[en] The aim of this study was to evaluate the value of ^99mTc-MIBI imaging in 46 cases of thyroid masses (18 malignant, 28 benign and 24 cases of postoperative relapse or metastatic thyroid cancer. Results showed that radioactivity filling in primary cancer lesion was observed in 14 out of 18 thyroid carcinoma, whereas only 9 out of 28 in benign lesions. ^99mTc-MIBI imaging was positive in 19 out of 24 patients with postoperative relapse or lymph nods metastases. Its positivity was significantly higher than ¹³¹I imaging, thereby ^99mTc-MIBI imaging was highly valuable in detecting early thyroid carcinoma, especially, in finding out distant metastases and postoperative relapse

[en] Serum CA_15-3 levels of 41 pre-operative patients with breast tumor and 113 post-operative patients with breast cancer were measured by radioimmunoassay. The sensitivity and specificity were 20%, 93.7% and 71.2%, respectively. In 50 patients with bone metastasis, the sensitivity was 78.0%. It appears that due to its low sensitivity for early diagnosis, CA_15-3 RIA has little use for screening in general population to detect primary breast cancer in early stage but is beneficial for detecting its metastasis and recurrence

[en] The 3, 24 h ¹³¹I and 30 min ^99mTc uptake rates have been measured in 101 cases with thyroid disease. The 30 min ^99mTc uptake rate was also measured in 22 cases with normal thyroid. The results showed that 30 min ^99mTc uptake rate of normal thyroid were 3.73 +- 1.56. The coincident rate of increased value in ^99mTc uptake with ¹³¹I uptake were 82.4%, while those of decreased value were 91.3% and 88.5% respectively. Above studies have shown that in functional image of thyroid ^99mTc uptake is more useful than 24 h ¹³¹I uptake test

[en] Objective: To evaluate the methods and clinical value of mammary sentinel lymphoscintigraphy in breast cancer. Methods: 117 patients with breast tumor in stage T_1-2N₀ were examined before sentinel node biopsy were considered. Some of them were compared in different injection volume at both side and several cases with SPECT/CT tomographic fusions. 13 patients were subdermally injected with 55.5 MBq (0.5 ml) ⁹⁹Tc^m-DTPA-human serum albumin (HSA) on the surface of the lesion, 50 patients with 92.5 MBq (4 ml) unfiltered ⁹⁹Tc^m-sulfur colloid (SC) in four divided doses around the lesion and 54 patients in the upper part of the lesion with the same volume of the SC in one-point-injection. Results: The sentinel lymph node (SLN) could quickly be shown by any of three methods but the best time of view and number of lymph nodes differed personly and mainly affected by injection depth and volume. It was showed that the 3rd method could find more juxtaclavicular, supraclavicular and internal mammary nodes. SLN were successfully identified in 69.2% with HSA in 30 min and over 84% with SC in 2 h. SPECT/CT tomographic fusions were more helpful to recognize SLN and abnormal lymphatic drainage. Conclusion: The mammary sentinel lymphoscintigraphy in breast cancer is differ from past lymphatic imaging and is essential for localizing SLN correctly, identifying abnormal lymphatic drainage and designing new therapeutic regime

[en] Fifteen patients with clinical diagnosed thyroid tumor were examined with ^99mTc(V)-DMSA and the results were compared with pathologic findings.The lesions of 2 patients with medullary thyroid carcinoma had strong positive uptake and the pattern of radioactive distribution were similar to that of CT scan, Uptake of the other benign and amlignant diseases of thyroid were almost negative. The results indicated that the use of ^99mTc(V) DMSA would be great clinical value for the diagnosis, localization and follow-up medullary thyroid carcinoma

[en] Objective: We explored the potential clinical value of SPECT sentinel lymphoscintigraphy combined with a positional CT in defining the radiation target volume of internal mammary lymph nodes (IMN). Methods: (1) Forty breast cancer patients were enrolled, using ⁹⁹Tc^m-sulfur colloid (SC) as radiotracer and GE Millennium VG Hawkeye as imaging instrument. The depth ( distance from center of IMN to the surface of pectoralis major) and width (distance between the center of IMN and mid-sternal line) of each IMN were measured in the Hawkeye fusion images. (2) Hawkeye CT and diagnostic enhanced CT images of the same patients were analyzed, with the same reference points selected and their depths and widths measured. The location accuracy by the positional CT was evaluated. (3) Hawkeye positional CT and diagnostic CT scan were performed respectively using the CT quality control model attached to Hawkeye. The distances between the center of spheres on the Hawkeye CT and diagnostic CT images were measured, and then the data were compared and the model location accuracy of Hawkeye evaluated. Statistical comparison for the depth and the width between left and right IMN were performed with the t-test. Result: (1) Seventy IMN in 40 patients were studied. The depth was 1.10-3.99 cm with an average of 2.15 cm. The width was 1.52-6.59 cm with an average of 4.37 cm. The difference of depth between left and right IMN was not statistically significant (t= 1.1, P= 0.275), neither was the width (t=0.8, P=0.408). Only 11.4% (8/70) of the IMN and 10.0% (4/40) of the patients could fit the routine field. (2) CT position system of Hawkeye for localization of IMN was similar to that of diagnostic CT. Conclusion: IMN lymphoscintigraphy using Hawkeye CT positional system may be helpful for defining individual IMN radiation target volume. (authors)

[en] Background: Cervical cancer gets the highest incidence in female reproductive system and is ranked secondary in mortality rate of Chinese female tumors. Lymphatic metastasis is the uppermost mode, so the conventional surgery performed in early stage patients is radical hysterectomy along with pelvic lymph nodes dissection. However, the latter is often ccompanied with some disadvantages and a series of intercurrent diseases such as prolonged surgery time, increased blood loss, vessel and nerve damage, lymph cyst with infection, pelvic conglutination, lymphedema of thighs or legs. Since sentinel lymph node (SLN) stands important in clinical value, we refer to the experience we've got in breast cancer for investigating the feasibility of SLNs detection in cervical cancer after radionuclide injection as well as the guidance significance of lymphoscintigraphy in rapid search for SLNs in surgery. Methods: Millennium VG ECT/CT manufactured by GE Company and 99Tcm -sulphur colloid (⁹⁹Tc^m -SC) produced by CIS-US Company were used in the study. Between April and November 2003, 20 patients with cervical cancer FIGO (International Federation of Gynecology and Obstetrics) stage Ib or IIa underwent SLNs radionuclide dection. 10-12 hour before surgery, 148 Mbq/2 ml ⁹⁹Tc^m -SC were injected into the cervical tissue around the tumor at 3 and 9 o'clock evenly about 0.5 cm deep. Then the patients underwent instant lymphoscintigraphy, positioning tomography and a delayed imaging. In surgery, a hand-held γ-ray detector probe was used to find the ^hot spots' . Besides, 4ml blue dye was injected evenly through the same places as the nuclide did and the blue sentinel lymph nodes (BSLNs) were recorded. Then the conventional pelvic nodes dissection and histological check up of the nodes were performed. Comparing the difference between the two Methods, analyzing the relation between the 'hot spots' and BSLNS, and checking the histological results. Results In the study we found 53 SLNs. Combining the two Methods, all the SLNs were found in the all 20 patients, the detection rate reaches 100% while the false negative rate 0%. T-detection rate is 92.5% (49/53) whereas blue dye detection rate shows 88.7 % (47/53); the complete compliance of the two Methods reaches 75% (15/20). In 13 patients, lymphoscintigraphy showed the same SLNs region as γ-detection did ,the rate is 65% (13/20). In addition, the frequency of SLNs located in obturator, hypogastric area, external iliac, and common iliac shows 75%, 45%, 20% and 20% respectively. The data indicates that it quite agrees with the theoretical lymph drain of cervical cancer and is very close to some study results reported. Conclusion: Radionuclide allows successful SLNs detection in cervical cancer patients, and the detection rate would be raised if it is combined with blue dye. Presurgical lymphoscintigraphy contributes to directing positioning SLNs rapidly in surgery. The clinical validity of this technique could be evaluated prospectively. (authors)

[en] Objective: To investigate the influence of ¹⁸F-deoxyglucose γ-camera PET imaging on the clinical staging of non-small cell lung cancer (NSCLC) in comparison to the convention staging as well as the changes in treatment planning and the target area of radiotherapy. Methods: Fourty-nine patients with pathologically confirmed NSCLC complete with history, physical examination, routine roentgenography and clinical staging by the conventional method were entered into the present study. An initial staging and treatment plan were established basing on all the above information. After hPET, a revised staging and treatment plan were, then, made. The emphasis of the present study was laid upon the changes in staging and treatment plan with and without the participation of hPET and also upon the difference in the primary tomor volume silhouetted by CT and hPET. Results: Before hPET, curative plan was intended for 22 patients and palliative plan for 27 among these 49 patients. After hPET, 36.7%(18/49) found their clinical stage changed: 5 elevated and 13 lowered. The treatment plan was also changed in 36.7%. The primary tumor volume revealed by CT was reduced in 17.7%(P=0.002) by hPET. Conclusions: The participation of hPET obviously influences the clinical staging and treatment planning of NSCLC. It is hopeful that hPET be used in differentiating atelectasis from tumor. (authors)

[en] Objective: In the literature, data regarding the optimal threshold for defining the true target volume in radiotherapy are controversial The aim of this study was to use a phantom to evaluate an optimal threshold segmentation for ¹⁸F-fluorodeoxyglucose (FDG) PET/CT clinical applications. Methods: A NEMA IEC-Body Set^TM phantom (DATA SPECTUM, USA) with spheres in various sizes (volume: 0.52, 1.15, 2.60, 5.50, 11.40 and 26.50 ml) was used to simulate lung cancer lesions of different tar- get/background (T/B) ratios. Firstly, an appropriate window in CT slice was selected and adjusted so that the sphere volumes on CT are equal to the true sphere volumes on phantoms. Secondly, the threshold of PET images was adjusted to an optimal value such that the PET volume equalizes the CT volume. An optimal threshold was thus calculated by the following formula: I_threshold=I_back + x% I_{max-back(slice)}, where I_threshold was an absolute threshold, I_back was mean radioactivity in background, and x% I_{max-back(slice)} was a relative threshold. Both the size and coverage delineated at optimal threshold were compared with those generated at a fixed threshold of 42% maximum voxel radioactivity (commonly used in commercial programs). SPSS 13.0 and Wilcoxon test were used for statistical analysis. Results: For spheres >5.50 ml with various T/B ratios, the mean deviation of optimal threshold between the middle half slices and the maximum slice was (1.6 ± 2.0)%, whereas the corresponding value between the peripheral half slices and the maximum was (19.3 ± 10.1)% (Z=-7.26, P<0.01). The % volume-deviation calculated with different optimal thresholds at maximum slice was ≤5% if the relative threshold varied within 20%-25%. The mean % volume-deviation delineated by I_threshold=I_back + 20% I_{max-back(slice)} was (12.6 ± 6.6)%, while the corresponding value delineated by a fixed threshold of 42% I_max(total) was (-17.2 ± 15.2)% (Z=-2.67, P < 0.01). These results implied that I_threshold=I_back + 20% I_{max-back(slice)} was superior to 42% I_max(total) in the estimation of spherical le- sion volume(97.1% vs 79.4%, Z=-2.67, P<0.01). Conclusion: I_back +20% I_{max-back(slice)} might be a more optimal threshold segmentation method than the conventional 42% I_max(total) parameter for more accurate target volume delineation and is independent of the target volume information provided by CT slice in advance. (authors)

[en] Objective: The aim of this study was to investigate the possible influential factors in ⁹⁹Tc^m-sulphur colloid (SC) internal mammary, sentinel node (IMSN) lymphoscintigraphy. Methods: IMSN lymphoscintigraphy data from 263 breast cancer patients with T₁ or T₂ tumors were retrospectively reviewed. Parameters including patients'age, left or right breast, various quadrants, focus properties, o'clock site a- round tumor of injection, injection volume, injection radioactivity and delay time of imaging were selected as influential factors to be analyzed by single factor and multifactor analyses with SPSS 11.5, significant value was P<0.05. Results: Left breast and inner half breast were easier to drain to internal mammary nodes (IMN) than that of right breast and outer half breast (Wald=27.71, P<0.05 and Wald=6.46, P< 0.05). Peri-tumoral injection with three sites was better than with four sites (Wald=11.57, P=0.001). A bet- ter imaging quality was gained in 0.5 x 10^-3 L per site. Radioactivity, age, location of injection, and delay time were insignificant to identify the IMSN. Conclusion: Left breast and inner half breast, injection site, and injection volume are all independent factors affecting IMSN lymphoscintigraphy. (authors)