Nuclear Medicine and Molecular Imaging最新文献

Thyroid cancer, one of the most common endocrine tumors, generally has a favorable prognosis but remains a significant medical and societal concern due to its high incidence. Early diagnosis and treatment of differentiated thyroid cancer (DTC) significantly affect long-term outcomes, requiring the selection and application of appropriate initial treatments to improve prognosis and quality of life. Recent advances in technology and health information systems have enhanced our understanding of the molecular genetics of thyroid cancer, facilitating the identification of aggressive subgroups and enabling the accumulation of research on risk factors through big data. The Korean Thyroid Association (KTA) has revised the "KTA Guidelines on the Management of Differentiated Thyroid Cancers 2024" to incorporate these advances, which were developed by a multidisciplinary team and underwent extensive review and approval processes by various academic societies. This article summarizes the 2024 KTA guidelines for radioactive iodine (RAI) therapy in patients with DTC, written by the Nuclear Medicine members of the KTA Guideline Committee, and covers RAI therapy as initial management of DTC and RAI therapy in advanced thyroid cancer.

Purpose: Recently introduced hybrid 2-[18 F]-fluoro-2-deoxy-D-glucose (18 F-FDG) Positron Emission Tomography (PET) combined with Magnetic Resonance Imaging (MRI) may aid in proper diagnosis and staging of perihilar cholangiocarcinoma (pCCA). The aim of this study is to assess the effect of 18 F-FDG PET/MRI on diagnosis and clinical decision making in the pre-operative work up of pCCA.

Methods: In this single-centre pilot study patients with presumed resectable pCCA underwent state-of-the-art 18 F-FDG hybrid PET/MRI using digital silicone photomultiplier detectors integrated within a 3-Tesla bore. Data were collected on several baseline and imaging characteristics. The primary outcome measure was the added diagnostic information and the effect on clinical decision making. Secondary aim was to correlate quantitative PET signal intensity to patient- and tumour characteristics. High and low SUVmax subgroups related to the mean value were made. Significance of lesion- and patient characteristics with the high and low SUVmax subgroups, as well as TLR and TBR, was evaluated with Fisher's exact test or Mann-Whitney-U test.

Results: In total 14 patients were included (mean age 62.4 years, 64% male). Final diagnosis was pCCA in 10 patients (71.4%), follicular lymphoma in one patient (7.1%) and benign disease in the remaining three patients. FDG-PET/MRI added valuable diagnostic information in six (43%) patients and affected clinical decision making in two of these patients (14%) by increasing confidence for malignancy which lead to the decision for surgery on short term. High SUVmax values were seen in half of cases with pCCA and half of cases with non-cancerous lesions. In addition, high SUVmax values were directly associated with primary sclerosing cholangitis when present (p = 0.03).

Conclusion: Simultaneous 18 F-FDG-PET/MRI added diagnostic information in six of fourteen patients and influenced clinical decision making in two patients (14%) with presumed resectable pCCA.

The rapid advancements in natural language processing, particularly with the development of Generative Pre-trained Transformer (GPT) models, have opened up new avenues for researchers across various domains. This review article explores the potential of GPT as a research tool, focusing on the core functionalities, key features, and real-world applications of the GPT-4 model. We delve into the concept of prompt engineering, a crucial technique for effectively utilizing GPT, and provide guidelines for designing optimal prompts. Through case studies, we demonstrate how GPT can be applied at various stages of the research process, including literature review, data analysis, and manuscript preparation. The utilization of GPT is expected to enhance research efficiency, stimulate creative thinking, facilitate interdisciplinary collaboration, and increase the impact of research findings. However, it is essential to view GPT as a complementary tool rather than a substitute for human expertise, keeping in mind its limitations and ethical considerations. As GPT continues to evolve, researchers must develop a deep understanding of this technology and leverage its potential to advance their research endeavors while being mindful of its implications.

A 79-year-old man with prostate cancer (PCa) was referred to our center to perform a [¹¹C]Choline PET/CT for biochemical recurrence. Positron emission tomography/computed tomography (PET/CT) scan detected PCa recurrence in the prostate gland and several pelvic and abdominal lymph nodes. Two abnormal uptakes were also identified in the right breast and in the liver, respectively. Breast histological findings turned out to be gynecomastia, while the liver lesion resulted in a benign perfusion anomaly at follow-up magnetic resonance imaging (MRI). Although incidental findings were benign in this case, it is important to always investigate abnormal uptakes of [¹¹C]Choline, as it could be an expression of further metastases or synchronous malignancies such as breast cancer and hepatocellular carcinoma.