Presse Medicale最新文献

{"title":"Thyroid functional and molecular imaging","authors":"Luca Giovanella ,&nbsp;Anca M. Avram ,&nbsp;Petra Petranović Ovčariček ,&nbsp;Jerome Clerc","doi":"10.1016/j.lpm.2022.104116","DOIUrl":"10.1016/j.lpm.2022.104116","url":null,"abstract":"<div><p>Radioiodine uptake (RAIU) test with iodine-123 (Na[¹²³I]I) or iodine-131 (Na[¹³¹I]I) enables accurate evaluation and quantification of iodine uptake and kinetics within thyroid cells. Thyroid Scintigraphy (TS) employing Na[¹²³I]I or ^99mTc-pertechnetate (Na[^99mTc]TcO₄) provides information regarding the function and topographical distribution of thyroid cells activity, including detection and localization of ectopic thyroid tissue. Destructive thyrotoxicosis is characterized by low RAIU with scintigraphically reduced radiotracer activity in the thyroid tissue, while productive thyrotoxicosis (i.e. hyperthyroidism “stricto sensu”) is characterized by high RAIU with scintigraphically diffuse (i.e. Graves’ Disease, GD and diffuse thyroid autonomy) or focal (i.e. autonomously functioning thyroid nodules, AFTN) overactivity. Accordingly, RAIU and/or TS are widely used to differentiate different causes of thyrotoxicosis. In addition, several radiopharmaceuticals are also available to help differentiate benign from malignant thyroid nodules and inform clinical decision-making: scintigraphic identification of AFTNs obviate fine-needle aspiration (FNA) biopsy, and [^99mTc]Tc-hexakis-(2‑methoxy-2-isobutyl isonitrile ([^99mTc]Tc-MIBI) and/or ¹⁸F-fluoro-<span>d</span>-glucose ([¹⁸F]FDG) may complement the work-up of cytologically indeterminate “cold” nodules for reducing the need for diagnostic lobectomies/thyroidectomies. Finally, RAIU studies are also useful for calculating the administered therapeutic activity of Na[¹³¹I]I to treat hyperthyroidism and euthyroid multinodular goiter. All considered, thyroid molecular imaging allows functional characterization of different thyroid diseases, even before clinical symptoms become manifest, and remains integral to the management of such conditions. Our present paper summarizes basic concepts, clinical applications, and potential developments of thyroid molecular imaging in patients affected by thyrotoxicosis and thyroid nodules.</p></div>","PeriodicalId":20530,"journal":{"name":"Presse Medicale","volume":"51 2","pages":"Article 104116"},"PeriodicalIF":2.7,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0755498222000094/pdfft?md5=82f8086235114201f414e73e9605ddad&pid=1-s2.0-S0755498222000094-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10331944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Molecular Imaging in neuroendocrine neoplasias","authors":"Emanuel Christ ,&nbsp;Damian Wild ,&nbsp;Julie Refardt","doi":"10.1016/j.lpm.2022.104115","DOIUrl":"10.1016/j.lpm.2022.104115","url":null,"abstract":"<div><p>Molecular imaging<span>, which uses molecular targets due to the overexpression of specific peptide hormone receptors on the tumour surface, has become an indispensable diagnostic technique.</span></p><p>Neuroendocrine neoplasms (NENs) especially differentiated NENs or neuroendocrine tumours (NETs) are a rare group of heterogeneous tumours, characterized by the expression of hormone receptors on the tumour cell surface. This property makes them receptive to diagnostic and therapeutic approaches (theranostics) using radiolabelled peptides.</p><p>Amongst the known hormone receptors, somatostatin receptors (SSTR) are expressed on the majority of NETs and are therefore the most relevant receptors for theranostic approaches. Current research aims to medically upregulate their expression, while other focuses are on the use of different radiopeptides (64Cu and 67Cu) or somatostatin-antagonists instead of the established somatostatin agonists.</p><p><span>The GLP-1 receptor is another clinically relevant target, as GLP-1-R imaging has become the new standard for the localisation of insulinomas<span>. For staging and prognostic evaluation in dedifferentiated NENs, 18F-FDG-imaging is useful, but lacks a therapeutic counterpart. Further options for patients with insufficient expression of SSTR involve metaiodobenzylguanidine (MIBG) and the molecular target C-X-C motif chemokine receptor-4 (CXCR4). New targets such as the glucose-dependant insulinotropic </span></span>polypeptide receptor (GIPR) and the fibroblast activation protein (FAP) have been identified in NENs recently and await further evaluation.</p><p><span>For medullary thyroid cancer 18-F-DOPA imaging is standard, however this technique is rather second line for other NENs. In this area, the discovery of minigastrin, which targets the cholecystokinin-2 (CCK2) receptors in </span>medullary thyroid carcinoma<span> and foregut NENs, may improve future management.</span></p><p>This review aims to provide an overview of the most commonly used functional imaging modalities for theranostics in NENs today and in the possible future.</p></div>","PeriodicalId":20530,"journal":{"name":"Presse Medicale","volume":"51 2","pages":"Article 104115"},"PeriodicalIF":2.7,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10340256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac functional imaging","authors":"Arshid Azarine ,&nbsp;François Scalbert ,&nbsp;Philippe Garçon","doi":"10.1016/j.lpm.2022.104119","DOIUrl":"10.1016/j.lpm.2022.104119","url":null,"abstract":"<div><p><span>During the last 20 years, cardiac imaging<span> has drastically evolved. Positron emission tomography<span> (PET), fast three-dimensional (3D) imaging with the latest generations of echocardiography<span><span> &amp; multi-detector computed tomography (CT), stress perfusion assessed by magnetic resonance imaging (MRI), blood flow analysis using four-dimensional (4D) flow MRI, all these techniques offer new trends for optimal noninvasive functional cardiac imaging. Dynamic functional imaging is obtained by acquiring images of the heart at different phases of the cardiac cycle, allowing assessment of cardiac motion, function, and perfusion. Between CT<span> and Cardiac MRI (CMR), CMR has the best temporal resolution, which is suitable for functional imaging while </span></span>cardiac CT provides higher spatial resolution with isotropic data that have an identical resolution in the three dimensions of the space. The latest generations of CT scanners enable whole heart assessment in one beat, offering also an acceptable temporal resolution with the possibility to display the images in a dynamic mode. Another rapidly growing technique using functional and </span></span></span></span>molecular imaging<span> for the assessment of biological and metabolic pathways is the PET using radio-labeled tracers<span>. Meanwhile, the oldest cardiac imaging tool with doppler ultrasound technology has never stopped evolving. Echocardiography today performs 3D imaging, stress perfusion, and myocardial strain assessment, with high temporal resolution. It still is the first line and more accessible exam for the patient. These different modalities are complementary and may be even combined into PET-CT or PET-MRI. The ability to combine the functional/molecular data with anatomical images may implement a new dimension to our diagnostic tools.</span></span></p></div>","PeriodicalId":20530,"journal":{"name":"Presse Medicale","volume":"51 2","pages":"Article 104119"},"PeriodicalIF":2.7,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10452201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Molecular imaging or functional: An increasingly applied method in all fields of medicine","authors":"Emanuel Christ ,&nbsp;Jean Louis Wémeau","doi":"10.1016/j.lpm.2022.104145","DOIUrl":"10.1016/j.lpm.2022.104145","url":null,"abstract":"","PeriodicalId":20530,"journal":{"name":"Presse Medicale","volume":"51 2","pages":"Article 104145"},"PeriodicalIF":2.7,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10729884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Functional imaging in thyroid cancer patients with metastases and therapeutic implications","authors":"Martin Schlumberger,&nbsp;Camilo Garcia,&nbsp;Julien Hadoux,&nbsp;Michele Klain,&nbsp;Livia Lamartina","doi":"10.1016/j.lpm.2022.104113","DOIUrl":"10.1016/j.lpm.2022.104113","url":null,"abstract":"<div><p>Functional imaging plays a central role in the management of thyroid cancer patients.</p><p><span><span>In patients with a </span>differentiated thyroid cancer<span> (DTC), radioactive iodine<span><span> (RAI) is used mostly with a therapeutic intent, either post-operatively or as the first line systemic treatment in patients with known structural disease. A </span>whole body scan is performed a few days after the RAI administration, and this procedure is very sensitive to detect all tumor foci with RAI uptake. PET/CT with </span></span></span>¹⁸<span>F-FDG complements the use of RAI at the initial evaluation of patients with high-risk DTC, during follow-up in those with rising serum thyroglobulin levels over time, for the work-up of patients with documented structural disease and for assessing the efficacy of focal or systemic treatment modalities. </span>¹⁸F-FDG uptake is a prognostic indicator in all these clinical conditions. A dosimetric approach with ¹²⁴I PET/CT showed encouraging results.</p><p><span>Several functional imaging modalities are currently available for medullary thyroid carcinoma (MTC) patients. </span><em>¹⁸F-</em>FDG-PET/CT may be sensitive in MTC patients with high FDG uptake that signals aggressive disease. ¹⁸<span><span>F-DOPA is the most sensitive imaging technique<span> to visualize small tumor foci, and is also highly specific in patients with a known MTC, but should be complemented by a CT scan of the chest and by a MRI of the liver to detect small </span></span>metastases.</span></p></div>","PeriodicalId":20530,"journal":{"name":"Presse Medicale","volume":"51 2","pages":"Article 104113"},"PeriodicalIF":2.7,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10340257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Functional imaging for hyperparathyroidism","authors":"Pr Damien Huglo","doi":"10.1016/j.lpm.2022.104120","DOIUrl":"10.1016/j.lpm.2022.104120","url":null,"abstract":"<div><p><span>Once hyperparathyroidism<span><span> has been proven, the goal of parathyroid<span> functional imaging is to identify one or more pathological glands in view of guiding a possibly targeted surgical procedure, while maximizing the chances for recovery. Currently, parathyroid radionuclide imaging is based on two techniques, parathyroid </span></span>scintigraphy and </span></span>¹⁸<span>F-fluorocholine - positron emission tomography (PET).</span></p><p><span>The main radiopharmaceutical in scintigraphy is </span>^99m<span><span>Tc-sestamibi, which can be used alone, in the dual-phase parathyroid scan, or in comparison with a thyroid<span> radiotracer, </span></span>pertechnetate (NaTcO</span>₄<span>) or iodine 123 (dual-tracer method). The acquisitions can be planar and/or tomographic (SPECT). It is now recognized that the </span>^99m<span><span>Tc-sestamibi - iodine 123 dual-tracer method is more efficient than the dual-phase scan, while SPECT-CT improves the sensitivity and specificity of the scintigraphy. This imaging and cervical ultrasonography are considered to be the two first-line reference techniques in </span>preoperative assessment of hyperparathyroidism.</span></p><p>More recently developed, ¹⁸F-fluorocholine detected by PET-CT has shown excellent performance, at least equal to that of scintigraphy. Initially considered as a second-line technique, its advantages over scintigraphy have prompted some authors to suggest it as the only examination to be performed in preoperative assessment of hyperparathyroidism. That said, due to a lack of specificity in ¹⁸<span>F-fluorocholine uptake, which has been observed on inflammatory lesions and, particularly, in the mediastinal lymph nodes<span>, and given the absence of simultaneous comparison of thyroid function, this strategy remains contested, and possibly reserved for patients without any associated thyroid pathology; large-scale evaluation would be justified.</span></span></p></div>","PeriodicalId":20530,"journal":{"name":"Presse Medicale","volume":"51 2","pages":"Article 104120"},"PeriodicalIF":2.7,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10458416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pituitary adenoma & nuclear medicine: Recent outcomes and ongoing developments","authors":"Benjamin Chevalier ,&nbsp;Arnaud Jannin ,&nbsp;Stephanie Espiard ,&nbsp;Emilie Merlen ,&nbsp;Amandine Beron ,&nbsp;Georges Lion ,&nbsp;Marie-Christine Vantyghem ,&nbsp;Damien Huglo ,&nbsp;Christine Cortet-Rudelli ,&nbsp;Clio Baillet","doi":"10.1016/j.lpm.2022.104144","DOIUrl":"10.1016/j.lpm.2022.104144","url":null,"abstract":"<div><p><span><span>In order to explore pituitary adenoma (PA), magnetic resonance imaging (MRI) remains the cornerstone. However, there are some limitations and MRI can be non-conclusive. The development of additional imaging modalities like nuclear medicine explorations may help to confirm PA diagnosis, guide management and follow up. Nuclear medicine uses </span>radiopharmaceuticals<span> for imaging with single photon emission computed tomography (SPECT), or </span></span>positron emission tomography<span> (PET), coupled to CT scan. Radiopharmaceuticals products target specific cellular elements which allow to explore several biological pathways. Nuclear medicine may also be used for therapeutic purposes and recent developments of approach based on Peptide Receptor<span><span> Radionuclide Therapy<span> (PRRT) for treatment of aggressive PA and pituitary carcinoma will be reviewed. Several </span></span>radiotracers have been studied in the context of PA, and the aim of this paper is to discuss their respective performances and clinical interest.</span></span></p></div>","PeriodicalId":20530,"journal":{"name":"Presse Medicale","volume":"51 2","pages":"Article 104144"},"PeriodicalIF":2.7,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10692430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Author's response to the letter on the article: “Long-COVID: cognitive deficits (brain fog) and brain lesions in non-hospitalized patients”","authors":"Jacques HUGON","doi":"10.1016/j.lpm.2022.104137","DOIUrl":"10.1016/j.lpm.2022.104137","url":null,"abstract":"","PeriodicalId":20530,"journal":{"name":"Presse Medicale","volume":"51 2","pages":"Article 104137"},"PeriodicalIF":2.7,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10729347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Functional Imaging for Neurodegenerative Diseases","authors":"François CHOLLET ,&nbsp;Pierre PAYOUX","doi":"10.1016/j.lpm.2022.104121","DOIUrl":"10.1016/j.lpm.2022.104121","url":null,"abstract":"<div><p><span>Diagnosis and monitoring of neurodegenerative diseases has changed profoundly over the past twenty years. Biomarkers are now included in most diagnostic procedures as well as in </span>clinical trials<span>. Neuroimaging biomarkers provide access to brain structure and function over the course of neurodegenerative diseases. They have brought new insights into a wide range of neurodegenerative diseases and have made it possible to describe some of the imaging challenges in clinical populations. MRI mainly explores brain structure while molecular imaging<span>, functional MRI and electro- and magnetoencephalography examine brain function. In this paper, we describe and analyse the current and potential contribution of MRI and molecular imaging in the field of neurodegenerative diseases.</span></span></p></div>","PeriodicalId":20530,"journal":{"name":"Presse Medicale","volume":"51 2","pages":"Article 104121"},"PeriodicalIF":2.7,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10340296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-COVID: Cognitive deficits (brain fog) and brain lesions in non–hospitalized patients","authors":"Jacques HUGON","doi":"10.1016/j.lpm.2021.104090","DOIUrl":"10.1016/j.lpm.2021.104090","url":null,"abstract":"","PeriodicalId":20530,"journal":{"name":"Presse Medicale","volume":"51 2","pages":"Article 104090"},"PeriodicalIF":2.7,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8552626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10382397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}