Pineal gland tumors are significant despite being rare (<1%) among all brain tumors. Germ cell tumors are the most common among the pineal gland tumors. Often affecting young adults, pineal gland germ cell tumors are hard to diagnose due to different symptoms and potential spread. But they rarely show leptomeningeal spread and extracranial metastases. Other differentials include primary tumors of the pineal region, Pineal gliomas, and metastases. The leptomeningeal spread of these tumors has not been studied so far. Conventional radiological imaging modalities are routinely used to diagnose and evaluate these tumors. We report a case here showing a pineal gland tumor with leptomeningeal spread detected by 18F-FDG PET/CT. Our case shows how pineal gland tumors can behave unusually and how 18F-FDG PET/CT can be crucial for accurately assessing the extent of the disease in the body to provide effective treatment. This case report illustrates the rare type of spread of pineal gland tumor and how 18F-FDG PET/CT helps detect this rare type of metastasis, thereby helping in prognostication and deciding further treatment of the patient.
{"title":"Utility of <sup>18</sup>F-FDG PET/CT in Detecting Spinal Drop Metastases from Pineal Gland Tumors.","authors":"Kabilash Dhayalan, Harish Goyal, Pradap Palanivelu, Dhanapathi Halanaik","doi":"10.22038/AOJNMB.2024.74259.1518","DOIUrl":"https://doi.org/10.22038/AOJNMB.2024.74259.1518","url":null,"abstract":"<p><p>Pineal gland tumors are significant despite being rare (<1%) among all brain tumors. Germ cell tumors are the most common among the pineal gland tumors. Often affecting young adults, pineal gland germ cell tumors are hard to diagnose due to different symptoms and potential spread. But they rarely show leptomeningeal spread and extracranial metastases. Other differentials include primary tumors of the pineal region, Pineal gliomas, and metastases. The leptomeningeal spread of these tumors has not been studied so far. Conventional radiological imaging modalities are routinely used to diagnose and evaluate these tumors. We report a case here showing a pineal gland tumor with leptomeningeal spread detected by <sup>18</sup>F-FDG PET/CT. Our case shows how pineal gland tumors can behave unusually and how <sup>18</sup>F-FDG PET/CT can be crucial for accurately assessing the extent of the disease in the body to provide effective treatment. This case report illustrates the rare type of spread of pineal gland tumor and how <sup>18</sup>F-FDG PET/CT helps detect this rare type of metastasis, thereby helping in prognostication and deciding further treatment of the patient.</p>","PeriodicalId":8503,"journal":{"name":"Asia Oceania Journal of Nuclear Medicine and Biology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11263771/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141756881","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}
Pub Date : 2024-01-01DOI: 10.22038/AOJNMB.2024.76465.1538
Awiral Saxena, Manjit Sarma, P Shanmuga Sundaram, Padma Subramanyam, Anwin Joseph Kavanal
Perforation of the bowel can be a life-threatening condition and is usually clinically diagnosed when a patient presents with such features as severe abdominal pain, tenderness, and tachycardia. Bowel perforation may be corroborated by various conventional imaging modalities, including X-ray, ultrasonography, computed tomography, and magnetic resonance imaging. Nuclear medicine imaging modalities seldom have a role to play in these settings. Rarely diagnosis of perforation may be missed if it is concealed and does not present with the usual signs. Mostly the perforation will eventually be diagnosed if they develop signs and symptoms and is taken up for an exploratory laparotomy. A delay in diagnosis can later lead to significant patient morbidity or even mortality. This report describes a case where possible intestinal perforation was suspected on a 99mTc-DTPA renogram in a postoperative patient with significant urine leak, the presence of which was confirmed intraoperatively. To our knowledge, this was the first such case in the literature.
肠穿孔可能会危及生命,通常在患者出现剧烈腹痛、压痛和心动过速等症状时才会被临床诊断出来。肠穿孔可通过各种常规成像方式得到证实,包括 X 光、超声波、计算机断层扫描和磁共振成像。核医学成像模式在这些情况下很少发挥作用。如果穿孔比较隐蔽,而且没有通常的体征,则可能会漏诊。大多数情况下,如果患者出现症状和体征,并接受剖腹探查手术,穿孔最终会被确诊。延误诊断可能会导致患者严重发病甚至死亡。本报告描述了一个病例,该病例的术后患者有明显漏尿,99m锝-DTPA肾图怀疑可能存在肠穿孔,术中证实了肠穿孔的存在。据我们所知,这是文献中首个此类病例。
{"title":"Incidental diagnosis of intestinal perforation on a <sup>99m</sup>Tc DTPA renogram.","authors":"Awiral Saxena, Manjit Sarma, P Shanmuga Sundaram, Padma Subramanyam, Anwin Joseph Kavanal","doi":"10.22038/AOJNMB.2024.76465.1538","DOIUrl":"https://doi.org/10.22038/AOJNMB.2024.76465.1538","url":null,"abstract":"<p><p>Perforation of the bowel can be a life-threatening condition and is usually clinically diagnosed when a patient presents with such features as severe abdominal pain, tenderness, and tachycardia. Bowel perforation may be corroborated by various conventional imaging modalities, including X-ray, ultrasonography, computed tomography, and magnetic resonance imaging. Nuclear medicine imaging modalities seldom have a role to play in these settings. Rarely diagnosis of perforation may be missed if it is concealed and does not present with the usual signs. Mostly the perforation will eventually be diagnosed if they develop signs and symptoms and is taken up for an exploratory laparotomy. A delay in diagnosis can later lead to significant patient morbidity or even mortality. This report describes a case where possible intestinal perforation was suspected on a <sup>99m</sup>Tc-DTPA renogram in a postoperative patient with significant urine leak, the presence of which was confirmed intraoperatively. To our knowledge, this was the first such case in the literature.</p>","PeriodicalId":8503,"journal":{"name":"Asia Oceania Journal of Nuclear Medicine and Biology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11263776/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141756875","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}
Pub Date : 2024-01-01DOI: 10.22038/AOJNMB.2023.71860.1503
Dale L Bailey, Kathy P Willowson, Carl Muñoz-Ferrada
Objectives: To address the problem of using large volumes of long-lived radionuclides in test phantoms to check calibration accuracy of PET and SPECT systems we have developed a test object which (a) contains less radioactivity, (b) has a low total volume, and (c) is easier to store than currently used phantoms, while still making use of readily-available "standardised" test objects.
Methods: We have designed a hollow acrylic cylindrical insert compatible with the NEMA/IEC PET Body Image Quality (IQ) phantom used in NU 2 performance testing of PET systems. The insert measures 90 mm internal diameter and 70 mm internal height and so is sufficiently large to not be subject to partial volume effects in PET or SPECT imaging. The volume of the insert is approximately 500 mL. It has been designed as a replacement for the standard long cylindrical "lung insert" in the IQ phantom without needing to remove the fillable hollow spheres of the phantom. The insert been tested with 18F, 68Ga and 124I PET/CT and 99mTc, 131I and 177Lu SPECT/CT on scanners that had previously been calibrated for these radionuclides.
Results: The scanners were found to produce accurate image reconstructions in the insert with 5% of the true value without any confounding uncertainty from partial volume effects when compared to NEMA NU 2-2018 Phantom measurement.
Conclusions: The "ARTnet Insert" is simple to use, inexpensive, compatible with current phantoms and is suitable for both PET and SPECT systems. It does not suffer from significant partial volume losses permitting its use even with the poor spatial resolution of high-energy imaging with 131I SPECT. Furthermore, it uses less radioactivity in a smaller volume than would be required to fill the entire phantom as is usually done. Long-term storage is practical while allowing radioactive decay of the insert contents.
目的:为了解决在测试模型中使用大量长寿命放射性核素来检查 PET 和 SPECT 系统校准准确性的问题,我们开发了一种测试物体,它(a)放射性含量较少,(b)总体积较小,(c)比目前使用的模型更容易储存,同时仍可使用现成的 "标准化 "测试物体:方法:我们设计了一种与 NEMA/IEC PET 人体图像质量(IQ)模型兼容的空心丙烯酸圆柱形插入物,该模型用于 PET 系统的 NU 2 性能测试。插入物的内径为 90 毫米,内高为 70 毫米,因此足够大,在 PET 或 SPECT 成像中不会受到部分体积效应的影响。插入物的体积约为 500 毫升。其设计目的是替代 IQ 模型中的标准长圆柱形 "肺插入物",而无需移除模型中的可填充空心球。该插件已在扫描仪上进行了 18F、68Ga 和 124I PET/CT 以及 99mTc、131I 和 177Lu SPECT/CT 测试,这些扫描仪之前已对这些放射性核素进行过校准:结果:与 NEMA NU 2-2018 Phantom 测量结果相比,发现扫描仪在插入件中生成的图像重建精确度为真实值的 5%,没有任何因部分容积效应而产生的不确定性:ARTnet Insert "使用简单,价格低廉,与当前的模型兼容,适用于 PET 和 SPECT 系统。它不会产生明显的部分体积损失,即使在 131I SPECT 高能成像空间分辨率较低的情况下也能使用。此外,与通常填满整个模型所需的体积相比,它在较小体积内使用的放射性更少。在允许插入物放射性衰变的同时,长期储存也是可行的。
{"title":"A practical method for assessing quantitative scanner accuracy with long-lived radionuclides: The ARTnet insert.","authors":"Dale L Bailey, Kathy P Willowson, Carl Muñoz-Ferrada","doi":"10.22038/AOJNMB.2023.71860.1503","DOIUrl":"10.22038/AOJNMB.2023.71860.1503","url":null,"abstract":"<p><strong>Objectives: </strong>To address the problem of using large volumes of long-lived radionuclides in test phantoms to check calibration accuracy of PET and SPECT systems we have developed a test object which (a) contains less radioactivity, (b) has a low total volume, and (c) is easier to store than currently used phantoms, while still making use of readily-available \"standardised\" test objects.</p><p><strong>Methods: </strong>We have designed a hollow acrylic cylindrical insert compatible with the NEMA/IEC PET Body Image Quality (IQ) phantom used in NU 2 performance testing of PET systems. The insert measures 90 mm internal diameter and 70 mm internal height and so is sufficiently large to not be subject to partial volume effects in PET or SPECT imaging. The volume of the insert is approximately 500 mL. It has been designed as a replacement for the standard long cylindrical \"lung insert\" in the IQ phantom without needing to remove the fillable hollow spheres of the phantom. The insert been tested with <sup>18</sup>F, <sup>68</sup>Ga and <sup>124</sup>I PET/CT and <sup>99m</sup>Tc, <sup>131</sup>I and <sup>177</sup>Lu SPECT/CT on scanners that had previously been calibrated for these radionuclides.</p><p><strong>Results: </strong>The scanners were found to produce accurate image reconstructions in the insert with 5% of the true value without any confounding uncertainty from partial volume effects when compared to NEMA NU 2-2018 Phantom measurement.</p><p><strong>Conclusions: </strong>The \"ARTnet Insert\" is simple to use, inexpensive, compatible with current phantoms and is suitable for both PET and SPECT systems. It does not suffer from significant partial volume losses permitting its use even with the poor spatial resolution of high-energy imaging with <sup>131</sup>I SPECT. Furthermore, it uses less radioactivity in a smaller volume than would be required to fill the entire phantom as is usually done. Long-term storage is practical while allowing radioactive decay of the insert contents.</p>","PeriodicalId":8503,"journal":{"name":"Asia Oceania Journal of Nuclear Medicine and Biology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10757053/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139073267","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}
Objectives: Despite significant progress in the field of nuclear medicine, basic nuclear medicine awareness and understanding among clinicians remains unsatisfactory, leading to under utilization of nuclear medicine modalities. To evaluate the awareness and knowledge regarding nuclear medicine and appropriate use of Nuclear medicine modalities, among medical students and faculty members.
Method: In this descriptive cross sectional study, a self timer limited objective questionnaire based on Google forms was distributed to the study population and scores obtained by the participants were analyzed.
Results: Percent scores range for intern, residency trainees, and senior resident/faculty groups for general awareness were 16-46%, 37-58% and 62-91% and for knowledge and appropriate use were 7-21%, 28-43%, and 35-85% respectively. Overall, 61% of the participants had poor awareness and knowledge regarding nuclear medicine modalities. None of the participants had received nuclear medicine exposure or education during their academics or training. Only 49% of the participants considered utilizing nuclear medicine modalities for their patient management.
Conclusion: Undergraduate interns and residency trainees had a poor to fair level of awareness and knowledge regarding nuclear medicine. Hence creating more awareness in early stages of their career by incorporating Nuclear medicine basic education in medical undergraduate curriculum is required. The senior residents/faculty members had a moderate to good level of awareness and knowledge but still improvement in their knowledge would lead to a more appropriate and better utilization of nuclear medicine modalities for optimum patient management in a variety of clinical settings.
{"title":"Assessment of awareness and knowledge regarding nuclear medicine and appropriate use of Nuclear medicine modalities, among medical students and faculty members in two academic medical institutes in North India: A Cross sectional Study.","authors":"Nitin Gupta, Priya Sareen, Sudesh Kumar, Muninder Negi","doi":"10.22038/AOJNMB.2023.71375.1497","DOIUrl":"10.22038/AOJNMB.2023.71375.1497","url":null,"abstract":"<p><strong>Objectives: </strong>Despite significant progress in the field of nuclear medicine, basic nuclear medicine awareness and understanding among clinicians remains unsatisfactory, leading to under utilization of nuclear medicine modalities. To evaluate the awareness and knowledge regarding nuclear medicine and appropriate use of Nuclear medicine modalities, among medical students and faculty members.</p><p><strong>Method: </strong>In this descriptive cross sectional study, a self timer limited objective questionnaire based on Google forms was distributed to the study population and scores obtained by the participants were analyzed.</p><p><strong>Results: </strong>Percent scores range for intern, residency trainees, and senior resident/faculty groups for general awareness were 16-46%, 37-58% and 62-91% and for knowledge and appropriate use were 7-21%, 28-43%, and 35-85% respectively. Overall, 61% of the participants had poor awareness and knowledge regarding nuclear medicine modalities. None of the participants had received nuclear medicine exposure or education during their academics or training. Only 49% of the participants considered utilizing nuclear medicine modalities for their patient management.</p><p><strong>Conclusion: </strong>Undergraduate interns and residency trainees had a poor to fair level of awareness and knowledge regarding nuclear medicine. Hence creating more awareness in early stages of their career by incorporating Nuclear medicine basic education in medical undergraduate curriculum is required. The senior residents/faculty members had a moderate to good level of awareness and knowledge but still improvement in their knowledge would lead to a more appropriate and better utilization of nuclear medicine modalities for optimum patient management in a variety of clinical settings.</p>","PeriodicalId":8503,"journal":{"name":"Asia Oceania Journal of Nuclear Medicine and Biology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10757062/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139073268","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}
Pub Date : 2024-01-01DOI: 10.22038/AOJNMB.2023.73907.1515
Kishin Tokuyama, Yusuke Inoue, Keiji Matsunaga, Yasunori Hamaguchi, Saori Sekimoto
Splenosis occurs as a result of autotransplantation of splenic tissue following splenic injury or splenectomy. A 56-year-old man with esophageal cancer underwent thoracoscopic-assisted subtotal esophagectomy accompanied by three-field lymph node dissection, and retrosternal gastric tube reconstruction. The spleen was injured during the surgery and was removed. A retrosternal nodule of 12 mm in diameter was detected near the reconstructed gastric tube on computed tomography (CT) performed 3 years and 6 months postoperatively. Retrospectively, the nodule was observed in the same area on early postoperative CT and gradually increased in size. No accessory spleen was identified on the preoperative CT. Splenosis was suspected, and 99mTc-Sn-colloid single photon emission computed tomography (SPECT)/CT was performed. It revealed intense uptake in the retrosternal nodule, consistent with the diagnosis of thoracic splenosis. Subsequently, the patient has been under observation without treatment. 99mTc-labeled colloid SPECT/CT allowed confident diagnosis of thoracic splenosis following esophageal cancer surgery. This examination is considered valuable for the evaluation of ectopic splenic tissue.
{"title":"<sup>99m</sup>Tc-Sn-colloid SPECT/CT in thoracic splenosis after esophageal cancer surgery.","authors":"Kishin Tokuyama, Yusuke Inoue, Keiji Matsunaga, Yasunori Hamaguchi, Saori Sekimoto","doi":"10.22038/AOJNMB.2023.73907.1515","DOIUrl":"10.22038/AOJNMB.2023.73907.1515","url":null,"abstract":"<p><p>Splenosis occurs as a result of autotransplantation of splenic tissue following splenic injury or splenectomy. A 56-year-old man with esophageal cancer underwent thoracoscopic-assisted subtotal esophagectomy accompanied by three-field lymph node dissection, and retrosternal gastric tube reconstruction. The spleen was injured during the surgery and was removed. A retrosternal nodule of 12 mm in diameter was detected near the reconstructed gastric tube on computed tomography (CT) performed 3 years and 6 months postoperatively. Retrospectively, the nodule was observed in the same area on early postoperative CT and gradually increased in size. No accessory spleen was identified on the preoperative CT. Splenosis was suspected, and <sup>99m</sup>Tc-Sn-colloid single photon emission computed tomography (SPECT)/CT was performed. It revealed intense uptake in the retrosternal nodule, consistent with the diagnosis of thoracic splenosis. Subsequently, the patient has been under observation without treatment. <sup>99m</sup>Tc-labeled colloid SPECT/CT allowed confident diagnosis of thoracic splenosis following esophageal cancer surgery. This examination is considered valuable for the evaluation of ectopic splenic tissue.</p>","PeriodicalId":8503,"journal":{"name":"Asia Oceania Journal of Nuclear Medicine and Biology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10757057/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139073266","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}
Objectives: Physiological myocardial 18F-fluorodeoxyglucose (18F-FDG) uptake in oncologic positron emission tomography (PET)/computed tomography (CT) is commonly observed with multiple variations under clinical fasting conditions. The purpose of the present study was to evaluate physiological myocardial 18F-FDG uptake pattern by comparing with the results in cardiac sarcoidosis.
Methods: A total of 174 examinations in 174 patients without cardiac disease and 27 examinations in 17 patients with cardiac sarcoidosis were performed. The polar map images generated from 18F-FDG PET/CT data were visually assessed as "basal-ring," "focal," and "focal on diffuse" patterns. Semi-quantitative analysis was also performed using the regional relative 18F-FDG uptake (% uptake).
Results: On visual analysis, the "focal on diffuse" pattern was the most common in both examinations (43% and 59%, respectively). The physiological % uptake in the lateral and basal septal walls tended to be higher. Subgroup analysis showed significantly higher uptake in the mid-wall and left circumflex territory. In cardiac sarcoidosis patients, there was a significant difference only between segments 2 and 15 (p=0.04). No significant differences were observed between the base-mid-apical territory and coronary artery branch territory.
Conclusion: High 18F-FDG uptake in the basal septal walls is likely to be observed as both physiological uptake in patients without cardiac disease and pathological uptake in patients with cardiac sarcoidosis.
{"title":"Physiological myocardial <sup>18</sup>F-FDG uptake pattern in oncologic PET/CT: comparison with findings in cardiac sarcoidosis.","authors":"Takashi Norikane, Yuka Yamamoto, Yasukage Takami, Katsuya Mitamura, Takuya Kobata, Yukito Maeda, Takahisa Noma, Yoshihiro Nishiyama","doi":"10.22038/AOJNMB.2023.70254.1490","DOIUrl":"10.22038/AOJNMB.2023.70254.1490","url":null,"abstract":"<p><strong>Objectives: </strong>Physiological myocardial <sup>18</sup>F-fluorodeoxyglucose (<sup>18</sup>F-FDG) uptake in oncologic positron emission tomography (PET)/computed tomography (CT) is commonly observed with multiple variations under clinical fasting conditions. The purpose of the present study was to evaluate physiological myocardial <sup>18</sup>F-FDG uptake pattern by comparing with the results in cardiac sarcoidosis.</p><p><strong>Methods: </strong>A total of 174 examinations in 174 patients without cardiac disease and 27 examinations in 17 patients with cardiac sarcoidosis were performed. The polar map images generated from <sup>18</sup>F-FDG PET/CT data were visually assessed as \"basal-ring,\" \"focal,\" and \"focal on diffuse\" patterns. Semi-quantitative analysis was also performed using the regional relative <sup>18</sup>F-FDG uptake (% uptake).</p><p><strong>Results: </strong>On visual analysis, the \"focal on diffuse\" pattern was the most common in both examinations (43% and 59%, respectively). The physiological % uptake in the lateral and basal septal walls tended to be higher. Subgroup analysis showed significantly higher uptake in the mid-wall and left circumflex territory. In cardiac sarcoidosis patients, there was a significant difference only between segments 2 and 15 (p=0.04). No significant differences were observed between the base-mid-apical territory and coronary artery branch territory.</p><p><strong>Conclusion: </strong>High <sup>18</sup>F-FDG uptake in the basal septal walls is likely to be observed as both physiological uptake in patients without cardiac disease and pathological uptake in patients with cardiac sarcoidosis.</p>","PeriodicalId":8503,"journal":{"name":"Asia Oceania Journal of Nuclear Medicine and Biology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10757061/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139073285","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}
Objectives: The traditional practice of empiric radioiodine (I-131) prescription is scientifically obsolete and inappropriate for inoperable metastatic differentiated thyroid cancer. However, theranostically guided prescription is still years away for many institutions. A personalized predictive method of radioiodine prescription that bridges the gap between empiric and theranostic methods is presented. It is an adaptation of the "maximum tolerated activity" method, where serial blood sampling is replaced by population kinetics carefully chosen by the user. It aims to maximize crossfire benefits within safety constraints to overcome tumour absorbed dose heterogeneity for a safe and effective first radioiodine fraction i.e., the First Strike.
Methods: The EANM method of blood dosimetry was incorporated with population kinetics, marrow and lung safety constraints, body habitus and clinical assessment of metastatic extent. Population data of whole body and blood kinetics in patients with and without metastases, prepared by recombinant human thyroid stimulating hormone or thyroid hormone withdrawal, and the maximum safe marrow dose rate were deduced from published data. For diffuse lung metastases, the lung safety limit was linearly scaled by height and separated into lung and remainder-of-body components.
Results: The slowest whole body Time Integrated Activity Coefficient (TIAC) amongst patients with any metastases was 33.5±17.0 h and the highest percentage of whole body TIAC attributed to blood was 16.6±7.9%, prepared by thyroid hormone withdrawal. A variety of other average radioiodine kinetics is tabulated. Maximum safe marrow dose rate was deduced to be 0.265 Gy/h per fraction, where blood TIAC is normalised to administered activity. An easy-to-use calculator was developed which only requires height, weight and gender to populate recommendations for personalized First Strike prescription. The user decides by clinical gestalt whether the prescription is to be constrained by marrow or lung, then selects an activity depending on how extensive the metastases are likely to be. A Standard Female with oligometastasis and good urine output without diffuse lung metastasis is expected to safely tolerate 8.03 GBq of radioiodine as the First Strike.
Conclusion: This predictive method will help institutions rationalise the First Strike prescription based on radiobiologically sound principles, personalised to individual circumstances.
{"title":"First Strike personalized predictive radioiodine prescription for inoperable metastatic differentiated thyroid cancer.","authors":"Yung Hsiang Kao","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objectives: </strong>The traditional practice of empiric radioiodine (I-131) prescription is scientifically obsolete and inappropriate for inoperable metastatic differentiated thyroid cancer. However, theranostically guided prescription is still years away for many institutions. A personalized predictive method of radioiodine prescription that bridges the gap between empiric and theranostic methods is presented. It is an adaptation of the \"maximum tolerated activity\" method, where serial blood sampling is replaced by population kinetics carefully chosen by the user. It aims to maximize crossfire benefits within safety constraints to overcome tumour absorbed dose heterogeneity for a safe and effective first radioiodine fraction i.e., the First Strike.</p><p><strong>Methods: </strong>The EANM method of blood dosimetry was incorporated with population kinetics, marrow and lung safety constraints, body habitus and clinical assessment of metastatic extent. Population data of whole body and blood kinetics in patients with and without metastases, prepared by recombinant human thyroid stimulating hormone or thyroid hormone withdrawal, and the maximum safe marrow dose rate were deduced from published data. For diffuse lung metastases, the lung safety limit was linearly scaled by height and separated into lung and remainder-of-body components.</p><p><strong>Results: </strong>The slowest whole body Time Integrated Activity Coefficient (TIAC) amongst patients with any metastases was 33.5±17.0 h and the highest percentage of whole body TIAC attributed to blood was 16.6±7.9%, prepared by thyroid hormone withdrawal. A variety of other average radioiodine kinetics is tabulated. Maximum safe marrow dose rate was deduced to be 0.265 Gy/h per fraction, where blood TIAC is normalised to administered activity. An easy-to-use calculator was developed which only requires height, weight and gender to populate recommendations for personalized First Strike prescription. The user decides by clinical gestalt whether the prescription is to be constrained by marrow or lung, then selects an activity depending on how extensive the metastases are likely to be. A Standard Female with oligometastasis and good urine output without diffuse lung metastasis is expected to safely tolerate 8.03 GBq of radioiodine as the First Strike.</p><p><strong>Conclusion: </strong>This predictive method will help institutions rationalise the First Strike prescription based on radiobiologically sound principles, personalised to individual circumstances.</p>","PeriodicalId":8503,"journal":{"name":"Asia Oceania Journal of Nuclear Medicine and Biology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10261697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10012001","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}
Pub Date : 2023-01-01DOI: 10.22038/AOJNMB.2022.66011.1457
Alberto Nieri, Luca Urso, Matteo Caracciolo, Maria Ciccone, Licia Uccelli, Corrado Cittanti, Antonio Cuneo, Mirco Bartolomei
Hodgkin Lymphoma (HL) is a malignancy involving lymph nodes and lymphatic system. [18F]F-FDG PET/CT (FDG-PET) imaging is routinely used for staging, to assess early chemotherapy response (interim FDG-PET), at the end of treatment (EoT FDG-PET) and for the identification of disease recurrence. We present a case of a 39-year-old man treated for HL. FDG-PET scans performed after first line therapy (both Interim PET and at the end of therapy) demonstrated a persistent and significant mediastinal FDG uptake. The patient was treated with a second line therapy but the FDG-PET uptake did not change. After board discussion a new surgical, thoracoscopy-guided biopsy was performed. Histopathology demonstrated a dense fibrous tissue with occasional chronic inflammatory infiltrates. Persistent FDG-PET positivity may suggest refractory or relapsed disease. However, occasionally, non-malignant conditions are responsible for a persistent FDG uptake, not related to primary disease. An accurate evaluation of clinical history and previous imaging exams is mandatory for clinicians and others experts to avoid misinterpretations of FDG-PET results. Nevertheless, in some cases, only a more invasive procedure, such as a biopsy, may finally lead to a definitive diagnosis.
{"title":"Misinterpretation of an inflammatory FDG uptake in a patient treated for Hodgkin lymphoma: a case report.","authors":"Alberto Nieri, Luca Urso, Matteo Caracciolo, Maria Ciccone, Licia Uccelli, Corrado Cittanti, Antonio Cuneo, Mirco Bartolomei","doi":"10.22038/AOJNMB.2022.66011.1457","DOIUrl":"https://doi.org/10.22038/AOJNMB.2022.66011.1457","url":null,"abstract":"<p><p>Hodgkin Lymphoma (HL) is a malignancy involving lymph nodes and lymphatic system. [<sup>18</sup>F]F-FDG PET/CT (FDG-PET) imaging is routinely used for staging, to assess early chemotherapy response (interim FDG-PET), at the end of treatment (EoT FDG-PET) and for the identification of disease recurrence. We present a case of a 39-year-old man treated for HL. FDG-PET scans performed after first line therapy (both Interim PET and at the end of therapy) demonstrated a persistent and significant mediastinal FDG uptake. The patient was treated with a second line therapy but the FDG-PET uptake did not change. After board discussion a new surgical, thoracoscopy-guided biopsy was performed. Histopathology demonstrated a dense fibrous tissue with occasional chronic inflammatory infiltrates. Persistent FDG-PET positivity may suggest refractory or relapsed disease. However, occasionally, non-malignant conditions are responsible for a persistent FDG uptake, not related to primary disease. An accurate evaluation of clinical history and previous imaging exams is mandatory for clinicians and others experts to avoid misinterpretations of FDG-PET results. Nevertheless, in some cases, only a more invasive procedure, such as a biopsy, may finally lead to a definitive diagnosis.</p>","PeriodicalId":8503,"journal":{"name":"Asia Oceania Journal of Nuclear Medicine and Biology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10261686/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10029342","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}
Objectives: Due to the suitable physical characteristics of 89Zr as a PET radionuclide and affinity of Trastuzumab monoclonal antibody against HER2, [89Zr]Zr-Trastuzumab was prepared and went through preclinical evaluations for ultimate human applications.
Methods: 89Zr was produced by using 89Y(p,n)89Zr reaction at a 30 MeV cyclotron (radionuclide purity>99.9%, specific activity of 17 GBq/µg). p-SCN-Bn-Deferoxamine (DFO); was conjugated to trastuzumab, followed by labeling with 89Zr in oxalate form at optimized condition. Cell binding, internalization and, radioimmuno-activity assays were studied using HER2+ BT474 and HER2- CHO cell lines. Finally, the biodistribution of the radioimmunoconjugate was assessed in normal and HER2+ BT474 tumor-bearing mice using tissue counting and imaging at different intervals after injection. Also, a woman with HER2-positive metastatic breast cancer under treatment with Herceptin underwent both [89Zr]Zr-Trastuzumab and, [18F]FDG PET/CTs.
Results: 89Zr was produced with high radionuclidic and radiochemical purities (>99%) and [89Zr]Zr-DFO-Trastuzumab was prepared with radiochemical purity of >98% and specific activity of 9.85 GBq/µmol. The radioimmunoconjugate was stable both in PBS buffer and in human serum for at least 48 h. The radioimmunoactivity assay demonstrated about 70% of [89Zr]Zr-DFO-Trastuzumab is bound to the BT474 cells at the number of 250×106 cells. Cell binding studies showed that about 28% of radioimmunoconjugate is attached to BT474 cells after 90 min. Internalization studies showed that 50% of [89Zr]Zr-Trastuzumab is internalized to BT474 cells only in 6 h. The biodistribution study of the labeled compound in normal mice demonstrated the same pattern of the monoclonal antibodies which is entirely different from the biodistribution of free 89Zr. Biodistribution and imaging studies in tumor-bearing mice showed the significant uptake values of [89Zr]Zr-Trastuzumab in tumor sites. [89Zr]Zr-Trastuzumab PET/CT revealed metastatic lesions documented previously with [18F]FDG PET/CT scan in a woman with breast cancer who was under treatment with Herceptin. Although the [18F]FDG PET/CT scan had better quality images, the valuable and unique advantage of [89Zr]Zr-Trastuzumab PET/CT is delineating HER2+ metastasis, which is essential in diagnosis and HER2-based treatments.
Conclusion: The prepared [89Zr]Zr-Trastuzumab has a high potential radio-pharmaceutical for immune-PET imaging of the patients with HER2+ tumors.
{"title":"Development and evaluation of <sup>89</sup>Zr-trastuzumab for clinical applications.","authors":"Fatemeh Mohammadpour-Ghazi, Hassan Yousefnia, GhasemAli Divband, Samaneh Zolghadri, Behrouz Alirezapour, Fatemeh Shakeri","doi":"10.22038/AOJNMB.2022.68093.1471","DOIUrl":"https://doi.org/10.22038/AOJNMB.2022.68093.1471","url":null,"abstract":"<p><strong>Objectives: </strong>Due to the suitable physical characteristics of <sup>89</sup>Zr as a PET radionuclide and affinity of Trastuzumab monoclonal antibody against HER2, [<sup>89</sup>Zr]Zr-Trastuzumab was prepared and went through preclinical evaluations for ultimate human applications.</p><p><strong>Methods: </strong><sup>89</sup>Zr was produced by using <sup>89</sup>Y(p,n)<sup>89</sup>Zr reaction at a 30 MeV cyclotron (radionuclide purity>99.9%, specific activity of 17 GBq/µg). p-SCN-Bn-Deferoxamine (DFO); was conjugated to trastuzumab, followed by labeling with <sup>89</sup>Zr in oxalate form at optimized condition. Cell binding, internalization and, radioimmuno-activity assays were studied using HER2+ BT474 and HER2- CHO cell lines. Finally, the biodistribution of the radioimmunoconjugate was assessed in normal and HER2+ BT474 tumor-bearing mice using tissue counting and imaging at different intervals after injection. Also, a woman with HER2-positive metastatic breast cancer under treatment with Herceptin underwent both [<sup>89</sup>Zr]Zr-Trastuzumab and, [<sup>18</sup>F]FDG PET/CTs.</p><p><strong>Results: </strong><sup>89</sup>Zr was produced with high radionuclidic and radiochemical purities (>99%) and [<sup>89</sup>Zr]Zr-DFO-Trastuzumab was prepared with radiochemical purity of >98% and specific activity of 9.85 GBq/µmol. The radioimmunoconjugate was stable both in PBS buffer and in human serum for at least 48 h. The radioimmunoactivity assay demonstrated about 70% of [<sup>89</sup>Zr]Zr-DFO-Trastuzumab is bound to the BT474 cells at the number of 250×10<sup>6</sup> cells. Cell binding studies showed that about 28% of radioimmunoconjugate is attached to BT474 cells after 90 min. Internalization studies showed that 50% of [<sup>89</sup>Zr]Zr-Trastuzumab is internalized to BT474 cells only in 6 h. The biodistribution study of the labeled compound in normal mice demonstrated the same pattern of the monoclonal antibodies which is entirely different from the biodistribution of free <sup>89</sup>Zr. Biodistribution and imaging studies in tumor-bearing mice showed the significant uptake values of [<sup>89</sup>Zr]Zr-Trastuzumab in tumor sites. [<sup>89</sup>Zr]Zr-Trastuzumab PET/CT revealed metastatic lesions documented previously with [<sup>18</sup>F]FDG PET/CT scan in a woman with breast cancer who was under treatment with Herceptin. Although the [<sup>18</sup>F]FDG PET/CT scan had better quality images, the valuable and unique advantage of [<sup>89</sup>Zr]Zr-Trastuzumab PET/CT is delineating HER2+ metastasis, which is essential in diagnosis and HER2-based treatments.</p><p><strong>Conclusion: </strong>The prepared [<sup>89</sup>Zr]Zr-Trastuzumab has a high potential radio-pharmaceutical for immune-PET imaging of the patients with HER2+ tumors.</p>","PeriodicalId":8503,"journal":{"name":"Asia Oceania Journal of Nuclear Medicine and Biology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10261689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10029346","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}
Pub Date : 2023-01-01DOI: 10.22038/AOJNMB.2022.69339.1483
Seyed Rasoul Zakavi
No Abstract is available.
没有摘要可用。
{"title":"AOJNMB enters the Second Decade of Publication.","authors":"Seyed Rasoul Zakavi","doi":"10.22038/AOJNMB.2022.69339.1483","DOIUrl":"https://doi.org/10.22038/AOJNMB.2022.69339.1483","url":null,"abstract":"<p><p>No Abstract is available.</p>","PeriodicalId":8503,"journal":{"name":"Asia Oceania Journal of Nuclear Medicine and Biology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9803620/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10488486","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}