| 1. |
- Brans, B, et al.
(författare)
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Clinical applications of newer radionuclide therapies
- 2006
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Ingår i: European Journal of Cancer. - : Elsevier BV. - 1879-0852 .- 0959-8049. ; 42:8, s. 994-1003
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Tidskriftsartikel (refereegranskat)abstract
- When radio-iodine was first used in the treatment of metastasized thyroid carcinoma in 1943, its success in terms of tumour response, quality of life improvement and survival was considered a 'miracle', as in those days metastatic cancer was generally fatal. Inspired by this, many efforts have been made to apply radioisotope therapy to other tumours. Radionuclide therapy uses radioactive isotopes labelled with specific targeting agents that aim to deliver the irradiation of the isotope to the tumour, while sparing normal tissues. Its unique modality allows to systemically target radiosensitive tumours throughout the body. Another important principle is its so-called 'cross-fire' action, whereby, owing to the larger reach of the radiation in relation to the cell diameter, a tumour cell receives lethal hits also from isotopes in the neighbourhood that are not directly associated with this cell. The treatment is therefore less hampered by inhomogeneous distribution and metabolism than for example chemo- or immunotherapy. The European Association of Nuclear Medicine has issued guidelines on so-called 'established' therapies (www.eanm.org), i.e. hyperthyroidism, thyroid carcinoma, refractory synovitis, bone metastases, mIBG therapy, (32)p therapy and Lipiodol therapy. Newer therapies include radio-peptide therapy, radio-immunotherapy of lymphoma and microsphere therapy for liver cancer. The aim of a recently held workshop at the ECCO13 conference 2005 and this review is to inform the oncology community about these new developing therapies. (c) 2006 Elsevier Ltd. All rights reserved.
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| 2. |
- Brans, B., et al.
(författare)
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Clinical radionuclide therapy dosimetry: the quest for the "Holy Gray"
- 2007
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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
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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.
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| 3. |
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| 4. |
- Dencker, Magnus, et al.
(författare)
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BMI and objectively measured body fat and body fat distribution in prepubertal children.
- 2007
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Ingår i: Clinical Physiology and Functional Imaging. - 1475-0961. ; 27:1, s. 12-16
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Tidskriftsartikel (refereegranskat)abstract
- Background Body Mass Index (BMI) is often used as a surrogate estimate of body fat in epidemiological studies. This study explores the association between BMI, body fat and body fat distribution assessed by Dual-Energy X-Ray Absorptiometry (DXA) in younger children. Methods Cross-sectional study of 246 children (138 boys and 108 girls) aged 8-11 years. DXA was used to quantify abdominal fat mass (AFM), total body fat (TBF) and also total body fat as percentage of total body mass (BF%). Body fat distribution was calculated as AFM/TBF. Results We found close correlations between BMI vs. TBF, BF% and AFM (r = 0.94, r = 0.92 and r = 0.93) for boys and (r = 0.95, r = 0.92 and r = 0.95) for girls, respectively (P < 0.05 for all r-values). However, significantly lower correlation (P < 0.001 for difference between the r-values) existed for body fat distribution (r = 0.64 for boys and 0.73 for girls). Conclusion Percentage body fat, TBF and AFM were all closely associated with BMI, suggesting that BMI serves as a good surrogate marker for obesity in population studies. However, a significantly lower correlation existed for BMI vs. body fat distribution, which may be a limitation when BMI is used to study cardiovascular risk factors in epidemiological studies.
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| 5. |
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| 6. |
- Dencker, Magnus, et al.
(författare)
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Body fat related to daily physical activity and insulin concentrations in non-diabetic children.
- 2008
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Ingår i: Clinical Physiology and Functional Imaging. - 1475-0961. ; 28, s. 211-215
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Tidskriftsartikel (refereegranskat)abstract
- This study explored the associations between body fat versus daily physical activity and insulin concentrations in non-diabetic young children in a cross-sectional study of 172 children (93 boys and 79 girls) aged 8-11 years. Blood samples were analysed for serum insulin and daily physical activity was measured by accelerometers. Time spent performing vigorous activity was estimated from accelerometer data by using established cut-off points. Dual-energy x-ray absorptiometry (DXA) was used to quantify abdominal fat mass (AFM) and total body fat (TBF), also calculated as percentage of body weight (BF%). Body fat distribution was calculated as AFM/TBF. Body fat distribution was independently linked to both insulin concentrations and physical activity. In contrast, TBF, AFM, and BF% were linked to physical activity only and not to insulin concentrations. In conclusion in this population of non-diabetic children, body fat distribution was independently associated with increased concentrations of insulin and deceased amount of vigorous activity per day. Also, AFM, TBF, and BF% were independently related to minutes of vigorous activity per day.
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| 7. |
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| 8. |
- Dencker, Magnus, et al.
(författare)
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Daily physical activity and its relation to aerobic fitness in children aged 8-11 years.
- 2006
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Ingår i: European Journal of Applied Physiology. - : Springer Science and Business Media LLC. - 1439-6327 .- 1439-6319. ; 96:5, s. 587-592
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Tidskriftsartikel (refereegranskat)abstract
- A positive relationship between daily physical activity and aerobic fitness exists in adults. Studies in children have given conflicting results, possibly because of differences in methods used to assess daily physical activity and fitness. No study regarding daily physical activity and fitness in children has been published, where fitness has been assessed by direct measurement of maximum oxygen uptake and related to daily physical activity intensities by accelerometers. We examined 248 children (140 boys and 108 girls), aged 7.9-11.1 years. Maximum workload and maximal oxygen uptake (VO2PEAK) by indirect calorimetry were measured during a maximum bicycle ergometer exercise test. Exercise capacity was adjusted for body mass and (body mass)(2/3). Daily physical activity was evaluated by accelerometers, worn around the waist for 4 days. Mean accelerometer counts and time spent in vigorous physical activity were calculated. VO2PEAK was correlated with mean accelerometer counts (r=0.23 for boys and r=0.23 for girls, both P < 0.05), but somewhat better with time spent in vigorous activity (r=0.32 for boys, r=0.30 for girls, both P < 0.05). All results remained virtually the same regardless of the method used to adjust for differences in body size.
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| 9. |
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| 10. |
- Dencker, Magnus, et al.
(författare)
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Daily physical activity related to aerobic fitness and body fat in an urban sample of children.
- 2008
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Ingår i: Scandinavian Journal of Medicine & Science in Sports. - : Wiley. - 1600-0838 .- 0905-7188. ; 18, s. 728-735
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Tidskriftsartikel (refereegranskat)abstract
- This study evaluates associations between objectively measured daily physical activity vs aerobic fitness and body fat in children aged 8-11 years. A cross-sectional study of 225 children aged 7.9-11.1 years was performed. Abdominal fat mass (AFM) and total body fat (TBF) were quantified by dual-energy x-ray absorptiometry. TBF was calculated as percentage of total body mass (BF%). Body fat distribution was calculated as AFM/TBF. Aerobic fitness was measured by indirect calorimetry during a maximal cycle ergometer exercise test. Daily physical activity was assessed by accelerometers for 4 days and daily accumulation of moderate-to-vigorous and vigorous activity was calculated. Significant relationships (P<0.05) existed for vigorous activity vs ln BF% (r=-0.40), ln AFM (r=-0.35), TBF/AFM (r=-0.22) and aerobic fitness (r=0.38), whereas moderate-to-vigorous activity displayed weaker relationships (-0.22, -0.18, -0.12 NS, and 0.25). Multiple regression analyses with inclusion of possible confounders concluded that vigorous activity was independently related to aerobic fitness and ln BF% or ln AFM. Moderate-to-vigorous activity was only independently related to aerobic fitness. In this population, low daily accumulation of vigorous activity was, already in children aged 8-11 years, associated with more body fat and lower aerobic fitness. A similar relation was not found for daily accumulation of moderate-to-vigorous activity.
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