| 61. |
- Bozkurt, Murat Fani, et al.
(författare)
-
Guideline for PET/CT imaging of neuroendocrine neoplasms with Ga-68-DOTA-conjugated somatostatin receptor targeting peptides and F-18-DOPA
- 2017
-
Ingår i: European Journal of Nuclear Medicine and Molecular Imaging. - : SPRINGER. - 1619-7070 .- 1619-7089. ; 44:9, s. 1588-1601
-
Tidskriftsartikel (refereegranskat)abstract
- Purpose & Methods Neuroendocrine neoplasms are a heterogenous group of tumours, for which nuclear medicine plays an important role in the diagnostic work-up as well as in the targeted therapeutic options. This guideline is aimed to assist nuclear medicine physicians in recommending, performing, reporting and interpreting the results of somatostatin receptor (SSTR) PET/CT imaging using Ga-68-DOTA-conjugated peptides, as well as F-18-DOPA imaging for various neuroendocrine neoplasms. Results & Conclusion The previous procedural guideline by EANM regarding the use PET/CT tumour imaging with Ga-68-conjugated peptides has been revised and updated with the relevant and recent literature in the field with contribution of distinguished experts.
|
|
| 62. |
|
|
| 63. |
- Brans, B., et al.
(författare)
-
Clinical radionuclide therapy dosimetry: the quest for the "Holy Gray"
- 2007
-
Ingår i: European Journal of Nuclear Medicine and Molecular Imaging. - : Springer Science and Business Media LLC. - 1619-7070 .- 1619-7089. ; 34:5, s. 772-786
-
Forskningsöversikt (refereegranskat)abstract
- Introduction Radionuclide therapy has distinct similarities to, but also profound differences from external radiotherapy. Review This review discusses techniques and results of previously developed dosimetry methods in thyroid carcinoma, neuro-endocrine tumours, solid tumours and lymphoma. In each case, emphasis is placed on the level of evidence and practical applicability. Although dosimetry has been of enormous value in the preclinical phase of radiopharmaceutical development, its clinical use to optimise administered activity on an individual patient basis has been less evident. In phase I and II trials, dosimetry may be considered an inherent part of therapy to establish the maximum tolerated dose and dose-response relationship. To prove that dosimetry-based radionuclide therapy is of additional benefit over fixed dosing or dosing per kilogram body weight, prospective randomised phase III trials with appropriate end points have to be undertaken. Data in the literature which underscore the potential of dosimetry to avoid under- and overdosing and to standardise radionuclide therapy methods internationally are very scarce. Developments In each section, particular developments and insights into these therapies are related to opportunities for dosimetry. The recent developments in PET and PET/CT imaging, including micro-devices for animal research, and molecular medicine provide major challenges for innovative therapy and dosimetry techniques. Furthermore, the increasing scientific interest in the radiobiological features specific to radionuclide therapy will advance our ability to administer this treatment modality optimally.
|
|
| 64. |
|
|
| 65. |
- Bucci, Marco, et al.
(författare)
-
A multisite analysis of the concordance between visual image interpretation and quantitative analysis of [18F]flutemetamol amyloid PET images
- 2021
-
Ingår i: European Journal of Nuclear Medicine and Molecular Imaging. - : Springer Science and Business Media LLC. - 1619-7070 .- 1619-7089. ; 48:7, s. 2183-2199
-
Tidskriftsartikel (refereegranskat)abstract
- Background: [18F]flutemetamol PET scanning provides information on brain amyloid load and has been approved for routine clinical use based upon visual interpretation as either negative (equating to none or sparse amyloid plaques) or amyloid positive (equating to moderate or frequent plaques). Quantitation is however fundamental to the practice of nuclear medicine and hence can be used to supplement amyloid reading methodology especially in unclear cases. Methods: A total of 2770 [18F]flutemetamol images were collected from 3 clinical studies and 6 research cohorts with available visual reading of [18F]flutemetamol and quantitative analysis of images. These were assessed further to examine both the discordance and concordance between visual and quantitative imaging primarily using thresholds robustly established using pathology as the standard of truth. Scans covered a wide range of cases (i.e. from cognitively unimpaired subjects to patients attending the memory clinics). Methods of quantifying amyloid ranged from using CE/510K cleared marked software (e.g. CortexID, Brass), to other research-based methods (e.g. PMOD, CapAIBL). Additionally, the clinical follow-up of two types of discordance between visual and quantitation (V+Q- and V-Q+) was examined with competing risk regression analysis to assess possible differences in prediction for progression to Alzheimer’s disease (AD) and other diagnoses (OD). Results: Weighted mean concordance between visual and quantitation using the autopsy-derived threshold was 94% using pons as the reference region. Concordance from a sensitivity analysis which assessed the maximum agreement for each cohort using a range of cut-off values was also estimated at approximately 96% (weighted mean). Agreement was generally higher in clinical cases compared to research cases. V-Q+ discordant cases were 11% more likely to progress to AD than V+Q- for the SUVr with pons as reference region. Conclusions: Quantitation of amyloid PET shows a high agreement vs binary visual reading and also allows for a continuous measure that, in conjunction with possible discordant analysis, could be used in the future to identify possible earlier pathological deposition as well as monitor disease progression and treatment effectiveness.
|
|
| 66. |
|
|
| 67. |
|
|
| 68. |
- Busslinger, Sarah D., et al.
(författare)
-
Comparison of the tolerability of 161Tb- and 177Lu-labeled somatostatin analogues in the preclinical setting
- 2024
-
Ingår i: EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING. - 1619-7070 .- 1619-7089.
-
Tidskriftsartikel (refereegranskat)abstract
- Purpose [Lu-177]Lu-DOTATATE is an established somatostatin receptor (SSTR) agonist for the treatment of metastasized neuroendocrine neoplasms, while the SSTR antagonist [Lu-177]Lu-DOTA-LM3 has only scarcely been employed in clinics. Impressive preclinical data obtained with [Tb-161]Tb-DOTA-LM3 in tumor-bearing mice indicated the potential of terbium-161 as an alternative to lutetium-177. The aim of the present study was to compare the tolerability of Tb-161- and Lu-177-based DOTA-LM3 and DOTATATE in immunocompetent mice. Methods Dosimetry calculations were performed based on biodistribution data of the radiopeptides in immunocompetent mice. Treatment-related effects on blood cell counts were assessed on Days 10, 28 and 56 after application of [Tb-161]Tb-DOTA-LM3 or [Tb-161]Tb-DOTATATE at 20 MBq per mouse. These radiopeptides were also applied at 100 MBq per mouse and the effects compared to those observed after application of the Lu-177-labeled counterparts. Bone marrow smears, blood plasma parameters and organ histology were assessed at the end of the study. Results The absorbed organ dose was commonly higher for the SSTR antagonist than for the SSTR agonist and for terbium-161 over lutetium-177. Application of a therapeutic activity level of 20 MBq [Tb-161]Tb-DOTA-LM3 or [Tb-161]Tb-DOTATATE was well tolerated without major hematological changes. The injection of 100 MBq of the Tb-161- and Lu-177-based somatostatin analogues affected the blood cell counts, however. The lymphocytes were 40-50% lower in treated mice compared to the untreated controls on Day 10 irrespective of the radionuclide employed. At the same timepoint, thrombocyte and erythrocyte counts were 30-50% and 6-12% lower, respectively, after administration of the SSTR antagonist (p < 0.05) while changes were less pronounced in mice injected with the SSTR agonist. All blood cell counts were in the normal range on Day 56. Histological analyses revealed minimal abnormalities in the kidneys, liver and spleen of treated mice. No correlation was observed between the organ dose and frequency of the occurrence of abnormalities. Conclusion Hematologic changes were more pronounced in mice treated with the SSTR antagonist than in those treated with the SSTR agonist. Despite the increased absorbed dose delivered by terbium-161 over lutetium-177, [Tb-161]Tb-DOTA-LM3 and [Tb-161]Tb-DOTATATE should be safe at activity levels that are recommended for their respective Lu-177-based analogues.
|
|
| 69. |
- Bäck, Anna, 1976-, et al.
(författare)
-
Diuretic decision seven minutes post Tc-99m-MAG3 administration in a renography
- 2018
-
Ingår i: European Journal of Nuclear Medicine and Molecular Imaging. - : Springer. - 1619-7070 .- 1619-7089. ; 45:Suppl. 1, s. S765-S765
-
Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Aim: The F+10 method in supine position, which has been implemented at our Nuclear Medicine department since 2015, involves a 30- minute long dynamic acquisition. The diuretic is only administered when necessary and decision is taken by the radiographers in a semi-automated fashion without consulting a physician, by calculating the remaining activity in the kidneys seven minutes post 99mTc-MAG3 injection and comparing the value with an arbitrary threshold of 75 %. If needed, the diuretic is injected three minutes later. The aim of this study was to correlate our method with the established previously used F+20 protocol in adults. Is the currently used threshold of 75% of activity left in any kidney at seven minutes the optimal cut-off value for diuretic administration?Material and Methods: This is an ongoing retrospective study which include 320 F+20 examinations of adult patients performed during 2013-2015. They were all re-evaluated according to the currently used F+10 method, categorized as requiring diuretic or not and correlated to the original F+20 examination. A ROC-curve was drawn to delineate the best cut-off value for remaining renal activity. Sensitivity, specificity and accuracy were calculated.Results: Preliminary results indicate that the F+10 re-evaluations with the currently used cut-off value of 75% did not correlate with the original F+20 examinations. In 80% (255 examinations) of the F+10 re-evaluations diuretic would have been considered necessary while only 52% (167 examinations) received diuretics in the original F+20 renographies (sensitivity 1.0, specificity 0.42). However, all the patients who required furosemide in the original F+20 renographies would have received diuretic if they had been imaged with the F+10 protocol. Furthermore, examination time is considerably reduced. After an evaluation of the ROC-curve the optimal cut-off value was 94% (sensitivity 0.92, specificity 0.84, accuracy 0.88). However, by implementing this value, 13 patients (4%) would have been falsely categorized as not requiring diuretic.Conclusions: The 99mTc-MAG3 renography with the F+10 protocol in supine position is a feasible and acceptable method in clinical practice.
|
|
| 70. |
|
|
