Positron emission tomography

正电子发射断层扫描
  • 文章类型: Journal Article
    血管炎症是心血管疾病的主要原因,特别是动脉粥样硬化疾病,早期发现血管炎症可能是最终降低残余心血管发病率和死亡率的关键。本文讨论了非侵入性成像技术评估血管炎症的临床应用进展。关注冠状动脉粥样硬化。包括多种模式的讨论:计算机断层扫描(CT)成像(审查的主要重点),心脏磁共振,超声,和正电子发射断层扫描成像。该综述涵盖了新技术的最新进展,例如冠状动脉炎症的新型CT生物标志物(例如,血管周围脂肪衰减指数),用于正电子发射断层扫描-CT成像的新型炎症特异性示踪剂,和其他人。探索了每种模式的优点和局限性,强调多模态成像的潜力和人工智能图像解释的使用,以提高对冠状动脉疾病等常见疾病的诊断和预后潜力。
    Vascular inflammation is a major contributor to cardiovascular disease, particularly atherosclerotic disease, and early detection of vascular inflammation may be key to the ultimate reduction of residual cardiovascular morbidity and mortality. This review paper discusses the progress toward the clinical utility of noninvasive imaging techniques for assessing vascular inflammation, with a focus on coronary atherosclerosis. A discussion of multiple modalities is included: computed tomography (CT) imaging (the major focus of the review), cardiac magnetic resonance, ultrasound, and positron emission tomography imaging. The review covers recent progress in new technologies such as the novel CT biomarkers of coronary inflammation (eg, the perivascular fat attenuation index), new inflammation-specific tracers for positron emission tomography-CT imaging, and others. The strengths and limitations of each modality are explored, highlighting the potential for multi-modality imaging and the use of artificial intelligence image interpretation to improve both diagnostic and prognostic potential for common conditions such as coronary artery disease.
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  • 文章类型: Journal Article
    失神癫痫通常与行为停滞和短暂的意识缺陷有关,然而,在损害的严重程度上存在很大的差异。尽管对该主题进行了数十年的研究,失神发作的病理生理学和行为损害的潜在机制仍不清楚.已经提出了几种理由,包括广泛的皮质失活,减少对外界刺激的感知,和默认模式网络的瞬时暂停,在其他人中。这篇综述旨在总结目前有关失神癫痫发作时意识受损的神经相关知识。我们回顾了使用失神癫痫动物模型的研究证据,脑电图,功能磁共振成像,脑磁图,正电子发射断层扫描,和单光子发射计算机断层扫描。
    Absence seizures are classically associated with behavioral arrest and transient deficits in consciousness, yet substantial variability exists in the severity of the impairment. Despite several decades of research on the topic, the pathophysiology of absence seizures and the mechanisms underlying behavioral impairment remain unclear. Several rationales have been proposed including widespread cortical deactivation, reduced perception of external stimuli, and transient suspension of the default mode network, among others. This review aims to summarize the current knowledge on the neural correlates of impaired consciousness in absence seizures. We review evidence from studies using animal models of absence epilepsy, electroencephalography, functional magnetic resonance imaging, magnetoencephalography, positron emission tomography, and single photon emission computed tomography.
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  • 文章类型: Journal Article
    正电子发射断层扫描(PET)成像推动了医疗诊断和研究的发展,跨越各个领域,包括心脏病学,神经学,感染检测,和肿瘤学。将机器学习(ML)算法集成到PET数据分析中,进一步增强了其包括疾病诊断和分类的能力。图像分割,和定量分析。ML算法使研究人员和临床医生能够从复杂的大PET数据集中提取有价值的见解,实现自动模式识别,预测健康结果建模,和更有效的数据分析。这篇综述解释了PET成像的基本知识,PET图像分析的统计方法,和PET数据分析的挑战。我们还讨论了通过将PET数据与机器学习算法相结合来提高分析能力,以及这种组合在PET图像研究各个方面的应用。这篇综述还强调了PET成像的当前趋势和未来方向,强调机器学习和大型PET图像数据分析在提高诊断准确性和个性化医疗方法方面的驱动和关键作用。PET成像之间的整合将塑造医学诊断和研究的未来。
    Positron emission tomography (PET) imaging has moved forward the development of medical diagnostics and research across various domains, including cardiology, neurology, infection detection, and oncology. The integration of machine learning (ML) algorithms into PET data analysis has further enhanced their capabilities of including disease diagnosis and classification, image segmentation, and quantitative analysis. ML algorithms empower researchers and clinicians to extract valuable insights from complex big PET datasets, which enabling automated pattern recognition, predictive health outcome modeling, and more efficient data analysis. This review explains the basic knowledge of PET imaging, statistical methods for PET image analysis, and challenges of PET data analysis. We also discussed the improvement of analysis capabilities by combining PET data with machine learning algorithms and the application of this combination in various aspects of PET image research. This review also highlights current trends and future directions in PET imaging, emphasizing the driving and critical role of machine learning and big PET image data analytics in improving diagnostic accuracy and personalized medical approaches. Integration between PET imaging will shape the future of medical diagnosis and research.
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  • 文章类型: Journal Article
    CAR-T细胞疗法,也称为嵌合抗原受体T细胞疗法,是免疫治疗非霍奇金淋巴瘤(NHL)领域的一种新方法。在接受CAR-T细胞治疗的患者中,氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描([18F]FDGPET/CT)在追踪治疗反应和评估免疫治疗的整体疗效方面发挥着关键作用。这项研究的目的是对旨在通过[18F]FDGPET/CT评估和预测接受CAR-T细胞治疗的NHL患者毒性的研究文献进行系统综述。两名研究人员询问了PubMed/MEDLINE和Cochrane中央对照试验注册(CENTRAL)数据库,以寻求涉及在接受CAR-T细胞治疗的淋巴瘤患者中使用[18F]FDGPET/CT的研究。全面的计算机文献检索允许纳入11项研究。通过使用第2版“诊断准确性研究质量评估”工具(QUADAS-2),系统评价中纳入的研究的偏倚风险评分为低。目前的文献强调[18F]FDGPET/CT在评估和预测接受CAR-T细胞治疗的NHL患者的毒性中的作用。强调CAR-T细胞疗法研究的演变性质。需要更多的研究来增加文献中收集的证据。
    CAR-T-cell therapy, also referred to as chimeric antigen receptor T-cell therapy, is a novel method in the field of immunotherapy for the treatment of non-Hodgkin\'s lymphoma (NHL). In patients receiving CAR-T-cell therapy, fluorodeoxyglucose Positron Emission Tomography/Computer Tomography ([18F]FDG PET/CT) plays a critical role in tracking treatment response and evaluating the immunotherapy\'s overall efficacy. The aim of this study is to provide a systematic review of the literature on the studies aiming to assess and predict toxicity by means of [18F]FDG PET/CT in patients with NHL receiving CAR-T-cell therapy. PubMed/MEDLINE and Cochrane Central Register of Controlled Trials (CENTRAL) databases were interrogated by two investigators to seek studies involving the use of [18F]FDG PET/CT in patients with lymphoma undergoing CAR-T-cell therapy. The comprehensive computer literature search allowed 11 studies to be included. The risk of bias for the studies included in the systematic review was scored as low by using version 2 of the \"Quality Assessment of Diagnostic Accuracy Studies\" tool (QUADAS-2). The current literature emphasizes the role of [18F]FDG PET/CT in assessing and predicting toxicity in patients with NHL receiving CAR-T-cell therapy, highlighting the evolving nature of research in CAR-T-cell therapy. Additional studies are warranted to increase the collected evidence in the literature.
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  • 文章类型: Journal Article
    目的:前列腺特异性膜抗原(PSMA)靶向正电子发射断层扫描(PET)彻底改变了前列腺癌(PCa)的诊断和治疗,提供优于传统方法的诊断准确性,并实现与热无关的应用。然而,识别非特异性骨摄取(UBU)已经出现了一个重要的诊断挑战,如果误解,可能会导致过度分期和不适当的治疗决定。本系统综述探讨了接受PSMA-PET成像的PCa患者中UBU的现象。
    方法:评估患病率的研究,地形分布,根据系统评价和荟萃分析(PRISMA)方法的首选报告项目选择UBU的潜在临床意义,并使用诊断准确性研究质量评估(QUADAS-2)工具进行评估。
    结果:在PSMA-PET扫描中使用UBU的PCa患者的百分比范围为0至71.7%,根据使用的放射性药物,[18F]PSMA-1007发病率最高。肋骨是所有PSMA靶向放射性药物中UBU的主要部位。脊柱是[68Ga]Ga-PSMA-11,[18F]DCFPyL的第二常见UBU位点,[18F]rhPSMA-7,而骨盆带代表[18F]PSMA-1007的第二常见部位。UBU的平均最大标准化摄取值(SUVmax)在3.4至7.7之间变化,通常低于骨转移。
    结论:我们的发现强调需要提高对UBU的认识和精确解释,以避免潜在的过度分期和随后的不当治疗决定。考虑到使用的放射性药物,PET衍生的半定量参数,UBU的地形分布,根据临床和实验室参数准确评估预测试概率可能有助于核医学医师解释PSMA-PET的发现。
    OBJECTIVE: Prostate-Specific Membrane Antigen (PSMA)-targeted Positron Emission Tomography (PET) has revolutionised prostate cancer (PCa) diagnosis and treatment, offering superior diagnostic accuracy over traditional methods and enabling theragnostic applications. However, a significant diagnostic challenge has emerged with identifying unspecific bone uptakes (UBUs), which could lead to over-staging and inappropriate treatment decisions if misinterpreted. This systematic review explores the phenomenon of UBUs in PCa patients undergoing PSMA-PET imaging.
    METHODS: Studies assessing the prevalence, topographical distribution, and potential clinical implications of UBUs were selected according to the Preferred Reporting Items for a Systematic Review and Meta-Analysis (PRISMA) method and evaluated with the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool.
    RESULTS: The percentage of PCa patients with UBUs on PSMA-PET scans ranged from 0 to 71.7%, depending on the radiopharmaceutical used, with [18F]PSMA-1007 showing the highest incidence. The ribs are the primary site of UBUs across all PSMA-targeted radiopharmaceuticals. The spine is the second most frequent UBU site for [68Ga]Ga-PSMA-11, [18F]DCFPyL, [18F]rhPSMA-7, while the pelvic girdle represents the second most frequent site for [18F]PSMA-1007. The average maximum Standardized Uptake Value (SUVmax) of UBUs varied from 3.4 to 7.7 and was generally lower than that of bone metastases.
    CONCLUSIONS: Our findings underscore the need for heightened awareness and precise interpretation of UBUs to avoid potential over-staging and subsequent inappropriate treatment decisions. Considering the radiopharmaceutical used, PET-derived semiquantitative parameters, the topographical distribution of UBUs, and accurately evaluating the pre-test probability based on clinical and laboratory parameters may aid nuclear medicine physicians in interpreting PSMA-PET findings.
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  • 文章类型: Journal Article
    目的:系统评价现有证据,使用18F-FDGPET/CT分析风湿性多肌痛(PMR)或巨细胞动脉炎(GCA)患者颅外大血管血管炎(LVV)的患病率。
    方法:检索PubMed和EMBASE,并由两名评审员筛选结果。使用改良版本的纽卡斯尔-渥太华量表评估研究质量。使用I2统计量和Q检验评估研究之间的异质性。按疾病类型进行了进一步的亚组分析,学习质量,和18F-FDGPET/CT摄取标准。通过漏斗图和Egger检验评估发表偏倚。
    结果:确定了268种出版物,其中17项符合选择标准,并纳入荟萃分析.通过18F-FDGPET/CT检查,颅外LVV的总体合并患病率为54.5%[95%CI:42.6%至66.1%]。GCA患者的患病率明显高于PMR患者(60.1%vs.41.8%,p=0.006)。同样,偏倚风险较低的研究报告颅外LVV患病率较高(61.1%vs.46.9%;p=0.010)。未观察到发表偏倚。
    结论:18F-FDGPET/CT检查可用于检测颅外LVV,PMR或GCA患者。这种参与在GCA患者中更为常见,并且可能根据研究的质量而有所不同。
    OBJECTIVE: Systematic review of current evidence to analyze the prevalence of extracranial large vessel vasculitis (LVV) using 18F-FDG PET/CT in patients with polymyalgia rheumatica (PMR) or giant cell arteritis (GCA).
    METHODS: PubMed and EMBASE were searched and the results were screened by two reviewers. Study quality was assessed using a modified version of the Newcastle-Ottawa scale. Heterogeneity between studies was assessed using the I2 statistic and the Q test. Further subgroup analyses were performed by disease type, study quality, and 18F-FDG PET/CT uptake criteria. Publication bias was assessed by funnel plot and Egger\'s test.
    RESULTS: 268 publications were identified, of which 17 met the selection criteria and were included in the meta-analysis. The overall pooled prevalence of extracranial LVV by 18F-FDG PET/CT was 54.5% [95% CI: 42.6%-66.1%]. In patients with GCA the prevalence was significantly higher than in patients with PMR (60.1% vs. 41.8%, P = 0.006). Likewise, studies with a lower risk of bias reported a higher prevalence of extracranial LVV (61.1% vs. 46.9%; P = 0.010). No publication bias was observed.
    CONCLUSIONS: The 18F-FDG PET/CT test may be useful in the detection of extracranial LVV, both in patients with PMR or GCA. Such involvement is more frequent in patients with GCA, and may vary depending on the quality of the studies.
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  • 文章类型: English Abstract
    OBJECTIVE: Neuroendocrine neoplasms of the lung are a heterogenous tumor group. The pathological classification comprises diffuse idiopathic pulmonary neuroendocrine cell hyperplasia, classic neuroendocrine tumors, and neuroendocrine carcinoma. Classic neuroendocrine tumors include typical and atypical carcinoid tumors.
    METHODS: Imaging plays an important role in diagnosis and can help in identifying the tumor biology. Overall, this tumor group is rare, comprising less than 2% of all thoracic tumors.
    CONCLUSIONS: In the current review, the various tumors are presented and important aspects regarding pathological classification, imaging modalities, and treatment are described.
    UNASSIGNED: KLINISCHES PROBLEM: Die neuroendokrinen Neoplasien der Lunge stellen eine heterogene Gruppe von Tumoren dar. Die pathologische Einteilung enthält die diffuse idiopathische neuroendokrine Zellhyperplasie, die klassischen neuroendokrinen Tumoren und das neuroendokrine Karzinom. Die klassischen neuroendokrinen Tumoren beinhalten das typische und atypische Karzinoid.
    UNASSIGNED: Die Bildgebung hat einen wichtigen Anteil an der Diagnosestellung der Tumoren und kann helfen, die Tumorbiologie widerzuspiegeln. Insgesamt sind die Tumoren selten mit einer Frequenz von nur weniger als 2 % aller thorakaler Tumoren. EMPFEHLUNG FüR DIE PRAXIS: Der vorliegende Artikel stellt die verschiedenen Tumoren dar und beinhaltet die wichtigen Aspekte der pathologischen Einteilung, der Bildgebung und der Therapie.
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  • 文章类型: Journal Article
    在癌症免疫疗法中利用嵌合抗原受体(CAR)T细胞疗法靶向分化簇(CD)19是最近的重大进展。尽管这种方法具有很强的特异性和选择性,它并非没有并发症。因此,我们进行了系统评价,以评估正电子发射断层扫描(PET)在评估CAR-T细胞治疗引起的不良反应方面的现状.在PubMed等数据库中对相关文章进行了彻底的搜索,Scopus,和WebofScience直到2024年3月。两名审稿人独立选择文章并提取数据,然后使用MicrosoftExcel进行组织和分类。评估偏倚风险和方法学质量。总的来说,检查了18篇文章,共涉及753名患者,在这项研究中。分析了广泛的公用事业,包括预测性,相关的,和诊断实用程序。虽然在上述所有领域都取得了积极成果,纳入研究的异质性和使用不同的PET衍生参数阻碍了对纳入研究的定量分析.这项研究为这个有前途的领域提供了开创性的探索,目的是在即将进行的临床试验中鼓励进一步和更有针对性的研究。
    The utilization of chimeric antigen receptor (CAR) T-cell therapy to target cluster of differentiation (CD)19 in cancer immunotherapy has been a recent and significant advancement. Although this approach is highly specific and selective, it is not without complications. Therefore, a systematic review was conducted to assess the current state of positron emission tomography (PET) in evaluating the adverse effects induced by CAR T-cell therapy. A thorough search of relevant articles was performed in databases such as PubMed, Scopus, and Web of Science up until March 2024. Two reviewers independently selected articles and extracted data, which was then organized and categorized using Microsoft Excel. The risk of bias and methodological quality was assessed. In total, 18 articles were examined, involving a total of 753 patients, in this study. A wide range of utilities were analyzed, including predictive, correlative, and diagnostic utilities. While positive outcomes were observed in all the mentioned areas, quantitative analysis of the included studies was hindered by their heterogeneity and use of varying PET-derived parameters. This study offers a pioneering exploration of this promising field, with the goal of encouraging further and more focused research in upcoming clinical trials.
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  • 文章类型: Journal Article
    在这篇系统综述和荟萃分析(符合PRISMA标准)中,我们试图探讨18F-FDGPET在葡萄膜黑色素瘤中的诊断和预后价值.对主要医学文献数据库进行了系统搜索,包括评估18F-FDGPET作为评估葡萄膜黑色素瘤患者的成像方式的研究。总的来说,共纳入27项研究。12个有关于原发性眼内肿瘤中18F-FDGPET检出率的数据。合并敏感性为45%(95CI:41-50%)。此外,研究表明,原发性肿瘤越大,它的摄取越高。在纳入的研究中,图13评估了18F-FDGPET在检测转移中的作用。合并的敏感性和特异性分别为96%(95CI:81-99%)和100%(95CI:94-100%),分别。关于肝转移,它们是95%(95CI:79-99%)和100%(95CI:91-100%),分别。值得注意的是,18F-FDG摄取水平是患者生存的重要预测因子.最后,18F-FDGPET可以从组织病理学角度表征病变,区分高风险和低风险疾病。总的来说,虽然在检测原发性眼内肿瘤方面不可靠,18F-FDGPET对于诊断转移性葡萄膜黑色素瘤非常准确。就患者预后而言,它也可能是非常有价值的模态。因此,18F-FDGPET可推荐用于诊断为葡萄膜黑色素瘤的患者,以增强决策和患者管理。
    In this systematic review and meta-analysis (PRISMA-compliant), we tried to investigate diagnostic and prognostic values of 18F-FDG PET in uveal melanoma. A systematic search was conducted on the main medical literature databases to include studies that evaluated 18F-FDG PET as the imaging modality to evaluate patients with uveal melanoma. Overall, 27 studies were included. Twelve had data about the detection rate of 18F-FDG PET in primary intra-ocular tumours. The pooled sensitivity was 45% (95%CI: 41-50%). Furthermore, studies showed that the larger the primary tumour, the higher its uptake. Among the included studies, 13 assessed 18F-FDG PET in detecting metastasis. The pooled sensitivity and specificity were 96% (95%CI: 81-99%) and 100% (95%CI: 94-100%), respectively. Regarding liver metastasis, they were 95% (95%CI: 79-99%) and 100% (95%CI: 91-100%), respectively. Noteworthy, the level of 18F-FDG uptake was a strong predictor of patient survival. Lastly, 18F-FDG PET could characterise lesions from the histopathology perspective, distinguishing high-risk from low-risk diseases. Overall, although not reliable in detecting primary intra-ocular tumours, 18F-FDG PET is highly accurate for diagnosing metastatic uveal melanomas. It can also be a highly valuable modality in terms of patient prognostication. Thus, 18F-FDG PET can be recommended in patients diagnosed with uveal melanoma to enhance decision-making and patient management.
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  • 文章类型: Case Reports
    经导管主动脉瓣植入术(TAVI)越来越多地用于治疗严重的主动脉瓣狭窄,主要是老年和/或医学上有缺陷的患者,由于其微创性质。与任何瓣膜置换程序一样,心内膜炎是公认的并发症,在TAVI患者中更是如此,合并症在其中非常普遍。我们报告了一名70岁的男性,有肝硬化病史,最近有TAVI,表现为反复发烧和持续的戊糖片菌血症。心内膜炎的诊断延迟,因为微生物最初作为污染物被丢弃,考虑到球菌很少被描述为人类病原体。然而,在肝硬化患者中,微生物群可能导致间歇性菌血症,从而影响人工瓣膜。经胸超声心动图对证实诊断没有帮助,就像TAVI患者的情况一样。经食管超声心动图被认为是危险的,由于食管静脉曲张使潜在的肝硬化复杂化。因此,心内膜炎的诊断基于持续菌血症和Duke's标准,包括高烧,诱发性心脏病,脾梗死,以及排除替代诊断。此外,肝硬化增加了治疗的副作用,并导致需要改变治疗方案和延长住院时间。鉴于局势的不稳定,通过2-脱氧-2-[氟-18]氟-D-葡萄糖正电子发射断层扫描-计算机断层扫描(18F-FDGPET-CT)扫描证实治疗成功.这是肝硬化患者中第一例报道的TAVI片球菌心内膜炎,强调了在诊断和治疗同时存在的TAVI心内膜炎患者中的独特挑战。
    Transcatheter aortic valve implantation (TAVI) is increasingly being used in the management of severe aortic stenosis, mainly in older and/or medically compromised patients, due to its minimally invasive nature. As in any valve replacement procedure, endocarditis is a recognized complication, more so in TAVI patients, in whom comorbidities are highly prevalent. We report the case of a 70-year-old male with a history of liver cirrhosis and a recent TAVI, who presented with recurrent fever and sustainedPediococcus pentosaceus bacteremia. The diagnosis of endocarditis was delayed, as the microorganism was initially discarded as a contaminant, given that Pediococci are rarely described as human pathogens. However, in cirrhotic patients, microbiota may cause intermittent bacteremia and thereby affect prosthetic valves. Transthoracic echocardiography was not helpful in validating the diagnosis, as is often the case in TAVI patients. Transesophageal echocardiography was deemed perilous, due to esophageal varices complicating the underlying cirrhosis. Therefore, endocarditis diagnosis was based on sustained bacteremia and Duke\'s criteria, including the presence of high fever, a predisposing cardiac lesion, splenic infarction, and the exclusion of an alternative diagnosis. Moreover, cirrhosis enhanced the side effects of treatment and led to the need for regimen changes and prolonged hospitalization. Given the precariousness of the situation, confirmation of treatment success by 2-deoxy-2-[fluorine-18]fluoro-D-glucose positron emission tomography-computed tomography (18F-FDG PET-CT) scan was sought. This is the first reported case of Pediococcus TAVI endocarditis in a cirrhotic patient, highlighting the unique challenges in the diagnosis and management of TAVI endocarditis in patients with co-existing conditions.
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