Hellenic journal of nuclear medicine最新文献

{"title":"Will artificial intelligence be, one day, powerful enough to obviate the need of randomized clinical trials?","authors":"Spyros Retsas","doi":"10.1967/s002449912581","DOIUrl":"10.1967/s002449912581","url":null,"abstract":"<p><p>Artificial Intelligence (AI) currently occupies the headlines in the media as well as the medical press, with messages of its emerging unlimited potential, but also tales of doom and gloom predicting risks for the extinction of humanity! One such headline in the London TIMES of 6^th June 2023 reads: - \"Two years to save the world, says AI adviser\". To the uninformed, AI is nothing more than the processing of a colossal amount of data with lightning speed, now achievable with the latest spectacular developments in computing. However, could such power be harnessed to accurately predict the therapeutic potential of a new treatment emerging from Phase I, or Phase II trials, without the need to proceed to Phase III randomised, at times placebo controlled, trials? The deontological and ethical concerns about randomised trials have frequently occupied the medical literature as several clinical researchers feel uncomfortable with this kind of clinical research, especially when a placebo is allocated to patients with cancer, enlisted in a Phase III trial. Others have argued that in contrast to the belief that randomised controlled trials are more reliable estimators of the efficacy of a treatment, investigators have found that, in some settings, observational studies did not overestimate the size of the treatment effect compared with their randomised counterparts. An accurate prediction of the true potential of a novel treatment with AI, thus obviating the need of a phase III, randomised trial, could save time, effort, and finances, as well as relieve the ethical burden of allocating treatment at random to patients with cancer and limited life expectancy.</p>","PeriodicalId":12871,"journal":{"name":"Hellenic journal of nuclear medicine","volume":"26 2","pages":"160"},"PeriodicalIF":1.5,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10045775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spleen visualization in both TTR and AL amyloidosis during ^99mTc-DPD scintigraphy. Do we have to deal with a different than the myocardial uptake mechanism?","authors":"Maria Koutelou,&nbsp;Georgios Tziomalos,&nbsp;Vasileios Chatzoglou,&nbsp;Nikitas Pappas,&nbsp;Emmanouil Papanastasiou,&nbsp;Vasiliki Chatzipavlidou,&nbsp;Argyrios Doumas","doi":"10.1967/s002449912577","DOIUrl":"10.1967/s002449912577","url":null,"abstract":"<p><p>Technetium-99m- diphosphono-1,2-propanodicarboxylic acid (^99mTc-DPD) is currently used in Europe for the diagnosis of cardiac amyloidosis, being able to distinguish light chain (AL) from transthyretin (TTR) type. We are reporting obvious spleen visualization in two patients suffering the first from proven TTR and the second from AL type of cardiac amyloidosis, with myocardial uptake-as anticipated-only in the first one. We raise the hypothesis that a common uptake mechanism exists for the spleen amyloid regardless of the type of the disease (AL or TTR), and is possibly different than the cardiac uptake mechanism.</p>","PeriodicalId":12871,"journal":{"name":"Hellenic journal of nuclear medicine","volume":"26 2","pages":"140-144"},"PeriodicalIF":1.5,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10047749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Carcinoid syndrome-Symptoms and therapeutic approaches.","authors":"Alexandra Chrisoulidou","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The carcinoid syndrome (CS) is a constellation of symptoms attributed to hypersecretion of amines, prostaglandins and polypeptides. The cardinal symptoms of CS are flushing, diarrhea and bronchospasm; however, CS may present with various symptoms and signs, as: Skin: cutaneous flushes, cyanosis, pellagra, Gastrointestinal: diarrhea, nausea, abdominal cramps, vomiting, Heart: tricuspid and pulmonic valve thickening causing right heart failure, edema, Respiratory: wheezing, dyspnea.</p>","PeriodicalId":12871,"journal":{"name":"Hellenic journal of nuclear medicine","volume":"26 Suppl ","pages":"52-56"},"PeriodicalIF":1.5,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10135767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiopharmaceuticals used for diagnosis and therapy of NETs.","authors":"Maria Papachristou","doi":"","DOIUrl":"","url":null,"abstract":"&lt;p&gt;&lt;p&gt;The first description of the in vivo visualization of somatostatin receptor-positive tumors in patients was based on the use of a radioiodine (&lt;sup&gt;123&lt;/sup&gt;I) labelled somatostatin analogue (Krenning et al. 1989). In the years that followed an Indium-111 (&lt;sup&gt;111&lt;/sup&gt;In) labelled somatostatin analogue, chelated with diethylenetriaminepentaacetic acid (DTPA), was successfully developed. Subsequently, &lt;sup&gt;111&lt;/sup&gt;In-OctreoScan was introduced worldwide. In the years to come &lt;sup&gt;99m&lt;/sup&gt;Tc-Tektrotyde became commercially available with easy access. In the last decade, with the increasing use of positron emission tomography (PET) imaging, somatostatin analogues have been labelled with various positron-emitting isotopes, such as Gallium-68 (&lt;sup&gt;68&lt;/sup&gt;Ga) and Copper-64 (&lt;sup&gt;64&lt;/sup&gt;Cu) (Lewis et al. 1999, Schottelius et al. 2004, Gabriel et al. 2007) e.g &lt;sup&gt;68&lt;/sup&gt;Ga-DOTATOC, &lt;sup&gt;68&lt;/sup&gt;Ga-DOTATATE &lt;sup&gt;68&lt;/sup&gt;Ga-DOTANOC and &lt;sup&gt;68&lt;/sup&gt;Cu-DOTATATE. Scintigraphy with these investigational compounds display encouraging good imaging quality amd improved sensitivity in tumor site detection compared with SPECT scintigraphy. Also, other PET radiopharmaceuticals were developed, such as &lt;sup&gt;18&lt;/sup&gt;F-dihydroxy-phenyl-alanine (&lt;sup&gt;18&lt;/sup&gt;F-DOPA) and &lt;sup&gt;11&lt;/sup&gt;C-labelled 5-hydroxytryptophan (&lt;sup&gt;11&lt;/sup&gt;C-5-HTP) with encouraging results in terms of visualization of GEP-NETs (Koopmans et al. 2008). After the successful introduction of SRS in the diagnosis and staging of NETs, the next logical step was to increase the administered activity so that the radiopharmaceutical can induce tumor shrinkage in patients who had inoperable and/or metastasized NENs. Therefore, the first peptide receptor radionuclide therapy (PRRT) was performed with high administered activity of [&lt;sup&gt;111&lt;/sup&gt;In-DTPA0] octreotide (Krenning et al. 1994a). To make significant advancements in the treatment of somatostatin receptor-positive metastatic disease, more efficient radiolabelled somatostatin analogues were developed with higher affinity to the somatostatin receptor. Treatment with radiolabelled peptides or PRRT is a promising new therapeutic option in the management of inoperable or metastasized NETs. Symptomatic control can be achieved with all &lt;sup&gt;111&lt;/sup&gt;In-, &lt;sup&gt;90&lt;/sup&gt;Y- and &lt;sup&gt;177&lt;/sup&gt;Lu-labelled somatostatin analogue-based PRRT. For objective response and long-lasting duration of response, &lt;sup&gt;90&lt;/sup&gt;Y-DOTATOC and &lt;sup&gt;177&lt;/sup&gt;Lu-DOTATATE are the most promising radiopharmaceuticals. Side effects of PRRT are few and mild, if adequate kidney protective measures are taken and dose-limits are respected. In a minority of patients, when SRS fails to identify neuroendocrine disease, MIBG scintigraphy and subsequent &lt;sup&gt;131&lt;/sup&gt;I-MBG therapy might be an alternative treatment option. Targeted alpha-particle therapy (TAT) has emerged as an alternative treatment option to beta emitters in PRRT. The use of alpha emitters for cancer therapy has two ad","PeriodicalId":12871,"journal":{"name":"Hellenic journal of nuclear medicine","volume":"26 Suppl ","pages":"19-20"},"PeriodicalIF":1.5,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10141293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of positron computed tomography (PET/CT) in lung cancer staging.","authors":"Emmanouil Panagiotidis","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Lung cancer is the leading cause of cancer-related mortalities with the rate of incidence reaching about 1.5 million cases per year worldwide. Approximately 350 people die each day from lung cancer in USA-nearly 2.5 times more than the number of people who die from colorectal cancer (CRC), which is the second leading cause of cancer death overall. In 2023, an estimated 238,340 people (117,550 men and 120,790 women) will be diagnosed with lung cancer, and 127,070 people will die from the disease. Although approximately 80% of lung cancers are caused by cigarette smoking, the toll among people who have never smoked is substantial, ranking among the top 10 causes of cancer death when categorized separately. Lung cancer encompasses a variety of biologically distinct tumours. The two primary types of lung cancer are non-small cell lung cancer (NSCLC), which accounts for 81% of cases, and small cell lung cancer (SCLC), which accounts for 14% of cases. NSCLC is further categorized as adenocarcinoma, which is slightly more common in women, followed by squamous cell carcinoma and large cell carcinoma.</p>","PeriodicalId":12871,"journal":{"name":"Hellenic journal of nuclear medicine","volume":"26 Suppl ","pages":"22-29"},"PeriodicalIF":1.5,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10135766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biomarkers in neuroendocrine neoplasms.","authors":"Chrisanthi Zouli,&nbsp;Eleana Zisimopoulou,&nbsp;Alexandra Chrisoulidou","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Neuroendocrine tumors are a heterogenous group of rare neoplasms with different morphological features, immunophenotype, molecular profile, and clinical presentation. They can derive from any neuroendocrine cell throughout the body, but the majority of NENs is developed in the gastrointestinal tract. They can be divided into two groups, based on hormone secretion, functioning and non-functioning NENs. The first group is characterised from the secretion of specific substances, defining the clinical manifestations. Functional NENs can be divided into carcinoid tumors, with serotonin overproduction, and functional GEP NEN's (mostly located in pancreas) that may secrete insulin, VIP, gastrin, glucagon or somatostatin. Non-functioning NENs, comprise approximately 85% of NEN's. As these tumors lack specific symptoms, they come to clinical attention later, when they have a large size or metastases. Apart from the specific biomarkers that functional NENs are producing, there are some general markers that are produced from all NENs and play a major role in the diagnosis, prognosis and follow up of these patients. These are chromogranin (CgA), neuron-specific enolase (NSE) and 5-hydroxyindolic acetic acid (5-HIAA).</p>","PeriodicalId":12871,"journal":{"name":"Hellenic journal of nuclear medicine","volume":"26 Suppl ","pages":"44-48"},"PeriodicalIF":1.5,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10135768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The progress in multiple myeloma.","authors":"P Hatjiharissi","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Multiple myeloma (MM) is a neoplastic disease characterized by the proliferation of clonal plasma cells. This disease arises from an initial asymptomatic stage known as monoclonal gammopathy of unknown significance (MGUS). The clinical phenotype that lies between MGUS and MM is commonly known as smoldering multiple myeloma (SMM). In individuals with MGUS and SMM, the risk of progression to MM persists constantly. In MGUS, the progression rate to MM or a related malignancy is around 1% per year, while in SMM, the progression rate to MM is approximately 10% per year. Recently, myeloma was defined as a clonal proliferation of malignant plasma cells that results in end organ damage or myeloma-defining events. MM is a genetically complex disease that exhibits clinical and biological diversity. Currently, the revised International Staging System (R-ISS) is used for prognostication in newly diagnosed patients. For transplant-eligible patients with newly diagnosed MM, the standard of care treatment (SoC) regimen is induction therapy, followed by ASCT and maintenance therapy. In general, the recommended induction therapy is a triplet or quadruplet-agent therapy consisting of a proteasome inhibitor, an immunomodulatory compound, and/or a CD38 antibody in combination with dexamethasone. Myeloma patients who are ineligible for a transplant are typically treated with a triplet combination, which necessitates specialized knowledge of treatment adverse effects. Although the prognosis for patients with MM has significantly improved over time due to advances in treatment, the disease remains incurable and relapses are common. Because various immunotherapeutic agents, new drugs and combinations have become available, selecting the most effective treatment for patients with relapsed/refractory MM needs both art and science.</p>","PeriodicalId":12871,"journal":{"name":"Hellenic journal of nuclear medicine","volume":"26 Suppl ","pages":"30-35"},"PeriodicalIF":1.5,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10141288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nuclear Cardio-Oncology.","authors":"Maria Koutelou","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Nuclear cardio-oncology is a specialized field that combines aspects of nuclear medicine, cardiology, and oncology to diagnose and manage cardiovascular complications in cancer patients. It focuses on the assessment of cardiovascular health and the detection of potential heart-related side effects caused by cancer treatments.</p>","PeriodicalId":12871,"journal":{"name":"Hellenic journal of nuclear medicine","volume":"26 Suppl ","pages":"12-13"},"PeriodicalIF":1.5,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10141287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dosimetry in MRT: Our recent experience.","authors":"Lydia Angeliki Zoglopitou","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Personalized dosimetry is tending to become the \"gold standard\" in Molecular Radiotherapy (MRT). Setting up carefully all the procedures involved in the workflow is crucial for the final clinical result.</p><p><strong>Aim: </strong>Individualized MRT dosimetry using a recently installed commercial system, comprising of a dual SPECT/CT camera, a treatment planning software (TPS) and a dose calibrator was implemented on patients undergoing ¹⁷⁷Lu-DOTATATE and ¹⁷⁷Lu-PSMA therapies. The clinical workflow implemented in our department is presented in detail. Measurement and calculation of the Calibration Factor (CF) to translate the count rate into activity concentration (quantitative data), and system's commissioning, was discussed.</p><p><strong>Materials and methods: </strong>Calibration of the dose calibrator, the SPECT/CT system and the TPS, measured using the clinical acquisition protocol, were analyzed along with potential errors introduced by the procedure and means of future optimization. In addition, image acquisition parameters, image reconstruction and image registration were discussed. Anatomical contouring of the organs at risk (OARs) and functional contouring of the lesions, followed by the dose calculation of the aforementioned structures, with the use of different calculation algorithms, were presented, compared and evaluated.</p><p><strong>Results and discussion: </strong>According to our experience, different fitting of each organ's activity curve, results in differences in the final calculated dose. Use of bi-exponential fitting seems to better approach physical and metabolic decay. Calculated absorbed doses for the OARs were found similar to those expected from literature. Finally, department's future work was discussed, including reproducible patient setup for image acquisition, high dose CT for finer contouring and comparison of the calculated doses with other TPSs.</p>","PeriodicalId":12871,"journal":{"name":"Hellenic journal of nuclear medicine","volume":"26 Suppl ","pages":"15"},"PeriodicalIF":1.5,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10141289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lung cancer: CT guided BX-EBUS: How and when?","authors":"Miltiadis Krokidis","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Histological diagnosis is mandatory for the majority of solid lesions in the lungs in order to characterize the lesions but also to assess the response to treatment. Flexible bronchoscopy has a variable and often poor success rate in sampling pulmonary lesions which are not visible endoscopically. Such focal radiological opacities without endobronchial extension are referred to as peripheral pulmonary lesions and sampling is usually performed under guidance with computed tomography that is a safe and effective technique and became a common procedure representing an essential step for diagnosis and treatment planning. It is usually performed with an 18G or 20G coaxial needle system and several novel guidance and navigation tools may be integrated to clinical practice to offer more accurate lesion targeting. There is however still a percentage of negative sampling a recent study revealed that small lesion size, lower ¹⁸F-FDG uptake or location at the lung bases may lead to inconclusive histology. The diagnostic yield may be increased if PET/CT fusion imaging is used intraprocedurally. CT guided biopsies may also be applied in the same setup with interventions such as ablation of lung lesions offering a \"one-stop\" approach for such patients.</p>","PeriodicalId":12871,"journal":{"name":"Hellenic journal of nuclear medicine","volume":"26 Suppl ","pages":"21"},"PeriodicalIF":1.5,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10141294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}