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Bio-distribution study of Tc-99m HMPAO labeled platelet in healthy volunteer. 健康志愿者体内 Tc-99m HMPAO 标记血小板的生物分布研究。
Q3 Medicine Pub Date : 2024-01-01 DOI: 10.22038/AOJNMB.2024.71620.1525
Mahdieh Parvizi, Mehrshad Abbasi, Hojjat Ahmadzadehfar, Abbas Tafakhori, Maryam Naseri, Ali Khalaj, Saeed Farzanehfar

Objectives: The bio-distribution of Tc-99m HMPAO labeled platelets (LP), which could be used to image subtle thrombosis, is not reported in a human yet, which is the subject of the current study.

Method: The platelets were extracted from 49 ml whole blood and labeled with Tc-99m HMPAO, then re-injected to the healthy volunteer. Anterior and posterior whole body imaging was done by a dual-head gamma camera 3, 18, 33, 46, 81, 124, 190 min and 15 hours after injection. Also a whole-body SPECT was done at 137 min post-injection. The area under the curves of the spleen, liver, left kidney, bladder, right lung, brain, and abdominal aorta ROIs was calculated to estimate the accumulation of labeled platelets within the organs.

Results: The spleen was the target organ. The kidneys, liver, and heart were also remarkably visualized. The thyroid, stomach, bladder, or gastrointestinal (GI) uptake/activity was not significant. The stomach visualization was enhanced after ingestion at 60 min. The sagittal and lateral sinuses were delineated, and the background of the brain was very low. During the study, the area under the curve of activity was 738, 308, 302, 196, 230, 121, 79, 216, 529, 369, 162, and 54 counts. min/pixel for spleen, liver, heart, right lung, left kidney, right iliac artery, sagittal sinus, thyroid, bladder, stomach, GI, and background, respectively.

Conclusion: The quality of the scan with low dose Tc-99m HMPAO LPs is optimal. We documented the bio-distribution of LPs. The optimal imaging time was 80-120 min post-injection when the free Tc-99m and GI transit were negligible. The sagittal and lateral sinuses were visualized enabling detection of possible clots in the vessels.

研究目的:锝-99m HMPAO标记血小板(LP)可用于对细微血栓形成进行成像,但目前还没有关于其在人体中的生物分布的报道,这正是本研究的主题:方法:从 49 毫升全血中提取血小板并用 Tc-99m HMPAO 标记,然后重新注射到健康志愿者体内。注射后3、18、33、46、81、124、190分钟和15小时,使用双头伽马相机进行前后全身成像。此外,还在注射后 137 分钟进行了全身 SPECT 扫描。计算脾脏、肝脏、左肾、膀胱、右肺、大脑和腹主动脉ROI的曲线下面积,以估计标记血小板在器官内的积聚情况:结果:脾脏是目标器官。结果:脾脏是目标器官,肾脏、肝脏和心脏也明显可见。甲状腺、胃、膀胱或胃肠道(GI)的摄取/活性不明显。摄入 60 分钟后,胃的可视化增强。矢状窦和外侧窦清晰可见,脑部背景非常低。研究期间,脾脏、肝脏、心脏、右肺、左肾、右髂动脉、矢状窦、甲状腺、膀胱、胃、消化道和背景的活动曲线下面积分别为 738、308、302、196、230、121、79、216、529、369、162 和 54 计数:结论:低剂量 Tc-99m HMPAO LPs 的扫描质量最佳。我们记录了 LPs 的生物分布。最佳成像时间为注射后 80-120 分钟,此时游离锝-99m 和胃肠道转运可忽略不计。矢状窦和外侧窦的可视化使我们能够发现血管中可能存在的血栓。
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引用次数: 0
Incidental Finding of Triple Ectopic Thyroid: Case Report and Review of the Literature. 偶然发现的三异位甲状腺:病例报告与文献综述
Q3 Medicine Pub Date : 2024-01-01 DOI: 10.22038/AOJNMB.2024.75895.1532
Fatima Zeineddine, Gerard El-Hajj, Marie-Ange Hajj, Rita Chahinian

Ectopic thyroid tissue is a rare congenital anomaly, with the presence of three simultaneous ectopic foci being exceedingly rare. We describe a case of a totally asymptomatic 26-year-old male discovered to have triple ectopic thyroid following incidental elevated thyroid-stimulating hormone (TSH) levels. Subsequent ultrasonography of the neck showed an absent thyroid gland in its conventional location. A Technetium-99m pertechnetate (Tc-99m) thyroid scan showed three distinct foci of radiotracer uptake in the upper cervical, lingual, and sublingual regions, corresponding to triple ectopic thyroid. An extensive review of the literature was conducted to provide a broader understanding and deeper insights into this uncommon condition. This case underscores the pivotal role of Technetium-99m thyroid scanning in diagnosing triple ectopic thyroid, particularly in instances where the orthotopic thyroid gland is absent. A comprehensive understanding of this rare entity is indispensable for radiologists and clinicians, enabling accurate diagnosis and informed decision-making regarding the appropriate therapeutic strategies.

异位甲状腺组织是一种罕见的先天性畸形,同时存在三个异位灶的情况更是极为罕见。我们描述了一例完全无症状的26岁男性病例,该患者因偶然发现促甲状腺激素(TSH)水平升高而被发现患有三重异位甲状腺。随后的颈部超声波检查显示甲状腺在其常规位置缺失。过硫酸锝(Tc-99m)甲状腺扫描显示,上颈部、舌部和舌下有三个明显的放射性示踪剂摄取灶,与三异位甲状腺相对应。为了对这种不常见的疾病有更广泛的了解和更深入的认识,我们对文献进行了广泛的回顾。该病例强调了锝-99m甲状腺扫描在诊断三异位甲状腺中的关键作用,尤其是在正位甲状腺缺失的情况下。放射科医生和临床医生必须全面了解这种罕见的疾病,才能做出准确的诊断,并就适当的治疗策略做出明智的决策。
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引用次数: 0
18F-FDG PET/CT imaging of IgG4-producing MALT lymphoma with multiple site involvement. 多部位受累的 IgG4 型 MALT 淋巴瘤的 18F-FDG PET/CT 成像。
Q3 Medicine Pub Date : 2024-01-01 DOI: 10.22038/AOJNMB.2023.73477.1512
Kodai Kawaji, Seiji Kurata, Katsuhisa Matsuo, Hiroaki Miyoshi, Jun Akiba, Fumihiko Mouri, Akiko Sumi, Kiminori Fujimoto, Toshi Abe

18F-FDG PET/CT is regarded as a modality utilized for the purpose of lesion localization, staging and assessment of treatment response in patients with lymphoma. However, it is difficult that we diagnose among multifocal lymphoma, IgG4-related disease (IgG4-RD), or a combination of both conditions when confronted with multiple sites of 18F-FDG uptake with heightened serum IgG4 levels. We present a case of a 72-year-old male who was suspected of Sjögren's syndrome based on symptoms of xerostomia accompanied by swelling of the bilateral upper eyelid and salivary glands. Following a diagnostic biopsy that revealed mucosa-associated lymphoid tissue (MALT) lymphoma as a possible finding, 18F-FDG PET/CT was conducted, which demonstrated multiple sites of 18F-FDG accumulation. While multifocal MALT lymphoma was initially suspected, the coexistence of IgG4-RD could not be definitively ruled out due to the elevated serum IgG4 levels. Subsequent histopathological and immunohistochemical examinations confirmed the diagnosis of IgG4-producing MALT lymphoma. After receiving systemic therapy with rituximab, the swelling of the bilateral upper eyelid and parotid glands resolved upon visual examination, and the serum IgG4 levels returned to within the normal range in a few months. No new lesions were detected during the subsequent follow-up examinations conducted over a period of 3 years.

18F-FDG PET/CT 被认为是一种用于淋巴瘤患者病灶定位、分期和治疗反应评估的方法。然而,面对多部位 18F-FDG 摄取和血清 IgG4 水平升高的情况,我们很难诊断多灶性淋巴瘤、IgG4 相关疾病(IgG4-RD)或两者的合并症。我们报告了一例 72 岁男性患者的病例,他因口干舌燥并伴有双侧上眼睑和唾液腺肿胀的症状而被怀疑患有斯约格伦综合征。诊断性活组织检查发现可能是粘膜相关淋巴组织(MALT)淋巴瘤,随后进行了 18F-FDG PET/CT 检查,结果显示 18F-FDG 在多个部位聚集。虽然最初怀疑是多灶性 MALT 淋巴瘤,但由于血清 IgG4 水平升高,无法明确排除 IgG4-RD 并存的可能性。随后的组织病理学和免疫组化检查证实了 IgG4 产出型 MALT 淋巴瘤的诊断。在接受利妥昔单抗全身治疗后,双侧上眼睑和腮腺肿胀在肉眼观察下消失,血清IgG4水平在几个月后恢复到正常范围。在随后长达 3 年的随访检查中,没有发现新的病变。
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引用次数: 0
Formulating a national position statement and guide on modern theranostics in the Philippines. 制定菲律宾关于现代治疗学的国家立场声明和指南。
Q3 Medicine Pub Date : 2024-01-01 DOI: 10.22038/AOJNMB.2023.72838.1508
Patricia A Bautista-Peñalosa, Francis Gerard M Estrada, Emerita A Barrenechea, Teofilo O L San Luis

Barriers to the establishment of advanced technologies in developing countries were overcome when modern theranostics pertaining to the use of Ga-68 and Lu-177 PSMA and DOTATATE were first offered to patients in the Philippines in early 2018. However, significant growth was not experienced at St. Luke's Medical Center for five years and lutetium was not yet distributed to other institutions by a radiopharmaceutical supplier. Due to the relative novelty and rapid expansion of theranostics worldwide, position statements were released by the Australasian Association of Nuclear Medicine Specialists, European Association of Nuclear Medicine, Society of Nuclear Medicine and Molecular Imaging, and International Atomic Energy Agency primarily to uphold patient safety and ensure a level of standard among its practitioners. Subsequently in the latter half of 2022, these were adopted and modified according to what is feasible and applicable locally within the Philippine Society of Nuclear Medicine, considering the current status and future possibilities. Different representatives were involved, and several groups were mobilized for successful implementation. A liability clause was incorporated to discourage unprofessional acts.

2018年初,菲律宾首次向患者提供与使用Ga-68和Lu-177 PSMA和DOTATATE有关的现代治疗技术,从而克服了在发展中国家建立先进技术的障碍。然而,圣卢克医疗中心在五年内未经历重大发展,放射性药物供应商尚未将镥分销给其他机构。由于治疗仪在全球范围内的相对新颖性和快速扩张,澳大拉西亚核医学专家协会、欧洲核医学协会、核医学与分子成像学会和国际原子能机构发布了立场声明,主要是为了维护患者安全,确保从业人员的标准水平。随后,在 2022 年下半年,菲律宾核医学会考虑到现状和未来的可能性,根据当地的可行性和适用性通过并修改了这些标准。不同的代表都参与其中,并动员了几个团体以成功实施。纳入了一项责任条款,以阻止不专业的行为。
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引用次数: 0
Evaluation of the diagnostic value of Sentinel Lymph Node in patients with gastric adenocarcinoma. 评估前哨淋巴结对胃腺癌患者的诊断价值。
Q3 Medicine Pub Date : 2024-01-01 DOI: 10.22038/AOJNMB.2023.70461.1491
Ramin Sadeghi, Reza Taheri, Ali Jangjoo, Akbar Pakdel, Mohammad-Hassan Arjmand, Mohammad Reza Motiei, Bahram Memar, Mohsen Aliakbarian

Objectives: Sentinel lymph node biopsy (SLNB) has been proven as a safe and efficient procedure in some cancers like breast cancer and melanoma with a reduction of complications and side effects of unnecessary lymphadenectomy in many patients. However, the diagnostic value of SLNB in gastric cancer is a point of debate. This study evaluated the diagnostic value of SLNB using radiotracer and isosulphan blue dye injection in patients with Gastric Adenocarcinomas (GA).

Methods: This descriptive study was performed at Imam-Reza HOSPITAL on 39 patients diagnosed with GA with no lymphatic metastasis using two methods: the combination of radionuclide with isosulphan together (R&I) method compared with the isosulphan alone method. Lymphatic dissection was performed in all patients. The pathological results were compared between the sentinel lymph nodes (SLN) and other lymph nodes and their accordance rate was calculated.

Results: In the T1 group, the sentinel lymph node biopsy detection rate was 100% for the combination of the R&I method and 60% for the isosulphan method and the false negative rate was zero. These values respectively were 88.8% and 88.8% in the T2 group with a false negative rate of 75%. In the T3 group, the values were 100% for the combination of the R&I method and 93.7% for the isosulphan method with a false negative rate of 40%. In the combination of the R&I method, the sensitivity, specificity, and positive and negative predictive values were 57.9, 100, 100, and 69.2 percent respectively.

Conclusion: Based on the false negative rate (47.4%), SLNB by injection of isosulphan blue dye alone is not a diagnostic enough value for predicting lymph node metastasis in GA. Although, SLNB by combination of the R&I had better accuracy compared to the isosulphan alone, more studies with larger samples are needed to prove this result.

目的:前哨淋巴结活检(SLNB)已被证实是乳腺癌和黑色素瘤等癌症的一种安全有效的检查方法,可减少许多患者不必要的淋巴结切除术所带来的并发症和副作用。然而,SLNB 在胃癌中的诊断价值还存在争议。本研究评估了使用放射性示踪剂和异石杉碱蓝染料注射对胃腺癌(GA)患者进行 SLNB 的诊断价值:这项描述性研究是在伊玛目-礼萨医院(Imam-Reza HOSPITAL)对 39 名确诊为无淋巴转移的胃腺癌患者进行的,采用了两种方法:将放射性核素与异舒兰蓝联合使用的方法(R&I)与单独使用异舒兰蓝的方法进行比较。所有患者都进行了淋巴清扫。比较前哨淋巴结(SLN)和其他淋巴结的病理结果,并计算其符合率:在 T1 组中,R&I 组合法的前哨淋巴结活检检出率为 100%,isosulphan 法为 60%,假阴性率为零。T2组的这一数值分别为88.8%和88.8%,假阴性率为75%。在 T3 组中,R&I 组合方法的数值为 100%,异舒芬方法的数值为 93.7%,假阴性率为 40%。在 R&I 组合方法中,灵敏度、特异性、阳性预测值和阴性预测值分别为 57.9%、100%、100% 和 69.2%:从假阴性率(47.4%)来看,单纯注射异舒凡蓝染料进行 SLNB 对预测 GA 淋巴结转移的诊断价值不足。虽然联合使用 R&I 进行 SLNB 比单独使用异舒凡的准确性更高,但还需要更多的研究和更大的样本来证明这一结果。
{"title":"Evaluation of the diagnostic value of Sentinel Lymph Node in patients with gastric adenocarcinoma.","authors":"Ramin Sadeghi, Reza Taheri, Ali Jangjoo, Akbar Pakdel, Mohammad-Hassan Arjmand, Mohammad Reza Motiei, Bahram Memar, Mohsen Aliakbarian","doi":"10.22038/AOJNMB.2023.70461.1491","DOIUrl":"10.22038/AOJNMB.2023.70461.1491","url":null,"abstract":"<p><strong>Objectives: </strong>Sentinel lymph node biopsy (SLNB) has been proven as a safe and efficient procedure in some cancers like breast cancer and melanoma with a reduction of complications and side effects of unnecessary lymphadenectomy in many patients. However, the diagnostic value of SLNB in gastric cancer is a point of debate. This study evaluated the diagnostic value of SLNB using radiotracer and isosulphan blue dye injection in patients with Gastric Adenocarcinomas (GA).</p><p><strong>Methods: </strong>This descriptive study was performed at Imam-Reza HOSPITAL on 39 patients diagnosed with GA with no lymphatic metastasis using two methods: the combination of radionuclide with isosulphan together (R&I) method compared with the isosulphan alone method. Lymphatic dissection was performed in all patients. The pathological results were compared between the sentinel lymph nodes (SLN) and other lymph nodes and their accordance rate was calculated.</p><p><strong>Results: </strong>In the T1 group, the sentinel lymph node biopsy detection rate was 100% for the combination of the R&I method and 60% for the isosulphan method and the false negative rate was zero. These values respectively were 88.8% and 88.8% in the T2 group with a false negative rate of 75%. In the T3 group, the values were 100% for the combination of the R&I method and 93.7% for the isosulphan method with a false negative rate of 40%. In the combination of the R&I method, the sensitivity, specificity, and positive and negative predictive values were 57.9, 100, 100, and 69.2 percent respectively.</p><p><strong>Conclusion: </strong>Based on the false negative rate (47.4%), SLNB by injection of isosulphan blue dye alone is not a diagnostic enough value for predicting lymph node metastasis in GA. Although, SLNB by combination of the R&I had better accuracy compared to the isosulphan alone, more studies with larger samples are needed to prove this result.</p>","PeriodicalId":8503,"journal":{"name":"Asia Oceania Journal of Nuclear Medicine and Biology","volume":"12 1","pages":"21-26"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10757058/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139073282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
On the Optimization of the Protocol for Automated Radiosyntheses of [68Ga]Ga-Pentixafor, [68Ga]Ga-FAPI-4 and [68Ga]Ga-DOTATATE in a Modular-Lab Standard. 在模块化实验室标准中优化[68Ga]Ga-Pentixafor、[68Ga]Ga-FAPI-4 和 [68Ga]Ga-DOTATATE 的自动放射合成程序。
Q3 Medicine Pub Date : 2024-01-01 DOI: 10.22038/AOJNMB.2024.77059.1545
Sreeja Raj Menon, Arpit Mitra, Sudeep Sahu, Sangita Lad, Avik Chakraborty, Mukti Kanta Ray, Sharmila Banerjee

Objectives: The present work describes the automated radiochemical synthesis of different PET tracers like [68Ga]Ga-Pentixafor, [68Ga]Ga-FAPI-4 and [68Ga]Ga-DOTATATE using optimized single protocol in the non-cassette based Eckert & Ziegler (EZ) Modular Lab (fixed tubing system) without any modification in the inbuilt human machine interface (HMI) software. Recently, PET agents viz. [68Ga]Ga-Pentixafor and [68Ga]Ga-FAPI-4 are gaining prominence for the diagnosis of overexpressed Chemokine Receptor-4 (CXCR4) and Fibroblast Activation Protein (FAP) receptor, respectively, in the microenvironment of numerous cancer types. The promising results observed with the clinical usage of [68Ga]Ga-DOTATATE produced using the automated protocol, provided impetus for the clinical translation of [68Ga]Ga-Pentixafor and [68Ga]Ga-FAPI-4 using the in-house developed automated radiolabeling protocol.

Methods: Herein we report a single radiolabeling protocol for the automated preparation of [68Ga]Ga-Pentixafor and [68Ga]Ga-FAPI-4 in the non-cassette based EZ Modular-Lab Standard radiochemistry module, without any changes in schematic, graphical user interface (GUI) software and time list, from that used for routine production of [68Ga]Ga-DOTATATE in our centre, since 2015. Physico-chemical quality control and in-vitro stability analyses were carried out using radio-TLC and radio-HPLC.

Results: The automated protocol yielded reliable and consistent non-decay corrected (ndc) radiochemical yield (RCY) of (84.4%±0.9%) and (85.5%±1.4%) respectively, for [68Ga]Ga-Pentixafor and [68Ga]Ga-FAPI-4, with RCP>98%, which are comparable to the RCY of (84.4%±1.2%) and RCP (99.1%±0.3%) for [68Ga]Ga-DOTATATE. The biological quality control studies confirmed the formulations to be of ready-to-use pharmaceutical grade.

Conclusion: The consistent and reliable RCY and RCP of multiple 68Ga-labeled PET tracers by single automated radiochemistry protocol exhibits the versatility of the EZ Modular Lab.

目的:本工作描述了在不修改内置人机界面软件的情况下,在基于非盒式的 Eckert & Ziegler (EZ) 模块化实验室(固定管道系统)中使用优化的单一协议自动放射化学合成不同的 PET 示踪剂,如 [68Ga]Ga-Pentixafor、[68Ga]Ga-FAPI-4 和 [68Ga]Ga-DOTATATE。最近,[68Ga]Ga-Pentixafor 和[68Ga]Ga-FAPI-4 这两种正电子发射计算机断层显像剂在诊断多种癌症微环境中过度表达的趋化因子受体-4(CXCR4)和成纤维细胞活化蛋白(FAP)受体方面越来越受到重视。使用自动化方案生产的[68Ga]Ga-DOTATATE在临床应用中取得了良好的效果,这为使用内部开发的自动化放射性标记方案将[68Ga]Ga-Pentixafor和[68Ga]Ga-FAPI-4应用于临床提供了动力。方法:在此,我们报告了自2015年以来在非盒式EZ Modular-Lab标准放射化学模块中自动制备[68Ga]Ga-Pentixafor和[68Ga]Ga-FAPI-4的单一放射标记方案,与本中心用于常规生产[68Ga]Ga-DOTATATE的方案相比,该方案在原理图、图形用户界面(GUI)软件和时间列表方面没有任何变化。使用放射性-TLC和放射性-HPLC进行了理化质量控制和体外稳定性分析:结果:[68Ga]Ga-Pentixafor和[68Ga]Ga-FAPI-4的非衰变校正(ndc)放射化学收率(RCY)分别为(84.4%±0.9%)和(85.5%±1.4%),RCP>98%,与[68Ga]Ga-DOTATATE的RCY(84.4%±1.2%)和RCP(99.1%±0.3%)相当。生物质量控制研究证实这些制剂为即用药物级:结论:通过单个自动化放射化学方案实现多种 68Ga 标记 PET 示踪剂的一致、可靠的 RCY 和 RCP,展示了 EZ 模块化实验室的多功能性。
{"title":"On the Optimization of the Protocol for Automated Radiosyntheses of [<sup>68</sup>Ga]Ga-Pentixafor, [<sup>68</sup>Ga]Ga-FAPI-4 and [<sup>68</sup>Ga]Ga-DOTATATE in a Modular-Lab Standard.","authors":"Sreeja Raj Menon, Arpit Mitra, Sudeep Sahu, Sangita Lad, Avik Chakraborty, Mukti Kanta Ray, Sharmila Banerjee","doi":"10.22038/AOJNMB.2024.77059.1545","DOIUrl":"https://doi.org/10.22038/AOJNMB.2024.77059.1545","url":null,"abstract":"<p><strong>Objectives: </strong>The present work describes the automated radiochemical synthesis of different PET tracers like [<sup>68</sup>Ga]Ga-Pentixafor, [<sup>68</sup>Ga]Ga-FAPI-4 and [<sup>68</sup>Ga]Ga-DOTATATE using optimized single protocol in the non-cassette based Eckert & Ziegler (EZ) Modular Lab (fixed tubing system) without any modification in the inbuilt human machine interface (HMI) software. Recently, PET agents viz. [<sup>68</sup>Ga]Ga-Pentixafor and [<sup>68</sup>Ga]Ga-FAPI-4 are gaining prominence for the diagnosis of overexpressed Chemokine Receptor-4 (CXCR4) and Fibroblast Activation Protein (FAP) receptor, respectively, in the microenvironment of numerous cancer types. The promising results observed with the clinical usage of [<sup>68</sup>Ga]Ga-DOTATATE produced using the automated protocol, provided impetus for the clinical translation of [<sup>68</sup>Ga]Ga-Pentixafor and [<sup>68</sup>Ga]Ga-FAPI-4 using the in-house developed automated radiolabeling protocol.</p><p><strong>Methods: </strong>Herein we report a single radiolabeling protocol for the automated preparation of [<sup>68</sup>Ga]Ga-Pentixafor and [<sup>68</sup>Ga]Ga-FAPI-4 in the non-cassette based EZ Modular-Lab Standard radiochemistry module, without any changes in schematic, graphical user interface (GUI) software and time list, from that used for routine production of [<sup>68</sup>Ga]Ga-DOTATATE in our centre, since 2015. Physico-chemical quality control and in-vitro stability analyses were carried out using radio-TLC and radio-HPLC.</p><p><strong>Results: </strong>The automated protocol yielded reliable and consistent non-decay corrected (ndc) radiochemical yield (RCY) of (84.4%±0.9%) and (85.5%±1.4%) respectively, for [<sup>68</sup>Ga]Ga-Pentixafor and [<sup>68</sup>Ga]Ga-FAPI-4, with RCP>98%, which are comparable to the RCY of (84.4%±1.2%) and RCP (99.1%±0.3%) for [<sup>68</sup>Ga]Ga-DOTATATE. The biological quality control studies confirmed the formulations to be of ready-to-use pharmaceutical grade.</p><p><strong>Conclusion: </strong>The consistent and reliable RCY and RCP of multiple <sup>68</sup>Ga-labeled PET tracers by single automated radiochemistry protocol exhibits the versatility of the EZ Modular Lab.</p>","PeriodicalId":8503,"journal":{"name":"Asia Oceania Journal of Nuclear Medicine and Biology","volume":"12 2","pages":"149-160"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11263773/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141756877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
18F-FDG PET CT in cardiac device infections - A Case series. 18F-FDG PET CT 在心脏设备感染中的应用--病例系列。
Q3 Medicine Pub Date : 2024-01-01 DOI: 10.22038/AOJNMB.2024.77504.1547
Awiral Saxena, Manjit Sarma, Bhagirath Bhad, Ramkesh Ratheesan, Padma Subramanyam, P Shanmuga Sundaram

With the increasing number of interventional cardiology procedures, the number of cardiac device infections (including pacemakers, prosthetic valves, coronary and aortic stents) have also increased. These infections can cause significant morbidity and can even lead to mortality if not managed promptly. If suspected clinically the first-line imaging modality is Trans-Thoracic Echocardiography, while Transesophageal Echocardiography is also used in selected cases. The confirmation of a cardiac device infection is mostly done with the help of blood or pus culture. Even though Echocardiography is a very efficient technique for the evaluation of the heart, it cannot differentiate infection from thrombus or fibrosis. With the increasing availability of Positron Emission Tomography CT (PET CT) machines worldwide, the use of 18F-FDG PET CT for infection imaging has gained traction, especially for cardiac device infection. Most of the recent studies show a good diagnostic accuracy of 18F-FDG PET CT with many of the recent diagnostic and management guidelines now acknowledging its role, especially in equivocal cases. We present six such cases where 18F-FDG PET CT provided valuable information either for diagnosis, confirming the presence of infection, delineating extent, therapy response or sometimes even helping appropriate treatment decision making in patients with suspected cardiac device infection.

随着介入心脏病学手术数量的增加,心脏设备感染(包括起搏器、人工瓣膜、冠状动脉和主动脉支架)的数量也在增加。这些感染会导致严重的发病率,如果处理不及时甚至会导致死亡。如果临床上怀疑有心脏装置感染,第一线影像检查方法是经胸超声心动图,经食道超声心动图也可用于特定病例。心脏设备感染的确诊大多需要借助血液或脓液培养。尽管超声心动图是一种非常有效的心脏评估技术,但它无法区分感染与血栓或纤维化。随着正电子发射计算机断层扫描(PET CT)机在全球范围内的普及,18F-FDG PET CT 在感染成像中的应用越来越受到重视,尤其是在心脏设备感染方面。最近的大多数研究表明,18F-FDG PET CT 具有良好的诊断准确性,许多最新的诊断和管理指南都承认了它的作用,尤其是在诊断不明确的病例中。我们介绍了六个这样的病例,在这些病例中,18F-FDG PET CT 为疑似心脏设备感染患者的诊断、确诊感染的存在、划定感染范围、治疗反应,有时甚至帮助做出适当的治疗决策提供了有价值的信息。
{"title":"<sup>18</sup>F-FDG PET CT in cardiac device infections - A Case series.","authors":"Awiral Saxena, Manjit Sarma, Bhagirath Bhad, Ramkesh Ratheesan, Padma Subramanyam, P Shanmuga Sundaram","doi":"10.22038/AOJNMB.2024.77504.1547","DOIUrl":"https://doi.org/10.22038/AOJNMB.2024.77504.1547","url":null,"abstract":"<p><p>With the increasing number of interventional cardiology procedures, the number of cardiac device infections (including pacemakers, prosthetic valves, coronary and aortic stents) have also increased. These infections can cause significant morbidity and can even lead to mortality if not managed promptly. If suspected clinically the first-line imaging modality is Trans-Thoracic Echocardiography, while Transesophageal Echocardiography is also used in selected cases. The confirmation of a cardiac device infection is mostly done with the help of blood or pus culture. Even though Echocardiography is a very efficient technique for the evaluation of the heart, it cannot differentiate infection from thrombus or fibrosis. With the increasing availability of Positron Emission Tomography CT (PET CT) machines worldwide, the use of <sup>18</sup>F-FDG PET CT for infection imaging has gained traction, especially for cardiac device infection. Most of the recent studies show a good diagnostic accuracy of <sup>18</sup>F-FDG PET CT with many of the recent diagnostic and management guidelines now acknowledging its role, especially in equivocal cases. We present six such cases where <sup>18</sup>F-FDG PET CT provided valuable information either for diagnosis, confirming the presence of infection, delineating extent, therapy response or sometimes even helping appropriate treatment decision making in patients with suspected cardiac device infection.</p>","PeriodicalId":8503,"journal":{"name":"Asia Oceania Journal of Nuclear Medicine and Biology","volume":"12 2","pages":"161-169"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11263774/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141756870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Development of an automated region-of-interest-setting method based on a deep neural network for brain perfusion single photon emission computed tomography quantification methods. 为脑灌注单光子发射计算机断层扫描量化方法开发基于深度神经网络的兴趣区自动设定方法。
Q3 Medicine Pub Date : 2024-01-01 DOI: 10.22038/AOJNMB.2024.75375.1528
Taeko Tomimatsu, Kosuke Yamashita, Takumi Sakata, Ryosuke Kamezaki, Ryuji Ikeda, Shinya Shiraishi, Yoshikazu Uchiyama, Shigeki Ito

Objectives: A simple noninvasive microsphere (SIMS) method using 123I-IMP and an improved brain uptake ratio (IBUR) method using 99mTc-ECD for the quantitative measurement of regional cerebral blood flow have been recently reported. The input functions of these methods were determined using the administered dose, which was obtained by analyzing the time activity curve of the pulmonary artery (PA) for SIMS and the ascending aorta (AAo) for the IBUR methods for dynamic chest images. If the PA and AAo regions of interest (ROIs) can be determined using deep convolutional neural networks (DCNN) for segmentation, the accuracy of these ROI-setting methods can be improved through simple analytical operations to ensure repeatability and reproducibility. The purpose of this study was to develop new PA and AAo-ROI setting methods using a DCNN (DCNN-ROI method).

Methods: A U-Net architecture based on convolutional neural networks was used to determine the PA and AAo candidate regions. Images of 290 patients who underwent 123I-IMP RI-angiography and 108 patients who underwent 99mTc-ECD RI-angiography were used. The PA and AAo-ROI results for the DCNN-ROI method were compared to those obtained using manual methods. The counts for the input function on the PA and AAo-ROI were determined by integrating the area under the curve (AUC) counts of the time-activity curve of PA and AAo-ROI, respectively. The effectiveness of the DCNN-ROI method was elucidated through a comparison with the integrated AUC counts of the DCNN-ROI and the manual ROI.

Results: The coincidence ratio for the locations of the PA and AAo-ROI obtained using the DCNN method and that for the manual method was 100%. Strong correlations were observed between the AUC counts using the DCNN and manual methods.

Conclusion: New ROI- setting programs were developed using a deep convolution neural network DCNN to determine the input functions for the SIMS and IBUR methods. The accuracy of these methods is comparable to that of the manual method.

目的:最近报道了一种使用 123I-IMP 的简易无创微球体(SIMS)方法和一种使用 99mTc-ECD 的改进脑摄取比(IBUR)方法,用于定量测量区域脑血流。这些方法的输入函数是通过给药剂量确定的,而给药剂量是通过分析动态胸部图像中肺动脉(PA)(SIMS)和升主动脉(AAo)(IBUR)方法的时间活动曲线获得的。如果能使用深度卷积神经网络(DCNN)确定 PA 和 AAo 的感兴趣区(ROI)进行分割,就能通过简单的分析操作提高这些 ROI 设置方法的准确性,从而确保重复性和再现性。本研究的目的是利用 DCNN(DCNN-ROI 方法)开发新的 PA 和 AAo-ROI 设置方法:方法:使用基于卷积神经网络的 U-Net 架构来确定 PA 和 AAo 候选区域。使用了 290 名接受 123I-IMP RI-angiography 的患者和 108 名接受 99mTc-ECD RI-angiography 的患者的图像。将 DCNN-ROI 方法的 PA 和 AAo-ROI 结果与人工方法的结果进行了比较。PA和AAo-ROI的输入函数计数分别通过PA和AAo-ROI的时间-活动曲线的曲线下面积(AUC)计数积分确定。通过与 DCNN-ROI 和人工 ROI 的积分 AUC 计数进行比较,阐明了 DCNN-ROI 方法的有效性:结果:使用 DCNN 方法获得的 PA 和 AAo-ROI 位置与人工方法的重合率为 100%。使用 DCNN 方法和手动方法得出的 AUC 计数之间存在很强的相关性:使用深度卷积神经网络 DCNN 开发了新的 ROI 设置程序,以确定 SIMS 和 IBUR 方法的输入函数。这些方法的准确性与手动方法相当。
{"title":"Development of an automated region-of-interest-setting method based on a deep neural network for brain perfusion single photon emission computed tomography quantification methods.","authors":"Taeko Tomimatsu, Kosuke Yamashita, Takumi Sakata, Ryosuke Kamezaki, Ryuji Ikeda, Shinya Shiraishi, Yoshikazu Uchiyama, Shigeki Ito","doi":"10.22038/AOJNMB.2024.75375.1528","DOIUrl":"https://doi.org/10.22038/AOJNMB.2024.75375.1528","url":null,"abstract":"<p><strong>Objectives: </strong>A simple noninvasive microsphere (SIMS) method using <sup>123</sup>I-IMP and an improved brain uptake ratio (IBUR) method using <sup>99m</sup>Tc-ECD for the quantitative measurement of regional cerebral blood flow have been recently reported. The input functions of these methods were determined using the administered dose, which was obtained by analyzing the time activity curve of the pulmonary artery (PA) for SIMS and the ascending aorta (AAo) for the IBUR methods for dynamic chest images. If the PA and AAo regions of interest (ROIs) can be determined using deep convolutional neural networks (DCNN) for segmentation, the accuracy of these ROI-setting methods can be improved through simple analytical operations to ensure repeatability and reproducibility. The purpose of this study was to develop new PA and AAo-ROI setting methods using a DCNN (DCNN-ROI method).</p><p><strong>Methods: </strong>A U-Net architecture based on convolutional neural networks was used to determine the PA and AAo candidate regions. Images of 290 patients who underwent <sup>123</sup>I-IMP RI-angiography and 108 patients who underwent <sup>99m</sup>Tc-ECD RI-angiography were used. The PA and AAo-ROI results for the DCNN-ROI method were compared to those obtained using manual methods. The counts for the input function on the PA and AAo-ROI were determined by integrating the area under the curve (AUC) counts of the time-activity curve of PA and AAo-ROI, respectively. The effectiveness of the DCNN-ROI method was elucidated through a comparison with the integrated AUC counts of the DCNN-ROI and the manual ROI.</p><p><strong>Results: </strong>The coincidence ratio for the locations of the PA and AAo-ROI obtained using the DCNN method and that for the manual method was 100%. Strong correlations were observed between the AUC counts using the DCNN and manual methods.</p><p><strong>Conclusion: </strong>New ROI- setting programs were developed using a deep convolution neural network DCNN to determine the input functions for the SIMS and IBUR methods. The accuracy of these methods is comparable to that of the manual method.</p>","PeriodicalId":8503,"journal":{"name":"Asia Oceania Journal of Nuclear Medicine and Biology","volume":"12 2","pages":"120-130"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11263778/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141756873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Graves' disease post-COVID-19 m-RNA vaccine in pediatric age group. 儿科年龄组接种COVID-19 m-RNA疫苗后出现的巴塞杜氏病。
Q3 Medicine Pub Date : 2024-01-01 DOI: 10.22038/AOJNMB.2023.73051.1510
Abhaa Sulaiyam Al-Jahhafi, Asma Ali Al-Sawaai, Zamzam Khalifa Al-Bimani, Naima Khamis Al-Bulushi

The surge of the COVID-19 pandemic (December / 2019 - May/2023) and its catastrophic effect worldwide have necessitated emergent intervention to reduce its influence on people's health and life. To eliminate and reduce the impact of COVID-19 infection, COVID-19 vaccination was emergently authorized in December 2020 which has established good safety and efficacy. Having said that, some adverse effects merged in a few individuals. We are reporting an adolescent patient a 17-year-old female who has been diagnosed with Graves' disease after post-COVID-19 vaccinations. In addition, she was a confirmed case of COVID-19 infection three months earlier. The patient presented with typical features of hyperthyroidism 30 days post receiving the first dose of the vaccination. Based on the patient's presentation relative to the administration of the vaccine and prior infection of the virus. We proposed the synergistic effect of both factors to induce Graves' disease in this young healthy female with no family history of autoimmune disease. We are reporting this case for pediatric endocrinologists to be aware of the interaction and possible impact of the COVID-19 vaccine on thyroid function.

COVID-19 大流行(2019 年 12 月至 2023 年 5 月)的飙升及其在全球范围内的灾难性影响使得有必要采取紧急干预措施,以减少其对人们健康和生活的影响。为了消除和减少 COVID-19 感染的影响,2020 年 12 月紧急批准接种 COVID-19 疫苗,该疫苗具有良好的安全性和有效性。尽管如此,少数人还是出现了一些不良反应。我们报告了一名 17 岁女性青少年患者,她在接种 COVID-19 疫苗后被诊断出患有巴塞杜氏病。此外,她在三个月前曾确诊感染过 COVID-19。患者在接种第一剂疫苗 30 天后出现典型的甲状腺功能亢进症状。根据患者在接种疫苗和之前感染病毒时的表现,我们提出了疫苗与甲状腺功能亢进的协同作用。我们认为,这两种因素的协同作用诱发了这名无自身免疫性疾病家族史的年轻健康女性患上巴塞杜氏病。我们报告此病例是为了让儿科内分泌专家了解 COVID-19 疫苗对甲状腺功能的相互作用和可能影响。
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引用次数: 0
Tubarial salivary glands on PSMA ligands based PET imaging and post 177Lu PSMA therapy scan: reiterating its importance. 基于 PSMA 配体的 PET 成像和 177Lu PSMA 治疗后扫描中的管状唾液腺:重申其重要性。
Q3 Medicine Pub Date : 2024-01-01 DOI: 10.22038/AOJNMB.2023.72138.1505
Srinivas Ananth Kumar, Anjali Meena, Ashwani Sood, Rajender Kumar, Bhagwant Rai Mittal

68Ga-PSMA PET/CT has been routinely utilized in patients with intermediate to high-risk category prostate carcinoma for staging, biochemical recurrence and before planning the PSMA radioligand therapy (RLT). 177Lu-PSMA RLT has also been approved by FDA as a novel treatment modality in metastatic carcinoma prostate patients who have failed to other lines of treatment. The non-target organs like salivary and lacrimal glands have shown to have high physiological PSMA uptake on PSMA PET/CT. Recently, strong uptake of PSMA ligand has also been noted in the dorsal wall of the nasopharynx in the region of torus tubarius on PSMA PET/CT, which has led to the identification of new pair of salivary gland structures called "tubarial salivary glands". The clinical significance of these distinct anatomical structures lies in the fact these structures might be involved in a variety of immune related, inflammatory disorders, malignancies and could be a probable organ at risk during radiotherapy in case of head and neck malignancies, causing adverse effects to the patient.

68Ga-PSMA PET/CT 已成为中高危前列腺癌患者进行分期、生化复发和计划 PSMA 放射性配体治疗(RLT)前的常规方法。177Lu-PSMA RLT 还获得了美国食品及药物管理局(FDA)的批准,作为一种新型治疗方法,用于治疗其他治疗方法无效的转移性前列腺癌患者。唾液腺和泪腺等非靶器官在 PSMA PET/CT 上显示出较高的生理性 PSMA 摄取。最近,PSMA PET/CT 在鼻咽背壁的管状环区域也发现了 PSMA 配体的强摄取,从而发现了一对新的唾液腺结构,称为 "管状唾液腺"。这些独特解剖结构的临床意义在于,这些结构可能与各种免疫相关疾病、炎症、恶性肿瘤有关,并且可能是头颈部恶性肿瘤放疗期间的危险器官,对患者造成不良影响。
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引用次数: 0
期刊
Asia Oceania Journal of Nuclear Medicine and Biology
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