Nuklearmedizin-nuclear Medicine最新文献

{"title":"Comparison of bone marrow biopsy and fluorodeoxyglucose-positron emission tomography for the assessment of bone marrow infiltration in children with Hodgkin's lymphoma.","authors":"Esra Arslantaş,&nbsp;Ali Ayçiçek,&nbsp;Ferhan Akıcı,&nbsp;Selvinaz Özkara,&nbsp;Burçak Yılmaz,&nbsp;Nihal Özdemir,&nbsp;Cengiz Bayram","doi":"10.1055/a-1972-9292","DOIUrl":"https://doi.org/10.1055/a-1972-9292","url":null,"abstract":"<p><strong>Purpose: </strong>To compare bone marrow biopsy (BMB) with [18F]-fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography (PET/CT) imaging in the demonstration of bone marrow involvement in children with Hodgkin's Lymphoma (HL) and to investigate the effectiveness of PET/CT imaging and thus the necessity for BMB at staging.</p><p><strong>Methods: </strong>Pediatric patients with HL, who underwent both bilateral iliac BMB and PET/CT imaging at disease staging were retrospectively analyzed. In determining bone marrow involvement (BMinv), BMB and/or first/follow-up PET/CT imaging were eligible for review.</p><p><strong>Results: </strong>Fifty-six patients were included. BMinv was detected by PET/CT imaging in 6/56 (10.7%), whereas the proportion was 3/56 (5.3%) in BMB specimens. Bone marrow biopsies and PET/CT images were concordant in 53/56 (94.6%) patients with BMB specimens missing three cases of BMinv detected by PET/CT. When diagnostic accuracy was calculated, sensitivity, specificity, positive predictive value and negative predictive values for PET/CT were 100%, 100%, 100%, 100%, respectively, and the same values for BMB were 50%, 100%, 100%, 94.3%, respectively.</p><p><strong>Conclusions: </strong>The results of PET/CT and BMB for staging of pediatric HL patients were compatible, and PET/CT imaging was found to provide high diagnostic performance in determining BMinv. In keeping with earlier research, the current study showed that BMB may not be necessary in every patient at staging, and should be reserved for cases where PET/CT is inconclusive.</p>","PeriodicalId":19238,"journal":{"name":"Nuklearmedizin-nuclear Medicine","volume":"62 1","pages":"20-26"},"PeriodicalIF":1.5,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10667810","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":"Evaluation of activity kinetics in breast milk and calculation of the resulting effective radiation dose after 99mTc-MIBI scintigraphy of a breastfeeding women.","authors":"Christian Happel,&nbsp;Daniel Gröner,&nbsp;Wolfgang Tilman Kranert,&nbsp;Frank Grünwald","doi":"10.1055/a-1937-9466","DOIUrl":"https://doi.org/10.1055/a-1937-9466","url":null,"abstract":"<p><strong>Introduction: </strong>In breastfeeding women, the indication for scintigraphic imaging is strongly restricted due to potential transition of the radiopharmaceutical to the child via breast milk. The potential activity uptake of the breastfed child depends on the chemical compound of the radio pharmaceutical as well as biokinetics and metabolism in the maternal body.</p><p><strong>Methods: </strong>In the presented case ^99mTc-MIBI scintigraphy was performed in a breastfeeding woman with sonographically suspicious thyroid nodules. Breastfeeding was interrupted for 30 hours and the breast milk during this period was collected and analysed to determine the excreted activity and the potentially resulting dose to the breastfed child.</p><p><strong>Results: </strong>Activity concentration in the first breast milk sample (1.83 hours after administration of 500 MBq ^99mTc-MIBI) was 380 Bq/mL, resulting in an absolute activity of 50 kBq for a sample size of 132 mL. Subsequently activity concentration decreased to 6 Bq/mL (29.8 hours p.i.). The calculated effective half-life of the secretion of ^99mTc-MIBI via breast milk was 4.7 hours. The potentially resulting effective dose for the breastfed child was 13.4 µSv (ICRP80: dose coefficient: 0.13 mSv/MBq for ^99mTc).</p><p><strong>Conclusion: </strong>Time activity curve showed a rapid decrease of the ^99mTc-MIBI activity secreted to the breast milk. More than 90 % of the total secreted activity is attributable to the first 12 hours after administration. Therefore, an interruption of breastfeeding of 24 hours seems to be adequate.</p>","PeriodicalId":19238,"journal":{"name":"Nuklearmedizin-nuclear Medicine","volume":"62 1","pages":"45-46"},"PeriodicalIF":1.5,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9234281","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":"Diagnostic value of FDG-PET/CT in the diagnostic work-up of inflammation of unknown origin.","authors":"Luisa Maria Knappe,&nbsp;Frederik Anton Verburg,&nbsp;Luca Giovanella,&nbsp;Markus Luster,&nbsp;Damiano Librizzi","doi":"10.1055/a-1976-1765","DOIUrl":"https://doi.org/10.1055/a-1976-1765","url":null,"abstract":"<p><p>Introduction The present study aims to evaluate the clinical diagnostic value of FDG-PET/CT in patients with inflammation of unknown origin. Material and methods We retrospectively analyzed data of 130 patients who presented general inflammatory symptoms and/or elevated level of CRP and underwent FDG-PET/CT for the purpose of identifying unknown foci of inflammation. The accuracy of PET/CT findings was assessed against the standard of eventual clinical diagnosis e.g. results of pathology, microbiology or other imaging methods. Results In 99/130 patients (76 %) a final diagnosis was established, FDG-PET/CT showed a sensitivity and specificity of each 93 %. A decreased pseudocholinesterase is associated with a higher SUVmax value and with a higher CRP value whereas no significant relationship was found between elevated CRP values and the SUVmax, although higher CRP values are associated significantly with a true positive PET/CT result. Conclusion FDG-PET/CT is a highly sensitive, specific and accurate method for the detection of foci of inflammation of unknown origin. The combination of decreased pseudocholinesterase and increased CRP levels may be a useful tool to select patients for FDG PET/CT.</p>","PeriodicalId":19238,"journal":{"name":"Nuklearmedizin-nuclear Medicine","volume":"62 1","pages":"27-33"},"PeriodicalIF":1.5,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9220503","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":"Veranstaltungen","authors":"","doi":"10.1055/a-1998-8277","DOIUrl":"https://doi.org/10.1055/a-1998-8277","url":null,"abstract":"Veranstaltungsort:Kongresshalle am Zoo LeipzigPfaffendorfer Straße 3104105 LeipzigDeutschlandInformationen:Conventus Congressmanagement & Marketing GmbH+49 3641 31 16-371 https://kardiodiagnostik.de/","PeriodicalId":19238,"journal":{"name":"Nuklearmedizin-nuclear Medicine","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136178662","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":"Role of 68Ga-FAPI-04 PET/CT in the Initial Staging of Esophageal Cancer.","authors":"Huipan Liu,&nbsp;Xiao Yang,&nbsp;Zhouxiang You,&nbsp;Zhi Hu,&nbsp;Yue Chen","doi":"10.1055/a-1984-8044","DOIUrl":"https://doi.org/10.1055/a-1984-8044","url":null,"abstract":"<p><strong>Aim: </strong>To investigate the clinical value of 68Ga-FAPI-04 PET/CT for initial staging of esophageal cancer.</p><p><strong>Methods: </strong>A total of 44 newly diagnosed patients with esophageal cancer were included in the analysis on the basis of postoperative pathology or clinical and radiologic follow-up.</p><p><strong>Results: </strong>All primary lesions showed increased 68Ga-FAPI-04 uptake, with an SUVmax of 14.92 ± 6.91. A total of 561 lymph nodes were verified by surgery (507) or clinical and radiologic follow-up (54), of which 92 lymph nodes were diagnosed as showing metastases. Seventy-five lymph nodes with metastases showed positive findings on 68Ga-FAPI-04, with a diameter of about 1.06 ± 0.53 cm and SUVmax of 8.10±4.71. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value for lymph node metastasis detection were 81.5%, 99.3%, 96.6%, 96.2%, and 96.5%, respectively.</p><p><strong>Conclusion: </strong>68Ga-FAPI-04 PET/CT showed good diagnostic performance in detecting lymph node metastases of esophageal cancer.</p>","PeriodicalId":19238,"journal":{"name":"Nuklearmedizin-nuclear Medicine","volume":"62 1","pages":"38-44"},"PeriodicalIF":1.5,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10667809","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":"[18F]FDG PET/CT guided biopsy confirms diagnosis of granulomatosis with polyangiitis.","authors":"Anne Katharina Krebold,&nbsp;Tina Schaller,&nbsp;Madeleine Appenzeller,&nbsp;Martin Schwaiblmair,&nbsp;Malte Kircher,&nbsp;Ralph Alexander Bundschuh,&nbsp;Constantin Lapa,&nbsp;Alexander Dierks","doi":"10.1055/a-1907-4248","DOIUrl":"https://doi.org/10.1055/a-1907-4248","url":null,"abstract":"A 55-year-old man with a prior medical history of chronic sinusitis was referred due to progressive dyspnea and weight loss. Computed tomography (CT) of the chest revealed multiple consolidations in both lungs. For further work-up, positron remission tomography/CT (PET/CT) with [18F]fluoro-D-glucose ([18F]FDG) was subsequently performed demonstrating high [18F]FDG uptake in the nasal cavity (SUVmax: 16.9). In addition, intense tracer accumulation in the aforementioned lung lesions (SUVmax: 21.9) was observed (▶ Fig. 1). Biopsies of the nasal septum and the lungs were performed. Pathologic workup revealed acute and chronic inflammation with granulomatous features (▶ Fig. 2), confirmed by the presence of anti-neutrophil cytoplasmic antibodies in serum. A diagnosis of granulomatosis with polyangiitis (GPA) was established, and anti-inflammatory therapy consisting of high dose prednisolone and rituximab was initiated.","PeriodicalId":19238,"journal":{"name":"Nuklearmedizin-nuclear Medicine","volume":"61 6","pages":"462-463"},"PeriodicalIF":1.5,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10686482","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":"Medullary Thyroid Carcinoma presenting as an Incidentaloma on Gallium-68-PSMA-PET/CT - Systematic Literature Review and Case Report.","authors":"Friederike Eilsberger,&nbsp;Markus Luster,&nbsp;Damiano Librizzi,&nbsp;Fiona Rodepeter,&nbsp;Katharina Holzer,&nbsp;Andreas Pfestroff","doi":"10.1055/a-1896-0106","DOIUrl":"https://doi.org/10.1055/a-1896-0106","url":null,"abstract":"The prostate-specific membrane antigen (PSMA) is established in imaging and treatment of prostate cancer, especially in recurrent disease. PSMA is a membranebound glycoprotein with the function of a glutamic acid releasing carboxypeptidase enzyme, which is biologically expressed by the prostate and among others, proximal renal tubule cells, small intestine, central and peripheral nervous system [1]. Positrone Emission Tomography (PET)/ Computed Tomography (CT) imaging with Gallium (Ga)-68 in prostate cancer has its benefits in demonstrating the extent of the current disease and in preceding possible therapy with radionuclides like Lutetium (Lu)-177 and also the feasibility of intraoperative probe-assisted detection and localization of respective lesions. Numerous immunohistochemical studies have shown that PSMA is also upregulated on the endothelial cells of the neovasculature of a diverse group of other solid tumors. PSMA appears to promote endothelial invasion cell proliferation through its regulation of lytic proteases that can cleave the extracellular matrix [2]. PSMA expression in the neovasculature of tumors was likewise shown for example in renal cell carcinoma, rectal carcinoma, lung cancer, hepatocellular carcinoma, lymphoma, urinary bladder, stomach, small intestine and differentiated thyroid cancer [3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14]. Heitkötter et al discussed that in thyroid carcinomas, PSMA expression was more common in poorly differentiated species [15]. Poorly differentiated tumors grow rapidly, resulting in intratumoral hypoxemia, in which PSMA supports neovascularization. It is therefore not surprising that several studies have demonstrated an association between high PSMA expression and poorer prognosis and outcome. Haffner et al. were able to demonstrate this association in squamous cell carcinoma of the oral cavity, Jiao et al. in hepatocellular carcinoma and Sollini et al. in differentiated thyroid cancer [16, 17, 18].","PeriodicalId":19238,"journal":{"name":"Nuklearmedizin-nuclear Medicine","volume":"61 6","pages":"458-461"},"PeriodicalIF":1.5,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10671602","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":"Distribution of Functional Status of Thyroid Nodules and Malignancy Rates of Hyperfunctioning and Hypofunctioning Thyroid Nodules in Germany.","authors":"Simone Agnes Schenke,&nbsp;Michael C Kreissl,&nbsp;Michael Grunert,&nbsp;Anja Hach,&nbsp;Sarvar Haghghi,&nbsp;Tatjana Kandror,&nbsp;Eckhard Peppert,&nbsp;Sandra Rosenbaum-Krumme,&nbsp;Verena Ruhlmann,&nbsp;Alexander Stahl,&nbsp;Dieter Wanjura,&nbsp;Konstantin Zaplatnikov,&nbsp;Michael Zimny,&nbsp;Elena Gilman,&nbsp;Ken Herrmann,&nbsp;Rainer Görges","doi":"10.1055/a-1856-4052","DOIUrl":"https://doi.org/10.1055/a-1856-4052","url":null,"abstract":"<p><strong>Aim: </strong>Thyroid scintigraphy enables the depiction of the functional status of thyroid nodules (TNs) with both, ^99mTc-pertechnetate and ¹²³Iodine. The functional status is relevant for diagnostic procedures for the differentiation of benign and malignant TNs. The aim of this study was to examine the current frequencies of hyper-, hypo- and isofunctioning TNs in Germany and to estimate the risk of malignancy with regard to functional status.</p><p><strong>Methods: </strong>In 11 study centers, a minimum of 100 nodules per center were consecutively enrolled between July 2019 and April 2020. Inclusion criteria were: newly diagnosed nodule, nodule' size of 10 mm or more, thyroid scintigraphy. Exclusion criteria were: completely cystic TNs, patients with prior radioiodine therapy or thyroid surgery. The risk of malignancy was estimated for hyper- and hypofunctioning TNs.</p><p><strong>Results: </strong>Overall, 849 patients (72 % women) with 1262 TNs were included. Patients' age ranged from 18 to 90 years. Most TNs were hypofunctioning (n=535, 42%) followed by isofunctioning TNs (n=488, 39%) and hyperfunctioning TNs (n=239, 19%). When only TNs with a maximum size of 2 cm or more were considered the rate of hyperfunctioning and hypofunctioning TNs increased (to 27% and 49%) while isofunctioning TNs decreased. Only one of all hyperfunctioning TNs was malignant. In hypofunctioning nodules, the malignancy rate was estimated at 10%.</p><p><strong>Conclusion: </strong>In Germany, the proportion of hyperfunctioning TNs is approximately 20% and increases in larger TNs to up to 27%. Due to the low risk of malignancy in hyperfunctioning TNs, no further procedures to rule out malignancy are necessary. The risk of malignancy of hypofunctioning TNs is significantly higher. Thus, a thyroid scintigraphy is a useful diagnostic tool in Germany.</p>","PeriodicalId":19238,"journal":{"name":"Nuklearmedizin-nuclear Medicine","volume":"61 5","pages":"376-384"},"PeriodicalIF":1.5,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9554216","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":"Enhancing PSMA-PET/CT with intravenous contrast: Improved tracer clearance in the prostate bed.","authors":"A. Tulipan, Angela Jaramillo Guzman, T. Haslerud, Kjartan Foldnes, O. Kvernenes, A. Honoré, N. Brekke, L. Reisæter, M. Biermann","doi":"10.1055/a-1821-8112","DOIUrl":"https://doi.org/10.1055/a-1821-8112","url":null,"abstract":"AIMS\u0000We observed hitherto unreported layering of radioactivity in the bladder on PET/CT in prostate cancer (PC) when combined with contrast-enhanced CT (CECT). This effect facilitates assessment of the prostate bed in PC.\u0000\u0000\u0000METHODS\u0000Among 128 patients imaged with [18F]PSMA-1007, we selected all 8 studies without and 28 studies with CECT. 20 patients also underwent PET/MR. As controls, we chose 20 and 16 males studied with [18F]FDG for extrapelvic disease with and without CECT. Posterior anterior (PA) ratio was calculated as SUVpost/SUVant * 100 % based on maximal standard uptake values (SUV) in 20 mm spheres in the anterior and posterior bladder. Four nuclear physicians scored assessibility of the bladder base on a 3-point Likert scale (3 = optimal, 1 = poor). We acquired serial PET/CT over 4 hours of a flask with layering of 100 ml intravenous contrast agent and 100 ml physiological saline with 40 MBq of [18F]PSMA-1007, while a control flask was shaken at the start of the experiment.\u0000\u0000\u0000RESULTS\u0000Layering of tracer was observed in all PET/CT studies with CE-CT, but not in studies without contrast. Median PA ratios were 44 % (interquartile range 33-62) for [18F]PSMA-1007 and 73 % (52-67) for [18F]FDG, respectively. Intravenous contrast improved assessibility scores in PET of the bladder base, but the effect only reached significance in the PET/MR data. In the in vitro data, radioactivity was retained in the aqueous supernatant over the entire experiment whereas there was no separation of phases in the control flask over time.\u0000\u0000\u0000CONCLUSION\u0000When performing PET combined with CECT, sedimentation of contrast agent in the bladder leads to upward displacement of radioactivity, enhancing clarity of PET images in the posterior bladder and the prostate bed on both PET/CT and PET/MR.","PeriodicalId":19238,"journal":{"name":"Nuklearmedizin-nuclear Medicine","volume":"44 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2022-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75316039","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":"[18F]DCFPyL PET/CT for Imaging of Prostate Cancer.","authors":"Steven P Rowe,&nbsp;Andreas Buck,&nbsp;Ralph A Bundschuh,&nbsp;Constantin Lapa,&nbsp;Sebastian E Serfling,&nbsp;Thorsten Derlin,&nbsp;Takahiro Higuchi,&nbsp;Michael A Gorin,&nbsp;Martin G Pomper,&nbsp;Rudolf A Werner","doi":"10.1055/a-1659-0010","DOIUrl":"https://doi.org/10.1055/a-1659-0010","url":null,"abstract":"<p><p>Prostate-specific membrane antigen (PSMA)-directed positron emission tomography (PET) has gained increasing interest for imaging of men affected by prostate cancer (PC). In recent years, ⁶⁸Ga-labeled PSMA compounds have been widely utilized, although there is a trend towards increased utilization of ¹⁸F-labeled agents. Among others, [¹⁸F]DCFPyL (piflufolastat F 18, PYLARIFY) has been tested in multiple major trials, such as OSPREY and CONDOR, which provided robust evidence on the clinical utility of this compound for staging, restaging, and change in management. Recent explorative prospective trials have also utilized [¹⁸F]DCFPyL PET/CT for response assessment, e.g., in patients under abiraterone or enzalutamide, rendering this ¹⁸F-labeled PSMA radiotracer as an attractive biomarker for image-guided strategies in men with PC. After recent approval by the U.S. Food and Drug Administration, one may expect more widespread use, not only in the U.S., but also in Europe in the long term. In the present review, we will provide an overview of the current clinical utility of [¹⁸F]DCFPyL in various clinical settings for men with PC.</p>","PeriodicalId":19238,"journal":{"name":"Nuklearmedizin-nuclear Medicine","volume":"61 3","pages":"240-246"},"PeriodicalIF":1.5,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39911564","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}