21-60 (41.13±9.78) years. According to the diagnostic criteria of anemia in WHO and relevant literature, the patients were divided into 3 groups: mild anemia (90 g/L-lower limits of normal), moderate anemia (60-90 g/L) and severe anemia (30-60 g/L). A total of 56 healthy physical examiners were recruited as controls; this group included 29 males and 27 females aged 19-58 (41.96±9.27) years. Statistical Parametric Mapping 8 software was used to process and analyze the PET images of anemia group and healthy controls. The brain PET images of all anemia groups and the control group were tested by voxel-to-voxel two-sample t-test to obtain difference distribution maps of brain PET metabolism between each group. XjView software was used to conduct stereotaxic and quantitative analyses of voxel values in brain regions reflecting statistical differences. The t values of all abnormal regions were obtained. Results:Compared with those in the control group, hypometabolic brain areas in patients with anemia were mainly distributed in the bilateral superior, middle, and inferior frontal gyri; the right inferior temporal gyri; and the right inferior parietal lobule gyri, the total voxel value was 3705 ( t=5.01-5.85, all P<0.05). Hypermetabolic areas were not observed in anemia patients. Compared with that in the mild group, hypometabolism in the moderate group was observed in the bilateral inferior frontal, right middle frontal, right inferior temporal gyri, and the right inferior parietal lobule gyri, the total voxel value was 832 ( t=5.22-5.86, all P<0.05). Hypometabolism in the severe group was observed in the bilateral superior frontal, bilateral middle-inferior frontal, right inferior temporal, and right inferior parietal lobule gyri, the total voxel value was 1834 ( t=5.42-6.05, all P<0.05). Compared with that in the moderate group, hypometabolism in the severe group was noted in the left superior frontal, left middle-inferior frontal, and right middle frontal gyri, right inferior temporal lobe, and right inferior parietal lobule gyri, the total voxel value was 1598 ( t=5.72-6.48, all P<0.05). Conclusions:Patients with anemia showed relative reductions in regional cerebral resting glucose metabolism. The cerebral regions demonstrating reduced metabolism were mainly related to emotion cognition. As anemia progressed, areas reflecting a decrease in cerebral metabolism increased.

目的 探讨18F-脱氧葡萄糖(18F-fluorodeoxyglucose,18F-FDG)正电子发射计算机断层扫描(positron emission tomography/computed tomography,PET/CT)联合功能磁共振成像(function magnetic resonance imaging,fMRI)在原发性中枢神经系统淋巴瘤(primary central nervous system lymphoma,PCNSL)中的诊断价值.方法 回顾性分析17例PCNSL患者PET/CT影像学特征[最大标准摄取值(standard uptake value maximum,SUVmax),平均标准摄取值(standard uptake value maximum mean,SUVmean)]及其中10例患者功能磁共振影像学特征[磁共振扩散加权成像(diffusion weighted imaging,DWI),磁共振灌注成像(perfusion weighted imaging,PWI)],同时统计14例Ⅲ～Ⅵ级胶质瘤和14例脑转移瘤患者PET/CT影像学特征(SUVmax、SUVmean),绘制PCNSL组与脑胶质瘤、转移瘤联合组的SUVmax及SUVmean受试者工作特征曲线(receiver operator characteristic curve,ROC),确定诊断最优阈值,观察10例原发性中枢神经系统淋巴瘤患者ADC病灶平均值与SUVmax及SUVmean的相关性.结果 17例淋巴瘤组共28个病灶,10例具有MRI影像资料患者,共15个病灶.淋巴瘤组与胶质瘤、转移瘤联合组SUVmax(t=0)、SUVmean(t=0)差异有统计学意义.根据ROC曲线分析,SUVmax曲线下面积AUC:0.836,取截断值SUVmax为17.55时,敏感性0.765,特异性0.821;SUVmean曲线下面积AUC:0.853,取截断值SUVmean为11.9时,敏感性0.882,特异性0.75.10例具有MRI影像资料的PCNSL患者,病灶PWI呈低灌注13例,等灌注2例,DWI弥散受限,且平均ADC值与SUVmax(r=—0.725,P=0.018)及SUVmean(r=—0.666,P=0.036)呈负相关.结论 原发性中枢神经系统淋巴瘤18F-FDG PET/CT摄取程度高于胶质瘤组和转移瘤组,且SUVmax 17.55和SUVmean 11.9可作为参考诊断阈值,指导淋巴瘤与其他颅内常见肿瘤(胶质瘤和转移瘤)的鉴别,结合其功能MRI弥散受限及灌注减低等特点更有助于提高PCNSL诊断特异性.

目的 通过动脉自旋标记(ASL)探讨人类免疫缺陷病毒(HIV)相关神经认知障碍患者局部脑血流量(rCBF)异常改变及其与神经认知功能损害的相关性.方法 收集2017-01—2019-08在河南省人民医院行血清学检测呈HIV阳性、并经国家指定实验室确诊的获得性免疫缺陷综合征(AIDS)患者,将符合相应标准的患者分别分为无症状神经认知功能损害组(20例)、轻度神经认知功能损害组(18例)及HIV相关痴呆组(17例),以同期招募的30例性别、年龄相匹配的健康志愿者为对照组.使用蒙特利尔认知评估量表(MoCA)评估受试者的神经认知功能,所有受试者均在安静状态下行脑部3.0T MRI检查(扫描序列包括3D-T1、T2、FLAIR及3D-ASL等),并基于统计参数图(SPM8)软件进行数据分析以分别获得患者组较对照组的脑血流灌注差异分布图,比较4组之间rCBF的差异及异常rCBF与MoCA的相关性.结果 4组间MoCA量表总分差异有统计学意义(P<0.05).无症状神经认知功能损害组左侧额上回(体素值为18)、左侧额中回(体素值为20)rCBF均明显低于对照组,差异均有统计学意义(P<0.05).轻度神经认知功能损害组左侧额上中回(体素值分别为34、28)、右侧额上回(体素值为23)、左侧颞上回(体素值为19)、左侧前扣带回(体素值为16)、左侧豆状核(体素值为14)rCBF均明显低于对照组,差异均有统计学意义(P<0.05).HIV相关痴呆组左侧额上中回(体素值分别为48、40)、右侧额上中回(体素值分别为39、28)、左侧颞上回(体素值为30)、左侧前扣带回(体素值为27)、左侧豆状核(体素值为26)及左侧海马rCBF(体素值为18)均明显低于对照组,差异均有统计学意义(P<0.05).无症状神经认知功能损害组左侧额上回rCBF与患者注意与集中因子分呈正相关(r=0.522,P=0.039).轻度神经认知功能损害组左侧额上回rCBF与患者注意与集中及抽象思维因子分均呈正相关(r=0.613、0.531,P=0.021、0.031),左侧额中回rCBF与患者执行功能及抽象思维因子分均呈正相关(r=0.542、0.575,P=0.029、0.024),右侧额上回rCBF与患者抽象思维因子分呈正相关(r=0.671,P=0.016).HIV相关痴呆组左侧额上回rCBF与患者MoCA量表总分、注意与集中及抽象思维因子分均呈正相关(r=0.723、0.764、0.695,P=0.007、0.005、0.009),左侧额中回rCBF与患者MoCA量表总分、执行功能及抽象思维因子分均呈正相关(r=0.692、0.628、0.710,P=0.009、0.019、0.008),右侧额上回rCBF与MoCA量表总分、患者抽象思维因子分呈正相关(r=0.752、0.641,P=0.006、0.017),左侧颞上回rCBF与患者记忆及视空间技能因子分均呈正相关(r=0.590、0.652,P=0.027、0.016).结论 HIV相关神经认知障碍患者存在额颞叶、前扣带回等脑区的血流灌注下降,可能是AIDS患者出现神经认知障碍的病因之一.

Objective:To prepare 68Ga-2-(4, 7-bis(carboxymethyl)-1, 4, 7-triazonan-1-yl)pentanedioic acid (NODAGA)-YHWYGYTPQNVI (GE11) and evaluate its feasibility of PET imaging for pancreatic cancer. Methods:GE11 peptide was conjugated with NODAGA and then labeled with 68Ga. The labeling yield, radiochemical purity, hydrophilicity, stability and specificity in vitro were determined. Human pancreatic cancer BxPC3 nude mice models ( n=9) were established. MicroPET imaging was then obtained after 30 and 90 min, and mice were sacrificed at 90 min to acquire the radioactivity distribution of main organs and tumors. Pair t test was used to analyze the data. Results:The labeling yield was (73.5±5.4)% and radiochemical purity was more than 98%. After incubation 120 min in mouse serum at 37 ℃, radiochemical purity was more than 92%. The uptake was specific in BxPC3 cell lines. MicroPET images showed that 68Ga-NODAGA-GE11 could accumulate quickly in tumor. Value of tumor uptake was significantly higher than that of normal pancreas at 90 min ((1.38±0.25) vs (0.49±0.07) %ID/g; t=12.67, P<0.05), and the radio-uptake of blood, muscle and bone was lower than that of tumor. Conclusions:68Ga-NODAGA-GE11 is easy to be prepared with high radiochemical purity and good stability, and can specifically target BxPC3 xenograft tumor. However, due to the high uptake in the kidneys and liver, the value of 68Ga-NODAGA-GE11 in PET imaging for pancreatic tumor needs further study.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has resulted in an ongoing global pandemic of coronavirus disease 2019 (COVID-19). The challenges associated with imaging infected patients have resulted, to date, in a paucity of metabolic imaging studies of patients with severe COVID-19 infection. Furthermore, it remains unclear if any abnormal metabolic events are taking place in patients who have recovered from COVID-19. To use [18F] fluorodeoxyglucose ([18F] FDG) positron emission tomography/computed tomography (PET/CT) to measure metabolic activity in inflamed organs of patients convalescing post severe COVID-19 infection. A prospective study was performed in seven convalescing patients who were recovering from severe COVID-19 infection in February 2020. Prior to [18F] FDG PET/CT, all patients had received two consecutive negative results of real-time reverse transcriptase polymerase chain reaction (RT-PCR) for SARS-CoV-2 nucleic acid. Clinical intake including symptoms, treatment, laboratory test results, and follow-up was performed. The PET/CT images of COVID-19 patients were compared to a control group of patients that were matched for age and sex. Residual pulmonary lesions were present in all patients and maximum standard uptake value (SUVmax), average standard uptake value (SUVavg), maximum CT intensity (CTmax), and average CT intensity (CTavg) were all significantly greater than in the control group (p < 0.01 for all). In addition, SUVmax and SUVavg were significantly greater in the mediastinal lymph node and liver, and SUVmax was significantly greater in the spleen, of COVID-19 patients compared with controls (p < 0.05 for all). For the spleen, SUVmax (r2 = 0.863, p = 0.003) and SUVavg (r2 = 0.797, p = 0.007) were significantly correlated with blood lymphocyte count, and which was below the normal range in five of the seven (71.4%) patients convalescing post severe COVID-19 infection. [18F] FDG PET/CT quantitative analysis has shown that significant inflammation remained in lungs, mediastinal lymph nodes, spleen, and liver after two consecutive negative RT-PCR tests in patients convalescing post severe COVID-19 infection.

Objective:To study the correlation between changes of cerebral striatal dopamine D 2 receptors non-displaceable binding potential (BP ND), functional connectivity (FC) and clinical symptoms in patients with first-episode major depressive disorder (MDD), by 11C-Raclopride PET/CT and resting state fMRI (rs-fMRI). Methods:Thirty-eight first-episode depression patients (MDD group) and forty healthy volunteers (control group) matched with age, gender and years of education were selected. All subjects were scored with Hamilton depression scale (24 versions) before enrollment.All the subjects underwent cerebral 11C-Raclopride PET/CT and rs-fMRI in resting state. MIAKAT and DPARSF were used to analyze BP ND of cerebral striatal dopamine D 2 receptors and FC of striatum and the whole brain in subjects, respectively. Changes of striatal dopamine D 2 receptors BP ND and striatum and the whole brain FC of MDD were analyzed, and correlations among BP ND, FC and Hamilton depression rating scale were calculated by Rest 1.8 and SPSS 20.0. Results:Compared with the control group, BP ND of bilateral caudate nucleus and putamen dopamine D 2 receptors in the MDD group were decreased(left caudate nucleus: 1.16±0.37 vs 1.48±0.39, right caudate nucleus: 1.21±0.31 vs 1.62±0.48, left putamen: 1.73±0.47 vs 2.21±0.66, right putamen: 1.79±0.46 vs 2.17±0.65, t=3.66, -4.42, -3.68, -2.91, all P<0.001). Besides, FC of left caudate nucleus and left medial prefrontal lobes(4.38±1.31, 2.35±0.48), left caudate nucleus and left middle frontal gyrus(3.36±1.11, 1.64±0.56), left caudate nucleus and left superior frontal gyrus(3.14±0.78, 1.64±0.53), left putamen and left medial prefrontal lobes(4.10±1.42, 2.42±0.64, t=6.82, P<0.05), right caudate nucleus and right medial prefrontal lobes (4.32±1.30, 2.33±0.63, t=8.51, P<0.05), right putamen and right medial prefrontal lobes(3.77±1.25, 2.31±0.63, t=6.49, P<0.05)in the MDD group were increased.FC of left putamen and left anterior cingulate(1.60±0.55, 2.68±0.84, t=-6.76, P<0.05), right caudate nucleus and right amygdala (1.67±0.57, 3.46±0.64, t=-8.27, P<0.05) in the MDD group were decreased. Furthermore, there were significant negative correlations between D 2 receptors BP ND of bilateral striatum and FC of the same lateral striatum and medial prefrontal lobes ( r=-0.66, -0.50, -0.67, -0.47, all P<0.05). In MDD group, FC in left caudate nucleus and left medial prefrontal lobe were positively correlated with total score of Hamilton depression scale and anxiety somatization( r=0.55, 0.68, P<0.001). FC in left putamen and left medial prefrontal cortex were positively correlated with cognitive impairment and retardation ( r=0.37, 0.40, P=0.021, 0.001). FC of right caudate nucleus and right medial prefrontal lobe were positively correlated with Hamilton depression scale total score and anxiety somatization ( r=0.52, 0.67, all P<0.001). FC in right putamen and right medial prefrontal cortex was positively correlated with cognitive impairment ( r=0.50, P=0.002). Conclusion:The abnormal BP ND of cerebral striatal dopamine D 2 receptor of patients with first-episode depression is related to the abnormal activity of dopamine reward circuit related neurons in patients with MDD, which was related to clinical symptoms of depression. It may be involved in the pathogenesis of depression.

Objective To study the imaging features of 18F-fluorodeoxyglucose(FDG) PET/CT in patients with autoimmune encephalitis (AE) and evaluate the value of PET/CT on early diagnosis of AE.Methods Sixteen patients with AE (11 males,5 females,age:11-68 years) between March 2012 and December 2017 were included.Patients had positive antibodies in cerebrospinal fluid or (and) serum without immunity therapy.The imaging (18F-FDG PET/CT,MRI) and clinical data were analyzed.Results Nine patients suffered from anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis and other 7 patients had limbic encephalitis (LE),which including 2 cases of anti-leucine-rich glioma inactivated 1 (LGI1) encephalitis,3 cases of anti-γ-aminobutyric acid-B receptor(GABAsR) encephalitis,1 case of anti-Hu encephalitis and 1 case of anti-Yo encephalitis.Fifteen patients showed scattered hypermetabolism or hypometabolism in the brain on PET/CT imaging,and the positive rate was 15/16.Among those patients with anti-NMDAR encephalitis,hypermetabolism in frontotemporal parietal lobes and hypometabolism in occipital lobe were shown;hypermetabolism in limbic systems including temporal lobe and hippocampus were shown in LE.No abnormal CT density was found at the same phase.Slightly higher signals on T2,fluid-attenuated inversion recovery (FLAIR) and diffusion weighted imaging (DWI) were detected in some patients,and the positive rate was 7/16.Conclusions Patients with AE of different types have different characteristics on 18F-FDG PET/CT.18F-FDG PET/CT has high positive rate for early diagnosis of AE.

Objective To explore the changes of dopamine D2 receptor in dopamine pathway in in-somnia patients and discuss its clinical significance. Methods From January 2016 to December 2016, 15 patients with insomnia (1 male, 14 females, age:(44.3±8.6) years) and 15 gender-/age-matched-healthy volunteers (control group;3 males, 12 females, age:(40.5±9.0) years) were included to undergo resting brain 11C-Raclopride PET/CT imaging. The D2 receptor binding potential (BPND) of the dopamine pathway was calculated by molecular imaging and kinetic analysis toolbox ( MIAKAT) software. The BP ND , Hamilton depression scale ( HAMD) , transient and graphics memory scale results were compared with two-sample t test and Mann-Whitney u test between the two groups. Pearson correlation analysis was used to evaluate the correlation between BPND(nucleus accumbens, caudate nucleus, putamen) and Pittsburgh sleep quality in-dex ( PSQI) , HAMD, course of disease, transient memory and graphical memory scale scores in the patient group. Results The BP ND in bilateral putamen, nucleus accumbens and left caudate nucleus of patients was lower than that of controls( left putamen:z=-2.717, right putamen:z=-2.883, both P<0.01;left nu-cleus accumbens:t=-2.269, right nucleus accumbens:t=-2.410, both P<0.05;left caudate nucleus:t=-2.632,P<0. 05), but the BPND level of right caudate nucleus was not significantly different(z=-0.850, P>0.05) . The scores of HAMD in the patient group were higher than those in control group ( t=10. 273, P<0. 01), while the scores of instantaneous memory (t=-4.888, P<0.01) and graphical memory scale (t=-2.624, P<0.05) were lower. There were significant negative correlations between the BP ND of bilateral nucleus ac-cumbens, caudate nucleus and putamen and the course of insomnia in the patient group ( r range:-0.761 to-0.682, all P<0.01) . Conclusion Patients with insomnia have abnormal neurotransmitter system of dopa-mine D2 and it may play a role in the pathogenesis of insomnia.

目的 探讨18F-脱氧葡萄糖(FDG) PET-CT联合尿本-周蛋白对多发性骨髓瘤患者诊断、治疗效果及预后评估的临床价值.方法 回顾性分析2012年3月-2016年4月在河南省人民医院PET-CT中心18F-FDGPET-CT显像中表现为多发骨质破坏和骨质代谢异常但未发现骨外恶性肿瘤的患者58例,经随访诊断为多发骨髓瘤32例、多发骨转移瘤26例.再在原有诊断标准上添加尿本-周蛋白检查阳性形成新的诊断标准,对所有患者进行重新诊断,数据分析采用x2检验.结果 18F-FDG PET-CT和18F-FDGPET-CT联合尿本-周蛋白对多发性骨髓瘤诊断的灵敏度分别为81.3％和93.8％,特异性分别为76.9％和84.6％,阳性预测值分别为81.3％和88.2％,阴性预测值分别为76.9％和89.7％.18F-FDG PET-CT诊断准确性为79.3％,18 F-FDGPET-CT联合尿本-周蛋白诊断准确性提高到93.3％,两者差异有统计学意义(x2=3.12,P＜0.05).结论 18F-FDG PET-CT联合尿本-周蛋白对多发性骨髓瘤的诊断具有增益价值.

The present study investigated changes in the regional cerebral metabolic rates of glucose uptake (rCMRglc) using 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) and regional homogeneity (ReHo), together with resting-state blood oxygen level-dependent (BOLD) functional magnetic resonance imaging (fMRI), in patients with major depressive disorder (MDD). In total, 18 patients with untreated MDD and 17 healthy control subjects underwent 18F-FDG PET and BOLD-fMRI scanning. The MDD patients' cerebral changes, measured as rCMRglc and ReHo values, were mapped and statistically analyzed. Compared with the control group, the patients with MDD had a decreased rCMRglc in the bilateral superior, middle and inferior frontal gyrus, in the bilateral superior and middle temporal gyrus, in the bilateral anterior cingulate cortex, in the bilateral putamen and caudate, and in the left pallidum, but an increased rCMRglc in the bilateral hippocampus and left thalamus. The ReHo values in the patient group were decreased in the bilateral superior and middle frontal gyrus, left pallidum, bilateral putamen and left anterior cingulate cortex, but increased in the right hippocampus and thalamus. No statistically significant differences were identified between decreased metabolism and ReHo brain regions of MDD patients (χ2=9.16; P=0.90) and between increased metabolism and ReHo brain regions (χ2=3.96; P=0.27), when comparing activated brain regions of PET and MRI. The standardized uptake values (SUV) of the bilateral superior, middle and inferior frontal gyrus, bilateral superior and middle temporal gyrus, bilateral putamen, the left caudate and pallidum, the left anterior cingulate cortex, and the bilateral hippocampus and thalamus were correlated with the ReHo (r=0.51-0.83; P<0.05). However, no correlation was detected between the SUV and ReHo in the right caudate and anterior cingulate cortex (r=0.41 and 0.37, respectively; P>0.05). Taken together, these results demonstrated that patients with MDD displayed characteristic patterns regarding changes of brain glucose uptake and ReHo in the resting state. Furthermore, 18F-FDG PET may be a more sensitive technique compared with BOLD-fMRI for the identification of brain lesions in patients with MDD.