Objective To develop a new approach for identifing the lesion boundary on PET images and evaluate its reliability. Methods PET images were displayed by the self-developed software. A line was drawn across the center of the lesions in an image,with each end stretching a little beyond the lesion boundary. Then the software measured standard uptake value (SUV) of each pixel in the line segment. The mean SUV values of each of the two extending segments were used as the background values of each side. The SUV value of each pixel subtracted the homolateral background value from the centre of the line segment to both ends and the difference value equal to or less than zero was defined a lesion boundary point. Several line segments were drawn to obtain different points and these points were connected to form entire lesion boundary. 15 lesions on the PET and CT images from 13 patients with NCSLC were studied and their active contours were identified by the difference method and the threshold of the background-subtracted tumor maximum uptake (THR). The lesion areas were then calculated. Results The active contours of 15 lesions identified by the difference method were slightly different from those by THR. The lesion morphology detected by the two approaches was similar and the calculated areas did not differ (P = 0.609). Conclusion The difference method can identify the lesion boundary to accurately achieve the lesion size and thus can be used to evaluate the tumor response to chemotherapy.

Objective 99Tcm-ethylenedicysteine (EC) is a new radiopharmaceutical for renal dynamic imaging produced by Jiangsu Institute of Nuclear Medicine,China. The aim of this phase Ⅳ clinical trial was to evaluate the efficacy and safety of 99Tcm-EC in a large number of patients with various renal disorders. Methods Fourteen Chinese hospitals had participated in this multi-center clinical triM. The 99TcmEC kits from eleven production batches were used. Three hundred and twenty-eight patients were entered into the study. Patients were intravenously injected with 99Tcm-EC and a series of dynamic renal imaging was acquired in each patient. The quality of kits and images was analyzed. Possible adverse events were observed and recorded. Results All quality control parameters of the radiopharmaceutical kits were up to the standard requirement. The radiochemical purity of 99Tcm-EC in all production batches exceeded 90%. All functioning kidneys were clearly visualized and high-quality renograms were obtained in all 328 patients. No adverse events were recorded during or after the examination process. Conclusion 99Tcm-EC is a potentially useful radiopharmaceutical in dynamic renal functional studies.

Objective To observe the action specificity of acupuncture on Baihui(DU20) on brain under pathological condition.Methods Ten vascular dementia(VD) patients were randomized into two groups: group A received routine acupuncture for treating hemiplegia,and group B received acupuncture on Baihui additionally,one time per day,and the treatment lasted 20 days.Brain positron emission tomography(PET) and single-photon emission-computed tomography(SPECT) were carried out to observe the changes of focal cerebral glucose metabolism and brain blood flow in the two groups.Results In group B,the amplitude of glucose metabolism in PET and SPECT was increased in the affected frontal lobe,thalamus,caudate nucleus and cerebellum as compared with that in group A,so did the amplitude of glucose metabolism in the healthy frontal lobe,parietal lobe,occipital lobe,thalamus,lenticular nucleus and cerebellum(P0.05).The amplitude of brain blood flow in PET and SPECT was increased in the affected frontal lobe,temporal lobe and cerebellum in group B as compared with that in group A,so did the amplitude of brain blood flow in the healthy parietal lobe,temporal lobe,occipital lobe and cerebellum(P0.05).Conclusion Acupuncture on Baihui has a specific effect on increasing the glucose metabolism and blood flow of brain lobes and cerebellum of VD patients.

目的运用PET显像技术,探讨针刺治疗血管性痴呆(VD)的疗效。方法符合美国精神病学会DSMⅣ制定的VD的诊断标准病例5例,均接受针对偏瘫的常规体针外加百会、水沟、神门等穴位进行针刺治疗;治疗前、后均接受18F-FDGPET脑显像,并比较治疗前后脑各功能区的葡萄糖代谢的变化。结果针刺治疗后,双侧额叶、顶叶、颞叶、枕叶、丘脑、豆状核、尾核、扣带回和小脑的葡萄糖代谢均有不同程度的升高。其中,双侧额叶、健脑颞叶、双侧丘脑、健脑豆状核的葡萄糖代谢升高有统计学意义。结论针刺治疗可以改善血管性痴呆的症状,并提高生活质量。

目的:运用脑功能成像方法,观察针刺神门穴作用的相对特异性。方法:10例血管性痴呆(VD)患者,随机分为两组,A组治以针对偏瘫的常规针刺,B组加用双侧神门穴,共完成20次治疗。治疗前后所有患者接受正电子发射体层摄影(PET)和单光子发射计算体层摄影(SPECT)脑功能成像检查。统计比较常规针刺和加用神门穴后局部脑区葡萄糖代谢和血流量变化幅度。结果:加用神门穴后,VD患者双侧项叶、患脑丘脑、尾核的葡萄糖代谢升幅提高(P<0.05),患脑额叶、健脑颞叶、枕叶、小脑的葡萄糖代谢升幅降低(P<0.05);VD患者双侧额叶、颞叶、小脑、健脑顶叶、枕叶血流量的升幅提高(P<0.05)。结论:针刺神门穴,对皮层的影响大于对基底节区的影响;就基底节区而言,针刺神门穴相对特异地作用于尾核;就皮层而言,针刺神门穴相对特异地作用于顶叶。

OBJECTIVE:Using methods of clinical scale assessment and cerebral functional imaging to compare the relative specificity of needling acupoints Baihui (DU20), Shuigou (DU26) and Shenmen (HT7) in intervening vascular dementia (VD) in different areas in the brain.METHODS:Fifty patients with VD were randomized into 5 groups. Needling on conventionally used acupoints of hand and foot three Yang-meridians aiming at hemiplegia was applied to the patients in Group A, and needling on DU20 to Group B, on DU26 to Group C, on HT7 to Group D and on all the three to Group E was applied additionally. Assessments of Mini Mental State Examination (MMSE), Activities of Daily Living (ADL) and Family Attitude Questionnaire (FAQ) were made. And the positron emission computerized tomography (PET) and single photon emission computerized tomography (SPECT) examinations were conducted in 5 selected patients from each group before and after treatment.RESULTS:Needling on conventional acupoints plus DU20 could effect the inner temporal system, thalamencephalon system and prefrontal cortical system to improve memory and executive capacity of VD patients; conventional acupoints plus DU26 could effect more to the prefrontal cortical system to obviously elevate the executive capacity; that plus HT7 would reveal an effect similar to but rather weaker than plus DU20, and effect more to memory; and that plus all the three simultaneously could effect rather roundly multiple aspects of the nervous system related to intellectual activities, to elevate the recognition and enhance the executive capacity.CONCLUSION:Needling on various acupoints like DU20, DU26 and HT7 have effects on different brain areas.

The [11C]methyl iodide (11C-CH3I ) is a very important methylated precursor in 11C labeled PET tracer synthesis. In order to get higher and more stable radiosynthesis yield of 11C-CH3I, this research aims at optimizing the key steps over the radiosynthesis procedure. After the system temperature of the module was optimized, a higher synthesis yield of 11C-CH3I (90.2 ±2.5)% was got, and 100% success rate of the synthesis was obtained at the same time. The synthesis time was 11min,and the radiochemical purity of the precursor was over 98%. Thus optimization of the system can lead to producing 11C-CH3I with higher and more stable yield.

Objective To evaluate the diagnostic value of ~ 13 N- ammonia PET imaging in astrocytomas. Methods Dynamic ~ 13 N- ammonia PET was performed in 30 patients with suspected brain gliomas. FDG PET was also performed in 17 of them within 2 weeks of each other. All patients were detected by CT or MRI. The final clinical results had been acquired by histopathological diagnosis, stereotatic biopsy or by following-up. All PET images were interpreted by two experienced nuclear physicians. Based on analysis the perfusion and delay's images, at least two images, moderate uptake or intense uptake were defined as positive of visual interpretation (+), and faint uptake or no uptake were defined as negative results (-). For the semi-quantitative analysis, regions of interest were outlined on the site of maximum ~ 13 N- ammonia and white matter on PET images. Tumor-to-white matter (T/W) count ratios were calculated. Results The increased uptake of ~ 13 N- ammonia at the lesions was found in 14 of 15 astrocytomas, the sensitivity was 93.3%. Four non-astrocytomas were positive with ~ 13 N- ammonia, the specificity was 73.3%. The accuracy rate of diagnosis was 83.3%. MRI correctively diagnosed 10 gilomas in 15 cases. Five of six astrocytomas were positive with FDG PET, one of them did not uptake FDG. The average T/W ratio of ~ 13 N- ammonia in astrocytomas was 1.94±0.41. The average T/W ratio of ~ 13 N- ammonia in non-astrocytomas was 1.06± 0.62 . Conclusion There are substantial uptakes of ~ 13 N- ammonia in astrocytomas. ~ 13 N- ammonia PET may be useful in the diagnosis of astrocytoma.

Objective: To analyze the factors associated with lung cancer invasion, evaluate the feasibility of standard up take value (SUV) as a metastasis predictor. Methods: Two hundred and six patients with pathologically confirmed lung cancer by FDG-PET were studied. Multivariate analysis was done to find the factors associated with invasion, and correlated SUV with tumor type and differentiation. Nominal regression was used for metastasis prediction. The diagnostic value was evaluated with receiver operator characteristic (ROC) curve. Results: SUV was significantly different among tumor types and differentiation. Chance for metastasis was increased with SUV. When SUV>7, the chance was greater than 50% for all surgical cases and 70% for adenocarcinoma. The area under ROC curve of lung adenocarcinoma was 70.9%. Diagnostic sensitivity was greater than 86% when SUV was equal to or greater than 9.6. Conclusion: SUV could be used as a local metastasis predictor in operated lung cancer cases.

目的:观察百会、水沟、神门针刺前后,血管性痴呆(VD)患者丘脑葡萄糖代谢的变化,研究该穴组对丘脑功能的影响.方法:10例VD患者,随机分为2组.对照组治以针对偏瘫的常规穴位(手足三阳经为主),治疗组加用百会、水沟、神门.治疗前后,所有患者均接受正电子发射型计算机断层显像检测葡萄糖代谢水平.划定VD患者双侧丘脑为感兴趣区,分析其葡萄糖代谢水平,并进行治疗前后的比较.结果:治疗组治疗后,双侧丘脑葡萄糖代谢有显著提高;对照组治疗后,双侧丘脑均无明显变化.结论:百会、水沟、神门能有针对性地作用于VD患者的丘脑,提高其葡萄糖代谢.

早期诊断并治疗老年性痴呆有助于阻止或延缓病情的发展.但当有临床表现并通过认知功能检测诊断为阿尔茨海默病(AD)时常已至中晚期.磁共振氢质子波谱(H-MRS)研究显示,轻度AD患者额、颞叶N-乙酰天门冬氨酸(NAA)减少,并认为颞叶NAA减少对AD具有早期诊断意义[1].

正电子发射型计算机断层显像(PET)的广泛临床应用,利用18F标记的脱氧葡萄糖(FDG)为示踪剂,通过测定组织细胞糖代谢的改变,从细胞内功能代谢变化角度鉴别肺内病变的性质,明显提高了肺内肿块定性诊断的准确性,降低了误诊率,得到了临床医生的广泛认可.但作为一种特殊类型,炎性假瘤的FDG摄取却表现多样.在解读PET影像时,要引起足够的重视,以进一步提高诊断的准确性.

Objective To establish a rapid,effective method for the synthesis of 11C-acetate and study the biodistribution of 11C-acetate in mice in order to support the clinical demand in PET center.Methods By unloading the 11C-CO2 to the vessel which contained 0.2 ml CH3MgBr in THF,the first reaction could be going,then phosphoric acid(aqueous 17%v/v,0.2 ml)was added to the residue,and the produce was distilled at 170 ℃ into a vial containing 5 ml physiological phosphate buffer.The mice receiving 11C-acetate were sacrificed,the liver and tissue samples from other organs were weighed and radiocounted.Results Only 15 min was taken from 11C-CO2 to 11C-acetate and the yield was 34.6%.Chemical and radiochemical purity was more than 99% and 98%.The radioactivity was mainly distributed in liver and kidney.Conclusion The synthesis which has been improved the condition of reaction is rapid,effective and the yield is higher than before.

目的评价^99Tc^m-甲氧基异丁基异腈（MIBI）甲状腺亲肿瘤显像鉴别甲状腺结节良恶性的临床价值。方法106例甲状腺结节手术患者中101例先进行了甲状腺结节常^99Tc^mO4^-显像；106例患者均静脉注射^99Tc^m-MIBI 370 MBq后进行15min早期和2h延迟显像，结果与病理检查结果对比。结果13例甲状腺恶性肿瘤中的5例、93例良性结节中的23例^99Tc^m-MIBI显像阳性。^99Tc^m-MIBI显像诊断甲状腺恶性肿瘤的灵敏度为38．5％，特异性为75．3％，准确性为70．8％。甲状腺良恶性肿瘤显像的阳性率差异无显著性（x^2=0．49，P〉0．05）。结论^99Tc^m-MIBI显像不能鉴别甲状腺结节的良恶性，其临床意义有限。

Objective: To observe the change of cerebral metabolism in long-term drug abuser by positron emission tomography(PET) with 2-deoxy-2[18F]fluoro-D-glucose (18FDG), and to provide the information of molecular imaging for the study of drug addiction. Methods: 7 cocaine-dependent subjects with cocaine addicted history of more than 10 years and 11 comparison subjects were involved in the study. After PET scan the data of the subjects were transmitted to computer, image registration was performed by the self-developed software according to the standard MRI brain imaging. Then regions of interest(ROIs) were drawn in left cerebral structures which include parietal cortex, anterior cingulate gyrus, head of caudate nucleus, striaturn, thalamus, inferior frontal gyrus, orbitofrontal cortex, exterior temporal cortex (including insular lobe), hippocampum and cerebellar cortex, antimere of each brain structure was created enantiomorphously. Two ROIs of each structure were drawn in the adjoining imaging slices. Mean radioactive counts of ROIs were calculated by the software. Analysis was used to compare the ROIs of each brain structures with these of the iso-lateral cerebellar cortex respectively. Results: Long-term drug addicted subjects showed reduction of cerebral metabolic rate of glucose of brain structures in some extent except for right parietal cortex. Conclusion: PET imaging can be used for the study of drug abuse.

本课题运用正电子发射型计算机断层显像(PET)技术,以18F-FDG为显影示踪剂,观察了针刺配合美多巴疗法对PD患者不同脑区葡萄糖代谢的影响,并与单纯美多巴治疗的PD患者比较,报道如下.

目的:分析肺肿瘤脱氧葡萄糖正电子发射体层摄影术(FD G-PE T)低摄取特征。方法:病理确诊肺肿瘤,回顾性分析PE T代谢表现,以SU V m ax<2.5为低代谢标准,综合分析病例分布特点。结果:21例肺肿瘤低FD G摄取,17例为腺癌。高分化腺癌呈低摄取最多,占高分化腺癌病例的40%。结论:低代谢由肿瘤的组织特性决定,多见于腺癌。PE T肺内低代谢病灶解析,要注意排除分化较好的腺癌可能,结合C T病灶特征,可提高诊断准确率。

Objective To probe the mechanism of electro-scalp acupuncture in treatment of Parkinson's disease (PD) by single photon emission computer tomography (SPECT). Methods Five cases of PD received electro-scalp acupuncture at Dingnie Qianxiexian (MS 6), Epangxian III (MS 4), Dingpangxian I (MS 8), Dingpangxian II (MS 9) and Zhenxia Pangxian (MS 14). Contralateral points were selected for pathologic change on one side and bilateral points were selected for pathologic lesion on both sides. All the patients received 99mTc-TRODAT-1 SPECT examination before and after acupuncture treatment of 6 weeks. And activities of dopamine transporter (DAT) were analyzed by the ratio of striatum/occipital lobe (ST/OC), which was evaluated by means of technique of regional of interesting (ROI). Results The ratio of ST/OC on the same side of the affected extremity before and after treatment were 1.19 +/- 0.15 and 1.24 +/- 0.31 respectively. And on the other side were 0.90 +/- 0.12 and 0.95 +/- 0.25 respectively. They were increased after treatment (P > 0.05). Conclusion Electro-scalp acupuncture can decrease the loss of DAT and improve the activities of DAT in the striatum of the patient of PD.

目的评价 99 Tc m -甲氧基异丁基异腈（MIBI）甲状腺亲肿瘤显像鉴别甲状腺结节良恶性的临床价值。方法 106例甲状腺结节手术患者中101例先进行了甲状腺结节常规 99 Tc m O 4 - 显像;106例患者均静脉注射 99 Tc m -MIBI 370 MBq 后进行15 min 早期和2 h 延迟显像,结果与病理检查结果对比。结果 13例甲状腺恶性肿瘤中的5例、93例良性结节中的23例 99 Tc m -MIBI 显像阳性。 99 Tc m -MIBI 显像诊断甲状腺恶性肿瘤的灵敏度为38.5%,特异性为75.3%,准确性为70.8%。甲状腺良恶性肿瘤显像的阳性率差异无显著性（x~2=0.49,P＞0.05）。结论 99 Tc m -MIBI 显像不能鉴别甲状腺结节的良恶性,其临床意义有限。