RESUMEN
OBJECTIVE: To approach the initial CT findings of invasive pulmonary aspergillosis (IPA) in patients with immunosuppression. METHODS: All consecutive adult patients who met the diagnostic criteria of the 2008 European Organization for Research and Treatment of Cancer/ Mycoses Study Group (EORTC/MSG) for proven or probable IPA were included as of January 2005 to June 2011. The patients were divided into two groups according to patients with or without hematological malignancy. The initial CT findings in our study were retrospectively reviewed by two thoracic radiologists, while patients' demographics and clinical outcomes were blinded. The pattern and number of abnormalities were recorded. RESULTS: A total of 65 IPA patients were eligible, with 34 hematological malignancy patients and 31 non-hematological patients. Among all IPA patients, the pattern of ground-glass opacity and consolidation or mass formation was most commonly seen (56.9%), followed by macronodules (46.2%); halo sign (32.3%) was relatively uncommon. Ground-glass opacity and consolidation or mass formation were more commonly identified in non-hematological patients than in hematological malignancy patients (54.8%, 45.2% vs. 8.8%, both P<0.05), but macronodules, infarct-shaped macronodules and halo signs were less frequently identified in the non-hematological group (16.1%, 3.2%, 12.9%, respectively) than in the hematological malignancy group (73.5%, 23.5% and 50.0%, respectively, P<0.05 or P<0.01). The airway-invasive form of IPA was more frequently seen in non-hematological patients (67.8%), whereas the angioinvasive form was more common in hematological malignancy patients (64.7%, P<0.01). CONCLUSION: Our data indicate that CT findings of IPA in non-hematological patients more commonly present as the airway-invasive form, manifesting ground-glass opacity and consolidation or mass formation, whereas in patients with hematological malignancy it more likely shows evidence of the angioinvasive form with macronodules and halo signs.
Asunto(s)
Aspergilosis Pulmonar Invasiva/diagnóstico por imagen , Pulmón/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Adulto , Anciano , Femenino , Neoplasias Hematológicas/complicaciones , Humanos , Aspergilosis Pulmonar Invasiva/etiología , Masculino , Persona de Mediana Edad , Estudios RetrospectivosRESUMEN
To develop a molecular probe for MRI detection of human tumor telomerase reverse transcriptase (hTERT) mRNA expression. Uniformly phosphorothioate-modified hTERT antisense oligonucleotide (ASON) homing hTERT mRNA was labeled with gadolinium (Gd) through the bifunctional chelator 1,4,7, 10-tetraazacyclododecane-N, N', N'', N'''-tetraacetic acid (DOTA) stirred within 45 minutes at 60 °C. The Gd labeled probes were characterized in vitro. The cellular uptake rate and biodistribution of (99m) Tc-DOTA-ASON was measured instead of that of Gd-DOTA-ASON. A549 lung adenocarcinoma model was established in BALB/c nude mice and Gd-DOTA-ASON was injected intraperitoneally and MR images were acquired using 7.0T Micro-MRI (Bruker Biospec, Ettlingen, Germany) at different time points. Immunohistochemical analysis of telomerase activity of each xenograft was operated two days after in vivo imaging. The binding efficiency of Gd-DOTA-ASON reached as high as 71.7 ± 4.5% (n = 6). Gd-DOTA-ASON displayed perfect stability in fresh human serum at 37 °C for 24 h. Compared with normal lung cells, A549 cells showed an obviously higher uptake of (99m) Tc-DOTA-ASON than that of lung cells (10.5 ± 2.7% vs. 4.8 ± 2.6%, P < 0.05). The signal intensity of A549 xenografts can be enhanced by Gd-DOTA-ASON and the signal to noise ratio (SNR) of tumor to muscle reached 2.37 and maintained a relatively high level within 6 h after injection. The activity of hTERT in A549 tumors can be suppressed by Gd-DOTA-ASON in pathological slices. The results of this study show that Gd-DOTA-ASON can be a promising intracellular MR contrast probe for targeting telomerase-positive carcinomas.