I had been training in Xinhua Hospital, affiliated to Jiao Tong University of Shanghai from March 2nd to March 25th. Here I would like to briefly introduce nuclear medicine department of Xinhua hospital and two other hospitals I have visited in Shanghai.
Nuclear Medicine Department of Xinhua Hospital is equipped with two SPECT-CT and one PET-CT camera. Also one cyclotron is installed. 10 to 15 PET studies are performed every day. Most studies are oncology PET and predominantly used tracer is 18F-FDG. Radiopharmaceuticals labeled with 11C, like methionine, acetate or choline are also available, but used only for research work. With regard to general nuclear medicine, routinely performed studies are bone scan with MDP, DMSA renal cortex scan and renography with DTPA; lung perfusion and ventilation studies with MAA and technegas are also being carried out. The department also has a ward for radioiodine therapy of thyroid cancer, and about 6-7 patients per week undergo radioactive iodine treatment there. In addition, urea breath test of helicobacter pylori infection with 14C labeled urea is also regularly performed.
Xinhua hospital has very developed pediatric surgery, that’s why many pediatric patients from Shanghai and other regions of China undergo PET study there. During my training I could see many interesting and rare cases, like pahygyria, hepatoblastoma, clear cell sarcoma of the kidney, panniculitis-like T-cell lymphoma, and many others. Unfortunately, due to high cost of PET-CT study in China (it is not covered by the health insurance), there were many patients with advanced stages and metastatic spread. The most common cancer in pediatric patients undergoing PET-CT in Xinhua hospital was neuroblastoma. As for the adult patients, lung cancer and lymphoma were most frequent. There were also many cases of tuberculosis, including cases of tbs with uncommon presentation. Many pediatric patients had been diagnosed with sinusitis.
With regard to the research work, nuclear medicine department of Xinhua hospital is pretty much concentrated on thyroid cancer diagnosis and treatment. Here are some topics of their research papers: “Comparison of 18F-AIF-NOTA-PRGD2 and 18F-FDG Uptake in Lymph Node Metastasis of Differentiated Thyroid Cancer”; “Management of Differentiated Thyroid Cancer with Rising Thyroglobulin and Negative Diagnostic Radioiodine Whole Body Scan”; “A bone metastases model of anaplastic thyroid carcinoma in athymic nude mice”.
As interesting features of Xinhua hospital nuclear medicine department I should mention:
- very detailed PET-CT reports, written in accordance with segments of the body, not importance of the findings.
- filling of the stomach with water as an inverse contrast, for better visualization of the stomach walls and intestines.
- 99mTc labeled tracer injections are performed through the shielded wall, so as to reduce the time of irradiation of the staff.
In my last week in Shanghai I have also visited two of the hospitals, affiliated to Jiao Tong University. Just like Xinhua hospital, nuclear medicine departments of these hospitals have their own field of interest (hepatobiliary system diseases, urinary tract diseases), related to the hospital specialization, although can carry out studies of all diversity of diseases. The equipment of these hospitals is relatively good. Many up-to-date devices, including semiconductor cardiac SPECT and new PET-CT cameras had been installed at the time of my visit. Nuclear medicine departments of these two hospitals were also equipped with wards for radioiodine treatment.
In conclusion I could say, that the staff headed by the Professor Wang was very friendly and hospitable. Thanks to them I had very good time in Shanghai and gained some experience in pediatric cancer PET-CT.