Seminars in nuclear medicine最新文献

{"title":"The Role of 18-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (18F-FDG PET/CT) in the Diagnosis and Evaluation of Spondylodiscitis","authors":"Diana Paez MD ,&nbsp;Francesco Giammarile MD ,&nbsp;Anita Brink MD ,&nbsp;Osvaldo García-Pérez MD ,&nbsp;Enrique Estrada-Lobato MD, MSc","doi":"10.1053/j.semnuclmed.2024.04.001","DOIUrl":"10.1053/j.semnuclmed.2024.04.001","url":null,"abstract":"<div><p>Spondylodiscitis, characterized by inflammation of the intervertebral disc and adjacent vertebral bodies, presents a diagnostic challenge due to its nonspecific clinical manifestations and variable imaging findings.</p><p>This review examines the role of PET-CT with FDG, in the evaluation of spondylodiscitis, focusing on its utility in diagnosis, assessment of disease extent, treatment response monitoring, and prognostication.</p><p>FDG PET-CT, by combining metabolic and anatomical imaging modalities, offers superior sensitivity and specificity compared to conventional imaging techniques in detecting infectious foci, distinguishing between infection and post-treatment changes, and identifying occult sources of infection. Additionally, FDG PET-CT facilitates the localization of infection, aiding in targeted biopsy and guiding surgical intervention. Moreover, quantitative PET parameters, such as standardized uptake values (SUVs), hold promise for predicting treatment response and prognosis. Despite its advantages, FDG PET-CT has limitations, including false-positive results in the setting of inflammation and limited availability in resource-constrained settings.</p><p>Collaborative efforts between radiologists, nuclear medicine specialists, infectious disease specialists, and spine surgeons are essential to optimize the role of FDG PET-CT in the multidisciplinary management of spondylodiscitis. Further research is warranted to elucidate the cost-effectiveness and clinical impact of FDG PET-CT in this challenging clinical entity.</p></div>","PeriodicalId":21643,"journal":{"name":"Seminars in nuclear medicine","volume":"54 3","pages":"Pages 409-414"},"PeriodicalIF":4.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140857680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PET/CT and PET/MR in Soft Tissue Sarcoma: An Update","authors":"Hedieh Khalatbari MD, MBA ,&nbsp;Barry L Shulkin MD, MBA ,&nbsp;Marguerite T Parisi MD","doi":"10.1053/j.semnuclmed.2024.01.005","DOIUrl":"10.1053/j.semnuclmed.2024.01.005","url":null,"abstract":"<div><p>Soft tissue sarcomas account for 6%-8% of pediatric cancers. The rhabdomyosarcoma family is the most frequent soft tissue sarcoma in this age group accounting for 3% of pediatric cancers. Rhabdomyosarcomas are high-grade tumors with a high propensity to metastasize. The risk-adapted, multimodal therapeutic approach for rhabdomyosarcomas incorporates a combination of surgery, radiotherapy, and multi-agent cytotoxic chemotherapy.</p><p>Soft tissue sarcomas other than rhabdomyosarcoma account for 3%-4% of pediatric cancers. The nonrhabdomyosarcoma soft tissue sarcomas include both low-grade and high-grade tumors. While surgery is the mainstay of therapy in most non-rhabdomyosarcoma soft tissue sarcomas, many cases require a multimodal therapeutic approach including radiotherapy and chemotherapy.</p><p>In North America, most pediatric patients with soft tissue sarcomas are treated in Children's Oncology Group clinical trials. In this article, we will primarily focus on the staging, risk stratification, imaging recommendations, and interpretations in accordance with the Children's Oncology Group trials. We will review the results and recommendations of International Soft Tissue Sarcoma Database Consortium and European trials in relevant sections where they provide complementary guidelines.</p></div>","PeriodicalId":21643,"journal":{"name":"Seminars in nuclear medicine","volume":"54 3","pages":"Pages 313-331"},"PeriodicalIF":4.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139997347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SPECT/CT, PET/CT, and PET/MRI for Response Assessment of Bone Metastases","authors":"Nazanin Zamani-Siahkali MD ,&nbsp;Seyed Ali Mirshahvalad MD, MPH, FEBNM ,&nbsp;Abolfazl Farbod MD ,&nbsp;Ghasemali Divband MD ,&nbsp;Christian Pirich MD, PHD ,&nbsp;Patrick Veit-Haibach MD ,&nbsp;Gary Cook MBBS, MSC, MD ,&nbsp;Mohsen Beheshti MD","doi":"10.1053/j.semnuclmed.2023.11.005","DOIUrl":"10.1053/j.semnuclmed.2023.11.005","url":null,"abstract":"<div><p>Recent developments in hybrid SPECT/CT systems and the use of cadmium-zinc-telluride (CZT) detectors have improved the diagnostic accuracy of bone scintigraphy. These advancements have paved the way for novel quantitative approaches to accurate and reproducible treatment monitoring of bone metastases. PET/CT imaging using [¹⁸F]F-FDG and [¹⁸F]F-NaF have shown promising clinical utility in bone metastases assessment and monitoring response to therapy and prediction of treatment response in a broad range of malignancies. Additionally, specific tumor-targeting tracers like [^99mTc]Tc-PSMA, [⁶⁸Ga]Ga-PSMA, or [¹¹C]C- or [¹⁸F]F-Choline revealed high diagnostic performance for early assessment and prognostication of bone metastases, particularly in prostate cancer. PET/MRI appears highly accurate imaging modality, but has associated limitations notably, limited availability, more complex logistics and high installation costs. Advances in artificial intelligence (Al) seem to improve the accuracy of imaging modalities and provide an assistant role in the evaluation of treatment response of bone metastases.</p></div>","PeriodicalId":21643,"journal":{"name":"Seminars in nuclear medicine","volume":"54 3","pages":"Pages 356-370"},"PeriodicalIF":4.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0001299823000934/pdfft?md5=9796e6c2a1b1c88d7454288527f3bf6f&pid=1-s2.0-S0001299823000934-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139088247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter from the Editors","authors":"Kirsten Bouchelouche MD, DMSc,&nbsp;M Michael Sathekge MD, PhD","doi":"10.1053/j.semnuclmed.2024.04.002","DOIUrl":"10.1053/j.semnuclmed.2024.04.002","url":null,"abstract":"","PeriodicalId":21643,"journal":{"name":"Seminars in nuclear medicine","volume":"54 3","pages":"Pages 311-312"},"PeriodicalIF":4.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140864297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"State of the Art Imaging of Osteoporosis","authors":"Michelle Chen BA ,&nbsp;Maria Gerges BS ,&nbsp;William Y. Raynor MD ,&nbsp;Peter Sang Uk Park BA ,&nbsp;Edward Nguyen MD ,&nbsp;David H. Chan MD ,&nbsp;Ali Gholamrezanezhad MD","doi":"10.1053/j.semnuclmed.2023.10.008","DOIUrl":"10.1053/j.semnuclmed.2023.10.008","url":null,"abstract":"<div><p><span><span><span>Osteoporosis is a common disease, particularly prevalent in </span>geriatric<span> populations, which causes significant worldwide morbidity due to increased bone fragility and fracture risk. Currently, the gold-standard modality for diagnosis and evaluation of osteoporosis progression and treatment relies on dual-energy x-ray </span></span>absorptiometry<span> (DXA), which measures bone mineral density (BMD) and calculates a score based upon standard deviation of measured BMD from the mean. However, other imaging modalities can also be used to evaluate osteoporosis. Here, we review historical as well as current research into development of new imaging modalities that can provide more nuanced or opportunistic analyses of bone quality, turnover, and density that can be helpful in triaging severity and determining treatment success in osteoporosis. We discuss the use of opportunistic computed tomography (CT) scans, as well as the use of quantitative CT<span><span> to help determine fracture risk and perform more detailed bone quality analysis than would be allowed by DXA . Within magnetic resonance imaging (MRI), new developments include the use of advanced MRI techniques such as </span>quantitative susceptibility mapping<span><span> (QSM), magnetic resonance spectroscopy<span>, and chemical shift encoding-based water-fat MRI (CSE-MRI) to enable clinicians improved assessment of nonmineralized bone compartments as well as a way to longitudinally assess bone quality without the repeated exposure to </span></span>ionizing radiation<span>. Within ultrasound, development of quantitative ultrasound shows promise particularly in future low-cost, broadly available screening tools. We focus primarily on historical and recent developments within radiotracer use as applicable to osteoporosis, particularly in the use of hybrid methods such as NaF-PET/CT, wherein patients with osteoporosis show reduced uptake of radiotracers such as NaF. Use of radiotracers may provide clinicians with even earlier detection windows for osteoporosis than would traditional biomarkers. Given the metabolic nature of this disease, current investigation into the role </span></span></span></span></span>molecular imaging<span> can play in the prediction of this disease as well as in replacing invasive diagnostic procedures shows particular promise.</span></p></div>","PeriodicalId":21643,"journal":{"name":"Seminars in nuclear medicine","volume":"54 3","pages":"Pages 415-426"},"PeriodicalIF":4.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138567109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Molecular Imaging in Soft-tissue Sarcoma: Evolving Role of FDG PET","authors":"Kip E. Guja MD PhD ,&nbsp;Kristen N. Ganjoo MD ,&nbsp;Andrei Iagaru MD","doi":"10.1053/j.semnuclmed.2024.02.001","DOIUrl":"10.1053/j.semnuclmed.2024.02.001","url":null,"abstract":"<div><p>Soft tissue sarcomas are a rare and heterogenous group of tumors that account for 2% of all cancer-related deaths. Molecular imaging with FDG PET can offer valuable metabolic information to help inform clinical management of soft tissue sarcomas that is unique and complementary to conventional diagnostic imaging techniques. FDG PET imaging often correlates with tumor grade, can help guide biopsy, and frequently detects additional sites of disease compared to conventional imaging in patients being considered for definitive or salvage therapy. Traditional size-based evaluation of treatment response is often inadequate in soft tissue sarcoma and changes in metabolic activity can add significant value to interim and end of treatment imaging for high-grade sarcomas. FDG PET can be used for detection of recurrence or malignant transformation and thus play a vital role in surveillance. This article reviews the evolving role of FDG PET in initial diagnosis, staging, treatment response assessment, and restaging. Further studies on the use of FDG PET in soft sarcoma are needed, particularly for rare histopathologic subtypes.</p></div>","PeriodicalId":21643,"journal":{"name":"Seminars in nuclear medicine","volume":"54 3","pages":"Pages 332-339"},"PeriodicalIF":4.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140022554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of Nuclear Imaging in Cardiac Stereotactic Body Radiotherapy for Ablation of Ventricular Tachycardia","authors":"Connor Haberl MASc, BASc ,&nbsp;Andrew M. Crean MD, MRCP, FRCR, MPH ,&nbsp;Jason G.E. Zelt MD, PhD ,&nbsp;Calum J. Redpath MD, MBChB, PhD ,&nbsp;Robert A. deKemp PhD, MASNC","doi":"10.1053/j.semnuclmed.2024.03.002","DOIUrl":"10.1053/j.semnuclmed.2024.03.002","url":null,"abstract":"<div><p>Ventricular tachycardia (VT) is a life-threatening arrhythmia common in patients with structural heart disease or nonischemic cardiomyopathy. Many VTs originate from regions of fibrotic scar tissue, where delayed electrical signals exit scar and re-enter viable myocardium. Cardiac stereotactic body radiotherapy (SBRT) has emerged as a completely noninvasive alternative to catheter ablation for the treatment of recurrent or refractory ventricular tachycardia. While there is no common consensus on the ideal imaging workflow, therapy planning for cardiac SBRT often combines information from a plurality of imaging modalities including MRI, CT, electroanatomic mapping and nuclear imaging. MRI and CT provide detailed anatomic information, and late enhancement contrast imaging can indicate regions of fibrosis. Electroanatomic maps indicate regions of heterogenous conduction voltage or early activation which are indicative of arrhythmogenic tissue. Some early clinical adopters performing cardiac SBRT report the use of myocardial perfusion and viability nuclear imaging to identify regions of scar. Nuclear imaging of hibernating myocardium, inflammation and sympathetic innervation have been studied for ventricular arrhythmia prognosis and in research relating to catheter ablation of VT but have yet to be studied in their potential applications for cardiac SBRT. The integration of information from these many imaging modalities to identify a target for ablation can be challenging. Multimodality image registration and dedicated therapy planning tools may enable higher target accuracy, accelerate therapy planning workflows and improve patient outcomes. Understanding the pathophysiology of ventricular arrhythmias, and localizing the arrhythmogenic tissues, is vital for successful ablation with cardiac SBRT. Nuclear imaging provides an arsenal of imaging strategies to identify regional scar, hibernation, inflammation, and sympathetic denervation with some advantages over alternative imaging strategies.</p></div>","PeriodicalId":21643,"journal":{"name":"Seminars in nuclear medicine","volume":"54 3","pages":"Pages 427-437"},"PeriodicalIF":4.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0001299824000278/pdfft?md5=751613342d04cddcc6e0e8956dd752fd&pid=1-s2.0-S0001299824000278-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140788533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PET/CT in Inflammatory and Auto-immune Disorders: Focus on Several Key Molecular Concepts, FDG, and Radiolabeled Probe Perspectives","authors":"Florent L Besson MD, PhD ,&nbsp;Gaetane Nocturne MD, PhD ,&nbsp;Nicolas Noël MD, PhD ,&nbsp;Olivier Gheysens MD, PhD ,&nbsp;Riemer H.J.A. Slart MD, PhD ,&nbsp;Andor W.J.M. Glaudemans MD, PhD","doi":"10.1053/j.semnuclmed.2023.10.005","DOIUrl":"10.1053/j.semnuclmed.2023.10.005","url":null,"abstract":"<div><p><span><span>Chronic immune diseases mainly include autoimmune and </span>inflammatory diseases. Managing chronic inflammatory and autoimmune diseases has become a significant </span>public health<span> concern, and therapeutic advancements over the past 50 years have been substantial. As therapeutic tools continue to multiply, the challenge now lies in providing each patient with personalized care tailored to the specifics of their condition, ushering in the era of personalized medicine. Precise and holistic imaging is essential in this context to comprehensively map the inflammatory processes in each patient, identify prognostic factors, and monitor treatment responses and complications. Imaging of patients with inflammatory and autoimmune diseases must provide a comprehensive view of the body, enabling the whole-body mapping of systemic involvement. It should identify key cellular players in the pathology, involving both innate immunity (dendritic cells, macrophages), adaptive immunity (lymphocytes), and microenvironmental cells (stromal cells, tissue cells). As a highly sensitive imaging tool with vectorized molecular probe capabilities, PET/CT can be of high relevance in the management of numerous inflammatory and autoimmune diseases. Relying on key molecular concepts of immunity, the clinical usefulness of FDG-PET/CT in several relevant inflammatory and immune-inflammatory conditions, validated or emerging, will be discussed in this review, together with radiolabeled probe perspectives.</span></p></div>","PeriodicalId":21643,"journal":{"name":"Seminars in nuclear medicine","volume":"54 3","pages":"Pages 379-393"},"PeriodicalIF":4.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135765562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Molecular Imaging with PET-CT and PET-MRI in Pediatric Musculoskeletal Diseases","authors":"Kip E. Guja MD, PhD ,&nbsp;Gerald Behr MD ,&nbsp;Akshay Bedmutha MD ,&nbsp;Marlena Kuhn BS ,&nbsp;Helen R. Nadel MD ,&nbsp;Neeta Pandit-Taskar MD","doi":"10.1053/j.semnuclmed.2024.03.003","DOIUrl":"10.1053/j.semnuclmed.2024.03.003","url":null,"abstract":"<div><p>Molecular imaging has emerged as an integral part of oncologic imaging. Given the physiologic changes that precede anatomic changes, molecular imaging can enable early detection of disease and monitoring of response. [18F] Fluorodeoxyglucose (FDG) Positron emission tomography (PET) is the predominant molecular imaging modality used in oncologic assessment and can be performed using PET/CT or PET/MR. In pediatric patients, PET/MRI imaging is generally preferred due to low radiation exposure and PET/MRI is particularly advantageous for imaging musculoskeletal (MSK) diseases, as MRI provides superior characterization of tissue changes as compared to CT. In this article, we provide an overview of the typical role of PET CT/MRI in assessment of some common pediatric malignancies and benign MSK diseases with case examples. We also discuss the relative advantages of PET/MRI compared to PET/CT, and review published data with a primary focus on the use of PET/MR.</p></div>","PeriodicalId":21643,"journal":{"name":"Seminars in nuclear medicine","volume":"54 3","pages":"Pages 438-455"},"PeriodicalIF":4.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140864856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How to Perform FAPI PET? An Expedited Systematic Review Providing a Recommendation for FAPI PET Imaging With Different FAPI Tracers","authors":"Morten Bentestuen MD ,&nbsp;Surenth Nalliah MD ,&nbsp;Marie M.K. Stolberg MD ,&nbsp;Helle D. Zacho MD, PhD, DMSc","doi":"10.1053/j.semnuclmed.2023.11.003","DOIUrl":"10.1053/j.semnuclmed.2023.11.003","url":null,"abstract":"<div><p>This expedited systematic review aims to provide the first overview of the different Fibroblast activation protein inhibitor (FAPI) PET scan procedures in the literature and discuss how to efficiently obtain optimal FAPI PET images based on the best available evidence. The PubMed, Embase, Cochrane Library, and Web of Science databases were systematically searched in April 2023. Peer-reviewed cohort studies published in English and used FAPI tracers were included. Articles were excluded if critical scan procedure information was missing, or the article was not retrievable from a university library within 30 days. Data were grouped according to the FAPI tracer applied. Meta-analysis with proper statistics was deemed not feasible based on a pilot study. A total of 946 records were identified. After screening, 159 studies were included. [⁶⁸Ga]Ga-FAPI-04 was applied in 98 studies (61%), followed by [⁶⁸Ga]Ga-FAPI-46 in 19 studies (12%). Most studies did not report specific patient preparation. A mean/median administered activity of 80-200 MBq was most common; however, wide ranges were seen in [⁶⁸Ga]Ga-FAPI-04 PET studies (56-370 MBq). An injection-to-scan-time of 60 minutes was dominant for all FAPI PET studies. A possible trend toward shorter injection-to-scan times was observed for [⁶⁸Ga]Ga-FAPI-46. Three studies evaluated [⁶⁸Ga]Ga-FAPI-46 PET acquisition at multiple time points in more than 593 cancer lesions, all yielding equivalent tumor detection at 10 minutes vs later time points despite slightly lower tumor-to-background Ratios. Despite the wide ranges, most institutions administer an average of 80-200 MBq [⁶⁸Ga]Ga-FAPI-04/46 and scan patients at 60 minutes postinjection. For [⁶⁸Ga]Ga-FAPI-46, the present evidence consistently supports the feasibility of image acquisition earlier than 30 minutes. Currently, data on the optimal FAPI PET scan procedure are limited, and more studies are encouraged. The current review can serve as a temporary guideline for institutions planning FAPI PET studies.</p></div>","PeriodicalId":21643,"journal":{"name":"Seminars in nuclear medicine","volume":"54 3","pages":"Pages 345-355"},"PeriodicalIF":4.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0001299823000922/pdfft?md5=c78c3466dc48bfe83d31835ae2d9b453&pid=1-s2.0-S0001299823000922-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138488405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}