scholarly journals Paediatric nuclear medicine practice: an international survey by the IAEA

2019 ◽  
Vol 47 (6) ◽  
pp. 1552-1563 ◽  
Author(s):  
G. L. Poli ◽  
L. Torres ◽  
M. Coca ◽  
M. Veselinovic ◽  
M. Lassmann ◽  
...  
Keyword(s):  
Nuclear Medicine ◽  
Latin America ◽  
Fdg Pet ◽  
Single Photon ◽  
International Standards ◽  
Current Status ◽  
High Dose ◽  
Pet Ct ◽  
Nuclear Medicine Procedures ◽  
Fdg Pet Ct

Abstract Purpose The International Atomic Energy Agency (IAEA) decided to initiate a survey to evaluate the current status of the practice of paediatric nuclear medicine worldwide, with the focus mainly on low and middle-income countries specifically in Latin America, Eastern Europe, Africa and Asia. This investigation sought to determine if the practice in paediatric nuclear medicine in these countries differed from that indicated by the survey of the Nuclear Medicine Global Initiative (NMGI) and if nuclear medicine practitioners were following established paediatric nuclear medicine guidelines. Methods A total of 133 institutes took part in the survey from 62 different IAEA member states within Africa (29), Asia (39), Europe (29) and Latin America (36). The four most frequent conventional (single-photon) nuclear medicine procedures were 99mTc labelled MDP, DSMA, MAG3 and pertechnetate thyroid scans. In addition, 46 centres provided data on FDG PET/CT, including exposure data for the CT component. Nearly half of the sites (48%) perform less than 200 paediatric nuclear medicine studies per year, while 11% perform more than 1000 such studies per year. Results Administered activities largely exceeded the recommendations for most of the sites for DMSA, MAG3 and pertechnetate, while compliance with international standards was somehow better for MDP studies. For FDG PET, the results were more uniform than for conventional nuclear medicine procedures. However, the use of CT in PET/CT for paediatric nuclear medicine revealed a high variability and, in some cases, high, dose-length product (DLP) values. This observation indicates that further attention is warranted for optimizing clinical practice in FDG PET/CT. Conclusions Overall, in most parts of the world, efforts have been undertaken to comply either with the EANM dosage card or with the North American Consensus Guidelines. However, variability in the practice of paediatric nuclear medicine still exists. The results of this survey provide valuable recommendations for a path towards global standardization of determining the amount of activity to be administered to children undergoing nuclear medicine procedures.

scholarly journals Impact of [18F]FDG-PET and [18F]FLT-PET-Parameters in Patients with Suspected Relapse of Irradiated Lung Cancer

Diagnostics ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 279
Author(s):  
Tine N. Christensen ◽  
Seppo W. Langer ◽  
Gitte Persson ◽  
Klaus Richter Larsen ◽  
Annemarie G. Amtoft ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Overall Survival ◽  
Fdg Pet ◽  
Tumor Volume ◽  
High Dose ◽  
Flt Pet ◽  
Pet Ct ◽  
Radiation Induced ◽  
Fdg Pet Ct ◽  
Induced Changes

Radiation-induced changes may cause a non-malignant high 2-deoxy-2-[18F]fluoro-d-glucose (FDG)-uptake. The 3′-deoxy-3′-[18F]fluorothymidine (FLT)-PET/CT performs better in the differential diagnosis of inflammatory changes and lung lesions with a higher specificity than FDG-PET/CT. We investigated the association between post-radiotherapy FDG-PET-parameters, FLT-PET-parameters, and outcome. Sixty-one patients suspected for having a relapse after definitive radiotherapy for lung cancer were included. All the patients had FDG-PET/CT and FLT-PET/CT. FDG-PET- and FLT-PET-parameters were collected from within the irradiated high-dose volume (HDV) and from recurrent pulmonary lesions. For associations between PET-parameters and relapse status, respectively, the overall survival was analyzed. Thirty patients had a relapse, of these, 16 patients had a relapse within the HDV. FDG-SUVmax and FLT-SUVmax were higher in relapsed HDVs compared with non-relapsed HDVs (median FDG-SUVmax: 12.8 vs. 4.2; p < 0.001; median FLT-SUVmax 3.9 vs. 2.2; p < 0.001). A relapse within HDV had higher FDG-SUVpeak (median FDG-SUVpeak: 7.1 vs. 3.5; p = 0.014) and was larger (median metabolic tumor volume (MTV50%): 2.5 vs. 0.7; 0.014) than the relapsed lesions outside of HDV. The proliferative tumor volume (PTV50%) was prognostic for the overall survival (hazard ratio: 1.07 pr cm3 [1.01–1.13]; p = 0.014) in the univariate analysis, but not in the multivariate analysis. FDG-SUVmax and FLT-SUVmax may be helpful tools for differentiating the relapse from radiation-induced changes, however, they should not be used definitively for relapse detection.

Current status of FDG-PET/CT in staging of adult lymphoma

2015 ◽  
Vol 3 (4) ◽  
pp. 253-269 ◽  
Author(s):  
Alberto Biggi ◽  
Luca Guerra ◽  
Michael S. Hofman
Keyword(s):  
Fdg Pet ◽  
Current Status ◽  
Pet Ct ◽  
Fdg Pet Ct

scholarly journals Adipose-Derived Mesenchymal Stromal Cells Improve the Healing of Colonic Anastomoses Following High Dose of Irradiation Through Anti-Inflammatory and Angiogenic Processes

2017 ◽  
Vol 26 (12) ◽  
pp. 1919-1930 ◽  
Author(s):  
Dirk Van de putte ◽  
Christelle Demarquay ◽  
Elke Van Daele ◽  
Lara Moussa ◽  
Christian Vanhove ◽  
...  
Keyword(s):  
Side Effects ◽  
Mesenchymal Stromal Cells ◽  
Stromal Cells ◽  
Fdg Pet ◽  
Inflammatory Process ◽  
Colonic Anastomosis ◽  
Vascular Density ◽  
High Dose ◽  
Pet Ct ◽  
Fdg Pet Ct

Cancer patients treated with radiotherapy (RT) could develop severe late side effects that affect their quality of life. Long-term bowel complications after RT are mainly characterized by a transmural fibrosis that could lead to intestinal obstruction. Today, surgical resection is the only effective treatment. However, preoperative RT increases the risk of anastomotic leakage. In this study, we attempted to use mesenchymal stromal cells from adipose tissue (Ad-MSCs) to improve colonic anastomosis after high-dose irradiation. MSCs were isolated from the subcutaneous fat of rats, amplified in vitro, and characterized by flow cytometry. An animal model of late radiation side effects was induced by local irradiation of the colon. Colonic anastomosis was performed 4 wk after irradiation. It was analyzed another 4 wk later (i.e., 8 wk after irradiation). The Ad-MSC-treated group received injections several times before and after the surgical procedure. The therapeutic benefit of the Ad-MSC treatment was determined by colonoscopy and histology. The inflammatory process was investigated using Fluorine-182-Fluoro-2-Deoxy-d-Glucose Positron Emission Tomography and Computed Tomography (18F-FDG-PET/CT) imaging and macrophage infiltrate analyses. Vascular density was assessed using immunohistochemistry. Results show that Ad-MSC treatment reduces ulcer size, increases mucosal vascular density, and limits hemorrhage. We also determined that 1 Ad-MSC injection limits the inflammatory process, as evaluated through 18F-FDG-PET-CT (at 4 wk), with a greater proportion of type 2 macrophages after iterative cell injections (8 wk). In conclusion, Ad-MSC injections promote anastomotic healing in an irradiated colon through enhanced vessel formation and reduced inflammation. This study also determined parameters that could be improved in further investigations.

Interim Restaging FDG-PET/CT to Guide Use of High Dose Sequential Induction Therapy with Rituximab-Dose-Intensive Cyclophosphamide, Etoposide, Cisplatin (RDICEP) and Rituximab-Carmustine, Etoposide, Cytarabine, Melphalan (RBEAM) and Autologous Stem Cell Transplantation (ASCT) for Poor Prognosis Diffuse Large B-Cell Lymphoma (DLBCL). ClinicalTrials. Gov Identifier: NCT00530179.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 3414-3414
Author(s):  
Douglas A. Stewart ◽  
Peter Duggan ◽  
Nizar J Bahlis ◽  
Andrew Daly ◽  
Michelle Geddes ◽  
...  
Keyword(s):  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Fdg Pet ◽  
Research Funding ◽  
Poor Prognosis ◽  
Elevated Serum ◽  
High Dose ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
Pet Scans

Abstract Abstract 3414 Poster Board III-302 Purpose Approximately 50-55% of patients (pts) with stage 3-4 DLBCL and elevated serum LDH achieve long-term event-free survival (EFS) following R-CHOP chemotherapy. A prospective, multicentre, phase II clinical trial was designed to evaluate the use of high dose sequential therapy with RDICEP then RBEAM/ASCT for such pts who have positive interim restaging FDG-PET/CT scans after 2 cycles of RCHOP. Patients and Methods Pts were eligible if they were HIV-, 18-65 years of age, and had stage 3-4 DLBCL with elevated serum LDH. An FDG-PET/CT scan was performed 10-15 days following the second cycle of R-CHOP. Pts with negative interim restaging PET scans completed 4 further cycles of RCHOP, whereas pts with positive PET scans (more than 1 site with uptake more intense than background liver) received one cycle of RDICEP (Rituximab 375mg/m2 day 1 and 8, C 1.75g/m2 d2-4, E 350mg/m2 d2-4 P 35mg/m2 d2-4, G-CSF d15-21 and autologous blood stem cell collection by apheresis d21or 22) followed by one cycle of RBEAM/ASCT (Rituximab 375mg/m2 day -6 and +14, BCNU 300mg/m2 d-6, E 200mg/m2 d-5to-2, A 400mg/m2 d-5to-2, M 140mg/m2 d-1). Results Of the 36 pts who have been accrued from 5/2007-7/2009, 33 pts have undergone interim PET/CT restaging following 2 cycles RCHOP. All 33 pts had IPI scores 3-5, the median age was 55 years (range19-65) with 7 pts (21%) older than 60 years, 20 (61%) had ECOG status 2-4, 28 (85%) had stage 4, 22 (67%) >1 extranodal site. At a median follow-up of 12mo, the 1 year OS and EFS rates for all 33 pts are 82% (95%CI = 66-98%) and 76% (95%CI = 58-83%), respectively. Interim restaging PET/CT was positive for 16 pts and negative for 17 pts. The EFS rates for PET+ and PET- pts are 78% (95%CI = 57-100%) and 66% (95%CI = 36-99%), respectively (logrank p=0.97). To date, 4 pts have died, 3 from lymphoma at 6, 10, 11 months post-RCHOP1, and 1 from sepsis and necrotic bowel on day 5 post-ASCT. Conclusions Preliminary results of this phase II study are encouraging, and suggest that high dose induction therapy with RDICEP and RBEAM/ASCT might improve EFS for poor prognosis DLBCL with positive interim restaging PET/CT. Accrual will continue to target ≥ 35 PET+ and ≥35 PET- pts. Disclosures Stewart: Hoffmann La Roche: Advisory Board, Honoraria, Research Funding. Off Label Use: Rituximab with High Dose Chemotherapy and Autologous Stem Cell Transplantation for DLBCL. Bence-Bruckler:Hoffmann La Roche: Honoraria, Research Funding.

Peripheral Nerve Involvement (Neurolymphomatosis) as a Manifestation of Intravascular Large B-Cell Lymphoma

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 4128-4128
Author(s):  
Takafumi Koyama ◽  
Kan-ichi Iwama ◽  
Masayuki Yamakura ◽  
Masami Takeuchi ◽  
Kosei Matsue
Keyword(s):  
Peripheral Nerve ◽  
Fdg Pet ◽  
B Cell Lymphoma ◽  
High Dose ◽  
Cns Involvement ◽  
Large B Cell Lymphoma ◽  
Nerve Involvement ◽  
Pet Ct ◽  
Peripheral Nerve Involvement ◽  
Fdg Pet Ct

Abstract Abstract 4128 Background; Intravascular large B-cell lymphoma (IVL) is characterised by proliferation of lymphoma cells only in the lumina of small vessels in various organs, a high incidence of neurological symptoms associated with central nervous system (CNS) involvement has been reported, but its association with peripheral nerve involvement (neurolymphomatosis, NL) has rarely described previously. We recently encountered 2 patients with IVL who relapsed as a NL shortly after the completion of chemotherapy. Because both NL and IVL is extremely rare clinical condition, its occurrence led us to explore the predilection of NL in patients with IVL. Method; We reviewed the medical records of patients with diagnosis of IVL over the past 4 years. Diagnosis of IVL was made by the definition of WHO classification of hematopoietic tumours. The diagnosis of NL required: 1) clinical symptoms and neurological findings related to the peripheral neuropathy of cranial or spinal nerves; and 2) histological confirmation of lymphoma cells within the peripheral nerve, nerve root/plexus, or cranial nerve; or 3) CT/MRI demonstration of nerve enhancement and/or enlargement of peripheral nerve(s) that were also demonstrated by accumulation of FDG by FDG-PET/CT. Results; We identified 5 patients of NL among 12 IVL patients. NL occurred as an initial manifestation in one patient and relapse disease in the remaining 4 patients. All 5 patients had neurologic symptoms corresponding to the NL of cranial and/or peripheral nerve. Comparison of clinical and laboratory features could not disclose the difference in IVL patients with or without NL in terms of presence or absence of haemophagocytosis, bone marrow infiltration, neurological symptoms, cytopenia, soluble interleukin 2 receptor level, and skin lesions. All of the 4 patients with NL as a relapse disease occurred during or shortly after R-CHOP chemotherapy. Brain MRI and whole-spine MRI with thin sliced coronal image could reveal the nerve infiltration by gadolinium enhancement and enlargement of nerve structure, it might not always sensitive enough for its detection because of patchy distribution and small lesion. In contrast, FDG-PET/CT successfully revealed the involved lesions as a linear or nodular FDG-uptake which was anatomically correlated with cranial nerves, nerve plexus, spinal nerve root, or peripheral nerves in all of the 5 cases. In addition FDG-PET/CT was useful for evaluating the therapeutic responses. Treatment with high-dose methotrexate with or without systemic chemotherapy appeared beneficial, however one of the 5 patient needed additional localized irradiation for relapse disease. Conclusion; Considering the extreme rarity of both IVL and NL, there may be a strong predilection of NL in patients with IVL. As IVL has a high frequency of CNS involvement, it may also have a high frequency of peripheral nerve involvement. Early recognition and familiarity of the disease and prompt institution of aggressive chemotherapy incorporating high-dose MTX with or without involved field radiation might be useful, although further studies are still warranted. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Nuclear medicine in SARS-CoV-2 pandemia: 18F-FDG-PET/CT to visualize COVID-19

2020 ◽  
Vol 59 (03) ◽  
pp. 276-280 ◽  
Author(s):  
Susanne Lütje ◽  
Milka Marinova ◽  
Daniel Kütting ◽  
Ulrike Attenberger ◽  
Markus Essler ◽  
...  
Keyword(s):  
Nuclear Medicine ◽  
Fdg Pet ◽  
Distress Syndrome ◽  
Clinical Presentation ◽  
Newly Diagnosed ◽  
Medical Specialties ◽  
Pet Ct ◽  
Current Outbreak ◽  
18F Fdg ◽  
Fdg Pet Ct

AbstractThe current outbreak of coronavirus SARS-CoV-2 has reached multiple countries worldwide. While the number of newly diagnosed cases and fatalities is rising quickly, far-reaching measures were enacted to prevent further spread. Diagnosis relies on clinical presentation, exposure history, PCR using specimens from the respiratory tract together with computed tomography (CT) imaging. One of the hallmarks of a critical course of COVID-19 is the development of severe acute respiratory distress syndrome (ARDS). As management of COVID-19 can be considered a multi-disciplinary approach involving various medical specialties, we here review the first 18F-FDG-PET/CT scans of COVID-19 to discuss how Nuclear Medicine could contribute to management of this disease.

Nuclear Medicine in Early-Stage Melanoma: Sentinel Node Biopsy—FDG-PET/CT

PET Clinics ◽  
2011 ◽  
Vol 6 (1) ◽  
pp. 9-25 ◽  
Author(s):  
Elif Hindié ◽  
Farid Sarandi ◽  
Soraya Banayan ◽  
David Groheux ◽  
Domenico Rubello ◽  
...  
Keyword(s):  
Nuclear Medicine ◽  
Sentinel Node ◽  
Sentinel Node Biopsy ◽  
Fdg Pet ◽  
Early Stage ◽  
Node Biopsy ◽  
Pet Ct ◽  
Fdg Pet Ct

scholarly journals Recommendations of the Spanish Societies of Radiation Oncology (SEOR), Nuclear Medicine & Molecular Imaging (SEMNiM), and Medical Physics (SEFM) on 18F-FDG PET-CT for radiotherapy treatment planning

2012 ◽  
Vol 17 (6) ◽  
pp. 298-318 ◽  
Author(s):  
Begoña Caballero Perea ◽  
Antonio Cabrera Villegas ◽  
José Miguel Delgado Rodríguez ◽  
María José García Velloso ◽  
Ana María García Vicente ◽  
...  
Keyword(s):  
Nuclear Medicine ◽  
Molecular Imaging ◽  
Radiation Oncology ◽  
Fdg Pet ◽  
Medical Physics ◽  
Radiotherapy Treatment Planning ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct ◽  
Radiotherapy Treatment

scholarly journals Bilateral Vertebral Artery Vasculitis—A Rare Manifestation of Giant Cell Arteritis and a Difficult Diagnosis Made Possible by 2-[18F]FDG PET/CT

Diagnostics ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 879
Author(s):  
Natasja Justesen ◽  
Michael Hansen ◽  
Mads Jensen ◽  
Oliver Klefter ◽  
Jane Brittain ◽  
...  
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Fdg Pet ◽  
Temporal Artery ◽  
High Dose ◽  
Temporal Artery Biopsy ◽  
Glucocorticoid Treatment ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

: Giant cell arteritis (GCA) is the most common form of large vessel vasculitis. GCA is a medical and ophthalmological emergency, and rapid diagnosis and treatment with high-dose corticosteroids is critical in order to reduce the risk of stroke and sudden irreversible loss of vision. GCA can be difficult to diagnose due to insidious and unspecific symptoms—especially if typical superficial extracranial arteries are not affected. In these cases, verification of clinical diagnosis using temporal artery biopsy is not possible. This example illustrates the diagnostic value of hybrid imaging with 2-deoxy-2-[18F]fluoro-D-glucose positron emission tomography/computed tomography (2-[18F]FDG PET/CT), and the limitations of the temporal artery biopsy in bilateral vertebral GCA, causing transient ischemic attack in the visual cortex. In addition it indicates that inflammation in the artery wall can be visualized on 2-[18F]FDG PET/CT despite long term and ongoing high dose glucocorticoid treatment.

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