Objective To evaluate the diagnostic value of Aβ protein PET brain imaging model in distinguishing patients with Alzheimer's disease （AD） from mild cognitive impairment （MCI）. Methods Thirty-two subjects with cognitive impairment were enrolled in this study. All participants were diagnosed with AD or MCI by clinical examination and underwent 18F-AV-45 （2.96~4.44 MBq/kg）PET/CT scan（heart and head）. The fitting curves of specific activity of left ventricle and region of interest （ROI） at different time points were delineated, and then the metabolic rate K was calculated by Logan model. The difference in metabolic rate K value was compared between AD and MCI groups by using Mann-Whitney U test. The diagnostic efficiency of Logan model was evaluated by the receiver operator characteristic （ROC） curve. Results The degree of Aβ protein deposition in the cerebral cortex of AD and MCI patients was different. AD and MCI patients could be distinguished with the K value of Logan model. The K value in the AD group was 3.96（2.66, 4.26）, significantly higher than 2.62（1.41, 2.96） in the MCI group （P < 0.05）. According to ROC curve analysis, the optimal diagnostic threshold of K value was 3.23, the diagnostic sensitivity was 100%, the specificity was 58.33%, and the area under ROC curve （AUC） was 0.781 （Z = -2.350, P < 0.05）, respectively. Conclusion Aβ protein PET imaging with Logan model has high diagnostic efficacy in distinguishing AD from MCI.

目的 探讨18F-氟脱氧葡萄糖(18F-FDG)PET-CT影像组学方法鉴别中低分化肝细胞癌(HCC)和肝内胆管细胞癌(ICC)的可行性.方法 本前瞻性研究对象为2015年6月至2018年4月在中山大学附属第三医院行18F-FDG PET-CT检查的36例原发性肝癌患者.患者签署知情同意书,符合医学伦理学规定.其中男31例,女5例;年龄21～74岁,中位年龄52岁.中低分化HCC 26例,ICC 10例.利用3D Slicer软件在18F-FDG PET-CT图像上勾画病灶感兴趣区体积,提取每个病灶的影像组学特征.105个影像组学特征经LASSO回归模型进行筛选和优化,构建影像组学标签诊断模型.采用受试者工作特征(ROC)曲线检验该模型在鉴别中低分化HCC和ICC中的诊断效能.结果 每个病灶均得到105个PET-CT影像组学特征,筛选和优化后得到2个PET-CT影像组学特征Sphericity和ZoneVariance,纳入Logistic回归模型,得到影像组学标签诊断模型为logit(P)=-8.984+10.506×Sphericity+61.341×ZoneVariance.该模型的ROC曲线下面积为0.923,95％CI:0.84～1.00,敏感度为1.00,特异度为0.73.结论 18F-FDG PET-CT影像组学能较好地鉴别中低分化HCC和ICC,具有较高的敏感度和特异度,诊断价值高.

Objective To investigate the feasibility of 131I-labeled hepatoma aptamer JHIT2 (131I-JHIT2) as a novel molecular probe for hepatoma-targeted imaging. Methods The 131I-JHIT2 was prepared by Iodogen method. The labeling rate and radiochemical purity were measured by paper chromatography. The radiochemical purity of 131I-JHIT2 was detected in different solutions at different time points. The radioactivity count of 131I-JHIT2 after combining with human hepatoma HepG2 and normal liver cell L02 was measured by gamma counter. The HepG2 tumor-bearing nude mice were sacrificed at different time points after caudal venous injection of approximately 0.74 MBq 131I-JHIT2. The percentage of radioactivity uptake value and tumor/muscle (T/M) radioactivity ratio per 1 g tissues of each organ were measured and calculated. Single-photon emission computed tomography (SPECT)-CT imaging was performed after caudal venous injection of approximately 9.25 MBq 131I-JHIT2 in tumor-bearing nude mice. The tumor/non-tumor (T/NT) ratio was observed and measured at different time points. The radioactive count was statistically compared between two types of cells by t test. Results The labeling rate of 131I-JHIT2 was (67.8±0.5)%, and the radiochemical purity after purification was (91.4±1.1)%. The radiochemical purity of 131I-JHIT2 in PBS or normal saline at room temperature for 24 h was both above 80%. After 131I-JHIT2 combining with two types of cells, the radioactive count of HepG2 cells was (415±9) CPM, significantly higher than (288±7) CPM of L02 cells (t=15.3, P<0.05). At 30 min and 2 h after caudal venous injection of 131I-JHIT2, the percentage of radioactivity uptake value per 1 g tumor tissue in tumor-bearing mice was (4.17±2.83) and (2.22±0.64) %ID/g, and the T/M ratio was 2.01±1.15 and 2.07±0.82. SPECT-CT imaging demonstrated that radioactive uptake was observed at the tumor site in tumor-bearing nude mice and the T/NT ratio was 2.63 at 30 min after 131I-JHIT2 injection. The radioactivity decreased at 2 h, and the T/NT ratio was 1.82. Conclusions 131I-JHIT2 probe possesses relatively high stability in vitro, and has certain targeting capacity towards HepG2 cells in vitro and HepG2 tumor-bearing nude mouse model, which lays certain foundation for the targeted radionuclide diagnosis and treatment of liver cancer. Key words: Carcinoma, hepatocellular; Aptamer; Radionuclide imaging

Objective To evaluate the value of semi-quantitative indices of 68Ga-prostate specific membrane antigen (PSMA)-11 PET/CT in differentiating malignant and benign prostate lesions.Methods From November 2017 to June 2018,30 patients (age:52-86 years) who underwent 68Ga-PSMA-11 PET/CT imaging in the Third Affiliated Hospital of Sun Yat-sen University were retrospectively analyzed,and the serum total prostate specific antigen (tPSA) and free prostate specific antigen (fPSA) were examined within 1 week before PET/CT imaging.Semi-quantitative indices of 68Ga-PSMA-11 PET/CT on prostate lesions were measured by automatic segmentation algorithm method,including PSMA-related lesion volume (VPSMA),maximum standardized uptake value (SUVmax),mean standardized uptake value (SUVmean),peak standardized uptake value (SUVpeak) and total lesion uptake value of PSMA (TLUPSMA).The indices were compared between malignant and benign prostate lesions,and the optimal cut-off values for differentiating malignant and benign prostate lesions were obtained by receiver operating characteristic (ROC) curve analysis.Results According to the pathological results,19 patients had malignant lesions and 11 were with benign diseases.The differences of tPSA,SUVmax,SUVmean SUVpeak and TLUPSMA between malignant and benign prostate lesions were statistically significant (u values:17.00-48.00,all P＜0.05),but there were no significant differences of fPSA,fPSA/tPSA and VPSMA between 2 groups (u values:64.00-99.00,all P＞0.05).The optimal cut-off value of tPSA was 18.30 μg/L for differentiating malignant and benign prostate lesions,with sensitivity of 13/17 (PSA of 2 patients were missing),specificity of 9/11 and area under curve (AUC) of 0.743.The optimal cut-off values of SUVmax,SUVmean and SUVpeak were 5.50,3.09 and 3.56,respectively,with all corresponding sensitivity of 18/19,all specificity of 9/11,and AUC of 0.902,0.907 and 0.919,respectively.The optimal cut-off value of TLUPSMA was 54.81 cm3,with sensitivity of 14/19,specificity of 9/11 and AUC of 0.804.Conclusion The semi-quantitative indices of 68Ga-PSMA-11 PET/CT are valuable for differentiating malignant and benign prostate lesions,in which SUVpeak is superior to other indices.

目的 探讨18F-氟代脱氧葡萄糖正电子发射型计算机断层显像/计算机断层显像(18F-FDG PET/CT)半定量代谢参数(参数)检测乳房外Paget's病(EMPD)淋巴结转移的价值.方法 收集19例首次确诊为EMPD患者的PET/CT图像,纳入代谢异常的淋巴结47个(同区域有多个异常淋巴结时只选取1个代谢最高的淋巴结),通过阈值自动分割法测量淋巴结18F-FDG PET/CT半定量代谢指标,包括最大标准摄取值(SUVmax)、平均标准摄取值(SUVmean)、病灶糖酵解总量(TLG)、肿瘤代谢体积(MTV).所有患者均在PET/CT检查后1周内手术,按是否有转移将47个淋巴结分为转移组与非转移组,比较各参数,用受试者工作特征(ROC)曲线获得各参数鉴别淋巴结良恶性病变的最佳阈值.结果 转移组淋巴结9个,非转移组淋巴结38个.转移组SUVmax、SUVmean、TLG均高于非转移组(P均<0.05).SUVmax、SUVmean、TLG鉴别转移淋巴结与非转移淋巴结的最佳截断值分别6.535(AUC=0.795,P=0.006)、4.085(AUC=0.792,P=0.007)、6.22 cm3(AUC=0.772,P=0.012),灵敏度分别为77.8％、77.8％、77.8％,特异度分别为73.7％、81.6％、68.4％.结论 18F-FDG PET/CT半定量代谢参数对鉴别EMPD是否出现淋巴结转移具有中度诊断价值.

目的 分析单光子发射计算机断层成像/电子计算机断层扫描(SPECT/CT)骨显像在脊柱骨转移瘤临床诊断中的应用价值,以提高临床诊断脊柱骨转移瘤的准确度.方法 选取72例2016年1月至2017年6月医院收治的恶性肿瘤患者,给予所有患者SPECT/CT骨显像,分析患者的脊柱骨转移瘤诊断结果 .结果以手术病理结果为诊断标准,SPECT/CT骨显像诊断脊柱骨转移瘤的准确度为95.8％,灵敏度和特异度分别为97.9％、91.7％,阳性和阴性预测值分别为95.9％、95.7％.脊柱骨转移瘤的转移部位:除5例多发转移患者外,其余42例患者共发现脊柱骨转移灶73处,其中以胸腰椎转移病灶为主,腰椎有19处,胸椎有45处.结论 SPECT/CT骨显像在脊柱骨转移瘤诊断中具有较高的灵敏度和特异度,能够为临床诊治提供重要参考.

Objective To investigate the diagnostic value of 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/CT delayed imaging in the diagnosis of primary liver cancer. Methods Clinical data of 80 patients with primary liver cancer who were admitted to the Third Affiliated Hospital of Sun Yat-sen University between October 2014 and December 2016 were retrospectively analyzed. Among them, 62 cases were males and 18 were females, aged (58±12) years old on average. According to the tumor diameter, the patients were divided into the small liver cancer group (n=30), nodular liver cancer group (n=23) and large liver cancer group (n=27). The informed consents of all patients were obtained and the local ethical committee approval was received. PET/CT early imaging was performed on the patients at 40-60 min after they were intravenously injected with contrast agent 18F-FDG, and PET/CT delayed imaging was performed at 2 h later. The maximal standardized uptake values (SUVmax) of the lesions in two imagings were detected. The early imaging, delayed imaging and the imaging changes at different stages were observed and compared among three groups. The SUVmax values were compared among three groups using one-way analysis of variance and LSD-t test, and were compared between two groups using t test. The rates were compared using Chi-square test. Results The SUVmax values of the early imaging and delayed imaging were respectively 5.1±1.9 and 5.5±2.3 in the nodular liver cancer group, significantly higher than 3.9±1.4 and 4.3±2.0 in the small liver cancer group (LSD-t=2.60, 2.03; P<0.05), whereas significantly lower than 6.9±2.6 and 8.5±2.9 in the large liver cancer group (LSD-t=-2.82, -4.08; P<0.05). The SUVmax value of the delayed imaging in the large liver cancer group was significantly higher than that of the early imaging (t=2.05, P<0.05). The percentage of patients with SUVmax values of the delayed imaging higher than that of the early imaging was 93%(25/27) in the large liver cancer group, significantly higher than 53%(16/30) in the small liver cancer group and 61%(14/23) in the nodular liver cancer group (χ2=10.85, 7.28; P<0.05). Conclusions The 18F-FDG uptake of the delayed imaging increases significantly along with the tumor diameter increases. Application of 18F-FDG PET/CT delayed imaging can elevate the detection rate of liver cancer, especially large liver cancer. Key words: Liver neoplasms; Fluorodeoxyglucose F18; Delayed imaging; Positron-emission tomography

通过总结核医学临床工作中容易导致儿童核素脑单光子发射计算机断层显像(single photon emission computedtomography,SPECT)检查失败的两大影响因素,针对这些因素采取了多种心理护理及显像技巧的综合应用方法,有效地提高了该项检查的成功率,既为临床提供了可靠的诊断依据,又为核素显像积累了实用经验.

Objective To investigate the causes and preventive measures against the incidence of gastrointestinal tract reaction in differentiated thyroid carcinoma patients after iodine-131 therapy.Methods In total, 479 patients diagnosed with differentiated thyroid carcinoma received iodine-131therapy after surgery.The level of thyroid function was measured before iodine-131 therapy.Before and during iodine-131 therapy, medicine treatment was delivered using metoclopramide, proton pump inhibitors (PPI), prokinetic agents and mucosal protective agents.All patients were assigned into different groups according to the type and quantity of adjuvant drugs.After iodine-131 therapy, the incidence of gastrointestinal tract reaction was observed and compared among different groups.Results During iodine-131 therapy, the incidence of gastrointestinal reaction was 11.9%, which was negatively correlated with FT3 and FT4 and positively correlated with the dose of iodine-131 (all P<0.05).Iodine-131 was an independent risk factor of the incidence of gastrointestinal reaction (OR=3.174, 95% CI=1.450-6.946, P=0.004).The risk of gastrointestinal reaction in the prokinetic agents group was significantly lower than that in their counterparts without intake of prokinetic agents (P=0.032), whereas it was considerably higher in the mucosal protective agents group compared with that in those without intake of mucosal protective agents (P=0.015).The risk of gastrointestinal reaction did not significantly differ according to the intake of metoclopramide or PPI (both P>0.05).The incidence of gastrointestinal reaction in patients receiving prokinetic agents in combination with 1 or 2 types of drugs was significantly lower than that in those intake of prokinetic agents plus three types of drugs (P=0.002, P=0.003).Conclusions Throughout the iodine-131 therapy, the incidence of gastrointestinal reaction is correlated with the level of thyroid function and dosage of iodine-131.Use of prokinetic agents can effectively reduce the risk of gastrointestinal reaction.

目的 了解分化型甲状腺癌术后131I治疗过程中胃肠道反应发生情况.方法 收集分化型甲状腺癌术后行131I治疗患者资料,观察患者治疗期间出现胃肠道反应[恶心和(或)呕吐]情况,根据患者呕吐次数将呕吐严重程度分为轻微(1~2次)、中度(3~4次)和严重(4次以上),分析患者胃肠道反应发生率及其与患者治疗次数及剂量间关系.结果 共纳入703例次,其中男210例次,女493例次,年龄(40.7±14.6)岁,中位年龄38岁.在这703例次中,共出现胃肠道反应96例次,占13.7%,其中仅表现为恶心者60例次,占8.5%,呕吐者36例次,占5.1%,以轻微呕吐者居多,占3.3%.再次治疗或多次治疗时,随着131I剂量逐渐增大(x2=342.374,P=0.000),胃肠道反应或呕吐的发生率高于初次治疗时(x2=32.780,P=0.000;x2=36.833,P=0.000).结论 分化型甲状腺癌术后患者,随着131I治疗次数和剂量增加,发生胃肠道反应可能性加大.

ObjectiveConclude the experience and methods in the process of a SPECT/CT’s Instalation and Quality Control in order to facilitate new equipment instaled and been put into use smoothly and quickly.Method (1)Plan and prepare for the instalation.(2)Instal the new SPECT/CT equipment.(3)Test and calibrate the main performance parameters of the equipment. (4) Conclude the precautions of technical training and operation of the equipment in details.Result The SPECT/CT was instaled successful and the technical training was finished both in two weeks, al of the main parameters passed the performance tests and achieved the ideal state. The detector 1 and detector 2 of the SPECT both had very good intrinsic uniformity, the intrinsic values of intrinsic uniformity in CFOV were 1.56% and 1.78%, and in UFOV were 1.85% and 1.87%, the differential values of intrinsic uniformity in CFOV were 1.25% and 1.43%, and in UFOV were 1.25% and 1.44%. The parameters of CT part were also reached the specifications.Conclusion A instalation of a SPECT/CT could be done in a short time and the equipment could be put into use quikly with a wel preparation. Either were mastering the operation of the new equipment and the quality control methods.

目的:设计与搭建适应检测物体更换较快应用场合的可自行学习并更换对象模板的视觉智能机械手系统.方法:利用LabVIEW开发平台和NI Vision软件包,选择合适的硬件设备搭建视觉智能机械手系统:采用调用DLL的方式配置相机参数及控制其进行图像采集;并对采集到的图像进行LUT,阈值分割和形态学变换,消除一定光照干扰等环境变化影响,使其适于下一步分析;通过Geometric匹配及对特征区域的灰度值判断,实现物件的识别与检测.同时针对物件识别需要的信息设计与完成相应的模版学习与更换程序.结果:实现了对目标物体的视觉识别及控制机器手的抓取,视觉识别准确率达到97％以上,其特色还在于可以在应用实践中实时实地方便地进行自主学习与制作对象模板,在目标频繁变更的情况下快速实现对不同物体的视觉识别与抓取控制.结论:采用LabVIEW开发平台和NI Vision软件包可搭建出具有视觉智能识别功能,且识别准确率较高,可便捷地学习与更换识别对象的智能机械手系统,具有应用价值.

Inordertomonitorthegrowthstatesofbiologicalcellsinrealtime,acontinuousperfusion culturing system which can realize real-time continuous monitoring of the cells in vitro was developed. The system mainly includes four parts:a pH-CO2 control sub-system,a temperature control sub-system, a continuous perfusion sub-system and a detachable cell culture pool.The detachable cell culture pool was designed by pro-E software and made with PMMA material.CHO and 3 T3 cells were cultured in the cell culture pool for three days.The cells grew well and their sizes,movement and other parameters were detected in real time.Therefore,the continuous perfusion culture system can be used as a monitor for long-term and real-time experiments on cells.By combining with microscopic and micro-manipulation sys-tem,it can be also used to handle and inject cells to perform cell transfection and transferring experi-ments.

VBAI is used to establish intelligent biomedical image processing and analysis program to solve the problems existed in the present biomedical image processing and analysis software. Three applications about microsphere imaging,red-blood cell imaging and pollen imaging were performed as examples of application. The results indicate that VBAI can create image processing and analysis program easily for particular situations and purposes. It can give objective result by detecting mass of images automatically and quickly. VBAI is a powerful tool to establish biomedical image processing and analysis program for laboratories with different purposes.