Objective To evaluate the impact of low-dose 131I therapy and high-dose 131I therapy on the clinical outcome in PTC patients coexisting with Hashimoto's thyroiditis (HT).Methods A total of 140 non-distant metastatic PTC patients (16 males,124 females,age range:16-66 years) from July 2010 to December 2014 were enrolled in this retrospective study.Patients concurrent with HT (n=84,group A) were divided into low-dose group (1 110 MBq,n=56,group A1) and high-dose group (5 550 MBq,n=28,group A2) according to 131I ablation dose.Patients without HT (n =56) were enrolled as control group (group B),and received 1 110 MBq of 131I.The thyroid remnant ablation outcome was evaluated according to 131I diagnostic whole-body scan (Dx-WBS),neck ultrasonography (US),serum Tg and TgAb level 6-8 months after 131I ablation therapy.The successful ablation rates were compared by x2 test.Kruskal-Wallis rank sum test was also used.Results There were no significant differences among the 3 groups in terms of both clinicopathological features and postoperative remnant thyroid (H:0.203-2.944,x2:0.271-0.970,all P＞0.05).When negative Dx-WBS and US were deemed as successful ablation criterion,complete ablation rate was found significantly more in group B (94.6％,53/56) than that in group A1 (82.1％,46/56;x2=4.264,P＜0.05),but no significant difference was found between group A2 (85.7％,24/28) and group A1 (x2 =0.318,P＞0.05).When combining negative sTg (sTg＜1 μg/L,TgAb＜46 kU/L) with the above 2 criterions to assess remnant ablation outcome,group B also had a higher successful rate to achieve complete ablation (85.7％,48/56) compared with group A1 (75.6％,34/45),but without statistical significance (x2=2.978,P＞0.05),and no difference was observed between group A2 (12/15) and group A1 (x2=1.320,P＞ 0.05).Conclusion Non-distant metastatic PTC patients coexisting with HT has undesirable 131I ablation outcome compared with those without HT,increasing 131I dose is unhelpful to enhance efficiency of remnant ablation for PTC patients with HT.

Objective To explore optimized method of estimating 131I effective half-life(EHL) in patients with Graves' disease(GD).Methods The EHL was obtained by measuring thyroid radioactive iodine uptake (RAIU) of 126 patients (32 males,94 females,average age (38.47± 11.49) years) with GD at 4,24,48,96,120,144,168,192 and 216 h.Two-sample t test,bivariate correlation analysis and curve estimation were used for statistical analysis.Results The EHL of 126 patients was 0.5-7.5 (4.70±1.46) d.The EHL was 3.0-7.5(5.25±1.01) d and 0.5-6.0(3.24±1.52) d in group A (94 patients,without advanced peak of RAIU) and group B (32 patients,with advanced peak of RAIU),respectively,and the difference between the 2 groups was significant (t =8.499,P＜0.01).The EHL had no significant correlation with RAIU4h/RAIU24h(r=-0.177,P＞0.05) in group A,while it had negative correlation with RAIU4h/RAIU24h in group B (r =-0.724,P＜0.01).In group A,the EHL of patients with RAIU24h/RAIU48h ＞100％ was 3.0-7.5 (5.11 ±0.98) d,the EHL of patients with RAIU24h/RAIU48h ≤ 100％ was 4.0-7.0(5.91±0.94) d (t=3.141,P＜0.01).In group B,when RAIU4h/RAIU24h+RAIU24h/RAIU48h was used as the independent variable in S curve model to estimate the EHL,the result was the best (R2=0.930,F=397.22,both P＜0.01,b0 =-3.038 0,b1 =9.659 4).Conclusions In order to optimally estimate EHL,patients should be grouped according to 131I turnover.In patients with advanced peak of RAIU,the EHL should be calculated by using formula of (RAIU4h/RAIU24h +RAIU24h/RAIU48h).If no advanced peak of RAIU exists,patients should be further divided according to RAIU24h/RAIU48h ＞ 100％ or RAIU24h/RAIU48h ≤100％,and the EHL mean value of each group is taken as the estimated EHL.

Objective To establish rat models of extrahepatic biliary atresia,and to observe the characteristics of 99Tcm-MIBI hepatobiliary scintigraphy and evaluate its association with the expression Pglycoprotein (P-gp) in intestinal tissues.Methods A total of 12 SD rats were randomly divided into the normal control group (3 rats) and the group of common bile duct ligation (CBDL;9 rats).CBDL was used to establish the rat model of extrahepatic biliary atresia.99Tcm-MIBI hepatobiliary scintigraphy was performed at 2,3 and 4 weeks after ligation in the CBDL group and normal control group with continuous dynamic acquisition (3 min/frame) for 30 min and then delaying imaging at 30 min,1,2 and 3 h.After that,all rats were sacrificed,and the blood samples were taken out for the determination of serum ALT,AST,TBIL,DBIL,IBIL,ALP,γ-GT and TBA,and the tissues of duodenum,jejunum,ileum,colon and cecum were taken out for analyzing the expression level of P-gp by immunohistochemistry.Two-sample t test and one-way analysis of variance were used.Results Compared with the normal control group,the serum levels of ALT,AST,TBIL,DBIL,IBIL,ALP,γ-GT and TBA were significantly increasing at 2,3,4 weeks after ligation in CBDL group (t:-3.04 to-44.54,all P＜0.05).99Tcm-MIBI hepatobiliary imaging showed that there was radioactive accumulation in colon or cecum area,excluding the duodenum,jejunum and ileum area,at 3 h after intravenous injection of 99Tcm-MIBI in CBDL group.The results of immunohistochemistry showed that with the obstruction time prolonged,the expression levels of P-gp in duodenum,jejunum and ileum segments were gradually decreased (F=5.17,9.07,23.52;all P＜0.05),while the expression levels in the colon and cecum segments were not changed obviously (F=2.00,3.17;both P＞0.05).Conclusion 99Tcm-MIBI can be excreted through intestinal mucosa,and this process may be associated with P-gp expression.

Atherosclerotic plaque rupture and secondary thrombosis are main causes of cardiovascular events (MACE).The early identification of vulnerable plaque has great significance for clinical assessment of the risk of MACE and decision of treatment strategy in patients with high risk CAD.This review summarizes the research progress of noninvasive molecular imaging of vulnerable atherosclerosis plaques and the related molecular probes in recent years.

Objective To evaluate the value of 18F-FDG PET/CT in preoperative diagnosis and staging of suspected extrahepatic cholangiocarcinoma (EHCC).Methods The clinical data of 116 patients (72 males,44 females;age range 26-89 years) with suspected EHCC from January 2013 to October 2014 were retrospectively analyzed.All patients received preoperative whole body 18F-FDG PET/CT scan.The imaging results were compared with final clinical diagnosis.The diagnostic sensitivity,specificity,positive predictive value,negative predictive value and accuracy of 18F-FDG PET/CT were calculated.Two-sample t test was applied to compare lesion SUVmax of malignant and benign diseases.One-way analysis of variance was applied to compare SUVmax of highly,moderately and poorly differentiated tumors.x2 test was used to compare the difference of diagnostic sensitivities for hilar cholangiocarcinomas and common bile duct tumors.Results All patients were confirmed by exploratory laparotomy and subsequent histologic examination.A total of 94 cases (93 adenocarcinomas and 1 squamous carcinoma) were confirmed malignant and 22 cases (11 biliary calculi,9 cholangitis,1 choledochal cyst,1 tuberculosis) were confirmed benign.The diagnostic sensitivity,specificity,positive predictive value,negative predictive value and accuracy of 18F-FDG PET/CT for primary tumor were 61.7％ (58/94),77.3％ (17/22),92.1％ (58/63),32.1％ (17/53),64.7％ (75/116),respectively.The diagnostic sensitivity and specificity for regional lymph node metastasis were 45.5％(15/33),91.4％(53/58),and those for distant metastasis were 3/4,94.3％(82/87).The SUVmax of malignant tumors were higher than that of benign lesions (4.57± 3.75,2.72± 2.48;t =2.83,P＜ 0.05),while the differences of SUVmax among highly,moderately and poorly differentiated tumors were not significant (4.89±4.75,4.23±2.49,4.47±2.73;F=0.269,P＞0.05).18F-FDG PET/CT showed a lower sensitivity in hilar cholangiocarcinomas than that in common bile duct tumors,while no statistical significance was observed:48.6％ (17/35) vs 69.0％ (40/58),x2=3.827,P＞0.05.Conclusions The value of 18F-FDG PET/CT in preoperative diagnosis and staging of EHCC is limited.It can distinguish some benign diseases from malignant tumors,but with higher false positive for cholangitis.It can help to adjust treatment strategies by detecting distant metastasis.

Objective To evaluate the clinical value of 18F-FDG PET/CT in preoperative assessment for endometrial cancer.Methods A retrospective study was performed in 51 patients (average age (59± 12) years) with confirmed or suspicious diagnosis of endometrial cancer from February 2013 to December 2015.Thirty-three patients underwent curettage surgery at least 1 week before PET/CT imaging.With SUVmax as the statistical variable,comparison was made between the pathologically confirmed benign and malignant groups,and in case of the latter,the extent of infiltration,histologic grade and subtype of primary tumor,lymph node and distant metastases were also analyzed.Two-sample t test was used to analyze the data,and diagnostic efficacy of PET/CT for metastasis was calculated.Results There were 43 patients with endometrial cancer and 8 patients with benign uterine tumor.SUVmax was found to significantly correlate with histopathology classification (benign:3.4 ± 1.2,malignant:12.8 ± 6.5) and depth of myometrial invasion (≥1/2:17.7±5.4,＜1/2:10.9±5.9;t=-8.7 and 3.2,both P＜0.05),but not with cervical stromal invasion,histologic grade or histologic subtype(t =1.8,-1.9,1.5,all P＞0.05).The sensitivity,specificity,accuracy,positive predictive value (PPV) and negative predictive value (NPV) of PET/CT for the detection of lymph node metastases on a lesion basis were 85.7％ (18/21),98.2％ (271/276),97.3％ (289/ 297),78.3％(18/23),98.9％ (271/274),respectively,and on a patient basis were 6/6,97.3％ (36/ 37),97.7％ (42/43),6/7,100％ (36/36),respectively.The sensitivity and PPV of PET/CT for the detection of other metastases on a lesion basis were both 11/12.Conclusion SUVmax could be a clinically valuable tool for preoperative evaluation of the presence of deep myometrial invasion,lymph node metastases and other metastases in patients with endometrial cancer,particularly in specificity and NPV.

Objective To develop a vulnerable plaque targeting ultrasound contrast agent (UCA) and to evaluate its affinity and imaging performance in vitro.Methods E-selectin receptor-targeting UCA,which conjugated with monoclonal antibody of E-selectin,was prepared with filming-rehydration method and biotin-avidin linkage.The size and distribution of UCA were measured with particle size analyzer,the connectivity condition of microbubbles with E-selectin antibody was also detected with fluorescence analysis.The cytotoxicity from microbubble and ultrasound irradiation was evaluated through cell counting kit-8 (CCK8) assay.The adhesion effect of UCA was assessed after co-incubated with activated mouse endothelial cells (bEnd.3) and compared with that of free antibody intervention group and control group.The imaging performance of UCA at different time points was observed on an ultrasound equipment with a high-frequency transducer.Two-sample t test and one-way analysis of variance were performed to analyze the data.Results E-selectin receptor-targeting UCA was successfully prepared.The cytotoxicity result with CCK8 assay demonstrated the favorable biocompatibility of UCA.The connection amount of UCA on activated bEnd.3 cells ((6.23 ± 0.45) bubbles/cell) was significantly higher than that of the free antibody intervention group ((1.57±0.34) bubbles/cell) and control group ((0.07±0.03) bubbles/cell;F=291.43,P＜0.01).The performance of in vitro ultrasonography at the same time points showed no obvious difference between targeting UCA and control UCA (all t＜0.51,all P＞0.05).Conclusions The prepared E-selectin receptor-targeting UCA has favorable targeting and imaging capabilities.It might be a potentially ultrasound molecular imaging agent for early detection and prognosis evaluation of vulnerable plaque.