Annals of Nuclear Medicine最新文献

Objective: Peptide receptor radionuclide therapy (PRRT) with radiolabeled somatostatin analogs is an innovative treatment for advanced well-differentiated neuroendocrine tumors (NETs). In Japan, PRRT with Lutetium-177 oxodotreotide (¹⁷⁷Lu- oxodotreotide) was recently approved following Phase I and Phase I/II clinical trials, which primarily assessed safety and response rates. However, its long-term efficacy and safety remain unclear. We conducted a record-based analysis of these trials to evaluate progression-free survival (PFS), overall survival (OS), and long-term safety.

Methods: We recruited Japanese patients from the Phase I and Phase I/II clinical trials. Patients received four infusions of 7.4 GBq ¹⁷⁷Lu-oxodotreotide every 8 weeks. We reviewed the database records to assess OS, disease progression, and adverse events.

Results: Twenty-one patients (median age, 57 years) were recruited. The primary tumor sites included the pancreas (n=11), small intestine (n=5), rectum (n=2), lungs (n=2), and stomach (n=1). Twenty (95.2%) patients had liver metastases, whereas 19 (90.5%) had grade 2 tumors. The median PFS period was 36.6 months; median OS period was not　reached. Two (9.5%) patients achieved a complete response, 12 (57.1%) achieved a partial response, six (28.6%) had stable disease, and one (4.8%) had progressive disease. One patient had chronic myeloid leukemia 15 months post-PRRT.

Conclusions: PRRT demonstrated sustained efficacy and safety in Japanese patients with NET.

Objective: Lymphoscintigraphy has been used to diagnose chylopericardium; however, systematic studies on its detection rate for pediatric patients are lacking. We assessed the detection rate of lymphoscintigraphy with technetium-99 m for chylopericardium in pediatric patients and the factors affecting its diagnostic accuracy.

Methods: Ten patients diagnosed with chylopericardium based on pericardiocentesis who underwent lymphoscintigraphy were included in this retrospective study. The diagnosis of chylopericardium was established by consensus among pediatric surgeons, cardiologists, and physicians based on the clinical course, including the etiology of pericardial effusion and reaction to treatment, appearance of chylopericardium, and the level of triglyceride in the pericardium. The presence or absence of tracer accumulation in the pericardium was determined on images obtained 45 min and 2 h post-injection. A negative lymphoscintigraphy result was defined as the absence of accumulation on both images. Several factors were compared between positive and negative result groups using Fisher's exact test and Mann-Whitney U test: age; cardiac surgery; presence of a drainage tube within the pericardium at scintigraphy; pericardial fluid triglyceride level; and occurrence of chylothorax, liver uptake, and dermal backflow.

Results: Among the 10 patients with chylopericardium, six had a positive lymphoscintigraphy result. The detection rate was 30.0% (3/10) and 60.0% (6/10) at 45 min and 2 h post-injection, respectively. The positive and negative result groups exhibited significant differences in triglyceride level (358.2 ± 166.4 mg/dl [range, 153-659] vs. 107.3 ± 87.5 mg/dl [range, 57-238], respectively; P = 0.019) and evident chylopericardium based on appearance in the pericardial fluid (6/0 vs. 1/3, respectively; P = 0.033). Other factors did not significantly differ between the groups. However, the presence or absence of a drainage tube within the pericardium at the time of lymphoscintigraphy was not associated with the lymphoscintigraphic result.

Conclusion: Despite the small cohort, the detection rate of lymphoscintigraphy with technetium-99 m for pediatric chylopericardium 2 h post-injection was 60%, and that obtained 45 min post-injection was 30%. Negative lymphoscintigraphy results may be associated with low triglyceride levels in pericardial effusion.