1.Have you ever heard of nuclear medicine department in hospital? When we walk into a hospital, we all know about internal medicine and surgery, and we also know about laboratory and radiology departments, and we know which department to go to when we want to see a doctor. But when it comes to nuclear medicine, many people may not have heard of it. What does nuclear medicine do? Does it examine diseases or treat diseases? What kind of diseases can be diagnosed and treated? Nuclear medicine is a department that uses modern nuclear medicine techniques to diagnose and treat diseases. But because our country’s economy is relatively backward, nuclear medicine departments are mostly concentrated in large hospitals, and there are few nuclear medicine departments in small and medium-sized hospitals. 2.What is nuclear medicine? Nuclear medicine is a science of diagnosing and treating diseases by using drugs marked with radionuclides, which is the product of medical modernization and the application of nuclear technology in the field of medicine. Nuclear medicine is a very fast developing new discipline, radionuclide tracer technology is the most basic technology of nuclear medicine. 3.What is radionuclide tracer technology? Radionuclide tracer technology is the essence of nuclear medicine, both diagnosis and treatment are closely related to this technology. Tracer technology is actually not new to us. For example, tracer technology is used to observe the habits of wild pandas in nature. Scientists caught the wild panda, put a radio transmitter on its body, people in the room through the instrument can detect the movements of pandas, that radio transmitter is a tracer. As you can imagine, as a tracer, it must be very light and small, and cannot be detected by the panda, nor can it affect and interfere with the behavior and function of the panda. The tracer used for nuclear medicine examination is not a radio transmitter, but a radionuclide. By connecting the radionuclide to certain compounds, it becomes a radiopharmaceutical, and by introducing it into the body, we can detect the distribution of that drug in the body through instruments outside the body. If we want to understand the heart, we can connect the radionuclide to the drug that likes to the heart. If we want to find the tumor, we can also connect the radionuclide to the pro-tumor drug, so we can observe the metabolism and function of each organ or tissue of the patient by using radionuclide tracer technology. 4.What kind of examinations can be done by nuclear medicine SPECT? It can understand the function of the heart, kidney, liver, gallbladder, thyroid and other major organs; it can understand the blood perfusion of heart muscle, brain, lung and other organs; it can understand and determine the existence of tumor and lymphatic metastasis and bone metastasis, etc. All the functions, blood flow and metabolism of organs and tissues. There are different kinds of radiopharmaceuticals used for different examinations and different purposes of function and metabolism, and there are often very few kinds of labeled radionuclides. 5.What is the difference between nuclear medicine imaging and radiological imaging and ultrasound examination methods? The difference is very big, there is a fundamental difference. The imaging of nuclear medicine depends on the blood flow, cell function, cell number, metabolic activity and drainage of organs or tissues, and is a kind of functional metabolic imaging. In contrast, CT, MR, B ultrasound and other examinations mainly show the anatomical and morphological changes of organs or tissues by showing the changes of functional metabolism, although the resolution is very high, but it is not as good as nuclear medicine examination. 6.Is the application of radiopharmaceutical examination safe? It is very safe. There are 2 main factors that cause unsafe factors in various imaging examinations. 1 is the effect of chemical composition of drugs, mainly allergic reactions and toxic reactions; 1 is the radiation caused by radioactivity. Since the nuclide tracer technology is very sensitive, the chemical components of the radioactive drugs used in nuclear medicine are extremely small and almost negligible. Therefore, it hardly causes allergic and toxic reactions. The nuclide used for nuclear diagnosis mainly emits gamma rays, which are characterized by strong penetration ability and little damage to the body. For example, the absorbed dose received by a patient for a nuclear medicine bladder urinary reflux imaging is only 1% of that for an X-ray cystogram. We know that X-ray is safe for patients, so nuclear medicine imaging is even more so. 7.Is nuclear medicine examination very expensive? Most of the nuclear medicine examinations are a few hundred dollars, but there are also several thousand dollars or even about ten thousand dollars, so intuitively it is very expensive. The price mainly depends on the cost. Whether such an expensive test is worth it or not depends on how useful it is in the whole diagnostic and treatment process and whether it saves or costs money for the patient. For example, whole-body bone imaging in nuclear medicine is a very sensitive method for early detection of tumor bone metastasis, and it costs several hundred dollars to do one. However, it can detect bone metastases and can avoid many unnecessary surgeries. And the expense of reducing the wrong surgery is far more than the expense of doing bone imaging. Not to mention the surgery that shouldn’t be done anymore, the damage caused to the patient is even more immeasurable. Another example is that many patients with coronary artery disease will avoid unnecessary catheter interventions after having nuclear medicine myocardial perfusion imaging done. Nuclear medicine exams cost about$2,000, and catheter interventions often cost tens of thousands of dollars. Reducing the risk of restenosis due to catheterization and the occurrence of restenosis after the procedure is even more critical to the patient’s prognosis. 8.What is whole body bone imaging? Bone imaging is one of the most commonly used imaging examinations in nuclear medicine, with a history of more than 30 years, accounting for one-third of the workload of nuclear imaging in general hospitals at home and abroad. It is a technique of injecting osteophilic radioactive drugs into the body through a vein, and then imaging the whole body through special instruments and equipment. It can show the morphology of whole body bones more clearly, and it can reflect the blood supply and metabolism of bones, so it has important value for the diagnosis of various bone diseases and the observation of treatment effect. 9.What problems can whole body bone imaging help us solve? For patients with malignant tumors, it can detect bone metastases at an early stage, as well as the staging of some malignant tumors such as prostate cancer, breast cancer and lung cancer before treatment and follow-up after treatment; for the diagnosis of unexplained bone pain (excluding bone tumors); in addition, for subtle fractures that are difficult to detect by X-ray, such as fractures of ribs, finger bones and toes; bone imaging can also observe the survival of transplanted bone and the follow-up after artificial joint replacement, etc. The follow-up of artificial joint replacement and so on. 10.What preparations do patients need to make before whole-body bone imaging? After the injection of the imaging agent, the patient needs to drink more water, usually about 500-1000ml of water within two hours after the injection, when urinating, should prevent urine contamination of clothing and body, if found contaminated should promptly replace the contaminated clothes and contaminated skin local cleaning before doing the examination, and before the examination, drain the urine, and remove metal objects on the body such as necklaces, keys, coins to prevent the examination results. If the patient has used barium during the recent radiology examination, it should be drained before the examination. 11.What are the advantages and disadvantages of whole-body bone imaging compared with X-ray bone films? The main advantage is that it has a high sensitivity in the detection of bone disease and can show the presence of lesions earlier than the appearance of abnormalities on X-ray. In most cases, bone imaging can detect bone metastases at an early stage, usually 3-6 months or more in advance of an X-ray; it can detect lesions outside the scope of the X-ray because the whole body can be understood in a single imaging, and in some cases hidden or subtle fractures such as cracked ribs and fractures of the navicular bone of the wrist, which cannot be detected initially by X-ray but are only detected during follow-up examinations. In contrast, bone imaging is able to make a timely diagnosis. The main disadvantage is that the specificity is not high, which means that almost all bone diseases will show abnormal distribution of radioactivity on bone imaging, so it is difficult to make a definite diagnosis of bone disease based only on isolated localized areas of increased (or decreased) radioactivity on bone imaging. 12.Do all patients with malignant tumors need to undergo whole-body bone imaging before surgery? For most patients diagnosed with extraosseous malignant tumors, especially some tumors that metastasize to bone most often, such as breast cancer, lung cancer, gastric cancer, thyroid cancer, prostate cancer, rectal cancer, etc., regardless of whether there are symptoms of bone pain or not, preoperative bone imaging should be performed if available to understand whether there are bone metastases in order to decide the treatment plan. 13.Is it necessary to do whole-body bone imaging after treatment for malignant tumor patients without bone pain symptoms? For the above-mentioned malignant tumor patients with most frequent bone metastases, once bone pain occurs, we can all think of doing bone imaging as soon as possible to exclude bone metastases. However, is it necessary to do bone imaging for patients without bone pain? The answer is that it is still necessary. Because about 19%-34% of patients have bone metastasis without bone pain. Therefore, in the first few years of the primary tumor, do not wait until the bone pain appears before you think of having bone imaging. 14.Is the abnormality of bone imaging in tumor patients always due to bone metastasis? Because of the high sensitivity and low specificity of bone imaging in detecting osteogenic lesions, some benign skeletal diseases may also show abnormal bone imaging. It is common in fractures caused by trauma; various inflammatory diseases such as osteomyelitis and bone abscess; benign bone tumors such as osteoid osteoma, bone cyst and osteochondroma; some arthritis can also show abnormal performance, such as degenerative osteoarthritis and rheumatoid arthritis. In addition, some soft tissues outside the bone can also take up bone imaging agents. In conclusion, when the bone imaging of tumor patients appears abnormal, don’t be too nervous, but combine with medical history and related imaging data to make a correct judgment. 15.What is nuclear myocardial perfusion imaging? Nuclear myocardial perfusion imaging is a diagnostic imaging method, which has the advantages of simplicity, non-invasiveness, safety and high diagnostic accuracy. It has the advantages of simple, non-invasive, safe and accurate diagnosis. Through nuclear myocardial perfusion imaging, the blood perfusion of the myocardium and the functional status of the myocardial cells can be observed, that is to say, whether the myocardium is ischemic or not can be seen directly. 16.How can nuclear myocardial perfusion imaging help patients with symptoms such as precordial discomfort, pain and breath-holding? These symptoms may be caused by myocardial ischemia in coronary heart disease. Therefore, myocardial perfusion imaging can help patients with these symptoms to diagnose accurately with or without coronary artery disease, with an accuracy rate of more than 90% or even 95%, so that they can get timely treatment. 17.What else can nuclear myocardial perfusion imaging do for patients with coronary artery disease? For patients who have been diagnosed with coronary artery disease, nuclear myocardial perfusion imaging can help assess your prognosis and estimate your risk level. That is, if your myocardial perfusion imaging is normal, it indicates that the chance of cardiac events (myocardial infarction, sudden cardiac death, etc.) within one year is less than 1%, indicating a good prognosis and is relatively safe. 18.How does nuclear myocardial perfusion imaging help in the treatment selection of patients with coronary artery disease? Nuclear myocardial imaging can help you determine your treatment plan. That is, if your myocardial perfusion image is normal, internal medication is preferred; if there is myocardial ischemia, coronary stenting or coronary artery bypass grafting should be performed. 19.What is the effect of nuclear myocardial perfusion imaging on patients who have had stents or bypass surgery? Nuclear myocardial perfusion imaging can evaluate the efficacy; it can see if there is any new myocardial ischemia. 20.Why is a stress test performed at the same time as a nuclear myocardial perfusion imaging? In general, even if the stenosis of coronary artery reaches 70-80%, myocardial ischemia may not appear under resting condition, but only when the oxygen consumption of the heart increases, i.e. under load (exercise, exertion, emotional excitement, etc.). Therefore, in order to accurately diagnose myocardial ischemia in coronary heart disease, a stress test should be done during nuclear myocardial perfusion imaging. 21.What is stress myocardial perfusion imaging? It is the intervention of stress test during myocardial perfusion imaging. The purpose of the stress test is to put the patient’s heart under stress, so that if myocardial ischemia occurs, it can be reflected by myocardial perfusion imaging to get an accurate diagnosis. 22.What should the patient pay attention to before the stress test? Before the stress test, patients should stop using vasodilators and heart rate inhibitors (such as nitrates, angiotensin inhibitors, β-blockers, etc.), which may affect the stress test and thus the accuracy of myocardial ischemia diagnosis. 23.What is the procedure of nuclear myocardial perfusion imaging? Nuclear myocardial perfusion imaging is usually completed in two days, and the load and resting images are performed separately. The imaging agent (radionuclide) is injected intravenously during the loading test or at rest, and then a fatty meal (fried eggs, whole milk, chocolate, etc.) is eaten 20 minutes to half an hour later, and myocardial perfusion imaging is performed in about 90 minutes. 24.What should the patient pay attention to during the nuclear myocardial perfusion imaging? The patient should pay attention to the following: have a vegetarian breakfast on the day of the imaging test, stop taking vasodilators and beta-blockers 1-2 days before the test, and bring a fatty meal such as fried eggs or milk to the nuclear medicine department on the day of the test; the drug load test (adenosine, pansentin) is not recommended for people with bronchial asthma. 25.What is the effect of nuclear myocardial imaging on patients with myocardial infarction? In patients with myocardial infarction, the purpose of nuclear myocardial imaging is to assess the presence or absence of viable myocardium within the myocardial infarction zone to determine the next step of treatment. The best method available is nuclear myocardial metabolic imaging. 26.What is nuclear myocardial metabolic imaging? The surviving myocardium in the infarct is in an ischemic state and has an increased ability to take up glucose. By detecting the presence or absence of glucose uptake by myocardial cells in the myocardial infarction zone, nuclide myocardial metabolic imaging can accurately determine the presence or absence of viable myocardium in the myocardial infarction zone. 27.What is the difference between nuclear myocardial perfusion imaging and multi-row CT and coronary angiography? Nuclear myocardial perfusion imaging, multi-row CT and coronary angiography can be used to diagnose coronary artery disease. Myocardial perfusion imaging shows whether there is ischemia in the myocardium and whether myocardial cells are functioning normally. Multi-row CT and coronary angiography mainly show whether there is plaque, calcification and stenosis in the coronary arteries. If the rice grows well, it means that the supply of nutrients and water is sufficient, so the farmer does not need to repair the canals; once the rice in a paddy field withers, it means that the paddy field lacks nutrients, so the farmer only needs to repair the canals that supply the paddy field, but not all the canals. Therefore, nuclear myocardial perfusion imaging is to observe the growth of rice (ischemia of the myocardium), while multi-row CT and coronary angiography are to observe whether there is blockage in the drains (blockage of the drains). 28.What is the importance of understanding myocardial ischemia for coronary heart patients? Understanding myocardial ischemia can not only help patients accurately diagnose coronary artery disease, but also, more importantly, help patients with coronary artery disease identify the “criminal vessel”. Because the site of myocardial ischemia is identified, the diseased coronary artery is identified. 29.What is the significance of identifying the “criminal vessels” of the heart? Coronary artery atherosclerosis is a widespread lesion, and once it causes myocardial ischemia, it should be treated by coronary revascularization as soon as possible to prevent cardiac events. Before performing coronary revascularization, doctors need to find the “criminal vessel” causing myocardial ischemia in order to target coronary stent placement and bypass surgery. Therefore, it is clinically important to perform nuclear myocardial imaging to identify the “offender vessel” before performing coronary revascularization. 30.What is nuclear lung perfusion imaging? Nuclear pulmonary perfusion imaging is: through intravenous injection of a small amount of radioactive protein particles, which enter the pulmonary artery with blood flow and temporarily stay in the pulmonary capillaries, the patency of the pulmonary artery and its branches can be shown by special imaging equipment (SPECT). The special imaging equipment (SPECT) can show the patency of pulmonary arteries and branches. The nuclear pulmonary perfusion imaging can accurately determine the site, scope and degree of pulmonary artery and branch blockage. 31.Pulmonary embolism is an obstructive disease of the pulmonary artery, which can be diagnosed by pulmonary perfusion imaging, why is it necessary to perform pulmonary ventilation imaging? Pulmonary perfusion imaging is a very good method to diagnose pulmonary embolism, but its specificity is low, that is, all diseases that can cause pulmonary artery obstruction, such as chronic bronchitis, tuberculosis, lung tumor, lung infection, etc., will cause abnormal pulmonary perfusion imaging, and these diseases will also cause abnormal pulmonary ventilation imaging, while pulmonary ventilation imaging is mostly normal in pulmonary embolism; therefore, the combination of pulmonary perfusion imaging and pulmonary Therefore, the combined application of pulmonary perfusion imaging and pulmonary ventilation imaging can greatly improve the accuracy of pulmonary embolism diagnosis. 32.Why is it necessary to perform nuclear double lower limb venous imaging at the same time when performing nuclear perfusion/ventilation imaging to diagnose pulmonary embolism? Most of the emboli that cause pulmonary embolism come from the blood clots in the veins of the lower extremities. The advantage of this procedure is that while diagnosing pulmonary embolism, the source of the emboli is also clearly identified, which facilitates the treatment of the cause. The other is that it can reduce the use of radiopharmaceuticals once, which means it reduces the trouble of secondary examination and saves a share of drug cost. 33.What are the main nuclear medicine methods used to examine the genitourinary system? Nephrogram, renal dynamic imaging, renal static imaging, vesicoureteral reflux imaging, scrotal imaging and uterine ureteral imaging. Among them, the most commonly used are nephrography and renal dynamic imaging. 34. What are the main clinical problems that nephrograms and renal dynamic imaging are used to examine? Nephrograms or renal dynamics can be used to understand the function of the kidneys and the degree of renal impairment, as well as to determine whether there is an obstruction in the urinary tract. GFR and ERPF are two important parameters for determining renal function. 35.What is the difference between nuclear medicine and other methods of kidney function tests (such as creatinine and urea nitrogen measurements)? Both nephrogram and renal dynamic imaging use the principle of isotope tracer technique to observe the kidney and urinary tract. The tracer drug used is excreted from the urinary system and its passage through the kidneys and urinary tract reflects the process of urine production and excretion. The information obtained is more consistent with the condition of the urinary system in the physiological state, and the results are more accurate. In addition, some laboratory tests of renal function commonly used in clinical practice can only obtain the function of the sum of the two kidneys, and cannot understand the specific situation of each kidney. In contrast, nephrogram and renal dynamic imaging can observe and judge the respective function of each kidney and the condition of each side of the urinary tract, an advantage that is very valuable in clinical practice. 36.Which is better, nephrogram or renal ambulatory imaging? Nephrogram is a non-graphic functional examination method with low cost, but the error is larger and the accuracy of the results is not high. Renal dynamic imaging can obtain images of both kidneys and bilateral urinary tract, and the results obtained are informative, sensitive and accurate than nephrogram, so nowadays, renal dynamic imaging is more often used in clinical practice. 37.What preparation is needed for the renal dynamic imaging examination? No special preparation is needed before the examination. It should be noted that because renal dynamic imaging is a functional test, it should be performed under the normal physiological state of the human body, so the patient should not fast and should eat normally, otherwise it may cause errors in the results. 38.Can dialysis patients have nephrogram and renal dynamic imaging? Both nuclear medicine examinations are very safe, and the drugs used have little effect on the kidneys. Therefore, patients with severely impaired kidney function can also undergo these tests. 39.Can children have renal dynamic imaging? Because the imaging agent used for renal dynamic imaging is cleared from the body quickly and the half-reduction period is very short, it is very safe for human body, so children and even newborns can undergo renal dynamic imaging examination. Since the patient’s body has to be kept still during the examination, some sedative medication is needed before the examination for young children who cannot cooperate. Can dynamic renal imaging be performed immediately after an intravenous pyelogram or enhanced CT examination? Intravenous pyelogram or enhanced CT examination requires injection of contrast agent, which has a transient effect on kidney function. If these tests are done immediately, it may cause errors in the results of renal dynamic imaging, so renal dynamic imaging should not be done on the same day as the above tests. 41.Can renal angiography detect renal vascular disease? A part of the image data of renal dynamic imaging is to observe the renal artery blood flow, which can be used to understand the situation of renal vessels initially and help to infer renal vascular disease by judging the function of the kidney. On the basis of renal dynamic imaging, captopril test can also be performed to improve the diagnosis rate of renal vascular disease. 42.Is it harmful to perform renal dynamic imaging repeatedly? The results of renal dynamic imaging can help determine the clinical efficacy, so patients may repeat renal dynamic imaging several times. At present, the commonly used renal dynamic imaging agent is 99mTc (99mTc) labeled, the physical half-life of this nuclide is only 6h, plus the imaging agent is rapidly excreted from the urinary system after entering the blood, the amount remaining in the body at the end of the examination is very small. Through continuous removal and decay, the body is largely free of the imaging drug by 24h. The radiation energy of 99mTc is not high (140 keV) and its residence time in the body is very short, so the exposure of the subject is very little and has no effect on the body. It is very safe even for multiple examinations. 43.What is radionuclide internal irradiation therapy? Compared with the ordinary external irradiation treatment (radiation is irradiated from outside the body to the diseased tissue), internal irradiation treatment is to introduce drugs into the body through oral or intravenous injection, which is different from ordinary drugs, it is a kind of drug containing radionuclide that can be gathered in the diseased tissue, at this time, the radionuclide will emit a kind of ray to kill cancer cells, so as to achieve the purpose of treating the disease. 44.Is it safe to apply radionuclide internal irradiation treatment? The radionuclide in internal irradiation therapy can only kill the diseased tissues within 2~3mm, but has no effect on the surrounding normal tissues, just like a missile destroying the target. 45.Which kind of hyperthyroidism is suitable for radioactive iodine-131 treatment? Graves’ disease (toxic diffuse goiter) and Graves’ disease hyperthyroidism can be treated with iodine-131 in the following cases: 1) abnormal liver function, hypocellularity unsuitable for antithyroid drug (ATD) treatment; allergy to ATD drugs; 2) relapse after ATD treatment; 3) relapse after surgery or unwillingness to operate; 4) toxic nodular goiter with hyperthyroidism (Plummer’s disease); 5. chronic lymphocytic thyroiditis with Graves’ disease; 6. non-toxic goiter can also be treated with iodine-131 from the cosmetic point of view. 46. What preparations should be made before iodine-131 treatment for hyperthyroidism? Because iodine-containing foods, medications and antithyroid drugs have an effect on the uptake of iodine-131 by the thyroid gland, antithyroid drugs and iodine-containing foods and medications should generally be discontinued for at least 4-6 weeks prior to treatment. Symptomatic treatment of hyperthyroidism symptoms such as heartburn, low white blood cells and abnormal liver function should be continued during discontinuation of medication. 47. What tests should be done before iodine-131 treatment for hyperthyroidism? Before taking iodine-131 treatment, patients with hyperthyroidism should have their thyroid iodine-131 uptake rate measured, biochemical indicators of thyroid function such as TT3, TT4, FT3, FT4, TSH measured, thyroid antibodies such as A-Tg, A-TPO and TSH receptor antibodies (TRAb, TBII, etc.) measured, thyroid nuclear imaging or ultrasound to clarify the size of the thyroid gland and make preliminary judgments on the nature of thyroid nodules. The nature of the thyroid nodule. 48.What is iodine-131? What are its medical uses? Iodine-131 is a radioactive drug, an isotope of iodine, with a physical half-life of 8.04 days; it emits γ-rays for imaging and β-rays for treatment to play a diagnostic and therapeutic role. Since the synthesis of thyroxine by the thyroid tissue in the body requires the participation of iodine, iodine-131 can accumulate in the thyroid tissue. Beta rays have a range of only 2 mm in the thyroid gland, and the energy it releases can destroy the hyperfunctioning thyroid tissue and shrink the enlarged thyroid gland as if it had undergone an operation. Therefore, iodine-131 is mainly used for the treatment of hyperthyroidism such as Graves’ disease and Plummer’s disease. It is also used for the determination of thyroid function, thyroid imaging, and the treatment and follow-up of well-differentiated thyroid cancer and its metastases. 49. Is nuclear medicine examination of the thyroid gland harmful to humans? The chemical amount of iodine-131 used in the determination of iodine absorption rate of thyroid gland is very small. The chemical amount of radioactive dose of 2 microjuice is 1.6×10-11 grams, which has no effect or harm to human body. The radioactive drug 99mTcO4- , which is commonly used for thyroid imaging, has a relatively short physical half-life (6 hours). The radioactive dose received by the patient is lower than the dose of a single X-ray chest film. 50. Can hyperthyroidism treated with iodine-131 cause hypothyroidism? The three current treatments for hyperthyroidism (anti-thyroid medication, iodine-131, and surgery) can all cause hypothyroidism. Therefore, hypothyroidism is not caused only by iodine-131 treatment. The incidence of hypothyroidism due to hyperthyroidism treated with iodine-131 varies from hospital to hospital at home and abroad, but in China it is mostly 10-25%, and the trend is increasing year by year. 51. Can hyperthyroid patients be treated with anti-thyroid drugs and iodine-131 at the same time? Because anti-thyroid medication can affect the uptake of iodine-131 by the thyroid gland and the results of biochemical measurements of thyroid function, anti-thyroid medication (ATD) should be stopped and iodine-containing food and medication should be avoided for more than 4 weeks before undergoing nuclear medicine examination and treatment. However, in patients with severe hyperthyroidism, because of the patient’s poor general condition and the slow therapeutic effect of iodine-131, in order to prevent the aggravation of the disease or the emergence of hyperthyroid crisis, the drug is usually stopped only three days before the determination of the iodine uptake rate of the thyroid gland, and ATD therapy is continued after three days of iodine-131 until iodine-131 takes effect. 52. Can hyperthyroidism with malignant proptosis recover after iodine-131 treatment? According to different reports, 15-60% of patients with hyperthyroidism may have proptosis in one or both eyes. Some proptosis may appear before the onset of hyperthyroidism, some may appear during the treatment of hyperthyroidism, and a few may appear after the control of hyperthyroidism or even during hypothyroidism. There is no specific treatment for hyperthyroidism proptosis at home and abroad. Clinical practice shows that most of the hyperthyroidism proptosis is reduced after iodine-131 treatment, but in very few patients, the proptosis is still aggravated after the hyperthyroidism is controlled. 53. What are the treatment methods for hyperthyroidism in Graves’ disease? What are the disadvantages of each? There are three main treatments for hyperthyroidism in Graves’ disease, including internal antithyroid drug (ATD) therapy, 131I therapy in nuclear medicine, and surgical treatment. Internal ATD treatment is relatively mild and the dosage can be adjusted in time during the treatment. One of the disadvantages of ATD treatment is that it is easy to relapse when the medication is stopped or reduced, and the relapse rate of ATD treatment is reported to be around 40-60%. 131I therapy is easy to use, and usually only one dose of 131I is given, and the symptoms of hyperthyroidism start to improve about 4 weeks after treatment, and the remission rate of hyperthyroidism can reach 75-80% in about one year. Therefore, it is suitable for the treatment of patients with hyperthyroidism who have abnormal liver and kidney function or decreased blood cells due to ATD treatment. Some patients with no significant improvement in symptoms or incomplete remission after six months of 131I treatment may be retreated with 131I. A major complication of 131I therapy is hypothyroidism. Studies have shown that some people with hypothyroidism occurring within one year after 131I therapy (early onset hypothyroidism) can return to normal with thyroid hormone replacement therapy; however, hypothyroidism occurring after one year of 131I therapy (late onset hypothyroidism) often requires longer or lifelong thyroid hormone replacement therapy. In addition, in patients with hyperthyroidism with severe proptosis, surgical treatment should be used to avoid further aggravation of the proptosis. Surgical treatment is usually performed by subtotal thyroidectomy for hyperthyroidism, which provides rapid relief of hyperthyroidism and is particularly suitable for patients with markedly enlarged thyroid glands with proptosis and hyperthyroidism with nodules, but has the disadvantage of being invasive and may cause surgical complications such as damage to the recurrent laryngeal nerve and hypoparathyroidism in some cases. Some patients still have recurrence of hyperthyroidism or hypothyroidism after surgery. 54. What are the advantages and disadvantages of hypothyroidism treatment? Once hypothyroidism is diagnosed, the treatment method is relatively simple, using thyroid hormone replacement therapy, the patient’s thyroid hormone level can be adjusted to normal, because the treatment only replenishes the patient’s body with insufficient thyroid hormone, as long as the body’s thyroid hormone level is adjusted to the normal range, it will not cause damage to the patient’s liver and kidney function and hematopoietic system; it will not affect pregnancy and breastfeeding. However, if heart disease is accompanied by low thyroid hormone, supplemental treatment from small doses is required. 55.When is radionuclide therapy suitable for bone metastases? As we all know, patients with malignant tumors will have multiple metastases in various parts of the body when they reach advanced stage, among which bone is also a common metastatic site. Especially for patients with lung cancer, breast cancer and prostate cancer, about 70% to 80% of them will have bone metastasis, and nearly half of them have severe bone pain. Usually we apply external irradiation for treatment (radiotherapy), but when multiple bone metastases occur throughout the body, this method is quite limited. If a nuclide bone scan suggests radioactive concentration at the site of multiple bone metastases throughout the body, we can consider applying radionuclide for treatment at this time. Radionuclide internal irradiation for bone metastasis cancer can relieve pain, reduce symptoms, improve patients’ survival quality, and even prolong life. 56.What kind of patients with bone metastases are suitable for treatment with radionuclide irradiation? For patients with extensive bone metastases, if the bone imaging shows radioactive concentration at the lesion site, white blood cells above 3.5×109/L and platelets above 90×109/L, they can be treated with radionuclide irradiation. 57.Why can radionuclide be applied to treat bone metastasis cancer? Bone tissue is damaged by the invasion of tumor cells at the site of bone metastasis, and the repairing effect of osteoblasts is extremely active. The radiopharmaceuticals used to treat bone metastases have osteotropic effect, therefore, the metabolically active parts of bone tissue will concentrate the radiopharmaceuticals, while normal bone will concentrate less. In this way, the radiopharmaceuticals will concentrate around the tumor lesion and irradiate the tumor with the beta-rays emitted by radionuclides to achieve pain relief and destruction of tumor tissue. 58.Why can 89Sr be applied to treat bone metastasis cancer? 89Sr is a highly osteophilic radionuclide, which is of the same family as calcium and participates in the metabolic process of bone minerals like calcium after entering the body. After intravenous injection, the amount of 89Sr in bone metastasis lesions is 2 to 25 times that of normal bone, and it stays in the cancer lesions. Its retention time in the bone tumor lesions is about 100 days, emitting rays to kill cancer cells, shrink the lesions and play a good analgesic effect. The distance of the rays in the tissue is only 2.4mm, which will not damage the surrounding normal tissues or organs. 59.Is it safe to apply 89Sr to treat bone metastasis cancer? There may be transient bone marrow suppression when 89Sr is applied to treat bone metastasis cancer. About 20% to 30% of patients may have a decrease in white blood cells and platelets after treatment, and most of them can return to the pre-treatment level after 2 to 3 months. Therefore, it is safe to apply 89Sr for the treatment of bone metastasis cancer. 60.Compared with other treatment methods, what are the advantages of applying radionuclide to treat bone metastasis cancer and is it expensive? Current methods of treating bone pain caused by bone metastasis cancer, such as analgesics, chemotherapy and hormone therapy, have great side effects, and their effects are not ideal for patients in advanced stages. Although the application of external irradiation therapy can effectively treat bone pain, it is more effective in treating single bone metastases and is not applicable to extensive bone metastases. Internal radionuclide irradiation therapy is a kind of targeted treatment, which is simple, can be directly injected intravenously, with little damage to surrounding tissues and few side effects, and not only has good pain relief effect, but also has the effect of eliminating and shrinking bone metastases. The commonly used internal irradiation treatment nuclides are 89Sr and 153Sm. 153Sm is a phosphate compound as a carrier concentrated in the lesion bone site, the highest uptake ratio at the lesion site 3 days after injection, so the time of pain relief is relatively fast, but the maintenance time of pain relief is relatively short, and monthly injection is needed. The price of each treatment is about 2000 RMB. For 89Sr treatment, the accumulation of drug at the tumor site reaches a peak about 10 days after injection, so the time of pain relief is relatively slow, but the maintenance time is long, the average maintenance time is 3-6 months, so the second treatment time should be at least 3 months apart. The price of each treatment is about RMB 8,000. 89Sr and 153Sm have an efficiency of 80% to 90% in the treatment of bone metastases, especially for patients whose primary tumors are prostate cancer, breast cancer and lung cancer. Moreover, 89Sr has less inhibitory effect on bone marrow than 153Sm. Therefore, 153Sm is recommended for patients with severe disease who want to relieve pain faster and whose families are in relative financial difficulties, while 89Sr is recommended for patients with mild pain who want to maintain a longer period of pain relief. 61.Why is nuclear medicine imaging a functional metabolic and molecular imaging diagnostic technique?
Nuclear medicine imaging is a diagnostic imaging technique at the functional metabolic and cellular molecular level. Patients receive intravenous or oral injection of microscopic drugs called disease “probes” before the examination, which are involved in the circulation and metabolism of organs and tissues and cells in the body, and constantly emit extremely faint signals. The early detection and judgment of abnormal changes in functional metabolism and cellular molecular levels in the human body, the early localization, characterization, quantification and periodic diagnosis of complex and difficult diseases that cannot be detected or are difficult to diagnose by conventional radiological imaging, such as various malignant tumors, the correct guidance for the implementation of reasonable individualized and comprehensive treatment of malignant tumors, and the early screening of malignant tumors, cardiovascular and cerebrovascular diseases and functional brain diseases in high-risk groups are of great help. Nuclear medicine functional imaging is simple, sensitive, specific, non-invasive, safe, easy to repeat, accurate and reliable. 62.What are the main methods of nuclear medicine molecular imaging technology? Nuclear medicine molecular imaging technology mainly includes PET (positron emission computed tomography) and SPECT (single photon emission computed tomography), which occupy a very important position in molecular imaging research and can make quantitative analysis of physiological and biochemical processes in living tissues, such as blood flow, energy metabolism, protein synthesis, fatty acid metabolism, neurotransmitter synthesis rate It is also possible to quantify physiological and biochemical processes in living tissues, such as blood flow, energy metabolism, protein synthesis, fatty acid metabolism, rate of neurotransmitter synthesis, receptor density, selectivity and kinetics of ligand binding, protein function and gene expression. By directly labeling drugs with positron emitters, we can make prospective judgments on drug dose, site of action, possible toxic side effects, etc., determine the type of metabolic reactions and products, observe the interactions between drugs and other drugs, drug-nutrient interactions, drug-receptor interactions, drug-enzyme interactions, etc., so as to achieve diagnosis and efficacy judgment. 63.What is SPECT technology? It is actually a γ-camera with one or more probes rotating 360° around a certain organ of the patient, acquiring a frame every certain angle during the rotation, and then superimposing the image and reconstructing it into a cross-sectional, coronal, sagittal or any desired tomographic, cross-sectional image of the organ. SPECT can also perform both planar and dynamic (functional) imaging of organs. 64.What is PET technology? PET, or Positron Emission Computed Tomography, is the most advanced medical technology in the world. PET is one of the most advanced medical imaging devices in the world, and is the most advanced medical imaging technology that can image human function and metabolism at the cellular-molecular level. PET can quantitatively and dynamically detect changes in metabolic substances or drugs in the human body from outside the body, making it the best method to diagnose and guide the treatment of various malignant tumors, coronary heart disease and brain diseases. The clinical application of PET is one of the main signs of high-tech medical diagnostic technology in developed countries today, and the application of PET in clinical medicine is mainly focused on three major fields: malignant tumor, neurological system and cardiovascular system. 65.What is PET/CT technology? PET/CT, the most advanced positron emission computed tomography and advanced high-resolution multi-row spiral CT, is a large functional metabolic and molecular imaging diagnostic device that combines the functions of PET and CT at the same time to achieve the true sense of complementary advantages (1+1>2), providing accurate anatomical structure and functional and metabolic information of lesions (such as malignant tumors) in one examination. The diagnostic accuracy of PET/CT is significantly better than that of PET alone or multi-row CT, which is an epoch-making milestone in the history of medical imaging diagnostic technology. At the same time, PET/CT is one of the most important high technologies in the international life sciences (brain function, gene and protein function imaging diagnosis) research and its clinical application. 66.What are the advantages of PET/CT technology? Medical imaging modes can be broadly divided into two categories: anatomical imaging and functional imaging, the former mainly describes human anatomy and morphological changes, represented by X-ray radiography; the latter mainly describes human functional metabolism and molecular abnormalities, represented by nuclear medicine imaging, which have different characteristics. In contrast, nuclear medicine imaging detects the extremely weak signal changes emitted by the imaging drugs injected into the human body, which are called “probes” for diseases, as the imaging parameters, and the resulting images focus on the function of internal organs, metabolism and other physiological and biochemical processes. PET/CT, the most advanced PET technology and high-resolution multi-row spiral CT, is a large functional metabolic and molecular imaging diagnostic device that combines the most advanced human functional metabolic imaging technology and multi-row spiral CT, using the same examination bed and the same image processing workstation. It provides precise information on anatomical structure and functional metabolic changes of lesions (e.g. malignant tumors) at the same time, which significantly improves the accuracy of disease diagnosis. The diagnostic accuracy of PET/CT is significantly better than that of PET alone or multi-row CT alone, and PET/CT is an epoch-making milestone in the history of medical imaging diagnostic technology today. 67. Why can PET and PET/CT technology detect early tumors? Malignant tumors and their metastases are characterized by fast cell growth, vigorous metabolism and strong proliferation ability. In the early stage of cancer, when cancer cells have not yet formed obvious tumors in human body, their metabolic level can be significantly different from normal cells. PET, PET/CT imaging technology is to inject extremely small amount of “tumor probe” into human body, and under the special in vitro detection instrument, the multi-dimensional three-dimensional image shows all organs of human body as if a “transparent person”, showing the physiological metabolism and anatomical structure of the whole body, and various lesions can be seen by doctors at a glance, and early tumors below 2 cm (as small as 3 mm) can be detected, forming obvious “bright spots” on the scanned image. bright spot” on the scan image, so that the naked eye can see cancer cells with particularly vigorous metabolism, discover hidden cancer lesions at an early stage, and realize early detection, early diagnosis and early treatment of cancer. This high-tech fundamentally changes the traditional imaging equipment for tumor diagnosis and treatment, enabling clinicians to understand the dynamic process of tumor occurrence and development from the cellular molecular level. At the same time, early diagnosis of coronary heart disease, epilepsy and other neurological and mental system diseases can be made. 68.What are the advantages of nuclear medicine imaging technology compared with radiological ultrasound diagnostic imaging technology? Medical imaging includes radiology (X-ray plain film, CT, etc.), magnetic resonance imaging (MRI), ultrasound and nuclear medicine imaging (PET, PET/CT, SPECT), etc. Nuclear medicine imaging technology is different from other diagnostic imaging technologies in that it introduces microscopic imaging drugs called disease “probes” into the body, and uses high technology to investigate the dynamic and/or static distribution of the “probes” in the body or target organs outside the body. These “probes” have the same physiological and biochemical characteristics as the natural metabolites in the human body, which allows us to understand the changes in the function, physiology and biochemistry, metabolism and gene expression of human organs. Most of the diseases only have functional (including blood flow, metabolism, receptor and gene expression) changes in the early stage of the disease process, some diseases after clinical treatment, the local structural changes of the lesions return to normal, but the functional and metabolic damage of the body tissues and organs still exist, at this time, X-rays, ultrasound, CT and MRI examinations are often negative, and nuclear medicine imaging can be used for the diagnosis of diseases, especially for early qualitative diagnosis and timely diagnosis. Nuclear medicine imaging can provide important diagnostic information for disease diagnosis, especially for early qualitative diagnosis and timely efficacy determination. Compared with other diagnostic imaging technologies, the advantages of nuclear medicine imaging technology are: early diagnosis of diseases; more accurate examination results; rapid whole-body examination; and safe and non-invasive examination. 69.What is the relationship between nuclear medicine imaging technology and other diagnostic imaging technology? The functional metabolism and anatomical structure of human organs and tissues are interdependent. The functional metabolism of human organs is based on their anatomical structures, and the existence of anatomical structures must depend on their normal functional metabolic activities (blood supply and metabolism). Changes in anatomical structure are inevitably accompanied by changes in functional metabolism, and lasting abnormalities in functional metabolic activity will eventually lead to damage to the anatomical structure, which determines that the relationship between nuclear medicine imaging technology and other diagnostic imaging technologies can only be complementary, mutually reinforcing, and mutually integrated. The emergence of nuclear medicine PET/CT examination technology enables patients to obtain precise anatomical structure and functional and metabolic information of lesions at the same time, thus avoiding unnecessary other examinations or invasive examinations and high costs of treatment; it is relatively reasonable for patients, especially for patients with malignant tumors or high-risk groups with a tendency to develop malignant tumors, in terms of clinical effectiveness and price ratio. In terms of clinical application efficiency and price ratio, it is a relatively reasonable medical consumption for patients, especially for malignant tumor patients or high-risk groups with malignant tumor tendency. 70.What are the characteristics of nuclear medicine tumor molecular imaging diagnosis technology? After entering the 21st century, medicine has entered the era of “molecular medicine”. The understanding of diseases must be deepened from isolated organs and systems to the cellular and molecular levels of physiology and biochemistry, providing information on the cellular and molecular levels of disease changes and elucidating the metabolic activity of diseased tissues to help diagnosis, treatment and efficacy evaluation. Since tumor tissues are rich in blood supply, enhanced metabolism and increased energy consumption, nuclear medicine examination often uses molecular “probes” to understand the metabolic activity of tumors in terms of sugar, fat and protein; thus, it has high clinical value for the differential diagnosis of benign and malignant tumors, tumor grading, metastasis detection, efficacy observation, differential diagnosis of necrosis caused by radiation therapy and chemotherapy and tumor recurrence, and helps in the proper management and prognosis of tumor patients. Therefore, nuclear medicine PET and PET/CT technology is the best means of clinical tumor molecular imaging diagnostic technology at present. 71.What problems can PET and PET/CT solve for tumor patients? 1. Identification of benign and malignant tumors or lesions: As we all know, it is very important to identify the benign and malignant tumors, which is not only related to the treatment plan, but also directly affects the prognosis of patients. If a patient has a single nodule in the lung, after PET/CT examination, if the nodule has low metabolic activity, it indicates a high possibility of benign lesion, and the choice of surgery should be cautious; on the contrary, if the nodule has high metabolic activity, it indicates a possibility of malignancy, and active treatment measures, including surgery, should be taken. 2. tumor staging: tumor staging is an important basis for deciding the treatment plan of patients. a PET/CT whole body imaging can provide information on the presence or absence of metastases in various organs of the body such as brain, lung, lymph nodes, liver, adrenal glands and bones, which is helpful for accurate clinical staging of various tumors such as lung cancer, breast cancer, colon cancer, ovarian cancer and lymphoma. Taking the diagnosis of lymph node metastasis as an example, PET/CT is more accurate because CT or MRI is to consider enlarged lymph nodes (>1cm) as metastasis, among which there is no lack of enlarged lymph nodes due to chronic inflammation or misjudging normal-sized lymph nodes that have been invaded by tumor tissues as normal, while PET is more accurate in determining whether metastasis is metastasis based on the metabolic activity of lymph nodes than considering only the size of lesions. 3. Evaluation of therapeutic efficacy: Due to the high sensitivity of PET/CT and its functional metabolic imaging, it is more accurate and sensitive in judging the efficacy of radiotherapy and chemotherapy, which is helpful to guide clinicians to adjust the treatment plan in time. 4. Identify necrosis, fibrosis and residual or recurrence after tumor treatment: PET/CT can identify necrosis, fibrosis and residual or recurrence of tumor after chemotherapy, radiotherapy and surgery, which is difficult to do by other imaging means. 5. Helping to develop tumor radiotherapy plan: PET/CT can help radiotherapists to outline more reasonable biological target areas and help to develop radiotherapy plan. 6. Searching for primary tumor foci: Patients who have clearly had tumor metastases can further search for the primary tumor foci through PET/CT examination. 72.What problems can PET and PET/CT solve for patients with brain diseases? 1. localization of epileptic foci and assessment of surgical efficacy: it helps to localize epileptic foci and provides reference for brain surgery. the match rate between PET/CT and invasive cranial cortical EEG to localize epileptic foci is over 90%, which provides a new non-invasive option for localization of epileptic foci. the majority of patients whose epileptic foci are resected under the guidance of PET/CT localization can have their disease controlled after surgery. 2. Early diagnosis of dementia: There is no effective treatment for dementia, but some patients can improve their symptoms or slow down the progression of the disease with appropriate treatment if detected early. Therefore, early diagnosis of dementia by PET/CT is of great importance to patients, families and society. It can also distinguish between progeria and vascular dementia. 3. Application in cerebrovascular diseases: early localization, efficacy evaluation and prognosis judgment of transient ischemic attack (TIA) and cerebral infarction. 73. and PET/CT can solve what problems in patients with cardiovascular diseases? It is the most reliable method to determine whether myocardium at the infarct site is alive or not. The survival of myocardium at the infarct site is directly related to the ability to undergo coronary artery bypass grafting (CABG) and coronary transluminal angioplasty (PTCA), and to estimate the prognosis of the procedure. If there is surviving myocardium at the site of myocardial infarction, it will be an indication for CABG or PTCA and the procedure can be successful. 74. What benefits can PET and PET/CT health screening bring? PET and PET/CT technology is the world’s most advanced medical imaging diagnostic equipment, which is called “the crown of modern medical high technology”. It can reflect the function and metabolic status of various organs, such as brain, heart, lung, liver, spleen and stomach, etc. Its examination results are imaginatively called “translucent man” in medical imaging, and can detect malignant tumors in abnormal metabolic state at an early stage, which makes the dream of early diagnosis of malignant tumors come true for human beings, and is called “radar” for detecting tumors or “magic detectors” for discovering tumors. With the improvement of people’s living standard and the enhancement of self-care consciousness, there is more demand for health check-ups in the society. Since PET/CT is a sensitive and accurate means for early detection of tumor, brain and cardiovascular diseases, some developed countries and regions in China have adopted PET/CT as an effective high-tech means for screening tumor, brain and cardiovascular diseases. means. If malignant tumors can be detected early, they can be completely cured. 75.Why do we call PET and PET/CT “radar” for tumor detection or “magic detectors” for tumor detection? Every disease will go through the development process from genetic mutation → metabolic abnormality → morphological change. PET and PET/CT can more accurately reflect the normal or abnormal physiological metabolic activities of human body, and reflect the pathophysiological changes of tumor in human body at the molecular level, which obviously improves the accuracy of diagnosis and the rationality of treatment plan. and the rationality of treatment plan. PET and PET/CT are the most perfect and highest grade imaging methods for malignant tumor diagnosis today, which can fully realize the “four definitions” of tumor diagnosis: “localization”: detecting lesions and clarifying lesion sites. “Qualitative”: to clearly show the pathological and pathophysiological nature of morphological and functional changes. Quantitative”: to quantify the morphological and functional changes of the disease or lesion. Periodic” : Determine the stage of disease progression. What is the clinical value of PET and PET/CT in the diagnosis and treatment of tumor diseases? If you are a patient with early stage tumor and you don’t know? If you are a patient with tumor and do not know how far it has progressed? If you are receiving chemotherapy or radiotherapy and want to know whether it is effective or not? If you are a post-surgical tumor patient and don’t know if there is a recurrence? Then, PET and PET/CT will tell you a lot …… a. Early diagnosis and differential diagnosis of malignant tumors or lesions: PET imaging uses positron tracers that can specifically participate in the metabolic activity of malignant tumors, which can sensitively and early show the specific metabolic changes in cancerous tissues for the purpose of early diagnosis of tumors. b. Accurate clinical staging of tumors: Tumor staging is an important basis for deciding the treatment plan of patients. One PET/CT whole-body imaging can provide information on the presence or absence of metastases in various organs of the body, such as brain, lung, lymph nodes, liver, adrenal glands and bones, which is helpful for accurate clinical staging of various tumors, such as lung cancer, breast cancer, colon cancer, ovarian cancer and lymphoma. c. Beneficial to guide or adjust clinical treatment plan: PET/CT can identify tumor necrosis, fibrosis and residual or recurrence after chemotherapy, radiotherapy and surgery, which is difficult to do by other imaging means. It can also detect the efficacy of tumor treatment (surgery, radiotherapy and chemotherapy) after treatment by observing the changes in the specific metabolism of cancer tissue before and after treatment. For patients who have clearly metastatic foci of tumor, PET / CT examination can further search for the primary foci of tumor. d. Helping to formulate radiotherapy plan: PET/CT can help radiotherapist to outline more reasonable biological target area and help to formulate radiotherapy plan. 77.Why is nuclear medicine imaging very safe? During the nuclear medicine imaging procedure, the patient only needs a small amount of medication injected intravenously and does not need to suffer any other pain. The injected drug is an ultra-short half-life isotope, which is extremely low in radioactivity and decays quickly, disappearing from the body within ten minutes to a few hours. For example, the amount of radiation caused by radionuclides in a PET/CT examination is only about 1/10 of that in an X-ray examination, according to a large-scale clinical survey. 78.Why do PET and PET/CT examinations actually save patients’ medical costs? Have you suffered from not one CT/MRI/B ultrasound/X-RAY/biochemical examination in the hospital, which consumes precious time, a lot of energy and expensive medical expenses, and some people even pay the price of life …… A large number of domestic and foreign economic studies have shown that PET and PET/CT examinations can significantly save medical costs if the costs and benefits of PET and PET/CT examinations are analyzed comprehensively. This is because PET/CT examinations allow for more accurate diagnosis of patients and enable patients to receive timely and effective treatment, avoiding many inappropriate examinations, misdiagnoses and treatments, and as a result, significant savings in medical costs overall. At the same time, it reduces the patient’s pain caused by inappropriate treatment and improves the quality of life. Due to the obvious advantages of PET/CT in saving medical costs, many health insurance companies in the United States and Western Europe are willing to pay for PET/CT in oncology and heart diseases for their patients. 79.What are the main groups of people for whom PET and PET/CT are suitable? Tumor is one of the major causes of human death, and its occurrence and development has a process, starting from genetic mutation, through abnormal interpretation, metabolic abnormalities, functional abnormalities, structural abnormalities and finally to clinical symptoms. When clinical symptoms appear and a lump is found, most patients are already in the middle and late stages of tumor and have lost the best time for treatment. When the tumor is in the early stage, timely detection can basically cure the tumor; when the tumor is found in the middle or late stage for treatment, it will cause smoke and fumes, and the condition will deteriorate rapidly, and the cancer cells will spread unstoppably like a flood. High-tech PET and PET/CT have provided modern means for early detection of tumors. For middle-aged people who are in important positions and under great pressure at work, elderly people or people with family history of tumors, regular PET and PET/CT examinations are a guarantee of good health. PET, PET/CT is suitable for any group of people except pregnant women, such as patients with diabetes or patients who cannot maintain stability on their own (e.g. children) need to inform the doctor first and take appropriate measures for them before the examination. 80.What is the significance of health check-ups starting from not looking for diseases? Two patients, one of whom has had an annual physical examination for many years, were found to have a lung disease. During the checkup, a small shadow was found on the lung, which was diagnosed as lung cancer. The other one has been coughing in recent years and always thought it was an old problem of bronchitis. However, recently his health condition was deteriorating and he went to the hospital for examination, and was diagnosed with advanced lung cancer, for which there was nothing modern medicine could do. Two patients, suffering from the same disease, ended up with a world of difference. The reason for this is that the patient with good prognosis had early detection of tumor and early treatment through regular medical checkups. There is an old saying in the medical field “not to treat the disease that has already occurred, but to treat the disease that has already occurred without self-perception, so as to achieve early treatment. There is no obvious line between health and disease. A person’s body may have latent pathological defects or dysfunction, while the surface is still very “healthy”, when the body is in a healthy and non-healthy “critical” state, timely medical examination will be able to seize the best disposal time. If detected early and treated timely, the cure rate of various malignant tumors will be significantly increased. For example, the 5-year survival rate of early surgery for gastric cancer is over 90%, while the 5-year survival rate of mid- to late-stage surgery is only 8%-17%; the early cure rate of breast cancer is 90%, while the mid- to late-stage cure rate is less than 50%. Other chronic diseases wait until symptoms appear, and not only do serious comorbidities and organ damage occur, but they are also very difficult to treat. The daunting thing is that some malignant tumors generally have no obvious symptoms in the early stage, which can be easily ignored by people, and when obvious symptoms and signs appear, they are often in the late stage of the disease and miss the best time for treatment. According to statistics, at present, less than 2% of people in China can achieve regular health check-ups. From the perspective of preventive medicine, all healthy people should take part in at least one health checkup every year, and “subhealth” people should do so. The incidence rate of malignant tumors in China is 0.12%, which means that every minute 2-3 people are diagnosed as cancer patients or die of cancer, and it has become the first killer of our residents. The World Health Organization points out that 1/3 of malignant tumors can be prevented, 1/3 can be effectively treated and 1/3 can be conservatively treated. As long as active prevention, early detection and reasonable treatment, the risk of cancer can be reduced and malignant tumor cure is possible. Nowadays, with the development of modern technology, the whole body three-dimensional transparent image allows us to identify the lesion of a certain organ at a glance, which is the expected “God’s eye” for tumor detection – PET, PET/CT.