Nuklearmedizin in Deutschland

1989 ◽  
Vol 28 (01) ◽  
pp. 1-10
Author(s):  
C. Winkler
Keyword(s):  
Nuclear Medicine ◽  
Thyroid Cancer ◽  
Clinical Practice ◽  
Radioiodine Therapy ◽  
State Of The Art ◽  
The State ◽  
Stepping Stones ◽  
Scintigraphic Imaging ◽  
Basic Principles

The development of nuclear medicine in Germany from early approaches with 32P and 1311 to the first radioiodine therapy of thyroid cancer up to the clarification of basic principles for current thyroid diagnostics and for functional scintigraphic imaging are presented. Selected references are used in portraying scientific stepping stones of our speciality as well as its establishment in clinical practice during the first two decades. Researchers, places, and facts are specified and interpreted in their relation to the state-of-the-art of nuclear medicine.

scholarly journals Personalized management of differentiated thyroid cancer in real life – practical guidance from a multidisciplinary panel of experts

Endocrine ◽  
2020 ◽  
Vol 70 (2) ◽  
pp. 280-291
Author(s):  
Alfredo Campennì ◽  
Daniele Barbaro ◽  
Marco Guzzo ◽  
Francesca Capoccetti ◽  
Luca Giovanella
Keyword(s):  
Nuclear Medicine ◽  
Thyroid Cancer ◽  
Clinical Practice ◽  
Molecular Imaging ◽  
Routine Clinical Practice ◽  
Whole Body ◽  
Neck Ultrasound ◽  
Long Term Follow Up

Abstract Purpose The standard of care for differentiated thyroid carcinoma (DTC) includes surgery, risk-adapted postoperative radioiodine therapy (RaIT), individualized thyroid hormone therapy, and follow-up for detection of patients with persistent or recurrent disease. In 2019, the nine Martinique Principles for managing thyroid cancer were developed by the American Thyroid Association, European Association of Nuclear Medicine, Society of Nuclear Medicine and Molecular Imaging, and European Thyroid Association. In this review, we present our clinical practice recommendations with regard to implementing these principles in the diagnosis, treatment, and long-term follow-up of patients with DTC. Methods A multidisciplinary panel of five thyroid cancer experts addressed the implementation of the Martinique Principles in routine clinical practice based on clinical experience and evidence from the literature. Results We provide a suggested approach for the assessment and diagnosis of DTC in routine clinical practice, including the use of neck ultrasound, measurement of serum thyroid-stimulating hormone and calcitonin, fine-needle aspiration, cytology, and molecular imaging. Recommendations for the use of surgery (lobectomy vs. total thyroidectomy) and postoperative RaIT are also provided. Long-term follow-up with neck ultrasound and measurement of serum anti-thyroglobulin antibody and basal/stimulated thyroglobulin is standard, with 123/131I radioiodine diagnostic whole-body scans and 18F-fluoro-2-deoxyglucose positron emission tomography/computed tomography suggested in selected patients. Management of metastatic DTC should involve a multidisciplinary team. Conclusions In routine clinical practice, the Martinique Principles should be implemented in order to optimize clinical management/outcomes of patients with DTC.

Nuclear medical inpatient treatment in Germany

2010 ◽  
Vol 49 (02) ◽  
pp. 49-57 ◽  
Author(s):  
M. Dietlein ◽  
C. Reiners ◽  
R. Lorenz
Keyword(s):  
Nuclear Medicine ◽  
Thyroid Cancer ◽  
Inpatient Treatment ◽  
Radioiodine Therapy ◽  
Main Diagnosis ◽  
Medical Inpatient ◽  
Iodine Prophylaxis ◽  
Iodine Supply ◽  
Quality Report ◽  
Quality Reports

SummaryAll public licensed hospitals of Germany are obligated since 2004 to establish and to publish a structured biennial quality report. The aim of this study was to analyse the quality reports from 2008 of clinics with nuclear-medicine therapy ward and to investigate developments for the inpatient nuclear-medicine therapy by comparing the results with the quality reports of the years 2004 and 2006. Methods: All available structured quality reports of clinics with a nuclear-medicine therapy ward of the years 2004, 2006 and 2008 were evaluated. Results: The total number of inpatient treatment cases in 2008 amounted to 54 190 (2006: 54 884; 2004: 57 366). This corresponds to a decrease of 5.5% in comparison to 2004. The number of the therapy wards decreased at the same time to currently 117 (2006: 120; 2004: 124). Remarkable changes were found in the spectrum of the main diagnosis. Thus, the most frequent diagnosis with the ICD-code E05 (hyperthyroidism) decreased continuously from 37 747 treatments in 2004 and 34 764 in 2006 to 31 756 in the year 2008. In contrast, the ICD-diagnoses for thyroid cancer (C73, Z08) with 14 761 cases in 2008 increased with time (2006: 13 426; 2004: 12 581). Conclusions: In analogy to the observations from Europe after introduction of an iodine prophylaxis the improved iodine supply in Germany has led to a decline of the radioiodine therapy due to hyperthyroidism.

Procedure guidelines for radioiodine therapy of differentiated thyroid cancer (version 2)

2004 ◽  
Vol 43 (04) ◽  
pp. 115-120 ◽  
Author(s):  
J. Dressler ◽  
J. Farahati ◽  
F. Grünwald ◽  
B. Leisner ◽  
E. Moser ◽  
...  
Keyword(s):  
Nuclear Medicine ◽  
Thyroid Cancer ◽  
Differentiated Thyroid Cancer ◽  
Radioiodine Therapy ◽  
Tnm Classification ◽  
Whole Body ◽  
Procedure Guidelines ◽  
Special Cases ◽  
Deutsche Gesellschaft Für Chirurgie ◽  
Thyroglobulin Concentration

SummaryThe procedure guidelines for radioiodine therapy (RIT) of differentiated thyroid cancer (version 2) are the counterpart to the procedure guidelines for 131I whole-body scintigraphy (version 2) and specify the interdisciplinary guidelines for thyroid cancer of the Deutsche Krebs-gesellschaft and the Deutsche Gesellschaft für Chirurgie concerning the nuclear medicine part. Compared with version 1 facultative options for RIT can be chosen in special cases: ablative RIT for papillary microcarcinoma ≤1 cm, ablative RIT for mixed forms of anaplastic and differentiated thyroid cancer, and RIT in patients with a measurable or increasing thyroglobulin concentration but without detectable metastases by imaging. The description of the pretherapeutic dosimetry now includes the isotopes 123I and 124I as well as a broader range of the activity of 131I. Activities of 2-5 GBq 131I are recommended for the first ablative RIT. If high accumulative activities of 131I are expected, men who have not yet finished their family planning should be advised to the option of sperm cryoconservation. An interdisciplinary consensus is necessary whether the new TNM-classification (UICC, 6th edition, 2002) will lead to modified recommendations for surgical or nuclear medicine therapy, especially for the surgical completeness and for the ablative RIT of pT1 papillary cancer.

scholarly journals Promising treatments for neuropathic pain

2014 ◽  
Vol 72 (11) ◽  
pp. 881-888 ◽  
Author(s):  
Pedro Schestatsky ◽  
Liliane Vidor ◽  
Pablo Brea Winckler ◽  
Tatiane Gomes de Araújo ◽  
Wolnei Caumo
Keyword(s):  
Neuropathic Pain ◽  
Clinical Practice ◽  
Clinical Evidence ◽  
State Of The Art ◽  
The State ◽  
Daily Clinical Practice ◽  
Present Review ◽  
Treatment Modalities

In the last few years the understanding of mechanisms and, consequently, the diagnosis of neuropathic pain (NP) has becoming progressively clearer in clinical practice. However, the treatment of such condition remains challenging so far. One of the reasons for such difficulty is the diversity of mechanisms involved in NP generation and its persistency. In the present review we discuss several treatment modalities for NP that are scantily applied in daily clinical practice. For that, we collected positive clinical evidence of unusual and SECS (Safe, Easy, Cheap, and Sensible) approaches for NP. The aim of this review is not to establish the “state of the art” or rigid guidelines for NP treatment. In a different way, we only want bring new possibilities of treatment to the readers and also to motivate investigators to confirm those positive preliminary but promising results for NP reliev.

scholarly journals Moving beyond the concept of altered state of consciousness: the Non-Ordinary Mental Expressions (NOMEs)

2021 ◽  
Vol 8 (3) ◽  
pp. 615-631
Author(s):  
Enrico Facco ◽  
Fabio Fracas ◽  
Patrizio Tressoldi
Keyword(s):  
Clinical Practice ◽  
State Of The Art ◽  
The State ◽  
Altered States Of Consciousness ◽  
Altered States ◽  
Altered State ◽  
New Classification ◽  
States Of Consciousness ◽  
Altered State Of Consciousness

Aim of this paper is to review the state of the art of so-called altered states of consciousness, anomalous experiences, and exceptional human experiences, showing the need for reappraising the whole topic and gather them under one roof. The term Non-Ordinary Mental Expressions (NOMEs) and a new classification of non-pathological ostensibly odd phenomena is introduced, emphasizing their epistemological, transcultural and interdisciplinary implications with their huge  implications in medical and psychotherapeutical clinical practice. 

scholarly journals Theranostics in Nuclear Medicine Practice

2017 ◽  
Author(s):  
Anna Yordanova ◽  
Elisabeth Eppard ◽  
Stefan Kürpig ◽  
Stefan Schönberger ◽  
Maria Gonzalez-Carmona ◽  
...  
Keyword(s):  
Nuclear Medicine ◽  
Thyroid Cancer ◽  
Personalized Medicine ◽  
Targeted Therapies ◽  
Radioiodine Therapy ◽  
Diagnostic Techniques ◽  
Molecular Targeting ◽  
Theranostic Agents ◽  
Nuclear Medicine Practice ◽  
Diagnostics And Therapy

The importance of personalized medicine is growing, since there is an urged need to avoid unnecessary and expensive treatments. In nuclear medicine, the theranostic approach is an established tool for a specific molecular targeting in means of diagnostics and therapy. The visualisation of potential targets can help to predict if a patient would benefit from a particular treatment or not. Thanks to the quick development of radiopharmaceuticals and diagnostic techniques, the use of theranostic agents is constantly rising. In this article important milestones of nuclear therapies and diagnostics in the context of theranostics are highlighted. It begins with the well-known radioiodine therapy in patients with thyroid cancer and then guides through different approaches for the treatment of advanced cancer with targeted therapies. The aim of this review is to provide a summary of background knowledge, current applications and advantages of targeted therapies and imaging in nuclear medicine practice.

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