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Mini review of first-in-human integrin αvβ6 PET tracers 首次人用整合素αvβ6 PET示踪剂的综述
Pub Date : 2023-10-09 DOI: 10.3389/fnume.2023.1271208
Richard H. Kimura, Andrei Iagaru, H. Henry Guo
This mini review of clinically-evaluated integrin αvβ6 PET-tracers reveals distinct differences in human-biodistribution patterns between linear peptides, including disulfide-stabilized formats, compared to head-to-tail cyclized peptides. All PET tracers mentioned in this mini review were able to delineate disease from normal tissues, but some αvβ6 PET tracers are better than others for particular clinical applications. Each αvβ6 PET tracer was validated for its ability to bind integrin αvβ6 with high affinity. However, all the head-to-tail cyclized peptide PET-tracers reviewed here did not accumulate in the GI-tract, in striking contrast to the linear and disulfide-bonded counterparts currently undergoing clinical evaluation in cancer, IPF and long COVID. Multiple independent investigators have reported the presence of β6 mRNA as well as αvβ6 protein in the GI-tract. Currently, there remains further need for biochemical, clinical, and structural data to satisfactorily explain the state-of-the-art in human αvβ6-imaging.
这项对临床评估的整合素αvβ6 pet示踪剂的小型综述揭示了线性肽(包括二硫稳定格式)与从头到尾环化肽在人体生物分布模式上的明显差异。在这篇小型综述中提到的所有PET示踪剂都能够从正常组织中描绘疾病,但在特定的临床应用中,一些αvβ6 PET示踪剂比其他示踪剂更好。每个αvβ6 PET示踪剂都具有高亲和力结合整合素αvβ6的能力。然而,本文综述的所有首尾环化肽pet示踪剂均未在胃肠道中积累,这与目前正在癌症、IPF和长COVID中进行临床评估的线性和二硫键化示踪剂形成鲜明对比。多个独立研究人员报道了gi道中β6 mRNA和αvβ6蛋白的存在。目前,仍需要进一步的生化、临床和结构数据来令人满意地解释人类αvβ6成像的最新进展。
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引用次数: 0
[18F]NaF PET/CT imaging of response to single fraction SABR to bone metastases from breast cancer [18F]单组分SABR对乳腺癌骨转移的影响
Pub Date : 2023-10-04 DOI: 10.3389/fnume.2023.1197397
Nicholas Hardcastle, Yang Liu, Shankar Siva, Steven David
Breast cancer commonly metastasises to the skeleton, and stereotactic ablative body radiation therapy (SABR) is an emerging treatment for oligometastatic disease. Accurately imaging bone metastases and their response to treatment is challenging. [ 18 F]NaF-PET has a higher sensitivity and specificity than conventional bone scans for detecting breast cancer bone metastases. In this pre-defined secondary analysis of a prospective trial, we evaluated the change in [ 18 F]NaF uptake after SABR. Patients with oligometastatic breast cancer received a single fraction of 20 Gy to up to three bone metastases. [ 18 F]NaF-PET was acquired before and 12 months after SABR. Pre- and post-treatment [ 18 F]NaF-PET images were registered to the treatment planning CT. The relative change in tumour SUV max and SUV mean was quantified. The intersection of each of the radiation therapy isodose contours with a non-tumour bone was created. The change in SUV mean in sub-volumes of non-tumour bone receiving doses of 0–20 Gy was quantified. In total, 14 patients, with 17 bone metastases, were available for analysis. A total of 15 metastases exhibited a reduction in SUV max ; the median reduction was 42% and the maximum reduction 82%. An increased absolute reduction in SUV max was observed with higher pre-treatment SUV max . One patient exhibited increased SUV max after treatment, which was attributed to normal peri-tumoural bone regeneration in the context of a bone metastasis. There was a median reduction of 15%–34% for non-tumour bone in each dose level.
乳腺癌通常转移到骨骼,立体定向消融体放射治疗(SABR)是一种新兴的治疗低转移性疾病的方法。准确成像骨转移及其对治疗的反应是具有挑战性的。[18 F] nafe - pet在检测乳腺癌骨转移方面比传统骨扫描具有更高的敏感性和特异性。在这项预先定义的前瞻性试验的二次分析中,我们评估了SABR后[18 F]NaF摄取的变化。少转移性乳腺癌患者接受20 Gy的单次放疗,最多可达到三个骨转移灶。[18 F]在SABR前和SABR后12个月获得NaF-PET。将治疗前和治疗后[18 F]的NaF-PET图像注册到治疗计划CT上。量化肿瘤SUV max和SUV mean的相对变化。每个放射治疗等剂量等值线与非肿瘤骨的交点被创建。对接受0-20 Gy剂量的非肿瘤骨亚体积中SUV平均值的变化进行了量化。共有14例患者,17例骨转移,可用于分析。共有15例转移灶的SUV max降低;中位降幅为42%,最大降幅为82%。SUV max的绝对减少量随着预处理SUV max的增加而增加。一名患者在治疗后表现出增加的SUV max,这归因于骨转移背景下正常的肿瘤周围骨再生。在每个剂量水平下,非肿瘤骨的中位数减少15%-34%。
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引用次数: 0
Evaluation of deep space exploration risks and mitigations against radiation and microgravity 评估深空探测风险及对辐射和微重力的缓解措施
Pub Date : 2023-09-21 DOI: 10.3389/fnume.2023.1225034
William Dobney, Louise Mols, Dhruti Mistry, Kevin Tabury, Bjorn Baselet, Sarah Baatout
Ionizing radiation and microgravity are two considerable health risks encountered during deep space exploration. Both have deleterious effects on the human body. On one hand, weightlessness is known to induce a weakening of the immune system, a delayed wound healing and musculoskeletal, cardiovascular, and sensorimotor deconditioning. On the other hand, radiation exposure can lead to long-term health effects such as cancer and cataract, as well as adverse effects to the central nervous and cardiovascular systems. Ionizing radiation originates from three main sources in space: galactic cosmic radiation, solar particle events and solar winds. Furthermore, inside the spacecraft and inside certain space habitats on Lunar and Martian surfaces, the crew is exposed to intravehicular radiation, which arises from nuclear reactions between space radiation and matter. Besides the approaches already in use, such as radiation shielding materials (such as aluminium, water or polyethylene), alternative shielding materials (including boron nanotubes, complex hybrids, composite hybrid materials, and regolith) and active shielding (using fields to deflect radiation particles) are being investigated for their abilities to mitigate the effects of ionizing radiation. From a biological point-of-view, it can be predicted that exposure to ionizing radiation during missions beyond Low Earth Orbit (LEO) will affect the human body in undesirable ways, e.g., increasing the risks of cataract, cardiovascular and central nervous system diseases, carcinogenesis, as well as accelerated ageing. Therefore, it is necessary to assess the risks related to deep space exploration and to develop mitigation strategies to reduce these risks to a tolerable level. By using biomarkers for radiation sensitivity, space agencies are developing extensive personalised medical examination programmes to determine an astronaut's vulnerability to radiation. Moreover, researchers are developing pharmacological solutions (e.g., radioprotectors and radiomitigators) to proactively or reactively protect astronauts during deep space exploration. Finally, research is necessary to develop more effective countermeasures for use in future human space missions, which can also lead to improvements to medical care on Earth. This review will discuss the risks space travel beyond LEO poses to astronauts, methods to monitor astronauts' health, and possible approaches to mitigate these risks.
电离辐射和微重力是深空探测过程中遇到的两大健康风险。两者都对人体有害。一方面,已知失重会导致免疫系统减弱,伤口愈合延迟,肌肉骨骼、心血管和感觉运动失调。另一方面,辐射暴露会导致长期的健康影响,如癌症和白内障,以及对中枢神经和心血管系统的不利影响。电离辐射在太空中有三个主要来源:银河宇宙辐射、太阳粒子事件和太阳风。此外,在航天器内以及月球和火星表面的某些太空栖息地内,机组人员暴露在由空间辐射与物质之间的核反应产生的舱内辐射中。除了已经使用的方法,如辐射屏蔽材料(如铝、水或聚乙烯),替代屏蔽材料(包括硼纳米管、复杂杂化材料、复合杂化材料和风化层)和主动屏蔽(利用场偏转辐射粒子)正在研究它们减轻电离辐射影响的能力。从生物学的角度来看,可以预测,在低地球轨道(LEO)以外的任务期间暴露于电离辐射将以不希望的方式影响人体,例如,增加白内障、心血管和中枢神经系统疾病、致癌以及加速衰老的风险。因此,有必要评估与深空探索有关的风险,并制定缓解战略,将这些风险降低到可容忍的水平。通过使用辐射敏感性的生物标志物,各空间机构正在制定广泛的个性化医疗检查方案,以确定宇航员对辐射的脆弱性。此外,研究人员正在开发药理学解决方案(例如,辐射保护剂和辐射缓释剂),以便在深空探索期间主动或被动地保护宇航员。最后,有必要进行研究,以制定更有效的对策,用于未来的人类空间任务,这也可以改善地球上的医疗保健。本综述将讨论近地轨道以外的太空旅行对宇航员构成的风险、监测宇航员健康的方法以及减轻这些风险的可能途径。
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引用次数: 0
Radiolabeled iron oxide nanoparticles functionalized with PSMA/BN ligands for dual-targeting of prostate cancer PSMA/BN配体功能化的放射性标记氧化铁纳米颗粒用于前列腺癌的双靶向治疗
Pub Date : 2023-09-20 DOI: 10.3389/fnume.2023.1184309
Danae Efremia Bajwa, Evangelia-Alexandra Salvanou, Maria Theodosiou, Theodora S. Koutsikou, Eleni K. Efthimiadou, Penelope Bouziotis, Christos Liolios
Introduction Prostate cancer (PCa) is the second most frequent cancer diagnosis in men and the fifth leading cause of death worldwide. Prostate Specific Membrane Antigen (PSMA) and Gastrin Releasing Peptide (GRP) receptors are overexpressed in PCa. In this study, we have developed iron oxide nanoparticles (IONs) functionalized with the Prostate Specific Membrane Antigen (PSMA) and Gastrin Releasing Peptide (GRP) ligands for dual targeting of Prostate cancer. Methods IONs were developed with a thin silica layer on their surface with MPTES (carrying -SH groups, IONs-SH), and they were coupled either with a pharmacophore targeting PSMA (IONs-PSMA) or with bombesin peptide (IONs-BN), targeting GRP receptors, or with both (IONs-PSMA/BN). The functionalized IONs were characterized for their size, zeta potential, and efficiency of functionalization using dynamic light scattering (DLS) and Fourier-Transform Infrared Spectroscopy (FT-IR). All the aforementioned types of IONs were radiolabeled directly with Technetium-99m ( 99m Tc) and evaluated for their radiolabeling efficiency, stability, and binding ability on two different PCa cell lines (PC3 and LNCaP). Results and Discussion The MTT assay demonstrated low toxicity of the IONs against PC3 and LNCaP cells, while the performed wound-healing assay further proved that these nanostructures did not affect cellular growth mechanisms. The observed hemolysis ratio after co-incubation with red blood cells was extremely low. Furthermore, the 99m Tc-radiolabeled IONs showed good stability in human serum, DTPA, and histidine, and high specific binding rates in cancer cells, supporting their future utilization as potential diagnostic tools for PCa with Single Photon Emission Computed Tomography (SPECT) imaging.
前列腺癌(PCa)是男性第二大最常见的癌症诊断,也是全球第五大死亡原因。前列腺特异性膜抗原(PSMA)和胃泌素释放肽(GRP)受体在前列腺癌中过表达。在这项研究中,我们开发了具有前列腺特异性膜抗原(PSMA)和胃泌素释放肽(GRP)配体功能化的氧化铁纳米颗粒(离子),用于前列腺癌的双重靶向治疗。方法将离子与MPTES(携带-SH基团,IONs-SH)表面形成一层薄薄的二氧化硅层,并与靶向PSMA的药效团(IONs-PSMA)或靶向GRP受体的bombesin肽(IONs-BN)偶联,或同时与两者(IONs-PSMA/BN)偶联。利用动态光散射(DLS)和傅里叶变换红外光谱(FT-IR)对功能化离子的大小、ζ电位和功能化效率进行了表征。用锝-99m (99m Tc)直接对上述所有类型的离子进行放射性标记,并在两种不同的PCa细胞系(PC3和LNCaP)上评估其放射性标记效率、稳定性和结合能力。MTT实验证明了离子对PC3和LNCaP细胞的低毒性,而进行的伤口愈合实验进一步证明了这些纳米结构不影响细胞生长机制。与红细胞共孵育后观察到溶血率极低。此外,99m tc放射性标记离子在人血清、DTPA和组氨酸中表现出良好的稳定性,在癌细胞中具有很高的特异性结合率,支持它们未来作为单光子发射计算机断层扫描(SPECT)诊断前列腺癌的潜在工具。
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引用次数: 0
Multicentric 68Ga-PSMA PET radiomics for treatment response assessment of 177Lu-PSMA-617 radioligand therapy in patients with metastatic castration-resistant prostate cancer 多中心68Ga-PSMA PET放射组学用于评估177Lu-PSMA-617放射配体治疗转移性去势抵抗性前列腺癌患者的治疗反应
Pub Date : 2023-09-14 DOI: 10.3389/fnume.2023.1234853
Robin Gutsche, Gizem Gülmüs, Felix M. Mottaghy, Florian Gärtner, Markus Essler, Dirk von Mallek, Hojjat Ahmadzadehfar, Philipp Lohmann, Alexander Heinzel
Objective The treatment with 177 Lutetium PSMA ( 177 Lu-PSMA) in patients with metastatic castration-resistant prostate cancer (mCRPC) has recently been approved by FDA and EMA. Since treatment success is highly variable between patients, the prediction of treatment response and identification of short- and long-term survivors after treatment could help to tailor mCRPC diagnosis and treatment accordingly. The aim of this study is to investigate the value of radiomics parameters extracted from pretreatment 68 Ga-PSMA PET images for prediction of treatment response. Methods Forty-five mCRPC patients treated with 177 Lu-PSMA-617 from two university hospital centers were retrospectively reviewed for this study. Radiomics features were extracted from the volumetric segmentations of metastases in the bone. A random forest model was trained and validated to predict treatment response based on age and conventionally used PET parameters, radiomics features, and combinations thereof. Further, overall survival was predicted by using the identified radiomics signature and compared to a Cox regression model based on age and PET parameters. Results The machine learning model based on a combined radiomics signature of three features and patient age achieved an AUC of 0.82 in 5-fold cross validation and outperformed models based on age and PET parameters or radiomics features (AUC, 0.75 and 0.76, respectively). A Cox regression model based on this radiomics signature showed the best performance to predict the overall survival (C-index, 0.67). Conclusion Our results demonstrate that a machine learning model to predict response to 177 Lu-PSMA treatment based on a combination of radiomics and patient age outperforms a model based on age and PET parameters. Moreover, the identified radiomics signature based on pretreatment 68 Ga-PSMA PET images might be able to identify patients with an improved outcome and serve as a supportive tool in clinical decision making.
目的:177 Lutetium PSMA (177 luu -PSMA)治疗转移性去势抵抗性前列腺癌(mCRPC)已获得FDA和EMA的批准。由于患者之间的治疗成功率差异很大,因此预测治疗反应和确定治疗后的短期和长期幸存者有助于相应地调整mCRPC的诊断和治疗。本研究的目的是探讨从预处理的68张Ga-PSMA PET图像中提取的放射组学参数对预测治疗反应的价值。方法回顾性分析两所大学医院收治的45例经177例Lu-PSMA-617治疗的mCRPC患者。放射组学特征是从骨转移的体积分割中提取的。随机森林模型被训练和验证,以预测基于年龄和常规使用的PET参数、放射组学特征及其组合的治疗反应。此外,通过使用确定的放射组学特征预测总生存率,并将其与基于年龄和PET参数的Cox回归模型进行比较。结果基于三个特征和患者年龄的放射组学联合特征的机器学习模型在5倍交叉验证中获得了0.82的AUC,优于基于年龄和PET参数或放射组学特征的模型(AUC分别为0.75和0.76)。基于放射组学特征的Cox回归模型在预测总生存率方面表现最佳(C-index, 0.67)。我们的研究结果表明,基于放射组学和患者年龄相结合的机器学习模型预测177 Lu-PSMA治疗的反应优于基于年龄和PET参数的模型。此外,基于预处理68 Ga-PSMA PET图像识别的放射组学特征可能能够识别预后改善的患者,并作为临床决策的支持性工具。
{"title":"Multicentric 68Ga-PSMA PET radiomics for treatment response assessment of 177Lu-PSMA-617 radioligand therapy in patients with metastatic castration-resistant prostate cancer","authors":"Robin Gutsche, Gizem Gülmüs, Felix M. Mottaghy, Florian Gärtner, Markus Essler, Dirk von Mallek, Hojjat Ahmadzadehfar, Philipp Lohmann, Alexander Heinzel","doi":"10.3389/fnume.2023.1234853","DOIUrl":"https://doi.org/10.3389/fnume.2023.1234853","url":null,"abstract":"Objective The treatment with 177 Lutetium PSMA ( 177 Lu-PSMA) in patients with metastatic castration-resistant prostate cancer (mCRPC) has recently been approved by FDA and EMA. Since treatment success is highly variable between patients, the prediction of treatment response and identification of short- and long-term survivors after treatment could help to tailor mCRPC diagnosis and treatment accordingly. The aim of this study is to investigate the value of radiomics parameters extracted from pretreatment 68 Ga-PSMA PET images for prediction of treatment response. Methods Forty-five mCRPC patients treated with 177 Lu-PSMA-617 from two university hospital centers were retrospectively reviewed for this study. Radiomics features were extracted from the volumetric segmentations of metastases in the bone. A random forest model was trained and validated to predict treatment response based on age and conventionally used PET parameters, radiomics features, and combinations thereof. Further, overall survival was predicted by using the identified radiomics signature and compared to a Cox regression model based on age and PET parameters. Results The machine learning model based on a combined radiomics signature of three features and patient age achieved an AUC of 0.82 in 5-fold cross validation and outperformed models based on age and PET parameters or radiomics features (AUC, 0.75 and 0.76, respectively). A Cox regression model based on this radiomics signature showed the best performance to predict the overall survival (C-index, 0.67). Conclusion Our results demonstrate that a machine learning model to predict response to 177 Lu-PSMA treatment based on a combination of radiomics and patient age outperforms a model based on age and PET parameters. Moreover, the identified radiomics signature based on pretreatment 68 Ga-PSMA PET images might be able to identify patients with an improved outcome and serve as a supportive tool in clinical decision making.","PeriodicalId":73095,"journal":{"name":"Frontiers in nuclear medicine (Lausanne, Switzerland)","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134911457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Post-acquisition standardization of positron emission tomography images 正电子发射断层成像的采集后标准化
Pub Date : 2023-09-12 DOI: 10.3389/fnume.2023.1210931
Aliasghar Mortazi, Jayaram K. Udupa, Dewey Odhner, Yubing Tong, Drew A. Torigian
Purpose Tissue radiotracer activity measured from positron emission tomography (PET) images is an important biomarker that is clinically utilized for diagnosis, staging, prognostication, and treatment response assessment in patients with cancer and other clinical disorders. Using PET image values to define a normal range of metabolic activity for quantification purposes is challenging due to variations in patient-related factors and technical factors. Although the formulation of standardized uptake value (SUV) has compensated for some of these variabilities, significant non-standardness still persists. We propose an image processing method to substantially mitigate these variabilities. Methods The standardization method is similar for activity concentration (AC) PET and SUV PET images with some differences and consists of two steps. The calibration step is performed only once for each of AC PET or SUV PET, employs a set of images of normal subjects, and requires a reference object, while the transformation step is executed for each patient image to be standardized. In the calibration step, a standardized scale is determined along with 3 key image intensity landmarks defined on it including the minimum percentile intensity s min , median intensity s m , and high percentile intensity s max . s min and s m are estimated based on image intensities within the body region in the normal calibration image set. The optimal value of the maximum percentile β corresponding to the intensity s max is estimated via an optimization process by using the reference object to optimally separate the highly variable high uptake values from the normal uptake intensities. In the transformation step , the first two landmarks—the minimum percentile intensity p α ( I ), and the median intensity p m ( I )—are found for the given image I for the body region, and the high percentile intensity p β ( I ) is determined corresponding to the optimally estimated high percentile value β . Subsequently, intensities of I are mapped to the standard scale piecewise linearly for different segments. We employ three strategies for evaluation and comparison with other standardization methods: (i) comparing coefficient of variation (CV O ) of mean intensity within test objects O across different normal test subjects before and after standardization; (ii) comparing mean absolute difference (MD O ) of mean intensity within test objects O across different subjects in repeat scans before and after standardization; (iii) comparing CV O of mean intensity across different normal subjects before and after standardization where the scans came from different brands of scanners. Results Our data set consisted of 84 FDG-PET/CT scans of the body torso including 38 normal subjects and two repeat-scans of 23 patients. We utilized one of two objects—liver and spleen—as a reference object and the other for testing. The proposed standardization method reduced CV O and MD O by a factor of 3–8 in comparison to
从正电子发射断层扫描(PET)图像中测量的组织放射性示踪剂活性是一种重要的生物标志物,在临床上用于癌症和其他临床疾病患者的诊断、分期、预后和治疗反应评估。由于患者相关因素和技术因素的差异,使用PET图像值来定义代谢活动的正常范围是具有挑战性的。尽管标准化摄取值(SUV)的制定弥补了一些这些可变性,但显著的非标准化仍然存在。我们提出了一种图像处理方法,以大大减轻这些变化。方法活性浓度(AC) PET与SUV PET图像的标准化方法相似,但存在一定差异,分为两步。AC PET或SUV PET各只进行一次校准步骤,采用一组正常受试者的图像,并需要一个参考对象,而对每个待标准化的患者图像执行变换步骤。在校准步骤中,确定一个标准化尺度,并在其上定义3个关键图像强度标志,包括最小百分位数强度s min,中位数强度s m和高百分位数强度s max。S min和S m是基于正常校准图像集中身体区域内的图像强度估计的。利用参考对象将变化较大的高吸收值与正常吸收强度最优分离,通过优化过程估计出强度s max对应的最大百分位数β的最优值。在变换步骤中,找到给定图像I的身体区域的前两个标志-最小百分位数强度p α (I)和中位数强度p m (I),并确定高百分位数强度p β (I)对应于最佳估计的高百分位数值β。随后,对于不同的段,将I的强度分段线性映射到标准尺度。我们采用了三种策略来评估和比较其他标准化方法:(i)比较标准化前后不同正常受试者的测试对象内平均强度的变异系数(CV O);(ii)比较标准化前后不同受试者重复扫描测试对象内平均强度的平均绝对差(MD O);(iii)比较来自不同品牌扫描仪的扫描在标准化前后不同正常人的平均强度CV O。结果我们的数据集包括84个身体躯干的FDG-PET/CT扫描,包括38个正常受试者和23个患者的2个重复扫描。我们用肝脏和脾脏两个对象中的一个作为参考对象,另一个作为检测对象。与其他标准化方法和未标准化方法相比,所提出的标准化方法将CV O和MD O降低了3-8倍。通过我们的方法标准化后,来自两种不同品牌扫描仪的图像强度(AC和SUV)在统计上无法区分,而未经标准化,它们的差异很大,相差3-9倍。结论该方法自动化程度高,优于现有的标准化方法,能有效克服SUV残留变异和扫描仪间变异。
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引用次数: 0
To tell or not to tell … the patient about potential harm. 告诉或不告诉 … 关于潜在危害的患者
Pub Date : 2023-09-05 eCollection Date: 2023-01-01 DOI: 10.3389/fnume.2023.1258960
Timothy L Bartholow

Extravasation, as distinct from infiltration, is when a potentially toxic agent (e.g., radiographic contrast, chemotherapy, anesthesia or radionuclide) is unintentionally administered to the surrounding tissue instead of directly into the vein. There is an expectation for vascular access in interventional medicine across nearly all specialties that this high frequency, study/treatment critical procedure needs to occur with rare failure and that this failure rate should be characterized in quality assurance. This opinion piece, written by a family practitioner who has served as the chief medical officer for a not-for-profit payer, reflects on our responsibility to be aware as clinicians of known potential harm and disclose to patients before a risk has occurred and if harm has occurred. In this paper, clinical obligations of reporting will be reviewed, which are necessary to maintain and enhance our trust with our patients. In the second half, the perspectives of a not-for-profit payer chief medical officer will be considered.

与浸润不同,外渗是指一种潜在的毒性物质(如放射造影剂、化疗、麻醉或放射性核素)无意中被施用到周围组织,而不是直接进入静脉。对于介入医学中几乎所有专业的血管通路,人们都期望这种高频率、研究/治疗关键程序发生时很少失败,并且这种失败率应该在质量保证中得到表征。这篇评论文章是由一位家庭医生写的,他曾担任一家非营利付款人的首席医疗官,它反映了我们作为临床医生的责任,即意识到已知的潜在危害,并在风险发生之前和伤害发生之前向患者披露。本文将回顾临床报告义务,这对于维护和增强我们与患者的信任是必要的。在下半年,一个非营利性支付首席医疗官的观点将被考虑。
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引用次数: 0
Case report: 18F-FDG PET-CT findings in Bickerstaff encephalitis before and after treatment. 病例报告:Bickerstaff脑炎治疗前后18F-FDG PET-CT结果
Pub Date : 2023-08-24 eCollection Date: 2023-01-01 DOI: 10.3389/fnume.2023.1235173
Nora E Kerik-Rotenberg, Jocelyn Cruz-Perez, Ivan E Diaz-Meneses, Alfredo Javier Aguirre Enriquez, Sarah Elizabeth González Ríos, Emilly A Cortés-Mancera, Fabio Sinisterra Solís, Francisco Romero Castellanos, Edwin Steven Vargas-Canas, Jesús Ramirez-Bermudez
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引用次数: 0
Theranostics in breast cancer. 乳腺癌的治疗学
Pub Date : 2023-08-04 eCollection Date: 2023-01-01 DOI: 10.3389/fnume.2023.1236565
M Vorster, B P Hadebe, M M Sathekge

Introduction: Breast cancer is a complex disease and constitutes the leading cause of cancer in women globally. Conventional treatment modalities include surgery, chemotherapy, radiation therapy, and hormonal therapy; all of these have their limitations and often result in significant side effects or toxicity. Targeted radionuclide therapy based on a theranostic approach has been successfully applied in several malignancies, such as prostate cancer, thyroid cancer, and neuro-endocrine tumours. Several studies have also highlighted the potential of theranostic applications in breast cancer.

Aim: This review aims to provide an overview of the most promising current and future theranostic approaches in breast cancer.

Discussion: The discussion includes pre-clinical as well as clinical data on some of the most successful targets used to date. Examples of potential theranostic approaches include those targeting the Human epidermal growth factor receptor 2 (HER2) expression, angiogenesis, aspects of the tumour microenvironment, Gastrin-releasing peptide receptor (GRPR), Prostate-specific membrane antigen (PSMA) and Chemokine receptor 4 (CXCR-4) expression. Several challenges to widespread clinical implementation remain, which include regulatory approval, access to the various radiopharmaceuticals and imaging technology, cost-effectiveness, and the absence of robust clinical data.

Conclusion: Theranostic approaches have the potential to greatly improve diagnosis, treatment, and outcomes for patients with breast cancer. More research is needed to fully explore the potential of such approaches and to identify the best potential targets, considering feasibility, costs, efficacy, side effects and outcomes.

乳腺癌是一种复杂的疾病,是全球妇女癌症的主要原因。传统的治疗方式包括手术、化疗、放射治疗和激素治疗;所有这些都有其局限性,并经常导致严重的副作用或毒性。基于治疗方法的靶向放射性核素治疗已成功应用于多种恶性肿瘤,如前列腺癌、甲状腺癌和神经内分泌肿瘤。几项研究强调了治疗乳腺癌的应用潜力。本文综述了目前和未来最有前途的乳腺癌治疗方法。讨论包括一些迄今为止最成功的靶点的临床前和临床数据。潜在的治疗方法包括靶向HER-2表达、血管生成、肿瘤微环境方面、GRPr-、PSMA-和CXCR-4表达的方法。广泛的临床应用仍然面临一些挑战,包括监管部门的批准、各种放射性药物和成像技术的获取、成本效益以及缺乏可靠的临床数据。治疗方法有可能极大地改善乳腺癌患者的诊断、治疗和预后。需要更多的研究来充分探索这些方法的潜力,并在考虑可行性、成本、功效、副作用和结果的情况下确定最佳的潜在目标。
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引用次数: 0
Case report: Peptide receptor radioligand therapy in metastatic pediatric neuroendocrine tumors. 病例报告:小儿转移性神经内分泌肿瘤的肽受体放射配体治疗
Pub Date : 2023-08-03 eCollection Date: 2023-01-01 DOI: 10.3389/fnume.2023.1193880
Khanyisile Hlongwa, Olumayowa Kolade, Abdulilah Alnabulsi, Rachelle Steyn, Anita Brink, Vikas Prasad, Stuart More

Neuroendocrine tumors (NETs) are not commonly diagnosed in children. Metastatic NETs tend to have poor outcomes, and this is seen in adult and pediatric populations. The role of somatostatin receptor imaging using [68Ga]Ga-DOTA-TATE for imaging and peptide receptor radionuclide therapy (PRRT) with [177Lu]Lu-DOTA-TATE in children is currently not well established. The guidelines for treating pediatric neuroendocrine tumors are still lacking. Extensive trials have been conducted in adult patients and have demonstrated improved survival in metastatic NETs with PRRT using [177Lu]Lu-DOTA-TATE. We present two pediatric patients with metastatic NETs who were imaged with [68Ga]Ga-DOTA-TATE PET/CT and treated with [177Lu]Lu-DOTA-TATE therapy.

神经内分泌肿瘤(NETs)在儿童中并不常见。转移性NETs往往预后较差,这在成人和儿童人群中都很常见。[68Ga]Ga-DOTA-TATE在儿童生长抑素受体成像和[177Lu]Lu-DOTA-TATE肽受体放射性核素治疗(PRRT)中的作用目前尚未得到很好的证实。儿童神经内分泌肿瘤的治疗指南仍然缺乏。在成人患者中进行了广泛的试验,并证明使用[177Lu]Lu-DOTA-TATE的PRRT可提高转移性NETs的生存率。我们报告了两例小儿转移性NETs患者,他们接受了[68Ga]Ga-DOTA-TATE PET/CT成像并接受了[177Lu]Lu-DOTA-TATE治疗。
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Frontiers in nuclear medicine (Lausanne, Switzerland)
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