251
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Naya M, Manabe O, Koyanagawa K, Tamaki N. The role of nuclear medicine in assessments of cardiac dyssynchrony. J Nucl Cardiol 2018; 25:1980-1987. [PMID: 28956317 DOI: 10.1007/s12350-017-1072-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Accepted: 08/29/2017] [Indexed: 12/30/2022]
Abstract
Radionuclide imaging has an advantage for quantitative analyses of the tracer concentration and its temporal changes. Myocardial perfusion and function have been adapted for synchrony analyses. Extracted parameters have been demonstrated to measure ventricular synchrony and even to predict CRT outcomes. ERNA has the advantages of higher temporal resolution, greater reproducibility, and the volumetric analysis of both ventricles that can be applied for analyses of intraventricular synchrony and interventricular synchrony. Several software packages such as Quantitative Gated SPECT, the Emory Cardiac Toolbox, cardioREPO, and Heart Function View are available to assess the LV dyssynchrony parameters from GSPECT. A count-based method is applied to extract the amplitude and phase from each of the reconstructed GSPECT short-axis datasets throughout the cardiac cycle and then subjected to a Fourier analysis, the results of which are displayed on a polar map and histogram. Some of the parameters such as the bandwidth (expressed as the 95% width of the phase histogram) and the standard deviation of the phase are obtained by the phase histogram to assess the intraventricular synchrony. This review paper focuses on the application of the LV dyssynchrony parameters estimated by cardiac SPECT in patients with a heart disease.
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Affiliation(s)
- Masanao Naya
- Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, Kita-15, Nishi-7, Kita-ku, Sapporo, 060-8638, Japan.
| | - Osamu Manabe
- Department of Nuclear Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Kazuhiro Koyanagawa
- Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, Kita-15, Nishi-7, Kita-ku, Sapporo, 060-8638, Japan
| | - Nagara Tamaki
- Department of Radiology, Kyoto Prefectural University of Medicine, Kyoto, Japan
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252
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Martínez J, Peñalver A, Baciu T, Artigues M, Danús M, Aguilar C, Borrull F. Presence of artificial radionuclides in samples from potable water and wastewater treatment plants. J Environ Radioact 2018; 192:187-193. [PMID: 29982003 DOI: 10.1016/j.jenvrad.2018.06.024] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 06/25/2018] [Accepted: 06/27/2018] [Indexed: 06/08/2023]
Abstract
Human activity, such as the operation of nuclear power plants (NPPs) and the use of radionuclides in nuclear medicine, results in the presence of artificial radionuclides in surface waters, which may even reach potable water treatment plants (PWTPs) and wastewater treatment plants (WWTPs). In this study, water and sludge samples from a PWTP are radiologically monitored. The incoming water of the plant is influenced by the presence of an NPP upstream. Two WWTPs receiving wastewater from medical centres and other origins are also studied. As a result, 131I, 60Co and 137Cs have been determined in the dewatered sludge samples from the PWTP, while 131I, 99mTc, 67Ga and 111In were detected in the sludge samples from the WWTPs. The radionuclide activities in the influent water from the WWTPs studied were lower than the minimum detectable activity values. Therefore, on the basis of our results, the analysis of sludge samples is very useful as it enables the concentration of any radionuclides that may be present in the incoming water. Lastly, as higher activity of 131I was detected in the samples studied, the total effective dose was assessed for WWTP workers, as they handle dewatered sludge containing this radionuclide. It can be concluded that there is no risk in terms of total exposure.
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Affiliation(s)
- J Martínez
- Departament de Química Analítica i Química Orgànica, Universitat Rovira i Virgili, Unitat de Radioquímica Ambiental i Sanitaria (URAIS), Consorci d'Aigües de Tarragona (CAT), Carretera Nacional 340, Km. 1094, 43895, L'Ampolla, Tarragona, Spain
| | - A Peñalver
- Departament de Química Analítica i Química Orgànica, Universitat Rovira i Virgili, Unitat de Radioquímica Ambiental i Sanitaria (URAIS), Consorci d'Aigües de Tarragona (CAT), Carretera Nacional 340, Km. 1094, 43895, L'Ampolla, Tarragona, Spain
| | - T Baciu
- Departament de Química Analítica i Química Orgànica, Universitat Rovira i Virgili, Unitat de Radioquímica Ambiental i Sanitaria (URAIS), Consorci d'Aigües de Tarragona (CAT), Carretera Nacional 340, Km. 1094, 43895, L'Ampolla, Tarragona, Spain
| | | | - M Danús
- Departament de Medicina Nuclear, Hospital Universitari Sant Joan de Reus, Av. del Dr Josep Laporte, 243204, Reus, Spain
| | - C Aguilar
- Departament de Química Analítica i Química Orgànica, Universitat Rovira i Virgili, Unitat de Radioquímica Ambiental i Sanitaria (URAIS), Consorci d'Aigües de Tarragona (CAT), Carretera Nacional 340, Km. 1094, 43895, L'Ampolla, Tarragona, Spain.
| | - F Borrull
- Departament de Química Analítica i Química Orgànica, Universitat Rovira i Virgili, Unitat de Radioquímica Ambiental i Sanitaria (URAIS), Consorci d'Aigües de Tarragona (CAT), Carretera Nacional 340, Km. 1094, 43895, L'Ampolla, Tarragona, Spain
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253
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Ageyama N, Kurosawa H, Fujimoto O, Uehara T, Hiroe M, Arano Y, Yoshida T, Yasutomi Y, Imanaka-Yoshida K. Successful Inflammation Imaging of Non-Human Primate Hearts Using an Antibody Specific for Tenascin-C. Int Heart J 2018; 60:151-158. [PMID: 30464121 DOI: 10.1536/ihj.17-734] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Inflammation after myocardial infarction (MI) may be a major factor influencing ventricular remodeling, leading to congestive heart failure and arrhythmia. Therefore, inflammation in the heart needs to be monitored. Tenascin-C (TNC) is an extracellular matrix molecule not normally expressed, but it is strongly upregulated when associated with active inflammation. Based on this characteristic, we successfully imaged in vivo inflammatory lesions in rat models using 111Indium (111In)-labeled anti-TNC antibodies. The aim of the present study was to further assess the applicability of this molecular imaging probe to detect inflammatory activity in primate hearts.We generated an MI model of cynomolgus monkeys (Macaca fascicularis) by coronary artery ligation and performed dual-isotope single-photon emission computed tomography (SPECT) imaging with an 111In-labeled anti-TNC antibody Fab' fragment (111In-TNC Fab') and 99mtechnetium methoxy-isobutyl isonitrile (99mTc-MIBI). Dual autoradiography was used to compare the uptake of 111In-TNC Fab' with histology and immunostaining for TNC. Dual-isotope SPECT showed the regional myocardial uptake of 111In-TNC Fab' complementary to a defect in the perfusion image by 99mTc-MIBI. The high radioactivity of 111In-TNC Fab' by autoradiography corresponded to immunostaining for TNC, which was observed in inflammatory lesions at the border zone between the infarcted and non-infarcted areas of the left ventricle and at the epi/pericarditis lesions of the right ventricle. These results demonstrate the potential of 111In-TNC-Fab' imaging to monitor myocardial injury and inflammation and suggest the feasibility of the non-invasive detection of cardiac inflammation following acute MI in a preclinical stage before testing in humans.
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Affiliation(s)
- Naohide Ageyama
- Tsukuba Primate Research Center, National Institute of Biomedical Innovation, Health and Nutrition
| | | | | | - Tomoya Uehara
- Department of Molecular Imaging and Radiotherapy, Chiba University Graduate School of Pharmaceutical Sciences
| | - Michiaki Hiroe
- Department of Cardiology, National Center for Global Health and Medicine.,Mie University Research Center for Matrix Biology
| | - Yasushi Arano
- Department of Molecular Imaging and Radiotherapy, Chiba University Graduate School of Pharmaceutical Sciences
| | - Toshimichi Yoshida
- Mie University Research Center for Matrix Biology.,Department of Pathology and Matrix Biology, Mie University Graduate School of Medicine
| | - Yasuhiro Yasutomi
- Tsukuba Primate Research Center, National Institute of Biomedical Innovation, Health and Nutrition
| | - Kyoko Imanaka-Yoshida
- Mie University Research Center for Matrix Biology.,Department of Pathology and Matrix Biology, Mie University Graduate School of Medicine
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254
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Mróz T, Brudecki K, Mietelski JW, Bartyzel M, Misiak R, Kornas A. Medical activated charcoal tablets as a cheap tool for passive monitoring of gaseous 131I activity in air of nuclear medicine departments. J Radioanal Nucl Chem 2018; 318:723-6. [PMID: 30369690 DOI: 10.1007/s10967-018-6107-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2018] [Indexed: 11/10/2022]
Abstract
It is well known that monitoring of radioactivity released from nuclear medicine departments is necessary to ensure the radiological safety of patients and personnel. Unfortunately, equipment for air sampling is often expensive, loud and is not suitable to use in hospitals. Our goal was to find cheap and simple system for passive monitoring of 131I activity concentration in the air of nuclear medicine departments. Medical activated charcoal tablets were used, because charcoal is excellent material for 131I trapping and tablets are readily available. Our proposed sampling protocol contains tablets preparation, exposure and measurements using HPGe detector. Different methods of tablets preparation (drying, impregnation with KI or NaOH) were tested while an experimental chamber was prepared for estimating 131I (released from Na131I, similar to that used in therapy) trapping efficiency of tablets in different conditions. Finally, tablets were placed in plastic holders and tested in nuclear medicine facilities.
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255
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Wrzesień M, Olszewski J. Wrist dosimeter in nuclear medicine - An alternative for the ring dosimeter? Phys Med 2018; 54:117-20. [PMID: 30337000 DOI: 10.1016/j.ejmp.2018.10.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 08/31/2018] [Accepted: 10/02/2018] [Indexed: 11/21/2022] Open
Abstract
PURPOSE Individual dosimetry is undoubtedly one of the best methods of assessing the exposure of personnel to ionizing radiation, however in case of nuclear medicine, the method applied to measure the dose does not always present a picture of the worker's actual exposure. The highly non-homogeneous dose distribution on the hand means that the ring dosimeter, routinely used to measure the Hp(0.07), provides only approximate dose values received by fingertips, the body part most exposed to ionizing radiation. This paper is an attempt to answer the question whether the wrist dosimeter used as a replacement for the ring dosimeter is able to provide information on doses for the most exposed fragments of the hand of an employee during handling procedures with the use of radiopharmaceuticals. MATERIALS Throughout measurements performed in five nuclear medicine facilities, high-sensitivity thermoluminescent detectors were used. RESULTS Correction coefficients have been determined, which constitute an amendment to be made to move from the dose recorded by the wrist dosimeter to the doses received by the most exposed hand fragments. The fingertips received on average 25 times higher doses, compared to the values recorded by the wrist dosimeter. CONCLUSIONS A wrist dosimeter can be used to measure the Hp(0.07) in nuclear medicine, including as a gauge of the most exposed parts of the hand - the fingertips. However, the applicability of correction coefficients makes it necessary to ensure a stable position of the wrist dosimeter during routine procedures.
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256
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Abstract
The foot and ankle delicately balance the need for support of the weight of the human body, with the need for flexibility. Palpable masses about the foot and ankle, therefore, are most commonly related to trauma or mechanical instability. Non-neoplastic causes, such as ganglion cysts and callus, therefore, predominate. However, the radiologist must be aware of the imaging appearance of less common benign and malignant neoplasms that can involve the foot and ankle.
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257
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Medina-Ornelas S, García-Pérez F, Granados-García M. Impacto de la medicina nuclear en el diagnóstico y tratamiento del cáncer diferenciado de tiroides. GAC MED MEX 2018; 154:509-519. [PMID: 30250318 DOI: 10.24875/gmm.18003206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Los pacientes afectados por el cáncer diferenciado de tiroides habitualmente presentan un curso clínico favorable, ya que la piedra angular del tratamiento es la cirugía; a pesar de esto, algunos pueden desarrollar un ominoso desenlace, debido a las características clinico-patológicas de esta enfermedad. El tratamiento óptimo aún es controvertido, en especial respecto a la extensión de la cirugía, indicaciones de radioyodo y la supresión de la hormona estimulante de la tiroides. La correcta evaluación de los riesgos, antes y después de la cirugía, facilita un selectivo enfoque del tratamiento; destacando la relevancia de revisar el impacto de la medicina nuclear en la correcta evaluación, tratamiento y seguimiento de los pacientes que padecen esta neoplasia. Patients affected by differentiated thyroid cancer usually have a favorable clinical course, since the cornerstone of treatment is surgery; despite this, some patients may develop an ominous outcome, due to the clinical-pathological features of this disease. Optimal treatment remains controversial, especially regarding the extent of surgery, indications for radioiodine and thyroid-stimulating hormone. The correct evaluation of risks before and after surgery facilitates a selective treatment approach; highlighting the importance of reviewing the impact of nuclear medicine on the correct evaluation, treatment and follow-up of patients suffering from this neoplasm.
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Affiliation(s)
- Sevastián Medina-Ornelas
- Departamento de Medicina Nuclear e Imagen Molecular. Secretaría de Salud, Instituto Nacional de Cancerología, Ciudad de México, México
| | - Francisco García-Pérez
- Departamento de Medicina Nuclear e Imagen Molecular. Secretaría de Salud, Instituto Nacional de Cancerología, Ciudad de México, México
| | - Martín Granados-García
- Departamento de Cirugía de Cabeza y Cuello. Secretaría de Salud, Instituto Nacional de Cancerología, Ciudad de México, México
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258
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Fanti S, Bonfiglioli R, Decristoforo C. Highlights of the 30th Annual Congress of the EANM, Vienna 2017: "Yes we can - make nuclear medicine great again". Eur J Nucl Med Mol Imaging 2018; 45:1781-1794. [PMID: 29725717 PMCID: PMC6097758 DOI: 10.1007/s00259-018-4029-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 04/16/2018] [Indexed: 11/30/2022]
Abstract
The 30th Annual Congress of the European Association of Nuclear Medicine (EANM) was held in Vienna, Austria, from 21 to 25 October 2017 under the chairmanship of Professor Francesco Giammarile. As always, the Congress was a great success: more than 6,379 participants came from 90 countries from all continents. Participants were presented with an excellent programme consisting of symposia, and scientific and featured sessions, CME sessions, and plenary lectures. These lectures were devoted to nuclear medicine imaging and therapy, including hybrid imaging and molecular life sciences. Additionally, the latest technology and innovations in the field were presented, and added to the success of the Congress. This review summarizes the major scientific contributions which were selected from more than 1,900 submitted abstracts, and presented in the closing highlights session. They cover the diverse areas of nuclear medicine, with particular focus on oncology, cardiovascular science, neurology, technological innovation and novel tracers, and also other clinical sciences. A particular focus of the Congress was on targeted radionuclide-based therapies, which all show promising and great innovations. The Congress was a unique opportunity to be thoroughly updated on this research. This Highlights Lecture could only be a brief summary of the large amount of data presented and discussed during the meeting, which can be found in much greater detail in the Congress proceedings book, published as volume 44, supplement 2 of the European Journal of Nuclear Medicine and Molecular Imaging in October 2017.
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Affiliation(s)
- Stefano Fanti
- Istituto di Medicina Nucleare, Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Alma Mater Studiorum Università di Bologna, Bologna, Italy
| | - Rachele Bonfiglioli
- Istituto di Medicina Nucleare, Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Alma Mater Studiorum Università di Bologna, Bologna, Italy
| | - Clemens Decristoforo
- Department of Nuclear Medicine, Medical University Innsbruck, Anichstrasse 35, A-6020, Innsbruck, Austria.
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259
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Spielmann V, Li WB, Zankl M. Finding sensitive parameters in internal dose calculations for radiopharmaceuticals commonly used in clinical nuclear medicine. Radiat Environ Biophys 2018; 57:277-284. [PMID: 29959514 DOI: 10.1007/s00411-018-0750-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 06/19/2018] [Indexed: 06/08/2023]
Abstract
Internal dosimetry after incorporation of radionuclides requires standardized biokinetic and dosimetric models. The aim of the present work was to identify the parameters and the components of the models which contribute most to dosimetric uncertainty. For this a method was developed allowing for the calculation of the uncertainties of the absorbed dose coefficients. More specifically, the sampling-based regression method and the variance-based method were used to develop and apply a global method of sensitivity analysis. This method was then used to quantify the impact of various biokinetic and dosimetric parameters on the uncertainty of internal doses associated with the incorporation of seven common radiopharmaceuticals. It turned out that the correlation between biokinetic parameters and time-integrated activity or calculated absorbed dose is strongest when the source and target organ are identical, in accordance with the ICRP and the MIRD approach. According to the ICRP approach, the parameter Fs which describes the fractional distribution of any incorporated radioactivity to organ S, has the greatest correlation with the time-integrated activity in the corresponding source organ or with the calculated dose in the corresponding target organ. In contrast, the MIRD approach suggested several biokinetic parameters with similar correlation. The dosimetric parameters usually contribute more to uncertainty in the calculated dose coefficients than the biokinetic parameters, in both approaches. The results obtained are helpful for the revision of biokinetic models for radiopharmaceuticals, because the most important parameters in clinical applications can now be identified and investigated in future studies.
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Affiliation(s)
- Vladimir Spielmann
- Institute of Radiation Protection, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany.
| | - Wei Bo Li
- Institute of Radiation Protection, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany.
| | - Maria Zankl
- Institute of Radiation Protection, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany
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260
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Otsuka R, Miyazaki Y, Kubo N, Kawahara M, Takaesu J, Fukuchi K. The Status of Stress Myocardial Perfusion Imaging Using 99mTc Pharmaceuticals in Japan: Results from a Nationwide Survey. Asia Ocean J Nucl Med Biol 2018; 6:90-96. [PMID: 29998141 PMCID: PMC6038977 DOI: 10.22038/aojnmb.2018.10477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective(s): To appropriately use one-day myocardial perfusion imaging (MPI) with 99mTc radiopharmaceuticals (i.e. to avoid shine-through artifacts), injection doses need to be optimized and dose ratios between the 1st and 2nd scans should be maintained at ≥ 3. However, the current state of practice in Japan is unclear. Thus, the aim of this study was to clarify the details of MPI protocols using 99mTc radiopharmaceuticals in Japan. Methods: A nationwide survey was conducted in June and July 2016. Questionnaires about stress MPI protocols using 99mTc radiopharmaceuticals were sent to 641 nuclear medicine facilities. Results: Responses were received from 246 facilities. One-day protocols were used in 97.1% of the facilities. The most common injection dose ratio was 2.5. Only 18.2% of facilities achieved the recommended injection dose ratio. Stress-only protocols were performed in only 1.7% of facilities; the primary reasons for not performing stress-only protocols were as follows: 1) “The reading-physician cannot interpret the image just after the first scan,” and 2) “Preparation of radiopharmaceuticals and scan arrangements turn out to be complicated.” Conclusion: Approximately 80% of nuclear medicine facilities do not follow the recommended injection dose ratio. Stress-only protocols are ideal, but are performed at very few facilities. Both optimization and standardization of stress MPI protocols using 99mTc radiopharmaceuticals are needed in Japan.
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Affiliation(s)
- Ryuto Otsuka
- Department of Medical Physics and Engineering, Course of Health Science, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yosuke Miyazaki
- Department of Medical Physics and Engineering, Course of Health Science, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Narumi Kubo
- Department of Medical Physics and Engineering, Course of Health Science, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Mio Kawahara
- Department of Medical Physics and Engineering, Course of Health Science, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Jun Takaesu
- Department of Medical Physics and Engineering, Course of Health Science, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Kazuki Fukuchi
- Department of Medical Physics and Engineering, Course of Health Science, Osaka University Graduate School of Medicine, Osaka, Japan
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261
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Tyng CJ, Barbosa PNVP, Bitencourt AGV, Amoedo MK, Almeida MFA, Lima ENP, Chojniak R. Computed tomography-guided preoperative localization of musculoskeletal lesions using the ROLL technique. Radiol Bras 2018; 51:147-150. [PMID: 29991834 PMCID: PMC6034724 DOI: 10.1590/0100-3984.2017.0010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Objective To describe the preoperative localization of musculoskeletal lesions with the
radioguided occult lesion localization (ROLL) technique. Materials and Methods In all cases, computed tomography-guided injection of technetium-99m sulfur
colloid was performed, directly into or near the suspicious lesion, up to 36
hours before the surgical procedure. Lesions were detected intraoperatively
with a gamma probe. Results We report the cases of six patients submitted to radioguided surgery,
including three patients with bone lesions suspicious for metastasis, two
patients suspected of recurrent sarcoma, and one patient with no previous
diagnosis who had a nodular lesion on the left leg. Patients tolerated the
procedure well, and no complications were associated with the puncture. All
marked lesions were easily identified intraoperatively and were excised with
clear margins. Conclusion The ROLL technique was effective in the intraoperative localization of occult
musculoskeletal lesions, demonstrating that it is a feasible and promising
technique for the surgical exploration of selected cases.
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Affiliation(s)
- Chiang Jeng Tyng
- MD, PhD, Department of Imaging, A.C.Camargo Cancer Center, São Paulo, SP, Brazil
| | | | | | | | | | | | - Rubens Chojniak
- MD, PhD, Department of Imaging, A.C.Camargo Cancer Center, São Paulo, SP, Brazil
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262
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Naqvi SAR, Roohi S, Iqbal A, Sherazi TA, Zahoor AF, Imran M. Ciprofloxacin: from infection therapy to molecular imaging. Mol Biol Rep 2018; 45:1457-1468. [PMID: 29974398 DOI: 10.1007/s11033-018-4220-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 06/25/2018] [Indexed: 12/19/2022]
Abstract
Diagnosis of deep-seated bacterial infection remains a serious medical challenge. The situation is becoming more severe with the increasing prevalence of bacteria that are resistant to multiple antibiotic classes. Early efforts to develop imaging agents for infection, such as technetium-99m (99mTc) labeled leukocytes, were encouraging, but they failed to differentiate between bacterial infection and sterile inflammation. Other diagnostic techniques, such as ultrasonography, magnetic resonance imaging, and computed tomography, also fail to distinguish between bacterial infection and sterile inflammation. In an attempt to bypass these problems, the potent, broad-spectrum antibiotic ciprofloxacin was labeled with 99mTc to image bacterial infection. Initial results were encouraging, but excitement declined when controversial results were reported. Subsequent radiolabeling of ciprofloxacin with 99mTc using tricarbonyl and nitrido core, fluorine and rhenium couldn't produce robust infection imaging agent and remained in discussion. The issue of developing a robust probe can be approached by reviewing the broad-spectrum activity of ciprofloxacin, labeling strategies, potential for imaging infection, and structure-activity (specificity) relationships. In this review we discuss ways to accelerate efforts to improve the specificity of ciprofloxacin-based imaging.
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Affiliation(s)
- Syed Ali Raza Naqvi
- Department of Chemistry, Government College University, Faisalabad, 38000, Pakistan.
| | - Samina Roohi
- Isotope Production Division, Pakistan Institute of Nuclear Science and Technology (PINSTECH), Nilore-Islamabad, Pakistan
| | - Anam Iqbal
- Department of Chemistry, Government College University, Faisalabad, 38000, Pakistan
| | - Tauqir A Sherazi
- Department of Chemistry, COMSATS University Islamabad, Abbottabad Campus, Abbottabad, 22060, Pakistan
| | - Ameer Fawad Zahoor
- Department of Chemistry, Government College University, Faisalabad, 38000, Pakistan
| | - Muhammad Imran
- State Key Laboratory of Fine Chemicals, School of Chemical Engineering, Dalian University of Technology, E-208 West Campus, 2 Ling Gong Rd., Dalian, 116024, China
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263
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Shichijo K, Takatsuji T, Fukumoto M, Nakashima M, Matsuyama MM, Sekine I. Autoradiographic analysis of internal plutonium radiation exposure in Nagasaki atomic bomb victims. Heliyon 2018; 4:e00666. [PMID: 30003160 PMCID: PMC6039857 DOI: 10.1016/j.heliyon.2018.e00666] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2018] [Accepted: 06/21/2018] [Indexed: 12/13/2022] Open
Abstract
Background Radiation doses received by Hiroshima and Nagasaki atomic bomb survivors has been evaluated from data related only to external exposure because there was no reliable evidence for internal exposure in atomic bomb victims. However, we assumed that the contribution of internal exposure cannot be ruled out. Methods Autoradiography was carried out with the 70-year old paraffin-embedded specimens taken from Nagasaki atomic bomb victims who died within 5 months after the bombing. After exposure to photo emulsion for 6 months alpha-tracks were revealed in the specimens. We confirmed the alpha-tracks were emitted from deposited plutonium (Pu) in reference to the track length of the 8.787 MeV alpha-particle of thorium series from Polonium-212. Radioactivity concentration of Pu was obtained by counting alpha-tracks. The absorbed dose of each cell nucleus penetrated by an alpha-particle was estimated by calculating the absorbed energy from the particle. Results Using old paraffin embedded sections processed about 70 years ago, we demonstrated for the first time that conditions in the aftermath of the bombing led to internal exposure to alpha-particles emitted from Pu, the fissile material of the Nagasaki atomic bomb. Dose rate of internal exposure was higher in the victims exposed outdoors than those indoors. Radioactivity concentration was relatively uniform among organs examined in a victim. Conclusion Pu was deposited in the bodies of the Nagasaki A-bomb victims presumably via various routes. Organ dose from Pu of the Nagasaki A-bomb victims studied was during their surviving period, which is lower compared with external exposure. However, the impact to the individual cell nucleus by a single alpha-particle might not be negligible, It would be meaningful; to analyze the relationship of the impact of internal exposure at the cellular level and organ dose. The 70-year old pathological specimens utilized in our study are an invaluable source for understanding internal radiation exposure and are crucial in elucidating experimentally unreproducible phenomena.
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Affiliation(s)
- Kazuko Shichijo
- Division of Tumor and Diagnostic Pathology, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan
| | | | - Manabu Fukumoto
- Department of Molecular Pathology, Tokyo Medical University, Tokyo, Japan
| | - Masahiro Nakashima
- Division of Tumor and Diagnostic Pathology, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan.,Tissue and Histopathology Section, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan
| | - Mutsumi M Matsuyama
- Tissue and Histopathology Section, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan
| | - Ichiro Sekine
- Division of Tumor and Diagnostic Pathology, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan.,Tissue and Histopathology Section, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan
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Abstract
Nuclear medicine studies evaluate physiology on a molecular level providing earlier detection of lesions before morphologic change is evident. 99mTc-MDP and 18F-fluoride bone scans detect osteomyelitis earlier than radiographs and computed tomography (CT); aid in diagnosis of temporomandibular joint disorder; and evaluate activity of condylar hyperplasia, extent of Paget disease, and viability of bone grafts. 18F-FDG PET/CT distinguish between soft tissue and bone infections and diagnose osteomyelitis complicated by fracture or surgery. FDG PET is more accurate than CT alone and has a major role in staging, restaging, and assessing response to therapy for head and neck malignancies and in detecting sequelae of therapy.
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Affiliation(s)
- Heidi R Wassef
- Department of Radiology, Keck School of Medicine of USC, PET Center, 1500 San Pablo Street, Los Angeles, CA 90033, USA.
| | - Patrick M Colletti
- Department of Radiology, Keck School of Medicine of USC, GNH 3549, Off Campus, Los Angeles, CA 90089-9311, USA
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265
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Wrzesień M. The effect of work system on the hand exposure of workers in 18F-FDG production centres. Australas Phys Eng Sci Med 2018; 41:541-548. [PMID: 29736636 PMCID: PMC5976709 DOI: 10.1007/s13246-018-0644-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Accepted: 04/25/2018] [Indexed: 11/29/2022]
Abstract
The production of the 18F isotope-the marker of deoxyglucose (18F-FDG)-the radiopharmaceutical most commonly used in the oncological diagnostic technique of positron emission tomography, requires a cyclotron device. At present, there are nine facilities working in Poland that are equipped with cyclotrons used for producing the short-lived isotopes. The aim of the paper is to determine the hand exposure of workers employed in the two 18F-FDG production centres taking in to account the production procedures and work system in those facilities. Measurements, which included all professional workers exposed to ionizing radiation that were employed in two facilities, were performed by using high-sensitivity thermoluminescent detectors during the routine activities of the personnel. The work system used at the production centre has an impact on the level of the recorded doses. Among the production procedures performed by the staff, the highest ionizing radiation doses have been received by the staff during the 18F-FDG quality control. The maximum estimated annual Hp(0.07) for chemists from the quality control department can exceed the annual skin limit dose (500 mSv). The source of lowest doses on the hands are the cyclotron operating procedure and the 18F-FDG production, provided that these procedures can't be combined with other production procedures.
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Affiliation(s)
- Małgorzata Wrzesień
- Faculty of Physics and Applied Informatics, Department of Nuclear Physics and Radiation Safety, University of Lodz, Pomorska 149/153, 90-236, Lodz, Poland.
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266
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Adinehvand K, Rahatabad FN. Monte-Carlo based assessment of MAGIC, MAGICAUG, PAGATUG and PAGATAUG polymer gel dosimeters for ovaries and uterus organ dosimetry in brachytherapy, nuclear medicine and Tele-therapy. Comput Methods Programs Biomed 2018; 159:37-50. [PMID: 29650317 DOI: 10.1016/j.cmpb.2018.02.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Revised: 01/11/2018] [Accepted: 02/22/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND AND OBJECTIVES Calculation of 3D dose distribution during radiotherapy and nuclear medicine helps us for better treatment of sensitive organs such as ovaries and uterus. In this research, we investigate two groups of normoxic dosimeters based on meta-acrylic acid (MAGIC and MAGICAUG) and polyacrylamide (PAGATUG and PAGATAUG) for brachytherapy, nuclear medicine and Tele-therapy in their sensitive and critical role as organ dosimeters. METHODS These polymer gel dosimeters are compared with soft tissue while irradiated by different energy photons in therapeutic applications. This comparison has been simulated by Monte-Carlo based MCNPX code. ORNL phantom-Female has been used to model the critical organs of kidneys, ovaries and uterus. Right kidney is proposed to be the source of irradiation and another two organs are exposed to this irradiation. RESULTS Effective atomic numbers of soft tissue, MAGIC, MAGICAUG, PAGATUG and PAGATAUG are 6.86, 7.07, 6.95, 7.28, and 7.07 respectively. Results show the polymer gel dosimeters are comparable to soft tissue for using in nuclear medicine and Tele-therapy. Differences between gel dosimeters and soft tissue are defined as the dose responses. This difference is less than 4.1%, 22.6% and 71.9% for Tele-therapy, nuclear medicine and brachytherapy respectively. The results approved that gel dosimeters are the best choice for ovaries and uterus in nuclear medicine and Tele-therapy respectively. CONCLUSIONS Due to the slight difference between the effective atomic numbers of these polymer gel dosimeters and soft tissue, these polymer gels are not suitable for brachytherapy since the dependence of photon interaction to atomic number, for low energy brachytherapy, had been so effective. Also this dependence to atomic number, decrease for photoelectric and increase for Compton. Therefore polymer gel dosimeters are not a good alternative to soft tissue replacement in brachytherapy.
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Affiliation(s)
- Karim Adinehvand
- Department of Medical Radiation Engineering, College of Engineering, Borujerd Branch, Islamic Azad University, Borujerd, Iran.
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267
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Merino-Casabiel X, Aller J, Arbizu J, García-Figueiras R, González C, Grande E, Jiménez-Fonseca P, Sevilla MI, Capdevila J. Consensus document on the progression and treatment response criteria in gastroenteropancreatic neuroendocrine tumors. Clin Transl Oncol 2018; 20:1522-1528. [PMID: 29766455 PMCID: PMC6223716 DOI: 10.1007/s12094-018-1881-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 04/23/2018] [Indexed: 12/11/2022]
Abstract
PURPOSE Gastroenteropancreatic neuroendocrine tumors are a heterogeneous group of low incidence neoplasms characterized by a low proliferative activity and slow growth. Their response to targeted therapies is heterogeneous and often does not lead to tumor shrinkage. Thus, evaluation of the therapeutic response should differ from other kind of tumors. METHODS To answer relevant questions about which techniques are best in the assessment of progression or treatment response a RAND/UCLA-based consensus process was implemented. Relevant clinical questions were listed followed by a systematic search of the literature. The expert panel answered all questions with recommendations, combining available evidence and expert opinion. Recommendations were validated through a questionnaire and a participatory meeting. RESULTS Expert recommendations regarding imaging tools for tumor assessment and evaluation of progression were agreed upon. Available imaging techniques were reviewed and recommendations for best patient monitoring practice and the best way to evaluate treatment response were formulated.
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Affiliation(s)
- X Merino-Casabiel
- Radiology Department, Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | - J Aller
- Endocrinology Department, Hospital Universitario Puerta de Hierro de Majadahonda, Madrid, Spain
| | - J Arbizu
- Nuclear Medicine Department, Clínica Universidad de Navarra, Pamplona, Spain
| | - R García-Figueiras
- Radiology Department, Complexo Hospitalario Universitario de Santiago de Compostela, A Coruña, Spain
| | - C González
- Radiology Department, Hospital Universitario Puerta de Hierro de Majadahonda, Madrid, Spain
| | - E Grande
- Medical Oncology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - P Jiménez-Fonseca
- Medical Oncology Department, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - M I Sevilla
- Medical Oncology Department, Investigación Clínica y Traslacional en Cáncer, Instituto de Investigaciones Biomédicas de Málaga (IBIMA), Hospital Universitario Regional y Virgen de la Victoria de Málaga, Malaga, Spain
| | - J Capdevila
- Medical Oncology Department and Gastrointestinal and Endocrine Tumor Unit, Hospital Universitario Vall d'Hebron, Vall d'Hebron Institute of Oncology (VHIO), Pg Vall d'Hebron, 119-129, 08035, Barcelona, Spain.
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268
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Sanchez-Hidalgo JM, Duran-Martinez M, Molero-Payan R, Rufian-Peña S, Arjona-Sanchez A, Casado-Adam A, Cosano-Alvarez A, Briceño-Delgado J. Gastrointestinal stromal tumors: A multidisciplinary challenge. World J Gastroenterol 2018; 24:1925-1941. [PMID: 29760538 PMCID: PMC5949708 DOI: 10.3748/wjg.v24.i18.1925] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 04/27/2018] [Accepted: 05/06/2018] [Indexed: 02/06/2023] Open
Abstract
Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors located in the alimentary tract. Its usual manifestation is gastrointestinal bleeding. However, small asymptomatic lesions are frequently detected as incidental finding. Characteristically, most GISTs (> 95%) are positive for the KIT protein (CD117) by IHC staining and approximately 80%-90% of GISTs carry a mutation in the c-KIT or PDGFRA genes. Mutational analysis should be performed when planning adjuvant and neoadjuvant therapy, due to its possible resistance to conventional treatment. The arise of tyrosine kinase inhibitor has supposed a revolution in GISTs treatment being useful as adjuvant, neoadjuvant or recurrence disease treatment. That is why a multidisciplinary approach to this disease is required. The correct characterization of the tumor at diagnosis (the diagnosis of recurrences and the evaluation of the response to treatment with tyrosine kinase inhibitors) is fundamental for facing these tumors and requires specialized Endoscopist, Radiologists and Nuclear Medicine Physician. Surgery is the only potentially curative treatment for suspected resectable GIST. In the case of high risk GISTs, surgery plus adjuvant Imatinib-Mesylate for 3 years is the standard treatment. Neoadjuvant imatinib-mesylate should be considered to shrink the tumor in case of locally advanced primary or recurrence disease, unresectable or potentially resectable metastasic tumors, and potentially resectable disease in complex anatomic locations to decrease the related morbidity. In the case of Metastatic GIST under Neoadjuvant treatment, when there are complete response, stable disease or limited disease progression, complete cytoreductive surgery could be a therapeutic option if feasible.
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Affiliation(s)
- Juan Manuel Sanchez-Hidalgo
- Department of General and Digestive Surgery, Reina Sofia University Hospital, Avda. Menéndez Pidal s/n, Cordoba 14004, Spain
| | - Manuel Duran-Martinez
- Department of General and Digestive Surgery, Reina Sofia University Hospital, Avda. Menéndez Pidal s/n, Cordoba 14004, Spain
| | - Rafael Molero-Payan
- Department of Intern Medicine, Reina Sofia University Hospital, Avda. Menéndez Pidal s/n, Cordoba 14004, Spain
- Lipids and Atherosclerosis Research Unit, IMIBIC/Hospital Universitario Reina Sofía/Universidad de Córdoba, Cordoba 14004, Spain
| | - Sebastian Rufian-Peña
- Department of General and Digestive Surgery, Reina Sofia University Hospital, Avda. Menéndez Pidal s/n, Cordoba 14004, Spain
| | - Alvaro Arjona-Sanchez
- Department of General and Digestive Surgery, Reina Sofia University Hospital, Avda. Menéndez Pidal s/n, Cordoba 14004, Spain
| | - Angela Casado-Adam
- Department of General and Digestive Surgery, Reina Sofia University Hospital, Avda. Menéndez Pidal s/n, Cordoba 14004, Spain
| | - Antonio Cosano-Alvarez
- Department of General and Digestive Surgery, Reina Sofia University Hospital, Avda. Menéndez Pidal s/n, Cordoba 14004, Spain
| | - Javier Briceño-Delgado
- Department of General and Digestive Surgery, Reina Sofia University Hospital, Avda. Menéndez Pidal s/n, Cordoba 14004, Spain
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269
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KleinJan GH, van Werkhoven E, van den Berg NS, Karakullukcu MB, Zijlmans HJMAA, van der Hage JA, van de Wiel BA, Buckle T, Klop WMC, Horenblas S, Valdés Olmos RA, van der Poel HG, van Leeuwen FWB. The best of both worlds: a hybrid approach for optimal pre- and intraoperative identification of sentinel lymph nodes. Eur J Nucl Med Mol Imaging 2018; 45:1915-1925. [PMID: 29696442 PMCID: PMC6132545 DOI: 10.1007/s00259-018-4028-x] [Citation(s) in RCA: 104] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Accepted: 04/16/2018] [Indexed: 02/05/2023]
Abstract
Purpose Hybrid image-guided surgery technologies such as combined radio- and fluorescence-guidance are increasingly gaining interest, but their added value still needs to be proven. In order to evaluate if and how fluorescence-guidance can help realize improvements beyond the current state-of-the-art in sentinel node (SN) biopsy procedures, use of the hybrid tracer indocyanine green (ICG)-99mTc-nancolloid was evaluated in a large cohort of patients. Patients and methods A prospective trial was conducted (n = 501 procedures) in a heterogeneous cohort of 495 patients with different malignancies (skin malignancies, oral cavity cancer, penile cancer, prostate cancer and vulva cancer). After injection of ICG-99mTc-nanocolloid, SNs were preoperatively identified based on lymphoscintigraphy and SPECT/CT. Intraoperatively, SNs were pursued via gamma tracing, visual identification (blue dye) and/or near-infrared fluorescence imaging during either open surgical procedures (head and neck, penile, vulvar cancer and melanoma) or robot assisted laparoscopic surgery (prostate cancer). As the patients acted as their own control, use of hybrid guidance could be compared to conventional radioguidance and the use of blue dye (n = 300). This was based on reported surgical complications, overall survival, LN recurrence free survival, and false negative rates (FNR). Results A total of 1,327 SN-related hotspots were identified on 501 preoperative SPECT/CT scans. Intraoperatively, a total number of 1,643 SNs were identified based on the combination of gamma-tracing (>98%) and fluorescence-guidance (>95%). In patients wherein blue dye was used (n = 300) fluorescence-based SN detection was superior over visual blue dye-based detection (22–78%). No adverse effects related to the use of the hybrid tracer or the fluorescence-guidance procedure were found and outcome values were not negatively influenced. Conclusion With ICG-99mTc-nanocolloid, the SN biopsy procedure has become more accurate and independent of the use of blue dye. With that, the procedure has evolved to be universal for different malignancies and anatomical locations. Electronic supplementary material The online version of this article (10.1007/s00259-018-4028-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- G H KleinJan
- Interventional Molecular Imaging Laboratory, Department of Radiology, Leiden University Medical Center, Albinusdreef 2 (C2-S zone), PO BOX 9600, 2300 RC, Leiden, The Netherlands
- Department of Nuclear Medicine, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
- Department of Urology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - E van Werkhoven
- Department of Biostatistics, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - N S van den Berg
- Interventional Molecular Imaging Laboratory, Department of Radiology, Leiden University Medical Center, Albinusdreef 2 (C2-S zone), PO BOX 9600, 2300 RC, Leiden, The Netherlands
- Department of Urology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
- Department of Head and Neck Surgery and Oncology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - M B Karakullukcu
- Department of Head and Neck Surgery and Oncology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - H J M A A Zijlmans
- Department of Gynecology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - J A van der Hage
- Department of Surgery, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - B A van de Wiel
- Department of Pathology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - T Buckle
- Interventional Molecular Imaging Laboratory, Department of Radiology, Leiden University Medical Center, Albinusdreef 2 (C2-S zone), PO BOX 9600, 2300 RC, Leiden, The Netherlands
| | - W M C Klop
- Department of Head and Neck Surgery and Oncology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - S Horenblas
- Department of Urology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - R A Valdés Olmos
- Interventional Molecular Imaging Laboratory, Department of Radiology, Leiden University Medical Center, Albinusdreef 2 (C2-S zone), PO BOX 9600, 2300 RC, Leiden, The Netherlands
- Department of Nuclear Medicine, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - H G van der Poel
- Department of Urology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - F W B van Leeuwen
- Interventional Molecular Imaging Laboratory, Department of Radiology, Leiden University Medical Center, Albinusdreef 2 (C2-S zone), PO BOX 9600, 2300 RC, Leiden, The Netherlands.
- Department of Urology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
- Department of Head and Neck Surgery and Oncology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
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270
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Abstract
As the use of positron emission tomography-computed tomography (PET-CT) has increased rapidly, there is a need to retrieve relevant medical images that can assist image interpretation. However, the images themselves lack the explicit information needed for query. We constructed a semantically structured database of nuclear medicine images using the Annotation and Image Markup (AIM) format and evaluated the ability the AIM annotations to improve image search. We created AIM annotation templates specific to the nuclear medicine domain and used them to annotate 100 nuclear medicine PET-CT studies in AIM format using controlled vocabulary. We evaluated image retrieval from 20 specific clinical queries. As the gold standard, two nuclear medicine physicians manually retrieved the relevant images from the image database using free text search of radiology reports for the same queries. We compared query results with the manually retrieved results obtained by the physicians. The query performance indicated a 98 % recall for simple queries and a 89 % recall for complex queries. In total, the queries provided 95 % (75 of 79 images) recall, 100 % precision, and an F1 score of 0.97 for the 20 clinical queries. Three of the four images missed by the queries required reasoning for successful retrieval. Nuclear medicine images augmented using semantic annotations in AIM enabled high recall and precision for simple queries, helping physicians to retrieve the relevant images. Further study using a larger data set and the implementation of an inference engine may improve query results for more complex queries.
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Affiliation(s)
- Kyung Hoon Hwang
- Department of Nuclear Medicine, Gachon University Gil Medical Center, Incheon, South Korea
| | - Haejun Lee
- Department of Nuclear Medicine, Gachon University Gil Medical Center, Incheon, South Korea
| | - Geon Koh
- Department of Nuclear Medicine, Gachon University Gil Medical Center, Incheon, South Korea
| | - Debra Willrett
- Department of Radiology, Stanford University, Stanford, CA, USA
| | - Daniel L Rubin
- Department of Radiology, Stanford University, Stanford, CA, USA. .,Department of Medicine (Biomedical Informatics Research), Stanford University, Stanford, CA, USA.
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271
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van Wyngaardt WM, Smith ML, Jackson TW, Howe B, Tobin SM, Reinhard MI. Development of the Australian Standard for Germanium-68 by two Liquid Scintillation Counting methods. Appl Radiat Isot 2018; 134:79-84. [PMID: 29102160 DOI: 10.1016/j.apradiso.2017.10.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Revised: 09/04/2017] [Accepted: 10/02/2017] [Indexed: 10/18/2022]
Abstract
In response to the increasing application of 68Ge/68Ga and 68Ga in nuclear medicine, an international comparison of activity measurement of 68Ge in equilibrium with 68Ga was organised. ANSTO standardised the comparison solution by the 4π(LS)β+-γ coincidence extrapolation and TDCR efficiency calculation methods, with excellent agreement between the two results. The primary standard was transferred to the ANSTO Secondary Standard Ionisation Chamber. Internationally traceable Australian Certified Reference Materials (ACRMs) of 68Ge/68Ga can now be prepared in various measurement geometries applied in nuclear medicine.
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Affiliation(s)
- W M van Wyngaardt
- Australian Nuclear Science and Technology Organisation, New Illawarra Rd, Lucas Heights 2234, NSW, Australia.
| | - M L Smith
- Australian Nuclear Science and Technology Organisation, New Illawarra Rd, Lucas Heights 2234, NSW, Australia
| | - T W Jackson
- Australian Nuclear Science and Technology Organisation, New Illawarra Rd, Lucas Heights 2234, NSW, Australia
| | - B Howe
- Australian Nuclear Science and Technology Organisation, New Illawarra Rd, Lucas Heights 2234, NSW, Australia
| | - S M Tobin
- Australian Nuclear Science and Technology Organisation, New Illawarra Rd, Lucas Heights 2234, NSW, Australia
| | - M I Reinhard
- Australian Nuclear Science and Technology Organisation, New Illawarra Rd, Lucas Heights 2234, NSW, Australia
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272
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Abstract
An increasing collection of imaging technologies makes it possible to differentiate treatment responders from nonresponders based on genetic variation. This chapter will review some of the imaging technologies currently available in nuclear medicine to visualize drug absorption, distribution, metabolism, and elimination. Some of the commonly used techniques to detect radiation-emitting compounds are the two-dimensional scintigraphy and the three-dimensional single-photon emission computed tomography (SPECT) which both detect photons using a gamma camera, and the three-dimensional positron emission tomography (PET), which detect the decay of positron-emitting radionuclides. Current examples include visualization of functional effects of genetic variants, and these provide proof of concept for imaging in pharmacogenetics as a tool to improve efficacy and safety of drugs.
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Affiliation(s)
- Mikkel H Vendelbo
- Aarhus University Hospital, Aarhus, Denmark; Aarhus University, Aarhus, Denmark
| | | | - Niels Jessen
- Aarhus University Hospital, Aarhus, Denmark; Aarhus University, Aarhus, Denmark.
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273
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Hirmas N, Jadaan R, Al-Ibraheem A. Peptide Receptor Radionuclide Therapy and the Treatment of Gastroentero-pancreatic Neuroendocrine Tumors: Current Findings and Future Perspectives. Nucl Med Mol Imaging 2018; 52:190-9. [PMID: 29942397 DOI: 10.1007/s13139-018-0517-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 03/10/2018] [Accepted: 03/15/2018] [Indexed: 02/07/2023] Open
Abstract
Purpose and Methods Patients with inoperable and metastasized neuroendocrine tumors (NETs), particularly those with grades 1 and 2, usually receive treatment with somatostatin analogues (SSAs). Peptide receptor radionuclide therapy (PRRT) has gained momentum over the past two decades in patients who progress on SSAs. 177Lu-DOTATATE is currently the most widely used radiopeptide for PRRT. We reviewed the recent evidence on PRRT and the treatment of gastroentero-pancreatic neuroendocrine tumors (GEP-NETs). Results 177Lu-DOTATATE can be used as neoadjuvant treatment in patients with inoperable GEP-NETs, who might be candidate for surgery after treatment and as adjuvant therapy after surgical intervention. Combination treatments of PRRT with chemotherapy or targeted agents as well as combinations of radionuclides in patients with NETs have been explored over the last few years. The majority of patients with NETs experience partial response or have disease stabilization, a small percentage has complete response, while some 30% of patients, however, will have disease progression. The safety and efficacy of retreatment with extra cycles of PRRT as salvage therapy have been evaluated in small retrospective series. Conclusion Overall, there is evidence that disease control and quality of life improve significantly after 117Lu PRRT therapy. Clinical trials on this therapy are scarce, and there is a need for further studies to establish proper management guidelines.
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274
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Brudecki K, Szczodry A, Mróz T, Kowalska A, Mietelski JW. Measurement of 131I activity in air indoor Polish nuclear medical hospital as a tool for an internal dose assessment. Radiat Environ Biophys 2018; 57:77-82. [PMID: 29243128 PMCID: PMC5816111 DOI: 10.1007/s00411-017-0724-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 12/06/2017] [Indexed: 05/27/2023]
Abstract
This paper presents results of 131I air activity measurements performed within nuclear medical hospitals as a tool for internal dose assessment. The study was conducted at a place of preparation and administration of 131I ("hot room") and at a nurse station. 131I activity measurements were performed for 5 and 4 consecutive working days, at the "hot room" and nurse station, respectively. Iodine from the air was collected by a mobile HVS-30 aerosol sampler combined with a gas sampler. Both the gaseous and aerosol fractions were measurement. The activities in the gaseous fraction ranged from (28 ± 1 Bq m-3) to (492 ± 4) Bq m-3. At both sampling sites, the activity of the gaseous iodine fraction trapped on activated charcoal was significantly higher than that of the aerosol fraction captured on Petrianov filter cloth. Based on these results, an attempt has been made to estimate annual inhalation effective doses, which were found to range from 0.47 mSv (nurse female) to 1.3 mSv (technician male). The highest annual inhalation equivalent doses have been found for thyroid as 32, 27, 13, and 11 mSv, respectively, for technician male, technical female, nurse male, and nurse female. The method presented here allows to fill the gaps in internal doses measurements. Moreover, because method has been successful used for many years in radioactive contamination monitoring of air in cases of serious nuclear accidents, it should also be used in nuclear medicine.
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Affiliation(s)
- K Brudecki
- Institute of Nuclear Physics, Polish Academy of Sciences, Radzikowskiego 152, 31-342, Krakow, Poland.
| | - A Szczodry
- Department of Endocrinology and Nuclear Medicine Holycross Cancer Center, Artwińskiego 3, 25-734, Kielce, Poland
| | - T Mróz
- Pedagogical University in Cracow, Podchorążych 2, 30-084, Krakow, Poland
| | - A Kowalska
- Department of Endocrinology and Nuclear Medicine Holycross Cancer Center, Artwińskiego 3, 25-734, Kielce, Poland
| | - J W Mietelski
- Institute of Nuclear Physics, Polish Academy of Sciences, Radzikowskiego 152, 31-342, Krakow, Poland
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275
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Aburadani I, Usuda K, Sumiya H, Sakagami S, Kiyokawa H, Matsuo S, Takamura M, Murai H, Takashima S, Kitano T, Okuda K, Nakajima K. Ability of the prognostic model of J-ACCESS study to predict cardiac events in a clinical setting: The APPROACH study. J Cardiol 2018; 72:81-86. [PMID: 29317133 DOI: 10.1016/j.jjcc.2017.12.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 11/26/2017] [Accepted: 12/04/2017] [Indexed: 01/23/2023]
Abstract
BACKGROUND In patients with coronary artery disease (CAD), one of the risk models available in Japan was a multivariate risk prediction model based on a Japanese multicenter database: the Japanese Assessment of Cardiac Events and Survival Study by Quantitative Gated SPECT (J-ACCESS). The aim of this study was to clinically validate the accuracy of this risk model. METHODS We evaluated the performance of the J-ACCESS model using data derived from the Assessment of the Predicted value of PROgnosis of cArdiaC events in Hokuriku (APPROACH) registry. Variables of age, summed stress score (SSS), left ventricular ejection fraction (LVEF), estimated glomerular filtration rate (eGFR), and diabetes mellitus were included. The major cardiac events were defined as cardiac death, non-fatal myocardial infarction, and heart failure that required hospitalization. The patients were followed up for three years to compare between predicted risk and actual events. RESULTS We evaluated 283 patients with suspected or confirmed CAD receiving myocardial perfusion imaging using 99mTc-tetrofosmin between March 2009 and August 2011. Mean age was 68.9±10.1 years, mean eGFR 67.4±24.3mL/min/1.73m2, mean SSS 5.2±7.2, and mean LVEF 65.4±14.0%. Fourteen (4.9%) patients experienced major cardiac events including cardiac death in 4 patients (1.4%), non-fatal myocardial infarction in 1 patient (0.3%), and severe heart failure in 9 patients (3.2%), respectively. While SSS≥8, LVEF<50%, eGFR<45mL/min/1.73m2, and event risk≥10% were significant variables in survival analysis, multivariate proportional hazard analysis showed that only LVEF and eGFR were significant. The event rate estimated from the J-ACCESS model was comparable to the actual number of major cardiac events (9 and 6, respectively, p=0.58 by Chi-square test). CONCLUSIONS The predictive ability of the J-ACCESS risk model is clinically valid among patients with CAD and could be applicable in clinical practice.
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Affiliation(s)
- Isao Aburadani
- Toyama Prefectural Central Hospital, Division of Cardiology, Department of Internal Medicine, Toyama, Japan.
| | - Kazuo Usuda
- Toyama Prefectural Central Hospital, Division of Cardiology, Department of Internal Medicine, Toyama, Japan
| | - Hisashi Sumiya
- Toyama Prefectural Central Hospital, Division of Radiology, Toyama, Japan
| | - Satoru Sakagami
- National Hospital Organization Kanazawa Medical Center, Division of Cardiology, Kanazawa, Japan
| | | | - Shinro Matsuo
- Kanazawa University, Department of Nuclear Medicine, Kanazawa, Japan
| | | | - Hisayoshi Murai
- Kanazawa University, Department of Cardiology, Kanazawa, Japan
| | | | - Teppei Kitano
- Kanazawa University, Department of Cardiology, Kanazawa, Japan
| | - Koichi Okuda
- Kanazawa Medical University, Department of Physics, Uchinada, Kahoku, Japan
| | - Kenichi Nakajima
- Kanazawa University, Department of Nuclear Medicine, Kanazawa, Japan.
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Hayakawa T, Hatsukawa Y, Tanimori T. 95gTc and 96gTc as alternatives to medical radioisotope 99mTc. Heliyon 2018; 4:e00497. [PMID: 29349358 PMCID: PMC5766687 DOI: 10.1016/j.heliyon.2017.e00497] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 11/27/2017] [Accepted: 12/28/2017] [Indexed: 11/21/2022] Open
Abstract
We studied 95gTc and 96gTc as alternatives to the medical radioisotope 99mTc. 96gTc (95gTc) can be produced by (p, n) reactions on an enriched 96Mo (95Mo) target with a proton beam provided by a compact accelerator such as a medical cyclotron that generate radioisotopes for positron emission tomography (PET). The γ-rays are measured with an electron-tracking Compton camera (ETCC). We calculated the relative intensities of the γ-rays from 95gTc and 96gTc. The calculated γ-ray intensity of a 96gTc (95gTc) nucleus is as high as 63% (70%) of that of a 99mTc nucleus. We also calculated the patient radiation doses of 95gTc and 96gTc, which were larger than that of 99mTc by a factor of 2-3 based on the applied assumptions. A medical PET cyclotron which can provide proton beams with energies of 11-12 MeV and a current of 100 μA can produce 12 GBq (39 GBq) of 96gTc (95gTc) for operation time of 8 h, which can be used for 240 (200) diagnostic scans.
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Affiliation(s)
- Takehito Hayakawa
- Tokai Quantum Science Center, National Institutes for Quantum and Radiological Science and Technology, Ibaraki 319-1106, Japan
| | - Yuichi Hatsukawa
- Tokai Quantum Science Center, National Institutes for Quantum and Radiological Science and Technology, Ibaraki 319-1106, Japan
| | - Toru Tanimori
- Department of Physics, Kyoto University, Kyoto 606-8502, Japan
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277
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Verdecia PO, Rodríguez LG, Águila RAS, León YM, Magaña YJ, Cassette P. 68Ga activity calibrations for nuclear medicine applications in Cuba. Appl Radiat Isot 2017; 134:112-116. [PMID: 29273465 DOI: 10.1016/j.apradiso.2017.11.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Revised: 11/07/2017] [Accepted: 11/07/2017] [Indexed: 11/26/2022]
Abstract
The realization and dissemination of the 68Ga activity measurement unit in Cuba is presented. Firstly, the implementation of the Triple to Double Coincidence Ratio (TDCR) method is described for the calibration of the activity concentration of a 68Ga solution using a Hidex™ commercial liquid scintillation counter and a FORTRAN code developed for the calculation of the 68Ga counting efficiencies in the given measurement system. The relative expanded uncertainty (k = 2) associated with the 68Ga activity concentration obtained with the TDCR method is equal to 2%. With the aim to validate this measurement uncertainty estimate, the method is also applied to an Amersham standard solution of 22Na - a positron emitter with a similar decay mode to the 68Ga disintegration scheme from the point of view of type of emitted particles detected in the measurement system. The observed difference between the measured 22Na activity concentration by the TDCR method and the corresponding reference value traceable to NIST is equal to 0.16%. Outcomes of transferring the 68Ga activity standard, realized with the TDCR method, to the secondary standard radionuclide calibrator Capintec CRC™ 15R and to three radionuclide calibrators used for 68Ga PET applications in a hospital are also shown.
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Affiliation(s)
- P Oropesa Verdecia
- Centro de Isotopos (CENTIS), Avenue Monumental y Carretera La Rada Km 3½, San José de las Lajas, Mayabeque 32700, Cuba.
| | - L García Rodríguez
- Centro de Isotopos (CENTIS), Avenue Monumental y Carretera La Rada Km 3½, San José de las Lajas, Mayabeque 32700, Cuba
| | - R A Serra Águila
- Centro de Isotopos (CENTIS), Avenue Monumental y Carretera La Rada Km 3½, San José de las Lajas, Mayabeque 32700, Cuba
| | - Y Moreno León
- Centro de Isotopos (CENTIS), Avenue Monumental y Carretera La Rada Km 3½, San José de las Lajas, Mayabeque 32700, Cuba
| | - Y Jénez Magaña
- Centro de Isotopos (CENTIS), Avenue Monumental y Carretera La Rada Km 3½, San José de las Lajas, Mayabeque 32700, Cuba
| | - P Cassette
- CEA, LIST, Laboratoire National Henri Becquerel (LNE-LNHB), Bât 602 Saclay, F-91191 Gif-sur-Yvette Cedex, France
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van Leeuwen FWB, Cornelissen B, Caobelli F, Evangelista L, Rbah-Vidal L, Del Vecchio S, Xavier C, Barbet J, de Jong M. Generation of fluorescently labeled tracers - which features influence the translational potential? EJNMMI Radiopharm Chem 2017; 2:15. [PMID: 29503856 PMCID: PMC5824706 DOI: 10.1186/s41181-017-0034-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Accepted: 11/23/2017] [Indexed: 01/16/2023] Open
Abstract
Given the increasing exploration of fluorescent tracers in the field of nuclear medicine, a need has risen for practical development guidelines that can help improve the translation aspects of fluorescent tracers. This editorial discusses the does and don'ts in developing fluorescence tracers. It has been put forward by the European Association of Nuclear Medicine (EANM) Translational Molecular Imaging & Therapy committee and has been approved by the EANM board.
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Affiliation(s)
- Fijs W. B. van Leeuwen
- Interventional Molecular Imaging Laboratory, Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Bart Cornelissen
- Department of Oncology, CRUK&MRC Oxford Institute for Radiation Oncology, University of Oxford, Oxford, UK
| | - Federico Caobelli
- Department of Nuclear Medicine, University Hospital Basel, Basel, Switzerland
| | - Laura Evangelista
- Nuclear Medicine and Molecular Imaging Unit, Veneto Institute of Oncology IOV – IRCCS, Padua, Italy
| | - Latifa Rbah-Vidal
- CRCINA, INSERM, CNRS, Université d’Angers, Université de Nantes, Nantes, France
| | - Silvana Del Vecchio
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Catarina Xavier
- In vivo Cellular and Molecular Imaging Lab (ICMI)-Department, Vrije Universiteit Brussel, Ixelles, Belgium
| | - Jacques Barbet
- CRCINA, INSERM, CNRS, Université d’Angers, Université de Nantes, Nantes, France
| | - Marion de Jong
- Department of Radiology & Nuclear Medicine, Erasmus Medical Centre, Rotterdam, the Netherlands
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Pak K, Kim K, Lee MJ, Lee JM, Kim BS, Kim SJ, Kim IJ. Correlation between the availability of dopamine transporter and olfactory function in healthy subjects. Eur Radiol 2017; 28:1756-1760. [PMID: 29164380 DOI: 10.1007/s00330-017-5147-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Revised: 09/25/2017] [Accepted: 10/18/2017] [Indexed: 01/18/2023]
Abstract
OBJECTIVES Olfactory dysfunction in Parkinson's disease is usually prodromal to other symptoms. In this study, we aimed to explore the association of olfactory function with the availabilities of striatal dopamine transporter (DAT) in healthy subjects. METHODS Data used in the preparation of this article were obtained from Parkinson's Progression Markers Initiative database ( www.ppmi-info.org/data ). The study population consisted of healthy controls with screening 123I-FP-CIT single photon emission tomography (SPECT). University of Pennsylvania Smell Identification Test (UPSIT) was assessed to evaluate the olfactory function. RESULTS Totally, 181 healthy subjects (117 male, 64 female) with 123I-FP-CIT SPECT data were included in this study. Specific binding ratios (SBRs) of the caudate nucleus (rho = -0.4217, p < 0.0001), putamen (rho = -0.2292, p = 0.0019), and striatum (rho=-0.3425, p < 0.0001) showed a reduction with ageing. SBRs of the caudate nucleus, putamen, and striatum were positively correlated with UPSIT (rho = 0.3716, p < 0.0001; rho = 0.3655, p < 0.0001; rho = 0.3880, p < 0.0001). After controlling for age by partial correlation, SBRs of the caudate nucleus, putamen, and striatum showed an influence on UPSIT (rho = 0.3288, p < 0.0001; rho = 0.3374, p < 0.0001; rho = 0.3511, p < 0.0001). CONCLUSION Olfactory function is associated with the availability of striatal DAT independent of age in healthy subjects. KEY POINTS • Olfactory dysfunction in Parkinson's disease is prodromal to other symptoms. • The availability of dopamine transporter showed a reduction with ageing. • Olfactory function is associated with the availability of dopamine transporter.
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Affiliation(s)
- Kyoungjune Pak
- Department of Nuclear Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Keunyoung Kim
- Department of Nuclear Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Myung Jun Lee
- Department of Neurology and Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Jae Meen Lee
- Department of Neurosurgery and Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Bum Soo Kim
- Department of Nuclear Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Seong-Jang Kim
- Department of Nuclear Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea.
| | - In Joo Kim
- Department of Nuclear Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
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280
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Ziemek T, Capogni M, Ratel G, Broda R, Dziel T, Fazio A, Listkowska A. Comparison of 131I activity measurements at the NCBJ RC POLATOM and the ENEA-INMRI linked to the BIPM SIR system. Appl Radiat Isot 2017; 134:380-384. [PMID: 29032880 DOI: 10.1016/j.apradiso.2017.09.040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Revised: 09/08/2017] [Accepted: 09/24/2017] [Indexed: 11/16/2022]
Abstract
A bilateral comparison between ENEA-INMRI (Italy) and NCBJ RC POLATOM (Poland) of 131I-solution activity measurements was organized in the year 2015 and piloted by POLATOM, which provided the sources for the comparison. The 131I master solution was standardized independently at both institutes by using Liquid Scintillation Counting and ionization chamber techniques. The 131I master solution was then sent by POLATOM to the BIPM International Reference System (SIR). The comparison was registered as an EURAMET.RI(II)-K2.I-131 key comparison allowing the ENEA-INMRI result to enter in the SIR database.
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Affiliation(s)
- T Ziemek
- National Centre for Nuclear Research Radioisotope Centre POLATOM, Otwock, Poland.
| | - M Capogni
- ENEA National Institute of Ionizing Radiation Metrology (ENEA-INMRI), Casaccia Research Centre, Rome, Italy.
| | - G Ratel
- Bureau International des Poids et Mesures (BIPM), Sèvres, France
| | - R Broda
- National Centre for Nuclear Research Radioisotope Centre POLATOM, Otwock, Poland
| | - T Dziel
- National Centre for Nuclear Research Radioisotope Centre POLATOM, Otwock, Poland
| | - A Fazio
- ENEA National Institute of Ionizing Radiation Metrology (ENEA-INMRI), Casaccia Research Centre, Rome, Italy
| | - A Listkowska
- National Centre for Nuclear Research Radioisotope Centre POLATOM, Otwock, Poland
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281
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Lau J, Lin KS, Bénard F. Past, Present, and Future: Development of Theranostic Agents Targeting Carbonic Anhydrase IX. Am J Cancer Res 2017; 7:4322-4339. [PMID: 29158829 PMCID: PMC5695016 DOI: 10.7150/thno.21848] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Accepted: 08/18/2017] [Indexed: 12/15/2022] Open
Abstract
Theranostics is the integration of diagnostic information with pharmaceuticals to increase effectiveness and safety of cancer treatments. Nuclear medicine provides a non-invasive means to visualize drug target expression across primary and metastatic sites, and assess pharmacokinetics and efficacy of companion therapeutic agents. This is significant given the increasing recognition of the importance of clonal heterogeneity in treatment response and resistance. Carbonic anhydrase IX (CA-IX) has been advocated as an attractive diagnostic and therapeutic biomarker for targeting hypoxia in solid malignancies. CA-IX confers cancer cell survival under low oxygen tension, and is associated with increased propensity for metastasis. As such, CA-IX is overexpressed in a broad spectrum of cancers. Different classes of antigen recognition molecules targeting CA-IX including monoclonal antibodies, peptides, small molecule inhibitors, and antibody mimetics have been radiolabeled for imaging and therapeutic applications. cG250, a chimeric monoclonal antibody, has been labeled with an assortment of radionuclides (124I, 111In, 89Zr, 131I, 90Y, and 177Lu) and is the most extensively investigated CA-IX radiopharmaceutical. In recent years, there have been tremendous advancements made by the research community in developing alternatives to cG250. Although still in preclinical settings, several small molecule inhibitors and antibody mimetics hold great promise in improving the management of aggressive and resistant cancers.
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282
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Almén A, Mattsson S. Radiological protection of foetuses and breast-fed children of occupationally exposed women in nuclear medicine - Challenges for hospitals. Phys Med 2017; 43:172-177. [PMID: 28882410 DOI: 10.1016/j.ejmp.2017.08.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 07/25/2017] [Accepted: 08/23/2017] [Indexed: 11/18/2022] Open
Abstract
This paper describes issues of concern for protecting foetuses and breast-fed children of occupationally exposed women in nuclear medicine from unnecessary exposure of ionising radiation. The protection principle is to ensure the same level of protection for the foetus and child as for the general public. Therefore international radiation protection standards recommend a dose constraint of 1mSv to a foetus during the remaining time of pregnancy after it is known/declared and a yearly dose constraint of 1mSv to a breast-fed child. It is not self-evident how to guarantee this level of radiation protection. The exposure situation in nuclear medicine is complex. Exploring existing reported occupational exposure levels suggests great variability between work tasks and facilities. The standards and guidelines found give no detailed advice. Therefore each facility needs to systematically review external and internal exposure levels in order to plan appropriate protection measures and issue their own guidelines and rules. One strategy might be that each facility defines tasks that do not require any restrictions and lists such duties that are not suitable to do when pregnant or breastfeeding, taking also potential exposure levels into consideration. This paper gives examples of such types of work. Information to the staff about the necessity of declaring pregnancy or breastfeeding is of fundamental importance. The internal policies issued by the hospital management should make clear the basis for taking care of pregnant and breastfeeding employees.
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Affiliation(s)
- A Almén
- Medical Radiation Physics, Department of Translational Medicine, Lund University, SE-205 02 Malmö, Sweden; Radiation Physics, Department of Haematology, Oncology and Radiation Physics, Skåne University Hospital, SE-221 85 Lund, Sweden.
| | - S Mattsson
- Medical Radiation Physics, Department of Translational Medicine, Lund University, SE-205 02 Malmö, Sweden
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283
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Du Y, Carrio I, De Vincentis G, Fanti S, Ilhan H, Mommsen C, Nitzsche E, Sundram F, Vogel W, Oyen W, Lewington V. Practical recommendations for radium-223 treatment of metastatic castration-resistant prostate cancer. Eur J Nucl Med Mol Imaging 2017; 44:1671-1678. [PMID: 28631036 PMCID: PMC5537325 DOI: 10.1007/s00259-017-3756-7] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Accepted: 06/07/2017] [Indexed: 11/30/2022]
Abstract
PURPOSE Radium Ra 223 dichloride (radium-223, Xofigo®) is the first targeted alpha therapy for patients with castration-resistant prostate cancer and symptomatic bone metastases. Radium-223 provides a new treatment option for this setting, but also necessitates a new treatment management approach. We provide straightforward and practical recommendations for European nuclear medicine centres to optimize radium-223 service provision. METHODS An independent research consultancy agency observed radium-223 procedures and conducted interviews with all key staff members involved in radium-223 treatment delivery in 11 nuclear medicine centres across six countries (Germany, Italy, the Netherlands, Spain, Switzerland and the UK) experienced in administering radium-223. The findings were collated and discussed at a meeting of experts from these centres, during which key consensus recommendations were defined. RESULTS The recommendations cover centre organization and preparation; patient referral; radium-223 ordering, preparation and disposal; radium-223 treatment delivery/administration; and patient experience. Guidance includes structured coordination and communication within centres and multidisciplinary teams, focusing on sharing best practice to provide high-quality, patient-centred care throughout the treatment pathway. CONCLUSIONS These expert recommendations are intended to complement existing management guidelines. Sharing best practice and experience will help nuclear medicine centres to optimize radium-223 service provision and improve patient care.
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Affiliation(s)
- Yong Du
- Department of Nuclear Medicine & PET/CT, The Royal Marsden NHS Foundation Trust, Fulham Road, London, SW3 6JJ, UK.
| | | | | | | | - Harun Ilhan
- Ludwig-Maximilians-University Hospital, Munich, Germany
| | - Caroline Mommsen
- Praxis für diagnostische und therapeutische Nuklearmedizin Berlin, Berlin, Germany
| | | | - Francis Sundram
- University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Wouter Vogel
- The Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Wim Oyen
- Department of Nuclear Medicine & PET/CT, The Royal Marsden NHS Foundation Trust, Fulham Road, London, SW3 6JJ, UK
- The Institute of Cancer Research, London, UK
| | - Val Lewington
- Guy's and St Thomas' NHS Foundation Trust, London, UK
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284
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Bahamonde S, Díaz-Londoño GM, García M, Albornoz F, Andrade P. Design and implementation of a mobile gamma spectrometry system to in vivo measure the accumulated activity of 131I in patients with thyroid diseases. Appl Radiat Isot 2017; 129:87-95. [PMID: 28830021 DOI: 10.1016/j.apradiso.2017.08.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Revised: 08/02/2017] [Accepted: 08/11/2017] [Indexed: 11/20/2022]
Abstract
The design and implementation of a mobile gamma spectrometry system to in vivo measure the accumulated activity of 131I in whole body and thyroid of patients with thyroid diseases are presented in this work. This system may be used for both pre-therapeutic and post-therapeutic dosimetry calculations. It consists of a detector and a movable support that allows its movement from one place to another.
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285
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KleinJan GH, Karakullukçu B, Klop WMC, Engelen T, van den Berg NS, van Leeuwen FWB. Introducing navigation during melanoma-related sentinel lymph node procedures in the head-and-neck region. EJNMMI Res 2017; 7:65. [PMID: 28819936 PMCID: PMC5560283 DOI: 10.1186/s13550-017-0312-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2017] [Accepted: 07/25/2017] [Indexed: 11/10/2022] Open
Abstract
Background Intraoperative sentinel node (SN) identification in patients with head-and-neck malignancies can be challenging due to unexpected drainage patterns and anatomical complexity. Here, intraoperative navigation-based guidance technologies may provide outcome. In this study, gamma camera-based freehandSPECT was evaluated in combination with the hybrid tracer ICG-99mTc-nanocolloid. Materials and methods Eight patients with melanoma located in the head-and-neck area were included. Indocyanine green (ICG)-99mTc-nanocolloid was injected preoperatively, whereafter lymphoscintigraphy and SPECT/CT imaging were performed in order to define the location of the SN(s). FreehandSPECT scans were generated in the operation room using a portable gamma camera. For lesion localization during surgery, freehandSPECT scans were projected in an augmented reality video-view that was used to spatially position a gamma-ray detection probe. Intraoperative fluorescence imaging was used to confirm the accuracy of the navigation-based approach and identify the exact location of the SNs. Results Preoperatively, 15 SNs were identified, of which 14 were identified using freehandSPECT. Navigation towards these nodes using the freehandSPECT approach was successful in 13 nodes. Fluorescence imaging provided optical confirmation of the navigation accuracy in all patients. In addition, fluorescence imaging allowed for the identification of (clustered) SNs that could not be identified based on navigation alone. Conclusions The use of gamma camera-based freehandSPECT aids intraoperative lesion identification and, with that, supports the transition from pre- to intraoperative imaging via augmented reality display and directional guidance.
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Affiliation(s)
- Gijs H KleinJan
- Interventional Molecular Imaging Laboratory, Department of Radiology, Leiden University Medical Hospital, Albinusdreef 2, C2-S zone, 9600, 2300 RC, Leiden, the Netherlands.,Department of Nuclear Medicine, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, the Netherlands
| | - Baris Karakullukçu
- Department of Head and Neck Oncology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, the Netherlands
| | - W Martin C Klop
- Department of Head and Neck Oncology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, the Netherlands
| | - Thijs Engelen
- Interventional Molecular Imaging Laboratory, Department of Radiology, Leiden University Medical Hospital, Albinusdreef 2, C2-S zone, 9600, 2300 RC, Leiden, the Netherlands
| | - Nynke S van den Berg
- Interventional Molecular Imaging Laboratory, Department of Radiology, Leiden University Medical Hospital, Albinusdreef 2, C2-S zone, 9600, 2300 RC, Leiden, the Netherlands.,Department of Head and Neck Oncology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, the Netherlands
| | - Fijs W B van Leeuwen
- Interventional Molecular Imaging Laboratory, Department of Radiology, Leiden University Medical Hospital, Albinusdreef 2, C2-S zone, 9600, 2300 RC, Leiden, the Netherlands. .,Department of Head and Neck Oncology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, the Netherlands.
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Tsapaki V, Kagadis GC, Brambilla M, Ciocca M, Clark CH, Delis H, Mettivier G. 1st European Congress of Medical Physics September 1-4, 2016; Medical Physics innovation and vision within Europe and beyond. Phys Med 2017; 41:1-4. [PMID: 28709862 DOI: 10.1016/j.ejmp.2017.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Accepted: 07/04/2017] [Indexed: 11/20/2022] Open
Abstract
Medical Physics is the scientific healthcare profession concerned with the application of the concepts and methods of physics in medicine. The European Federation of Organisations for Medical Physics (EFOMP) acts as the umbrella organization for European Medical Physics societies. Due to the rapid advancements in related scientific fields, medical physicists must have continuous education through workshops, training courses, conferences, and congresses during their professional life. The latest developments related to this increasingly significant medical speciality were presented during the 1st European Congress of Medical Physics 2016, held in Athens, September 1-4, 2016, organized by EFOMP, hosted by the Hellenic Association of Medical Physicists (HAMP), and summarized in the current volume.
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Abstract
Nuclear medicine imaging is widely used in pain medicine. Low back pain is commonly encountered by physicians, with its prevalence from 49% to 70%. Computed tomography (CT) or magnetic resonance imaging (MRI) are usually used to evaluate the cause of low back pain, however, these findings from these scans could also be observed in asymptomatic patients. Bone scintigraphy has an additional value in patients with low back pain. Complex regional pain syndrome (CRPS) is defined as a painful disorder of the extremities, which is characterized by sensory, autonomic, vasomotor, and trophic disturbances. To assist the diagnosis of CRPS, three-phase bone scintigraphy is thought to be superior compared to other modalities, and could be used to rule out CRPS due to its high specificity. Studies regarding the effect of bone scintigraphy in patients with extremity pain have not been widely conducted. Ultrasound, CT and MRI are widely used imaging modalities for evaluating extremity pain. However, SPECT/CT has an additional role in assessing pain in the extremities.
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Affiliation(s)
- Seung Hyeon Shin
- Department of Nuclear Medicine, Pusan National University Hospital, Busan, Korea
| | - Seong Jang Kim
- Department of Nuclear Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea.,BioMedical Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
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288
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Zvereva A, Schlattl H, Zankl M, Becker J, Petoussi-Henss N, Yeom YS, Kim CH, Hoeschen C, Parodi K. Feasibility of reducing differences in estimated doses in nuclear medicine between a patient-specific and a reference phantom. Phys Med 2017. [PMID: 28624290 DOI: 10.1016/j.ejmp.2017.06.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
The feasibility of reducing the differences between patient-specific internal doses and doses estimated using reference phantoms was evaluated. Relatively simple adjustments to a polygon-surface ICRP adult male reference phantom were applied to fit selected individual dimensions using the software Rhinoceros®4.0. We tested this approach on two patient-specific phantoms: the biggest and the smallest phantoms from the Helmholtz Zentrum München library. These phantoms have unrelated anatomy and large differences in body-mass-index. Three models approximating each patient's anatomy were considered: the voxel and the polygon-surface ICRP adult male reference phantoms and the adjusted polygon-surface reference phantom. The Specific Absorbed Fractions (SAFs) for internal photon and electron sources were calculated with the Monte Carlo code EGSnrc. Employing the time-integrated activity coefficients of a radiopharmaceutical (S)-4-(3-18F-fluoropropyl)-l-glutamic acid and the calculated SAFs, organ absorbed-dose coefficients were computed following the formalism promulgated by the Committee on Medical Internal Radiation Dose. We compared the absorbed-dose coefficients between each patient-specific phantom and other models considered with emphasis on the cross-fire component. The corresponding differences for most organs were notably lower for the adjusted reference models compared to the case when reference models were employed. Overall, the proposed approach provided reliable dose estimates for both tested patient-specific models despite the pronounced differences in their anatomy. To capture the full range of inter-individual anatomic variability more patient-specific phantoms are required. The results of this test study suggest a feasibility of estimating patient-specific doses within a relative uncertainty of 25% or less using adjusted reference models, when only simple phantom scaling is applied.
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Affiliation(s)
- Alexandra Zvereva
- Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Radiation Protection, Ingolstädter Landstrasse 1, 85764 Neuherberg, Germany; Ludwig Maximilians Universität München (LMU Munich), Experimental Physics - Medical Physics, Am Coulombwall 1, 85748 Garching, Germany.
| | - Helmut Schlattl
- Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Radiation Protection, Ingolstädter Landstrasse 1, 85764 Neuherberg, Germany
| | - Maria Zankl
- Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Radiation Protection, Ingolstädter Landstrasse 1, 85764 Neuherberg, Germany
| | - Janine Becker
- Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Radiation Protection, Ingolstädter Landstrasse 1, 85764 Neuherberg, Germany
| | - Nina Petoussi-Henss
- Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Radiation Protection, Ingolstädter Landstrasse 1, 85764 Neuherberg, Germany
| | - Yeon Soo Yeom
- Department of Nuclear Engineering, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, 04763 Seoul, Republic of Korea
| | - Chan Hyeong Kim
- Department of Nuclear Engineering, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, 04763 Seoul, Republic of Korea
| | - Christoph Hoeschen
- Otto von Guericke Universität Magdeburg, Institut für Medizintechnik, Universitätsplatz 2, 39104 Magdeburg, Germany
| | - Katia Parodi
- Ludwig Maximilians Universität München (LMU Munich), Experimental Physics - Medical Physics, Am Coulombwall 1, 85748 Garching, Germany
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289
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Ciarrocchi E, Belcari N. Cerenkov luminescence imaging: physics principles and potential applications in biomedical sciences. EJNMMI Phys 2017; 4:14. [PMID: 28283990 PMCID: PMC5346099 DOI: 10.1186/s40658-017-0181-8] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 02/27/2017] [Indexed: 12/24/2022] Open
Abstract
Cerenkov luminescence imaging (CLI) is a novel imaging modality to study charged particles with optical methods by detecting the Cerenkov luminescence produced in tissue. This paper first describes the physical processes that govern the production and transport in tissue of Cerenkov luminescence. The detectors used for CLI and their most relevant specifications to optimize the acquisition of the Cerenkov signal are then presented, and CLI is compared with the other optical imaging modalities sharing the same data acquisition and processing methods. Finally, the scientific work related to CLI and the applications for which CLI has been proposed are reviewed. The paper ends with some considerations about further perspectives for this novel imaging modality.
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Affiliation(s)
- Esther Ciarrocchi
- Department of Physics "E. Fermi", University of Pisa, Pisa, Italy. .,INFN, section of Pisa, Pisa, Italy.
| | - Nicola Belcari
- Department of Physics "E. Fermi", University of Pisa, Pisa, Italy.,INFN, section of Pisa, Pisa, Italy
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290
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Cho SG, Kim J, Song HC. Radiation Safety in Nuclear Medicine Procedures. Nucl Med Mol Imaging 2017; 51:11-16. [PMID: 28250853 PMCID: PMC5313457 DOI: 10.1007/s13139-016-0406-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Revised: 02/01/2016] [Accepted: 02/05/2016] [Indexed: 10/22/2022] Open
Abstract
Since the nuclear disaster at the Fukushima Daiichi Nuclear Power Plant in 2011, radiation safety has become an important issue in nuclear medicine. Many structured guidelines or recommendations of various academic societies or international campaigns demonstrate important issues of radiation safety in nuclear medicine procedures. There are ongoing efforts to fulfill the basic principles of radiation protection in daily nuclear medicine practice. This article reviews important principles of radiation protection in nuclear medicine procedures. Useful references, important issues, future perspectives of the optimization of nuclear medicine procedures, and diagnostic reference level are also discussed.
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Affiliation(s)
- Sang-Geon Cho
- Department of Nuclear Medicine, Medical Radiation Safety Research Center, Chonnam National University Hospital, 42 Jebong-ro, Dong-gu, 501-757 Gwang-ju, Korea
| | - Jahae Kim
- Department of Nuclear Medicine, Medical Radiation Safety Research Center, Chonnam National University Hospital, 42 Jebong-ro, Dong-gu, 501-757 Gwang-ju, Korea
| | - Ho-Chun Song
- Department of Nuclear Medicine, Medical Radiation Safety Research Center, Chonnam National University Hospital, 42 Jebong-ro, Dong-gu, 501-757 Gwang-ju, Korea
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291
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Brudecki K, Kowalska A, Zagrodzki P, Szczodry A, Mroz T, Janowski P, Mietelski JW. Measurement of 131I activity in thyroid of nuclear medical staff and internal dose assessment in a Polish nuclear medical hospital. Radiat Environ Biophys 2017; 56:19-26. [PMID: 28040836 PMCID: PMC5315721 DOI: 10.1007/s00411-016-0674-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Accepted: 12/19/2016] [Indexed: 05/15/2023]
Abstract
This paper presents results of 131I thyroid activity measurements in 30 members of the nuclear medicine personnel of the Department of Endocrinology and Nuclear Medicine Holy Cross Cancer Centre in Kielce, Poland. A whole-body spectrometer equipped with two semiconductor gamma radiation detectors served as the basic research instrument. In ten out of 30 examined staff members, the determined 131I activity was found to be above the detection limit (DL = 5 Bq of 131I in the thyroid). The measured activities ranged from (5 ± 2) Bq to (217 ± 56) Bq. The highest activities in thyroids were detected for technical and cleaning personnel, whereas the lowest values were recorded for medical doctors. Having measured the activities, an attempt has been made to estimate the corresponding annual effective doses, which were found to range from 0.02 to 0.8 mSv. The highest annual equivalent doses have been found for thyroid, ranging from 0.4 to 15.4 mSv, detected for a cleaner and a technician, respectively. The maximum estimated effective dose corresponds to 32% of the annual background dose in Poland, and to circa 4% of the annual limit for the effective dose due to occupational exposure of 20 mSv per year, which is in compliance with the value recommended by the International Commission on Radiological Protection.
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Affiliation(s)
- K Brudecki
- Institute of Nuclear Physics, Polish Academy of Sciences, Radzikowskiego 152, 31-342, Kraków, Poland.
| | - A Kowalska
- Department of Endocrinology and Nuclear Medicine, Holy Cross Cancer Center, Artwińskiego 3, 25-734, Kielce, Poland
| | - P Zagrodzki
- Institute of Nuclear Physics, Polish Academy of Sciences, Radzikowskiego 152, 31-342, Kraków, Poland
- Department of Food Chemistry and Nutrition, Medical College, Jagiellonian University, 30-688, Kraków, Poland
| | - A Szczodry
- Department of Endocrinology and Nuclear Medicine, Holy Cross Cancer Center, Artwińskiego 3, 25-734, Kielce, Poland
| | - T Mroz
- Pedagogical University in Cracow, Podchorążych 2, 30-084, Kraków, Poland
| | - P Janowski
- AGH University of Science and Technology, Mickiewicza 30, 30-059, Kraków, Poland
| | - J W Mietelski
- Institute of Nuclear Physics, Polish Academy of Sciences, Radzikowskiego 152, 31-342, Kraków, Poland
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292
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Harel F, Langleben D, Provencher S, Fournier A, Finnerty V, Nguyen QT, Letourneau M, Levac X, Abikhzer G, Guimond J, Mansour A, Guertin MC, Dupuis J. Molecular imaging of the human pulmonary vascular endothelium in pulmonary hypertension: a phase II safety and proof of principle trial. Eur J Nucl Med Mol Imaging 2017; 44:1136-1144. [PMID: 28236024 PMCID: PMC5434971 DOI: 10.1007/s00259-017-3655-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Accepted: 02/09/2017] [Indexed: 01/23/2023]
Abstract
PURPOSE The adrenomedullin receptor is densely expressed in the pulmonary vascular endothelium. PulmoBind, an adrenomedullin receptor ligand, was developed for molecular diagnosis of pulmonary vascular disease. We evaluated the safety of PulmoBind SPECT imaging and its capacity to detect pulmonary vascular disease associated with pulmonary hypertension (PH) in a human phase II study. METHODS Thirty patients with pulmonary arterial hypertension (PAH, n = 23) or chronic thromboembolic PH (CTEPH, n = 7) in WHO functional class II (n = 26) or III (n = 4) were compared to 15 healthy controls. Lung SPECT was performed after injection of 15 mCi 99mTc-PulmoBind in supine position. Qualitative and semi-quantitative analyses of lung uptake were performed. Reproducibility of repeated testing was evaluated in controls after 1 month. RESULTS PulmoBind injection was well tolerated without any serious adverse event. Imaging was markedly abnormal in PH with ∼50% of subjects showing moderate to severe heterogeneity of moderate to severe extent. The abnormalities were unevenly distributed between the right and left lungs as well as within each lung. Segmental defects compatible with pulmonary embolism were present in 7/7 subjects with CTEPH and in 2/23 subjects with PAH. There were no segmental defects in controls. The PulmoBind activity distribution index, a parameter indicative of heterogeneity, was elevated in PH (65% ± 28%) vs. controls (41% ± 13%, p = 0.0003). In the only subject with vasodilator-responsive idiopathic PAH, PulmoBind lung SPECT was completely normal. Repeated testing 1 month later in healthy controls was well tolerated and showed no significant variability of PulmoBind distribution. CONCLUSIONS In this phase II study, molecular SPECT imaging of the pulmonary vascular endothelium using 99mTc-PulmoBind was safe. PulmoBind showed potential to detect both pulmonary embolism and abnormalities indicative of pulmonary vascular disease in PAH. Phase III studies with this novel tracer and direct comparisons to lung perfusion agents such as labeled macro-aggregates of albumin are needed. CLINICAL TRIAL ClinicalTrials.gov, NCT02216279.
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Affiliation(s)
- François Harel
- Research Center, Montreal Heart Institute, 5000, Belanger Street, Montreal, QC, H1T 1C8, Canada.,Department of Nuclear Medicine, Université de Montréal, Montréal, Québec, Canada
| | - David Langleben
- Lady Davis Institute and Jewish General Hospital, McGill University, Montréal, Québec, Canada
| | - Steve Provencher
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec, Canada
| | | | - Vincent Finnerty
- Research Center, Montreal Heart Institute, 5000, Belanger Street, Montreal, QC, H1T 1C8, Canada
| | - Quang T Nguyen
- Research Center, Montreal Heart Institute, 5000, Belanger Street, Montreal, QC, H1T 1C8, Canada
| | | | - Xavier Levac
- Research Center, Montreal Heart Institute, 5000, Belanger Street, Montreal, QC, H1T 1C8, Canada
| | - Gad Abikhzer
- Lady Davis Institute and Jewish General Hospital, McGill University, Montréal, Québec, Canada
| | - Jean Guimond
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec, Canada
| | - Asmaa Mansour
- Montreal Health Innovation Coordination Center, Montréal, QC, Canada
| | | | - Jocelyn Dupuis
- Research Center, Montreal Heart Institute, 5000, Belanger Street, Montreal, QC, H1T 1C8, Canada. .,Department of Medicine, Université de Montréal, Montréal, Québec, Canada.
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293
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Engelmann N, Ondreka N, von Pückler K, Mohrs S, Sicken J, Neiger R. Applicability of 99m Tc-Labeled Human Serum Albumin Scintigraphy in Dogs With Protein-Losing Enteropathy. J Vet Intern Med 2017; 31:365-370. [PMID: 28220598 PMCID: PMC5354035 DOI: 10.1111/jvim.14673] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Revised: 12/28/2016] [Accepted: 01/16/2017] [Indexed: 12/22/2022] Open
Abstract
Background Diagnosis of protein loss into the gastrointestinal tract using noninvasive techniques is challenging. In people, scintigraphy not only is a sensitive tool to confirm protein‐losing enteropathy (PLE), but it also allows for localization of protein loss. Hypothesis/Objectives To investigate the feasibility of 99mTc‐labeled human serum albumin (HSA) scintigraphy in dogs with PLE in comparison with control dogs. Animals A total of 8 clinically healthy control research dogs and 7 client‐owned dogs with gastrointestinal clinical signs and hypoalbuminemia (serum albumin concentration <2.0 g/dL). Methods Prospective case–control study. After IV injection of 400 MBq freshly prepared 99mTc HSA (30 mg/dog), images of the abdomen were obtained 10, 60, 120, and 240 minutes postinjection. Additional images of the salivary and thyroid glands were obtained to rule out free 99mTc. A scan was considered positive for PLE when radiopharmaceutical exudation was detectable in the intestinal tract. Results Only 1 control dog showed exudation of the radiopharmaceutical into the intestinal tract. No free 99mTc was detected in any dog. In dogs with PLE, focal small intestinal and diffuse small intestinal radiopharmaceutical exudation into the bowel was detected in 2 and 3 dogs, respectively, whereas in 2 dogs, there was disagreement about whether radiopharmaceutical exudation was focal or diffuse. Conclusion and Clinical Importance 99mTc‐labeled HSA scintigraphy was feasible to diagnose PLE in dogs.
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Affiliation(s)
- N Engelmann
- Small Animal Clinic, Justus-Liebig University of Giessen, Giessen, Germany
| | - N Ondreka
- Small Animal Clinic, Justus-Liebig University of Giessen, Giessen, Germany
| | - K von Pückler
- Small Animal Clinic, Justus-Liebig University of Giessen, Giessen, Germany
| | - S Mohrs
- Small Animal Clinic, Justus-Liebig University of Giessen, Giessen, Germany
| | - J Sicken
- Small Animal Clinic, Justus-Liebig University of Giessen, Giessen, Germany
| | - R Neiger
- Small Animal Clinic, Justus-Liebig University of Giessen, Giessen, Germany
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294
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Goins B, Bao A, Phillips WT. Techniques for Loading Technetium-99m and Rhenium-186/188 Radionuclides into Preformed Liposomes for Diagnostic Imaging and Radionuclide Therapy. Methods Mol Biol 2017; 1522:155-178. [PMID: 27837538 DOI: 10.1007/978-1-4939-6591-5_13] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Liposomes can serve as carriers of radionuclides for diagnostic imaging and therapeutic applications. Herein, procedures are outlined for radiolabeling liposomes with the gamma-emitting radionuclide, technetium-99m (99mTc), for noninvasive detection of disease and for monitoring the pharmacokinetics and biodistribution of liposomal drugs, and/or with therapeutic beta-emitting radionuclides, rhenium-186/188 (186/188Re), for radionuclide therapy. These efficient and practical liposome radiolabeling methods use a post-labeling mechanism to load 99mTc or 186/188Re into preformed liposomes prepared in advance of the labeling procedure. For all liposome radiolabeling methods described, a lipophilic chelator is used to transport 99mTc or 186/188Re across the lipid bilayer of the preformed liposomes. Once within the liposome interior, the pre-encapsulated glutathione or ammonium sulfate (pH) gradient provides for stable entrapment of the 99mTc and 186/188Re within the liposomes. In the first method, 99mTc is transported across the lipid bilayer by the lipophilic chelator, hexamethylpropyleneamine oxime (HMPAO) and 99mTc-HMPAO becomes trapped by interaction with the pre-encapsulated glutathione within the liposomes. In the second method, 99mTc or 186/188Re is transported across the lipid bilayer by the lipophilic chelator, N,N-bis(2-mercaptoethyl)-N',N'-diethylethylenediamine (BMEDA), and 99mTc-BMEDA or 186/188Re-BMEDA becomes trapped by interaction with pre-encapsulated glutathione within the liposomes. In the third method, an ammonium sulfate (pH) gradient loading technique is employed using liposomes with an extraliposomal pH of 7.4 and an interior pH of 5.1. BMEDA, which is lipophilic at pH 7.4, serves as a lipophilic chelator for 99mTc or 186/188Re to transport the radionuclides across the lipid bilayer. Once within the more acidic liposome interior, 99mTc/186/188Re-BMEDA complex becomes protonated and more hydrophilic, which results in stable entrapment of the 99mTc/186/188Re-BMEDA complex within the liposomes. Since many commercially available liposomal drugs use an ammonium sulfate (pH) gradient for drug loading, these liposomal drugs can be directly radiolabeled with 99mTc-BMEDA for noninvasive monitoring of tissue distribution during treatment or with 186/188Re-BMEDA for combination chemo-radionuclide therapy.
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Affiliation(s)
- Beth Goins
- Department of Radiology, MSC 7800, University of Texas Health Science Center San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229-3900, USA
| | - Ande Bao
- Department of Radiation Oncology, School of Medicine, Case Western Reserve University/University Hospitals Cleveland Medical Center, 11100 Euclid Avenue, Cleveland, OH, 44106, USA
| | - William T Phillips
- Department of Radiology, MSC 7800, University of Texas Health Science Center San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229-3900, USA.
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295
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de Waal EGM, Glaudemans AWJM, Schröder CP, Vellenga E, Slart RHJA. Nuclear medicine imaging of multiple myeloma, particularly in the relapsed setting. Eur J Nucl Med Mol Imaging 2016; 44:332-341. [PMID: 27900520 PMCID: PMC5215256 DOI: 10.1007/s00259-016-3576-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Accepted: 11/18/2016] [Indexed: 02/04/2023]
Abstract
Multiple myeloma (MM) is characterized by a monoclonal plasma cell population in the bone marrow. Lytic lesions occur in up to 90 % of patients. For many years, whole-body X-ray (WBX) was the method of choice for detecting skeleton abnormalities. However, the value of WBX in relapsing disease is limited because lesions persist post-treatment, which restricts the capacity to distinguish between old, inactive skeletal lesions and new, active ones. Therefore, alternative techniques are necessary to visualize disease activity. Modern imaging techniques such as magnetic resonance imaging, positron emission tomography and computed tomography offer superior detection of myeloma bone disease and extramedullary manifestations. In particular, the properties of nuclear imaging enable the identification of disease activity by directly targeting the specific cellular properties of malignant plasma cells. In this review, an overview is provided of the effectiveness of radiopharmaceuticals that target metabolism, surface receptors and angiogenesis. The available literature data for commonly used nuclear imaging tracers, the promising first results of new tracers, and our pilot work indicate that a number of these radiopharmaceutical applications can be used effectively for staging and response monitoring of relapsing MM patients. Moreover, some tracers can potentially be used for radio immunotherapy.
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Affiliation(s)
- Esther G M de Waal
- Department of Hematology, University of Groningen, University Medical Center Groningen, PO Box 30001, 9700 RB, Groningen, The Netherlands.
| | - Andor W J M Glaudemans
- Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Carolien P Schröder
- Department of Medical Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Edo Vellenga
- Department of Hematology, University of Groningen, University Medical Center Groningen, PO Box 30001, 9700 RB, Groningen, The Netherlands
| | - Riemer H J A Slart
- Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,Department of Biomedical Photonic Imaging, University of Twente, Enschede, The Netherlands
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296
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Mathiessen A, Cimmino MA, Hammer HB, Haugen IK, Iagnocco A, Conaghan PG. Imaging of osteoarthritis (OA): What is new? Best Pract Res Clin Rheumatol 2016; 30:653-69. [PMID: 27931960 DOI: 10.1016/j.berh.2016.09.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Revised: 09/04/2016] [Accepted: 09/06/2016] [Indexed: 12/17/2022]
Abstract
In daily clinical practice, conventional radiography is still the most applied imaging technique to supplement clinical examination of patients with suspected osteoarthritis (OA); it may not always be needed for diagnosis. Modern imaging modalities can visualize multiple aspects of the joint, and depending on the diagnostic need, radiography may no longer be the modality of choice. Magnetic resonance imaging (MRI) provides a complete assessment of the joint and has a pivotal role in OA research. Computed tomography (CT) and nuclear medicine offer alternatives in research scenarios, while ultrasound can visualize bony and soft-tissue pathologies and is highly feasible in the clinic. In this chapter, we overview the recent literature on established and newer imaging modalities, summarizing their ability to detect and quantify the range of OA pathologies and determining how they may contribute to early OA diagnosis. This accurate imaging-based detection of pathologies will underpin true understanding of much needed structure-modifying therapies.
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297
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Morland D, Digeon B, Lalire P, Carsin-Vu A, Dejust S, Papathanassiou D. Usefulness of Hepatobiliary Scintigraphy in the Evaluation of Hepatic Cystic Lesions in Children. J Pediatr 2016; 177:332-332.e2. [PMID: 27475630 DOI: 10.1016/j.jpeds.2016.06.031] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 06/01/2016] [Accepted: 06/09/2016] [Indexed: 12/11/2022]
Affiliation(s)
- David Morland
- Nuclear Medicine Department Institut Jean Godinot; Biophysics Laboratory Unité de Formation et de Recherche de Médecine Université de Reims-Champagne Ardenne
| | - Béatrice Digeon
- Pediatric Department American Memorial Hospital Centre Hospitalo-Universitaire de Reims
| | - Paul Lalire
- Nuclear Medicine Department Institut Jean Godinot
| | - Aline Carsin-Vu
- Pediatric Radiology Department American Memorial Hospital Centre Hospitalo-Universitaire de Reims
| | - Sébastien Dejust
- Nuclear Medicine DepartmentInstitut Jean Godinot; Biophysics Laboratory Unité de Formation et de Recherche de Médecine Université de Reims-Champagne Ardenne; Centre de Recherche en Science et Technologie de l'Information et de la Communication Equipe d'Accueil 3804 Université de Reims-Champagne Ardenne Reims, France
| | - Dimitri Papathanassiou
- Nuclear Medicine DepartmentInstitut Jean Godinot; Biophysics Laboratory Unité de Formation et de Recherche de Médecine Université de Reims-Champagne Ardenne; Centre de Recherche en Science et Technologie de l'Information et de la Communication Equipe d'Accueil 3804 Université de Reims-Champagne Ardenne Reims, France
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298
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Pommé S, Collins SM, Harms A, Jerome SM. Fundamental uncertainty equations for nuclear dating applied to the 140Ba- 140La and 227Th- 223Ra chronometers. J Environ Radioact 2016; 162-163:358-370. [PMID: 27348041 DOI: 10.1016/j.jenvrad.2016.06.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Revised: 06/14/2016] [Accepted: 06/15/2016] [Indexed: 06/06/2023]
Abstract
Basic equations for age dating through activity ratio measurements are presented and applied to nuclear chronometers based on parent-daughter decay. Uncertainty propagation formulae are derived which relate the relative uncertainty on the half-lives and measured activity ratios with the relative uncertainty on the calculated time of a nuclear event. Particular attention is paid to the case of relatively short-lived radionuclides for which the change in decay rate during the measurement is non-negligible. Mathematical solutions are presented to correct the perceived activity ratio and adapt the uncertainty propagation formulae to complete the uncertainty budget. The formulae have been applied to 140Ba-140La chronometry, which is particularly useful for dating a nuclear explosion through measurement of the produced activity ratio of 140La and 140Ba in a finite time interval. They were also applied to the 227Th-223Ra parent-daughter pair produced for therapeutic use. The impact of inaccuracies in the nuclear decay data on the performance of these nuclear chronometers is shown and discussed.
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Affiliation(s)
- S Pommé
- European Commission, Joint Research Centre, Retieseweg 111, B-2440 Geel, Belgium.
| | - S M Collins
- National Physical Laboratory, Hampton Road, Teddington, Middlesex TW11 OLW, UK
| | - A Harms
- National Physical Laboratory, Hampton Road, Teddington, Middlesex TW11 OLW, UK
| | - S M Jerome
- National Physical Laboratory, Hampton Road, Teddington, Middlesex TW11 OLW, UK
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299
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Gómez-Perales JL, López-Martínez E, García-Mendoza A. A simple method for checking the proper functioning of a thin-layer radiochromatograph for radiochemical purity control of radiopharmaceuticals. Appl Radiat Isot 2016; 118:102-4. [PMID: 27619951 DOI: 10.1016/j.apradiso.2016.08.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Revised: 06/20/2016] [Accepted: 08/31/2016] [Indexed: 11/23/2022]
Abstract
Thin-layer radiochromatography is used for carrying out radiochemical purity control of gamma-emitter radiopharmaceuticals by using thin-layer radiochromatography scanners. It has been developed and implemented a simple method for validating the proper functioning of these instruments. This method helps to ensure accurate results in the radiochemical purity controls of gamma-emitter radiopharmaceuticals.
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300
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Karls S, Hassoun H, Derbekyan V. Vertebral Uptake of Tc-99m Macroaggregated Albumin (MAA) with SPECT/CT Occurring in Superior Vena Cava Obstruction. Nucl Med Mol Imaging 2016; 50:266-9. [PMID: 27540433 DOI: 10.1007/s13139-015-0372-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Revised: 09/08/2015] [Accepted: 09/09/2015] [Indexed: 11/30/2022] Open
Abstract
A 67-year-old male presented with dyspnea for which lung scintigraphy was ordered to rule out pulmonary embolus. Planar images demonstrated abnormal midline uptake of Tc-99m macroaggregated albumin, which SPECT/CT localized to several thoracic vertebrae. Thoracic vertebral uptake on perfusion lung scintigraphy was previously described on planar imaging. Radionuclide venography and contrast-enhanced CT subsequently demonstrated superior vena cava (SVC) obstruction with collateralization through the azygous/hemiazygous system and vertebral venous plexus. SPECT/CT differentiated residual esophageal/tracheal ventilation activity, a clinically insignificant finding, from vertebral uptake indicative of SVC obstruction, a potentially life-threatening condition.
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Affiliation(s)
- Shawn Karls
- C02.8711 Nuclear Medicine Department, Royal Victoria Hospital, 1001 Decarie Boulevard, Montréal, Québec H4A 3J1 Canada
| | - Hani Hassoun
- C02.8711 Nuclear Medicine Department, Royal Victoria Hospital, 1001 Decarie Boulevard, Montréal, Québec H4A 3J1 Canada
| | - Vilma Derbekyan
- C02.8711 Nuclear Medicine Department, Royal Victoria Hospital, 1001 Decarie Boulevard, Montréal, Québec H4A 3J1 Canada
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