The limited efficacy of antidepressants for major depressive disorder (MDD) underscores the urgent need to explore mechanisms behind treatment heterogeneity and identify new antidepressant targets. This study explores the role of metabotropic glutamate receptor 5 (mGluR5) in MDD, examining mGluR5 availability changes pre- and post-treatment, and their link to clinical outcomes. We studied 25 patients with MDD and 21 healthy controls, with 13 undergoing eight-week vortioxetine treatment (10 mg per day). mGluR5 availability was measured at baseline and follow-up using [18F]3-fluoro-5-[(pyridin-3-yl)ethynyl]benzonitrile positron emission tomography ([18F]FPEB PET) scans, and patients were categorized on the basis of their response. Results showed lower mGluR5 availability in patients with MDD versus the control group at baseline. Post-treatment, the group with MDD exhibited significant increases in mGluR5 availability in the dorsolateral prefrontal cortex and ventromedial prefrontal cortex (N = 13, Cohen's d = 0.83 and 1.01). The percentage increase in mGluR5 availability correlated with the percentage reduction in scores on the Hamilton rating scale for depression. These findings underscore mGluR5's key role in MDD pathophysiology and treatment.

In the original publication [...].

Abstract The limited efficacy of antidepressants for Major Depressive Disorder (MDD) underscores the need for novel targets. This study explores the role of metabotropic glutamate receptor 5 (mGluR5) in MDD, examining mGluR5 availability changes pre and post-treatment and their link to clinical outcomes. We studied 25 MDD patients and 21 healthy controls, with 13 undergoing eight-week vortioxetine treatment. mGluR5 availability was measured at baseline and follow-up using [18F]FPEB-PET scans, categorizing patients based on response. Results showed a global decrease in mGluR5 availability in MDD patients versus controls at baseline. Post-treatment, remitters exhibited a significant increase in mGluR5 availability in the dorsolateral and ventromedial prefrontal cortex (Cohen’s d = 2.33 and 4.27). These findings underscore mGluR5's key role in MDD pathophysiology and treatment. The post-treatment increase in mGluR5 in key brain areas among remitters suggests its potential as a novel therapeutic target for MDD.

Real-time detection of cellular senescence remains a clinical challenge. Here, we aimed to develop a positron emission tomography (PET) imaging probe targeting senescence-associated β-galactosidase (SA-β-Gal), the most widely used biomarker of cellular senescence, and investigate its performance for real-time in vivo quantitative detection of cellular senescence. A stable PET imaging agent [68Ga]Ga-BGal was obtained with a high labeling yield (90.0 ± 4.3%) and a radiochemical purity (>95%). [68Ga]Ga-BGal displayed high sensitivity and specificity for β-Gal both in vitro and in vivo. The reaction and uptake of the probe correlated with the β-Gal concentration and reaction time. In PET imaging, high β-Gal-expressing CT26.CL25 tumors and doxorubicin-treated HeLa tumors showed high signals from [68Ga]Ga-BGal, while a low signal was observed in CT26.WT and untreated HeLa tumors. In summary, we showcased successful PET imaging of senescence in preclinical models using probe [68Ga]Ga-BGal. This finding holds the potential for translating senescence imaging into clinical applications.

Cysteine cathepsin B (CTS-B) is a crucial enzyme that is overexpressed in numerous malignancies and contributes to the invasion and metastasis of cancer. Therefore, this study sets out to develop and evaluate an activity-based multimodality theranostic agent targeting CTS-B for cancer imaging and therapy. A CTS-B activity-based probe, BMX2, was synthesized and labeled efficiently with 68Ga and 90Y to produce 68Ga-BMX2 for multimodality imaging and 90Y-BMX2 for radiation therapy. The affinity and specificity of BMX2 binding with the CTS-B enzyme were determined by fluorescent western blots using recombined active human CTS-B enzyme (rh-CTS-B) and four cancer cell lines including HeLa, HepG2, MCF7, and U87MG, with CA074 as the CTS-B inhibitor for control. Confocal laser scanning microscope imaging and cell uptake measurement were also performed. Then, in vivo PET imaging and fluorescence imaging were acquired on HeLa xenografts. Finally, the therapeutic effect of 90Y-BMX2 was tested. BMX2 could be specifically activated by rh-CTS-B and stably bound to the enzyme. The binding of BMX2 with CTS-B is time-dependent and enzyme concentration-dependent. Although CTS-B expression varied between cell lines, all showed significant uptake of BMX2 and 68Ga-BMX2. In vivo optical and PET imaging showed a high tumor uptake of BMX2 and 68Ga-BMX2 and accumulation for more than 24 h. 90Y-BMX2 could significantly inhibit HeLa tumor growth. The development of 68Ga/90Y-BMX2, a radioactive and fluorescent dual modality theranostic agent, demonstrated an effective theranostic approach for PET diagnostic imaging, fluorescence imaging, and radionuclide therapy of cancers, which may have a potential for clinical translation for cancer theranostics in the future.

Objective:To investigate the effect of 18F-FDG combined with 18F-prostate specific membrane antigen (PSMA)-1007 PET/CT on TNM staging and clinical treatment decision of patients with prostate cancer. Methods:Clinical data and PET/CT images of 31 patients (age (69.9±9.2) years) with prostate cancer who underwent PET/CT imaging with 18F-FDG and 18F-PSMA-1007 (dual-tracer imaging) in the Second Xiangya Hospital of Central South University from June 2020 to March 2022 were retrospectively analyzed. Paired χ2 test was used to compare the diagnostic efficacy of 18F-FDG, 18F-PSMA-1007 and combined imaging for diagnosing primary prostate cancer, regional lymph node metastases and distant metastases, and to analyze the influence of combined imaging on clinical treatment decision. Results:There were 282 metastatic sites in 31 patients, including 46 regional lymph node metastases in 13 patients and 236 distant metastases in 15 patients. The detection rates of 18F-PSMA-1007 PET/CT and combined imaging for primary lesions were higher than the detection rate of 18F-FDG PET/CT (100%(31/31), 100%(31/31) vs 64.5%(20/31); χ2=13.37, P<0.001). Based on analysis of patients, the detection rates of 18F-PSMA-1007 PET/CT and combined imaging for regional lymph node metastases were higher than the detection rate of 18F-FDG PET/CT (12/13, 12/13 vs 6/13; χ2=4.51, P=0.034), and the 3 detection rates for distant metastases were also significantly different (15/15, 15/15 vs 10/15; χ2=6.00, P=0.042). Based on analysis of lesions, the detection rates of 18F-PSMA-1007 PET/CT and combined imaging for regional lymph node metastases were higher than the detection rate of 18F-FDG PET/CT (95.7%(44/46), 97.8%(45/46) and 45.7%(21/46); χ2 values: 25.37-49.56, all P<0.001). The detection rate of combined imaging for distant metastases was higher than that of 18F-FDG or 18F-PSMA-1007 PET/CT alone (96.2%(227/236) vs 68.6%(162/236), 58.9%(139/236)); and the detection rate of 18F-FDG PET/CT was higher than that of 18F-PSMA-1007 PET/CT ( χ2 values: 4.85-94.22, all P<0.05). Clinical treatment decisions in 10 patients (32.3%, 10/31) were changed based on the results of combined imaging. Conclusion:For prostate cancer with suspected distant metastases, 18F-FDG and 18F-PSMA-1007 dual-tracer PET/CT imaging can improve staging and guide clinical treatment decisions.

目的 探讨18F-氟脱氧葡萄糖(FDG)PET/CT在常见原发性胃淋巴瘤(PGL)[弥漫性大B细胞淋巴瘤(DLBCL)和黏膜相关淋巴样组织(MALT)淋巴瘤]组织病理学分型鉴别诊断和预后评估中的价值.方法 回顾性分析2015年3月至2022年3月于中南大学湘雅二医院行18F-FDGPET/CT检查的83例PGL患者的临床资料和影像资料,其中男性39例、女性44例,年龄范围为13～78岁,中位年龄为56(48,66)岁.根据组织病理学类型将患者分为DLBCL(46例)和MALT淋巴瘤(37例),比较2种类型PGL患者的临床特征[性别、年龄、Lugano分期、B症状、乳酸脱氢酶(LDH)水平、国际预后指数(IPI)、细胞增殖核抗原Ki-67(简称Ki-67)水平]、影像特征(胃壁厚度、胃壁增厚类型、病变部位、胃壁形态、胃外浸润)、代谢参数[最大标准化摄取值(SUVmax)、病灶糖酵解总量(TLG)、肿瘤代谢体积(MTV)]间的差异.计数资料用频数和百分比表示,组间比较采用卡方检验或Fisher确切概率法;符合正态分布的计量资料以(x)±s表示,组间比较采用两独立样本t检验;不符合正态分布的计量资料以M(Q1,Q3)表示,组间比较采用Mann-Whitney U检验.采用受试者工作特征(ROC)曲线分析代谢参数和胃壁厚度对鉴别DLBCL与MALT淋巴瘤的价值,对各代谢参数判断疾病进展的最佳临界值进行分类;采用Kaplan-Meier法进行生存分析,组间差异评估采用Log-rank法,对可能影响无进展生存(PFS)期的因素进行单因素和多因素Cox回归分析.结果 DLBCL较MALT淋巴瘤更易发生胃周浸润、胃腔肿块、胃窦受累、多部位受累和胃壁弥漫性增厚,且差异均有统计学意义(58.7％对 21.6％、21.7％对 2.7％、71.7％对 35.1％、54.3％对 32.4％、43.5％对 27.0％,x2=3.99～11.56,均P＜0.05);DLBCL患者的胃壁厚度、TLG、SUVmax显著高于MALT淋巴瘤患者[20.5(13.0,32.3)mm 对 12.0(10.0,16.5)mm、603.2(138.8,1 971.0)g 对 69.9(22.3,208.3)g、23.4±11.5 对 6.6±3.9],差异均有统计学意义(Z=-3.72、-4.24,t=-9.30,均P＜0.05).ROC 曲线分析结果显示,SUVmax、TLG、胃壁厚度对鉴别MALT淋巴瘤与DLBCL诊断效能的差异均有统计学意义(AUC=0.915、0.772、0.738,均P＜0.05),当SUVmax=11.95为临界值时,灵敏度为80.4％,特异度为91.9％.Kaplan-Meier生存分析结果显示,DLBCL患者的胃壁厚度、SUVmax、TLG、MTV与PFS率相关,差异均有统计学意义(x2=6.98～12.71,均P＜0.01);MALT淋巴瘤患者的年龄、Lugano分期、IPI、Ki-67、胃壁弥漫性增厚与PFS率相关,差异均有统计学意义(x2=4.31～15.11,均P＜0.05).单因素Cox回归分析结果显示,胃壁厚度、SUVmax、TLG、MTV为DLBCL患者PFS期的危险因素(HR=5.749～8.768,均P＜0.05);胃壁增厚类型为MALT淋巴瘤患者PFS期的危险因素(HR=8.683,P=0.022).多因素回归分析结果显示,SUVmax为DLBCL患者PFS期的独立危险因素(HR=9.317,P=0.047).结论 DLBCL和MALT淋巴瘤的18F-FDG PET/CT显像有一定特征性,18F-FDG PET/CT代谢参数既可以鉴别DLBCL与MALT淋巴瘤,同时也可以预测DLBCL患者的预后.

(1) Background: intervertebral disc degeneration (IVDD) defined as the degenerative changes in intervertebral disc is characterized by extracellular matrix (ECM) degradation and death in nucleus pulposus (NP) cells. (2) Methods: The model of IVDD was established in male Sprague Dawley rats using a puncture of a 21-gauge needle at the endplates located in the L4/5 intervertebral disc. Primary NP cells were stimulated by 10 ng/mL IL-1β for 24 h to mimic IVDD impairment in vitro. (3) Results: circFGFBP1 was downregulated in the IVDD samples. circFGFBP1 upregulation inhibited apoptosis and extracellular matrix (ECM) degradation and promoted proliferation in IL-1β-stimulated NP cells. Additionally, circFGFBP1 upregulation mitigated the loss of NP tissue and the destruction of the intervertebral disc structure in vivo during IVDD. FOXO3 could bind to the circFGFBP1 promoter to enhance its expression. circFGFBP1 upregulated BMP2 expression in NP via sponging miR-9-5p. FOXO3 enhanced the protection of circFGFBP1 in IL-1β-stimulated NP cells, whereas a miR-9-5p increase partly reversed the protection. miR-9-5p downregulation contributed to the survival of IL-1β-stimulated NP cells, which was partially reversed by BMP2 silence. (4) Conclusions: FOXO3 could activate the transcription of circFGFBP1 via binding to its promoter, which resulted in the enhancement of BMP2 via sponging miR-9-5p and then inhibited apoptosis and ECM degradation in NP cells during IVDD.

1689 Objectives: To analyze the clinical characteristics and 18F-FDG PET/CT manifestations of patients with Langerhans cell histiocytosis (LCH), and to explore the value of 18F-FDG PET/CT in the diagnosis, classification, treatment response evaluation and lesion progression of LCH. Methods: The clinical and imaging data of 14 patients (9 males and 5 females, with an average age of 43.07±11.72 years) who underwent PET/CT examination and were confirmed by pathology in our hospital from August 2013 to July 2019 were retrospectively analyzed, especially the 18F-FDG PET/CT manifestations. Results: The main clinical manifestations of 14 patients included bone pain, diabetes insipidus, cough, fatigue, local mass, etc. A total of 77 bone lesions were found in 18F-FDG PET/CT, mainly distributed in the skull (27 cases), ilium (17 cases), vertebral body and adnexa (13 cases), etc. The uptake of 18F-FDG was increased in different degrees, SUVmax was 7.77±3.97, MTV was 2.76±3.21, and TLG was 13.99±18.81. Pulmonary nodules and cystic bright shadows were found in 4 patients, slight uptake of 18F-FDG was increased, and SUVmax was all less than 2.34. Six patients presented multiple enlarged lymph nodes with increased uptake of 18F-FDG, and 65 lesions were mainly distributed in mediastinum, axilla, inguinal and pelvic wall. SUVmax was 4.14±2.64, MTV was 1.47±1.13, and TLG was 3.77±3.55. In addition, there were 1 patient with multiple intrahepatic nodules and 1 patient with thyroid mass, and the uptake of 18F-FDG was significantly increased. In addition, three patients after treatment for 18F-FDG PET/CT check, 1 case of swollen lymph nodes, 1 case of patients characterized by dissolving osseous bone destruction focal density increased, 1 cases of lesions and swollen lymph nodes shrinking, the most (92.5%) lesions 18F-FDG uptake reduced after treatment (SUV average was 5.89±2.47 at lesions before treatment, after treatment was 2.35±2.78).Another patient 1 was reexamined after 1 year without treatment. The lesion was obviously enlarged and the glucose metabolism was obviously increased. Conclusions: 18F-FDG PET/CT can be used for the diagnosis of bone lesion, lymph node lesion, affected range, degree and activity of different organs and tissues of LCH, and has a good clinical value for the classification and diagnosis of LCH. Meanwhile, 18F-FDG PET/CT can simultaneously evaluate the therapeutic effect and lesion progression of LCH. Key words: LCH; PET; FDG

Rationale: Epithelioid hemangioendothelioma (EHE) is a rare low-to-intermediate grade malignant vascular neoplasm. We report a primary splenic EHE with diffused metastasis who underwent F-18-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT). Our case emphasizes that EHE should be considered a differential diagnose of F-18-FDG-avid splenic malignancies. Patient concerns: A 39-year-old man presented with abdominal distension and chest distress for 20 days and lumbago for 2 days. Transthoracic echocardiography suggested a large amount of pericardial effusion. Contrast-enhanced CT imaging showed splenomegaly with multiple low-density nodules with ring enhancement. A large irregular mass was also found in the right superior mediastinum with heterogeneous density and enhancement. F-18-FDG PET/CT imaging revealed splenomegaly, filled with intense hypermetabolic nodules and masses. And multiple regions of increased F-18-FDG uptake were observed in the mediastinum, left pleura, and bones. Diagnosis: EHE of the spleen. Interventions: Half a month after the diagnosis was confirmed, the patient then underwent chemotherapy, Docetaxel combined with carboplatin, and Endu were administrated every 3 weeks. Outcomes: During the 6-month follow-up period, the patient has finished 4 cycles of chemotherapy combined with 2 months of targeted drug. Efficacy assessment is partial remission through CT imaging, and clinical symptoms of patient improved significantly. Lessons: Primary splenic EHE is extremely rare, especially with diffuse systemic metastasis. Our report suggested that EHE should be considered a differential diagnosis of F-18-FDG-avid splenic malignancies. Furthermore, F-18-FDG PET/CT plays critical role in staging and accessing disease extent of EHE.

Objective: The purpose of this study was to explore the value of 18F-FDG PET/CT in monitoring the disease activity and predicting the prognosis of the Adult-onset Still's disease (AOSD).Methods: We retrospectively analyzed the electronic medical records of 45 AOSD patients who underwent 18F-FDG PET/CT in the Second Xiangya Hospital. PET/CT imaging and clinical information were retrospectively reviewed and analyzed. 18F-FDG uptake was assessed by measuring standard uptake value (SUV) in the spleen, liver, bone marrow, and lymph nodes. The spleen-to-liver ratio of the SUVmax (SLRmax) and SUVmean (SLRmean), the bone-to-liver ratio of the SUVmax (BLRmax), and SUVmean (BLRmean), and the lymph nodes-to-liver ratio of the SUVmax (LyLRmax) were calculated. Clinical and laboratory information were collected and evaluated for association with metabolic parameters of 18F-FDG PET/CT. The influencing factors for recurrence within 1 year were analyzed to determine whether 18F-FDG PET/CT can predict the prognosis of AOSD patients.Results: Elevated 18F-FDG uptake could be observed in bone marrow, spleen, and lymph nodes of AOSD patients. Correlation analysis between 18F-FDG uptake of organs and laboratory examinations showed that SLRmean positively correlated with LDH, AST, ferritin, and the systemic score (r = 0.572, 0.353, 0.586, and 0.424, P < 0.05). The SLRmean had the highest correlation with ferritin (r = 0586, P < 0.001). All metabolic parameters in spleen, including SUVmax, SUVmean, SLRmax, and SLRmean, are positively correlated with LDH level (r = 0.405, 0.539, 0.481, and 0.572, P < 0.05). Bone marrow SUVmax, BLRmax, and BLRmean were correlated with C-reactive protein (CRP) level (r = 0.395, 0.437, and 0.469, P < 0.05). Analysis of the influencing factors of recurrence within 1 year showed that the spleen SUVmax, spleen SUVmean, SLRmax, SLRmean, ferritin, and the systemic score of the recurrence group was significantly higher than the non-recurrence group (P < 0.05). The SLRmean cutoff of 1.66 with a sensitivity of 72.7% and specificity of 80.0% had the highest performance in predicting recurrence.Conclusion: The glucose metabolism of the liver, spleen, and bone marrow of AOSD patients were correlated with laboratory inflammatory indicators and system score, suggesting that 18F-FDG PET/CT could be applied to evaluate disease activity. Moreover, spleen 18F-FDG uptake may be a potential biomarker for predicting clinical prognosis of AOSD patients.

To observe thoracolumbar segmental mobility using kinetic magnetic resonance imaging (kMRI) in patients with minimal thoracolumbar spondylosis and establish normal values for translational and angular segmental motion as well as the relative contribution of each segment to total thoracolumbar segmental motion in order to obtain a more complete understanding of this segmental motion in healthy and pathological conditions. Mid-sagittal images obtained by weight-bearing, multi-position kMRI in patients with symptomatic low back pain or radiculopathy were reviewed. The translational motion and angular variation of each segment from T10-L2 were calculated using MRAnalyzer Automated software. Only patients with a Pfirrmann grade of I or II, indicating minimal disc disease, for all thoracolumbar discs from T10-T11 to L1-L2 were included for further analysis. The mean translational motion measurements for each level of the lumbar spine were 1.15 mm at T10-T11, 1.20 mm at T11-T12, 1.23 mm at T12-L1, and 1.34 mm at L1-L2 (P < .05 for L1-L2 vs T10-T11). The mean angular motion measurements at each level were 3.26 degrees at T10-T11, 3.92 degrees at T11-T12, 4.95 degrees at T12-L1, and 6.85 degrees at L1-L2. The L1-L2 segment had significantly more angular motion than all other levels (P < .05). The mean percentage contribution of each level to the total angular mobility of the thoracolumbar spine was highest at L1-L2 (36.1%) and least at T10-T11 (17.1%; P < .01). Segmental motion was greatest in the proximal lumbar levels, and angular motion showed a gradually increasing trend from T10 to L2.

Abstract Objective: In the past decade, as the increasing application of high-resolution computed tomography (HRCT) screening, pure ground-glass opacity nodules (pGGNs) are encountered more frequently. However, the clinical strategies for invasive and noninvasive pGGNs are different. Thus, in this study, we aimed to analyze the value and efficacy of the 18F-FDG PET/CT combined with HRCT for identifying the atypical adenomatous hyperplasia (AAH), adenocarcinoma in situ (AIS), minimally invasive adenocarcinoma (MIA), and invasive adenocarcinoma. Methods: The 18F-FDG PET/CT images and pathologic specimens of 90 patients with resected pGGNs at 2nd Xiangya Hospital in China between August 2013 and November 2019 were reviewed. The nodule size, density, metabolic parameters, and radiologic characteristic were assessed from 18F-FDG PET/CT and HRCT datasets. To investigate the invasiveness of the pGGNs lesions, we grouped AAH, AIS and MIA into the non-IAC group and IA into the IAC group. Then a mathematical model for predicting the invasiveness of pGGNs was established and assessed based on multivariate logistics regression. Results: Of 90 pGGNs, 57 were non-IAC (63.3%, 29 were AAH and AIS, 28 were MIA), and 33 were IAC (36.7%). There is no significant difference between non-IAC and IAC groups in terms of age, sex, smoking history, periphery, bubble, or lobulation (p＞0.05). Multivariate logistic regression analysis identified the maximum of CT value (CTmax), average standard uptake value (SUVmean), vessel pass, and speculation as independent predictors of invasiveness. The mathematical model we established as y=exp(x)/[1+exp(x)],x=1.445+1.184×length+0.009×mean attenuation+1.582×SUVmax, where e is the natural logarithm. When the cut-off value was set at 0.82, the sensitivity, specificity, and accuracy of our model was 68.9%, 96.6%, and 83.3%, respectively. The area under the receiver operating characteristic (ROC) curve of the model was 0.881 (95% confidence interval (CI): 0.807 to 0.955), which was higher than the model without 18F-FDG PET/CT parameters (AUC value of the model without 18F-FDG 0.848). Conclusion: Our study demonstrated a nomogram to accurately discriminate the invasive status of the pGGNs by visual assessment and 18F-FDG PET/CT parameters. The predicting model could assist surgeons to make decisions for the treatment of patients with pGGN.

Objective:To explore the value and efficacy of the risk model based on the metabolic parameters of 18F-FDG PET-CT in predicting epidermal growth factor receptor (EGFR) gene mutations in non-small cell lung cancer (NSCLC). Methods:This retrospectives study reviewed 105 NSCLC patients who were tested for EGFR gene expression and underwent 18F-FDG PET-CT exam prior to treatment from Jan 2017 to June 2018 in our hospital. The patients were divided into EGFR mutations group ( n=40) and EGFR wild type group ( n=65). The differences between the different groups were analyzed in several clinical characteristics and three metabolic parameters based on 18F-FDG PET-CT, including the maximal standard uptake value (SUV max), metabolic tumor volume (MTV), total lesion glycolysis (TLG) of the primary tumor. Multivariate logistic regression analysis was performed to identify predictors of EGFR mutations, and the risk prediction model and nomogram graph were constructed. Diagnostic efficiency of the model was done by the receiver operating characteristics (ROC) curve analysis, and the Calibration plot was performed by Hosmer-Lemeshow (H-L) test to evaluate the calibration scale of the model. Results:There were statistically significant differences in gender, smoking status, serum CEA level, length of tumor, pathological types, TTF-1 and NapsinA expression between the EGFR mutant groups and EGFR wild-type groups (all P<0.05). The MTV and TLG of EGFR mutation group were 4.4 (4.5，37.1) cm 3 and 46.6 (21.2，118.2), respectively. The MTV and TLG of EGFR wild type group were 7.4 (3.2，13.5) cm 3 and 95.4 (26.4，345.1), respectively. The MTV and TLG of EGFR mutation group were significantly lower than those of EGFR wild type group ( Z=-2.452, P=0.014; Z=-2.379, P=0.017). ROC curve analysis showed area under the curve (AUC) predicted by SUV max, MTV and TLG for EGFR mutations was 0.597, 0.643 and 0.639, respectively. Multivariate analysis demonstrated that gender, length of tumor, SUV max and MTV were independent predictors of EGFR mutations, with the odds ratio (OR) values (95 %CI) as 3.811 (1.508-9.629), 1.679 (0.899-3.136), 0.928 (0.848-1.015) and 0.924 (0.865-0.986), respectively. The predictive model and nomogram graph was established, with the sensitivity, specificity, positive predictive value, negative predictive value and AUC of 80.0%, 66.2%, 68.8%, 75.3% and 0.775 (0.687-0.864), respectively. The H-L test showed the model had excellent accuracy (χ 2=3.872, P=0.869). Conclusion:The risk model based on the metabolic parameters of 18F-FDG PET-CT has a good performance in predicting the mutations of EGFR gene in patients with NSCLC.

[目的]分析肺母细胞瘤的PET-CT影像学特征.[方法]1例27岁男性,因“发热伴咽痛半月”入院,抗感染治疗后好转,治疗过程中发现右肺下叶占位病变,给予常规胸部增强CT、支气管镜、PET-CT、穿刺活检等检查最后确诊为肺母细胞瘤,结合本例病例诊疗过程,回顾性分析肺母细胞瘤的临床及影像学特征.[结果]胸部增强CT显示:右肺下叶占位性病变,其内密度欠均匀,见分叶及血管集束征,增强扫描不均匀强化.18F-FDG PET-CT检查发现病灶葡萄糖代谢增高,行肿块切除术,术后病理学检查确诊为肺母细胞瘤.[结论]18F-FDG PET-CT检查对肺母细胞瘤的病灶定位及定性诊断有良好价值,疑似肺母细胞瘤病例可早期选择PET-CT检查.

目的 总结POEMS综合征患者的临床特点及影像学表现,探讨氟代脱氧葡萄糖(18F-FDG) PET/CT在该病中的应用价值.方法 回顾性分析2014年9月至2018年9月在本院行PET/CT检查的10例经临床或病理证实的POEMS综合征患者的临床资料、实验室及影像学资料.结果 10例患者中男6例,女4例,年龄(52.9±9.8)岁,主要临床表现为不同程度的四肢麻木,轻-中度的肝、脾、淋巴结肿大,皮肤色素沉着等.实验室检查:10例均存在M蛋白血症,9例血清血管内皮生长因子(VEGF)水平异常升高,4例甲状腺功能异常及2例促肾上腺皮质激素(ACTH)异常升高.18F-FDG PET/CT影像学表现:10例患者均存在不同程度的骨病变,9例多发,1例单发,病灶共计198个,主要分布于脊椎、骨盆、肋骨等.所有骨病变中以硬化性最常见(157/198,79.3％),混合性次之(38/198,19.2％),溶骨性最少(3/198,1.5％).FDG阳性病灶约22.7％ (45/198),最大标准摄取值(SUVmax)为4.6±3.2,其中溶骨性骨病变SUVmax为10.8±10.0,混合性病变SUVmax为4.3±2.0,硬化性病变SUVmax为3.5±0.3.FDG阳性病灶以10 mm以上多见,FDG阴性病灶以5～10 mm多见.7例出现淋巴结病变者均伴FDG异常摄取,SUVmax为3.7±2.0.肝脏肿大者2例、脾肿大者6例.6例出现浆膜腔积液,其中4例多发,2例单发,均未见FDG异常摄取.结论 18F-FDG PET/CT可系统性地评估POEMS综合征的骨病变、淋巴结病变、肝、脾肿大、多浆膜腔积液等特点,对该病的早期诊断、活检定位及疗效评价方面具有重要临床价值.

Rationale: Malignant hepatic epithelioid hemangioendotheliom (HEH) is a rare vascular tumor of endothelial origin, with multiple metastases to the spleen. This report describes a diffuse HEH with splenic metastasis on 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) images and delayed mutifocal bone metastasis after liver transplantation (LTx). Patient concerns: A 30-year-old male was admitted to our hospital with a complaint of abdominal distension, fatigue, and anorexia for 2 months. Diagnoses: Mild to moderate FDG uptake in the whole liver, and multifocal FDG uptake in the spleen were observed on 18F-FDG PET/CT scan. Ultrasound guided liver biopsy was performed, and a diagnosis of HEH was confirmed. Interventions: The patient underwent LTx and splenectomy. Outcomes: The patient developed low back pain due to unknown etiology, 3 months after surgery. A follow-up 18F-FDG PET/CT scan demonstrated multifocal bone destruction. Unfortunately, the patient died 12 months after surgery. Lessons: It is noteworthy that despite liver transplantation for the treatment of HEH, there may be a risk of recurrence. For these patients with extrahepatic lesions, adjuvant chemotherapy may be a useful alternative treatment method for the prevention of recurrence.

To determine the clinicopathological and imaging features in 18F-fluoro-2-deoxyglucose (18F-FDG) positron emission tomography and computed tomography (PET/CT) for paraganglioma of testis, and to increase the diagnostic accuracy.
 Methods: A case of paraganglioma of testis with multiple lymph node and lung metastasis were reported. PET/CT and pathological findings in the case were retrospectively analyzed.
 Results: The patient presented with high blood pressure, high level of catecholamine, and urinary vanillylmandelic acid. The patient underwent 18F-FDG PET/CT, which showed the features including the right testis nodule with a star lesion nearby, the right spermatic cord, the lymphadenopathy of bilateral inguinal and retroperitoneum, the posterior basal segment of right lung nodule, and a lot of brown adipose tissues (BAT) in the whole body with intense FDG uptake. 18F-FDG PET/CT showed that the intense FDG uptake of the BAT disappeared after the excision of the right testis and metastasis of paraganglioma.
 Conclusion: PET/CT shows great value in localization diagnose, clinical staging and curative evaluation. PET/CT plays a helpful role in revealing the BAT with 18F-DG avidity in the patients with paraganglioma with elevated blood pressure, high level catecholamine, and urinary vanillylmandelic acid.

In recent years,the clinical application of the precise molecular targeted therapy and immunotherapy of lung cancer has been a focus of lung cancer research.8F-FDG PET/CT is an imaging technology that merges morphology and molecular metabolism.18F-FDG PET/CT can provide timely information about the activities of tumor cells compared with traditional imaging technologies,such as CT and MRI,and has significant value on guiding precise radio-chemotherapy and monitoring treatment efficacy in lung cancer.This article will focus on the application of 8F-FDG PET/CT in lung cancer,particularly in the delineation of targeted lesion,evaluation of treatment effect,and prognosis evaluation.