{"title":"Internal dosimetry and biodistribution of indigenously prepared 177Lu-DOTA-rituximab in lymphoma and other hematological malignancies treated with rituximab.","authors":"Yeshwanth Edamadaka, Rahul V Parghane, Sudeep Sahu, Sangita Lad, Kamaldeep, Gaurav Wanage, Chandrakala Shanmukhaiah, Vrinda Kulkarni, Sandip Basu","doi":"10.1097/MNM.0000000000001875","DOIUrl":"https://doi.org/10.1097/MNM.0000000000001875","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to evaluate the biodistribution and dosimetry of lutetium-177-1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid (177Lu-DOTA)-rituximab in CD20+ non-Hodgkin's lymphoma and other hematological malignancies treated with rituximab.</p><p><strong>Methods: </strong>The standard dosimetry protocol was used, with cold rituximab infusion, then a diagnostic activity of 177Lu-DOTA-rituximab. Planar images were acquired at multiple time points. Normal organs and tumor dosimetry were performed by using organ and tumor-specific regions of interest and whole-body counts were obtained serially after pixel matched, background, scatter, and attenuation correction. The mean radiation absorbed doses were obtained from OLINDA/EXM v2.1.1 and ORIGIN software.</p><p><strong>Results: </strong>A total of 22 patients were included in this study. Prolonged blood pool clearance of 177Lu-DOTA-rituximab with long residence time in the blood pool and normal organs were observed. The whole body effective half-life was 104.5 ± 22 h. The mean total body radiation absorbed dose was 0.208 ± 0.03 mGy/MBq and the mean total body effective dose was 0.196 ± 0.05 mGy/MBq of 177Lu-DOTA-rituximab. The mean radiation absorbed doses of 0.613 ± 0.21, 1.68 ± 2, 1.01 ± 0.42, and 0.136 ± 0.02mGy/MBq were seen for the liver, spleen, kidneys, and bone marrow, respectively. Tumor lesion uptake was noticed in two patients with tumor radiation absorbed doses were 0.842 mGy/MBq in one and 9.9 mGy/MBq in the other patient. A strong correlation was obtained between the cumulative activities of radiation-absorbed doses derived from ORIGIN and OLINDA software methods at a significant P value less than 0.001.</p><p><strong>Conclusion: </strong>The results of our study demonstrated favorable biodistribution and dosimetry of indigenously produced 177Lu-DOTA-rituximab in patients with CD20+ lymphoma. These results can be used for future studies of radioimmunotherapy employing 177Lu-DOTA-rituximab.</p>","PeriodicalId":19708,"journal":{"name":"Nuclear Medicine Communications","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141555311","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":"Utility of PSMA-PET derived volumetric parameters in initial risk stratification and prediction of prostate cancer metastasis - a head-to-head comparison of the radiotracers 18F-PSMA-1007 and 68Ga-PSMA-11.","authors":"Kunal Ramesh Chandekar, Swayamjeet Satapathy, Harmandeep Singh, Rajender Kumar, Santosh Kumar, Nandita Kakkar, Bhagwant Rai Mittal, Shrawan Kumar Singh","doi":"10.1097/MNM.0000000000001874","DOIUrl":"https://doi.org/10.1097/MNM.0000000000001874","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to explore and compare the utility of baseline 18F-PSMA-1007 and 68Ga-PSMA-11 PET/computed tomography (CT) derived volumetric parameters in initial risk stratification and prediction of prostate cancer (PCa) metastasis.</p><p><strong>Methods: </strong>Forty treatment-naïve, biopsy-proven intermediate-/high-risk PCa patients were prospectively recruited. Each patient underwent PET/CT with 68Ga-PSMA-11 and 18F-PSMA-1007 (within 2 weeks). The maximum and mean standardized uptake values (SUVmax and SUVmean) of primary tumor, prostate PSMA-tumor volume (PSMA-TVp), and prostate total lesion PSMA (TL-PSMAp) were measured.</p><p><strong>Results: </strong>PSMA-TVp and TL-PSMAp (with both radiotracers) mostly exhibited moderate-to-strong correlation with Gleason score, serum prostate-specific antigen level and clinical tumor stage (Spearman ρ = 0.361-0.783, P-values ≤0.022). Primary tumor SUVmax values were similar across initial risk categories. PSMA-TVp and TL-PSMAp, however, were significantly higher in high-risk PCa compared to intermediate-risk PCa (P-values ≤0.001). Receiver operating characteristic (ROC) curve analysis revealed that F-PSMA-TVp, Ga-PSMA-TVp, F-TL-PSMAp, and Ga-TL-PSMAp (optimal cutoff values of 20.9, 23.4, 142.5, and 144.8, respectively) could effectively differentiate high-risk from intermediate-risk PCa [area under the ROC curve (AUCs) 0.859-0.898, P-values <0.001] with high sensitivity (~68.8-75%) and excellent specificity (100%). PSMA-TVp and TL-PSMAp (with both radiotracers) could predict presence of regional and extraregional nodal metastasis (AUCs 0.703-0.801, P-values ≤0.03) with moderate sensitivity (~47.8-70.6%) and excellent specificity (~82.6-94.1%).</p><p><strong>Conclusion: </strong>Our results suggest that baseline PSMA-PET primary tumor volumetric parameters provide a noninvasive, objective, and accurate index for initial risk stratification and can predict presence of regional and extraregional nodal metastasis in PCa patients. Larger studies are warranted to evaluate their incremental role over conventional parameters.</p>","PeriodicalId":19708,"journal":{"name":"Nuclear Medicine Communications","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141458574","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":"BNMS guidelines for Nuclear Medicine Events and Learning Meetings: principles for departmental learning from unforeseen events.","authors":"David Little, Richard Graham, Stewart Redman","doi":"10.1097/MNM.0000000000001876","DOIUrl":"https://doi.org/10.1097/MNM.0000000000001876","url":null,"abstract":"","PeriodicalId":19708,"journal":{"name":"Nuclear Medicine Communications","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141469884","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":"Comparison of absolute renal uptake by using Tc-99m MAG-3 and Tc-99m DMSA.","authors":"Hasnain Dilawar, Salman Habib, Razia Rana, Akhtar Ahmed, Javaid Iqbal, Talal Abdul Rehman, Imran Hadi, Shazia Fatima","doi":"10.1097/MNM.0000000000001831","DOIUrl":"10.1097/MNM.0000000000001831","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study is to compare the value of absolute renal uptake (ARU %) in patients by using Tc-99m MAG-3 and Tc-99m DMSA scan.</p><p><strong>Material and methods: </strong>Absolute renal uptake is calculated using Tc-99m MAG-3 and Tc-99m DMSA in renal scintigraphy, Itoh and Tauex kidney depth methods used, respectively. n = 40 adult patients of both genders were included. All patients underwent Tc-99m MAG-3 and Tc-99m DMSA, respectively.</p><p><strong>Results: </strong>The values of ARU (%) were calculated separately in selected patients n = 40, (left = 17, right = 23 normal functioning kidneys) by MAG-3 and DMSA. Absolute renal uptake (%) of Tc-99m MAG-3 in left kidneys was found to be 15.2 ± 3.4, with spilt renal function 79.2 ± 14.7 and ARU (%) in right kidneys 16.2 ± 3.4 with spilt renal function 77.5 ± 19. Absolute renal uptake of Tc-99m DMSA in left kidneys was 17.5 ± 3.2 and in right kidneys 17.9 ± 4.5 with spilt renal function 81.8 ± 10.7 and 79.3 ± 13.8 for left and right kidney, respectively. Statistical analysis showed strong Pearson correlation.</p><p><strong>Conclusion: </strong>Absolute renal uptake % was found to be more reliable in cases of bilateral compromised kidneys. ARU (%) calculated by Tc-99m MAG-3 solely can be used as predictor of renal function. The use of Tc-99m MAG-3 has more advantages than Tc-99m DMSA alone in renal scintigraphy as dynamic scintigraphy gives less radiation burden to patient, more information regarding renal function, and shorter stay time at hospital in comparison to static renal imaging. SRF % is less reliable than ARU (%).</p>","PeriodicalId":19708,"journal":{"name":"Nuclear Medicine Communications","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140094407","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}
James W Scuffham, John C Dickson, Anthony Murray, Glenn D Flux
{"title":"Commentary on the current status of nuclear medicine medical physics expert support in the UK.","authors":"James W Scuffham, John C Dickson, Anthony Murray, Glenn D Flux","doi":"10.1097/MNM.0000000000001843","DOIUrl":"10.1097/MNM.0000000000001843","url":null,"abstract":"","PeriodicalId":19708,"journal":{"name":"Nuclear Medicine Communications","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11075750/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140877014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Samantha M Ree, Howard Greenwood, Jennifer D Young, Rachel Roberts, Francis R Livens, Scott L Heath, Jane K Sosabowski
{"title":"Selection of radionuclide(s) for targeted alpha therapy based on their nuclear decay properties.","authors":"Samantha M Ree, Howard Greenwood, Jennifer D Young, Rachel Roberts, Francis R Livens, Scott L Heath, Jane K Sosabowski","doi":"10.1097/MNM.0000000000001832","DOIUrl":"10.1097/MNM.0000000000001832","url":null,"abstract":"<p><p>Targeted alpha therapy (TAT) is a promising form of oncology treatment utilising alpha-emitting radionuclides that can specifically accumulate at disease sites. The high energy and high linear energy transfer associated with alpha emissions causes localised damage at target sites whilst minimising that to surrounding healthy tissue. The lack of appropriate radionuclides has inhibited research in TAT. The identification of appropriate radionuclides should be primarily a function of the radionuclide's nuclear decay properties, and not their biochemistry or economic factors since these last two factors can change; however, the nuclear decay properties are fixed to that nuclide. This study has defined and applied a criterion based on nuclear decay properties useful for TAT. This down-selection exercise concluded that the most appropriate radionuclides are: 149 Tb, 211 At/ 211 Po, 212 Pb/ 212 Bi/ 212 Po, 213 Bi/ 213 Po, 224 Ra, 225 Ra/ 225 Ac/ 221 Fr, 226 Ac/ 226 Th, 227 Th/ 223 Ra/ 219 Rn, 229 U, 230 U/ 226 Th, and 253 Fm, the majority of which have previously been considered for TAT. 229 U and 253 Fm have been newly identified and could become new radionuclides of interest for TAT, depending on their decay chain progeny.</p>","PeriodicalId":19708,"journal":{"name":"Nuclear Medicine Communications","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11075749/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140094456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"F-18-FDG PET-CT in investigating possible malignancy associated with rheumatic disease: beware of excessive radiation.","authors":"Adil Al-Nahhas, Ali S M Jawad","doi":"10.1097/MNM.0000000000001834","DOIUrl":"10.1097/MNM.0000000000001834","url":null,"abstract":"","PeriodicalId":19708,"journal":{"name":"Nuclear Medicine Communications","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140040093","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":"Quantifying partial volume effect in SPECT and planar imaging: optimizing region of interest for activity concentration estimation in different sphere sizes.","authors":"Mostafa Jalilifar, Mahdi Sadeghi, Alireza Emami-Ardekani, Kouhyar Geravand, Parham Geramifar","doi":"10.1097/MNM.0000000000001835","DOIUrl":"10.1097/MNM.0000000000001835","url":null,"abstract":"<p><strong>Introduction: </strong>To quantify the partial volume effect in single photon emission tomography (SPECT) and planar images of Carlson phantom as well as providing an optimum region of interest (ROI) required to more accurately estimate the activity concentration for different sphere sizes.</p><p><strong>Methods: </strong>131 I solution with the 161.16 kBq/ml concentration was uniformly filled into the different spheres of Carlson phantom (cold background condition) with the diameters of 7.3, 9.2, 11.4, 14.3, 17.9, 22.4 and 29.9 mm, and there was no background activity. In the hot background condition, the spheres were filled with the solution of 131 I with the 1276.5 kBq/ml addition to the background activity concentration of 161.16 kBq/ml in all the phantoms. The spheres were mounted inside the phantom and underwent SPECT and planar images. ROI was drawn closely on the boundary of each sphere image and it was extended to extract the true count.</p><p><strong>Results: </strong>In the cold background condition, the recovery coefficient (RC) value for SPECT images ranged between 0.8 and 1.03. However, in planar imaging, the RC value was 0.72 for the smallest sphere size and it increased for larger spheres until 0.98 for 29.9 mm. In the hot background condition, the RC value for sphere diameters larger than 20 mm was overestimated more than in the cold background condition. The ROI/size required to more accurately determine activity concentration for the cold background ranged from 1.18 to 2.7. However, in the hot background condition, this ratio varied from 1.34 to 4.05.</p><p><strong>Conclusion: </strong>In the quantification of partial volume effects, the spill-out effect seems to play a crucial role in the distribution of the image counts beyond the boundaries of the image pixels. However, more investigations are needed to accurately characterize limitations regarding the object size, background levels, and other factors.</p>","PeriodicalId":19708,"journal":{"name":"Nuclear Medicine Communications","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140175800","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}
Mehmet Emin Adin, Edvin Isufi, Jennifer Wu, Yulei Pang, Daniel Nguyen, Duygu Simsek Has, Civan Caner, Noha Aboueldaha, Mahmud Mossa-Basha, Darko Pucar
{"title":"Reactive axillary lymph nodes after COVID-19 mRNA vaccination: comparison of mRNA vs. attenuated whole-virus vaccines.","authors":"Mehmet Emin Adin, Edvin Isufi, Jennifer Wu, Yulei Pang, Daniel Nguyen, Duygu Simsek Has, Civan Caner, Noha Aboueldaha, Mahmud Mossa-Basha, Darko Pucar","doi":"10.1097/MNM.0000000000001833","DOIUrl":"10.1097/MNM.0000000000001833","url":null,"abstract":"<p><strong>Objective: </strong>To compare the incidence and natural course of reactive axillary lymph nodes (RAL) between mRNA and attenuated whole-virus vaccines using Deauville criteria.</p><p><strong>Methods: </strong>In this multi-institutional PET-CT study comprising multiple vaccine types (Pfizer-BioNTech/Comirnaty, Moderna/Spikevax, Sinovac/CoronaVac and Janssen vaccines), we evaluated the incidence and natural course of RAL in a large cohort of oncological patients utilizing a standardized Deauville scaling system (n=522; 293 Female, Deauville 3-5 positive for RAL). Univariate and multivariate analyses were conducted to evaluate the predictive value of clinical parameters (absolute neutrophil count [ANC], platelets, age, sex, tumor type, and vaccine-to-PET interval) for PET positivity.</p><p><strong>Results: </strong>Pfizer-BioNTech/Comirnaty and Moderna vaccines revealed similar RAL incidences for the first 20 days after the second dose of vaccine administration (44% for the first 10 days for both groups, 26% vs. 20% for 10-20 days, respectively for Moderna and Pfizer). However, Moderna recipients revealed significantly higher incidences of RAL after 20 days compared to Pfizer-BioNTech/Comirnaty, with nodal reactivity spanning up to the 9th week post-vaccination (15% vs. 4%, respectively P < 0.001). No RAL was observed in patients who received either a single dose of J&J vaccine or two doses of CroronaVac. Younger patients showed increased likelihood of RAL, otherwise, clinical/demographic parameters were not predictive of RAL ( P = 0.014 for age, P > 0.05 for additional clinical/demographic parameters).</p><p><strong>Conclusion: </strong>RAL based on strict PET criteria was observed with mRNA but not with attenuated whole-virus vaccines, in line with higher immunogenicity and stronger protection offered by mRNA vaccines.</p>","PeriodicalId":19708,"journal":{"name":"Nuclear Medicine Communications","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140094455","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}
Aileen Green, Peter Temsah, Leonard Goldfarb, Kristen Sanfolippo, Eric Knoche, Razi Muzaffar, Medhat M Osman
{"title":"Evaluating appropriateness of 18F-fluciclovine PET/CT relative to standard of care imaging guidelines and the impact of ADT on positivity: a prospective study in 62 Veterans Administration patients at a single institution.","authors":"Aileen Green, Peter Temsah, Leonard Goldfarb, Kristen Sanfolippo, Eric Knoche, Razi Muzaffar, Medhat M Osman","doi":"10.1097/MNM.0000000000001836","DOIUrl":"10.1097/MNM.0000000000001836","url":null,"abstract":"<p><strong>Background: </strong>According to the National Comprehensive Cancer Network Guidelines, 18F-fluciclovine PET/CT is considered appropriate after negative standard of care (SOC) imaging.</p><p><strong>Objective: </strong>To prospectively compare 18F-fluciclovine to SOC imaging, investigate whether it should be done when SOC imaging is (+), and evaluate its detection rate in patients receiving androgen deprivation therapy.</p><p><strong>Methods: </strong>We recruited 57 prostate cancer patients with biochemical recurrence with 18F-fluciclovine PET/CT and SOC imaging within 30 days. Prostate-specific antigen (PSA) level, Gleason score (GS), history of radical prostatectomy (RP), radiation therapy (RT) or hormone therapy (HT) were reviewed.</p><p><strong>Results: </strong>The 57 patients had a median PSA of 2.6 and average GS of 7.4; 27 (47.4%) had RP, 28 (49.1%) had RT, 1 (1.75%) had HT and 1 (1.75%) observation only. 18F-fluciclovine identified disease recurrence in 45/57 patients (78.9%), including oligometastasis in 18/45 (40%). SOC imaging identified recurrent disease in 12/57 patients (21.1%) while 18F-fluciclvoine identified additional sites of disease in 11/12 (91.7%). The (+) 18F-fluciclovine studies had a median PSA 2.6 ng/ml compared to 6.0 ng/ml in the (+) SOC studies.</p><p><strong>Conclusion: </strong>18F-fluciclovine was superior to SOC imaging for lesion detection, identification of oligometastasis and identification of additional sites of disease.</p>","PeriodicalId":19708,"journal":{"name":"Nuclear Medicine Communications","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140185151","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}