Objective To analyze the image characteristics and clinical value of 18F-FDG PET/CT in patients with extranodal nasal type natural killer/T-cell lymphoma (ENKTL).Methods From January 2012 to March 2016,20 ENKTL patients (12 males,8 females;median age 53 years) who underwent whole-body 18F-FDG PET/CT were enrolled in this retrospective study.Eleven patients were newly diagnosed,and 9 were previously treated.Clinical data were collected for histopathology and bone marrow biopsy,laboratory results,PET/CT and radiological findings such as CT or MRI.The final diagnosis was based on histopathology and immunohistochemistry.Mann-Whitney u test was used to compare the SUVmax of newly diagnosed patients and patients with recurrence or disease progression after therapy.Spearman correlation analysis was used to explore the relation between diameter of tumor-invaded lymph nodes and SUVmax.Results ENKTL could be found in all parts of the body,but more frequently in the nasal cavity,nasopharynx and skin.All lesions showed high uptake of FDG on PET/CT.The SUVmax of newly diagnosed patients was significantly higher than that of patients (n=7) with recurrence or disease progression:6.5(4.3,10.4) vs 5.4(3.4,8.9);u=6 853.500,z=-2.039,P＜0.05).The diameter of tumor-invaded lymph nodes showed weakly positive correlation with SUVmax(rs =0.290,P＜0.01),suggesting that invasion of ENKTL might not be accurately evaluated by the size of lymph nodes.The staging by PET/CT was concordant with clinical final staging in 11 newly diagnosed patients,while the staging by CT or MRI was only correct in 6 patients.Conclusions PET/CT is superior to conventional imaging modalities in diagnosis and staging for patients with ENKTL.Since some lesions might be found in the limbs,limbs should be included in the scan field.

Objective To evaluate the effect of P-gp inhibitors of verapamil (VER) and GF120918 on 18F-FDG uptake in Bcap37 and Bcap37/multidrug resistancce (MDR)1 cell lines in vitro,and to explore the relationship between 18F-FDG uptake and P-gp expression at cellular level.Methods Bcap37 and Bcap37/MDR1 cells were seeded into 6-well plates at a density of 1 × 106 per well.Three days later,37 kBq/ml 18F-FDG,or 37 kBq/ml 18F-FDG + 100 μmoL/L VER,or 37 kBq/ml 18F-FDG + 50 μmol/L GF120918 were added into each well.Mter incubated for 10,30,60 and 120 min at 37 ℃ and in 5％ CO2,the medium was removed and the cells were washed three times with 1 ml ice-cold PBS immediately.The radioactivity of 18 F-FDG was measured using a gamma counter.The uptake of 18F-FDG was expressed as the ratio of 18F-FDG radioactivity in Bcap37 or Bcap37/MDR1 cells and the overall radioactivity added to the cells in each well.The t test was used for statistical analysis.Results 18F-FDG uptake was higher in Bcap37/MDR1 cells than that in Bcap37 cells after incubated for 10 min.The uptake rate was (1.88 ±0.19) ％ in Bcap37/MDR1 cells and (1.37 ± 0.18) ％ in Bcap37 cells (t =7.832,P ＜ 0.05).On the contrary,18 F-FDG uptake was significantly higher in Bcap37 cells than that in Bcap37/MDR1 cells after incubated for 60 and 120 min.The uptake rates were (2.29 ±0.23)％ and (2.34 ±0.15)％ in Bcap37 cells,(1.47 ±0.14)％ and (1.53 ±0.22)％ in Bcap37/MDR1 cells (t =8.437,8.283,both P ＜ 0.05).18 F-FDG uptake was significantly higher with VER or GF120918 in Bcap37/MDR1 cells than that without VER or GF120918 after the incubation of 60 and 120 min (t =9.032,9.243 and 8.765,8.803,all P ＜ 0.05).The uptake rates with VER or GF120918 were (2.45 ±0.21)％ and (2.46 ±0.25)％,(2.50 ±0.24)％ and (2.48 ±0.27)％.There was no significant difference of 18F-FDG uptake in Bcap37 cells with or without VER or GF120918.Conclusions 18F-FDG is a substrate of P-gp at cellular level.P-gp may act as an efflux pump to reduce 18F-FDG uptake in Bcap37/MDR1 cells.The uptake of 18F-FDG can be used to evaluate the function of P-gp in tumor cells.

Objective To analyze the relevant factors influencing 18F-FDG uptake in the primary lesion of breast invasive ductal carcinoma (BIDC).Methods A total of 160 female patients underwent 18 F-FDG PET/CT examination from 2010 to 2015 and breast lesions were revealed.Lesions were divided into benign group (n =118) and malignant group (n =49,BIDC) according to pathological results.KruskalWallis H test and Mann-Whitney u test were performed to compare SUVmax of the two groups,and to investigate the relationship between the SUVmax of breast malignant lesion and patients' age as well as clinical pathological parameters including T stage,lymphatic vessel invasion,nuclear grade,route of metastasis,ER,PR,HER2 and Ki-67 expression,and subtype of breast cancer.The diagnostic efficiency of 18F-FDG PET/ CT in differentiating benign and malignant breast lesions was analyzed using ROC curve analysis.Results The SUVmax of BIDC was 6.09(3.88,9.26),higher than that of breast benign lesion (1.35 (0.95,2.35);u=341.0,P＜0.05).The SUVmax of BIDC showed statistically significant difference between groups with different T stage,with or without lymphatic vessel invasion,with different nuclear grade,different routes of metastasis and different Ki-67 expression (u:117.5-209.5,H=7.70,P＜0.01 or 0.05).For all breast lesions,lesions with the maximum diameter ≤ 2.0 cm and lesions with the maximum diameter ＞2.0 cm,the optimum cutoff values of SUVmax were ＞2.60,＞ 1.71 and ＞3.97,respectively.When the optimum cutoff values of SUVmax for breast lesions with the maximum diameter ≤2.0 cm were selected as ＞ 1.71 and ＞2.60,the Youden indexes were 0.66 and 0.61(z=0.566,P＞0.05).When the optimum cutoff values of SUVmax for breast lesions with the maximum diamter ＞2.0 cm were selected as ＞3.97 and ＞2.60,the Youden indexes were 0.89 and 0.81(z=0.748,P＞0.05).Conclusions T stage,lymphatic vessel invasion,nuclear grade,route of metastasis and Ki-67 expression of BIDC influence the uptake of 18F-FDG by tumor tissues.The SUVmax of the primary lesion of BIDC is related to the size of lesion,and thus the diagnostic threshold of SUVmax should be decreased appropriately for small lesions.

Objective To evaluate the value of whole body 18F-FDG PET/CT in the detection of recurrence/metastasis of cervical cancer.Methods A retrospective study was performed on 95 patients with cervical cancer who underwent 18F-FDG PET/CT after treatment.The lesion characteristics on 18F-FDG PET/CT were assessed visually and semi-quantitatively.A final diagnosis was confirmed by histopathology,diagnostic treatment and clinical follow-up imaging.The data were analyzed by Kappa test.Results 18 F-FDG PET/CT was positive in 54 patients,including 24 with local recurrence and 30 with distant metastases.The sensitivity,specificity and accuracy of 18F-FDG PET/CT for the detection of recurrence/metastasis of cervical cancer were 98.1％ (52/53),95.2％ (40/42) and 96.8％ (92/95),respectively.The positive predictive and negative predictive value were 96.3％ (52/54) and 97.6％ (40/41),respectively.18F-FDG PET/CT showed concordant results with pathological/clinical follow-up findings (Kappa =0.936,P＜0.05).Conclusion 18F-FDG PET/CT is a sensitive and specific modality for the detection of recurrence/metastasis of cervical cancer and might be useful for further treatment plan.

Objective To evaluate the relationship between 18F-FDG uptake and P-gp expression in Bcap37 or Bcap37/MDR1 tumor-bearing BALB/c nude mice.Methods Bcap37 or Bcap37/MDR1 cells were injected into BALB/c nude mice (1× 107cells/ml,0.2 ml/mouse) to construct mice models.Bcap37 (n=5) or Bcap37/MDR1 (n=5) tumor-bearing mice fasted for 6 h before imaging.After anesthesia,the mice were injected with 7.4 MBq of 18F-FDG via tail vein.The dynamic microPET scans were carried out for 90 min.On the microPET images,the ROI was drawn and the TAC was obtained.The next day,those 10 mice underwent dynamic microPET scans after injected with elacridar (GF120918) and 18F-FDG.Another 10 mice,5 with Bcap37 tumors and 5 with Bcap37/MDR1 tumors,were used.After 7.4 MBq 18F-FDG with or without 2.0 mg/kg GF120918 was administered via tail vein,microPET images were acquired at 60 min.ROI was drawn over the tumors and SUV was obtained.Two-sample t test was used to analyze the data.Results GF120918 did not significantly alter the 18F-FDG accumulation curve in Bcap37 tumors,but significantly enhanced the 18F-FDG accumulation in Bcap37/MDR1 tumors.GF120918 did not influence 18F-FDG uptake (SUV) in Bcap37 tumors (1.052±0.028,1.028±0.045,t =1.792,P＞0.05),but significantly increased the SUV in Bcap37/MDR1 tumors (1.015±0.043,0.712±0.031,t=3.365,P＜0.05);The SUV of 18 F-FDG in Bcap37 tumors was significantly higher than that in Bcap37/MDR1 tumors without injection of GF120918 (t =3.952,P＜0.05).The SUV was not significantly different when GF120118 was injected (t=1.835,P＞0.05).Conclusions 18F-FDG is a substrate of P-gp.18F-FDG imaging combined with GF120918 injection may be an effective noninvasive method for the detection of tumor's MDR.

Objective To investigate the value of gastrointestinal tract preparation with oral racean?isodamine tablets and isotonic mannitol in 18 F?FDG PET/CT imaging. Methods From July to September 2013, 129 patients with confirmed or suspected tumors who were referred for 18 F?FDG PET/CT imaging were divided into 2 groups. In the study group (30 males, 37 females, age (53.4±13.9) years), raceanisodam?ine tablets (10 mg) and 1 000-1 200 ml isotonic mannitol solution (2.5%) were orally taken at 10 min after in?jection of 18F?FDG;while in the control group (37 males, 25 females, age (60.0±12.8) years), 1 000-1 200 ml water was given. Mann?Whitney u test was used to compare the difference between the 2 groups in the filling degree of gastrointestinal lumen, delineation of tube wall, physiological uptake, matching degree of PET and CT images, delineation of mesentery, and the influence of gastrointestinal uptake on the identification of ab?dominal and pelvic lesions. χ2 test was used to compare the difference between the 2 groups in the uptake pattern of gastrointestinal tract and the incidence of side effects. Spearman correlation analysis was used to study the correlation between gastrointestinal lumen filling and PET/CT image matching. Results The gas?trointestinal lumen filling, delineation of tube wall, PET/CT image matching in the stomach, small intestine and colon (z: -5.096 to -2.665, all P<0.01),and delineation of mesentery (z=-2.781,P<0.01) were better in the study group than those in the control group. The filling degree of gastrointestinal lumen correla?ted with the corresponding PET/CT image matching (rs:0.521, 0.755, 0.239, all P<0.01). The physio?logical uptake of small intestine and colon was significantly higher in control group than that in the study group( z=-4.131, -3.095, both P<0.01) . But uptake in the stomach between the 2 groups was not signifi?cantly different(z=-0.776, P>0.05). There was statistically significant difference in the uptake pattern of small intestine between the two groups(χ2=12.884, P<0.01) , but not in the stomach and colon (χ2=0.559, 1.083,both P>0.05). The incidence of transient diarrhea (20?9%, 14/67) was higher in the study group than that in the control group (4.8%, 3/62;χ2=7.256,P<0.01). Conclusions The abdominal PET/CT image quality is improved by gastrointestinal preparation with oral raceanisodamine tablets (10 mg) and 1 000-1 200 ml isoton?ic mannitol solution (2.5%).

Objective To study the impact of human urinary kallidinogenase (HUK) on collateral circulation and blood perfusion in patients with acute cerebral ischemia (ACI) using multi-modality CT methods. Methods In a randomized controlled clinical trial, 75 patients diagnosed with ACI were enrolled and divided into experiment group (treated with HUK)and control group (untreated with HUK). All participants underwent computer technology perfusion (CTP) and computed tomographic angiography (CTA) examination before and fourteenth day after treatment. The CT cerebral perfusion imaging (CTP), CT cerebrovascular imaging (CTA) and National Institutes of Health Stroke Scale (NIHSS) score were analyzed in two groups. The NIHSS score, cerebral blood flow (CBF), cerebral blood volume (CBV), mean transit time (MTT), and time to peak (TTP) were compared between the two groups before and after 14 days therapy. Results ① After treatment, The two group showed increased CBF and CBV values and decreased MTT and TTP values. The CBF improvement was significantly better in the HUK-treated group than in the control group (t=2.470,P<0.05).②MTT and TTP were shorter in the HUK-treated group than in the control group (t=2.126, t=2.213, P<0.05).③ CTA maximum intensity projection (MIP) sequence revealed that the number of patients collateral vessels was significantly increased in the HUK-treated group than in the control group ( x2=4.265, P<0.05). ④The NIHSS score improvement was significantly better in the HUK-treated group after 14 days treatment than in the control group (t=4.330, P<0.05). Conclusion Human urinary kallidinogenase can improve blood perfusion and ameliorates neurological deficits. It is a safe and effective drug for treating ACI patients. The multi-modality CT methods are effective measure to assess blood perfusion and collateral circulation in patients with acute cerebral ischemia.

【Objective】 To investigate the clinical staffs′ knowledge about blood transfusion and their demands, so as to provide evidence for arranging the content for continuing education of blood transfusion medicine. 【Methods】 A self-designed questionnaire was used to investigate the blood transfusion related knowledge of 652 clinical staffs from other cities or counties/districts in Shaanxi Province, who came to our hospital to attend meetings, further training and study from July to August 2019. 【Results】 Clinical stsffs investigated lacked a deep understanding of blood transfusion and blood donation related knowledge, and even were ignorant of certain knowledge. The awareness rate of relevant knowledge was the highest among doctors, followed by laboratory technicians and the lowest among nurses. 【Conclusion】 The awareness rate of blood transfusion related knowledge among medical staffs is relatively low, suggesting the training of blood transfusion related knowledge should be enhanced.