Nuklearmedizin-nuclear Medicine最新文献

英文中文

Discrepancy of PSMA PET imaging and bone scan showing limited value of bone scan and CT in evaluation of extent of bone involvement. PSMA PET显像与骨扫描的差异显示骨扫描和CT在评估骨受累程度方面的价值有限。

IF 1.5 4区医学 Q3 Medicine

Nuklearmedizin-nuclear Medicine

Pub Date : 2022-10-01 Epub Date: 2022-07-11 DOI: 10.1055/a-1809-4570

Daniel Alexander Hescheler, Lars Stegger, Katrin Schlack, Martin Bögemann, Kambiz Rahbar

引用次数: 1

[Nuclear Medicine Physicians: A threatened species?] 核医学医生:濒危物种?]

IF 1.5 4区医学 Q3 Medicine

Nuklearmedizin-nuclear Medicine

Pub Date : 2022-10-01 Epub Date: 2022-08-17 DOI: 10.1055/a-1907-4122

Lutz S Freudenberg, Ben J Freudenberg, Rigobert Klett, Ken Herrmann

Die demografische Entwicklung in Deutschland führt zu einem ärztlichen Nachwuchsmangel. Ziel dieser Arbeit ist es, aus den von der Bundesärztekammer (BÄK) veröffentlichten Ärztestatistiken der letzten 25 Jahre die Entwicklung und den aktuellen demografischen Status der Nuklearmedizin in Deutschland darzustellen und deren Konsequenzen aufzuzeigen. Die seit 1996 von der BÄK jährlich veröffentlichten Zahlen der ärztlichen Versorgung in Deutschland wurden systematisch im Hinblick auf die Altersentwicklung und die Geschlechterverteilung in den Fächern Nuklearmedizin, Radiologie und Strahlentherapie zusammengefasst und mit einer deskriptiven Statistik ausgewertet. Die Anzahl der berufstätigen Fachärzt*innen hat sich von 1996–2021 in der Nuklearmedizin um 114% erhöht mit einer deutlichen Verschiebung der Altersstruktur in die älteren Altersgruppen: 2021 lag der Anteil der Ärzt*innen unter 40 Jahren bei 13,0% in der Nuklearmedizin und bei 21,0% in der Radiologie und derjenige Anteil über 60 Jahren bei 27,1% in der Nuklearmedizin und bei 22,3% in der Radiologie. Der Anteil an Frauen lag im Jahr 2021 in der Medizin insgesamt bei 48,5%, in der Nuklearmedizin, Radiologie und Strahlentherapie bei 34,4%, 37,1% bzw. 48,0%. Die Fachärzt*innen in der Nuklearmedizin sind 2021 deutlich älter als diejenigen in der Strahlentherapie und Radiologie, und der Anteil von Frauen ist unterdurchschnittlich. Wenn die Nuklearmedizin als eigenständiges Fach ihrer klinischen Verantwortung gerecht werden will und eigenständig bestehen bleiben möchte, müssen die Bemühungen vor allem um den weiblichen medizinischen Nachwuchs in der nuklearmedizinischen Gemeinschaft eine maximale Priorität bekommen.

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引用次数: 0

[Radioiodine testing in clinical routine: Status in Germany 2021]. [临床常规放射性碘检测:2021年德国现状]。

IF 1.5 4区医学 Q3 Medicine

Nuklearmedizin-nuclear Medicine

Pub Date : 2022-10-01 Epub Date: 2022-06-29 DOI: 10.1055/a-1868-5116

Paniz Akbarzadeh Taghavi, Tobias Fabiunke, Winfried Brenner

Introduction and aim: According to the German guideline on Radiation Protection in Medicine, the activity to be applied for radioiodine therapy of benign thyroid diseases is determined for each patient by means of the radioiodine test (RJT). The aim of this study is to record the different parameters of the RJT.

Material and methods: A web-based questionnaire was sent to all nuclear medicine departments in Germany via the DGN office. Parameters regarding tracer and activity, type of probe measurement, number and timing of measurements, use of fixed effective half-lives (eHWZ), calculation model and organ doses were requested. An assessment of continuous measurement of the thyroid iodine uptake over seven days by a wearable probe system was also requested.

Results: 38 of 94 facilities responded to the questionnaire. Major differences in RJT implementation were found concerning the parameters number and timing of measurements, probe-patient distance, use of fixed disease-specific eHWZ, and intended organ dose. Despite the DGN Guideline and DIN 6861-1, 74% of the facilities still use the simplified Marinelli formula from the DGN Recommendation of 1998. Only 8% have switched to the two-compartment model. 84% of the institutions expect that a wearable probe system could improve the calculation of the radioiodine activity necessary for treatment, but only 57% expect an improvement in the therapeutic outcome.

Conclusions: The methodology of RJT in Germany is heterogeneous and still based on the "Marinelli method" in most institutions despite new guidelines and recommendations. A continuous measurement of the iodine kinetics using a wearable probe system could result in further improving the radioiodine test in addition to the newer calculation algorithms.

简介和目的:根据德国《医学辐射防护指南》，通过放射性碘试验(RJT)确定每个患者用于良性甲状腺疾病放射性碘治疗的活度。本研究的目的是记录RJT的不同参数。材料和方法:通过DGN办公室向德国所有核医学部门发送了一份基于网络的调查问卷。要求提供有关示踪剂和活度、探针测量类型、测量次数和时间、固定有效半衰期(eHWZ)的使用、计算模型和器官剂量的参数。还要求对可穿戴探针系统在7天内连续测量甲状腺碘摄入量进行评估。结果:94家机构中有38家回复了问卷。RJT实施的主要差异涉及测量的参数数量和时间、探针与患者的距离、固定疾病特异性eHWZ的使用和预期器官剂量。尽管有DGN指南和DIN 6861-1, 74%的设施仍然使用1998年DGN建议中的简化Marinelli公式。只有8%的人选择了双车厢车型。84%的机构期望可穿戴探针系统可以改善治疗所需放射性碘活度的计算，但只有57%的机构期望改善治疗结果。结论:尽管有新的指导方针和建议，德国RJT的方法论是异质的，在大多数机构中仍然基于“Marinelli方法”。使用可穿戴探针系统对碘动力学进行连续测量，除了更新的计算算法外，还可以进一步改进放射性碘测试。

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引用次数: 1

Standardized 18F-FDG PET/CT radiomic features provide information on PD-L1 expression status in treatment-naïve patients with non-small cell lung cancer. 标准化的18F-FDG PET/CT放射学特征提供了treatment-naïve非小细胞肺癌患者PD-L1表达状态的信息。

IF 1.5 4区医学 Q3 Medicine

Nuklearmedizin-nuclear Medicine

Pub Date : 2022-10-01 Epub Date: 2022-06-29 DOI: 10.1055/a-1816-6950

Ruiyun Zhang, Wolfgang Hohenforst-Schmidt, Claus Steppert, Zsolt Sziklavari, Christian Schmidkonz, Armin Atzinger, Torsten Kuwert, Thorsten Klink, William Sterlacci, Arndt Hartmann, Michael Vieth, Stefan Förster

Purpose: To study the relationship between standardized 18F-FDG PET/CT radiomic features and clinicopathological variables and programmed death ligand-1 (PD-L1) expression status in non-small cell lung cancer (NSCLC) patients.

Methods: 58 NSCLC patients with preoperative 18F-FDG PET/CT scans and postoperative results of PD-L1 expression were retrospectively analysed. A standardized, open-source software was used to extract 86 radiomic features from PET and low-dose CT images. Univariate analysis and multivariate logistic regression were used to find independent predictors of PD-L1 expression. The Area Under the Curve (AUC) of receiver operating characteristic (ROC) curve was used to compare the ability of variables and their combination in predicting PD-L1 expression.

Results: Multivariate logistic regression resulted in the PET radiomic feature GLRLM_LGRE (Odds Rate (OR): 0.300 vs 0.114, 95% confidence interval (CI): 0.096-0.931 vs 0.021-0.616, in NSCLC and adenocarcinoma respectively) and the CT radiomic feature GLZLM_SZE (OR: 3.338 vs 7.504, 95%CI: 1.074-10.375 vs 1.382-40.755, in NSCLC and adenocarcinoma respectively), being independent predictors of PD-L1 status. In NSCLC group, after adjusting for gender and histology, the PET radiomic feature GLRLM_LGRE (OR: 0.282, 95%CI: 0.085-0.936) remained an independent predictor for PD-L1 status. In the adenocarcinoma group, when adjusting for gender the PET radiomic feature GLRLM_LGRE (OR: 0.115, 95%CI: 0.021-0.631) and the CT radiomic feature GLZLM_SZE (OR: 7.343, 95%CI: 1.285-41.965) remained associated with PD-L1 expression.

Conclusion: NSCLC and adenocarcinoma with PD-L1 expression show higher tumour heterogeneity. Heterogeneity-related 18F-FDG PET and CT radiomic features showed good ability to non-invasively predict PD-L1 expression.

目的:研究非小细胞肺癌(NSCLC)患者标准化18F-FDG PET/CT放射学特征与临床病理变量及程序性死亡配体-1 (PD-L1)表达状态的关系。方法:回顾性分析58例NSCLC患者术前18F-FDG PET/CT扫描及术后PD-L1表达结果。使用标准化的开源软件从PET和低剂量CT图像中提取86个放射学特征。采用单因素分析和多因素logistic回归寻找PD-L1表达的独立预测因子。采用受试者工作特征(ROC)曲线下面积(AUC)比较各变量及其组合预测PD-L1表达的能力。结果:多因素logistic回归结果显示，PET放射学特征GLRLM_LGRE(比值比(OR): 0.300 vs 0.114, 95%可信区间(CI): 0.096-0.931 vs 0.021-0.616，分别为NSCLC和腺癌)和CT放射学特征GLZLM_SZE (OR: 3.338 vs 7.504, 95%CI: 1.074-10.375 vs 1.382-40.755，分别为NSCLC和腺癌)是PD-L1状态的独立预测因子。在NSCLC组中，在调整性别和组织学后，PET放射学特征GLRLM_LGRE (OR: 0.282, 95%CI: 0.085-0.936)仍然是PD-L1状态的独立预测因子。在腺癌组中，当调整性别时，PET放射学特征GLRLM_LGRE (OR: 0.115, 95%CI: 0.021-0.631)和CT放射学特征GLZLM_SZE (OR: 7.343, 95%CI: 1.285-41.965)仍然与PD-L1表达相关。结论:PD-L1表达的非小细胞肺癌和腺癌具有较高的肿瘤异质性。异质性相关的18F-FDG PET和CT放射学特征显示出良好的无创预测PD-L1表达的能力。

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引用次数: 0

Monitoring orthodontic tooth movement in rats after piezocision by bone scintigraphy. 骨显像监测大鼠压切术后正畸牙齿运动。

IF 1.5 4区医学 Q3 Medicine

Nuklearmedizin-nuclear Medicine

Pub Date : 2022-10-01 Epub Date: 2022-07-27 DOI: 10.1055/a-1816-6825

Nicola Beindorff, Nikolaos Papadopoulos, Stefan Hoffmann, Ajay-Mohan Mohan, Mathias Lukas, Winfried Brenner, Paul-Georg Jost-Brinkmann, Thomas Präger

Aim: Piezocision, corticocision of mineralized tissue by ultrasound showed promising results in accelerating tooth movement induced by orthodontic appliances although the biologic effects of this procedure are not well-understood so far. The aim of this study was to investigate the impact of piezocision on bone remodeling in rats by bone SPECT imaging.

Material and methods: Ten male Wistar rats underwent surgical placement of orthodontic appliances on each side of the maxilla followed by piezocision on one side only. Each rat underwent ^99mTc-MDP bone SPECT/CT imaging before surgery (T0), and 2 (T1) and 4 weeks (T2) after surgery. Bone uptake is expressed as median [IQR] min-max in percentage of the injected activity per ml computed from the 10 voxels with the highest uptake (%IAmax10/ml).

Results: Pooled data regardless of the piezocision showed a significant increase in bone uptake from T0 (3.2 [2.8-3.9] 2.6-4.9) to T1 (4.4 [3.8-4.6] 3.4-4.8; p = 0.001). Thereafter, the uptake decreased to T2 (3.8 [3.1-4.4] 2.8-4.8; p = 0.116). No significant differences in bone uptake were found between the maxilla sides without and with piezocision: T1: without (4.3 [3.8-4.5] 3.4-4.8) vs. with (4.5 [3.7-4.6] 3.5-4.7; p=0.285), T2: without (4.0 [3.1-4.5] 2.8-4.8) vs. with (3.7 [3.0-4.4] 2.8-4.8; p=0.062).

Conclusion: ^99mTc-MDP bone SPECT imaging in rats was able to reproduce changes in bone uptake in the maxilla after placement of orthodontic appliances inducing measurable tooth movement. An additional effect of piezocision on bone remodeling in terms of bone uptake was not detectable which is probably due to the pronounced and significant effects induced by the orthodontic appliances per se, which may mask the potential effects of additional piezocision.

目的:超声对矿化组织的压切、皮质切在加速正畸矫治器引起的牙齿运动方面显示出有希望的结果，尽管这种方法的生物学效应迄今尚未得到很好的理解。本研究旨在通过骨SPECT显像研究压切术对大鼠骨重塑的影响。材料和方法:10只雄性Wistar大鼠在上颌骨两侧分别放置正畸矫治器，并仅对一侧进行压切。术前(T0)、术后2周(T1)和4周(T2)分别行99mTc-MDP骨SPECT/CT显像。骨摄取以每毫升注射活性百分比的中位数[IQR] min-max表示，从摄取最高的10个体素计算(%IAmax10/ml)。结果:合并数据显示，无论压切程度如何，骨摄取从T0(3.2[2.8-3.9] 2.6-4.9)到T1(4.4[3.8-4.6] 3.4-4.8)显著增加;P = 0.001)。此后，摄取降低至T2 (3.8 [3.1-4.4] 2.8-4.8;P = 0.116)。未做和做压切的上颌骨两侧骨摄取无显著差异:T1:未做(4.3 [3.8-4.5]3.4-4.8)vs.有(4.5 [3.7-4.6]3.5-4.7);p = 0.285), T2:没有(4.0[3.1—-4.5]2.8 - -4.8)和与(3.7 [3.0 - -4.4]2.8 - -4.8;p = 0.062)。结论:99mTc-MDP骨SPECT显像能够再现正畸矫形器放置后上颌骨摄取的变化，引起可测量的牙齿运动。在骨摄取方面，压切对骨重塑的额外影响未被检测到，这可能是由于正畸器具本身引起的明显和显著的影响，这可能掩盖了额外压切的潜在影响。

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引用次数: 0

Unusual accumulation of 177Lu-DOTATATE at the injection site of a COVID-19 vaccination. 177Lu-DOTATATE在COVID-19疫苗注射部位异常积聚。

IF 1.5 4区医学 Q3 Medicine

Nuklearmedizin-nuclear Medicine

Pub Date : 2022-10-01 Epub Date: 2022-08-09 DOI: 10.1055/a-1856-4238

Christof Scheer, Michael Jüptner, Timo Maier, Ulf Lützen

引用次数: 1

Successful PRRT-rechallenge in a metastasized neuroendocrine tumor of the middle ear. 中耳转移性神经内分泌肿瘤prrt再挑战成功。

IF 1.5 4区医学 Q3 Medicine

Nuklearmedizin-nuclear Medicine

Pub Date : 2022-10-01 Epub Date: 2022-08-18 DOI: 10.1055/a-1856-4290

Juri Ruf, Christoph Becker, Philippe Dovi-Akué, Volker Brass, Steffen Heeg

引用次数: 0

[The Youngsters of the German Society of Nuclear Medicine (Young DGN)]. [德国核医学学会青年(Young DGN)]。

IF 1.5 4区医学 Q3 Medicine

Nuklearmedizin-nuclear Medicine

Pub Date : 2022-08-01 Epub Date: 2022-07-11 DOI: 10.1055/a-1866-3000

Adrien Holzgreve, Friederike Eilsberger, Eric Einspänner, Johannes Kunz, Yasemin Aylin Sahin, Sarah Spreckelmeyer, Markus Luster, Constantin Lapa, Michael Schäfers, Benjamin Kläsner, Young Dgn

Institute 1 Department of Nuclear Medicine, University Hospital, LMU Munich, Munich, Germany 2 Department of Nuclear Medicine, University Hospital of Giessen and Marburg, Campus Marburg, Marburg, Germany 3 Division of Nuclear Medicine, Department of Radiology and Nuclear Medicine, Otto von Guericke University, Magdeburg, Germany 4 Nuclear Medicine, MVZ Radiologie Nuklearmedizin, Bethanien-Krankenhaus, Frankfurt am Main, Germany 5 Department of Nuclear Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany 6 Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Nuclear Medicine, Berlin, Germany 7 Nuclear Medicine, Medical Faculty, University of Augsburg, Augsburg, Germany 8 Department of Nuclear Medicine, University Hospital Münster, Münster, Germany 9 Department of Nuclear Medicine, Klinikum Konstanz, Konstanz, Germany

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引用次数: 2

Audiovisual intervention alleviates anxiety of patients during PET/CT imaging. 视听干预可减轻患者在PET/CT成像过程中的焦虑。

IF 1.5 4区医学 Q3 Medicine

Nuklearmedizin-nuclear Medicine

Pub Date : 2022-08-01 Epub Date: 2022-08-05 DOI: 10.1055/a-1759-4062

Safae Abouzian, Valle Camacho, Aida Sabaté, Patricia Stefaneli, Marina Sizova, Ignasi Gich, Diego López-Mora, Joan Duch, Alejandro Fernández, Montserrat Estorch, Ignasi Carrió, Albert Flotats

Aim: to assess if the use of an audiovisual intervention in the uptake room and/or in the scanning room, could help to reduce anxiety during [18F]FDG PET/CT imaging.

Methods: We prospectively studied 120 patients referred for [18F]FDG PET/CT imaging. Patients were allocated in 4 groups of 30 patients depending on the use of the audiovisual intervention: (1) no audiovisual intervention; (2) audiovisual intervention only in the uptake room; (3) audiovisual intervention only in the scanning room; (4) audiovisual intervention in the uptake and the scanning rooms. In order to measure the anxiety levels of the patients before and after the scan, all patients answered the State-Trait Anxiety Inventory (STAI).

Results: The anxiety status across typical situations on a daily basis (STAI-T) of the 4 groups of patients was comparable with no significant differences. The mean State Anxiety (STAI-S) sum-score at prescan and postscan among groups was: (1) 17.5±8.7 vs. 17.3±8.6, p=0.834; (2) 17.4±10.5 vs. 15.8±9.6, p=0.110; (3) 17.5±11.7 vs. 15.1±9.8, p= 0.013; (4) 17.4±9.7 vs. 14.9±8.1, p= 0.009. The percentage of patients with reduction of the STAI-S score among groups 1-4 was 17%, 47%, 50%, and 66%, respectively. The variation of the percentage of patients with lower scores after intervention among groups was statistically significant (p<0.001).

Conclusion: Audiovisual intervention decreases anxiety levels of patients referred for PET/CT imaging. The results of our study support a beneficial effect of the audiovisual intervention and its potential to alleviate the anxiety of oncological patients who undergo a PET/CT scan.

目的:评估在摄取室和/或扫描室使用视听干预是否有助于减少FDG PET/CT成像期间的焦虑[18F]。方法:我们前瞻性研究了120例经FDG PET/CT影像学检查的患者[18F]。根据视听干预的使用情况，将患者分为4组，每组30例患者:(1)不进行视听干预;(2)仅在摄取室进行视听干预;(3)仅在扫描室进行视听干预;(4)在摄取室和扫描室进行视听干预。为了测量扫描前后患者的焦虑水平，所有患者都回答了状态-特质焦虑量表(STAI)。结果:4组患者的日常典型情境焦虑状态(STAI-T)具有可比性，无显著差异。各组患者扫描前后状态焦虑(stat -s)总分均值为:(1)17.5±8.7比17.3±8.6,p=0.834;(2) 17.4±10.5 vs. 15.8±9.6,p=0.110;(3) 17.5±11.7 vs. 15.1±9.8,p= 0.013;(4) 17.4±9.7 vs. 14.9±8.1,p= 0.009。1-4组患者的STAI-S评分降低的比例分别为17%、47%、50%和66%。各组间干预后得分较低的患者百分比差异有统计学意义(p)。结论:视听干预降低了转介PET/CT成像患者的焦虑水平。我们的研究结果支持了视听干预的有益效果及其减轻接受PET/CT扫描的肿瘤患者焦虑的潜力。

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引用次数: 0

Enhancing PSMA-PET/CT with intravenous contrast: Improved tracer clearance in the prostate bed. 增强PSMA-PET/CT静脉造影剂:改善前列腺床示踪剂清除率。

IF 1.5 4区医学 Q3 Medicine

Nuklearmedizin-nuclear Medicine

Pub Date : 2022-06-14 DOI: 10.1055/a-1821-8112

A. Tulipan, Angela Jaramillo Guzman, T. Haslerud, Kjartan Foldnes, O. Kvernenes, A. Honoré, N. Brekke, L. Reisæter, M. Biermann

AIMSWe observed hitherto unreported layering of radioactivity in the bladder on PET/CT in prostate cancer (PC) when combined with contrast-enhanced CT (CECT). This effect facilitates assessment of the prostate bed in PC.METHODSAmong 128 patients imaged with [18F]PSMA-1007, we selected all 8 studies without and 28 studies with CECT. 20 patients also underwent PET/MR. As controls, we chose 20 and 16 males studied with [18F]FDG for extrapelvic disease with and without CECT. Posterior anterior (PA) ratio was calculated as SUVpost/SUVant * 100 % based on maximal standard uptake values (SUV) in 20 mm spheres in the anterior and posterior bladder. Four nuclear physicians scored assessibility of the bladder base on a 3-point Likert scale (3 = optimal, 1 = poor). We acquired serial PET/CT over 4 hours of a flask with layering of 100 ml intravenous contrast agent and 100 ml physiological saline with 40 MBq of [18F]PSMA-1007, while a control flask was shaken at the start of the experiment.RESULTSLayering of tracer was observed in all PET/CT studies with CE-CT, but not in studies without contrast. Median PA ratios were 44 % (interquartile range 33-62) for [18F]PSMA-1007 and 73 % (52-67) for [18F]FDG, respectively. Intravenous contrast improved assessibility scores in PET of the bladder base, but the effect only reached significance in the PET/MR data. In the in vitro data, radioactivity was retained in the aqueous supernatant over the entire experiment whereas there was no separation of phases in the control flask over time.CONCLUSIONWhen performing PET combined with CECT, sedimentation of contrast agent in the bladder leads to upward displacement of radioactivity, enhancing clarity of PET images in the posterior bladder and the prostate bed on both PET/CT and PET/MR.

目的:我们在前列腺癌(PC)的PET/CT上观察到迄今未报道的膀胱放射性分层，当结合对比增强CT (CECT)时。这一效应有助于评估前列腺癌患者的前列腺床。方法在128例经[18F]PSMA-1007显像的患者中，我们选择了8例未行CECT的研究和28例行CECT的研究。20例患者同时接受PET/MR检查。作为对照，我们选择了20名和16名男性[18F]FDG研究盆腔外疾病伴和不伴CECT。根据前膀胱和后膀胱20 mm球的最大标准摄取值(SUV)计算后前(PA)比为SUVpost/SUVant * 100%。4名核内科医生对膀胱基底的可评估性进行3分李克特评分(3 =最佳，1 =差)。我们在4小时的时间里对一个烧瓶进行了连续PET/CT扫描，烧瓶中分别滴入100毫升静脉造影剂和100毫升生理盐水，并加入40 MBq的[18F]PSMA-1007，同时在实验开始时摇晃一个对照烧瓶。结果在所有PET/CT联合CE-CT的研究中都观察到示踪剂的消失，而在没有对比的研究中则没有。[18F]PSMA-1007和[18F]FDG的中位PA比率分别为44%(四分位数范围33-62)和73%(52-67)。静脉造影剂提高了膀胱基底PET的可评估性评分，但仅在PET/MR数据中达到显著效果。在体外实验数据中，放射性在整个实验过程中都保留在水上清液中，而在对照烧瓶中，随着时间的推移没有相分离。结论PET与CECT联合应用时，造影剂在膀胱内的沉降导致放射性向上移位，增强了PET/CT和PET/MR上后膀胱和前列腺床的PET图像清晰度。

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引用次数: 2

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