The main purpose of this study is to evaluate the clinical value of 18F-fluorodeoxyglucose (18F-FDG) metabolism imaging in accurate staging and prognosis prediction before treatment of cervical cancer. 18F-FDG single photon emission computed tomography (SPECT/CT) was performed before treatment on 27 patients with cervical cancer and was analyzed retrospectively. All the images were analyzed by image fusion software. Meanwhile, primary tumor size and T/B, lymph nodes size and T/B were measured by software. Comparison of the relationship between primary tumor T/B of cervix and clinic pathological factors was performed using SPSS17.0. The diagnosis was established according to pathology results of surgery or/and multi-modalities of imaging and clinical following up. The results showed that the primary tumor T/B value of cervix was 5.9 (3.2). With the increased clinical stage, T/B of primary tumor value was significantly increased (P<0.05). The T/B value in patients ≥Ⅱa stage was significantly higher than those of ≤Ⅰb stage. There were no significant correlations between T/B value and primary tumor size, lymph-node metastasis, and histological type (P>0.05). Thirteen lymph nodes were detected by 18F-FDG imaging in 27 patients with cervical cancer. For diagnosing lymph nodes metastasis, the sensitivity, specificity, accuracy, positive and negative predictive value by 18F-FDG imaging were 75.0%, 78.9%, 77.8%, 60.0% and 88.2%, respectively. The T/B value of all lymph nodes was 6.3 (3.5), in which T/B value of distant metastasis was significantly higher than that of the pelvic metastasis (P<0.05). There were no significant correlations between T/B value and the size of lymph nodes (P>0.05). Uterine body uptaking FDG were discovered in 17 patients and 15 cases were then pathologically proved. Two of 15 cases were cancerous invasion of uterine body, and the other 13 cases were physiological changes of endometrial, and the T/B value of the former was significantly higher than that of the latter (P<0.05). There were positive correlation between invasion of uterine body and lymph nodes metastasis (P<0.05). In conclusion, 18F-FDG imaging has an obvious value for the diagnosis of outside pelvic and distant lymph node metastasis, uterine body infiltrated, and accurate staging. Primary focal T/B value of cervical cancer associates with the clinical stage, which can reflect the risk of patients, and were useful to preliminarily predict the prognosis of cervical cancer.
Objective To analyze and summarize advantages, disadvantages, and limitations of present imaging techniques in assessing efficacy of immunotherapy for patient with hepatocellular carcinoma in order to provide strong evidence for drug therapy evaluation and clinical decision-making for it. Method The relevant literatures about imaging evaluation of immunotherapy for hepatocellular carcinoma were collected to make a review, then analyze and summarize the value of different imaging techniques. Results The immunotherapy, characterized by the noninvasive, high specificity and good curative effect, had been playing an important role in the treatment of hepatocellular carcinoma in recent years. The imaging techniques currently used to assess the immunotherapy results of hepatocellular carinoma mainly included the CT, MRI, ultrasound, and nuclear medicine, which could be used to better evaluate the effectiveness of immunotherapy. It was very important for screening of the patients’ treatment options and judging of the survival and prognosis. The most of the evaluation indicators were based on the anatomic evaluation criteria and it had some certain limitations in evaluating the immunotherapy efficacy of patient with hepatocellular carcinoma. Conclusions As an emerging biological therapy, immunotherapy has gradually become a hotspot in diagnosis and treatment of hepatocellular carcinoma in future. Present imaging techniques and evaluation criteria have certain limitations. More multifunctional imaging indicators need to be improved and developed so as to provide strong evidence for drug therapy evaluation and clinical decision of patient with hepatocellular carcinoma.