Objective To research the neural substracts for the processing of the discourse-level English writing using PET-CT.Method Six healthy people underwent 18F-FDG PET examination in the pseudo-writing condition and the discourse-level English writing condition.statistical parametric mapping(SPM)was used to investigate the activicated focus in english writing thruugh pared-t test.Results The activated foci were observed in left inferior parietal lobule,left postcentral gyrus,left cingulate gyrus,left putamen,fight frontal precentral gyrus,right superior frontal gyrus,right thalamus medial dorsal nucleus,both cerebellum(P＜0.05).Conclusions The writing of English as a second language implicates conical and subcortical structures.Left inferior parietal lobule,right frontal and both cerebellum participate in the language production and processes,and left putamen is more engaged in English learning.

Objective To clarify PET image characteristic of spongiform leukoencephalopathy from heroin vapor inhalation and evaluate PET in the dignosis of the disease. Methods 18 F-FDG PET was performed in six patients with spongiform leukoencephalopathy from heroin vapor inhalation. They developed progressive cerebellar ataxia ,dysarthria and unresponsive in different degree respectively.They were a known drug abuser and had a history of heroin use for 1～3 years.Abstinence of heroin was performed from 1.5 to 3 months in the 2 patients .It was known that they took their heroin not by injection but by inhalation of heated heroin vapours,a method known as "chasing the dragon".Brain CT and MRI revealed some characteristics in all patients. Needle biopsy (n=2) was performed and pathological examination proved spongiform degeneration in the white matter. 13 N-ammonia PET was performed in 1 of 6 patients after 24 hours.Results Brain 18 F-FDG PET revealed bilateral and symmetrical 18 F-FDG accumulation decrease or defect areas invoving the internal capsule behind limb ,cerebral occipital lobes ,and cerebellar hemispheres(cerebellar white matter was severely involved).Brain 13 N-ammonia PET imaging demonstrated abnormal areas of decreased accumulation in the bilateral frontal lobes, bilateral temporal lobes , bilateral occipital lobes, bilateral cerebellar cortex and no 13 N-ammonia accumulation in the bilateral internal capsule behind limb and cerebellar white matter in 1 of 6 patients. The region of the lesion was larger than 18 F-FDG PET imaging in the same patient. Conclusion Spongiform leukoencephalopathy from heroin vapor inhalation has some characteristics on PET ,which are helpful for the diagnosis when combined addictive history.

Objective To explore the diagnostic value of 18F-FDG PET/CT in the inflammatory bowel diseases (IBD).Methods The clinicopathological data of 75 patients(46 males,29 females;average age 38 years) with IBD confirmed by colonoscopy from March 2010 to March 2014 were reviewed retrospectively.Among the 75 patients,30 were with ulcerative colitis(UC) and 45 were with Crohn's disease (CD).All underwent whole-body 18F-FDG PET/CT imaging.Enteroscope and CRP examination were performed within 1 week before or after PET/CT imaging.The results of 18F-FDG PET/CT were compared with those of located CT and enteroscope (x2,t tests).Linear correlation analysis was used to analyze the relationship between CRP and the SUVmax of lesions presented in IBD.Results (1) 18 F-FDG PET/CT accurately detected 65 patients with IBD,while located CT diagnosed 55 patients with IBD.The diagnostic sensitivities were significantly different:86.7％ (65/75) vs 73.3％ (55/75),x2 =4.167,P＜0.05.(2) Among 65 patients with positive results in 18F-FDG PET/CT,lesions were consistent with those detected by endoscopy in 33 (33/75,44.0％)patients.Results of the 2 methods in 24 patients (24/75,32.0％)were not completely same,those in 8 patients (8/75,10.7％)were totally different.18F-FDG PET/CT detected 145 lesions,while enteroscope only detected 119 lesions.Diffuse high FDG uptake was shown in intestinal wall in 40 of 65 patients,and mild mucosa injury was showed by enteroscope in 18 patients (45.0％,18/40).(3)Fortyeight of 65 patients detected by PET/CT were proven clinically to be in active stage,and the rest were in stable stage.The SUVmax of active stage group (8.31±4.21) was significantly higher than that of the chronic stage group (6.36±3.15;t =2.033,P＜0.05).There was a linear correlation between CRP and SUVmax of patients in active stage(r=0.453,P＜0.01).Conclusions 18F-FDG PET/CT is helpful to assess the activity of IBD and may serve as a supplementary diagnosing tool to detect the lesions under the epithelium of bowel,which are often false-negative by enteroscope.

Objective To assess the value of 18 F-FDG PET imaging in the localization of epileptic foci.Methods 18 F-FDG PET were performed in 22 patients with medically intractable epilepsy (15 males,7 females,mean years:19.0 years,mean duration:8.2 years). The open skull operations were undergone in 21 patients according to the results of 18 F-FDG PET, combining with scalp EEG and CT or/and MRI. 1 patient was refered for stereotactic operation. During operation,EcoG was detected for identifying the site of epileptogenic focus and lobectomy was performed . All specimens were examninated with the pathological tests. All patients were followed up for the curative effects. Results PET showed abnormalities in 21 patients(95.5%). Among them,single or multiple focal hypometabolisms were found in 20 patients and focal hypermetabolism in 1 patient. The scalp EEGs showed abnormalities in 17 patients(77.3%),but 8 of them did not showed clear latreralizing manifestations.The abnormalities were found on MR or/and CT in only 5 cases (22.7%).The epileptogenic foci detected by PET were consistent well with EcoG in 18cases(85.7%), consistent approximately in 2 cases and not consistent in 1 cases .Among 19 patients with abnormal PET findings , the pathological abnormalities were found in 18 cases (94.7%).No pathological abnormality was found in the patients with nomal PET imaing. After the open skull operations, 9 patients (42.9%) becomed seizure free . 9 patients (42.9%) had more than 50% seizure reduction and 3 patients (14.3%)showed no improvement. The patient treated with stereotactic operation also showed no significant improvement.Conclusion 18 F-FDG PET imaging is a sensitive and accurate modality to localizate the epileptic foci and has important clinical value in surgical therapy.

Objective To observe activated cerebral areas during the task of writing in second language by early and late acquisition bilinguals and explore the neuropsychological mechanism. Methods Twelve subjects were divided into group of early acquisition high proficiency bilinguals(EAHP) and group of late acquisition high proficiency bilinguals(LAHP). Each subject carried out the task of pseudo-writing and English writing. After functional imaging,statistical parametric mapping was used to compare data of the two tasks through paired- t test in both two groups. A conjunction analysis was conducted between the two groups also. Areas where the metabolism of glucose changed were analyzed. Then, the corresponding images about activated cerebral regions were obtained.Results Cerebral areas where the metabolism of glucose increased in EAHP: bilateral middle frontal gyrus( Z=4.35/2. 01 ), bilateral cerebellum ( Z = 2.97/2.53 ) and left head of caudate nucleus ( Z = 3.07 ), etc. Cerebral areas where the metabolism of glucose increased in LAHP: right superior frontal gyrus(Z=4.06), right cerebellum( Z=4.63), left putamen(Z=2.70) ,etc. Cerebral areas where the metabolism of glucose increased in compared data of LAHP with data of EAHP: right frontal gyrus ( Z = 2.92 ), right temporal lobe( Z = 2.31 ), etc. Conclusion Extensive cerebral cortex and subcortical structures participate the process of writing in the second language. Age of bilingual acquisition is one of the factors affecting cerebral localization of writing in second language.

Purpose Synchronous multiple primary esophageal carcinomas may be undetected by gastroscopy. This study aims to assess the role of 18F-fluorodeoxyglucose (18F-FDG) PET/CT in detecting synchronous multiple primary esophageal carcinomas. Materials and Methods Thirteen patients with synchronous multiple primary esophageal carcinoma who underwent gastroscopy and 18F-FDG PET/CT within two weeks before treatment were retrospectively analyzed. Results Gastroscopy and 18F-FDG PET/CT detected 22 and 29 esophageal carcinomatous foci respectively, and the difference was statistically significant (Z=-2.333, P<0.05). All the 29 esophageal carcinomatous foci showed high 18F-FDG uptake with a SUVmax ranging from 3.1 to 20.1 (mean, 10.7±5.7). 18F-FDG PET/CT also detected surrounding organ invasion in 3 patients, lymphatic metastasis in 10 patients and distant metastasis in 3 patients. Conclusion 18F-FDG PET/CT detects more esophageal carcinomatous foci compared with gastroscopy in patients with synchronous multiple primary esophageal carcinomas and also performs the staging diagnosis, which may help in improving clinical management and prognosis.

Objective To evaluate the complementary value of 11C-choline (CHO) PET/CT to 18F-FDG PET/CT in the staging of locally advanced nasopharyngeal carcinoma (NPC) and diagnosis of HCC.Methods From December 2007 to January 2010,15 patients with locally advanced NPC and 76 patients with HCC were prospectively enrolled into this study.The research was approved by the ethics committee,and all patients signed informed consents.Whole body 18 F-FDG PET/CT scans were performed on all patients and regional 11C-CHO PET/CT was conducted in 43 patients (15 with NPC,28 with HCC).A lesion with increased uptake of either 11 C-CHO or 18F-FDG was considered positive.SUVmax,tumor/brain (T/B) ratio and tumor/liver (T/L) ratio were calculated for semi-quantitative analysis.Two-sample t test,x2 test,Fisher exact test and linear correlation analysis were used for statistical analysis.Results (1) The lesion SUVmax of 18 F-FDG was higher compared to 11C-CHO (12.81 ± 5.00 vs 6.84 ± 2.76 ; t =6.416,P ＜0.01) in NPC patients.However,11C-CHO PET/CT had a much higher T/B ratio than 18F-FDG (18.62 ±7.95 vs 1.38 ±0.59 ; t =8.801,P ＜ 0.01).Significant correlation was found between the 2 tracers with regard to NPC lesion uptake (r =0.712,P ＜0.01).Compared with 18F-FDG PET/CT,11C-CHO PET/CT had better delineation of intracranial invasion in 50.0％ of patients (12/12 vs 6/12; x2 =8.000,P ＜0.05),skull base invasion in 4/14 patients and orbital invasion in 3/3 patients.(2) 18F-FDG PET/CT showed positive findings in 63.1％ (48/76) of HCC patients.In 28 HCC patients with negative findings on 18F-FDG PET/CT,11 C-CHO PET/CT was positive in 71.4％ (20/28) of patients.The dual-tracer PET/CT improved the diagnostic sensitivity (89.5％,68/76) of HCC compared with 18F-FDG PET/CT (63.1％,48/76) alone (x2 =14.559,P ＜0.01).11C-CHO PET/CT was more sensitive than 18F-FDG PET/CT for the detection of well differentiated HCC (6/9 vs 35.7％ (5/14) ; P =0.214).For the detection of moderately differentiated HCC,the sensitivity of 11C-CHO and 18F-FDG PET/CT was similar to each other (6/7vs 72.0％ (18/25),P =0.648).11C-CHO PET/CT was more sensitive than 18F-FDG for the detection of HCC lesions ＜5.0 cm (72.7％ (16/22) vs 42.1％ (16/38) ; x2 =5.249,P ＜0.05),especially for lesions ＜ 2.0 cm (5/7 vs 0/7; P =0.021).Conclusions 11 C-CHO PET/CT could improve the accuracy in T staging of NPC.It might also play a complementary role for 18 F-FDG PET/CT in the detection of HCC.

Objective To investigate the imaging presentation of T-and NK/T-cell lymphomas with different pathology subtypes on 18F-FDG PET/CT.Methods A total of 95 patients (66 males, 29 females, average age 38.42 years) with T-and NK/T-cell lymphoma proved by pathology from June 2006 to February 2016 were retrospectively analyzed.18F-FDG uptake (SUVmax), nodal invasion, nodal distribution, extra-nodal involvement and staging were compared among 7 pathological subtypes of T-and NK/T-cell lymphomas.One-way analysis of variance, Fisher exact test and Kruskal-Wallis H test were used for data analysis.Results There were significant differences in terms of 18F-FDG uptake, nodal invasion, nodal distribution, extra-nodal involvement and staging among different pathological subtypes of T-and NK/T-cell lymphomas (F=2.937, P<0.05;Fisher exact test,all P<0.01;H=19.883, P<0.01).NK/T-cell lymphoma was found to be prone to invade the nasal cavity and nasopharynx, enteropathic type T-cell lymphoma was specific to the intestine, and subcutaneous panniculitis-like T-cell lymphoma presented with subcutaneous infiltration.All those 3 subtypes were quite specific in their extra-nodal involvement.Most patients with angioimmunoblastic T-cell lymphoma (ATCL), peripheral unspecified T-cell lymphoma (PUTCL) and T immunoblastic lymphoma (TIBL) presented as stage Ⅳ disease.Widespread lymph node disease associated with splenic, parotid and serous membrane involvement were often seen in ATCL patients (most commonly to involve the parotid glands and serous membrane among the 7 subtypes).Nodal involvement was found in PUTCL patients, but extranodal involvement was rather non-specific.TIBL had a non-specific pattern of nodal involvement with low 18F-FDG uptake, lower than ATCL and the other 5 subtypes.Anaplastic large cell lymphoma subtypes had the highest 18F-FDG uptake when compared with the other 6 subtypes, but were less often to manifest as stage Ⅳ disease despite their preponderance for marrow and nodal infiltration.Conclusion Different pathological subtypes of T-and NK/T-cell lymphoma manifest different imaging presentations on 18F-FDG PET/CT, which are useful for understanding their biological characteristics.

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.

Objective To establish a diagnostic model based on 18F-FDG PET/CT and clinical data and assess its diagnostic potency for characterizing SPN.Methods From November 2004 to May 2014,164 patients with SPN who underwent 18F-FDG PET/CT scan were retrospectively analyzed.The patients'clinical factors (age,gender,history of smoking and history of malignancy),information on CT (diameter,location and spiculated edge of the lesion) and metabolic information on PET imaging were collected to establish a diagnostic model by using the binary logistic regression.Then,the optimal operating point (OOP)of the established model was set.The diagnostic potencies of the established model and PET were assessed by ROC curve.Results Malignancy was diagnosed in 104 of 164 SPN patients.The rest 60 patients had benign diseases.The factors of age,spiculation(0:no spiculation,1:obvious spiculation) and metabolic information(0:≤ mediastinal blood pool,1:＞mediastinal blood pool) were demonstrated to be useful for the establishment of the model (x2 =5.486,16.240,33.855,all P＜0.05).However,the factors of gender,history of smoking,the diameter and location of lesions showed no influence for the model (x2 =2.452,0.453,0.127,0.390,all P＞0.05) and rejected from the model established.The history of malignancy was excluded from statistical analysis because there were only 2 patients with history of malignancy.The established model was as follows:P=1/(1+e-Z),z=-5.512+0.061xage+2.208xspiculation+3.767×metabolic increase.The ROC AUC of the established model and PET using two-point scoring scale (TPSS) for charactering SPN were 0.92(95％ CI:0.87-0.96)and 0.80(95％ CI:0.73-0.86).The model had higher diagnostic efficacy compared with TPSS (z=4.369,P＜0.05).When P=0.796 7 was set as an OOP,the diagnostic sensitivities of the model and PET for charactering SPN were 91.3％ (95/104) and 94.2％ (98/104) respectively,and no significant difference was found between them (x2 =0.800,P＞0.05).However,significant difference was found between the diagnostic specificities of them (80.0％ (48/60) vs 65.0％ (39/60);x2 =7.111,P＜0.05).Conclusions A new diagnostic model for characterizing SPN based on the information from 18FFDG PET,thin-section CT and clinical data is successfully established.Its sensitivity for diagnosis of lung cancer is high,and its specificity is superior to PET using with TPSS.This model has a potential value for clinical application.