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					Journal of Nuclear Medicine
1、J Nucl Med. 2010 Jan;51(1):52-6. Epub 2009 Dec 15.
Diagnosis of cirrhotic portal hypertension and compensatory circulation using
transsplenic portal scintigraphy with (99m)Tc-phytate.
Gao L, Yang F, Ren C, Han J, Zhao Y, Li H.
Department of Nuclear Medicine, Qilu Hospital of Shandong University, Jinan
250012, China.

   Our objective was to investigate the diagnostic value and clinical significance of
transsplenic portal scintigraphy in cirrhotic portal hypertension and compensatory
circulation. METHODS: Transsplenic portal scintigraphy, ultrasound, and
gastroscopy were performed on 50 patients with cirrhotic portal hypertension and on
10 controls. According to the Child-Pugh classification, 15 patients with cirrhosis
were Child A, 19 were Child B, and 16 were Child C. RESULTS: In the control group,
the splenoportal vein was shaped like the letter S, and the portosystemic shunt index
was 0.19 +/- 0.07. Portal hypertension portosystemic shunts were of 3 types:
intrahepatic (13 patients; index, 0.52 +/- 0.19), compensatory (31 patients; index, 0.64
+/- 0.28); and completely extrahepatic (6 patients; index, 0.91 +/- 0.03). Collateral
vessels were uphill, downhill, or complex. The portosystemic shunt index increased as
cirrhosis and esophageal varices increased. There was statistical significance among
groups (P < 0.05 or < 0.01). CONCLUSION: Transsplenic portal scintigraphy was
sensitive for detecting the number and location of shunts and will allow for improved
surgical planning.

2、J Nucl Med. 2009 Dec;50(12):2049-57. Epub 2009 Nov 12.
Construction of mutant TKGFP for real-time imaging of temporal dynamics of HIF-1
signal transduction activity mediated by hypoxia and reoxygenation in tumors in
living mice.
Hsieh CH, Kuo JW, Lee YJ, Chang CW, Gelovani JG, Liu RS.
Institute of Medical Science, China Medical University, Taichung, Taiwan.

   The herpes simplex virus type 1 thymidine kinase (HSV1-tk)/green fluorescent
protein (TKGFP) dual-reporter gene and a multimodality imaging approach play a
critical role in monitoring therapeutic gene expression, immune cell trafficking, and
protein-protein interactions in translational molecular-genetic imaging. However, the
cytotoxicity and low temporal resolution of TKGFP limits its application in studies
that require a rapid turnover of the reporter. The purpose of this study was to construct
a novel mutant TKGFP fusion reporter gene with low cytotoxicity and high temporal
resolution for use in the real-time monitoring of temporal dynamics and spatial
heterogeneity of hypoxia-inducible factor 1 (HIF-1) signal transduction activity
mediated by hypoxia and reoxygenation in vitro and in vivo. METHODS:
Destabilized TKGFP was produced by inserting the nuclear export signal (NES)
sequence at the N terminus and fusing the degradation domain of mouse ornithine
decarboxylase (dMODC) at the C terminus. The stability of TKGFP in living
NG4TL4 cells was determined by Western blot analysis, HSV1-tk enzyme activity
assay, and flow cytometric analysis. The suitability of NESTKGFP:dMODC as a
transcription reporter was investigated by linking it to a promoter consisting of 8
copies of hypoxia-responsive elements, whose activities depend on HIF-1. The
dynamic transcriptional events mediated by hypoxia and reoxygenation were
monitored by NESTKGFP:dMODC or TKGFP and determined by optical imaging
and PET. RESULTS: Unlike TKGFP, NESTKGFP:dMODC was unstable in the
presence of cycloheximide and showed a short half-life of protein and enzyme activity.
Rapid turnover of NESTKGFP:dMODC occurred in a 26S proteasome-dependent
manner. Furthermore, NESTKGFP:dMODC showed an upregulated expression and
low cytotoxicity in living cells. Studies of hypoxia-responsive TKGFP and
NESTKGFP:dMODC expression showed that NESTKGFP:dMODC as a reporter
gene had better temporal resolution than did TKGFP for monitoring the dynamic
transcriptional events mediated by hypoxia and reoxygenation; the TKGFP expression
level was not optimal for the purpose of monitoring. CONCLUSION: In translational
molecular-genetic imaging, NESTKGFP:dMODC as a reporter gene, together with
optical imaging and PET, allows the direct monitoring of transcription induction and
easy determination of its association with other biochemical changes.

3、J Nucl Med. 2009 Nov;50(11):1857-64. Epub 2009 Oct 16.
Using dual-tracer PET to predict the biologic behavior of human colorectal cancer.
Wang H, Zhang J, Tian J, Qu B, Li T, Chen Y, Liu J, Wang S.
Nuclear Medicine Department, General Hospital of the Chinese People's Liberation
Army and Military Medical Postgraduate College, Beijing, China.

   (18)F-FDG and 3'-deoxy-3'-(18)F-fluorothymidine ((18)F-FLT) have been proven
useful in diagnosing and staging many types of cancer but with emphasis on different
aspects of tumor biology. The aim of the current study was to evaluate whether
(18)F-FDG and (18)F-FLT can be used complementarily in monitoring the biologic
characteristics of colorectal cancer (CRC). METHODS: Human CRC cell lines
SW480 and SW620 of the same genetic origin but different metastatic potential were
cultured and implanted into nude mice to create CRC models. Uptake of (18)F-FDG
and (18)F-FLT in SW480 and SW620 cells in vitro was assessed after incubation with
radiotracers for 0, 30, 60, 90, and 120 min. In vivo imaging of SW480 and SW620
tumor-bearing mice was performed using small-animal PET/CT at 60 min after
injection of each tracer. A region of interest was drawn over tumor and background to
calculate the tumor-to-nontumor ratio (T/NT) using software on reconstructed images.
Tumor growth rate, metastatic status, and survival time were assessed in
tumor-bearing mice. The relationship between uptake of the tracers, metastatic
capability, and tumor marker expression was evaluated using linear regression.
RESULTS: SW480 tumors grew more quickly than SW620 tumors (t = 3.332, P =
0.004). A higher incidence of lung and liver metastases was noted for SW480 than for
SW620 (P = 0.023). Uptake in SW480 and SW620 cells was significantly different
between (18)F-FDG and (18)F-FLT (t = 2.507, P = 0.021, vs. t = 3.497, P = 0.002). In
the small-animal PET study, the T/NT of (18)F-FDG did not differ between SW480
and SW620 tumors (2.69 +/- 0.98 vs. 3.09 +/- 1.26, P = 0.524), but the T/NT of
(18)F-FLT differed significantly between SW480 and SW620 tumors (3.65 +/- 0.51
vs. 2.22 +/- 0.42, P < 0.001). Heat shock protein 27 (HSP27) expression and integrin
beta(3) expression were higher, whereas vascular endothelial growth factor receptor 2
(VEGFR2) expression and Ki67 expression were lower, in SW480 cells than in
SW620 cells. For SW480, metastases in lung and liver correlated significantly with
(18)F-FLT uptake in tumors (r = 0.763, P = 0.005) and with expression of HSP27 (r =
0.894, P = 0.008) and integrin beta(3) (r = 0.635, P = 0.088). A correlation was also
found between (18)F-FLT uptake and expression of HSP27 (r = 0.924, P = 0.004) and
integrin beta(3) (r = 0.813, P = 0.025). No correlation was found between (18)F-FDG
uptake in tumors and metastasis in lung and liver (r = -0.111, P = 0.388). However,
there was a significantly negative correlation between (18)F-FDG uptake and the
survival time of tumor-bearing mice (r = -0.500, P = 0.017), to which (18)F-FLT did
not relate (r = 0.262, P = 0.182). CONCLUSION: High uptake of (18)F-FDG and
(18)F-FLT may reflect poorer survival and a higher metastatic potential for CRC in
mice. Combining (18)F-FDG with (18)F-FLT PET would be helpful in better
predicting the biologic behavior of CRC.

4、J Nucl Med. 2009 Jun 12. [Epub ahead of print]
Molecular Imaging of EGFR: It's Time to Go Beyond Receptor Expression.
Ningbo L, Jinming Y, Xue M, Jian S.
Shandong Tumor Hospital, Jinan, China.

5、J Nucl Med. 2009 Apr;50(4):506-12. Epub 2009 Mar 16.
The Role of 18F-FDG PET/CT in the evaluation of Ascites of Undetermined Origin.
Zhang M, Jiang X, Zhang M, Xu H, Zhai G, Li B.
Department of Nuclear Medicine, Ruijin Hospital, Shanghai Jiaotong University
School of Medicine, Shanghai, China.

   The first aim of our study was to compare the role of (18)F-FDG PET/CT with that
of CT alone in detecting the primary cause of ascites. A secondary aim was to
compare the value of (18)F-FDG PET/CT with that of CT alone in detecting
abdominal        cavity       metastasis.      Finally,      we        analyzed      the
receiver-operating-characteristic (ROC) curves of maximal standardized uptake
values (SUVmax), serum carcinoembryonic antigen, CA19-9, and CA12-5 for
differential diagnostic abilities. METHODS: The (18)F-FDG PET/CT scans of 40
patients with ascites of undetermined origin, including 30 patients with malignant
diseases and 10 with benign lesions, were reviewed for the presence of ascites.
Among the 40 patients, 34 had received their diagnosis by pathologic examination
and 6 by clinical follow-up. We also assessed the (18)F-FDG PET/CT scans of 20
healthy volunteers for comparison. All (18)F-FDG PET/CT images were visually
interpreted, and the SUVmax was measured. We compared the mean diameter of
true-positive lesions with that of false-negative lesions. The diagnostic abilities of
SUVmax, serum carcinoembryonic antigen, CA19-9, and CA12-5 were compared
using the ROC curve. RESULTS: The sensitivity, specificity, and accuracy of
PET/CT in detecting the primary cause of ascites were 63.3% (19/30), 70.0% (7/10),
and 65.0% (26/40), respectively, and those of CT alone were 36.7% (11/30), 80%
(8/10), and 47.5% (19/40), respectively (sensitivity, P < 0.05). The sensitivity of
PET/CT was higher than that of CT alone for detecting abdominal cavity metastasis
(86.4% vs. 27.3%, P < 0.01). The SUVmax in patients with malignant primary and
metastatic lesions was significantly higher than that in healthy volunteers and in
patients with benign ascites (P < 0.05). The mean maximal diameter of false-negative
lesions was significantly smaller than that of true-positive lesions (P < 0.05). In ROC
analysis, the areas under the curve of SUVmax, serum carcinoembryonic antigen,
CA19-9, and CA12-5 were 0.803 (P < 0.01), 0.773 (P < 0.05), 0.552 (P > 0.05), and
0.220 (P < 0.01), respectively. CONCLUSION: (18)F-FDG PET/CT assisted in
detecting the original cause of ascites. The differential diagnostic ability of
(18)F-FDG PET/CT was superior to that of CT alone, tumor markers, and cytology.
More attention should be paid to peritoneal tuberculosis, which can markedly
accumulate (18)F-FDG and mimic peritoneal carcinoma.



6、J Nucl Med. 2009 Mar;50(3):397-400. Epub 2009 Feb 17.
99mTc-HYNIC-TOC scintigraphy is superior to 131I-MIBG imaging in the
evaluation of extraadrenal pheochromocytoma.
Chen L, Li F, Zhuang H, Jing H, Du Y, Zeng Z.
Department of Nuclear Medicine, Peking Union Medical College Hospital, Chinese
Academy of Medical Sciences, Beijing, China.

   In this investigation, the efficacy of scintigraphy using (99m)Tc-labeled
hydrazinonicotinyl-Tyr3-octreotide (HYNIC-TOC) in the evaluation of extraadrenal
pheochromocytoma         was assessed and compared with (131)I-labeled
metaiodobenzylguanidine (MIBG) imaging. METHODS: Ninety-seven patients who
were suspected of having pheochromocytoma but showed no definite adrenal
abnormalities on CT were evaluated by both (99m)Tc-HYNIC-TOC scintigraphy and
(131)I-MIBG imaging. The results were compared with pathology findings or clinical
follow-up. RESULTS: Of 58 patients proven to be without pheochromocytoma,
(99m)Tc-HYNIC-TOC and (131)I-MIBG imaging excluded 56 and 58 patients,
respectively, rendering a specificity of 96.6% for (99m)Tc-HYNIC-TOC imaging and
100% for (131)I-MIBG imaging. In the evaluation of adrenal pheochromocytoma (14
patients), the sensitivity of (99m)Tc-HYNIC-TOC scintigraphy and (131)I-MIBG
imaging was 50% and 85.7%, respectively. However, in the evaluation of
extraadrenal     pheochromocytomas         (25    patients), the  sensitivity   of
(99m)Tc-HYNIC-TOC scintigraphy and (131)I-MIBG imaging was 96.0% and 72.0%,
respectively. CONCLUSION: (99m)Tc-HYNIC-TOC scintigraphy is more sensitive
than (131)I-MIBG imaging in the detection of extraadrenal pheochromocytomas.

7、J Nucl Med. 2009 Feb;50(2):303-8. Epub 2009 Jan 21.
PET-based biodistribution and radiation dosimetry of epidermal growth factor
receptor-selective tracer 11C-PD153035 in humans.
Liu N, Li M, Li X, Meng X, Yang G, Zhao S, Yang Y, Ma L, Fu Z, Yu J.
Department of Radiation Oncology, Tianjin Medical University Cancer Institute and
Hospital, Tianjin, China.

  Comment in: J Nucl Med. 2009 Jul;50(7):1195-6; author reply 1196, 1197.
The present study estimated the biodistribution and radiation-absorbed dose of
epidermal growth factor receptor (EGFR) radioligand 11C-PD153035 in whole-body
PET examinations of healthy volunteers. METHODS: Two-dimensional whole-body
PET was performed on 9 subjects after injection of 11C-PD153035 at 329.3+/-77.8
MBq (mean+/-SD). A total of 12 frames were acquired for approximately 90 min in 7
segments of the body. Regions of interest were drawn on PET images of source
organs. Residence time was calculated as the area under the time-activity curve.
Radiation dosimetry was calculated from organ residence time by use of MIRDOSE3
software. RESULTS: The renal and hepatobiliary systems played important roles in
11C-PD153035 excretion from the body, accounting for the excretion of
approximately 23% and 19% of the injected radioactivity, respectively. Blood-pool
activity was only moderate and declined over time. Tracer accumulation in the lungs,
bone marrow, and muscles was slight, resulting in low background activity in the
chest. The organs with the highest radiation-absorbed doses were the urinary bladder
and the gallbladder; the effective doses were 6.08E-02+/-1.85E-02 and
2.40E-02+/-8.01E-03 mGy/MBq, respectively. The effective dose equivalent was
7.43E-03+/-1.10E-03 mSv/MBq, and the dose-limiting organ was the urinary bladder.
CONCLUSION: On the basis of the estimated absorbed dose, 11C-PD153035
displayed a favorable radiation dose profile in humans and therefore could be used in
multiple PET examinations of the same subject per year. 11C-PD153035 is a
promising ligand for the investigation of EGFR in humans, especially in chest tumors
such as non-small cell lung cancer.
Eur J Nucl Med Mol Imaging
Eur J Nucl Med Mol Imaging. 2009 Oct;36(10):1611-21. Epub 2009 Apr 18.
Evaluation of left ventricular volumes and ejection fraction by gated SPECT and
cardiac MRI in patients with dilated cardiomyopathy.
Wang F, Zhang J, Fang W, Zhao SH, Lu MJ, He ZX.
Department of Nuclear Medicine, Cardiovascular Institute and Fu Wai Hospital,
Chinese Academy of Medical Sciences & Peking Union Medical College, 167, Bei Li
Shi Lu, 100037, Beijing, People's Republic of China.

   PURPOSE: The goal of this study was to evaluate the accuracy of gated single
photon emission computed tomography (SPECT) in the assessment of left ventricular
(LV) end-diastolic/end-systolic volumes (EDV, ESV) and ejection fraction (LVEF) in
patients with dilated cardiomyopathy, using cardiac magnetic resonance imaging
(MRI) as the reference method. Furthermore, software-specific characteristics of
Quantitative Gated SPECT (QGS), Emory Cardiac Toolbox (ECTB) and
4D-MSPECT were analysed. METHODS: Thirty-six patients with dilated
cardiomyopathy who underwent gated (99m)Tc-methoxyisobutylisonitrile SPECT
and cardiac MRI were included. LV EDV, ESV and LVEF values of gated SPECT
were calculated using QGS, ECTB and 4D-MSPECT. RESULTS: The correlation
between the results of gated SPECT and cardiac MRI was excellent for EDV [R =
0.872 (QGS), R = 0.879 (ECTB), R = 0.869 (4D-MSPECT)], ESV [R = 0.908 (QGS),
R = 0.897 (ECTB), R = 0.880 (4D-MSPECT)] and LVEF [R = 0.794 (QGS), R =
0.763 (ECTB), R = 0.710 (4D-MSPECT)]. EDV and ESV assessed by QGS did not
differ significantly from those assessed by cardiac MRI (all p = NS), whereas EDV
and ESV were overestimated by ECTB and 4D-MSPECT compared with cardiac MRI
(all p < 0.05). LVEF was overestimated by QGS, ECTB and 4D-MSPECT compared
with cardiac MRI (all p < 0.05). CONCLUSIONS: The correlation between gated
SPECT and cardiac MRI is excellent for LV volume and LVEF values calculated by
QGS, ECTB and 4D-MSPECT in patients with dilated cardiomyopathy. However,
algorithm-varying over- or underestimation of LV volumes and LVEF should be
accounted for in the clinical context.
Clinical Nuclear Medicine
1、Clin Nucl Med. 2010 Jan;35(1):53-4.
Interesting image. Two primary colon cancers shown on FDG PET/CT performed to
evaluate possible lung metastases from bladder cancer.
Cui R, Li F, Zhuang H.
Department of Nuclear Medicine, Peking Union Medical College Hospital, Peking
Union Medical College, Chinese Academy of Medical Sciences, Beijing, People's
Republic of China.

2、Clin Nucl Med. 2009 Oct;34(10):684-5.
Lung cancer with solitary bone metastasis in the radius.
Chun-Yi L, Yiing-Feng H, Hua-Tzu H, Chang-Sheng L.
Departments of Nuclear Medicine, Show Chwan Memorial Hospital, Changhua,
Taiwan, Republic of China.

  We present a 73-year-old man with a new diagnosis of right upper lung
adenocarcinoma. Right elbow x-ray and Tc-99m MDP whole body bone scan were
performed due to a reddish, swollen, and painful right forearm for 1 week. X-ray,
performed on March 25, 2008, showed an osteolytic lesion in the proximal right
radius with surrounding soft tissue swelling. Tc-99m whole body bone scan,
performed on March 19, 2008, had shown a single area of intense tracer uptake in the
proximal right radius and no other bony lesion was identified. Infectious processes
were considered initially, but the clinical symptoms and signs didn't improve after
antibiotic treatment for 10 days. Incisional biopsy of the proximal right forearm was
performed for diagnosis. Histopathologic examination confirmed a bone metastasis in
the proximal right radius.

3、Clin Nucl Med. 2009 Nov;34(11):836-7.
Coexistant iodine-negative pleural metastasis with iodine-positive lung and bone
metastases in a patient with differentiated thyroid cancer.
Qiu ZL, Luo QY.
Department of Nuclear Medicine, Shanghai Sixth People's Hospital, Shanghai Jiao
Tong University, Shanghai, People's Republic of China.

4、Clin Nucl Med. 2009 Nov;34(11):811-4.
Fulminant postirradiation soft tissue sarcoma.
Hsieh TC, Kao CH, Wu YC, Hsu CN, Wang CH, Lin YY, Yen KY, Sun SS.
Department of Nuclear Medicine and PET Center, China Medical University,
Taichung, Taiwan.

5、Clin Nucl Med. 2009 Nov;34(11):806-7.
Bone scintigraphic images of a patient with unusual metastatic alveolar soft-part
sarcoma.
Lin YY, Hsieh TC, Kao CH, Wang CH, Wu YC, Yen KY, Sun SS.
Department of Nuclear Medicine and PET Center, China Medical University Hospital,
Taichung, Taiwan.

6、Clin Nucl Med. 2009 Sep;34(9):615-9.
Thyrotoxicosis due to functioning metastatic follicular thyroid carcinoma after twelve
I-131 therapies.
Tan J, Zhang G, Xu W, Meng Z, Dong F, Zhang F, Jia Q, Liu X.
Department of Nuclear Medicine, Tianjin Medical University General Hospital,
Tianjin, People's Republic of China.

  We present a case of functioning metastatic follicular thyroid carcinoma (FTC)
causing severe thyrotoxicosis despite four years 12 iodine-131 therapies (1.461 Ci
cumulatively). Initially, the patient had ostalgia and fracture in the right femur.
Surgery-confirmed metastatic bone FTC and thyroidectomy-confirmed FTC. One
month later, iodine-131 treatment commenced. During the follow-up, different
metastatic sites showed different outcomes. Lung metastases disappeared, a thigh
metastasis persisted, a new metastasis in the head occurred and pelvic metastases
deteriorated into a huge mass elevating thyroglobulin and causing thyrotoxicosis
within 3 months. Presurgical PET/CT also demonstrated the massiveness of the pelvic
metastases. Thyrotoxicosis disappeared after surgical removal of the pelvic lesion.

7、Clin Nucl Med. 2009 Sep;34(9):594-5.
Non-Hodgkin's lymphoma of supraclavicular lymph nodes can mimic metastasis of
breast cancer during chemotherapy on FDG PET/CT.
Hua F, Feng X, Guan Y, Zhao J, Huang Z.
Department of Nuclear Medicine, Division of PET Center, Huashan Hospital, Fudan
University, Shanghai, People's Republic of China. huahuafc@yahoo.com.cn

   A 43-year-old woman who had a history of right mastectomy for breast cancer
presented with fever and swelling in the right supraclavicular region during her
second course of chemotherapy. An FDG PET/CT was performed to evaluate this
patient, which revealed mildly increased FDG activity in the lymph node in the
supraclavicular region. A metastatic lesion from the known breast cancer was
considered. However, biopsy results demonstrated that the abnormal activity in the
right supraclavicular region is due to T-cell lymphoma.

8、Clin Nucl Med. 2009 Aug;34(8):528-9.
Primary hepatic tuberculoma appears similar to hepatic malignancy on F-18 FDG
PET/CT.
Wang YT, Lu F, Zhu F, Qian ZB, Xu YP, Meng T.
Department of Nuclear Medicine, Xuzhou Central Hospital, People's Republic of
China. yuetao-w@163.com

9、Clin Nucl Med. 2009 Aug;34(8):515-7.
Tl-201 SPECT in clarifying false positive FDG PET findings caused by
osteoradionecrosis in a case of nasopharyngeal carcinoma.
Wang CH, Liang JA, Yen KY, Hsieh TC, Sun SS, Wu YC, Lin YY, Kao CH.
Department of Nuclear Medicine, PET Center, China Medical University Hospital,
Taiwan.

10、Clin Nucl Med. 2009 Jul;34(7):479-82.
Tc-99m pertechnetate/sestamibi imaging in a case of recurrent parathyroid carcinoma
with metabolic bone disorder.
Meng Z, Tan J, Zhang M, Dong F, Jia Q, Zhang F.
Department of Nuclear Medicine, Tianjin Medical University General Hospital,
Heping District, Tianjin, People's Republic of China. james_mencius@hotmail.com

11、Clin Nucl Med. 2009 Jul;34(7):441-2.
Simultaneously significant hepatic and mild splenic uptake of Tc-99m MDP resulting
from Waldenstrom macroglobulinemia.
Yang JG, Yin CH, Li CL, Zou LF.
Nuclear Medicine Department, Beijing Friendship Hospital, Capital Medical
University, Beijing, People's Republic of China. nmyangjigang@yahoo.com.cn

12、Clin Nucl Med. 2009 Jul;34(7):424-7.
Comparison of lung scintigraphy with multi-slice spiral computed tomography in the
diagnosis of pulmonary embolism.
Wang F, Fang W, Lv B, Lu JG, Xiong CM, Ni XH, He ZX.
Department of Nuclear Medicine, Cardiovascular Institute and Fu Wai Hospital,
Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing,
People's Republic of China.

   Erratum in: Clin Nucl Med. 2009 Nov;34(11):814.
PURPOSE: To compare the diagnostic efficacy of lung perfusion scans combined
with ventilation (V/Q) scans and/or chest radiography (CR) with contrast-enhanced
multislice spiral CT pulmonary angiography (CTPA) in diagnosing pulmonary
embolism (PE). MATERIALS AND METHODS: Eighty-two consecutive patients
with suspected PE underwent CTPA, lung perfusion scan, and CR. Of them, 28
patients underwent V/Q scans. The final diagnosis was made using a composite
reference test. RESULTS: The overall sensitivity and specificity were 89.2% and
92.1% for V/Q scan or perfusion scan combined with CR, and 97.3% and 97.4% for
CTPA. For the 28 patients with V/Q scan, the sensitivity and specificity were 91.7%
and 92.9% for V/Q scan, and 91.7% and 100.0% for CTPA. The segmental agreement
rate between perfusion scan and CTPA was 69.5% (kappa = 0.30, P < 0.05). The
perfusion scan revealed significantly more subsegmental abnormalities than CTPA
(59 vs. 10, chi2 test, P < 0.05). CONCLUSIONS: V/Q scan, perfusion scan combined
with CR and CTPA all show high efficacy in diagnosing PE. V/Q scan or perfusion
scan combined with CR is as accurate as CTPA.

13、Clin Nucl Med. 2009 Jun;34(6):362-4.
Focal pericarditis in a huge heart demonstrated by positron emission
tomography/computed tomography.
Yiu KH, Leung YL, Siu CW, Jim MH, Chow WH, Tse HF.
Division of Cardiology, Department of Medicine, Queen Mary Hospital, The
University of Hong Kong, Hong Kong, China. khkyiu@hotmail.com

14、Clin Nucl Med. 2009 Jun;34(6):346-9.
Bone scan flare phenomenon in non-small-cell lung cancer patients treated with
gefitinib.
Chao HS, Chang CP, Chiu CH, Chu LS, Chen YM, Tsai CM.
Zhongxing Branch, Taipei City Hospital, and Department of Medicine, School of
Medicine, National Yang-Ming University, Taipei, Taiwan, Republic of China.
   PURPOSE: The bone scan flare phenomenon has been evaluated in various cancers
in the presence of positive response to therapy. The aim of this study was to determine
whether flare phenomenon occurs in non-small-cell lung cancer patients, especially
adenocarcinoma in East-Asians, who respond dramatically and promptly to gefitinib.
METHODS: We retrospectively evaluated the radiographic and scintigraphic images
of 125 lung cancer patients who had previous gefitinib treatment between July 2003
and October 2005. Those patients who had the first post-treatment scan done within 3
months and the second scan performed after 3 months after starting the therapy were
included. New lesions or increased intensity observed on the first follow-up bone scan
with improvement on the second one during gefitinib treatment was defined as
positive for flare phenomenon. The results were correlated with clinical disease status.
RESULTS: Thirty-three non-small-cell lung cancer patients were included. Seven
(21.2%) of them showed bone scan flare phenomenon. Of these seven, 5 had
adenocarcinoma and 2 had unclassified non-small-cell lung cancer. Partial response
was achieved after treatment in all these cases, and flare phenomena were detected
between 29 and 77 days (median: 34 days) after treatment. CONCLUSION: The
findings show that the flare is common during the first 3 months of gefitinib initiation;
hence, a repeat bone scan should be reserved for later in the treatment course.

15、Clin Nucl Med. 2009 Mar;34(3):189-90.
Tc-99m MDP uptake in retroperitoneal fibrosis.
Zhang W, Zhang Y.
Department of Nuclear Medicine, The Third Hospital of Peking University, Beijing,
People's Republic of China. tsy1997@126.com

   A 60-year-old man with a history of surgical resection of leiomyosarcoma of the
right kidney had a bone scan to evaluate possible metastatic osseous disease. The
bone scan showed significantly increased Tc-99m MDP activity in the right abdomen,
corresponding to a heterogeneous mass in the right retroperitoneal region on the
subsequent abdominal CT scan. These findings were initially interpreted as recurrent
malignancy. However, the surgical pathology examination demonstrated that the
lesion was retroperitoneal fibrosis, which was not previously known to have increased
MDP uptake.

16、Clin Nucl Med. 2009 Mar;34(3):137-40.
Erector spinae metastases from differentiated thyroid cancer identified by I-131
SPECT/CT.
Qiu ZL, Luo QY.
Department of Nuclear Medicine, Shanghai Sixth People's Hospital, Shanghai Jiao
Tong University, Shanghai, People's Republic of China.

   Metastatic lesions from differentiated thyroid cancer (DTC) are usually seen in the
cervical lymph nodes, lungs, or bones. Skeletal muscle, especially erector spinae
metastasis from DTC, is extremely rare. In this report, 2 cases of DTC metastasizing
to the erector spinae incidentally found by I-131 whole-body scanning and low-dose
I-131 SPECT/CT scan are described. One is a PTC and the other is the follicular
variant of PTC. I-131 whole-body scan is indispensable for the management of
patients with DTC. However, precise localization of the foci of I-131 uptake is
formidable because of the lack of anatomic landmarks. Low-dose integrated
SPECT/CT allows for better location and definition of I-131 whole-body scan
findings for residual or metastases in DTC. Metastases to skeletal muscle in DTC may
be incidental findings and are more common on I-131 whole-body scans combined
with SPECT/CT scans.

17、Clin Nucl Med. 2009 Feb;34(2):109-10.
Right subdiaphragmatic crescent photopenia: atypical presentation of Chilaiditi sign
on FDG PET.
Hsieh TC, Kao CH, Wang CH, Wu YC, Yen KY, Lin YY, Sun SS.
Department of Nuclear Medicine and PET Center, China Medical University Hospital,
Taichung, Taiwan.

18、Clin Nucl Med. 2009 Feb;34(2):105-6.
Detection of double cystic intestinal duplication by Meckel's scan.
Yang JG, Ma DQ, Hao RR, Li CL, Zou LF.
Nuclear Medicine Department, Beijing Friendship Hospital Affiliated to Capital
Medical University, Beijing, People's Republic of China.

19、Clin Nucl Med. 2009 Feb;34(2):65-9.
Twenty-four-hour thallium-201 imaging enhances the detection of myocardial
ischemia and viability after myocardial infarction: a comparison study with
echocardiography follow-up.
He YM, Yang XJ, Wu YW, Zhang B.
Department of Cardiology, First Affiliated Hospital of Soochow University, Jiangsu
Province, People's Republic of China. heyongming@jsmail.com.cn

   BACKGROUND: To explore the value of 24 hour late Tl-201 imaging for
detection of myocardial ischemia/viability after myocardial infarction. MATERIALS
AND METHODS: Thirty-eighty patients with myocardial infarction underwent
immediate, 3 hour redistribution and 24-hour late imaging after intravenous injection
of 5 mCi Tl-201. Image quality analysis was performed using a 4-grade model. The
immediate/redistribution, redistribution/late, and immediate/late Tl-201 images were
analyzed double-blinded. The capability of detection of myocardial ischemia/viability
was compared between the 3 hour redistribution and the 24-hour late imaging.
Thirty-two patients underwent coronary angiography and successful revascularization
of stenotic coronary arteries. The relationship between the severity of coronary artery
stenosis and the time to completed redistribution of myocardial perfusion defects after
resting injection of Tl-201 was investigated. The sensitivity, specificity, and accuracy
for predicting an improvement in function post revascularization were compared
between the 24-hour late imaging and the 3-hour redistribution imaging by way of a
follow-up echocardiography. RESULTS: Three hour redistribution and 24-hour late
imaging showed no significant differences in image quality according to the 4-grade
model (P = 0.3580). Of 194 abnormal segments based on immediate Tl-201 imaging,
redistribution imaging showed 60 reversible segments, taking up 31% (60/94), and
late imaging showed 86 reversible segments, taking up 44% (86/194), with a
significant difference (P = 0.0064). Of 128 severely abnormal segments, redistribution
imaging showed 32 reversible segments, taking up 25% (32/128), and late imaging
showed 48 reversible segments, taking up 38% (48/128), with a significant difference
(P = 0.0310). Of 66 mildly abnormal segments, redistribution imaging showed 28
reversible segments, taking up 42% (28/66), and late imaging showed 38 reversible
segments, taking up 58% (38/66), with no significant difference. Twenty-four hour
late imaging showed an additional 30 reversible segments, taking up 22% (30/134)
among 134 abnormal segments based on the immediate Tl-201 imaging, which did
not improve on 3-hour redistribution imaging. The coronary arteries supplying the
reversible segments detected by the 24-hour late imaging were more severe in
diameter stenosis than those supplying the reversible segments detected by the 3-hour
redistribution imaging. The sensitivity, specificity, and accuracy for predicting the
functional improvement after the revascularization were 93% and 83%, 80% and 78%,
86% and 78%, respectively, by the 24-hour late imaging and the 3-hour redistribution
imaging correspondingly, with the former being superior to the latter on the basis of
the evaluation results of 9.90 +/- 3.62 months of follow-up echocardiography (chi =
10.8655, P = 0.0010). CONCLUSION: Twenty-four hour late Tl-201 imaging, with
satisfactory image quality, enhances the detection of myocardial ischemia/viability
after myocardial infarction.

20、Clin Nucl Med. 2009 Apr;34(4):245-6.
Findings of subdural hematoma on Tc-99m-TRODAT-1 SPECT.
Hsieh TC, Kao CH, Wu YC, Wang CH, Yen KY, Sun SS.
Department of Nuclear Medicine and PET Center, China Medical University Hospital,
Taichung, Taiwan.
   Chronic subdural hematoma (SDH) is difficult to diagnose by clinical
manifestations only. Nonspecific neurologic symptoms and signs may lead physicians
to make other diagnoses. Although head trauma is the most common cause, it may be
considered insignificant or omitted due to its minor initial manifestations. We present
a patient with an incidental finding of SDH on Tc-99m-TRODAT-1 SPECT that was
originally done for evaluation of his Parkinsonism. This reminds us to be vigilant
about other possible coincidental findings on routine examinations.

21、Clin Nucl Med. 2009 Apr;34(4):241-2.
Elevated FDG uptake in right middle segmental bronchus impacted with foreign
body.
Xing Y, Zhao J, Chen X, Song J.
Department of Nuclear Medicine, Shanghai First People's Hospital, Shanghai Jiaotong
University, Shanghai, People's Republic of China.

   A 62-year-old man with recurrent episodes of coughing underwent a whole-body
FDG PET/CT scan to evaluate possible lung malignancy. The PET images showed
increased FDG uptake in the right side of the bronchus corresponding to a foreign
body on the concurrent CT images. The foreign body was subsequently removed
through bronchofiberscopy and was proven to be a fishbone.

22、Clin Nucl Med. 2009 Apr;34(4):236-8.
Lung sequestration and Pott disease masquerading as primary lung cancer with bone
metastases on FDG PET/CT.
Su M, Fan Q, Fan C, Tian Y, Li F, Yang X, Zhuang H.
Department of Nuclear Medicine, West China Hospital, Sichuan University, Chengdu,
People's Republic of China.

   The chest x-ray from a 37-year-old man with a history of back pain showed a mass
in the left lower lung, which prompted an FDG PET/CT study to evaluate the nature
of the mass and possible metastases. The images revealed peripherally increased FDG
activity in the left lower lung mass. In addition, there was intense FDG activity in 2
adjacent thoracic vertebrae on PET images corresponding to the regions of bone
destruction on the concurrent CT. Therefore, a possible diagnosis of lung carcinoma
with bone metastases was suggested. However, subsequent tests demonstrated that the
left lung mass was in fact a lung sequestration, whereas the spinal lesions were due to
Pott disease (tuberculous spondylitis).


23、Clin Nucl Med. 2009 Jan;34(1):4-6.
The role of radioactive iodine therapy in young patients with papillary thyroid cancer.
Kuo SF, Chao TC, Chang HY, Hsueh C, Chang YC, Yang CH, Lin JD.
Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang
Gung Memorial Hospital, Chang Gung University, Taiwan, Republic of China.

   PURPOSE: The aim of this study was to investigate the outcome of postoperative
radioactive iodine (I-131) therapy in young patients with papillary thyroid carcinoma
(PTC). MATERIALS AND METHODS: This retrospective study reviewed the
medical records of primary PTC patients, 18 years old or younger, who were treated
at Chang Gung Medical Center in Taiwan from January 1977 to December 2006.
Forty-eight patients who had undergone postoperative I-131 therapy with a minimum
dose of 1.1 GBq (30 mCi) were enrolled in this retrospective study. At the end of
follow-up, patients were classified as "local disease" or "distant metastases" according
to I-131 scan results. RESULTS: The I-131 whole-body scan results revealed "local
disease" in 34 patients, and "distant metastases" in 14 patients. Patients with distant
metastases received significantly larger doses of I-131 than those with local disease (P
= 0.0086). One-month postoperative serum thyroglobulin differed markedly between
patients with local disease and those with distant metastases (P = 0.001). After a mean
follow-up period of 11.2 +/- 5.7 years, overall survival in the 48 patients was 97.9%.
CONCLUSIONS: I-131 therapy is effective for young PTC patients, and should be
given to all young PTC patients postoperatively in addition to thyroid hormone
administration, particularly those with distant metastases.

24、Clin Nucl Med. 2008 Dec;33(12):929-30.
Advanced squamous cell carcinoma of the bulbar conjunctiva seen on PET/CT.
Lin LF, Chang CY, Cherng SC.
Department of Nuclear Medicine, Tri-Service General Hospital, National Defense
Medical Center, Taipei, Taiwan, Republic of China.

   A 78-year-old female with a previous history of endometrial lymphoma was
referred to our hospital for F-18 fluorodeoxyglucose (FDG) positron emission
tomography (PET)/computed tomography (CT) imaging on account of a growing
tumor mass in the left eyeball with gradual visual loss for 5 months. The F-18 FDG
PET/CT images showed a focal lesion with intense FDG uptake in the left bulbar
conjunctiva with intraocular invasion. Excisional biopsy was performed under the
impression of a malignant neoplasm, and the pathologic diagnosis confirmed
squamous cell carcinoma.

25、Clin Nucl Med. 2008 Dec;33(12):920-1.
Tumoral calcinosis demonstrated on Tc-99m sestamibi scintigraphy.
Chang CY, Cheng CY, Shen DH, Bai CY, Lin LF, Huang WS.
Department of Nuclear Medicine, Tri-Service General Hospital, School of Medicine,
National Defense Medical Center, Taipei, Taiwan, Republic of China.

   A 61-year-old uremic male under hemodialysis underwent Tc-99m sestamibi
scintigraphy due to suspicious secondary hyperparathyroidism. The images showed
increased uptake in the right forearm, left shoulder, right knee and, to a lesser extent,
in the left hip and the right thigh. Subsequent Tc-99m MDP bone scintigraphy and
x-ray studies revealed intense extraosseous uptake and calcified masses in areas
corresponding to those found in Tc-99m sestamibi scintigraphy, suggesting tumoral
calcinoses. We demonstrate the rare case in which Tc-99m sestamibi was taken up by
tumoral calcinoses.
Molecular Imaging and Biology
1、Mol Imaging Biol. 2009 Dec 3. [Epub ahead of print]
MR Reporter Gene Imaging of Endostatin Expression and Therapy.
Wang K, Wang K, Shen B, Huang T, Sun X, Li W, Jin G, Li L, Bu L, Li R, Wang D,
Chen X.
Department of Medical Imaging and Nuclear Medicine, the 4th Affiliated Hospital,
Harbin Medical University, Harbin, 150001, China.

   PURPOSE: The aim of this study is to monitor endostatin gene expression and
therapy using transferrin receptor (TfR) as reporter gene and transferrin conjugate of
ultrasmall supramagnetic iron oxide nanoparticle (Tf-USPIO) as magnetic resonance
(MR) reporter probe. PROCEDURE: A retroviral plasmid (pLP-LNCX) encoding
mouse endostatin and TfR was constructed, and packaged with a titer of 4 x
10(7)colony-forming units per millimeter. MDA-MB-231 breast tumors were
established in BALB/c mice by subcutaneous injection of 2 x 10(6) MDA-MB-231
cells. Mice were intratumorally injected with recombinant retrovirus and imaged with
MR using Tf-USPIO. Western blot, Prussian blue, and immunohistochemical staining
were performed to validate the magnetic resonance imaging results. The antitumor
effect of retro-endostatin (ES)-TfR was also evaluated by intratumoral injection of the
viral vector. RESULTS: The expression of both endostatin and TfR genes in
MDA-MB-231 cells after retroviral transfection was confirmed by Western blot and
flow cytometry. Tf-USPIO conjugate binds specifically to cells stably transfected
with retro-ES-TfR. After intravenous injection of the Tf-USPIO conjugate, there was
a more pronounced decrease in T2 relaxation time in tumors treated with
retro-ES-TfR than in tumors treated with empty retrovirus retro-LNCX. The
expression of ES gene significantly delayed the growth of MDA-MB-231 tumor and
reduction of microvessel density and VEGF level as compared to those without viral
transfection or transfected with empty retro-LNCX vector. CONCLUSIONS:
Endostatin therapeutic gene expression was visualized successfully using TfR reporter
gene and Tf-USPIO MR reporter probe, which indicates that MR reporter gene
imaging may be valuable in gene therapy to evaluate therapeutic gene expression and
treatment efficacy.

2、Mol Imaging Biol. 2009 Oct 6. [Epub ahead of print]
Detection of Experimentally Induced Pulmonary Granuloma Inflammation in
Monocyte Chemoattractant Protein-1 Reporter Mice.
Rajasekaran S, Kao VY, Chen MR, Yang AL, Hsu CH, Chen CT, Lin KM.
Division of Medical Engineering Research, National Health Research Institutes,
Zhunan Town, Miaoli County, Taiwan, Republic of China.

   PURPOSE: Among different chemokines, monocyte chemoattractant protein-1
(MCP-1) plays an important role in inflammatory disorders of lung. In response to
stimuli, MCP-1 increases its transcription as an immediate early gene. In this paper,
we describe the MCP-1-enhanced green fluorescent protein(EGFP) transgenic mouse
in which EGFP expression is driven by human MCP-1 promoter and mimics the
MCP-1 expression in situ. Thus, the MCP-1 reporter mouse model is designed to
facilitate a better understanding of its role in various diseases. We employed this
mouse model in a pulmonary granulomatous inflammation model using intratracheal
instillation of Sephadex (SDX) beads and compared the EGFP reporter expression to
endogenous MCP-1 expression through the course of inflammation. PROCEDURES:
We analyzed the temporal pattern of SDX-induced infiltration of inflammatory cells
in lung and in bronchoalveolar lavage fluid (BALF). The changes in tissue
fluorescence, gene, and protein expressions for both MCP-1 and EGFP were analyzed.
RESULTS: SDX instillation caused massive infiltration of inflammatory cells in
BALF and lung tissue at the end of day 3. There was an increase of fluorescence in
SDX-treated lung and BALF cells. By using lipopolysaccharide-induced systemic
inflammation model, increase of fluorescence was found in bone marrow Gr-1(+)
cells with high Mac-1 expression. MCP-1 and EGFP gene expression and MCP-1
protein level were increased after day 1, peaked at day 3, and declined toward basal
levels at day 5. In contrast, EGFP protein level peaked after day 3 and remained
elevated after day 5. Immunohistochemical staining revealed the MCP-1 and EGFP
expression primarily at alveolar macrophages, macrophages infiltrating the
granulomatous lesions and in bronchiolar epithelial cells. CONCLUSIONS: By using
a pulmonary granuloma model, we showed that EGFP transgene reporter expression
in MCP-1-EGFP mouse was correlated to the endogenous MCP-1 induction. The
establishment of this mouse model will provide a valuable tool for monitoring the
activation of monocytes/macrophages and facilitate the studies on the roles of MCP-1
gene in various inflammatory diseases.

3、Mol Imaging Biol. 2010 Jan-Feb;12(1):9-14. Epub 2009 Jun 23.
Involvement of nigrostriatal pathway in Japanese encephalitis with movement
disorders: evidence from 99mTc-TRODAT-1 and 123I-IBZM SPECT imagings.
Liao CH, Ling Z, Chou CH, Huang WS, Denq JC, Lin JC, Chen CY, Chang CJ, Peng
GS.
Department of Neurology, Tri-Service General Hospital, National Defense Medical
Center, Cheng-Kung Rd Section 2, Taipei, 114, Taiwan, Republic of China.

    PURPOSE: The purpose of this study was to evaluate molecular evidence of
nigrostriatal pathway involvement in Japanese encephalitis (JE) survivors with
movement complications. METHODS: Three JE patients were recruited. All had
cranial magnetic resonance imaging (MRI) and single-photon emission computed
tomography (SPECT) studies with (99m)Tc-TRODAT-1 and (123)I-IBZM.
RESULTS: Cranial MRI revealed involvement of bilateral thalami, substantia nigra,
and medial temporal lobes in all three patients, but only case 1 had additional bilateral
basal ganglia involvement. The (99m)Tc-TRODAT-1 SPECT for presynaptic
dopamine transporter imaging disclosed asymmetrical decreases in bilateral striatal
uptake in all three patients. However, the (123)I-IBZM SPECT imaging for
postsynaptic D2 dopamine receptors (D2Rs) revealed inconsistent abnormalities
including asymmetrical bilateral decreases (case 1), unilateral decrease (case 2), and
bilateral increases (case 3) in striatal uptakes. CONCLUSION: Data have suggested
that presynaptic dopaminergic neurons in JE patients are more susceptible to JE virus
than postsynaptic striatal neurons. The degree of movement impairment was more
closely correlated to the degree of D2Rs disruption seen in (123)I-IBZM SPECT
imaging.

4、Mol Imaging Biol. 2010 Jan-Feb;12(1):63-70. Epub 2009 Jun 19.
Intravital Imaging of tumor apoptosis with FRET probes during tumor therapy.
Zhou F, Xing D, Wu S, Chen WR.
MOE Key Laboratory of Laser Life Science and Institute of Laser Life Science, South
China Normal University, Guangzhou, 510631, China.

   PURPOSE: The aim of the study is to dynamically and non-invasively monitor the
apoptosis events in vivo during photodynamic therapy (PDT) and chemotherapy.
PROCEDURES: A FRET probe, SCAT3, was utilized to determine activation of
caspase-3 during tumor cell apoptosis in mice, induced by PDT, and cisplatin
treatments. Using this method, dynamics of caspase-3 activation was observed both in
vitro and in vivo. RESULTS: Analysis of the fluorescent missions from tumor cells
indicated that the caspase-3 activation started immediately after PDT treatment. In
contrast, the caspase-3 activation started about 13 and 36 h after cisplatin treatment in
vitro and in vivo, respectively. CONCLUSIONS: FRET could be used effectively to
monitor activation of caspase-3 in living organism. This method could be used to
provide rapid assessment of apoptosis induced by anti-tumor therapies for
improvement of treatment efficacy.

5、Mol Imaging Biol. 2009 May-Jun;11(3):213-22. Epub 2009 Jan 9.
Dynamic monitoring of apoptosis in chemotherapies with multiple fluorescence
reporters.
Li Y, Xing D, Chen Q.
MOE Key Laboratory of Laser Life Science and Institute of Laser Life Science, South
China Normal University, Guangzhou, 510631, China.

   PURPOSE: The aim of the study is to dynamically and non-invasively monitor the
temporal relationship among caspase-3, BID, and cytochrome c in chemotherapy.
PROCEDURES: ASTC-a-1 cells expressing the corresponding fluorescence reporters
were treated with Taxol or cisplatin and imaged using FRET and fluorescence
overlapping technique. Western blot was performed to validate the fluorescence
analysis. RESULTS: In fluorescence imaging analysis, Taxol-induced apoptosis
showed caspase-3 activation (13 h 50 min) was prior to BID cleavage (15 h 10 min)
and subsequent significant cytochrome c release (17-18 h 20 min), whereas the
cisplatin-induced apoptosis showed BID cleavage (5 h 40 min) and significant
cytochrome c release (7-8 h 20 min) were prior to caspase-3 activation (14 h 20 min).
Western blot further validated the results above. CONCLUSIONS: The new approach
successfully reveals the difference in temporal signaling apoptosis events between
Taxol and cisplatin. It may help us come to a better understanding of the detailed
mechanisms in chemotherapeutic-agents-induced apoptosis.

6、Mol Imaging Biol. 2009 May-Jun;11(3):195-203. Epub 2008 Dec 2.
Toward quantitative small animal pinhole SPECT: assessment of quantitation
accuracy prior to image compensations.
Chen CL, Wang Y, Lee JJ, Tsui BM.
Department of Medical Imaging and Radiological Sciences, Chung Shan Medical
University, Taichung 402, Taiwan, Republic of China.

   PURPOSE: We assessed the quantitation accuracy of small animal pinhole single
photon emission computed tomography (SPECT) under the current preclinical
settings, where image compensations are not routinely applied. PROCEDURES: The
effects of several common image-degrading factors and imaging parameters on
quantitation accuracy were evaluated using Monte-Carlo simulation methods. Typical
preclinical imaging configurations were modeled, and quantitative analyses were
performed based on image reconstructions without compensating for attenuation,
scatter, and limited system resolution. RESULTS: Using mouse-sized phantom
studies as examples, attenuation effects alone degraded quantitation accuracy by up to
-18% (Tc-99m or In-111) or -41% (I-125). The inclusion of scatter effects changed
the above numbers to -12% (Tc-99m or In-111) and -21% (I-125), respectively,
indicating the significance of scatter in quantitative I-125 imaging. Region-of-interest
(ROI) definitions have greater impacts on regional quantitation accuracy for small
sphere sources as compared to attenuation and scatter effects. For the same ROI,
SPECT acquisitions using pinhole apertures of different sizes could significantly
affect the outcome, whereas the use of different radii-of-rotation yielded negligible
differences in quantitation accuracy for the imaging configurations simulated.
CONCLUSIONS: We have systematically quantified the influence of several factors
affecting the quantitation accuracy of small animal pinhole SPECT. In order to
consistently achieve accurate quantitation within 5% of the truth, comprehensive
image compensation methods are needed.

7、Mol Imaging Biol. 2009 May-Jun;11(3):188-94. Epub 2008 Nov 25.
Detection of homo- or hetero-association of Doks by fluorescence resonance energy
transfer in living cells.
Zhang F, Fu G, Wang C, Cao L, Yang HY, Wang GY, Chen YZ, He C.
Department of Neurobiology, Institute of Neuroscience, Second Military Medical
University, Shanghai, 200433, China.

   PURPOSE: The Dok proteins represent a family of adaptor proteins serving as
common substrates for protein tyrosine kinases and play an important role in
regulating signal transduction in multiple cell functions. Dimerization of Dok proteins
may represent a powerful and flexible regulatory mechanism that can achieve a
variety of consequences. This study aims to detect the homo- or hetero-association of
Doks in living cells. PROCEDURE: The transfection of CFP or YFP fusion protein
constructs was carried out using lipofectamine 2000. FRET Measurements were
performed using three-channel microscopy and Spectroscopy. RESULTS: By using
fluorescence resonance energy transfer technology, we demonstrated, for the first time
to our knowledge, that Dok5 and Dok1 could form homomeric and heteromeric
associations in living cells. Moreover, pleckstrin homology (PH) domain was found to
be essential for homomeric associations of Dok5, while PH domain and
phosphotyrosine binding domain were found to be crucial for homomeric associations
of Dok1 or heteromeric associations between Dok1 and Dok5. CONCLUSION: The
mechanisms underlying Doks' association may benefit the further understanding of
the important role of Dok proteins in regulating signal transduction activated by
tyrosine kinases.
Annals of Nuclear Medicine
1、Ann Nucl Med. 2010 Jan;24(1):13-9. Epub 2009 Dec 9.
Study on biodistribution and imaging of radioiodinated arginine-arginine-leucine
peptide in nude mice bearing human prostate carcinoma.
Yu M, Zhou H, Liu X, Huo Y, Zhu Y, Chen Y.
Department of Nuclear Medicine, Clinical Medical College of Yangzhou University,
Yangzhou, China. ymmcyh@yahoo.com.cn

   OBJECTIVE: To investigate the biodistribution and imaging of (131)I-labeled
arginine-arginine-leucine (RRL) peptide in human prostate carcinoma bearing nude
mice. METHODS: The 10-mer cyclic peptide containing the RRL sequence
(YCGGRRLGGC) was synthesized by the solid-phase method. Disulfide bonds
between the cysteines maintain the cyclic structure. Radioiodination of the RRL
peptide was performed by the chloramine-T method. (131)I-labeled peptides were
injected into the nude mice bearing human prostate carcinoma via a tail vein.
Biodistribution and imaging results in vivo were obtained. RESULTS: The
(131)I-labeling rate of RRL peptide was about 60%. The radiochemical purity was
96.5%. The radiochemical purity of the labeled compound remained 90.3% at 24 h in
human blood serum at 37 degrees C. In the biodistribution studies, radiolabeled RRL
peptide probe accumulated in the tumor to a level of approximately 2.52 and 0.65%
injected dose per gram of tissue at 6 and 24 h after administration. The data for the
(131)I-labeled control peptide were 0.73 and 0.06% ID/g at 6 and 24 h after
administration. The ratios of radioactivity in tumors to radioactivity in blood at 1, 6,
and 24 h after injection were about 0.32, 1.12, 1.30 for RRL peptide and 0.30, 0.37,
0.22 for control peptide. The ratios of radioactivity in tumors to radioactivity in
muscle at 1, 6, 24 h after injection were about 1.40, 3.94, 9.08 for RRL peptide and
1.98, 2.89, 1.78 for control peptide. At 24 h after administration, the SPECT imaging
obtained clearly showed a contrasting tumor on the right armpit of mice with high
concentrations of radioactivity, and the surrounding background was very low.
CONCLUSIONS: The results suggest that radioiodination of RRL peptide is feasible
and that the labeled compound is stable in human blood serum. The (131)I-labeled
RRL peptide shows high tumor uptake and good tumor-to-organ ratios that allow
noninvasive visualization of tumors. The (131)I-labeled compound is valuable to
detect tumors as molecular probe.

2、Ann Nucl Med. 2009 May;23(3):317-20. Epub 2009 Apr 2.
Tc-99m sestamibi parathyroid imaging in a rare case of parathyroid lipoadenoma.
Meng Z, Zhang M, Tan J, Zhang Y, Jia Q, Zhang F.
Department of Nuclear Medicine, Tianjin Medical University General Hospital,
Anshan Road No. 154, Heping, 300052 Tianjin, People's Republic of China.
james_mencius@hotmail.com

   Parathyroid lipoadenoma is an unusual cause of primary hyperparathyroidism. Only
a few earlier reports have documented parathyroid imaging in diagnostic studies of
parathyroid lipoadenoma. Our case was a 27-year-old man, who was originally
diagnosed with primary hyperparathyroidism. He underwent a Tc-99m sestamibi
dual-phase parathyroid imaging study, which revealed a right-inferior parathyroid
hyperfunctional lesion. The first operation removed a lesion of 1.5 cm in diameter in
the area, and parathyroid lipoadenoma was diagnosed by pathology. However,
hypercalcemia persisted. One week later, a Tc-99m sestamibi whole-body scan and
another dual-phase imagining were performed, which demonstrated a residual lesion
in the inferior part of the right thyroid region, while no ectopic lesion was found. A
second surgery was performed and pathological diagnosis was confirmed as
parathyroid lipoadenoma again. Our case demonstrated that although hyperfunctional
parathyroid lipoadenoma is rare, Tc-99m sestamibi parathyroid imaging is reliable in
locating the lesion for surgical purposes. And Tc-99m sestamibi imaging is useful in
reoperative and persistent hyperparathyroidism situations as well.

3、Ann Nucl Med. 2009 Feb;23(2):113-22. Epub 2009 Feb 19.
An experimental study on the antitumor effect of 131I-17-AAG in vitro and in vivo.
Wenyong T, Lu L, Daozhen C, Weidong Y, Ying H.
Nuclear Medicine Technology Institution, School of Clinical Medicine, Southeast
University, No. 87 Dingjia Qiao Road 210009 Nanjing, Jiangsu, China.
   OBJECTIVE:           To       observe        the       antitumor        effect     of
(131)I-17-allylamino-17-demethoxygeldanamycin ((131)I-17-AAG) in vitro/in vivo
and explore its antitumor mechanism with a view to its potential therapeutic
application. METHODS: (131)I-17-AAG was prepared by the reaction of 17-AAG
with Na [(131)I] in the presence of hydrogen peroxide. The effects of (131)17-AAG
on cell growth inhibition and cell cycle distribution in vitro were studied in BEL-7402
cells lines. Following BEL-7402 tumor implantation by subcutaneous xenografts into
nude mice, the reagents were injected through the tail vein, and the tumor volume was
measured and analyzed. At the end of the experiment, tumor specimens were
processed      for    histopathological     analysis.     Terminal      deoxynucleotidyl
transferase-mediated dUTP nick end labeling (TUNEL) was used to investigate
apoptosis. The expression change of Akt2 was tested by Western-blot analysis.
RESULTS: Methyl-thiazolyl-tetrazolium assay showed inhibition rates of 27.7 +/-
5.3%, 57.3 +/- 4.3%, and 63.7 +/- 3.1%, in Na(131)I group, 17-AAG group, and
(131)I-17-AAG group, respectively. The inhibition rate in the (131)I-17-AAG group
differed significantly between N(a131)I group and 17-AAG group (F = 229.49, P <
0.001). Following 48 h of treatment with the drug in each group, flow cytometry
analysis indicated that detected sub-G peaks (black) were 1.54 +/- 0.13%, 5.72 +/-
1.05%, 12.97 +/- 1.44%, and 20.65 +/- 1.36%, in dimethyl sulfoxide (DMSO) group,
Na(131)I group, 17-AAG group, and (131)I-17-AAG group, respectively. Following
infusion for 32 days, the tumor volumes in the (131)I-17-AAG group were
significantly smaller than those in the DMSO group (F = 24.18, P < 0.001) or the
(131)I group (F = 20.68, P < 0.001). Histopathological and TUNEL analyses showed
that (131)I-17-AAG inhibited the proliferation of tumor cells and induced apoptosis.
The expression of Akt2 in (131)I-17-AAG was significantly lower than that in the
DMSO group or (131)I group. CONCLUSIONS: (131)I-17-AAG can effectively
inhibit the growth of BEL-7402 tumor cells in vitro and in vivo. (131)I-17-AAG is a
promising agent for the treatment of BEL-7402 cell tumor.

4、Ann Nucl Med. 2008 Dec;22(10):849-58. Epub 2009 Jan 8.
Efficacy and safety of (32)P-nanocolloid for treatment of distant lymph node
metastasis in VX2 tumor-bearing rabbits.
Dong S, Huang G, Liu P, Ma Y, Yan W, Wan L, Zhu C.
Department of Nuclear Medicine, Renji Hospital, Medical School of Shanghi Jiaotong
University, No. 1630, Rd Dong Fang, 200127 Pudong New District, Shanghai, China.
   BACKGROUND: Eradication of micrometastases present in lymph nodes of
cancer patients improves their prognosis significantly. Radionuclide therapy possesses
the potential to eliminate such metastases. OBJECTIVE: This study was performed to
evaluate the efficacy and safety of (32)P-nanocolloid therapy in the treatment of
distant carcinoma cell metastases in lymph nodes of VX2 tumor-bearing rabbits.
METHODS: To obtain VX2 tumor micrometastases in right armpit lymph nodes of
12 male New Zealand white rabbits, VX2 tumors were implanted by hypodermal
inoculation into the right anterior limb. Animals were randomly divided into therapy
(n = 6) and control (n = 6) groups. (32)P-nanocolloid (0.5 mCi), 95% of which
was >50 nm in diameter, was administered to the therapy group, and saline was
administered to the control group. Injections were given once weekly for 4 weeks.
RESULTS: 2-Deoxy-2[(18)F]-fluoro-D -glucose positron emission tomography
revealed that the number of involved lymph nodes and the maximum standardized
uptake value decreased in the (32)P-nanocolloid therapy group as compared with the
baseline or saline control group (P < 0.05). The expression of the lymphangiogenesis
factors vascular endothelial growth factors (VEGF)-C and VEGF-D by VX2 tumor
cells present in lymph nodes was significantly lower in the therapy group as compared
with the control group. Additionally, apoptotic VX2 tumor cell death was
significantly greater in lymph nodes of the therapy as compared with the control
group (P < 0.01). With the exception of a decrease in white blood cells of peripheral
blood (P < 0.05), standard laboratory values were unaffected throughout the course of
therapy with (32)P-nanocolloid. CONCLUSIONS: These findings support treatment
with (32)P-nanocolloid as a safe and effective approach for eradication of lymph node
micrometastases.
PMID: 19142703 [PubMed - indexed for MEDLINE]
Nuclear Medicine and Biology
1、Nucl Med Biol. 2009 Nov;36(8):941-7. Epub 2009 Oct 3.
Evaluation of nigrostriatal damage and its change over weeks in a rat model of
Parkinson's disease: small animal positron emission tomography studies with
[(11)C]beta-CFT.
Liu L, Wang Y, Li B, Jia J, Sun Z, Zhang J, Tian J, Wang X.
Department of Physiology, Key Laboratory for Neurodegenerative Disorders of the
Ministry of Education, Capital Medical University, Beijing, P.R. China.

   INTRODUCTION: The cardinal pathological feature of Parkinson's disease (PD) is
progressive loss of dopaminergic neurons. Since dopamine transporter (DAT) is a
protein located presynaptically on dopaminergic nerve terminals, radioligands that
bind to these sites are promising radiopharmaceuticals for evaluation of the integrity
of the dopamine system. This study using positron emission tomography (PET)
tracers,                  [(11)C]-2beta-carbomethoxy-3beta-(4-fluorophenyl)-tropane
([(11)C]beta-CFT, radioligand for DAT), was aimed at evaluating the degree of
nigrostriatal damage and its change over weeks in a rat model of PD. METHODS:
The brains of these rats were unilaterally lesioned by mechanical transection of the
nigrostriatal dopamine pathway at the medial forebrain bundle (MFB). Behavioral
studies were carried out by apomorphine (APO) challenge prior to and 1, 2 and 4
weeks after MFB axotomy. Small animal PET scans were performed 2 days after the
behavioral test. Immunohistochemistry was conducted 4 days after the last PET scan.
RESULTS: Compared with the contralateral intact side, a progressively decreased
[(11)C]beta-CFT binding was observed on the lesioned side which correlated
inversely with the APO-induced rotations. Postmortem immunohistochemical studies
confirmed the loss of both striatal dopamine fibers and nigral neurons on the lesioned
side. CONCLUSION: These findings not only demonstrate that the neuronal
degeneration in this model is relatively slow, but also suggest [(11)C]beta-CFT is a
sensitive marker to monitor the degree of nigrostriatal damage and its change over
weeks. This marker can be used prospectively to study the progression of the disease,
thereby making detection of early phases of PD possible.

2、Nucl Med Biol. 2009 Jul;36(5):535-43. Epub 2009 May 7.
Imaging targeted at tumor with (188)Re-labeled VEGF(189) exon 6-encoded peptide
and effects of the transfecting truncated KDR gene in tumor-bearing nude mice.
Qin ZX, Li QW, Liu GY, Luo CX, Xie GF, Zheng L, Huang DD.
Department of Nuclear Medicine, Southwest Hospital, Third Military Medical
University, Chongqing, China.

   INTRODUCTION: Planar imaging of (188)Re-labeled vascular endothelial growth
factor (VEGF)(189) exon 6-encoded peptide (QKRKRKKSRYKS) with single photon
emission computed tomography (SPECT) in tumor-bearing nude mice and effects of
the transfecting truncated KDR gene on its imaging were investigated, so as to
provide a basis for further applying the peptide to tumor-targeted radionuclide
treatment. METHODS: QKRKRKKSRYKS, coupling with mercaptoacetyltriglycine
(MAG(3)) chelator was labeled with (188)Re; then in vivo distribution, planar
imaging with SPECT and blocking experiment in tumor-bearing nude mice were
analyzed. Recombinant adenovirus vectors carrying the truncated KDR gene were
constructed to transfect tumor tissues to evaluate the effects of truncated KDR on the
in       vivo      distribution      and       tumor       planar       imaging     of
(188)Re-MAG(3)-QKRKRKKSRYKS in tumor-bearing nude mice. RESULTS: The
labeled peptide exhibited a sound receptor binding activity. Planar imaging with
SPECT demonstrated significant radioactivity accumulation in tumor 1 h after
injection of the labeled peptide and disappearance of radioactivity 3 h later.
Significant radioactivity accumulation was also observed in the liver, intestines and
kidneys but was not obvious in other tissues. An hour after injection of the labeled
peptide, the percentage of the injected radioactive dose per gram (%ID/g) of tumor
and tumor/contralateral muscle tissues ratio were 1.98+/-0.38 and 2.53+/-0.33,
respectively, and increased to 3.08+/-0.84 and 3.61+/-0.59 in the group transfected
with the truncated KDR gene, respectively, and radioactivity accumulation in tumor
with planar imaging also increased significantly in the transfection group.
CONCLUSION: (188)Re-MAG(3)-QKRKRKKSRYKS can accumulate in tumor
tissues, which could be increased by the transfection of truncated KDR gene. This
study provides a basis for further applying the peptide to tumor targeted radionuclide
imaging and treatment.

3、Nucl Med Biol. 2009 May;36(4):467-75. Epub 2009 Mar 26.
Preliminary clinical study in patients with hemispatial neglect after stroke by neglect
test battery and 99mTc-ECD single-photon emission computed tomography.
Yin Y, Li X, Li Y, Gu H, Han C, Liu H.
Department of Nuclear Medicine, The First Affiliated Hospital of China Medical
University, Shen Yang 110001, China.

   OBJECTIVE: To explore the presence, clinical characteristics, anatomical foci in
image and mechanism of hemispatial neglect (HSN), neglect test battery and
single-photon emission computed tomography (SPECT) regional cerebral blood flow
(rCBF) imaging were performed on patients with stroke. METHODS: Thirty
dextromanual patients who were diagnosed as having unilateral stroke clinically were
recruited. A neglect test battery including line bisection test, star cancellation test and
drawing test was performed on the subjects. The severity of neglect was measured on
neglect tests. The lowest rCBF, the range with decreased rCBF, number of the foci
with decreased rCBF, the flow deficit size and the total number of pixels in the foci
were measured on SPECT rCBF imaging. RESULTS: Twenty-five patients were
diagnosed as having HSN by the neglect test battery. Contralateral neglect (CN) and
ipsilateral neglect (IN) were observed in both right and left hemisphere strokes. On
SPECT imaging, the patients with neglect had decreased rCBF in the frontal cortex
most often; followed by the parietal, occipital and temporal cortices; and basal ganglia
and thalamus in some cases. The patients who had two or more regions damaged
showed neglect more often and severity. The correlation coefficients between rCBF in
the foci, the decreased percentage of rCBF of the foci and the severity of neglect were
-0.119 (P>.05) and 0.221 (P>.05). The correlation coefficients between the range,
number of foci, the flow deficit size, the total number of pixels of the foci and the
severity of neglect were 0.537 (P<.05), 0.493 (P<.05), 0.561 (P<.05), 0.466 (P<.05),
respectively. No difference between CN and IN on SPECT images reached statistical
significance. CONCLUSIONS: The severity of neglect did not correlate with rCBF
and the decreased percentage of rCBF in the foci, while it was significantly correlated
with the range, number of foci, the flow deficit size and the total numbers of pixels of
the foci significantly. And the patients with CN and IN did not show any difference in
the presence of HSN, the manifestation on the neglect test battery and SPECT images.
HSN showed damage on multiple sites, with combined damages resulting in more
severe neglect.

4、Nucl Med Biol. 2009 Apr;36(3):313-21.
Establishment of an experimental human lung adenocarcinoma cell line SPC-A-1BM
with high bone metastases potency by (99m)Tc-MDP bone scintigraphy.
Yang S, Dong Q, Yao M, Shi M, Ye J, Zhao L, Su J, Gu W, Xie W, Wang K, Du Y,
Li Y, Huang Y.
Department of Nuclear Medicine, Shanghai Chest Hospital of Shanghai Jiaotong
University, Shanghai 200030, China. yzyg@sh163.net

   BACKGROUND: Bone metastasis is one of the most common clinical phenomena
of late stage lung cancer. A major impediment to understanding the pathogenesis of
bone metastasis has been the lack of an appropriate animal and cell model. This study
aims to establish human lung adenocarcinoma cell line with highly bone metastases
potency with (99m)Tc-MDP bone scintigraphy. METHODS: The human lung
adenocarcinoma cancer cells SPC-A-1 were injected into the left cardiac ventricle of
NIH-Beige-Nude-XID (NIH-BNX) immunodeficient mice. The metastatic lesions of
tumor-bearing mice were imaged with (99m)Tc-MDP bone scintigraphy on a Siemens
multi-single photon emission computed tomography. Pinhole images were acquired
on a GZ-B conventional gamma camera with a self-designed pinhole collimator. The
mice with bone metastasis were sacrificed under deep anesthesia, and the lesions were
resected. Bone metastatic cancer cells in the resected lesions were subjected for
culture and then reinoculated into the NIH-BNX mice through left cardiac ventricle.
The process was repeated for eight cycles to obtain a novel cell subline SPC-A-1BM.
Real-time polymerase chain reaction (PCR) was used to compare the gene expression
differences in the parental and SPC-A-1BM cells. RESULTS: The bone metastasis
sites were successfully revealed by bone scintigraphy. The established bone
metastasis cell line SPC-A-1BM had a high potential to metastasize in bone, including
mandible, humerus, thoracic vertebra, lumbar, femur, patella, ilium and cartilage rib.
The expression level of vascular endothelial growth factor gene family, Bcl-2 and cell
adhesion-related genes ECM1, ESM1, AF1Q, SERPINE2 and FN1 were examined.
Gene expression difference was found between parental and bone-seeking metastasis
cell SPC-A-1BM, which indicates SPC-A-1BM has metastatic capacity vs. its
parental cells. CONCLUSION: SPC-A-1BM is a bone-seeking metastasis human lung
adenocarcinoma cell line. Bone scintigraphy may be used as an accurate, sensitive,
noninvasive tool to detect experimental bone metastases in intact live NIH-BNX
mice.

5、Nucl Med Biol. 2009 Feb;36(2):207-13.
Comparative study of cellular kinetics of reporter probe [(131)I]FIAU in neonatal
cardiac myocytes after transfer of HSV1-tk reporter gene with two vectors.
Lan X, Yin X, Wang R, Liu Y, Zhang Y.
Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong
University of Science and Technology, Wuhan, China. lxl730724@hotmail.com

  AIM: Reporter gene imaging is a promising approach for noninvasive monitoring
of cardiac gene therapy. In this study, HSV1-tk (herpes simplex virus type 1
thymidine                  kinase)                 and                   FIAU
(2'-fluoro-2'-deoxy-1-beta-d-arabinofuranosyl-5-iodouracil) were used as the reporter
gene and probe, respectively. Cellular uptakes of radiolabeled FIAU of neonatal rat
cardiac myocytes transferred with HSV1-tk were compared between two vectors,
adenovirus and liposome. The aims of this study were to choose the better vector and
to provide a theoretical basis for good nuclide images. METHODS: Neonatal cardiac
myocytes were obtained from rat heart by single collagenase digestion. HSV1-tk
inserted into adenovirus vector (recombinant adenovirus type 5, Ad5-tk) and plasmid
(pDC316-tk) coated with Lipofectamine 2000 (pDC316-tk/lipoplex) were developed;
thus, HSV1-tk could be transferred into neonatal cardiac myocytes. FAU
(2'-fluoro-2'-deoxy-1-beta-d-arabinofuranosyluracil) was labeled with (131)I, and the
product was assessed after purification with reversed-phase Sep-Pak C-18 column.
The uptake rates of [(131)I]FIAU in the transferred cardiac myocytes at different
times (0.5, 1, 2, 3, 4 and 5 h) were detected. Furthermore, mRNA expression and
protein expression of HSV1-tk were detected by semiquantitative
reverse-transcriptase polymerase chain reaction and immunocytochemistry.
RESULTS: FAU could be labeled with (131)I, and the labeling efficiency and
radiochemical purity rates were 53.82+/-2.05% and 94.85+/-1.76%, respectively.
Time-dependent increase of the accumulation of [(131)I]FIAU was observed in both
the Ad5-tk group and the pDC316/lipoplex group, and the highest uptake rate
occurred at 5 h, with peak values of 12.55+/-0.37% and 2.09+/-0.34%, respectively.
Greater uptakes of [(131)I]FIAU in Ad5-tk-infected cells compared with
pDC316/lipoplex-transfected ones occurred at all the time points (t=12.978-38.253,
P<.01). The exogenous gene expression by polymerase chain reaction in adenovirus
vector-infected cardiac myocytes was significantly higher than that in
pDC316-tk/lipoplex-transducted ones (semiquantitative analysis, 3.11+/-0.14 versus
1.60+/-0.05, P<.01). Immunocytochemistry showed that the transferred cardiac
myocytes successfully expressed the target protein, and the positive rates were
81.70+/-0.40% in Ad5-tk and 22.06+/-0.32% in liposome (P<.01). CONCLUSIONS:
Both adenovirus and liposome could transfer reporter gene into cardiac myocytes
successfully, and the expressed exogenous protein could form functional enzymes
efficiently. However, the adenovirus vector acted more efficiently than did liposome,
with a higher uptake rate of the reporter probe. Thus, adenovirus is competent for
gene transfer in cardiac reporter gene imaging.

6、Nucl Med Biol. 2009 Feb;36(2):183-9.
Measurement of glucose metabolism in rat spinal cord slices with dynamic positron
autoradiography.
Fan X, Asai T, Morioka K, Uchida K, Baba H, Tanaka K, Zhuang J, Okazawa H,
Fujibayashi Y.
Department of Cardiovascular Surgery, Guangdong Cardiovascular Institute,
Guangdong Provincial People's Hospital, Guangzhou, China.

   We attempted to measure the regional metabolic rate of glucose (MRglc) in sliced
spinal cords in vitro. The thoracic spinal cord of a mature Wister rat was cut into
400-mum slices in oxygenated and cooled (1-4 degrees C) Krebs-Ringer solution.
After at least 60 min of preincubation, the spinal cord slices were transferred into
double polystyrene chambers and incubated in Krebs-Ringer solution at 36 degrees C,
bubbled with 5% O(2)/5% CO(2) gas. To measure MRglc, we used the dynamic
positron autoradiography technique (dPAT) with F-18-2-fluoro-2-deoxy-d-glucose
([(18)F]FDG) and the net influx constant of [(18)F]FDG as an index. Uptake curves
of [(18)F]FDG were well fitted by straight lines for more than 7 h after the slicing of
the spinal cord (linear regression coefficient, r=0.99), indicating a constant uptake of
glucose by the spinal cord tissue. The slope (K), which denotes MRglc, is affected by
tetrodotoxin, and high K(+) (50 mM) or Ca(2+)-free, high Mg(2+) solution. After 10
min of hypoxia, the K value following reoxygenation was similar to the unloaded
control value, but after 45 min of hypoxia, the K value was markedly lower than the
unloaded control value, and after >90 min of reoxygenation it was nearly 0. Our
results indicate that the living spinal cord slices used retained an activity-dependent
metabolism to some extent. This technique may provide a new approach for
measuring MRglc in sliced living spinal cord tissue in vitro and for quantifying the
dynamic changes in MRglc in response to various interventions such as hypoxia.
Cancer Biotherapy and Radiopharmaceuticals
1、Cancer Biother Radiopharm. 2009 Dec;24(6):717-21.
Review of mesenchymal stem cells and tumors: executioner or coconspirator?
Feng B, Chen L.
Clinical College of Nanjing University School of Medicine, Nanjing, China.

   Mesenchymal stem cells (MSCs) are a versatile group of nonhematopoietic stem
cells with high potency of proliferation and pluripotency of differentiation.
Endogenous MSCs circulate in the blood until being called to sites of inflammation or
tumors, where they could differentiate into bone, cartilage, fat, or muscle cells to
repair or replace damaged tissue. Ectogenous MSCs also demonstrate satisfactory
tropism toward primary tumor sites and metastatic foci with low immunogenicity and
thus can be exploited as a cell-mediated gene therapy to counteract tumor growth and
development. However, tumor-promoting, and even carcinogenetic, effects of MSCs
are also observed both in vitro and in vivo, raising potential risks in clinical
applications. Recent advances of MSCs in tumor-targeted biotherapy were
summarized. New findings of the interaction between MSCs and tumor cells in the
tumor microenvironment were expounded.

2、Cancer Biother Radiopharm. 2009 Dec;24(6):701-5.
Dosimetric study of Cs-131, I-125, and Pd-103 seeds for permanent prostate
brachytherapy.
Yang R, Wang J, Zhang H.
Department of Radiation Oncology, Cancer Center, Peking University Third Hospital,
Beijing, China.

   As a well-established single-modality approach for early-stage prostate cancer,
transperineal interstitial permanent prostate brachytherapy (TIPPB) has gained
increasing popularity due to its favorable clinical results. Currently, three isotopes,
namely Cs-131, I-125, and Pd-103, are commercially available for TIPPB. This is the
first study to systematically explore the dosimetric difference of these three isotopes
for TIPPB. In total, 25 patients with T1-T2c prostate cancer previously implanted
with I-125 seeds were randomly selected and replanned with Cs-131, I-125, and
Pd-103 seeds to the prescription doses of 115, 145, and 125 Gy, respectively. The
planning goals attempted were prostate V(p)100 approximately 95%, D(p)90 >or=
100%, and prostatic urethra D(u)10 <or= 150%. The dosimetric parameters, as well as
the number of seeds and needles required, were analyzed and compared. The mean
homogeneity index (HI) was 0.59, 0.56, and 0.46 for Cs-131, I-125, and Pd-103 plans,
respectively. The average D(u)10 was 124.6%, 125.7%, and 129.7%, respectively.
The average rectum V(r)100 was 0.19, 0.22, and 0.31 cc, respectively. In addition, the
average number of seeds was 57.9, 63.0, and 63.7, and the average number of needles
required was 31.6, 32.9, and 33.6 for Cs-131, I-125, and Pd-103 seeds, respectively.
This study demonstrates that TIPPB, utilizing Cs-131 seeds, allows for better dose
homogeneity, while providing comparable prostate coverage and sparing of the
urethra and rectum, with a comparable number of, or fewer, seeds and needles
required, compared to I-125 or Pd-103 seeds. Further biological and clinical studies
associated with Cs-131 are warranted.
3、Cancer Biother Radiopharm. 2009 Dec;24(6):681-7.
Anti-inflammatory effects of tanshinone IIA on radiation-induced microglia BV-2
cells inflammatory response.
Dong X, Dong J, Zhang R, Fan L, Liu L, Wu G.
Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of
Science and Technology, Wuhan, China.

   AIM: The aim of this study was to explore the inhibitory effects of Tanshinone II(A)
on the production of proinflammation cytokines in radiation-stimulated microglia.
METHODS: Microglia cells were treated with 2, 4, 8, 16, and 32 Gy of irradiation or
sham-irradiated in the presence or absence of 1.0 microg/mL of Tanshinone II(A).
The effects of Tanshinone II(A) on radiation-induced proinflammatory cytokines
were evaluated by real-time polymerase chain reaction; the expression level of
nuclear factor (NF-kappabeta) p65 in cytoplasm and nucleus was measured by
Western blot. Immunofluorescence staining and confocal microscopy analysis were
applied to detect the expression of gamma-H2AX and p65 postirradiation. RESULTS:
Radiation-induced release of proinflammatory cytokines in BV-2 cells was detectable
after irradiation. Tanshinone II(A) decreased the radiation-induced release of
proinflammatory cytokines. Further, Western blotting showed that Tanshinone II(A)
could attenuate the nuclear translocation of (NF-kappabeta) p65 submit
postirradiation. Immunofluorescence staining showed gamma-H2AX foci formation
with p65 translocation into the nucleus postirradiation. CONCLUSIONS: Our data
indicated that Tanshinone II(A) exerts anti-inflammatory properties by suppressing
the transcription of proinflammatory cytokine genes that might be associated with the
NF-kappabeta signaling pathway. It is postulated that irradiation causes immediate
cellular reaction, and that double-strand breaks trigger the molecular response that
leads to NF-kappabeta pathway activation.

4、Cancer Biother Radiopharm. 2009 Dec;24(6):675-80.
Resveratrol protects against Cisplatin-induced cardiotoxicity by alleviating oxidative
damage.
Wang J, He D, Zhang Q, Han Y, Jin S, Qi F.
Department of Medical Oncology, Tumor Hospital of Harbin Medical University,
Haping, Harbin, China.

   The clinical use of cisplatin, a potent antineoplastic agent, is limited by its severe
adverse effects. The present study was designed to evaluate the effects of resveratrol
on cisplatin-induced cardiac injury. Resveratrol is a potent free radical scavenger. In
the present study, we tested whether resveratrol would prevent cisplatin-induced
cardiotoxicity in rats. Plasma-enzyme activities and histologic myocardial changes
were examined. The anticancer role of resveratrol and/or cisplatin were measured by
MTT. Our data showed that cisplatin led to cardiac-function deterioration, myocardial
injury, increased lactate dehydrogenase, creatine kinase, malondialdehyde activities,
and decreased activities of superoxide dismutase, glutathione, glutathione peroxidase,
and catalase. Treatment with resveratrol effectively hindered the adverse effects of
cisplatin in a dose-dependent manner, such as myocardial injury and impaired heart
function. An in vitro cytotoxic study showed that resveratrol could increase the
antineoplastic activity of cisplatin to A549 adenocarcinoma cells. All the above lines
of evidence suggest that resveratrol protects cardiomyocytes from cisplatin-induced
cardiotoxicity via the suppression of oxidative stress.
5、Cancer Biother Radiopharm. 2009 Dec;24(6):733-5.
Indian hedgehog, a neglected member of hedgehog pathway, may offer a novel
avenue for colorectal cancer therapy.
Fu X, Yang X, Zhao L.
Department of Gastroenterology, The People's Hospital of Deyang City, Deyang,
Sichuan, China.

   Published data on hedgehog (Hh) pathway activation in colorectal cancer (CRC)
are conflicting, and the effect of the Hh pathway inhibitor on the viability of colon
cancer cells is controversial. This article focuses attention on the often-neglected, yet
likely, critical role of Indian Hh in the course of colonic tumor progression and
hypothesizes that upregulation of Indian Hh expression may offer a novel therapeutic
approach against CRC through inducing differentiation of tumor cells and through
abrogating the Sonic Hh signaling that drives CRC growth.

6、Cancer Biother Radiopharm. 2009 Oct;24(5):607-13.
A novel Bacillus Calmette-Guérin-based breast cancer vaccine that coexpresses
multiple tandem repeats of MUC1 and CD80 breaks the immune tolerance and
inhibits MUC1-positive breast cancer growth.
Yuan S, Shi C, Lv Y, Wang T, Wang H, Han W.
Department of Vascular and Endocrine Surgery, Xijing Hospital, Fourth Military
Medical University, Xi'an 710032, China.

   Many approaches targeting MUC1 for breast tumor immunotherapy have been
attempted. However, preclinical trials with MUC1 showed that MUC1 is a relatively
poor immunogen in human. B7 molecules that bind CD28 provide an
antigen-nonspecific signal, which, along with an antigen-specific signal, is crucial for
T-cell activation. In the present study, we constructed a novel Bacillus
Calmette-Guérin-based breast cancer vaccine that coexpressed four VNTRs
(variable-number tandem repeats) of MUC1 and CD80 (rBCG-MVNTR4-CD80). The
aim of our study was to enhance anti-MUC1 tumor immunity by vaccination of
hu-PBL-SCID mice with the recombinant BCG vaccine. The inhibition effect on
tumors from the mice immunized with rBCG-MVNTR4-CD80 significantly increased,
compared with rBCG-MVNTR4, BCG-pDE22, and phosphate-buffered saline
immunized mice (p < 0.05, p < 0.05, p < 0.05). ELISpot assays showed that there was
a significant increase in interferon-gamma production in the splenocytes from the
mice immunized with rBCG-MVNTR4-CD80. In addition, CD4 and CD8-positive
lymphocytes in tumors from rBCG-MVNTR4-CD80-immunized animals were
detected. These data showed that rBCG-MVNTR4-CD80 immunization elicited
tumor-specific immune response, which closely related with the B7 molecule (CD80),
indicating that the vaccine may be a good candidate for MUC1-positive breast cancer
immunotherapy.

7、Cancer Biother Radiopharm. 2009 Oct;24(5):597-605.
Inhibition growth and metastasis of melanoma by 4-1BBL expressed in normal tissue
cells by regulating the function of immune cells.
Hui Q, Yu X, Hui Z, Zuohua F.
Department of Oncology, Zhongnan Hospital, Wuhan University, Wuhan 430071,
China. qiuhui1999@163.com
   Many tumor immunotherapy efforts are focused on upregulating the expression of
4-1BB/4-1BBL by transferring genes into immune cells or tumor cells. In this study,
we sought to study whether 4-1BBL, expressed in normal tissue cells, inhibits the
growth and metastasis of tumor. The expressing plasmid, p4-1BBL, was constructed
and was used to treat established melanoma in situ model and metastasis tumor model
mice, respectively, with injecting directly into the skeletal muscle of the inoculation
site and systemically administering plasmid with the hydrodynamics-based
gene-delivery approach. Administration of p4-1BBL resulted in high-level expression
in the muscle and liver. Treatment of tumor-bearing mice with 4-1BBL plasmid DNA
significantly suppressed the growth and metastasis of melanoma without significant
toxicity, compared with mice treated with control-plasmid DNA. This treatment with
plasmid p4-1BBL in vivo induced an infiltration of CD8(+) T-cells into the tumor
milieu and an increase of levels of interleukin-2 and interferon-gamma. Our study
suggests that 4-1BBL expressed in normal tissue cells has significant antitumor
activity and may have therapeutic potential as an antitumor agent in the clinic.
Directly intramuscular injection peritumor and hydrodynamic intravenous injection
may provide promising immune gene-therapy approaches for different tumor clinical
stages.

8、Cancer Biother Radiopharm. 2009 Oct;24(5):589-96.
Discrepancies between antiangiogenic and antitumor effects of recombinant human
endostatin.
Huang G, Chen L.
Medical Oncology Department of Jinling Hospital, Medical School of Nanjing
University, Nanjing 210002, People's Republic of China.

   It has been widely accepted that antiangiogenesis therapy could deprive tumor cells
of nutrients and oxygen and suppress tumor growth. However, in the present study,
Lewis lung carcinomas and A549 adenocarcinomas established in male C57BL/6 and
BALB/c nude mice, respectively, were treated with recombinant human endostatin
(rh-endostatin). Earlier studies document discrepancies in the antiangiogenic and
antitumor outcomes of rh-endostatin treatment, at doses equivalent to clinical usage.
Although there was no significant regression of tumor growth, tumor vasculature was
widely disrupted within the first few days of treatment with rh-endostatin, as indicated
by reduced blood perfusion (visualized by dynamic-contrast-enhanced magnetic
resonance imaging) and reduced microvascular density. Interestingly, when
rh-endostatin treatment was discontinued, there was an elevation in the diffusion of
oxygen and tetramethylrhodamine isothiocyanate-dextran in both tumor classes,
which was detected by hypoxyprobe (pimonidazole) and fluorescence microscopy.
We conclude that the paradoxic outcomes in the antiangiogenic and antitumor
properties of rh-endostatin might derive from the tumors' tolerance to
antiangiogenesis inhibitors. Additionally, rh-endostatin might have the ability to
transiently normalize tumor vasculature.

9、Cancer Biother Radiopharm. 2009 Aug;24(4):453-60.
Evaluation of pharmacokinetics of 111In-labeled VNB-PEGylated liposomes after
intraperitoneal and intravenous administration in a tumor/ascites mouse model.
Lin YY, Li JJ, Chang CH, Lu YC, Hwang JJ, Tseng YL, Lin WJ, Ting G, Wang HE.
Biomedical Imaging and Radiological Sciences, National Yang-Ming University ,
Taipei, Taiwan, Republic of China.
   Nanoliposomes are important drug carriers that can passively target tumor sites by
the enhanced permeability and retention (EPR) effect in neoplasm lesions. This study
evaluated the biodistribution and pharmacokinetics of 111In-labeled vinorelbine
(VNB)-encapsulated PEGylated liposomes (IVNBPL) after intraperitoneal (i.p.) and
intravenous (i.v.) administration in a C26/tk-luc colon carcinoma ascites mouse model.
IVNBPL was prepared by labeling VNB-encapsulated PEGylated liposomes with
111In-oxine. BALB/c mice were i.p. inoculated with 2 x 10(5) C26/tk-luc cells in 500
muL of phosphate-buffered saline. Peritoneal tumor lesions were confirmed by
124I-FIAU/micro-PET (positron emission tomography) and bioluminescence imaging.
Ascites production was examined by ultrasound imaging on day 10 after tumor cell
inoculation. The pharmacokinetics and biodistribution studies of IVNBPL in a
tumor/ascites mouse model were conducted. The labeling efficiency was more than
90%. The in vitro stability in human plasma at 37 degrees C for 72 hours was 83% +/-
3.5%. For i.p. administration, the areas under curves (AUCs) of ascites and tumor
were 6.78- and 1.70-fold higher, whereas the AUCs of normal tissues were lower than
those via the i.v. route. This study demonstrates that i.p. administration is a better
approach than i.v. injection for IVNBPL, when applied to the treatment of i.p.
malignant disease in a tumor/ascites mouse model.

10、Cancer Biother Radiopharm. 2009 Aug;24(4):435-43.
Receptor-binding, biodistribution, dosimetry, and micro-SPECT/CT imaging of
111In-[DTPA(1), Lys(3), Tyr(4)]-bombesin analog in human prostate tumor-bearing
mice.
Ho CL, Chen LC, Lee WC, Chiu SP, Hsu WC, Wu YH, Yeh CH, Stabin MG, Jan ML,
Lin WJ, Lee TW, Chang CH.
Institute of Nuclear Energy Research, Taoyuan, Taiwan, Republic of China.

   Gastrin-releasing peptide receptors (GRPRs) are overexpressed on a variety of
human tumors, such as prostate, breast, and lung cancer. Bombesin (BN) is a
14-amino-acid peptide with high affinity for these GRPRs. We synthesized
DTPA-Q-K-Y-G-N-Q-W-A-V-G-H-L-M, a 13-amino-acid peptide chelated with
diethylenetriaminepentaacetic acid (DTPA), and radiolabeled this BN analog with
111InCl(3). Biologic activity of 111In-[DTPA(1), Lys(3), Tyr(4)]-BN was evaluated
in PC-3 prostate tumor-bearing severely compromised immunodeficient (SCID) mice.
The purity of synthesized [DTPA(1), Lys(3), Tyr(4)]-BN was greater than 95%. The
radiolabeling efficiency of 111In-[DTPA(1), Lys(3), Tyr(4)]-BN was 96.9% +/-
2.46%. The IC(50) and K(i) of [DTPA(1), Lys(3), Tyr(4)]-BN in the human bombesin
2 receptor were 1.05 +/- 0.46 and 0.83 +/- 0.36 nM, respectively. The K(d) of
111In-[DTPA(1), Lys(3), Tyr(4)]-BN in GRPR-expressing PC-3 tumor cells was 22.9
+/- 6.81 nM. Both biodistribution and micro-SPECT/CT (single-photon emission
computed tomography/computed tomography) imaging studies with 111In-[DTPA(1),
Lys(3), Tyr(4)]-BN demonstrated the highest uptake at 8 hours postinjection. The
Pearson correlation analysis showed a positive correlation of tumor uptake between
biodistribution and micro-SPECT/CT semiquantification imaging analysis (r = 0.832).
Our results revealed 111In-[DTPA(1), Lys(3), Tyr(4)]-BN has high affinity with BN
type 2 receptor. The results demonstrated a good uptake in the GRPR-overexpression
of PC-3 tumor-bearing SCID mice. 111In-[DTPA(1), Lys(3), Tyr(4)]-BN is a
potential agent for imaging GRPR-positive tumors in humans.
11、Cancer Biother Radiopharm. 2009 Aug;24(4):409-16.
The direct biologic effects of radioactive 125I seeds on pancreatic cancer cells
PANC-1, at continuous low-dose rates.
Wang J, Wang J, Liao A, Zhuang H, Zhao Y.
Department of Radiation Oncology, Cancer Center, Peking University Third Hospital,
Beijing, China. doctorwangjunjie@yahoo.com.cn

   The relative biologic effectiveness of model 6711 125I seeds (Ningbo Junan
Pharmaceutical Technology Company,Ningbo, China) and their effects on growth,
cell cycle, and apoptosis in human pancreatic cancer cell line PANC-1 were examined
in the present study. PANC-1 cells were exposed to the absorbed doses of 1, 2, 4, 6, 8,
and 10 Gyeither with 125I seeds (initial dose rate, 2.59 cGy=h) or with 60Co g-ray
irradiation (dose rate, 221 cGy=min),respectively. Significantly greater numbers of
apoptotic PANC-1 cells were detected following the continuouslow-dose-rate (CLDR)
irradiation of 125I seeds, compared with cells irradiated with identical doses of 60Co
g-ray. The D(0) for 60Co g-ray and 125I seed irradiation were 2.30 and 1.66,
respectively. The survival fraction after 125Iseed irradiation was significantly lower
than that of 60Co g-ray, with a relative biologic effectiveness of 1.39.PANC-1 cells
were dose dependently arrested in the S-phase by 60Co g-rays and in the G2=M phase
by 125I seeds,24 hour after irradiation. CLDR irradiation by 125I seeds was more
effective in inducing cell apoptosis in PANC-1cells than acute high-dose-rate 60Co g
irradiation. Interestingly, CLDR irradiation by 125I seeds can cause
PANC-1cell-cycle arrest at the G2=M phase and induce apoptosis, which may be an
important mechanism underlying 125Iseed-induced PANC-1 cell inhibition.

12、Cancer Biother Radiopharm. 2009 Jun;24(3):357-67.
The prevalence of FOXP3+ regulatory T-cells in peripheral blood of patients with
NSCLC.
Li L, Chao QG, Ping LZ, Xue C, Xia ZY, Qian D, Shi-ang H.
Cancer Center, Union Hospital, Tongji Medical School, Hua-Zhong University of
Science     and   Technology,    Wuhan,     People's    Republic   of     China.
liulixiehe2004@163.com

   We have studied CD4(+)CD25(high)FOXP3(+) regulatory T-cells (T(regs)) from
51 patients with non-small-cell lung cancer (NSCLC) and 33 healthy donors.
Regulatory T-cells were identified by fluorescence-activated cell sorting by using a
panel of antibodies and by reverse transcriptase polymerase chain reaction analysis
for FOXP3 expression. Functional studies were done to analyze their inhibitory role.
Finally, regulatory T-cells were analyzed in malignant pleura effusion (PE) from
patients with NSCLC. Patients with NSCLC have increased numbers of
CD4(+)CD25(high) FOXP3(+) T(regs) in their peripheral blood and pleura effusion
(PE), which express high levels of CTLA-4, GITR. These cells were anergic toward
T-cell receptor stimulation and, when cocultured with activated CD4(+)CD25(-) cells,
potently suppressed their proliferation and cytokine secretion. Our data suggest that in
NSCLC patients, there is an increase of CD4(+)CD25(high)FOXP3(+) regulatory
T-cells in the peripheral blood and tumor microenvironment. These T-cells might
prevent effective antitumor immune responses, and the increase in frequency of
CD4(+)CD25(high)FOXP3(+) Tregs might play a role in the modulation of the
immune response against NSCLC and could be important in the design of
immunotherapeutic approaches.
13、Cancer Biother Radiopharm. 2009 Jun;24(3):339-46.
Inhibition of ataxia-telangiectasia mutated by antisense oligonucleotide nanoparticles
induces radiosensitization of head and neck squamous-cell carcinoma in mice.
Zou J, Qiao X, Ye H, Zhang Y, Xian J, Zhao H, Liu S.
Department of Otolaryngology, West China Hospital, Sichuan University, Chengdu,
People's Republic of China.

   Ataxia-telangiectasia-mutated (ATM) is a radiosensitization gene. In the present
study, we investigated the efficacy of poly(D,L-lactide-co-glycolide) (PLGA)
nanoparticles containing ATM antisense oligonucleotides (ASOs) for the
radiosensitization of head and neck squamous-cell carcinoma in mice, using the
SCCVII cell line. Nanoparticles containing ATM ASOs were prepared with PLGA by
using a double-emulsion solvent evaporation method. The results showed that the
nanoparticles were suitable for intracellular uptake, and ATM ASOs inhibited ATM
expression when delivered by using nanoparticles or lipofectin, but not in their free
form. Meanwhile, we found that ATM reduction sensitized SCCVII cells in vitro and
tumors in vivo to irradiation. In conclusion, biodegradable PLGA nanoparticles, used
as a delivery carrier, enhanced intracellular uptake of ATM ASOs into SCCVII cells
and the inhibitory effect of ATM ASOs. These results demonstrated that antisense
ATM therapy, using PLGA nanoparticles, might provide a therapeutic benefit to
patients undergoing radiation therapy for head and neck squamous-cell carcinoma.

14、Cancer Biother Radiopharm. 2009 Apr;24(2):261-9.
Adenovirus-mediated ING4 expression suppresses pancreatic carcinoma cell growth
via induction of cell-cycle alteration, apoptosis, and inhibition of tumor angiogenesis.
Xie YF, Sheng W, Xiang J, Zhang H, Ye Z, Yang J.
Cell and Molecular Biology Institute, College of Medicine, Soochow University,
Suzhou, China.

   Recent studies have demonstrated that ING4, as a novel member of the ING
(inhibitor of growth) family, has a potential effect on tumor inhibition via multiple
pathways. However, adenovirus-mediated ING4 expression in the application of gene
therapy for pancreatic carcinoma has not been reported. To explore its therapeutic
effect on human pancreatic carcinoma, we constructed a recombinant adenoviral
vector, Ad-ING4, expressing the green fluorescent protein (GFP) marker gene and the
tumor-suppressor gene, humanized ING4 derived from murine ING4 with two
amino-acid modifications at residues 66 (Arg to Lys) and 156 (Ala to Thr) by
site-directed mutagenesis. We demonstrated that Ad-ING4-mediated transfection of
PANC-1 human pancreatic carcinoma cells inhibited cell growth, altered the cell
cycle with S-phase reduction and G2/M phase arrest, induced apoptosis, and
downregulated interleukin (IL)-6 and IL-8 expression of transfected tumor cells. In
athymic mice bearing the PANC-1 human pancreatic tumors, intratumoral injections
of Ad-ING4 suppressed the tumor growth, downregulated CD34 expression, and
reduced the tumor microvessel formation. Therefore, this study will provide a
framework for future clinical application of Ad-ING4 in human pancreatic carcinoma
gene therapy.
15、Cancer Biother Radiopharm. 2009 Apr;24(2):249-59.
Vascular endothelial growth factor-C siRNA delivered via calcium carbonate
nanoparticle effectively inhibits lymphangiogenesis and growth of colorectal cancer
in vivo.
He XW, Liu T, Xiao Y, Feng YL, Cheng DJ, Tingting G, Zhang L, Zhang Y, Chen
YX, Tingting G, Zhang L.
Department of General Surgery, Shaoxing First People's Hospital, Shaoxing, China.

   A nonviral gene carrier, calcium carbonate (CaCO(3))-nanoparticle, was evaluated
for the efficient in vitro and in vivo delivery of siRNA-targeting vascular endothelial
growth factor-C (VEGF-C). The chemically synthesized CaCO(3)-nanoparticle has a
58-nm diameter and a + 28.6-mV positive surface charge. It is capable of forming a
CaCO(3)-nanoparticle-DNA complex and transferring DNA into targeted cells with
high transfection efficiency, while effectively protecting the encapsulated DNA from
degradation. Further, the CaCO(3)-nanoparticle-DNA complex has no obvious
cytotoxicity for LoVo cells, while a liposome-DNA complex exhibited measurable
cytotoxicity. LoVo cells transfected with a VEGF-C-targeted small interfering RNA
(siRNA) via the CaCO(3)-nanoparticle exhibits significantly reduced VEGF-C
expression, as measured by real-time polymerase chain reaction (PCR) and
enzyme-linked immunosorbent assay, whereas no decrease in VEGF-C expression is
observed in cells treated by control transfection. Transfection of LoVo cells with
VEGF-C siRNA via the CaCO(3)-nanoparticle also dramatically suppresses tumor
lymphangiogenesis, tumor growth, and regional lymph-node metastasis in
subcutaneous xenografts. Significant downregulation of VEGF-C messenger RNA
expression in a subcutaneous xenograft derived from VEGF-C siRNA-treated LoVo
cells was confirmed by real-time PCR, as compared to controls. We conclude that the
CaCO(3)-nanoparticle is a novel, nonviral system for the effective delivery of siRNA
for cancer gene therapy.

16、Cancer Biother Radiopharm. 2009 Apr;24(2):243-7.
Inhibitory effects of VEGF-siRNA mediated by adenovirus on osteosarcoma-bearing
nude mice.
Gao YS, Mei J, Tong TL, Hu M, Xue HM, Cai XS.
Department of Orthopedics, Tongji Hospital, Tongji University, Shanghai, People's
Republic of China.

   As one of the blood-rich malignancies, the growth and metastasis of osteosarcoma
both depend on its angiogenesis, a procedure in which vascular endothelial growth
factor (VEGF) acts essentially. Although with the advent of neoadjuvant
chemotherapy, more aggressive surgical excision and logical therapy strategy, the
5-year survival rate remains relatively stable at 70%, at best. However, antiangiogenic
therapeutics, through gene silencing and targeting key sequences, probably brings an
outlook to the conventional algorithm. In our current research, human-specific
VEGF-siRNA (small interfering RNA) mediated by adenovirus was constructed and a
cell line of MG63 was cultured and used to make an osteosarcoma-bearing nude mice
model. The recombined adenovirus vector of Ad-VEGF-siRNA could successfully
suppress VEGF expression and slow down the multiplication of MG63 cells in vivo;
likewise, the down regulation of VEGF could be detected in vitro of the animal model.
Inhibitory effects on osteosarcoma growth and blockage of pulmonary metastasis
could be observed in the following oncotherapy procedure. The study demonstrates
potent growth and pulmonary metastasis inhibitory effects of VEGF-siRNA on
osteosarcoma in vivo and in vitro, which could potentially be applicable to the
treatment of cancers as an antiangiogenic therapeutic in the near future.

17、Cancer Biother Radiopharm. 2009 Apr;24(2):237-41.
Malignant melanoma therapy by chemotherapy and autoimmunity induced by
cytokine.
Jin S, Zhang Q, Kang X, Wang J, Sun W.
Department of Oncology, The Third College Hospital of Harbin Medical University,
Harbin, People's Republic of China.

   PURPOSE: The aim of this study was to evaluate the effect of combining
dacarbazine (DTIC) and granulocyte/macrophage colony-stimulating factor (GM-CSF)
with interleukin-2 (IL-2) in patients with advanced malignant melanoma. METHODS:
Twenty-seven (27) patients with advanced malignant melanoma received dacarbazine
(500 mg/m(2)/days 1-2, intravenously), GM-CSF (175 ug/m(2)/days 3-6,
subcutaneously), and interleukin-2 (400 MIU/m(2)/days 7-10, subcutaneously). Each
treatment cycle required 21 days to completion. RESULTS: Time to progression was
7-11 months. The total effective rate was 44.4%, and the combination of
chemotherapy, GM-CSF, and IL-2 had low toxicity. CONCLUSIONS: The
combination of DTIC with GM-CSF and IL-2 is feasible and possibly efficacious for
clinical use.

18、Cancer Biother Radiopharm. 2008 Dec;23(6):701-14.
Clinical Significance of FDG Single-Photon Emission Computed Tomography:
Computed Tomography in the Diagnosis of Head and Neck Cancers and Study of Its
Mechanism.
Li LF, Zhou SH, Zhao K, Wang SQ, Wu QL, Fan J, Cheng KJ, Ling L.
Department of Nuclear Medicine, Institute of Infectious Diseases, The First Affiliated
Hospital, College of Medicine, Zhejiang University, Hangzhou, China.

   Background: The metabolic changes of malignant cells are earlier than these of
morphology. (18)F-fluorodeoxyglucose (FDG) single-photon emission computed
tomography (SPECT)-computed tomography (CT) systems provide functional and
anatomic images that could significantly improve its diagnostic capability. The
molecular mechanisms of increased FDG uptake are still not fully understood. The
correlation between FDG uptake and the expression of Glut in various tumor cells is
still under debate. Further study is necessary to correlate increased FDG uptake by
tumors with their Glut-1 and Glut-3 expression, which will lead to a better
understanding and interpretation of SPECT-CT imaging. In this study, we, therefore,
investigated in patients with head and neck carcinoma (HNC) the relationship
between tumor FDG accumulation and the mRNA expression and protein expression
of Glut-1 and Glut-3. Materials and Methods: Overall, 25 patients with HNC who
underwent SPECT-CT imaging and CT or magnetic resonance imaging (MRI) studies
were performed between April 2002 and March 2004. Then, the mRNA and protein
expression of Glut-1 and Glut-3 in these 25 surgical or biopsied samples were studied
with HNC to determine the correlate increased FDG uptake by tumors with their
Glut-1 and Glut-3 expression. Results: Visual analysis of (18)F-FDG SPECT-CT
gave sensitivity, specificity, and accuracy levels of 100%, 62.5%, and 88%,
respectively. The tumor-to-background (T/B) ratios were 94.1%, 87.5%, and 92.0%
for (18)F-FDG SPECT/CT, and 64.7%, 50.0%, and 60.0% for CT and MRI. This
indicates that (18)F-FDG SPECT-CT is superior to CT and MRI. Significant
correlation was found between FDG and Glut-1 mRNA or Glut-1 protein (p < 0.001).
There was no correlation between T/B ratio and Glut-3 mRNA (r = 0.14, p > 0.01).
Conclusions: (18)F-FDG SPECT-CT can be as a prospective tool that can judge the
malignancy or benignity of head and neck tumor, stage and classify the tumor,
distinguish recurrence or necrosis or fibrosis of the tumor after treatment by surgery
or radiotherapy, and detect unknown primary tumor. Glut-1 may largely mediate basal
glucose transport in HNC cells.

19、Cancer Biother Radiopharm. 2009 Feb;24(1):91-8.
The antitumor effects of CIK cells combined with docetaxel against drug-resistant
lung adenocarcinoma cell line SPC-A1/DTX in vitro and in vivo.
Liu P, Chen L, Huang X.
Department of Medical Oncology, Jinling Hospital, Medical School of Nanjing
University, 305 Zhong Shan Eastern Road, Nanjing, People's Republic of China.

   OBJECTIVE: The aim of this study was to investigate the inhibitory effects of
cytokine-induced killer (CIK) cells combined with docetaxel (DTX) on the growth of
drug-resistant lung adenocarcinoma cell line SPC-A1/DTX in vitro and in vivo.
METHODS: The MTT assay was employed to evaluate the cytotoxic activity of DTX,
CIK cells, and DTX plused CIK cells against SPC-A1/DTX cells in vitro. For the in
vivo assay, SPC-A1/DTX cells were injected into nude mice subcutaneously to
establish a tumor-bearing mice model. On the day 14, normal saline, docetaxel, CIK
cells, and CIK cells combined with docetaxel were administered intraperitoneally,
respectively. All the nude mice were sacrificed at day 15 after treatment and the
tumors were weighed out. RESULTS: The MTT assay showed that CIK cells
possessed a higher antitumor cytotoxic activity against SPC-A1/DTX cells than
SPC-A1 cells in vitro (p < 0.05). The synergetic antitumor activity positively
correlated with the E:T ratio and the concentration of docetaxel. The animal data also
suggested that CIK cells combined with DTX had a stronger suppressive effect on
tumor growth in vivo. CONCLUSION: CIK cells plused with docetaxel demonstrated
a prominent augmentation of antitumor activity against multidrug resistance lung
adenocarcinoma cell lines both in vitro and in vivo.

20、Cancer Biother Radiopharm. 2009 Feb;24(1):81-90.
A new G6PD knockdown tumor-cell line with reduced proliferation and increased
susceptibility to oxidative stress.
Li D, Zhu Y, Tang Q, Lu H, Li H, Yang Y, Li Z, Tong S.
Department of Biochemistry, Kunming Medical University, 191 West Renmin Road,
Kunming, People's Republic of China.

   Glucose-6-phosphate dehydrogenase (G6PD) has been implicated in the regulation
of cellular antioxidative mechanisms. Tumor cells often lose the balance of oxidation
and antioxidation, but the role of G6PD in such an imbalance is still largely unknown.
To investigate the related function of G6PD in tumor cells, we established a stable
line of A375 human melanoma cells with G6PD gene knockdown by a shRNA
lentiviral cloning and expression system. The A375-G6PDDelta cells displayed the
stable GFP coexpression after repeated freeze-thaw cycles and multiple passages,
accompanied by an 88.83% suppression of the endogenous G6PD expression and a
78.47% decrease in G6PD activity. In comparison with the A375-WT cells, they were
characterized by a reduced proliferation with the MTT proliferation assay, a 25%
decrease in colony-forming efficiency, and an up to 40% increase of apoptotic rate
with flow cytometry analysis. When further challenged by diamide-induced oxidative
stress, these cells showed that a median lethal dose (LD(50)) of 1.2 mM decreased
from that of the A375-WT cells (1.8 mM), and levels of NADPH and GSH decreased
by 2.4-, 8.8-fold, respectively, with a 7.3-fold increase of H(2)O(2), as those of
A375-WT cells. These results demonstrated that A375-G6PDDelta is a new, stable
G6PD-deficient human tumor cell line, and that silencing G6PD expression decreased
tumor-cell proliferation and enhanced apoptosis. In addition, G6PD gene knockdown
rendered tumor cells more susceptible to diamide-induced oxidative stress. Together,
our data support the important functions of G6PD in the regulation of cell growth and
antioxidative capacity of tumor cells.

21、Cancer Biother Radiopharm. 2009 Feb;24(1):57-66.
Adenovirus-mediated wild-type p53 transfer radiosensitizes H1299 cells to
subclinical-dose carbon-ion irradiation through the restoration of p53 function.
Liu B, Zhang H, Duan X, Hao J, Xie Y, Zhou Q, Wang Y, Tian Y, Wang T.
Key Laboratory of Heavy Ion Radiation Medicine of Gansu Province, Institute of
Modern Physics, Chinese Academy of Sciences, 509 Nanchang Road, Lanzhou,
China.

   To determine whether adenovirus-mediated wild-type p53 transfer after
radiotherapy could radiosensitize non-small-cell lung cancer (NSCLC) cells to
subclinical-dose carbon-ion beam (C-beam), H1299 cells were exposed to a C-beam
or gamma-ray and then infected with 5 MOI of AdCMV-p53 or GFP (C-beam or
gamma-ray with p53 or GFP). Cell cycle was detected by flow cytometric analysis.
The apoptosis was examined by a fluorescent microscope with DAPI staining. DNA
fragmentation was monitored by the TUNEL assay. P53 mRNA was detected by
reverse-transcriptase polymerase chain reaction. The expression of p53, MDM(2), and
p21 was monitored by Western blot. Survival fractions were determined by
colony-forming assay. The percentages of G(1)-phase cells in C-beam with p53
increased by 8.2%-16.0%, 5.2%-7.0%, and 5.8%-18.9%, respectively, compared with
C-beam only, gamma-ray with p53, or p53 only. The accumulation of G(2)-phase
cells in C-beam with p53 increased by 5.7%-8.9% and 8.8%-14.8%, compared with
those in gamma-ray with p53 or p53 only, respectively. The percentage of apoptosis
for C-beam with p53 increased by 7.4%-19.1%, 5.8%-11.7%, and 5.2 %-19.2%,
respectively, compared with C-beam only, gamma-ray with p53, or p53 only. The
level of p53 mRNA in C-beam with p53 was significantly higher than that in p53 only.
The expression level of p53 and p21 in C-beam with p53 was significantly higher than
that in both C-beam with GFP and p53 only. The survival fractions for C-beam with
p53 were significantly less than those for the other groups (p < 0.05). The data
suggested that AdCMV-p53 transfer could more efficiently radiosensitize H1299 cells
to subclinical-dose C-beam irradiation through the restoration of p53 function.

22、Cancer Biother Radiopharm. 2009 Feb;24(1):41-8.
Membrane damage effect of therapeutic ultrasound on Ehrlich ascitic tumor cells.
Hao Q, Liu Q, Wang X, Wang P, Li T, Tong WY.
College of Life Sciences and Natural Pharmaceutical Chemistry, Shaanxi Normal
University, Xi'an China.
PURPOSE: The biologic effects and the underlying mechanisms of Ehrlich ascitic
tumor (EAT) cells induced by ultrasound were investigated in this study. METHODS:
Cells were subjected to ultrasonic irradiation with a frequency of 2.17 MHz and an
intensity of 3 W/cm(2) for variable periods of time. Trypan blue exclusion was used
to detect the integrity of cellular membrane; the membrane permeability was
investigated by the incorporation of fluorescein isothiocyanate dextran during
ultrasound exposure; and the cell membrane ultrastructure changes were observed
under a scanning electron microscope. The potential mechanism was estimated from
the generation of hydroxyl radicals, the lipid peroxidation levels, and intracellular
reactive oxygen radicals production. RESULTS: The cell membrane damage effects
induced by ultrasound increased with a prolonged exposure time; the fluorescent rates
of the cells irradiated with ultrasound for 30 and 60 seconds were 11.46% and 18.50%,
respectively; the amount of hydroxyl radicals in 30 (26.10 U/mL) and 60 seconds
(28.47 U/mL) were significantly enhanced, compared with the control group (24.44
U/mL); then, the level of lipid peroxidation was also changed from 0.27 to 0.54 (30
seconds) and 1.21 nmol/mL (60 seconds). CONCLUSIONS: Shear forces and free
radicals produced by acoustic cavitation may play important roles in these actions.

23、Cancer Biother Radiopharm. 2009 Feb;24(1):15-24.
In-vitro internalization and in-vivo tumor uptake of anti-EGFR monoclonal antibody
LA22 in A549 lung cancer cells and animal model.
Liu Z, Yu Z, He W, Ma S, Sun L, Wang F.
Medical Isotopes Research Center, Peking University, Beijing, China.

   PURPOSE: Internalization is one of the key steps for anticancer immunoconjugates
to deliver the drugs inside of cancer cells. Herein, the internalization property of
antiepidermal growth factor receptor (EGFR) monoclonal antibody (mAb) LA22 was
evaluated. MATERIALS AND METHODS: The binding and internalization
properties of LA22 on A549 cells were investigated by using 125I-LA22. In vitro
internalization was also confirmed by indirect fluorescent staining. In vivo tumor
targeting and internalization of 125I-LA22 were evaluated in the A549 nude mice
model. RESULTS: The mAb LA22 showed a high affinity to EGFRs expressed on
A549 cells (Kd = 0.69 +/- 0.13 nM). The in vitro internalization of LA22 was time-
and temperature dependent. The cell-surface-bound LA22 was rapidly internalized at
37 degrees C. The experimental results of LA22 internalization obtained from
radioassay and fluorescent staining were consistent with a good linear correlation. At
72 hours postinjection, a clear gamma-image of tumor was obtain in A549 tumor
xenografts, and the tumor uptake of 125I-LA22 was 8.00 +/- 0.61 percent injected
dose per gram (%ID/g) (2.19 +/- 0.37 %ID/g for 125I-mIgG). Similar to the in vitro
observation, 64.06% of the cell-bound mAb LA22 was internalized into the tumor
cells in vivo. CONCLUSIONS: The mAb, LA22, is a rapid, high-internalizing
antibody, and this property makes it a promising vehicle for tumor-targeted drug
delivery.

24、Cancer Biother Radiopharm. 2009 Feb;24(1):99-102.
Oncolytic virus as an agent for the treatment of malignant ascites.
Liu HL, Chen J.
Gene and Immunotherapy Section, Institute of Immunology, Third Military Medical
University, PLA, No. 30 Gaotanyan Street, Chongqing, People's Republic of China.
liu_hong_li@yahoo.com.cn
Oncolytic virus H101 is an adenovirus with an E1B-55KD gene deletion, which
selectively replicates in tumor cells, rather than in normal cells, resulting in specific
tumor cytolysis. Taking the selective killing of peritoneally planted tumor cells by the
oncolytic virus H101 as the rationale for the ascites treatment, we report in this paper
the intraperitoneal H101 in 9 patients with malignant ascites. The interval between the
paracentesises increased from a mean of 12.4+/- 3.4 to 39.9 +/- 11.6 days (p < 0.001).
The 30-day response was classified into complete response (CR) (no fluid recurrence),
partial response (PR) (fluid recurrence <50%), and no response (NR) (fluid
recurrence > or =50% or requiring paracentesis). Nine (9) patients had 3 CRs, 2 PRs,
and 4 NRs. Intraperitoneal H101 was well tolerated, and no severe adverse effects
were observed. Further, this report also highlights the potential of H101 in malignant
ascites treatment.
Nuclear Medicine Communications
1、Nucl Med Commun. 2009 Dec 22. [Epub ahead of print]
A simplified one-pot automated synthesis of [18F]FHBG for imaging reporter gene
expression.
Tang G, Tang X, Li H, Wang M, Li B, Liang M, Wu H, Wang Q.
Department of Nuclear Medicine, PET-CT Center, The First Affiliated Hospital, Sun
Yat-Sen University bCollege of Science, South China Agricultural University cNan
Fang PET Centre, Nan Fang Hospital, Southern Medical University, Guangzhou,
China.

   BACKGROUND: 9-(4-[F]fluoro-3-hydroxymethylbutyl) guanine ([F]FHBG) has
been used as a reporter probe to image the expression of the herpes simplex virus type
1 thymidine kinase (TK) reporter gene in living organisms with positron emission
tomography (PET). However, the routine production of [F]FHBG presents many
challenging laboratory requirements. AIM: To develop a simple one-pot
fully-automated synthesis procedure of [F]FHBG amenable for its routine use in
reporter gene expression PET imaging studies. METHODS: A TRACERlab FXF-N
synthesizer was substantially modified and adapted to the synthesis of [F]FHBG
through the two-step one-pot procedure. After the fluorination reaction of the tosylate
precursor and the hydrolysis of the intermediate product in the same reaction vessel,
the final product was purified by Sep-Pak cartridges instead of the high performance
liquid chromatography system. RESULTS: The fully automated synthesis of
[F]FHBG with Sep-Pak purification was performed within a short synthesis time. The
decay-uncorrected radiochemical yield of [F]FHBG was 8-14% (n=10), the
radiochemical purity was more than 99%, and the entire synthesis time was less than
40 min. In addition, the PET image of theTK-transfected nude mice model indicated a
much higher uptake of [F]FHBG in the TK-transfected tumor region than in the
control tumor region. CONCLUSION: The automated synthesis of [F]FHBG is very
easy to carry out using one-pot reactions combined with Sep-Pak purification. The
synthetic [F]FHBG can be used for PET imaging and monitoring of in vivo herpes
simplex virus type 1 TK gene expression.

2、Nucl Med Commun.. [Epub ahead of print]
Utility of 18F-FDG PET/CT for staging NK/T-cell lymphomas.
Hu-Bing W, Quan-Shi W, Ming-Fang W, Hong-Sheng L, Wen-Lan Z, Xiang-Hua Y,
Qiao-Yu W.
NanFang PET Center, Nanfang Hospital, Southern Medical University, Guangzhou,
Guangdong Province, China.

   PURPOSE: Extranodal natural killer (NK)/T-cell lymphoma is a rare neoplasm and
limited data has reported regarding the utilization of fluorine-18, fluorodeoxyglucose
positron emission tomography/computed tomography (F-FDG PET/CT) in this
disease. The aim of this study was to assess the role of F-FDG PET/CT in the staging
of NK/T-cell lymphomas. PATIENTS AND METHODS: Thirteen newly diagnosed
and two recurrent patients with NK/T-cell lymphoma who received F-FDG PET/CT
were studied. The lesion with intense F-FDG uptake was suggested as the positive and
was measured using maximal standardized uptake values. The results of PET/CT were
compared with the conventional staging examinations. RESULTS: F-FDG PET/CT
detected nasal or extranasal lymphoma lesions in at least one site in all of the 15
patients. There was no significant difference of F-FDG uptake in lesions between
patients with stage I-II disease and those with stage III-IV disease (maximal
standardized uptake values 8.44+/-5.56 vs. 10.32+/-7.80; t=0.757, P>0.05). In two
patients with an indeterminate diagnosis, the diagnosis of NK/T-cell lymphomas was
established by biopsy guided by PET/CT and the status of stage IV was correctly
identified. In 13 patients with definite diagnosis, the stage of disease was changed in
six patients on the basis of F-FDG PET/CT. Two patients were down staged, and four
patients upstaged. CONCLUSION: The lesions of the NK/T-cell lymphoma are
F-FDG avid and PET/CT seems to be useful in the staging of this disease.

3、Nucl Med Commun. 2010 Feb;31(2):147-51.
Radiolabeling RGD peptide and preliminary biodistribution evaluation in mice
bearing S180 tumors.
Ma Y, Yu J, Han Y, Shen H, Li Z, Zhou W, Yin D.
Shanghai Institute of Applied Physics (SINAP), Chinese Academy of Sciences, PR
China.

   OBJECTIVE: To prepare the rhenium-188 (188Re)-arginine-glycine-aspartic acid
(RGD) peptide in a convenient manner and to evaluate its potential as an agent for
alphavbeta3 integrin receptor-positive tumors. METHODS: Radiolabeled RGD was
obtained by conjugating the His group at the end of peptide with
fac-[188Re(H2O)3(CO)3]+. Chelating efficiency of fac-[188Re(H2O)3(CO)3]+ and
radiolabeling efficiency of radiolabeled peptide were measured by thin-layer
chromatography and high-performance liquid chromatography. In-vitro stability of
the radio-complex was determined in phosphate-buffered saline (0.05 mol/l, pH 7.4),
new-born calf serum, His or Cys solution at 37 degrees C or room temperature and
analyzed by thin-layer chromatography. A biodistribution study was carried out in
mice bearing S180 tumors. RESULTS: 188Re-RGD was obtained with a more than
95% of radiolabeling efficiency, and showed high stability in phosphate-buffered
saline, new-born calf serum, His and Cys solution. Furthermore, this radio-complex
was cleared rapidly from the blood and showed specific tumor uptake in mice bearing
S180 tumors. CONCLUSION: 188Re-RGD was prepared by a simple method.
Preliminary biodistribution results showed its potential as an agent for cancer therapy
and encouraged further investigation.

4、Nucl Med Commun. 2010 Jan;31(1):4-11.
The role of positron emission tomography imaging of B-amyloid in patients with
Alzheimer's disease.
Xiong KL, Yang QW, Gong SG, Zhang WG.
Department of Radiology, The Third Affiliated Hospital, The Third Military Medical
University, China.

   One of the hallmark pathologies of Alzheimer's disease (AD) is amyloid plaque
deposition in the brain. Although the advent of new therapeutic strategies aimed at
reducing b-amyloid burden in the brain is to potentially delay cognitive loss,
improved methods for amyloid visualization have become more imperative. Studies
so far have shown that positron emission tomography (PET) has produced the greatest
strides toward accomplishing this ambitious goal. Several PET amyloid imaging
ligands have recently been developed and tested in AD patients. High amyloid content
can be detected in vivo by PET in prodromal AD preceding the impairment of
functional activity. Hopefully, amyloid imaging may help in the early detection of the
disease and can be used for evaluating new drug therapies in AD. This study provides
an overview of recent advances in the development of amyloid imaging agents and
includes a summary of the clinical significance of amyloid imaging.
5、Nucl Med Commun. 2009 Dec 3. [Epub ahead of print]
Nasopharyngeal carcinoma: relationship between 18F-FDG PET-CT maximum
standardized uptake value, metabolic tumour volume and total lesion glycolysis and
TNM classification.
Chan WK, Mak HK, Huang B, Yeung DW, Kwong DL, Khong PL.
Departments of aDiagnostic Radiology bClinical Oncology, The University of Hong
Kong, Hong Kong SAR, China.

   PURPOSE: We aimed to evaluate the relationships between primary tumour;
maximum standardized uptake value (SUVmax), metabolic tumour volume (TV) and
total lesion glycolysis (TLG) and tumour-node metastases (TNM) classification in
nasopharyngeal       carcinoma     (NPC)     patients.   METHODS:       Fluorine-18
fluorodeoxyglucose positron emission tomography-computed tomography scans of 57
consecutive newly diagnosed NPC patients (age range, 15-80 years) were
retrospectively reviewed. SUVmax, TV and TLG were recorded. Two-tailed
Spearman's correlation was used to analyse the relationships between the metabolic
parameters and the TNM staging system. RESULTS: Positive correlations were
observed between SUVmax (P<0.001, R=0.516), TV (P<0.001, R=0.504) and TLG
(P<0.001, R=0.620) and T-stage, and both TV and SUVmax were independent
variables that significantly affected T-stage (P<0.001, adjusted R=0.370). No other
significant correlations were found between the metabolic parameters and TNM
classification system. CONCLUSION: The metabolic parameters derived from
fluorine-18 fluorodeoxyglucose positron emission tomography-computed tomography
were positively correlated with T-stage in primary NPC. Our findings may suggest a
complementary role of these parameters to TNM staging in prognostication of NPC
patients.

6、Nucl Med Commun. 2009 Sep 3. [Epub ahead of print]
Correlation of 18F-FDG PET activity with expressions of survivin, Ki67, and CD34
in non-small-cell lung cancer.
Han B, Lin S, Yu LJ, Wang RZ, Wang YY.
The Second Ward of Oncology Department, The First Hospital of Harbin Medical
University bPET/CT Center Departments of cRadiation Oncology dPathology, The
Tumor Hospital of Harbin Medical University, Harbin, China.

   PURPOSE: This work investigates the correlation between positron emission
tomography (PET) images and the expressions of survivin, Ki67, and CD34, as well
as the clinicopathological characteristics of non-small-cell lung cancer (NSCLC).
METHODS: Thirty-three NSCLC cases were scanned with F-fluorodeoxyglucose
(F-FDG), PET before surgery. Tumor resections were used to evaluate the
expressions of survivin, Ki67, and CD34 by immunohistochemical assay. Maximum
standardized uptake value (SUVmax), immunohistochemical results, as well as
clinicopathological characteristics in NSCLC were compared and analyzed.
RESULTS: The average SUVmax for the 33 NSCLC was 10.5+/-5.4. The expressions
of survivin and Ki67 were 84.8% (28 of 33) and 72.7% (24 of 33), respectively. The
median count of microvasculature vessel density labeled by CD34 was 24.5+/-6.7. In
the entire group, SUVmax was significantly correlated to Ki67, histological type, as
well as clinical type (P = 0.010, 0.048, 0.029, respectively). It revealed a median
survival of 33+/-0.6 months for SUVmax below 11 versus a median survival of
27+/-1.3 months for SUVmax values above 11 (P = 0.013). There were no significant
correlations between SUVmax and expressions of survivin and CD34, and no
correlations involving age, sex, differentiation, tumor node metastasis stage, and
lymph node metastasis. CONCLUSION: SUV-indexed FDG metabolic activity
correlated significantly with proliferative activity (Ki67 expression) as well as the
histological and clinical tumor type. These biological predictive markers combined
with F-FDG PET might provide more useful information on the diagnosis and
prognosis of patients with NSCLC. These conclusions require confirmation with
further studies.

7、Nucl Med Commun. 2009 Sep 3. [Epub ahead of print]
Exceptionally low metabolic activity in aggressive peripheral T-cell lymphoma.
Tang B, Douglas-Nikitin V, Balon H, Wong CO, Khong PL, Wong CY.
Departments of aNuclear Medicine bPathology, Oakland University William
Beaumont School of Medicine, Royal Oak, Michigan, USA cDepartment of
Diagnostic Radiology, The University of Hong Kong, Li Ka Shing Faculty of
Medicine, Hong Kong, HKSAR, China.

   PURPOSE: To investigate metabolic behavior of aggressive peripheral T-cell (PTC)
lymphoma compared with other aggressive T-cell (OTC) nonHodgkin's lymphomas
(NHLs) and the various grades (1, 2, 3) of follicular B-cell (FC) NHL as a reference
cell type for indolent to aggressive behavior. MATERIALS AND METHODS:
Pretreatment        2-deoxy-2-[F]      fluoro-d-glucose        positron      emission
tomography-computed tomography scans of 33 patients with pathologic diagnosis of
aggressive T-cell NHL and FC (FC1 = 6, FC2 = 8, FC3 = 9, PTC = 6, OTC = 4) were
analyzed. The maximal standardized uptake value (SUV) was measured over biopsy
region (BxSUV) and the highest tumor activity of the body (BmSUV). RESULTS:
There were significant differences in both BxSUV (P = 0.036) and BmSUV (P =
0.026) among these five groups with significantly lower metabolic activity in PTC
compared with other aggressive NHL (FC3, OTC). BmSUV in PTC was significantly
lower than that in OTC (8.2+/-2.5 vs. 22.3+/-7.0, P = 0.029) and was similar to that of
FC1 (9.4+/-1.9) and FC2 (9.7+/-1.4) but lower than that of FC3 (14.6+/-2.7). Similar
findings were noted in BxSUV between PTC and OTC (6.7+/-2.5 vs. 20.4+/-7.2, P =
0.035). CONCLUSION: Although 2-deoxy-2-[F]fluoro-d-glucose positron emission
tomography has been found to reflect metabolic activity for the aggressiveness of
B-cell NHL, PTC has an exceptionally low metabolic activity, similar to that of
low-grade B-cell FC1 and FC2.

8、Nucl Med Commun. 2009 Dec;30(12):971-7.
Imaging a pancreatic carcinoma xenograft model with 11C-acetate: a comparison
study with 18F-FDG.
Zhao C, Chen Z, Ye X, Zhang Y, Zhan H, Aburano T, Tian M, Zhang H.
Department of Nuclear Medicine, Second Affiliated Hospital of Zhejiang University
School of Medicine, Hangzhou, Zhejiang, China.
   PURPOSE: Pancreatic carcinoma is a malignant tumor with poor prognosis and its
early detection is still a clinical problem. The aim of this study was to evaluate the
efficacy of carbon-11-labeled acetate (11C-acetate)-positron emission tomography
(PET) for the detection of pancreatic carcinoma in a BxPC-3 human pancreatic
carcinoma xenograft-bearing immunodeficiency BALB/c-nu nude mice model.
METHODS: Whole-body 11C-acetate and fluorine-18-labeled fluorodeoxyglucose
(F-FDG) micro-PET imaging were performed weekly on BxPC-3 human pancreatic
carcinoma xenograft-bearing BALB/c-nu nude mice from the 2nd week after tumor
cell inoculation. Regions of interest method and tumor-to-nontumor ratio (T/N ratio)
were used for semiquantitative evaluation. Tumor proliferation was evaluated by
immunohistochemistry analysis of proliferating cell nuclear antigen. RESULTS:
Radiotracer accumulation in the tumor xenografts could be detected 1 week earlier in
11C-acetate-PET than that in 18F-FDG-PET. Peak T/N ratio was obtained at the 5th
week in 11C-acetate-PET and at the 4th week in 18F-FDG-PET. T/N ratio in
11C-acetate-PET was lower than that in 18F-FDG-PET during the same period. By
visual evaluation, tumor xenografts were more easily observed in 11C-acetate-PET
than in 18F-FDG-PET in most of the mice. Linear correlation analysis indicated T/N
ratios in C-acetate-PET had no significant correlation with those in 18F-FDG-PET.
Tumor size, T/N ratio in 11C-acetate-PET, and T/N ratio in 18F-FDG-PET were not
found to be significantly correlated with tumor proliferating cell nuclear antigen
expression. CONCLUSION: 11C-acetate-PET imaging can be used for the detection
of pancreatic carcinoma. In the early stage of tumor growth, 11C-acetate-PET has
better detectability than that of 18F-FDG-PET.

9、Nucl Med Commun. 2009 Sep;30(9):700-5.
Impact of image reconstruction on phase analysis of ECG-gated myocardial perfusion
SPECT studies.
Li D, Zhou Y, Feng J, Yuan D, Cao K, Garcia EV, Chen J.
Division of Nuclear Cardiology, Department of Cardiology, The First Affiliated
Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China.
lidianfu@gmail.com

   OBJECTIVES: Phase analysis (SyncTool) has been developed to assess
left-ventricular (LV) dyssynchrony from gated myocardial perfusion single-photon
emission computed tomography (GSPECT) studies. Conventionally, GSPECT data
are reconstructed using filtered backprojection (FBP). This study is intended to
determine the impact of various iterative reconstruction methods on SyncTool.
METHODS: Thirty consecutive patients, acquired using a Philips CardioMD system,
were enrolled in this study. The GSPECT data were reconstructed using FBP,
maximum likelihood expectation maximization (MLEM), MLEM with
three-dimensional resolution recovery (Astonish), MLEM with Vantage attenuation
correction (AC), and MLEM with Vantage AC and three-dimensional Monte
Carlo-based scatter correction (ACSC), respectively. The reconstructed data were
then submitted to SyncTool to measure LV dyssynchrony (phase standard deviation
and histogram bandwidth). The paired t-test was used to compare the LV
dyssynchrony indices given by MLEM, Astonish, AC, and ACSC, respectively, with
those given by the FBP. RESULTS: No statistical significance was observed for any
comparison between iterative reconstruction methods and the FBP. CONCLUSION:
Reconstruction methods have insignificant impact on the LV dyssynchrony indices,
indicating that the standard FBP reconstruction is sufficient for accurate phase
analysis, supporting the widespread clinical use of SyncTool in measuring LV
dyssynchrony.

10、Nucl Med Commun. 2009 Aug;30(8):639-50.
Value of 18F-FDG-PET/PET-CT in differentiated thyroid carcinoma with
radioiodine-negative whole-body scan: a meta-analysis.
Dong MJ, Liu ZF, Zhao K, Ruan LX, Wang GL, Yang SY, Sun F, Luo XG.
PET Center, the First Affiliated Hospital, College of Medicine, Zhejiang University,
Zhejiang, China.

   AIM: The aim of this study was to evaluate the diagnostic accuracy of
18F-fluorodeoxyglucose-PET (FDG-PET) and FDG-PET/computed tomography (CT)
in the detection of recurrent or metastatic differentiated thyroid carcinoma (DTC) that
was not identified by radioiodine whole-body scintigraphy (WBS). PATIENTS AND
METHODS: A total of 25 studies (comprising 789 patients) that were published from
January 1990 to September 2008 were reviewed. These studies evaluated the role of
FDG-PET and FDG-PET/CT in the detection of recurrent or metastatic DTC that
radioiodine WBS failed to detect. Systematic methods were used to identify, select,
and evaluate the methodological quality of the studies and to summarize the overall
findings of sensitivity and specificity. RESULTS: In total, 17 studies with 571
patients who had recurrent or metastatic DTC and a radioiodine-negative whole-body
scan were collected, and the overall patient-based sensitivity and specificity of
FDG-PET were 0.835 [95% confidence interval (CI): 0.791-0.873] and 0.843 (95%
CI: 0.791-0.886), respectively. Of these studies, six included lesion-based data,
totaling 237 lesions, and the pooled lesion-based sensitivity and specificity were
0.916 (95% CI: 0.863-0.953) and 0.775 (95% CI: 0.660-0.865), respectively. The
pooled sensitivity and specificity in the DTC patients who presented with elevated
serum thyroglobulin and negative 131I scan were 0.885 (95% CI: 0.828-0.929) and
0.847 (95% CI: 0.715-0.934), respectively. In the six studies where the 165 patients
were diagnosed by using FDG-PET/CT, pooled sensitivity and specificity were 0.935
(95% CI: 0.870-0.973) and 0.839 (95% CI: 0.723-0.920), respectively.
CONCLUSION: FDG-PET is especially effective in detecting patients with elevated
thyroglobulin levels and normal radioiodine WBS; FDG-PET/CT is a more sensitive
method in the follow-up of thyroid cancer recurrence or metastases, particularly in
those with negative WBS.

11、Nucl Med Commun. 2009 Aug;30(8):610-6.
Myocardial viability in chronic ischemic heart disease: comparison of
delayed-enhancement magnetic resonance imaging with 99mTc-sestamibi and
18F-fluorodeoxyglucose single-photon emission computed tomography.
Liu Q, Zhao S, Yan C, Lu M, Jiang S, Zhang Y, Li S, Liu Y, Yang M, He Z.
Department of Radiology, Cardiovascular Institute and Fuwai Hospital, Peking Union
Medical College and Chinese Academy of Medical Sciences, Beijing, China.

  OBJECTIVES: We sought to compare delayed-enhancement MRI (DE-MRI) with
99mTc-sestamibi and 18F-fluorodeoxyglucose (18F-FDG) single-photon emission
computed tomography (SPECT) for the assessment of myocardial viability.
METHODS: Thirty-four patients with prior myocardial infarction underwent DE-MRI
and 99mTc-sestamibi/18F-FDG SPECT. The area of delayed enhancement by
DE-MRI was defined as scar tissue. The region with concordantly reduced perfusion
and glucose metabolism was defined as nonviable myocardium. In a 17-segment
model, the segmental extent of hyperenhancement was compared with segmental
99mTc-sestamibi and 18F-FDG uptake defect. All segments were divided into five
different severities by segmental extent of hyperenhancement in DE-MRI and were
classified into different viability situations by segmental 99mTc-sestamibi and
18F-FDG uptake in SPECT. RESULTS: A total of 578 segments were studied.
Sensitivity and specificity of DE-MRI in identifying segments with flow/metabolism
match were 61.32 and 95.35%, respectively. Semiquantitatively assessed relative MRI
scar tissue correlated well with 99mTc-sestamibi and 18F-FDG SPECT (r = 0.63, P =
0.0284). However, of the 431 segments defined as normal by DE-MRI, 82 segments
(19%) were scored as nonviable by 18F-FDG SPECT. During these segments, 48
showed less than 50% reduced 18F-FDG uptake, 25 showed 50-75% reduced
18F-FDG uptake, and nine showed no 18F-FDG uptake. CONCLUSION: MRI
hyperenhancement as a marker of myocardial scar closely agrees with
99mTc-sestamibi and 18F-FDG SPECT. Nuclear technology and DE-MRI show their
own predominance and limitation in assessment of myocardial viability and detecting
irreversibly injured tissue.

12、Nucl Med Commun. 2009 Aug;30(8):586-93.
Thyroxine alone or thyroxine plus triiodothyronine replacement therapy for
hypothyroidism.
Ma C, Xie J, Huang X, Wang G, Wang Y, Wang X, Zuo S.
Departments of Nuclear Medicine, Affiliated Hospital, Qingdao University, Qingdao,
Shandong Province, China. machaopony@hotmail.com

   Standard therapy for patients with hypothyroidism is replacement with synthetic
thyroxine (T4). However, thyroxine plus triiodothyronine (T3) replacement therapy
resulted in marked improvements in several items of the Profile of Mood States and in
a few indices of psychometric function and quality of life. The adequacy of thyroxine
alone versus thyroxine plus triiodothyronine to treat hypothyroidism has yielded
conflicting results. Therefore, we conducted a systematic review of all included
published, randomized controlled trials to evaluate the effects of thyroxine alone or
thyroxine plus triiodothyronine replacement therapy for hypothyroidism. We
electronically searched Medline, Embase, the Cochrane Library, and China National
Infrastructure. We also manually searched the Chinese Journal of Isotopes, Radiologia
pratica, and the Chinese Journal of Endocrinology and Metabolism. A total of 10
randomized, double-blind trials (six crossovers, four parallel trials) were identified.
Pooled analyses were suggestive of a statistically significant increase of free and total
triiodothyronine, significant decrease of serum-free and total thyroxine in patients
treated with thyroxine plus triiodothyronine, weighted mean difference (WMD) 0.03,
-31.25, 2.19, 3.00; 95% confidence interval (CI) -0.14 to 0.20, -47.04 to -15.47,
0.46-3.92, 1.64-4.36, respectively. Thyroxin alone indicated significant benefits for
psychological or physical well-being in terms of the General Health Questionnaire-28
(WMD: -2.90; 95% CI: -3.18 to -2.63), general health (WMD: -0.38; 95% CI: -0.71 to
-0.05), physical component summary (WMD: 0.7; 95% CI: 0.53-0.87), and mental
component summary (WMD: 0.58; 95% CI: 0.25-0.75); physical functioning (WMD:
1.60; 95% CI: 1.29-1.90), role-physical test (WMD: 3.60; 95% CI: 2.66-4.54), bodily
pain (WMD: 2.50; 95% CI: 2.11-2.88), role-emotional (WMD: 2.08; 95% CI:
1.17-2.99), mental health (WMD: 1.30; 95% CI: 0.97-1.64) in items of the Short
Form-36 Health Survey; general well-being in items of the Thyroid Symptom
Questionnaire (WMD: -1.90; 95% CI: -2.48 to -1.32); better performance in the Letter
Number Sequencing-working memory test in items of cognitive performance scores
(WMD: 1.10; 95% CI: 0.08-2.13), significant treatment effect for blurred vision,
aches, and pain (WMD: -4.66, -0.80; 95% CI: -5.339 to -4.00, -1.34 to -0.26,
respectively). However, T4 plus T3 replacement improved cognitive performance
(WMD: -0.49; 95% CI: -0.90 to -0.08). No significant statistical differences were
found in biochemical variables, mood states clinical variables, adverse effects, and
drop-out. In subgroup analysis, two included studies examined the relationship
between mental improvement and causes of hypothyroidism, autoimmune, and
nonautoimmune hypothyroidism, respectively. T4 alone suggested significantly
higher total T4 (autoimmune and nonautoimmune thyroid, WMD: 4.5, 3.7; 95% CI:
2.24-6.76, 1.66-5.74, respectively), and significantly decreased thyroid-stimulating
hormone (WMD: -0.05; 95% CI: -0.09 to -0.01). Statistically significant improvement
occurred in pairs correctly recalled in the Digit Symbol Test for T4 plus T3
replacement (WMD: -1.60; 95% CI: -2.97 to -0.23) for nonautoimmune thyroid. In
conclusion, on the basis of data from recent studies, we conclude that combined T4
and T3 treatment does not improve well-being, cognitive function, or quality of life
compared with T4 alone. T4 alone may be beneficial in improving psychological or
physical well-being. According to the current evidence, T4 alone replacement may
remain the drug of choice for hypothyroid patients.

13、Nucl Med Commun. 2009 May;30(5):356-61.
Technetium-99m(V)-dimercaptosuccinic acid osteotropism in Staphylococcus
aureus-induced arthritis regulated by glucose-mediated acidification.
Wu Z, Liu M, Feng J, Weilin, Wu H, Wang J, Li Y.
The Second Affiliated Hospital of Guangzhou Medical College, Guangzhou, China.
wu_zhaozhong@126.com

   OBJECTIVES: To study the possible mechanism of the technetium-99m complex
of dimercaptosuccinic acid 99mTc(V)-DMSA accumulation in a model of
Staphylococcus aureus-induced bacterial arthritis regulated by glucose.MATERIALS
AND METHODS: After making the S. aureus-induced bacterial arthritis model, 14
rabbits were divided into two groups randomly, with one group receiving 6 g/kg 30%
glucose administration. Then all the rabbits were injected with 74 MBq
99mTc(V)-DMSA. Whole-body single photon emission computed tomography was
applied at different time points. The change of blood pH after blood glucose was also
assayed. The percentage of residual activity was evaluated over time in multiple
regions of interest, including the inflammatory joint lesions and the contralateral
normal joints. Regional joint tissue pH was measured with a needle probe at different
times after injecting glucose solution. Forty-two rabbits were divided into six groups
to assay the percentage injected dose.RESULTS: 99mTc(V)-DMSA showed a
noticeable osteotropic character in bone pathologies. There was no influence of
biodistribution of 99mTc(V)-DMSA by glucose loading, but the glucose loading
remarkably increased the uptake levels of 99mTc(V)-DMSA in inflammatory joint
lesions. A peak difference in glucose-loaded lesion/normal uptake was observed after
6 h. The pH values of the inflammatory joints were noticeably lower than those of the
normal joints of the contralateral legs.Conclusion: The increased lesion uptake and
tissue acidification in the glucose-loaded group supports the hypothesis that glucose
acidosis increases DMSA uptake in bacterial arthritis, as has been observed in tumors.
14、Nucl Med Commun. 2009 Jun;30(6):420-6.
Interstitial injection of (32)P-chromic phosphate during lung cancer resection to treat
occult lymphatic metastasis.
Gao W, Liu L, Liu ZY, Li XD, Li C.
Nuclear Medicine Technology Institution of Southeast University, Nanjing, China.

   OBJECTIVE: We aimed to study the interstitial injection of (32)P-chromic
phosphate colloids ((32)P-CP) during lung cancer resection to treat occult lymphatic
metastasis, and to observe its medium-term and long-term effects. METHODS:
Seventy-three patients underwent surgery combined with injection of (32)P-CP with
the dosage of 296-370 MBq/10 ml to the adipose and connective tissues neighboring
pulmonary hilum, superior mediastinum, carina of trachea, and suspicious invaded
pleura. Fifty-eight patients underwent only tumor resections served as control group.
A monofactorial analysis by a chi test was conducted to determine the differences in
positive rates of lymph nodes, the incidence of complications after the operation, the
rate of supraclavicular lymph node metastasis, and the survival rate between the two
groups. The survival curves were obtained using the Kaplan-Meier method and were
compared by a log-rank test. The Cox's multivariate analysis was performed to
identify the prognostic factors. RESULTS: There was no significant difference
between lymph node-positive rates and the incidences of major complications
(P>0.05). The rate of supraclavicular lymph node metastasis in surgery plus (32)P-CP
group was prominently lower than that in the control group (P<0.05). Three-year and
5-year survival rates of the two groups showed significant difference (P<0.05). A
Kaplan-Meier analysis revealed prominent statistical differences between the two
groups (P<0.05). The Cox's multivariate analysis showed that the injection of
(32)P-CP is one of the independent predictors of survival rates. CONCLUSION:
Interstitial mediation with (32)P-CP during the resection of lung cancer is effective in
inhibiting postoperative occult lymphatic metastasis, and showed satisfactory effects
in improving patients' medium-term and long-term survival rates.

15、Nucl Med Commun. 2009 Jun;30(6):415-9.
Nitrate-augmented myocardial perfusion imaging for assessment of myocardial
viability: recent advances.
Yang MF, Keng F, He ZX.
Department of Nuclear Medicine, Cardiovascular Institute and Fu Wai Hospital,
Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing,
China.

   Nitrate-augmented myocardial perfusion imaging has been demonstrated to
improve the detection of myocardial viability and accurately predicts recovery of left
ventricular (LV) function in patients with severe coronary artery disease and LV
dysfunction. Recently, several studies showed the prognostic utility of nitrate imaging
in evaluation of event-free survival in ischemic LV dysfunction. Furthermore, the
diagnostic power of nitrate imaging compared with positron emission tomography or
MRI, as well as the mechanism of nitrate-enhanced imaging, were also studied. We
describe recent studies using nitrate-augmented myocardial perfusion imaging for the
assessment of myocardial viability.
16、Nucl Med Commun. 2009 Feb;30(2):160-8.
Comparison of the long-term efficacy of low dose 131I versus antithyroid drugs in the
treatment of hyperthyroidism.
Chen DY, Jing J, Schneider PF, Chen TH.
Hyperthyroidism Treatment Center, Dongshan Division, The First Affiliated Hospital,
Sun Yat-sen University, Guangzhou, China.

   OBJECTIVE: In China the therapeutic options to treat hyperthyroidism comprise
antithyroid drugs (ATDs), radioiodine (131I) therapy and surgery. Physicians in
China avoid the risk of hypothyroidism as a consequence of either treatment because
patients from rural districts cannot easily comply with long-term medication.
Therefore, we prospectively assessed the efficacy and safety of 131I versus ATDs.
METHODS: Of 2021 hyperthyroid patients 460 without any previous treatment were
enrolled in a 9-year prospective, randomized, open-label blinded endpoint study and
randomly assigned to receive either 131I or ATD. Follow-up was 98.4+/-5.5 months.
The primary outcome was euthyroidism, persistent hyperthyroidism, recurrence, and
hypothyroidism. RESULTS: Euthyroidism was achieved in 69.9 and 41.2% using
either 131I or ATD, 2.4 and 19.2% remained hyperthyroid, hypothyroidism occurred
in 21.5 and 9.0%, recurrence in 6.2 and 30.5%, respectively. Time to cure was shorter
with 131I (44.8 vs. 74.8 months, P<0.01). Goiter size extended time to cure. Hard
goiter, complications, or ophthalmopathy were protective against hypothyroidism
after 131I therapy. Large goiters or long courses of hyperthyroidism predicted failure
of ATD treatment. CONCLUSION: This study showed a shorter cure time using 131I.
Time to remission in ATD patients was shorter during the first 9 months. Thereafter,
the 131I group showed a higher remission rate. Low long-term hypothyroidism and
low recurrence or persistent hyperthyroidism rates were achieved with our 131I dose
regimen, regardless of the underlying disease. Lesser 131I activity was used as
compared with current guidelines. Within limitations, our concept may simplify
procedures in other geographical regions.
PMID: 19194213 [PubMed - indexed for MEDLINE]

				
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